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Feigen CM, Charney MF, Glajchen S, Myers C, Cherny S, Lipnitsky R, Yang WW, Glassman NR, Lipton ML. Genetic Variants and Persistent Impairment Following Mild Traumatic Brain Injury: A Systematic Review. J Head Trauma Rehabil 2024:00001199-990000000-00148. [PMID: 38668678 DOI: 10.1097/htr.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVE The purpose of this review is to systematically assess primary research publications on known genetic variants, which modify the risk for symptoms or dysfunction persisting 30 days or more following mild traumatic brain injury (mTBI). SUMMARY OF REVIEW A search of PubMed and Embase from inception through June 2022 identified 42 studies that associated genetic variants with the presence of symptoms or cognitive dysfunction 30 days or more following mTBI. Risk of bias was assessed for each publication using the Newcastle Ottawa Scale (NOS). Fifteen of the 22 studies evaluating apolipoprotein E ( APOE ) ɛ4 concluded that it was associated with worse outcomes and 4 of the 8 studies investigating the brain-derived neurotrophic factor ( BDNF ) reported the Val66Met allele was associated with poorer outcomes. The review also identified 12 studies associating 28 additional variants with mTBI outcomes. Of these, 8 references associated specific variants with poorer outcomes. Aside from analyses comparing carriers and noncarriers of APOE ɛ4 and BDNF Val66Met, most of the reviewed studies were too dissimilar, particularly in terms of specific outcome measures but also in genes examined, to allow for direct comparisons of their findings. Moreover, these investigations were observational and subject to varying degrees of bias. CONCLUSIONS The most consistent finding across articles was that APOE ɛ4 is associated with persistent post-mTBI impairment (symptoms or cognitive dysfunction) more than 30 days after mTBI. The sparsity of other well-established and consistent findings in the mTBI literature should motivate larger, prospective studies, which characterize the risk for persistent impairment with standardized outcomes in mTBI posed by other genetic variants influencing mTBI recovery.
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Affiliation(s)
- Chaim M Feigen
- Author Affiliations: Department of Neurological Surgery, Montefiore Medical Center, Bronx, New York (Mr Feigen); Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York (Drs Charney and Lipton and Ms Glajchen); D. Samuel Gottesman Library, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York (Ms Glassman); Departments of Radiology, Psychiatry and Behavioral Sciences, and Neurology (Dr Lipton) and Dominick P. Purpura Department of Neuroscience (Mr Feigen and Dr Lipton), Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York; Tulane University, New Orleans, Louisiana (Ms Myers); New York Medical College, Valhalla, New York (Mr Cherny); New York University College of Dentistry, New York, New York (Ms Lipnitsky); and University of South Florida Health Morsani College of Medicine, Tampa, Florida (Ms Yang)
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Rufino KA, Goli P, Patriquin MA, Kosten TR, Nielsen DA, Salas R. Val/Met BDNF as a genetic risk for a false sense of security in post-discharge suicide risk. J Affect Disord 2024; 354:98-103. [PMID: 38447916 DOI: 10.1016/j.jad.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/14/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The time after discharge from psychiatric inpatient care is one of the most dangerous periods in terms of suicide risk. Predicting who is at higher risk could help with resource allocation to assure patients at high risk of suicide attempts are most closely followed. We previously showed that inpatients who improve their suicide ideation levels faster while in inpatient treatment are the ones with highest rates of post-discharge suicide. Here, we studied the possible genetic underpinnings associated with such risk. METHOD We recorded the slope of suicide ideation recovery of 710 psychiatric inpatients from which we studied two genetic variants likely associated with suicide risk: The serotonin transporter variant 5-HTTLPR, and the BDNF gene variant Val66Met. RESULTS We found that inpatients carrying the BDNF Met variant (hypothesized as conferring higher suicide risk) improved their suicide ideation scores faster than Val/Val carrying inpatients. No significant association was found for 5-HTTLPR. LIMITATIONS The present sample was genetically homogenous, and future research should replicate these findings on a more diverse sample. CONCLUSIONS In conclusion, we found a paradoxical result: Carrying the BDNF Met variant allows inpatients to improve faster, which was shown to confer higher risk at the post-discharge period. This may explain some inconsistencies in the literature in terms of the role of BDNF in suicide ideation and attempts.
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Affiliation(s)
- K A Rufino
- The Menninger Clinic, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Department of Social Sciences, The University of Houston Downtown, Houston, TX, USA
| | - P Goli
- Rice University, Houston, TX, USA
| | - M A Patriquin
- The Menninger Clinic, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Michael E DeBakey VA Medical Center, Houston, TX, USA
| | - T R Kosten
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Michael E DeBakey VA Medical Center, Houston, TX, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - D A Nielsen
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Michael E DeBakey VA Medical Center, Houston, TX, USA
| | - R Salas
- The Menninger Clinic, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA; Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston, TX, USA.
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Baghaei A, Zoshk MY, Hosseini M, Fasihi H, Nassireslami E, Shayesteh S, Laripour R, Amoli AE, Heidari R, Chamanara M. Prominent genetic variants and epigenetic changes in post-traumatic stress disorder among combat veterans. Mol Biol Rep 2024; 51:325. [PMID: 38393604 DOI: 10.1007/s11033-024-09276-0] [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: 10/22/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
Post-traumatic stress disorder (PTSD) is one of the most widespread and disabling psychiatric disorders among combat veterans. Substantial interindividual variability in susceptibility to PTSD suggests the presence of different risk factors for this disorder. Twin and family studies confirm genetic factors as important risk factors for PTSD. In addition to genetic factors, epigenetic factors, especially DNA methylation, can be considered as a potential mechanism in changing the risk of PTSD. So far, many genetic and epigenetic association studies have been conducted in relation to PTSD. In genetic studies, many single nucleotide polymorphisms have been identified as PTSD risk factors. Meanwhile, the variations in catecholamines-related genes, serotonin transporter and receptors, brain-derived neurotrophic factor, inflammatory factors, and apolipoprotein E are the most prominent candidates. CpG methylation in the upstream regions of many genes is also considered a PTSD risk factor. Accurate identification of genetic and epigenetic changes associated with PTSD can lead to the presentation of suitable biomarkers for susceptible individuals to this disorder. This study aimed to delineate prominent genetic variations and epigenetic changes associated with post-traumatic stress disorder in military veterans who have experienced combat, focusing on genetic and epigenetic association studies.
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Affiliation(s)
- Ahmadali Baghaei
- Trauma Research center, AJA university of Medical sciences, Tehran, Iran
| | | | - Mohsen Hosseini
- The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fasihi
- Biomaterial and Medicinal Chemistry Research Center, AJA University of Medical Science, Tehran, Iran
| | - Ehsan Nassireslami
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran
- Department of Pharmacology and Toxicology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Sevda Shayesteh
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran
| | - Reza Laripour
- Social and Preventive Medicine Department, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Aynaz Eslami Amoli
- Trauma Research center, AJA university of Medical sciences, Tehran, Iran
| | - Reza Heidari
- Cancer Epidemiology Research Center (AJA-CERTC), AJA University of Medical Sciences, Tehran, Iran.
- Medical Biotechnology Research Center, AJA University of Medical Sciences, Tehran, Iran.
| | - Mohsen Chamanara
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran.
- Student research committee, AJA University of Medical Sciences, Tehran, Iran.
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Boyko M, Gruenbaum BF, Oleshko A, Merzlikin I, Zlotnik A. Diet's Impact on Post-Traumatic Brain Injury Depression: Exploring Neurodegeneration, Chronic Blood-Brain Barrier Destruction, and Glutamate Neurotoxicity Mechanisms. Nutrients 2023; 15:4681. [PMID: 37960334 PMCID: PMC10649677 DOI: 10.3390/nu15214681] [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: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Traumatic brain injury (TBI) has a profound impact on cognitive and mental functioning, leading to lifelong impairment and significantly diminishing the quality of life for affected individuals. A healthy blood-brain barrier (BBB) plays a crucial role in guarding the brain against elevated levels of blood glutamate, making its permeability a vital aspect of glutamate regulation within the brain. Studies have shown the efficacy of reducing excess glutamate in the brain as a treatment for post-TBI depression, anxiety, and aggression. The purpose of this article is to evaluate the involvement of dietary glutamate in the development of depression after TBI. We performed a literature search to examine the effects of diets abundant in glutamate, which are common in Asian populations, when compared to diets low in glutamate, which are prevalent in Europe and America. We specifically explored these effects in the context of chronic BBB damage after TBI, which may initiate neurodegeneration and subsequently have an impact on depression through the mechanism of chronic glutamate neurotoxicity. A glutamate-rich diet leads to increased blood glutamate levels when contrasted with a glutamate-poor diet. Within the context of chronic BBB disruption, elevated blood glutamate levels translate to heightened brain glutamate concentrations, thereby intensifying neurodegeneration due to glutamate neurotoxicity.
