Nada Hadzic-Andelic

• Kleffelgård, Ingerid; Valaas, Lars-Johan; Søberg, Helene Lundgaard; Hadzic-Andelic, Nada; Røe, Cecilie & Steenstrup, Sophie [Show all 10 contributors for this article] (2026). The impact of persistent post-concussion symptoms and exercise intolerance on patient-specific functioning after mild traumtatic brain injury: a biopsychosocial persepctive. Journal of Rehabilitation Medicine. ISSN 1650-1977. 58. doi: 10.2340/jrm.v58.45811. Full text in Research Archive
• Vreeburg, Rick J.G.; Singh, Ranjit D.; Yue, John K.; Dijck, Jeroen T.J.M. van; Boogert, Hugo F. den & Posti, Jussi P. [Show all 262 contributors for this article] (2026). The effectiveness of decompressive craniectomy size in traumatic brain injury; an international, observational, comparative effectiveness study. Brain and Spine. 6. doi: 10.1016/j.bas.2026.106019. Full text in Research Archive Show summary

  Introduction Guidelines recommend large decompressive craniectomies (DC) in traumatic brain injury (TBI), yet the optimal size remains debated. Real-world practice often differs from guideline recommendations and generalizability of prior evidence to a broader TBI population is uncertain. Research question What is the comparative effectiveness of DC size on 12-month functional outcome in TBI? Material and methods We selected participants enrolled in the CENTER-TBI diagnosed with TBI who received a hemicraniectomy. Effect of DC size on functional outcome was evaluated with random-effects logistic regression, associating center case-mix adjusted DC sizes to GOSE. Center preference was quantified with the median odds ratio (MOR). Results Among 4509 patients enrolled in CENTER-TBI, 295 underwent a hemicraniectomy. DC size varied from 37 cm2 to 165cm2 (IQR 96 cm2-123cm2, ellipsoid calculation), with a two-times higher probability of receiving a 27 cm2 larger (IQR increase) DC for a similar patient in one center versus another random center (adjusted MOR for DC size 1·7). Only 4 patients received a DC ≥ 12 × 15 cm (cm) or 15 cm in diameter, while 0 patients received a DC ≤ 6 × 8 cm. Larger DC size was not associated with more favorable 12-month GOSE scores (aOR 0.73 for 27 cm2 increase in DC size, 95%CI 0.47-1.1). Discussion and conclusion DC size varied widely across European centers. Recommended DC sizes were rarely reached, as were very small DC sizes. Larger versus smaller DC was associated with similar outcomes, however heterogeneity in DC indication may have attenuated observable treatment effects. Neurosurgeons may continue to prefer larger over smaller decompressions.

• Søberg, Helene Lundgaard; Rasmussen, Mari Storli; Moksnes, Håkon Øgreid; Schäfer, Christoph; Anke, Audny Gabriele Wagner & Hadzic-Andelic, Nada [Show all 7 contributors for this article] (2026). Unmet Needs for Community-Based Rehabilitation the First 12 Months Postinjury in a Traumatic Brain Injury Population with Moderate-to-Severe Trauma—a Longitudinal Cohort Study. Archives of Rehabilitation Research and Clinical Translation. 8(2). doi: 10.1016/j.arrct.2026.100619. Full text in Research Archive
• Hadzic-Andelic, Nada; Lu, Juan; Fure, Silje Christine Reistad; Brunborg, Cathrine; Løvstad, Marianne & Røe, Cecilie [Show all 7 contributors for this article] (2026). Effects of cognitive–vocational rehabilitation on post-concussion symptoms and emotional distress: a secondary RCT analysis. Brain Injury. ISSN 0269-9052. doi: 10.1080/02699052.2026.2654829. Full text in Research Archive
• Graziano, Francesca; Guglielmi, Angelo; Consonni, Michela; Ogliari, Giorgia; Younsi, Alexander & Valla, Margherita [Show all 259 contributors for this article] (2026). Paediatric traumatic brain injury: clinical presentation, treatment approaches, management strategies, and outcomes. Insights from the CENTER-TBI study. Journal of Anesthesia, Analgesia and Critical Care. 6. doi: 10.1186/s44158-025-00312-4. Full text in Research Archive Show summary

