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Andersson MJ, Kapetanovic S, Håkansson A, Claesdotter-Knutsson E. Concussion history associated with adolescent psychological distress but not hazardous gambling: a cross-sectional study. BMC Psychol 2024; 12:329. [PMID: 38840182 DOI: 10.1186/s40359-024-01830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Sustaining multiple concussions over one's lifetime may be associated with behavioral and mood changes beyond the acute phase of injury. The present cross-sectional study examined the relationship between concussion history, the incidence of current moderate-severe psychological distress, and lifetime adolescent hazardous gambling in high school students. METHODS Four-hundred fifty-nine high school students from southern Sweden (age: 16.81 ± 0.83, 58.2% male) completed a survey assessing concussion history (0,1,2…>8), psychological distress using the Kessler-6 scale, and lifetime hazardous gambling using the NODS-CLiP scale. RESULTS Participants who self-reported three or more concussions were more likely to endorse moderate-severe symptoms of psychological distress than those with no concussion history while controlling for covariates, OR = 2.71, 95% CI [1.19, 6.18]. In contrast, concussion history was not associated with hazardous gambling after controlling for confounding variables. CONCLUSIONS Self-reporting three or more concussions was associated with increased current psychological distress beyond the acute phase of injury among high school students. Adolescents who have sustained multiple concussions should undergo mental health evaluations beyond the acute phase of injury to identify and treat psychological distress, but probing for hazardous gambling may not be clinically relevant in this previously concussed adolescent population.
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Affiliation(s)
- Mitchell J Andersson
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden.
- Clinical Sports and Mental Health Unit, Malmö Addiction Center, Region Skåne, Malmö, Sweden.
| | - Sabina Kapetanovic
- Department of Social and Behavioral Sciences, University West, Trollhättan, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Anders Håkansson
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden
- Clinical Sports and Mental Health Unit, Malmö Addiction Center, Region Skåne, Malmö, Sweden
| | - Emma Claesdotter-Knutsson
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry Outpatient Clinic, Region Skåne, Lund, Sweden
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Tang S, Xu S, Wilder D, Medina AE, Li X, Fiskum GM, Jiang L, Kakulavarapu VR, Long JB, Gullapalli RP, Sajja VS. Longitudinal Biochemical and Behavioral Alterations in a Gyrencephalic Model of Blast-Related Mild Traumatic Brain Injury. Neurotrauma Rep 2024; 5:254-266. [PMID: 38515547 PMCID: PMC10956534 DOI: 10.1089/neur.2024.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Blast-related traumatic brain injury (bTBI) is a major cause of neurological disorders in the U.S. military that can adversely impact some civilian populations as well and can lead to lifelong deficits and diminished quality of life. Among these types of injuries, the long-term sequelae are poorly understood because of variability in intensity and number of the blast exposure, as well as the range of subsequent symptoms that can overlap with those resulting from other traumatic events (e.g., post-traumatic stress disorder). Despite the valuable insights that rodent models have provided, there is a growing interest in using injury models using species with neuroanatomical features that more closely resemble the human brain. With this purpose, we established a gyrencephalic model of blast injury in ferrets, which underwent blast exposure applying conditions that closely mimic those associated with primary blast injuries to warfighters. In this study, we evaluated brain biochemical, microstructural, and behavioral profiles after blast exposure using in vivo longitudinal magnetic resonance imaging, histology, and behavioral assessments. In ferrets subjected to blast, the following alterations were found: 1) heightened impulsivity in decision making associated with pre-frontal cortex/amygdalar axis dysfunction; 2) transiently increased glutamate levels that are consistent with earlier findings during subacute stages post-TBI and may be involved in concomitant behavioral deficits; 3) abnormally high brain N-acetylaspartate levels that potentially reveal disrupted lipid synthesis and/or energy metabolism; and 4) dysfunction of pre-frontal cortex/auditory cortex signaling cascades that may reflect similar perturbations underlying secondary psychiatric disorders observed in warfighters after blast exposure.