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Affiliation(s)
- Matthew Boyko
- Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben-Gurion of the Negev, Beer-Sheva 84101, Israel
| | - Benjamin F Gruenbaum
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Anna Oleshko
- Department of Biology and Methods of Teaching Biology, A. S. Makarenko Sumy State Pedagogical University, Sumy 40002, Ukraine
| | - Igor Merzlikin
- Department of Biology and Methods of Teaching Biology, A. S. Makarenko Sumy State Pedagogical University, Sumy 40002, Ukraine
| | - Alexander Zlotnik
- Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben-Gurion of the Negev, Beer-Sheva 84101, Israel
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Murray SJ, Cancio LC. The Phenomenon of Community Reintegration for Veterans with Burn Injury: Supportive Communities and Future-Oriented Thinking. J Burn Care Res 2023; 44:555-562. [PMID: 31808802 DOI: 10.1093/jbcr/irz198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Indexed: 11/14/2022]
Abstract
Combat missions in the Middle East have resulted in approximately 52,000 U.S. veterans who have been wounded in action, with 10% of whom suffered burn injuries. More than 90% of the wounded survived, but many were unable to return to military service. The purpose of this study was to investigate the factors that impacted reintegration of veterans with combat burn injuries. Using a mixed-methods approach and analysis, we asked veterans with combat burns "What was your experience reintegrating into the civilian community?" Additionally, we administered the Community Reintegration of Injured Service Members (CRIS) tool to measure the current level of reintegration. Six veterans with combat burn injury identified two major themes: supportive communities and future-oriented thinking. Supportive communities are defined as communities that are veteran-specific, provide long-term burn/injury care, are financially beneficial, and support hobbies, education, and work opportunities. Future-oriented thinking is defined as thinking in which a veteran experiences a turning point in recovery, has a desire to serve others, develops new meaning in life, and experiences posttraumatic growth. In both themes, peer support was a key component. Community reintegration was enhanced by future-oriented thinking and a supportive community, both of which can be buoyed by peer support. These findings are similar to other studies noting the importance of peer support for veterans. Studies of civilians burn survivors describe similar reintegration issues. These two factors may also be applicable to those survivors. Further qualitative inquiry into peer support in the burn community at large may reveal more actionable evidence which could enable burn survivors to meet the long-term goal of community reintegration.
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Affiliation(s)
- Sarah J Murray
- US Army Institute of Surgical Research Burn Center, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315
| | - Leopoldo C Cancio
- US Army Institute of Surgical Research Burn Center, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315
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Longtain RB, Graham DP, Harding MJ, De La Garza R, Nielsen DA. Methylation of the serotonin transporter gene moderates the depressive subjective effect of cocaine. Behav Brain Res 2022; 418:113675. [PMID: 34798166 PMCID: PMC8671356 DOI: 10.1016/j.bbr.2021.113675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 11/02/2022]
Abstract
Genetic variation in the serotonin transporter (SLC6A4) has been shown to moderate the acute subjective effects of cocaine. Methylation of the SLC6A4 gene is associated with decreased transcription of the serotonin transporter, leading to increased serotonin in the synapse. In this study, methylation of the SLC6A4 gene was investigated in the moderation of the subjective effects of cocaine. Non-treatment-seeking cocaine-dependent individuals (N = 53) were intravenously administered cocaine (40 mg) and saline in a randomized order. The subjective effects of cocaine were self-reported using a visual analog scale starting prior to the administration of cocaine (-15 min) or saline and up to 20 min after infusion. Participants were evaluated for methylation of the SLC6A4 promoter region and 5-HTTLPR genotype. A series of ANCOVAs for SLC6A4 methylation (high/low) were run for each of ten subjective and three cardiovascular effects controlling for age, sex [utilizing the sex-determining region Y protein (SRY)], and population structure (determined from ancestry informative markers and STRUCTURE software). Participants with SLC6A4 hypermethylation reported greater subjective response to cocaine for 'depressed' relative to participants with SLC6A4 hypomethylation (experiment-wise p = 0.002). These findings indicate that SLC6A4 methylation moderates the 'depressed' subjective effect of cocaine in non-treatment-seeking cocaine-dependent participants.
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Affiliation(s)
- Riley B. Longtain
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and Michael E. DeBakey V.A. Medical Center, Houston, TX, USA
| | - David P. Graham
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and Michael E. DeBakey V.A. Medical Center, Houston, TX, USA,South Central Mental Illness, Research, Education and Clinical Center (MIRECC), Houston, TX, USA,Corresponding author: David P. Graham, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd (153-TBI), Building 100, STE 2B-126A, Houston, TX 77030, USA, Tel: 713 791 1414 × 24215,
| | - Mark J. Harding
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and Michael E. DeBakey V.A. Medical Center, Houston, TX, USA
| | | | - David A. Nielsen
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and Michael E. DeBakey V.A. Medical Center, Houston, TX, USA
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Cahill S, Chandola T, Hager R. Genetic Variants Associated With Resilience in Human and Animal Studies. Front Psychiatry 2022; 13:840120. [PMID: 35669264 PMCID: PMC9163442 DOI: 10.3389/fpsyt.2022.840120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity and is influenced by both environmental and genetic factors. The identification of specific genetic factors and their biological pathways underpinning resilient functioning can help in the identification of common key factors, but heterogeneities in the operationalisation of resilience have hampered advances. We conducted a systematic review of genetic variants associated with resilience to enable the identification of general resilience mechanisms. We adopted broad inclusion criteria for the definition of resilience to capture both human and animal model studies, which use a wide range of resilience definitions and measure very different outcomes. Analyzing 158 studies, we found 71 candidate genes associated with resilience. OPRM1 (Opioid receptor mu 1), NPY (neuropeptide Y), CACNA1C (calcium voltage-gated channel subunit alpha1 C), DCC (deleted in colorectal carcinoma), and FKBP5 (FKBP prolyl isomerase 5) had both animal and human variants associated with resilience, supporting the idea of shared biological pathways. Further, for OPRM1, OXTR (oxytocin receptor), CRHR1 (corticotropin-releasing hormone receptor 1), COMT (catechol-O-methyltransferase), BDNF (brain-derived neurotrophic factor), APOE (apolipoprotein E), and SLC6A4 (solute carrier family 6 member 4), the same allele was associated with resilience across divergent resilience definitions, which suggests these genes may therefore provide a starting point for further research examining commonality in resilience pathways.
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Affiliation(s)
- Stephanie Cahill
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Faculty of Humanities, Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom
| | - Tarani Chandola
- Faculty of Humanities, Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom.,Methods Hub, Department of Sociology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Reinmar Hager
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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Graham DP, Harding MJ, Nielsen DA. Pharmacogenetics of Addiction Therapy. Methods Mol Biol 2022; 2547:437-490. [PMID: 36068473 DOI: 10.1007/978-1-0716-2573-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Drug addiction is a serious relapsing disease that has high costs to society and to the individual addicts. Treatment of these addictions is still in its nascency, with only a few examples of successful therapies. Therapeutic response depends upon genetic, biological, social, and environmental components. A role for genetic makeup in the response to treatment has been shown for several addiction pharmacotherapies with response to treatment based on individual genetic makeup. In this chapter, we will discuss the role of genetics in pharmacotherapies, specifically for cocaine, alcohol, and opioid dependences. The continued elucidation of the role of genetics should aid in the development of new treatments and increase the efficacy of existing treatments.
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Affiliation(s)
- David P Graham
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Mark J Harding
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David A Nielsen
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Anto-Ocrah M, Oktapodas Feiler M, Pukall C, Pacos-Martinez A. Resilience and Sexuality After Concussion in Women. Sex Med 2021; 9:100297. [PMID: 33482610 PMCID: PMC7930863 DOI: 10.1016/j.esxm.2020.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/02/2022] Open
Abstract
Background Previous findings from our group show that in the acute (ie, 6–10 weeks) post-injury period, women with concussions have a 70% greater risk of sexual dysfunction than those with extremity injuries. There are currently limited treatment options for the clinical management of concussions. Resilience is a protective, modifiable psychological construct that has been shown to improve concussion-related sequelae. To date, however, no research has evaluated how resilience impacts sexuality outcomes after concussion in women. Aim Evaluate if resilience offers protection against negative sexuality outcomes in a cohort of reproductive, aged women with a concussion, seeking care in the Emergency Department of a Level-1 Trauma Center. We hypothesized that women with low resilience will be more likely to experience negative impacts on sexuality and that increasing levels of resilience will be associated with more positive sexuality outcomes. Methods Secondary data analyses. Measures Resilience was evaluated with the Resilience Scale (RS), and the Brain Injury Questionnaire for Sexuality (BIQS) was used for sexuality. Results Of the 299 participants recruited for the parent study, 80 with concussion had complete follow-up data and were included in these secondary analyses. Less than half (42.5%; n = 34) had low resilience (score≤130 on the RS), and the remaining 46 (57.5%) had high resilience (score>130 on the RS). In crude linear regression models, 1-unit increase in resilience was associated with a 4% increase in sexuality outcomes (β = 0.04, 95% CI:0.01, 0.05; P = .008). The effect estimate remained similar in post-concussion-symptom-adjusted models (β = 0.03, 95% CI:0.002, 0.06; P = .03). Mood-adjusted models showed a statistically significant interaction term (P < .0001). After stratifying by mood, findings showed that unit increases in resilience were associated with a 6% increase in sexuality outcomes for women in the high risk mood group (HADS score ≥11; PCS-adjusted β = 0.06, 95% CI:0.02, 0.11; P = .009). Conclusion Longitudinal studies are needed to evaluate how these improvements in resilience translate to patient recovery measures following concussion. Anto-Ocrah M, Oktapodas Feiler M, Pukall C, et al. Resilience and Sexuality After Concussion in Women. Sex Med 2021;9:100297.