  Objective: This observational study aims to describe the characteristics and management of paediatric head-injured patients across different paediatric age groups, compared with adults. Design: Secondary analysis of the CENTER-TBI study. Setting: 65 centers in Europe between December 2014 and December 2017. Patients: Patients with traumatic brain injury (TBI) admitted to the hospital were divided into different age groups: paediatrics (pTBI, age ≤ 17 years), adults (18-65 years), and elderly (> 65 years). Paediatrics were further subdivided into three groups: toddlers (from 0 to 4 years), children (from 5 to 12 years), and adolescents (from 13 to 17 years). Interventions: None. Measurements and main results: 3,661 patients were included in the analysis (2,138 admitted to the intensive care unit (ICU) and 1,523 to the ward). Among these, 227 were paediatric (27 toddlers [0-4 years], 65 children [5-12 years], and 135 adolescents [13-17 years]). Most pTBI patients admitted to the ICU presented with mild injuries (Glasgow Coma Scale [GCS] 13-15; 66%), although severe injuries (GCS ≤ 8) were more common in adolescents (23.8%). Susceptibility to neuroworsening and seizures was low in the paediatric group (6% and 3.5%, respectively). Intracranial pressure monitoring was performed in 52 (39.4%) of 132 paediatric ICU patients. Paediatric patients received less intensive therapy targeted to the intracranial pressure (ICP) control particularly in toddlers. Age below 18 years was associated with a lower risk of poor neurological outcomes at six months, particularly in adolescents and children (odds ratio (OR) = 0.31, 95% confidence interval (CI) = 0.15-0.58 p < 0.001 and OR = 0.29, 95% CI = 0.09-0.71, p < 0.001, respectively). In toddlers, the association was not statistically significant (OR = 0.48, 95% CI = 0.07-1.94, p = 0.4). Conclusions: Paediatric TBI differs significantly from non-paediatric cases, with predominantly mild injuries, lower neuroworsening rates, and less intensive management, especially in younger children. Outcomes at six months are generally more favorable in paediatric patients, emphasizing the need for age-specific management strategies in TBI care.

• Sundet, Anja Schanke; Løvstad, Marianne; Havnes, Ingrid Amalia; Andelic, Nada; Ustvedt, Caroline & Månum, Grethe [Show all 12 contributors for this article] (2025). Rates and temporal onset of mental health disorders during inpatient rehabilitation after acute physical injury or illness: An observational cohort study. PLOS ONE. 20(12). doi: 10.1371/journal.pone.0338207. Full text in Research Archive Show summary

  Purpose Patients exposed to acute injury or illness are at increased risk of developing mental health disorders, and at the same time, mental health disorders increase the risk for injury and illness. This study aimed to determine the rate and onset of mental health disorders in a mixed patient group receiving inpatient specialized rehabilitation following acute physical injury or illness and to assess whether mental health disorders emerged before or after the injury or illness. Methods Patients were recruited over a one-year period (2020–2021) during inpatient rehabilitation. To follow the patients` lifetime history of psychiatric morbidity, mental health disorders, including substance use disorders, were assessed using the M.I.N.I Plus structured diagnostic interview over two periods: 1) retrospective report of mental health disorders before injury or illness and 2) mental health disorders present during rehabilitation. In the latter case, we also took into account whether the condition was present at the time of injury or illness. Demographic and injury data were retrieved from medical charts, patient interviews, and the Oslo University Hospital Trauma Registry. Results The study included 130 patients, of whom 49% had a lifetime history, and 38% met the diagnostic criteria for one or more mental health disorders during inpatient rehabilitation. Specifically, the vast majority (72%) of patients with a current disorder had the condition already at the time of injury or illness. Only 5% developed a mental health disorder after injury or illness without having a lifetime history. Conclusion Mental health disorders are common and often predate patients physical injury or illness. Assessing patients` mental health in the sub-acute phase, without considering their mental health history, and especially their mental state at the time of injury or illness, may lead to an overestimation of injury or illness’s impact on mental health.