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Affiliation(s)
- Shiyu Tang
- Department of Diagnostic Radiology and Nuclear Medicine, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Center for Advanced Imaging Research (CAIR), Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Su Xu
- Department of Diagnostic Radiology and Nuclear Medicine, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Center for Advanced Imaging Research (CAIR), Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Donna Wilder
- Blast Induced Neurotrauma Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Alexandre E. Medina
- Department of Pediatrics, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Xin Li
- Department of Diagnostic Radiology and Nuclear Medicine, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Center for Advanced Imaging Research (CAIR), Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Gary M. Fiskum
- Department of Anesthesiology, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Shock, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Li Jiang
- Department of Diagnostic Radiology and Nuclear Medicine, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Center for Advanced Imaging Research (CAIR), Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Venkata R. Kakulavarapu
- Blast Induced Neurotrauma Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Joseph B. Long
- Blast Induced Neurotrauma Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Rao P. Gullapalli
- Department of Diagnostic Radiology and Nuclear Medicine, Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Center for Advanced Imaging Research (CAIR), Trauma, and Anesthesiology Research Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Martín-González E, Olmedo-Córdoba M, Prados-Pardo Á, Cruz-Garzón DJ, Flores P, Mora S, Moreno-Montoya M. Behavioral domains in compulsive rats: implications for understanding compulsive spectrum disorders. Front Behav Neurosci 2023; 17:1175137. [PMID: 37273281 PMCID: PMC10234153 DOI: 10.3389/fnbeh.2023.1175137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/21/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Compulsive behavior has been proposed as a transdiagnostic trait observed in different neuropsychiatric disorders, such as obsessive-compulsive disorder, autism, and schizophrenia. Research Domain Criteria (RDoC) strategy could help to disentangle the neuropsychological basis of compulsivity for developing new therapeutic and preventive approaches. In preclinical research, the selection of high-drinker (HD) vs. low-drinker (LD) animals by schedule-induced polydipsia (SIP) is considered a putative model of compulsivity, which includes a well-differentiated behavioral pattern. Methods The purpose of this research was to assess the cognitive control and the negative valence system domains in a phenotype of compulsive HD rats. After the selection of animals as HD or LD, we assessed behavioral inflexibility by probabilistic spatial reversal learning (PSRL), motor and cognitive impulsivity by variable delay-to-signal (VDS), and risky decision-making by rodent gambling task (rGT). Results HD rats performed fewer reversals and showed less probability of pressing the same lever that was previously reinforced on PSRL, more premature responses after the exposure to longer delays on VDS, and more disadvantageous risky choices on rGT. Moreover, HD animals performed more perseverative responses under the punishment period on rGT. Discussion These results highlight that HD compulsive phenotype exhibits behavioral inflexibility, insensitivity to positive feedback, waiting impulsivity, risky decision-making, and frustrative non-reward responsiveness. Moreover, these findings demonstrate the importance of mapping different behavioral domains to prevent, treat, and diagnose compulsive spectrum disorders correctly.