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Affiliation(s)
- Martina Anto-Ocrah
- Department of Emergency Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY; Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY; Department of Neurology, School of Medicine and Dentistry, University of Rochester, Rochester, NY.
| | - Marina Oktapodas Feiler
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY
| | - Caroline Pukall
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Amy Pacos-Martinez
- Department of Physical Medicine & Rehabilitation, School of Medicine and Dentistry, University of Rochester, Rochester, NY
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A Scoping Review of Predictors of Community Integration Following Traumatic Brain Injury: A Search for Meaningful Associations. J Head Trauma Rehabil 2020; 34:E32-E41. [PMID: 30499925 DOI: 10.1097/htr.0000000000000442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The purpose of this scoping review was to identify predictors of community integration for adults with traumatic brain injury. DATA SOURCES We searched the PubMed and PsycINFO databases and reviewed references of included studies. We selected studies exploring multiple components of community integration, including instrumental activities of daily living, leisure activities, and social activities. A total of 53 studies were included. DATA EXTRACTION We extracted data on sample size and sample characteristics (stage of injury and recovery, severity) and examined predictor variables, outcome measures for community integration, and significant findings, reported as correlations. DATA SYNTHESIS We found that the predictors of community integration fell into 4 categories: demographics, injury characteristics, disability and impairments, and environmental factors. There was large variability in reported relationships for demographics (r = 0.01-0.43), injury characteristics (r = 0.01-0.58), disability/functional impairments (r = 0.003-0.98) and environmental factors (r = 0.11-0.58). Cognition, disability, mobility/physical functioning, mood, social support, and length of posttraumatic amnesia had the strongest relationships with community integration outcomes. CONCLUSIONS Strategies for the management of cognitive, physical, and emotional functioning, and building and training a strong support system, may facilitate community integration outcomes. Additional work is warranted to further explore the discrepancies found among studies.
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González-Giraldo Y, Forero DA. Association between resilience and a functional polymorphism in the serotonin transporter (SLC6A4) gene: A meta-analysis. EXCLI JOURNAL 2020; 19:1174-1183. [PMID: 33088257 PMCID: PMC7573178 DOI: 10.17179/excli2020-2660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/15/2020] [Indexed: 12/20/2022]
Abstract
Resilience is a mechanism used by humans to adapt to adverse situations. It is a protective factor against mental health problems. This process can be influenced by environmental and genetic factors. Several genes have been associated with interindividual differences in resilience levels, but the results are inconclusive. Therefore, the aim of this meta-analysis was to evaluate the effect of a functional polymorphism (5-HTTLPR) in the SLC6A4 gene on resilience levels. A search in PubMed, HugeNavigator and Google Scholar databases was carried out and 16 studies about the association of 5-HTTLPR polymorphism and resilience in humans were identified. The OpenMeta[Analyst] program was employed to perform statistical analysis using a random-effects model. The final analysis included 9 studies, for a total of 4,080 subjects. Significant results were found when the standardized mean differences (SMD) of LL and SL carriers were compared, (SMD: -0.087 (confidence interval: -0.166 to -0.008; I2: 0 %); P value: 0.031). A significant result was also found in an analysis comparing SS/SL versus LL genotypes (SMD: -0.231; confidence interval: -0.400 to -0.061, P value: 0.008; I2: 0 %). This is the first meta-analysis performed to identify the pooled association of a functional polymorphism in the serotonin transporter gene and resilience. The current results suggest that the L/L genotype is associated with resilience. Further studies are necessary to elucidate the role of genetics on the resilience mechanisms.
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Affiliation(s)
- Yeimy González-Giraldo
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.,Center for Psychosocial Studies for Latin America and the Caribbean, Universidad Antonio Nariño, Bogotá, Colombia
| | - Diego A Forero
- School of Health and Sports Sciences, Fundación Universitaria de Área Andina, Bogotá, Colombia
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Nielsen DA, Deng H, Patriquin MA, Harding MJ, Oldham J, Salas R, Fowler JC, Frueh BC. Association of TPH1 and serotonin transporter genotypes with treatment response for suicidal ideation: a preliminary study. Eur Arch Psychiatry Clin Neurosci 2020; 270:633-642. [PMID: 30923939 DOI: 10.1007/s00406-019-01009-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/26/2019] [Indexed: 12/14/2022]
Abstract
Variants in three genes coding for components of the serotonergic system, the tryptophan hydroxylase 1 (TPH1) rs1799913, serotonin transporter (SLC6A4) 5-HTTLPR, and serotonin receptor 2A (HTR2A) rs6311, were evaluated for association with suicidal ideation (SI) and with recovery from SI in a psychiatric inpatient population. Five hundred and eighty-two adult inpatients, including 390 patients who had SI, collected from December 2012 to April 2016 were assessed. SI recovery, calculated as change in SI between the first two-week period after admission and weeks 5 and 6, was appraised for association with the three variants. In this preliminary study, both TPH1 and 5-HTTLPR genotypes were associated with recovery (TPH1: recessive model, increased recovery with AC genotype, P = 0.026; additive model, increased recovery with AC genotype, P = 0.037; 5-HTTLPR: recessive model, increased recovery with AC, P = 0.043). When patients with comorbid alcohol use disorder (AUD) were removed, given that TPH1 has been associated with alcoholism, the associations of those recovered from SI with TPH1 rs1799913 remained significant for the additive (increased recovery with AC, P = 0.045) and recessive (increased recovery with C-carriers, P = 0.008) models, and with 5-HTTLPR using the dominant model (increased recovery with S'S', P = 0.016). In females, an association of SI recovery with TPH1 rs1799913 was found using a recessive model (increased recovery with C-carriers, P = 0.031), with 5-HTTLPR using additive (increased recovery with L'S', P = 0.048) and recessive (increased recovery with S'S', P = 0.042) models. Additionally, an association of SI with TPH1 rs1799913 was found in females using both additive (increased risk in AC, P = 0.033) and recessive (increased risk in C-carriers, P = 0.043) models, and with 5-HTTLPR using a recessive model (increased risk in S'S', P = 0.030). This study provides evidence that variation in the TPH1 and serotonin transporter genes play key roles in moderating recovery from SI during treatment in an inpatient psychiatric clinic.
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Affiliation(s)
- David A Nielsen
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Research 151, Building 110, Suite 227, Houston, TX, 77030, USA. .,Department of Pharmacology and Chemical Biology, Baylor College of Medicine, Houston, TX, USA. .,Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
| | - Huiqiong Deng
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Michelle A Patriquin
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Research 151, Building 110, Suite 227, Houston, TX, 77030, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.,The Menninger Clinic, Houston, TX, USA
| | - Mark J Harding
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Research 151, Building 110, Suite 227, Houston, TX, 77030, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - John Oldham
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Research 151, Building 110, Suite 227, Houston, TX, 77030, USA
| | - Ramiro Salas
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Research 151, Building 110, Suite 227, Houston, TX, 77030, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.,The Menninger Clinic, Houston, TX, USA
| | - J Christopher Fowler
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Research 151, Building 110, Suite 227, Houston, TX, 77030, USA.,The Menninger Clinic, Houston, TX, USA
| | - B Christopher Frueh
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd., Research 151, Building 110, Suite 227, Houston, TX, 77030, USA.,The Menninger Clinic, Houston, TX, USA.,Department of Psychology, University of Hawaii, Hilo, USA
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Hellewell SC, Beaton CS, Welton T, Grieve SM. Characterizing the Risk of Depression Following Mild Traumatic Brain Injury: A Meta-Analysis of the Literature Comparing Chronic mTBI to Non-mTBI Populations. Front Neurol 2020; 11:350. [PMID: 32508733 PMCID: PMC7248359 DOI: 10.3389/fneur.2020.00350] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/08/2020] [Indexed: 12/11/2022] Open
Abstract
Objective: Mild traumatic brain injury (mTBI) is associated with depressed mood acutely post-injury, but there is little evidence regarding long-term depression. The aim of this study was to determine the odds ratio (OR) of depression chronically following mTBI. Methods: We searched Medline (PubMed), ProQuest, and Web of Science from date of database creation to January 23, 2019, for eligible studies examining depression at least 6 months post-injury in adult subjects with mTBI of any etiology, including civilians and military. Three authors independently reviewed titles and abstracts for study eligibility. Data were extracted and collated by two investigators. Risk of bias was assessed with the SIGN methodology. Study data were pooled using random-effects meta-analysis. The primary exposure was mTBI, and the primary outcome was depression. Secondary exploratory variables were time of assessment, age at injury, age at assessment, sex, and etiology. Results: We included 47 cross-sectional studies (n = 25,103 mTBI and 29,982 control), 26 cohort studies (n = 70,119 mTBI, 262,034 control), four prospective observational studies (n = 1,058 mTBI and 733 control), two prospective longitudinal studies (n = 119 mTBI, 81 control), two case-control studies (n = 56 mTBI, 56 control), and one randomized controlled trial (n = 252 mTBI, 3,214 control). mTBI was associated with a 3.29-fold increased risk of depression (OR 3.29, 95% CI 2.68–4.03, I2 = 96%). The OR for depression did not change when subjects were assessed at 6–12 months (OR 2.43, 1.45–4.07), years 1–2 (OR 4.12, 2.10–8.07); 2–10 (OR 3.28, 2.42–4.46), or 10+ (OR 3.42, 1.51–7.77). Similar risk of depression was sustained across different age at injury (<25: OR 2.26, 1.82–2.81; 25–35: OR 4.67, 3.06–7.14; >35: OR 2.69, 1.42–5.10) and different age at assessment (<40 years: OR 3.14, 2.48–3.99; >40 years: OR 4.57, 2.54–8.24). Female sex had a non-significant increase in OR (OR 19.97, 2.39–166.93) compared to male (OR 3.0, 2.33–3.86). mTBI etiology had no impact on depression. Conclusions: Those experiencing mTBI are more than three times more likely to experience depression compared to those without a history of mTBI, and this risk remains decades beyond the mTBI event. Future longitudinal studies are needed to identify and mitigate this risk.