• Jacob, Louis; Castro, John; Heslot, Camille; Andelic, Nada; Tenovuo, Olli & Azouvi, Philippe (2025). Absence from work in the 12 months following mild traumatic brain injury in Europe: a CENTER-TBI cohort study. Annals of Physical and Rehabilitation Medicine. ISSN 1877-0657. 68(8). doi: 10.1016/j.rehab.2025.102017. Full text in Research Archive Show summary

  Background Most of the prior research on absence from work after a mild traumatic brain injury (mTBI) was of a small sample size and had a limited number of follow-up assessments. Objectives Therefore, this study investigated the prevalence of absence from work, trajectories, and associated factors in the 12 months following mTBI in Europe. Methods Data from a European cohort (CENTER-TBI) were used. Absence from work was assessed at 2 weeks, 3 months, 6 months, and 12 months after mTBI. Associated factors included sociodemographic factors, current psychoactive substance use, pre-injury medical history, injury-related factors, medical care, complications, and discharge, and 2-week follow-up questionnaires. Inferential analyses relied on generalized estimating equations. Results This study included 1080 adults with mTBI who were working at the time of the injury (median [IQR] age, 46.0 [23.0] years; 69 % men). Absence from work decreased from 32 % at 2 weeks to 20 % at 12 months after the injury (P < 0.001). Around 76 % of adults returned to work within the first 3 months, whereas > 43 % of those absent from work at 3 months remained absent at 12 months. The 3 factors with the strongest association with absence from work were admission to hospital wards (OR = 2.57) or intensive care units (OR = 4.76), the presence of a pre-injury psychiatric disorder (OR = 2.55), and older age (OR = 1.61). Conclusions One-fifth of workers with mTBI were absent from work 12 months after the injury. Early identification of those at particular risk for not returning to work should be a clinical priority.

• Howe, Emilie Isager; Søberg, Helene L.; Røe, Cecilie; Løvstad, Marianne & Andelic, Nada (2025). “What standard should we set?”: A qualitative study of rehabilitation professionals’ perspectives on rehabilitation needs after traumatic injuries. Journal of Rehabilitation Medicine. ISSN 1650-1977. 57. doi: 10.2340/jrm.v57.44087. Full text in Research Archive Show summary

  Objective: To assess rehabilitation professionals’ perspectives on unmet rehabilitation needs in patients with traumatic injuries and how to bridge the gap between met and unmet needs. Design: Semi-structured focus-group interviews analysed using a reflexive thematic approach. Methods: Eighteen strategically sampled health professionals (67% female, aged 27–56 years) from specialist and community-based rehabilitation services in Northern and South-Eastern Norway were interviewed regarding their perspectives on alignment of current rehabilitation services with patient needs, reasons for misalignment, and potential service improvements. Results: Care continuity and multidisciplinary collaboration was identified as essential for high-quality rehabilitation services. Unmet needs were noted in community-based services for cognitive and mental health support, as well as financial assistance for patients. Health professionals faced challenges prioritizing patient needs and expressed frustration with not being able to provide legally mandated services. Contributing factors included insufficient resources, lack of competency standards, and weak organizational structure. Suggested improvements were early rehabilitation assessments and stronger collaboration between specialist and community services. Conclusions: Strengthening community-based rehabilitation for traumatic injuries requires establishing professional competency standards, stronger coordination across care levels, and greater integration of psychosocial support. Advancing these dimensions calls for critical reflection on clinical practice, service organization, and health policy.

• Whitehouse, Daniel P.; Wilson, Lindsay; Czeiter, Endre; Buki, Andras; Wang, Kevin K.W. & Steinbüchel, Nicole von [Show all 260 contributors for this article] (2025). Association of Blood-Based Biomarkers and 6-Month Patient-Reported Outcomes in Patients With Mild TBI. Neurology. ISSN 0028-3878. 104(1). doi: 10.1212/wnl.0000000000210040. Full text in Research Archive Show summary