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Affiliation(s)
- Elena Martín-González
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Manuela Olmedo-Córdoba
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Ángeles Prados-Pardo
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Daniel J. Cruz-Garzón
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Pilar Flores
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Santiago Mora
- Department of Neuroscience and Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Margarita Moreno-Montoya
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
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Frankot MA, O’Hearn CM, Blancke AM, Rodriguez B, Pechacek KM, Gandhi J, Hu G, Martens KM, Haar CV. Acute gut microbiome changes after traumatic brain injury are associated with chronic deficits in decision-making and impulsivity in male rats. Behav Neurosci 2023; 137:15-28. [PMID: 35901372 PMCID: PMC9996537 DOI: 10.1037/bne0000532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The mechanisms underlying chronic psychiatric-like impairments after traumatic brain injury (TBI) are currently unknown. The goal of the present study was to assess the role of diet and the gut microbiome in psychiatric symptoms after TBI. Rats were randomly assigned to receive a high-fat diet (HFD) or calorie-matched low-fat diet (LFD). After 2 weeks of free access, rats began training on the rodent gambling task (RGT), a measure of risky decision-making and motor impulsivity. After training, rats received a bilateral frontal TBI or a sham procedure and continued postinjury testing for 10 weeks. Fecal samples were collected before injury and 3-, 30-, and 60 days postinjury to evaluate the gut microbiome. HFD altered the microbiome, but ultimately had low-magnitude effects on behavior and did not modify functional outcomes after TBI. Injury-induced functional deficits were far more robust; TBI substantially decreased optimal choice and increased suboptimal choice and motor impulsivity on the RGT. TBI also affected the microbiome, and a model comparison approach revealed that bacterial diversity measured 3 days postinjury was predictive of chronic psychiatric-like deficits on the RGT. A functional metagenomic analysis identified changes to dopamine and serotonin synthesis pathways as a potential candidate mechanism. Thus, the gut may be a potential acute treatment target for psychiatric symptoms after TBI, as well as a biomarker for injury and deficit severity. However, further research will be needed to confirm and extend these findings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Alyssa M. Blancke
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Bryan Rodriguez
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | | | - Jasleen Gandhi
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, USA
| | - Gangqing Hu
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, USA
- Cancer Institute, West Virginia University, Morgantown, WV, USA
| | - Kris M. Martens
- Department of Psychology, West Virginia University, Morgantown, WV, USA
- Department of Neuroscience, West Virginia University, Morgantown, WV, USA
- Cancer Institute, West Virginia University, Morgantown, WV, USA
- Department of Neuroscience, Ohio State University, Columbus, OH, USA
| | - Cole Vonder Haar
- Department of Psychology, West Virginia University, Morgantown, WV, USA
- Department of Neuroscience, West Virginia University, Morgantown, WV, USA
- Cancer Institute, West Virginia University, Morgantown, WV, USA
- Department of Neuroscience, Ohio State University, Columbus, OH, USA
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Rauchman SH, Albert J, Pinkhasov A, Reiss AB. Mild-to-Moderate Traumatic Brain Injury: A Review with Focus on the Visual System. Neurol Int 2022; 14:453-470. [PMID: 35736619 PMCID: PMC9227114 DOI: 10.3390/neurolint14020038] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023] Open
Abstract
Traumatic Brain Injury (TBI) is a major global public health problem. Neurological damage from TBI may be mild, moderate, or severe and occurs both immediately at the time of impact (primary injury) and continues to evolve afterwards (secondary injury). In mild (m)TBI, common symptoms are headaches, dizziness and fatigue. Visual impairment is especially prevalent. Insomnia, attentional deficits and memory problems often occur. Neuroimaging methods for the management of TBI include computed tomography and magnetic resonance imaging. The location and the extent of injuries determine the motor and/or sensory deficits that result. Parietal lobe damage can lead to deficits in sensorimotor function, memory, and attention span. The processing of visual information may be disrupted, with consequences such as poor hand-eye coordination and balance. TBI may cause lesions in the occipital or parietal lobe that leave the TBI patient with incomplete homonymous hemianopia. Overall, TBI can interfere with everyday life by compromising the ability to work, sleep, drive, read, communicate and perform numerous activities previously taken for granted. Treatment and rehabilitation options available to TBI sufferers are inadequate and there is a pressing need for new ways to help these patients to optimize their functioning and maintain productivity and participation in life activities, family and community.
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Affiliation(s)
- Steven H. Rauchman
- The Fresno Institute of Neuroscience, Fresno, CA 93730, USA
- Correspondence:
| | - Jacqueline Albert
- Department of Medicine, Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (J.A.); (A.B.R.)
| | - Aaron Pinkhasov
- Department of Psychiatry, NYU Long Island School of Medicine, Mineola, NY 11501, USA;
| | - Allison B. Reiss
- Department of Medicine, Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (J.A.); (A.B.R.)