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Affiliation(s)
- Sarah C Hellewell
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Caerwen S Beaton
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Thomas Welton
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Stuart M Grieve
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Radiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
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14
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Vos L, Poritz JMP, Ngan E, Leon-Novelo L, Sherer M. The relationship between resilience, emotional distress, and community participation outcomes following traumatic brain injury. Brain Inj 2019; 33:1615-1623. [PMID: 31456432 DOI: 10.1080/02699052.2019.1658132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose/Objective: To determine how resilience is associated with social participation outcomes in persons with traumatic brain injury (TBI), in the context of emotional distress, demographics, and injury-related factors.Setting: Individuals with a history of TBI recruited the following stay at three rehabilitation facilities in the USA.Participants: 201 community-dwelling persons with medically documented TBI ranging in severity from mild to severe.Design: Prospective cohort observational study. Data were collected at two time points, approximately 6 months apart.Main Measures: TBI-QOL; PART-OResults: Resilience at baseline was moderately to strongly correlated with baseline psychological distress variables (rs= -.66) and social participation variables (rs =.33 to.57). In regression analyses, resilience was directly associated with social participation outcomes and formed a significant interaction with emotional distress in some models. Resilience failed to show a relationship with social participation at 6-month follow-up, when controlling for baseline social participation.Conclusions: Though related to emotional distress, self-reported resilience makes a unique contribution to predicting outcomes over time following brain injury, and may impact the relationship between stress and negative participation outcomes. As such, it is possible interventions that promote resilience may mitigate distress and promote community integration.
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Affiliation(s)
- Leia Vos
- TIRR Memorial Hermann, Brain Injury Research Center.,Neuropsychology, Zablocki VA Medical Center, Milwaukee, WI, USA.,Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA
| | | | - Esther Ngan
- School of Public Health, Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston
| | - Luis Leon-Novelo
- School of Public Health, Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston
| | - Mark Sherer
- TIRR Memorial Hermann, Brain Injury Research Center.,Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA
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15
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Resnick B, Klinedinst NJ, Yerges-Armstrong L, Magaziner J, Orwig D, Hochberg MC, Gruber-Baldini AL, Dorsey SG. Genotype, resilience and function and physical activity post hip fracture. Int J Orthop Trauma Nurs 2019; 34:36-42. [PMID: 31257007 DOI: 10.1016/j.ijotn.2019.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 12/15/2018] [Accepted: 03/07/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Individuals who are resilient are more likely to engage in functional tasks and exercise post hip fracture. There may be a genetic predisposition to being resilient. OBJECTIVES This study tested the direct and indirect association of 10 candidate genes, age, cognition, gender, comorbidities, pain and social activity on resilience, function and exercise post hip fracture. METHOD This was a descriptive study including 172 community dwelling older adults. Measures included: age, gender, cognition (Modified Mini Mental Status Exam), comorbidities, social activities (self-report), DNA (GRM1, NTRK1, NTRK2, GNB3, NPY, SLC6A15. SLC6A4, BDNF, CR1TR1, FKBP5), pain (areas of pain and Numeric Rating Scale), function (Physical and Instrumental Activities of Daily Living; Lower Extremity Gains Score; Short Physical Performance Battery; Grip Strength) and exercise (Yale Physical Activity Scale). RESULTS The majority of participants were Caucasian (93%), 50% were women and the average age was 81.09 (SD = 7.42). There were significant associations between resilience and single nucleotide polymorphisms from GRM1, NTRK1, NTRK2, GNB3, NPY and SLC6A15. Resilience, age, cognition, social activity, pain and genetic variability were directly and/or indirectly associated with exercise and/or function. DISCUSSION This study highlights the importance of resilience for engagement in exercise and function after hip fracture and provides preliminary evidence for a genetic role for resilience.
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Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA.
| | - N Jennifer Klinedinst
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
| | - Laura Yerges-Armstrong
- Program in Personalized Medicine, Division of Endocrinology, Department of Medicine, University of Maryland School of Medicine, 685 W. Baltimore St., Baltimore, MD 21201, USA
| | - Jay Magaziner
- University of Maryland, School of Medicine, Department of Epidemiology and Public Health, Baltimore, MD 21201, USA
| | - Denise Orwig
- University of Maryland, School of Medicine, Department of Epidemiology and Public Health, Baltimore, MD 21201, USA
| | - Marc C Hochberg
- University of Maryland, School of Medicine, 22 S Greene St, Baltimore, MD 21201, USA
| | - Ann L Gruber-Baldini
- University of Maryland, School of Medicine, Department of Epidemiology and Public Health, Baltimore, MD 21201, USA
| | - Susan G Dorsey
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
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16
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Niitsu K, Rice MJ, Houfek JF, Stoltenberg SF, Kupzyk KA, Barron CR. A Systematic Review of Genetic Influence on Psychological Resilience. Biol Res Nurs 2018; 21:61-71. [DOI: 10.1177/1099800418800396] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
When exposed to adversity, some individuals are at an increased risk of posttraumatic stress disorder, experiencing persistent biopsychosocial disturbances, whereas others adapt well, described as resilience. Resilience is a complex biopsychosocial phenomenon conceptualized as adaptation to adversity influenced by an individual’s genetic variants, epistasis, epigenetics, and gene-by-environment interactions. Studies on psychological resilience have focused on behavioral and psychosocial variables with far less examination of the genetic contributions. The purpose of this review is to identify specific genetic variants contributing to the biological capacity for psychological resilience. PubMed and PsycINFO were searched using the following key words: psychological resilience AND genotype(s). Additional articles were identified from the Human Genome Epidemiology Navigator using the term resilience, psychological. Ten studies met the criteria. Six genes were empirically associated with psychological resilience: serotonin-transporter-linked polymorphic region ( 5-HTTLPR), dopamine receptor D4, brain-derived neurotrophic factor ( BDNF), corticotropin-releasing hormone receptor 1, oxytocin receptor and regulator of G-protein signaling 2 . The findings of this systematic review suggest that the L/L or L’/L’ genotype of 5-HTTLPR and rs25531 in children/adolescents and the S/S or S’/S’ genotype in adults are most frequently related to resilience. Additionally, the Val/Val genotype of rs6265 in BDNF in Caucasians was also associated with resilience. There are numerous factors contributing to the complexity of determining the genetic influence on resilience including analysis of rs25531, assumptions of the mode of inheritance, operationalization of resilience, demographic and population characteristics, sample size, and other types of genetic influence including epistasis and epigenetics. While current evidence is supportive, further investigation of the genetic influence on resilience is required.
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Affiliation(s)
- Kosuke Niitsu
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael J. Rice
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Julia F. Houfek
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Kevin A. Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cecilia R. Barron
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
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17
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Polich G, Iaccarino MA, Kaptchuk TJ, Morales-Quezada L, Zafonte R. Placebo Effects in Traumatic Brain Injury. J Neurotrauma 2018; 35:1205-1212. [PMID: 29343158 PMCID: PMC6016098 DOI: 10.1089/neu.2017.5506] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In recent years, several randomized controlled trials evaluating pharmaceutical treatments for traumatic brain injury (TBI) have failed to demonstrate efficacy over placebo, with both active and placebo arms improving at comparable rates. These findings could be viewed in opposing ways, suggesting on the one hand failure of the tested outcome, but on the other, representing evidence of robust placebo effects in TBI. In this article, we examine several of the primary psychological processes driving placebo effects (verbal suggestion, cognitive re-framing, interpersonal interactions, conditioning, therapeutic alliance, anxiety reduction) as well as placebo neurobiology (top-down cortical regulation, reward system activation, dopaminergic and serotonergic neurotransmission). We then extrapolate from the literature to explore whether something inherent in TBI makes it particularly responsive to placebos. Viewed as such here, placebos may indeed represent a powerful and effective treatment for a variety of post-TBI complaints.