  Background and objectives: There is seemingly contradictory evidence concerning relationships between day-of-injury biomarkers and outcomes after mild traumatic brain injury (mTBI). To address this issue, we examined the association between a panel of biomarkers and multidimensional TBI outcomes. Methods: Participants with mTBI (Glasgow coma scores [GCSs] 13-15) were selected from Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury, a European observational study recruiting patients with TBI with indication for brain CT and presentation within 24 hours. Exclusion criteria for this secondary analysis were age younger than 16 years, incomplete biomarker panel, death, or no recorded outcomes. Participants were separated into 2 groups, CT-negative and CT-positive. Multivariable binary logistic regression was used to assess the relation between the log biomarker level (glial fibrillary acidic protein [GFAP], neurofilament light [NfL], neuron-specific enolase [NSE], S100 calcium-binding protein B [S100B], tau, ubiquitin C-terminal hydrolase L1 [UCH-L1]) and dichotomized 6-month outcomes (functional outcomes [GOSE score <8], health-related quality of life [HRQoL; Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS) score <52, Short-Form 12-Item Survey version 2 Mental Component Summary (SF12v2 MCS) score <40, Short-Form 12-Item Survey version 2 Physical Component Summary (SF12v2 PCS) score <40], persistent postconcussion symptoms [Rivermead Post-Concussion Symptoms Questionnaire score ≥16], anxiety disorder [Generalized Anxiety Disorder-7 (GAD-7) score ≥8], depression [Patient Health Questionnaire-9 (PHQ-9) score ≥10], and post-traumatic stress disorder [PTSD Checklist for DSM-5 (PCL-5) score ≥33]). Results: A total of 1,589 participants (865 CT-negative, 724 CT-positive) were included (77% GCS 15, median age 52 years, 66% male). Higher biomarker levels were associated with a GOSE score <8: CT-negative: S100B (odds ratio [OR] 1.78, 95% CI 1.43-2.23) and UCH-L1 (OR 1.16, 95% CI 1.01-1.33); CT-positive: GFAP (OR 1.22, 95% CI 1.11-1.36), NfL (OR 1.30, 95% CI 1.11-1.52), S100B (OR 1.51, 95% CI 1.23-1.86), tau (OR 1.36, 95% CI 1.17-1.59), and UCH-L1 (OR 1.34, 95% CI 1.17-1.53). In CT-positive participants, positive association was seen between NfL (OR 1.3, 95% CI 1.06-1.60) and UCH-L1 (OR 1.28, 95% CI 1.07-1.54) with QOLIBRI-OS; S100B (OR 1.32, 95% CI 1.02-1.70) with SF12v2 PCS; and NSE (OR 1.52, 95% CI 1.06-2.18) and UCH-L1 (OR 1.21, 95% CI 1.01-1.46) with the GAD-7. However, in CT-negative participants only, negative associations were seen between GFAP and impairment on the QOLIBRI-OS (OR 0.76, 95% CI 0.66-0.88), SF12v2 MCS (OR 0.71, 95% CI 0.61-0.82), SF12v2 PCS (OR 0.79, 95% CI 0.68-0.91), GAD-7 (OR 0.80, 0.68-0.95), PHQ-9 (OR 0.80, 95% CI 0.68-0.93), and PCL-5 (OR 0.80, 95% CI 0.66-0.97). Discussion: Participants with higher biomarker levels had greater odds of impaired functional recovery. However, in CT-negative participants, higher GFAP concentrations were associated with better HRQoL and less impaired mental health. Further exploration is required of the patient phenotypes that may explain the relationships observed in this analysis.

• Mikolić, Ana; Klaveren, David van; Jost, Mathilde; Maas, Andrew IR; Shi, Shuyuan & Silverberg, Noah D [Show all 246 contributors for this article] (2025). Prognostic models for depression and post-traumatic stress disorder symptoms following traumatic brain injury: a CENTER-TBI study. BMJ Mental Health. 28(1). doi: 10.1136/bmjment-2024-301181. Full text in Research Archive Show summary

  Background Traumatic brain injury (TBI) is associated with an increased risk of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). We aimed to identify predictors and develop models for the prediction of depression and PTSD symptoms at 6 months post-TBI. Methods We analysed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study. We used linear regression to model the relationship between predictors and depression (Patient Health Questionnaire-9) and PTSD symptoms (PTSD Checklist for Diagnostic and Statistical Manual for Mental Health Disorders Fifth Edition). Predictors were selected based on Akaike’s Information Criterion. Additionally, we fitted logistic models for the endpoints ‘probable MDD’ and ‘probable PTSD’. We also examined the incremental prognostic value of 2–3 weeks of symptoms. Results We included 2163 adults (76% Glasgow Coma Scale=13–15). Depending on the scoring criteria, 7–18% screened positive for probable MDD and about 10% for probable PTSD. For both outcomes, the selected models included psychiatric history, employment status, sex, injury cause, alcohol intoxication and total injury severity; and for depression symptoms also preinjury health and education. The performance of the models was modest (proportion of explained variance=R2 8% and 7% for depression and PTSD, respectively). Symptoms assessed at 2–3 weeks had a large incremental prognostic value (delta R2=0.25, 95% CI 0.24 to 0.26 for depression symptoms; delta R2=0.30, 95% CI 0.29 to 0.31 for PTSD). Conclusion Preinjury characteristics, such as psychiatric history and unemployment, and injury characteristics, such as violent injury cause, can increase the risk of mental health problems after TBI. The identification of patients at risk should be guided by early screening of mental health.

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