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Vonder Haar C, Frankot MA, Reck AM, Milleson V, Martens KM. Large-N Rat Data Enables Phenotyping of Risky Decision-Making: A Retrospective Analysis of Brain Injury on the Rodent Gambling Task. Front Behav Neurosci 2022; 16:837654. [PMID: 35548692 PMCID: PMC9084609 DOI: 10.3389/fnbeh.2022.837654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/18/2022] [Indexed: 11/29/2022] Open
Abstract
Decision-making is substantially altered after brain injuries. Patients and rats with brain injury are more likely to make suboptimal, and sometimes risky choices. Such changes in decision-making may arise from alterations in how sensitive individuals are to outcomes. To assess this, we compiled and harmonized a large dataset from four studies of TBI, each of which evaluated behavior on the Rodent Gambling Task (RGT). We then determined whether the following were altered: (1) sensitivity to overall contingencies, (2) sensitivity to immediate outcomes, or (3) general choice phenotypes. Overall sensitivity was evaluated using the matching law, immediate sensitivity by looking at the probability of switching choices given a win or loss, and choice phenotypes by k-means clustering. We found significant reductions in sensitivity to the overall outcomes and a bias toward riskier alternatives in TBI rats. However, the substantial individual variability led to poor overall fits in matching analyses. We also found that TBI caused a significant reduction in the tendency to repeatedly choose a given option, but no difference in win- or loss-specific sensitivity. Finally, clustering revealed 5 distinct decision-making phenotypes and TBI reduced membership in the “optimal” type. The current findings support a hypothesis that TBI reduces sensitivity to contingencies. However, in the case of tasks such as the RGT, this is not a simple shift to indiscriminate or less discriminate responding. Rather, TBI rats are more likely to develop suboptimal preferences and frequently switch choices. Treatments will have to consider how this behavior might be corrected.
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Affiliation(s)
- Cole Vonder Haar
- Department of Psychology, West Virginia University, Morgantown, WV, United States
- Department of Neuroscience, Ohio State University, Columbus, OH, United States
- *Correspondence: Cole Vonder Haar,
| | - Michelle A. Frankot
- Department of Psychology, West Virginia University, Morgantown, WV, United States
| | - A. Matthew Reck
- Department of Psychology, West Virginia University, Morgantown, WV, United States
| | - Virginia Milleson
- Department of Psychology, West Virginia University, Morgantown, WV, United States
| | - Kris M. Martens
- Department of Psychology, West Virginia University, Morgantown, WV, United States
- Department of Neuroscience, Ohio State University, Columbus, OH, United States
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Bozdemir E, Vigil FA, Chun SH, Espinoza L, Bugay V, Khoury SM, Holstein DM, Stoja A, Lozano D, Tunca C, Sprague SM, Cavazos JE, Brenner R, Liston TE, Shapiro MS, Lechleiter JD. Neuroprotective Roles of the Adenosine A 3 Receptor Agonist AST-004 in Mouse Model of Traumatic Brain Injury. Neurotherapeutics 2021; 18:2707-2721. [PMID: 34608616 PMCID: PMC8804149 DOI: 10.1007/s13311-021-01113-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 10/20/2022] Open
Abstract
Traumatic brain injury (TBI) remains one of the greatest public health concerns with increasing morbidity and mortality rates worldwide. Our group reported that stimulation of astrocyte mitochondrial metabolism by P2Y1 receptor agonists significantly reduced cerebral edema and reactive gliosis in a TBI model. Subsequent data on the pharmacokinetics (PK) and rapid metabolism of these compounds suggested that neuroprotection was likely mediated by a metabolite, AST-004, which binding data indicated was an adenosine A3 receptor (A3R) agonist. The neuroprotective efficacy of AST-004 was tested in a control closed cortical injury (CCCI) model of TBI in mice. Twenty-four (24) hours post-injury, mice subjected to CCCI and treated with AST-004 (0.22 mg/kg, injected 30 min post-trauma) exhibited significantly less secondary brain injury. These effects were quantified with less cell death (PSVue794 fluorescence) and loss of blood brain barrier breakdown (Evans blue extravasation assay), compared to vehicle-treated TBI mice. TBI-treated mice also exhibited significantly reduced neuroinflammatory markers, glial-fibrillary acidic protein (GFAP, astrogliosis) and ionized Ca2+-binding adaptor molecule 1 (Iba1, microgliosis), both at the mRNA (qRT-PCR) and protein (Western blot and immunofluorescence) levels, respectively. Four (4) weeks post-injury, both male and female TBI mice presented a significant reduction in freezing behavior during contextual fear conditioning (after foot shock). AST-004 treatment prevented this TBI-induced impairment in male mice, but did not significantly affect impairment in female mice. Impairment of spatial memory, assessed 24 and 48 h after the initial fear conditioning, was also reduced in AST-004-treated TBI-male mice. Female TBI mice did not exhibit memory impairment 24 and 48 h after contextual fear conditioning and similarly, AST-004-treated female TBI mice were comparable to sham mice. Finally, AST-004 treatments were found to increase in vivo ATP production in astrocytes (GFAP-targeted luciferase activity), consistent with the proposed mechanism of action. These data reveal AST-004 as a novel A3R agonist that increases astrocyte energy production and enhances their neuroprotective efficacy after brain injury.