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Affiliation(s)
- Ginger Polich
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
| | - Mary Alexis Iaccarino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
- Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts
| | - Ted J. Kaptchuk
- Program in Placebo Studies and Therapeutic Encounter, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Leon Morales-Quezada
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
- Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts
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18
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Naß J, Efferth T. Pharmacogenetics and Pharmacotherapy of Military Personnel Suffering from Post-traumatic Stress Disorder. Curr Neuropharmacol 2018; 15:831-860. [PMID: 27834145 PMCID: PMC5652029 DOI: 10.2174/1570159x15666161111113514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 09/23/2016] [Accepted: 11/08/2016] [Indexed: 12/26/2022] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is a severe problem among soldiers with combating experience difficult to treat. The pathogenesis is still not fully understood at the psychological level. Therefore, genetic research became a focus of interest. The identification of single nucleotide polymorphisms (SNPs) may help to predict, which persons are at high risk to develop PTSD as a starting point to develop novel targeted drugs for treatment. Methods: We conducted a systematic review on SNPs in genes related to PTSD pathology and development of targeted pharmacological treatment options based on PubMed database searches. We focused on clinical trials with military personnel. Results: SNPs in 22 human genes have been linked to PTSD. These genes encode proteins acting as neurotransmitters and receptors, downstream signal transducers and metabolizing enzymes. Pharmacological inhibitors may serve as drug candidates for PTSD treatment, e.g. β2 adrenoreceptor antagonists, dopamine antagonists, partial dopamine D2 receptor agonists, dopamine β hydroxylase inhibitors, fatty acid amid hydrolase antagonists, glucocorticoid receptor agonists, tropomyosin receptor kinase B agonists, selective serotonin reuptake inhibitors, catechol-O-methyltransferase inhibitors, gamma-amino butyric acid receptor agonists, glutamate receptor inhibitors, monoaminoxidase B inhibitors, N-methyl-d-aspartate receptor antagonists. Conclusion: The combination of genetic and pharmacological research may lead to novel target-based drug developments with improved specificity and efficacy to treat PTSD. Specific SNPs may be identified as reliable biomarkers to assess individual disease risk. Focusing on soldiers suffering from PTSD will not only help to improve treatment options for this specific group, but for all PTSD patients and the general population.
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Affiliation(s)
- Janine Naß
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz. Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz. Germany
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19
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Reid MW, Cooper DB, Lu LH, Iverson GL, Kennedy JE. Adversity and Resilience Are Associated with Outcome after Mild Traumatic Brain Injury in Military Service Members. J Neurotrauma 2018; 35:1146-1155. [PMID: 29357779 DOI: 10.1089/neu.2017.5424] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The objective of this study was to assess the associations between resilience, adversity, post-concussion symptoms, and post-traumatic stress symptom reporting after mild traumatic brain injury (mTBI). We hypothesized that resilience would be associated with less symptom reporting, and adversity would be associated with greater symptom reporting. This was a cross-sectional study of retrospective data collected for an ongoing TBI repository. United States military service members who screened positive for mTBI during a primary care visit completed the Trauma History Screen (THS), Connor-Davidson Resilience Scale (CD-RISC), Neurobehavioral Symptom Inventory (NSI), and post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C). Data collected from February 2015 to August 2016 were used for the present study. Only participants with complete data for the above measures were included, yielding a sample size of 165 participants. Adversity (THS) and resilience (CD-RISC) scores were each correlated significantly with post-concussion (NSI) and traumatic stress (PCL-C) total and subscale scores in the hypothesized direction. Interactions between adversity and resilience were absent for all measures except the NSI sensory subscale. Four traumatic event types were significantly associated positively with most NSI and PCL-C total and subscale scores, but the age at which traumatic events were first experienced showed few and mixed significant associations. In conclusion, resilience and adversity were significantly associated with symptom endorsement after mTBI. Screening for cumulative adversity may identify individuals at greater risk of developing persistent post-concussion symptoms and/or PTSD, and interventions that increase resilience may reduce symptom severity.
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Affiliation(s)
- Matthew W Reid
- 1 The Defense and Veterans Brain Injury Center, San Antonio Military Medical Center , San Antonio, Texas; Neurology Clinic, JBSA Ft. Sam Houston, Texas
| | - Douglas B Cooper
- 2 Defense and Veterans Brain Injury Center, San Antonio Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Lisa H Lu
- 1 The Defense and Veterans Brain Injury Center, San Antonio Military Medical Center , San Antonio, Texas; Neurology Clinic, JBSA Ft. Sam Houston, Texas
| | - Grant L Iverson
- 3 Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; and Home Base, A Red Sox Foundation and Massachusetts General Hospital Program , Boston, Massachusetts
| | - Jan E Kennedy
- 1 The Defense and Veterans Brain Injury Center, San Antonio Military Medical Center , San Antonio, Texas; Neurology Clinic, JBSA Ft. Sam Houston, Texas
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20
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Effects of Depression and Antidepressant Use on Cognitive Deficits and Functional Cognition Following Severe Traumatic Brain Injury. J Head Trauma Rehabil 2018; 31:E62-E73. [PMID: 26828711 DOI: 10.1097/htr.0000000000000214] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To use a Rehabilomics framework to evaluate relations hips between post-traumatic brain injury (TBI) depression (PTD) and potential associated factors, including antidepressant use, on cognitive recovery following severe TBI. PARTICIPANTS Severe TBI survivors (n = 154), recruited from a level 1 trauma center. DESIGN Prospective cohort study with assessments at 6 and 12 months postinjury. MAIN MEASURES Patient Health Questionnaire-9 (PTD symptoms); cognitive composite score from a neuropsychological assessment battery (cognitive impairment); and Functional Independence Measure-Cognition (FIM-Cog, self-reported functional cognition). RESULTS Individuals with and without PTD did not differ with respect to cognitive impairment. However, antidepressant use, regardless of PTD status, was associated with cognitive impairment. Individuals with PTD reported lower FIM-Cog scores at both time points compared with those without PTD. In a post hoc longitudinal analysis, individuals with late-onset PTD had worse cognitive impairment. CONCLUSION These results suggest that antidepressant use impairs cognition among individuals without PTD. Also, PTD did not directly affect cognitive impairment but may affect functional cognitive limitations through self-evaluation and apathy/motivation factors.
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21
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Association between resilience, acute stress symptoms and characteristics of family members of patients at early admission to the intensive care unit. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.mhp.2018.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Sun H, Luo C, Chen X, Tao L. Assessment of cognitive dysfunction in traumatic brain injury patients: a review. Forensic Sci Res 2017; 2:174-179. [PMID: 30483638 PMCID: PMC6197081 DOI: 10.1080/20961790.2017.1390836] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the major causes of human mortality and morbidity in the world. Brain injury could affect the core of a person's being - their thinking, memory, personality and behaviour. Electrophysiological markers from the human electroencephalogram and brain imaging provide a rich source of data which helps to elucidate specific processing impairments in TBI patients. To assess the cognitive and social function in traumatic brain injury patients, this review will focus on some of methods for assessing the disabling cognitive and social function deficits induced by TBI. There are many new technologies available to address TBI and recognition related questions. Integration of the various techniques will help to facilitate our comprehending of TBI, cognitive function and social function, and improve treatment and rehabilitation.
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Affiliation(s)
- Huiyan Sun
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China.,Affiliated Hospital, Chifeng University, Inner Mongolia, China
| | - Chengliang Luo
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
| | - Xiping Chen
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
| | - Luyang Tao
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
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23
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Patriquin MA, Hamon SC, Harding MJ, Nielsen EM, Newton TF, De La Garza R, Nielsen DA. Genetic moderation of cocaine subjective effects by variation in the TPH1, TPH2, and SLC6A4 serotonin genes. Psychiatr Genet 2017; 27:178-186. [PMID: 28590957 PMCID: PMC5572746 DOI: 10.1097/ypg.0000000000000178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study investigated variants of tryptophan hydroxylase (TPH)1, TPH2, and SLC6A4 in the moderation of the subjective effects of cocaine. METHODS Non-treatment-seeking cocaine-dependent individuals (N=66) were intravenously administered saline and cocaine (40 mg) in a randomized order. Participants self-reported subjective effects of cocaine using a visual analog scale starting before administration of saline or cocaine (-15 min) to up to 20 min after infusion. Self-report ratings on the visual analog scale ranged from 0 (no effect) to 100 (greatest effect). Participants were genotyped for the TPH1 rs1799913, TPH2 rs4290270, and SLC6A4 5-HTTLPR variants. Repeated-measures analysis of covariance was used to examine changes in subjective effect scores over time while controlling for population structure. RESULTS Participants carrying the TPH1 rs1799913 A allele reported greater subjective response to cocaine for 'stimulated' and 'access' relative to the CC genotype group. Those carrying the TPH2 rs4290270 A allele reported higher 'good effect' and lower 'depressed' effect relative to the TT genotype group. Those carrying the SLC6A4 5-HTTLPR S' allele reported greater 'desire' and 'access' compared with the L'L' genotype group. CONCLUSION These findings indicate that TPH1, TPH2, and SLC6A4 variants moderate the subjective effects of cocaine in non-treatment-seeking cocaine-dependent participants.
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Affiliation(s)
- Michelle A. Patriquin
- The Menninger Clinic
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
| | - Sara C. Hamon
- Statistical and Genetic Consulting LLC, Daren, CT USA
| | - Mark J. Harding
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- Michael E. DeBakey Veterans Affairs Medical Center; Houston, TX USA
| | - Ellen M. Nielsen
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- Michael E. DeBakey Veterans Affairs Medical Center; Houston, TX USA
| | - Thomas F. Newton
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
| | - Richard De La Garza
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- Michael E. DeBakey Veterans Affairs Medical Center; Houston, TX USA
| | - David A. Nielsen
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- Michael E. DeBakey Veterans Affairs Medical Center; Houston, TX USA
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Marwitz JH, Sima AP, Kreutzer JS, Dreer LE, Bergquist TF, Zafonte R, Johnson-Greene D, Felix ER. Longitudinal Examination of Resilience After Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study. Arch Phys Med Rehabil 2017; 99:264-271. [PMID: 28734937 DOI: 10.1016/j.apmr.2017.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/23/2017] [Accepted: 06/11/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To evaluate (1) the trajectory of resilience during the first year after a moderate-severe traumatic brain injury (TBI); (2) factors associated with resilience at 3, 6, and 12 months postinjury; and (3) changing relationships over time between resilience and other factors. DESIGN Longitudinal analysis of an observational cohort. SETTING Five inpatient rehabilitation centers. PARTICIPANTS Patients with TBI (N=195) enrolled in the resilience module of the TBI Model Systems study with data collected at 3-, 6-, and 12-month follow-up. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Connor-Davidson Resilience Scale. RESULTS Initially, resilience levels appeared to be stable during the first year postinjury. Individual growth curve models were used to examine resilience over time in relation to demographic, psychosocial, and injury characteristics. After adjusting for these characteristics, resilience actually declined over time. Higher levels of resilience were related to nonminority status, absence of preinjury substance abuse, lower anxiety and disability level, and greater life satisfaction. CONCLUSIONS Resilience is a construct that is relevant to understanding brain injury outcomes and has potential value in planning clinical interventions.
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Affiliation(s)
- Jennifer H Marwitz
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
| | - Adam P Sima
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA
| | - Jeffrey S Kreutzer
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA; Department of Neurological Surgery, Virginia Commonwealth University, Richmond, VA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Laura E Dreer
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL; Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL
| | - Thomas F Bergquist
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN; Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Douglas Johnson-Greene
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL
| | - Elizabeth R Felix
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL
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Kurowski BG, Treble-Barna A, Pitzer AJ, Wade SL, Martin LJ, Chima RS, Jegga A. Applying Systems Biology Methodology To Identify Genetic Factors Possibly Associated with Recovery after Traumatic Brain Injury. J Neurotrauma 2017; 34:2280-2290. [PMID: 28301983 DOI: 10.1089/neu.2016.4856] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality worldwide. It is linked with a number of medical, neurological, cognitive, and behavioral sequelae. The influence of genetic factors on the biology and related recovery after TBI is poorly understood. Studies that seek to elucidate the impact of genetic influences on neurorecovery after TBI will lead to better individualization of prognosis and inform development of novel treatments, which are considerably lacking. Current genetic studies related to TBI have focused on specific candidate genes. The objectives of this study were to use a system biology-based approach to identify biologic processes over-represented with genetic variants previously implicated in clinical outcomes after TBI and identify unique genes potentially related to recovery after TBI. After performing a systematic review to identify genes in the literature associated with clinical outcomes, we used the genes identified to perform a systems biology-based integrative computational analysis to ascertain the interactions between molecular components and to develop models for regulation and function of genes involved in TBI recovery. The analysis identified over-representation of genetic variants primarily in two biologic processes: response to injury (cell proliferation, cell death, inflammatory response, and cellular metabolism) and neurocognitive and behavioral reserve (brain development, cognition, and behavior). Overall, this study demonstrates the use of a systems biology-based approach to identify unique/novel genes or sets of genes important to the recovery process. Findings from this systems biology-based approach provide additional insight into the potential impact of genetic variants on the underlying complex biological processes important to TBI recovery and may inform the development of empirical genetic-related studies for TBI. Future studies that combine systems biology methodology and genomic, proteomic, and epigenetic approaches are needed in TBI.
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Affiliation(s)
- Brad G Kurowski
- 1 Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
| | - Amery Treble-Barna
- 2 Division of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Alexis J Pitzer
- 3 Department of Psychology, Xavier University , Cincinnati, Ohio
| | - Shari L Wade
- 1 Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
| | - Lisa J Martin
- 1 Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
| | - Ranjit S Chima
- 1 Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
| | - Anil Jegga
- 1 Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
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Neils-Strunjas J, Paul D, Clark AN, Mudar R, Duff MC, Waldron-Perrine B, Bechtold KT. Role of resilience in the rehabilitation of adults with acquired brain injury. Brain Inj 2017; 31:131-139. [DOI: 10.1080/02699052.2016.1229032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jean Neils-Strunjas
- Department of Communication Sciences and Disorders, Western Kentucky University, Bowling Green, KT, USA
| | - Diane Paul
- American Speech-Language-Hearing Association, Rockville, MD, USA
| | - Allison N. Clark
- Department of Physical Medicine & Rehabilitation, Baylor College of Medicine and Brain Injury Research Center at TIRR Memorial Hermann, Houston, TX, USA
| | - Raksha Mudar
- Department of Speech & Hearing Science, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Melissa C. Duff
- Department of Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA
| | | | - Kathleen T. Bechtold
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
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COMT Val 158Met polymorphism is associated with post-traumatic stress disorder and functional outcome following mild traumatic brain injury. J Clin Neurosci 2016; 35:109-116. [PMID: 27769642 DOI: 10.1016/j.jocn.2016.09.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/26/2016] [Indexed: 11/22/2022]
Abstract
Mild traumatic brain injury (mTBI) results in variable clinical trajectories and outcomes. The source of variability remains unclear, but may involve genetic variations, such as single nucleotide polymorphisms (SNPs). A SNP in catechol-o-methyltransferase (COMT) is suggested to influence development of post-traumatic stress disorder (PTSD), but its role in TBI remains unclear. Here, we utilize the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study to investigate whether the COMT Val158Met polymorphism is associated with PTSD and global functional outcome as measured by the PTSD Checklist - Civilian Version and Glasgow Outcome Scale Extended (GOSE), respectively. Results in 93 predominately Caucasian subjects with mTBI show that the COMT Met158 allele is associated with lower incidence of PTSD (univariate odds ratio (OR) of 0.25, 95% CI [0.09-0.69]) and higher GOSE scores (univariate OR 2.87, 95% CI [1.20-6.86]) 6-months following injury. The COMT Val158Met genotype and PTSD association persists after controlling for race (multivariable OR of 0.29, 95% CI [0.10-0.83]) and pre-existing psychiatric disorders/substance abuse (multivariable OR of 0.32, 95% CI [0.11-0.97]). PTSD emerged as a strong predictor of poorer outcome on GOSE (multivariable OR 0.09, 95% CI [0.03-0.26]), which persists after controlling for age, GCS, and race. When accounting for PTSD in multivariable analysis, the association of COMT genotype and GOSE did not remain significant (multivariable OR 1.73, 95% CI [0.69-4.35]). Whether COMT genotype indirectly influences global functional outcome through PTSD remains to be determined and larger studies in more diverse populations are needed to confirm these findings.
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28
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Association of Chronic Pain and Community Integration of Returning Veterans With and Without Traumatic Brain Injury. J Head Trauma Rehabil 2016; 31:E1-12. [PMID: 26098259 DOI: 10.1097/htr.0000000000000152] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the association between community integration and pain in veterans with and without mild blast-related traumatic brain injury (TBI). DESIGN AND PARTICIPANTS A cross-sectional study of 198 Operation Enduring Freedom/Operation Iraqi Freedom veterans, 135 with mild TBI and 63 without TBI exposure. MAIN MEASURES Community Integration Questionnaire (CIQ), Community Reintegration of Injured Service Members Instrument, Brief Pain Inventory. RESULTS Pain interference was significantly associated with CIQ social integration (P = .037), and pain severity was significantly associated with CIQ home integration (P = .038) and CIQ social integration (P = .044). Pain interference and pain severity had a significant interaction as related to the CIQ total score (P = .046), CIQ job score (P = .034), and CIQ productivity score (P = .034). Pain interference (P = .042) and pain severity (P = .015) were associated with community participation, but not perceived limitations (P > .05) or satisfaction (P > .05) as measures by the Community Reintegration of Injured Service Members Instrument. There was a significant interaction between TBI status and pain severity (P = .021) with community participation. CONCLUSIONS Chronic pain has a negative association with the community integration of returning veterans. Although TBI status was associated with overall community integration ratings, depression had a stronger association with impairments. These findings suggest, above and beyond the treatment of depression, the importance of effectively managing TBI-related pain to foster improved social functioning and to promote the psychological and social well-being of returning veterans.