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Affiliation(s)
- Eda Bozdemir
- Department of Cell Systems and Anatomy, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Fabio A. Vigil
- Department of Cellular and Integrative Physiology, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Sang H. Chun
- Department of Cell Systems and Anatomy, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Liliana Espinoza
- Department of Cellular and Integrative Physiology, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Vladislav Bugay
- Department of Cellular and Integrative Physiology, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Sarah M. Khoury
- Department of Cell Systems and Anatomy, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Deborah M. Holstein
- Department of Cell Systems and Anatomy, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Aiola Stoja
- Department of Cellular and Integrative Physiology, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Damian Lozano
- Department of Cell Systems and Anatomy, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Ceyda Tunca
- Department of Cell Systems and Anatomy, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Shane M. Sprague
- Department of Neurosurgery, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Jose E. Cavazos
- Department of Neurology, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Robert Brenner
- Department of Cellular and Integrative Physiology, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - Theodore E. Liston
- Astrocyte Pharmaceuticals Inc, 245 First Street, Suite 1800, Cambridge, MA 02142 USA
| | - Mark S. Shapiro
- Department of Cellular and Integrative Physiology, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
| | - James D. Lechleiter
- Department of Cell Systems and Anatomy, UT Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229-3904 USA
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Acute cognitive impairment after traumatic brain injury predicts the occurrence of brain atrophy patterns similar to those observed in Alzheimer's disease. GeroScience 2021; 43:2015-2039. [PMID: 33900530 DOI: 10.1007/s11357-021-00355-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022] Open
Abstract
Traumatic brain injuries (TBIs) are often followed by persistent structural brain alterations and by cognitive sequalae, including memory deficits, reduced neural processing speed, impaired social function, and decision-making difficulties. Although mild TBI (mTBI) is a risk factor for Alzheimer's disease (AD), the extent to which these conditions share patterns of macroscale neurodegeneration has not been quantified. Comparing such patterns can not only reveal how the neurodegenerative trajectories of TBI and AD are similar, but may also identify brain atrophy features which can be leveraged to prognosticate AD risk after TBI. The primary aim of this study is to systematically map how TBI affects white matter (WM) and gray matter (GM) properties in AD-analogous patterns. Our findings identify substantial similarities in the regional macroscale neurodegeneration patterns associated with mTBI and AD. In cerebral GM, such similarities are most extensive in brain areas involved in memory and executive function, such as the temporal poles and orbitofrontal cortices, respectively. Our results indicate that the spatial pattern of cerebral WM degradation observed in AD is broadly similar to the pattern of diffuse axonal injury observed in TBI, which frequently affects WM structures like the fornix, corpus callosum, and corona radiata. Using machine learning, we find that the severity of AD-like brain changes observed during the chronic stage of mTBI can be accurately prognosticated based on acute assessments of post-traumatic mild cognitive impairment. These findings suggest that acute post-traumatic cognitive impairment predicts the magnitude of AD-like brain atrophy, which is itself associated with AD risk.
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