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29
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Don't worry; be informed about the epigenetics of anxiety. Pharmacol Biochem Behav 2016; 146-147:60-72. [PMID: 27189589 DOI: 10.1016/j.pbb.2016.05.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/06/2016] [Accepted: 05/12/2016] [Indexed: 01/10/2023]
Abstract
Epigenetic processes regulate gene expression independent of the DNA sequence and are increasingly being investigated as contributors to the development of behavioral disorders. Environmental insults, such as stress, diet, or toxin exposure, can affect epigenetic mechanisms, including chromatin remodeling, DNA methylation, and non-coding RNAs that, in turn, alter the organism's phenotype. In this review, we examine the literature, derived at both the preclinical (animal) and clinical (human) levels, on epigenetic alterations associated with anxiety disorders. Using animal models of anxiety, researchers have identified epigenetic changes in several limbic and cortical brain regions known to be involved in stress and emotion responses. Environmental manipulations have been imposed prior to conception, during prenatal or early postnatal periods, and at juvenile and adult ages. Time of perturbation differentially affects the epigenome and many changes are brain region-specific. Although some sex-dependent effects are reported in animal studies, more research employing both sexes is needed particularly given that females exhibit a disproportionate number of anxiety disorders. The human literature is in its infancy but does reveal some epigenetic associations with anxiety behaviors and disorders. In particular, effects in monoaminergic systems are seen in line with evidence from etiological and treatment research. Further, there is evidence that epigenetic changes may be inherited to affect subsequent generations. We speculate on how epigenetic processes may interact with genetic contributions to inform prevention and treatment strategies for those who are at risk for or have anxiety disorders.
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30
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Resilience and Other Possible Outcomes After Mild Traumatic Brain Injury: a Systematic Review. Neuropsychol Rev 2016; 26:173-85. [PMID: 27154289 DOI: 10.1007/s11065-016-9317-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 04/17/2016] [Indexed: 10/21/2022]
Abstract
The relation between resilience and mild traumatic brain injury (TBI) outcome has been theorized but empirical studies have been scarce. This systematic review aimed to describe the research in this area. Electronic databases (Medline, CINAHL, PsychINFO, SPORTdiscus, and PILOTS) were searched from inception to August 2015 for studies in which resilience was measured following TBI. The search terms included 'TBI' 'concussion' 'postconcussion' 'resilience' and 'hardiness'. Inclusion criteria were peer reviewed original research reports published in English, human participants aged 18 years and over with brain injury, and an accepted definition of mild TBI. Hand searching of identified articles was also undertaken. Of the 71 studies identified, five studies were accepted for review. These studies were formally assessed for risk of bias by two independent reviewers. Each study carried a risk of bias, most commonly a detection bias, but none were excluded on this basis. A narrative interpretation of the findings was used because the studies reflected fundamental differences in the conceptualization of resilience. No studies employed a trajectory based approach to measure a resilient outcome. In most cases, the eligible studies assessed trait resilience with a scale and used it as a predictor of outcome (postconcussion symptoms). Three of these studies showed that greater trait resilience was associated with better mild TBI outcomes (fewer symptoms). Future research of the adult mild TBI response that predicts a resilient outcome is encouraged. These studies could yield empirical evidence for a resilient, and other possible mild TBI outcomes.
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31
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Resilience Following Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study. Arch Phys Med Rehabil 2015; 97:708-13. [PMID: 26707459 DOI: 10.1016/j.apmr.2015.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine resilience at 3 months after traumatic brain injury (TBI). DESIGN Cross-sectional analysis of an ongoing observational cohort. SETTING Five inpatient rehabilitation centers, with 3-month follow-up conducted primarily by telephone. PARTICIPANTS Persons with TBI (N=160) enrolled in the resilience module of the TBI Model System study with 3-month follow-up completed. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Connor-Davidson Resilience Scale. RESULTS Resilience scores were lower than those of the general population. A multivariable regression model, adjusting for other predictors, showed that higher education, absence of preinjury substance abuse, and less anxiety at follow-up were significantly related to greater resilience. CONCLUSIONS Analysis suggests that lack of resilience may be an issue for some individuals after moderate to severe TBI. Identifying persons most likely at risk for low resilience may be useful in planning clinical interventions.
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Winkler EA, Yue JK, McAllister TW, Temkin NR, Oh SS, Burchard EG, Hu D, Ferguson AR, Lingsma HF, Burke JF, Sorani MD, Rosand J, Yuh EL, Barber J, Tarapore PE, Gardner RC, Sharma S, Satris GG, Eng C, Puccio AM, Wang KKW, Mukherjee P, Valadka AB, Okonkwo DO, Diaz-Arrastia R, Manley GT. COMT Val 158 Met polymorphism is associated with nonverbal cognition following mild traumatic brain injury. Neurogenetics 2015; 17:31-41. [PMID: 26576546 DOI: 10.1007/s10048-015-0467-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 10/22/2015] [Indexed: 11/28/2022]
Abstract
Mild traumatic brain injury (mTBI) results in variable clinical outcomes, which may be influenced by genetic variation. A single-nucleotide polymorphism in catechol-o-methyltransferase (COMT), an enzyme which degrades catecholamine neurotransmitters, may influence cognitive deficits following moderate and/or severe head trauma. However, this has been disputed, and its role in mTBI has not been studied. Here, we utilize the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study to investigate whether the COMT Val (158) Met polymorphism influences outcome on a cognitive battery 6 months following mTBI--Wechsler Adult Intelligence Test Processing Speed Index Composite Score (WAIS-PSI), Trail Making Test (TMT) Trail B minus Trail A time, and California Verbal Learning Test, Second Edition Trial 1-5 Standard Score (CVLT-II). All patients had an emergency department Glasgow Coma Scale (GCS) of 13-15, no acute intracranial pathology on head CT, and no polytrauma as defined by an Abbreviated Injury Scale (AIS) score of ≥3 in any extracranial region. Results in 100 subjects aged 40.9 (SD 15.2) years (COMT Met (158) /Met (158) 29 %, Met (158) /Val (158) 47 %, Val (158) /Val (158) 24 %) show that the COMT Met (158) allele (mean 101.6 ± SE 2.1) associates with higher nonverbal processing speed on the WAIS-PSI when compared to Val (158) /Val (158) homozygotes (93.8 ± SE 3.0) after controlling for demographics and injury severity (mean increase 7.9 points, 95 % CI [1.4 to 14.3], p = 0.017). The COMT Val (158) Met polymorphism did not associate with mental flexibility on the TMT or with verbal learning on the CVLT-II. Hence, COMT Val (158) Met may preferentially modulate nonverbal cognition following uncomplicated mTBI.Registry: ClinicalTrials.gov Identifier NCT01565551.
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Affiliation(s)
- Ethan A Winkler
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - John K Yue
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nancy R Temkin
- Departments of Neurological Surgery and Biostatistics, University of Washington, Seattle, WA, USA
| | - Sam S Oh
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Esteban G Burchard
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Donglei Hu
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Adam R Ferguson
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Hester F Lingsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - John F Burke
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Marco D Sorani
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Jonathan Rosand
- Department of Neurology, Harvard Medical School, Boston, MA, USA.,Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Esther L Yuh
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.,Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | - Jason Barber
- Departments of Neurological Surgery and Biostatistics, University of Washington, Seattle, WA, USA
| | - Phiroz E Tarapore
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Raquel C Gardner
- Department of Neurology, Harvard Medical School, Boston, MA, USA.,Department of Neurology, San Francisco Veterans Administration Medical Center, San Francisco, CA, USA
| | - Sourabh Sharma
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Gabriela G Satris
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Celeste Eng
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ava M Puccio
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kevin K W Wang
- Center for Neuroproteomics and Biomarkers Research, Departments of Psychiatry and Neuroscience, University of Florida, Gainesville, FL, USA
| | - Pratik Mukherjee
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.,Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | | | - David O Okonkwo
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Center for Neuroscience and Regenerative Medicine, Bethesda, MD, USA
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA, 94110, USA. .,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
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Ashley-Koch AE, Garrett ME, Gibson J, Liu Y, Dennis MF, Kimbrel NA, Beckham JC, Hauser MA. Genome-wide association study of posttraumatic stress disorder in a cohort of Iraq-Afghanistan era veterans. J Affect Disord 2015; 184:225-34. [PMID: 26114229 PMCID: PMC4697755 DOI: 10.1016/j.jad.2015.03.049] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can develop after experiencing traumatic events. A genome-wide association study (GWAS) design was used to identify genetic risk factors for PTSD within a multi-racial sample primarily composed of U.S. veterans. METHODS Participants were recruited at multiple medical centers, and structured interviews were used to establish diagnoses. Genotypes were generated using three Illumina platforms and imputed with global reference data to create a common set of SNPs. SNPs that increased risk for PTSD were identified with logistic regression, while controlling for gender, trauma severity, and population substructure. Analyses were run separately in non-Hispanic black (NHB; n = 949) and non-Hispanic white (NHW; n = 759) participants. Meta-analysis was used to combine results from the two subsets. RESULTS SNPs within several interesting candidate genes were nominally significant. Within the NHB subset, the most significant genes were UNC13C and DSCAM. Within the NHW subset, the most significant genes were TBC1D2, SDC2 and PCDH7. In addition, PRKG1 and DDX60L were identified through meta-analysis. The top genes for the three analyses have been previously implicated in neurologic processes consistent with a role in PTSD. Pathway analysis of the top genes identified alternative splicing as the top GO term in all three analyses (FDR q < 3.5 × 10(-5)). LIMITATIONS No individual SNPs met genome-wide significance in the analyses. CONCLUSIONS This multi-racial PTSD GWAS identified biologically plausible candidate genes and suggests that post-transcriptional regulation may be important to the pathology of PTSD; however, replication of these findings is needed.
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Affiliation(s)
| | | | - Jason Gibson
- Department of Medicine, Duke University Medical Center, Durham, NC
| | - Yutao Liu
- Department of Medicine, Duke University Medical Center, Durham, NC
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC,The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
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34
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Holland JN, Schmidt AT. Static and Dynamic Factors Promoting Resilience following Traumatic Brain Injury: A Brief Review. Neural Plast 2015; 2015:902802. [PMID: 26347352 PMCID: PMC4539485 DOI: 10.1155/2015/902802] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/15/2015] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) is the greatest contributing cause of death and disability among children and young adults in the United States. The current paper briefly summarizes contemporary literature on factors that can improve outcomes (i.e., promote resilience) for children and adults following TBI. For the purpose of this paper, the authors divided these factors into static or unmodifiable factors (i.e., age, sex, intellectual abilities/education, and preinjury psychiatric history) and dynamic or modifiable factors (i.e., socioeconomic status, family functioning/social support, nutrition, and exercise). Drawing on human and animal studies, the research reviewed indicated that these various factors can improve outcomes in multiple domains of functioning (e.g., cognition, emotion regulation, health and wellness, behavior, etc.) following a TBI. However, many of these factors have not been studied across populations, have been limited to preclinical investigations, have been limited in their scope or follow-up, or have not involved a thorough evaluation of outcomes. Thus, although promising, continued research is vital in the area of factors promoting resilience following TBI in children and adults.
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Affiliation(s)
- Jessica N. Holland
- Department of Psychology and Philosophy, Sam Houston State University, Campus Box 2447, Huntsville, TX 77341, USA
| | - Adam T. Schmidt
- Department of Psychology and Philosophy, Sam Houston State University, Campus Box 2447, Huntsville, TX 77341, USA
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35
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Merritt VC, Lange RT, French LM. Resilience and symptom reporting following mild traumatic brain injury in military service members. Brain Inj 2015. [PMID: 26204318 DOI: 10.3109/02699052.2015.1043948] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). It was hypothesized that, as resilience increases, self-reported symptoms would decrease. RESEARCH DESIGN Cross-sectional design. METHODS AND PROCEDURES Participants were 142 US military service members who sustained a mTBI, divided into three resilience groups based on participants' responses on the Response to Stressful Experiences Scale: Moderate (n = 42); High (n = 51); and Very High (n = 49). Participants completed the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian Version (PCL-C) within 12 months following injury. MAIN OUTCOMES AND RESULTS There were significant main effects for the NSI total score, cognitive cluster and affective cluster, as well as for the PCL-C total score, avoidance cluster and hyperarousal cluster. Pairwise comparisons revealed that there was a negative relationship between resilience and self-reported symptoms overall. Specifically, participants with higher resilience reported fewer post-concussion and PTSD-related symptoms than participants with lower levels of resilience. CONCLUSIONS These findings underscore the important role that resilience plays in symptom expression in military service members with mTBI and suggest that research on targeted interventions to increase resilience in the acute phase following injury is indicated.
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Affiliation(s)
| | - Rael T Lange
- b Defense and Veterans Brain Injury Center , Bethesda , MD , USA .,c Walter Reed National Military Medical Center , Bethesda , MD , USA .,d University of British Columbia , Vancouver , BC , Canada .,e Center for Neuroscience and Regenerative Medicine , Bethesda , MD , USA , and
| | - Louis M French
- b Defense and Veterans Brain Injury Center , Bethesda , MD , USA .,c Walter Reed National Military Medical Center , Bethesda , MD , USA .,e Center for Neuroscience and Regenerative Medicine , Bethesda , MD , USA , and.,f Uniformed Services University of the Health Sciences , Bethesda , MD , USA
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Relationship Between Resilience, Adjustment, and Psychological Functioning After Traumatic Brain Injury. J Head Trauma Rehabil 2015; 30:241-8. [DOI: 10.1097/htr.0000000000000137] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Objective: To better understand the impact of genetics on resilience and successful aging, we tested a model of successful aging. Method: This was a descriptive study with a single interview and blood draw done with residents in a continuing care retirement community. Five genes associated with resilience were included in the model. The hypothesis was tested using structural equation modeling. Results: A total of 116 participants completed the survey. Two SNPs from SLC6A4 (rs25533 and rs1042173) and age were the only variables associated with physical resilience and explained 9% of the variance. Cognitive status, age, and depression were directly associated with successful aging; variance in rs25532 or rs1042173, resilience, and pain were indirectly associated with successful aging through depression. Discussion: Continued research to replicate these findings is needed so as to be able to recognize older adults at risk of low physical resilience and implement appropriate interventions.
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Failla MD, Kumar RG, Peitzman AB, Conley YP, Ferrell RE, Wagner AK. Variation in the BDNF gene interacts with age to predict mortality in a prospective, longitudinal cohort with severe TBI. Neurorehabil Neural Repair 2014; 29:234-46. [PMID: 25063686 DOI: 10.1177/1545968314542617] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mortality predictions following traumatic brain injury (TBI), and our understanding of TBI pathology, may be improved by including genetic risk in addition to traditional prognostic variables. One promising target is the gene coding for brain-derived neurotrophic factor (BDNF), a ubiquitous neurotrophin important for neuronal survival and neurogenesis. OBJECTIVE We hypothesized the addition of BDNF genetic variation would improve mortality prediction models and that BDNF Met-carriers (rs6265) and C-carriers (rs7124442) would have the highest mortality rates post-TBI. METHODS This study examined BDNF functional single nucleotide polymorphisms rs6265 (val66met) and rs7124442 (T>C) in relation to mortality in a prospective, longitudinal cohort with severe TBI. We examined 315 individuals receiving care for a closed head injury within the University of Pittsburgh Medical Center, aged 16 to 74 years. Mortality was examined acutely (0-7 days postinjury) and postacutely (8-365 days postinjury). A gene risk score (GRS) was developed to examine both BDNF loci. Cox proportional hazards models were used to calculate hazard ratios for survivability post-TBI while controlling for covariates. RESULTS BDNF GRS was significantly associated with acute mortality, regardless of age. Interestingly, subjects in the hypothesized no-risk allele group had the lowest survival probability. Postacutely, BDNF-GRS interacted with age such that younger participants in the no-risk group had the highest survival probability, while older participants in the hypothesized no-risk group had the lowest probability of survival. CONCLUSIONS These data suggest complex relationships between BDNF and TBI mortality that interact with age to influence survival predictions beyond clinical variables alone. Evidence supporting dynamic, temporal balances of pro-survival/pro-apoptotic target receptors may explain injury and age-related gene associations.
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Affiliation(s)
- Michelle D Failla
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh PA Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA
| | - Raj G Kumar
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh PA
| | - Andrew B Peitzman
- Department of Surgery, University of Pittsburgh, School of Medicine, Pittsburgh PA
| | - Yvette P Conley
- Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, Pittsburgh, PA
| | - Robert E Ferrell
- Department of Human Genetics, University of Pittsburgh, School of Public Health, Pittsburgh, PA
| | - Amy K Wagner
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh PA Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA Safar Center for Resuscitation Research, University Pittsburgh, Pittsburgh, PA
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Nielsen DA, Nielsen EM, Dasari T, Spellicy CJ. Pharmacogenetics of addiction therapy. Methods Mol Biol 2014; 1175:589-624. [PMID: 25150877 DOI: 10.1007/978-1-4939-0956-8_15] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Drug addiction is a serious relapsing disease that has high costs to society and to the individual addicts. Treatment of these addictions is still in its nascency, with only a few examples of successful therapies. Therapeutic response depends upon genetic, biological, social, and environmental components. A role for genetic makeup in the response to treatment has been shown for several addiction pharmacotherapies. For several addiction pharmacotherapies, response to treatment varies based on individual genetic makeup. In this chapter, we discuss the role of genetics in pharmacotherapies, specifically for cocaine, alcohol, and opioid dependences. The elucidation of the role of genetics should aid in the development of new treatments and increase the efficacy of existing treatments.
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Affiliation(s)
- David A Nielsen
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,
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