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Ganesh A, Al-Shamli S, Mahadevan S, Chan MF, Burke DT, Al Rasadi K, Al Saadoon M, Al–Adawi S. The Frequency of Neuropsychiatric Sequelae After Traumatic Brain Injury in the Global South: A systematic review and meta-analysis. Sultan Qaboos Univ Med J 2024; 24:161-176. [PMID: 38828247 PMCID: PMC11139369 DOI: 10.18295/squmj.12.2023.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 06/05/2024] Open
Abstract
This study aimed to assess the prevalence of neuropsychiatric sequelae following traumatic brain injury (TBI) among the Western Asian, South Asian and African regions of the global south. All studies on psychiatric disturbances or cognitive impairment following TBI conducted (until August 2021) in the 83 countries that constitute the aforementioned regions were reviewed; 6 databases were selected for the literature search. After evaluating the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, post-traumatic stress disorder (PTSD), TBI-related sleep disturbance (TBI-SD), obsessive-compulsive disorder (OCD) and cognitive impairment. Of 56 non-duplicated studies identified in the initial search, 27 were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in 1,882 samples was 35.35%, that of anxiety in 1,211 samples was 28.64%, that of PTSD in 426 samples was 19.94%, that of OCD in 313 samples was 19.48%, that of TBI-SD in 562 samples was 26.67% and that of cognitive impairment in 941 samples was 49.10%. To date, this is the first critical review to examine the spectrum of post-TBI neuropsychiatric sequelae in the specified regions. Although existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north.
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Affiliation(s)
- Aishwarya Ganesh
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Sangeetha Mahadevan
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Moon Fai Chan
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - David T. Burke
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Khalid Al Rasadi
- Medical Research Center, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Muna Al Saadoon
- Department of Child Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al–Adawi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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Syzdykbayev M, Kazymov M, Aubakirov M, Kurmangazina A, Kairkhanov E, Kazangapov R, Bryzhakhina Z, Imangazinova S, Sheinin A. A Modern Approach to the Treatment of Traumatic Brain Injury. MEDICINES (BASEL, SWITZERLAND) 2024; 11:10. [PMID: 38786549 PMCID: PMC11123131 DOI: 10.3390/medicines11050010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/18/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024]
Abstract
Background: Traumatic brain injury manifests itself in various forms, ranging from mild impairment of consciousness to severe coma and death. Traumatic brain injury remains one of the leading causes of morbidity and mortality. Currently, there is no therapy to reverse the effects associated with traumatic brain injury. New neuroprotective treatments for severe traumatic brain injury have not achieved significant clinical success. Methods: A literature review was performed to summarize the recent interdisciplinary findings on management of traumatic brain injury from both clinical and experimental perspective. Results: In the present review, we discuss the concepts of traditional and new approaches to treatment of traumatic brain injury. The recent development of different drug delivery approaches to the central nervous system is also discussed. Conclusions: The management of traumatic brain injury could be aimed either at the pathological mechanisms initiating the secondary brain injury or alleviating the symptoms accompanying the injury. In many cases, however, the treatment should be complex and include a variety of medical interventions and combination therapy.
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Affiliation(s)
- Marat Syzdykbayev
- Department of Hospital Surgery, Anesthesiology and Reanimatology, Semey Medical University, Semey 071400, Kazakhstan
| | - Maksut Kazymov
- Department of General Practitioners, Semey Medical University, Semey 071400, Kazakhstan
| | - Marat Aubakirov
- Department of Pediatric Surgery, Semey Medical University, Semey 071400, Kazakhstan
| | - Aigul Kurmangazina
- Committee for Medical and Pharmaceutical Control of the Ministry of Health of the Republic of Kazakhstan for East Kazakhstan Region, Ust-Kamenogorsk 070004, Kazakhstan
| | - Ernar Kairkhanov
- Pavlodar Branch of Semey Medical University, Pavlodar S03Y3M1, Kazakhstan
| | - Rustem Kazangapov
- Pavlodar Branch of Semey Medical University, Pavlodar S03Y3M1, Kazakhstan
| | - Zhanna Bryzhakhina
- Department Psychiatry and Narcology, Semey Medical University, Semey 071400, Kazakhstan
| | - Saule Imangazinova
- Department of Therapy, Astana Medical University, Astana 010000, Kazakhstan
| | - Anton Sheinin
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv 69978, Israel
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Schaffert J, LoBue C, Chiang HS, Peters ME, Hart Jr J, Cullum CM. Traumatic Brain Injury Characteristics Are Not Related to Neurocognitive Decline in Older Adults: A Nationwide Longitudinal Cohort Study. Arch Clin Neuropsychol 2024; 39:325-334. [PMID: 38332549 PMCID: PMC11042919 DOI: 10.1093/arclin/acae003] [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] [Received: 10/23/2023] [Revised: 12/13/2023] [Accepted: 01/17/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE Evaluate whether traumatic brain injury (TBI) characteristics, age of injury, or recency of injury predicts the course of neurocognitive decline and/or increases conversion rates to mild cognitive impairment (MCI) or dementia. METHODS Data were obtained from the National Alzheimer's Coordinating Center for participants 50-85 years old with 3-5 visits from 2015 to 2022, with or without TBI history (TBI+ = 508; TBI- = 2,382). Groups were stratified by self-reported TBI history (i.e., single TBI without loss of consciousness [LOC], single TBI with LOC, multiple TBI without LOC, and multiple TBI with LOC), age of most recent TBI, and recency of TBI. Mixed linear models compared neuropsychological composite trajectories (executive functioning/attention/speed, language, memory, and global), co-varying for age, gender, education, apolipoprotein E4 status, race/ethnicity, and baseline diagnosis (normal aging n = 1,720, MCI n = 749, or dementia n = 417). Logistic binary regression examined MCI/dementia conversion rates. RESULTS There was a slightly higher frequency of MCI/dementia in those with multiple TBIs (50% to 60% with and without LOC, compared to 39% with no TBI) at baseline, but longitudinal trajectories were similar. TBI history, age of injury, or recency of injury did not impact neurocognitive trajectories or conversion rates to MCI/dementia (all p's > .01). CONCLUSIONS TBI history, regardless of injury characteristics, age of injury, or recency of injury, did not worsen neurocognitive decline or MCI/dementia conversion. Additional longitudinal research in more diverse cohorts with a wider range of TBI severity is needed to evaluate the specific factors and possible mechanisms in which TBI may increase dementia risk.
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Affiliation(s)
- Jeff Schaffert
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Christian LoBue
- Departments of Psychiatry and Neurological Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Hsueh-Sheng Chiang
- Department of Neurology, UT Southwestern Dallas Medical Center, Dallas, TX 75390, USA
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Matthew E Peters
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - John Hart Jr
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA
- Departments of Neurology and Psychiatry, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - C Munro Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA
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Theadom A, Barker-Collo S, Parag V, Caspi A, Moffitt TE, Hogan S, Ramrakha S, Poulton R. Mild Traumatic Brain Injury Does Not Significantly Affect Midlife Cognitive Functioning Within the General Population: Findings From a Prospective Longitudinal Birth Cohort Study. J Head Trauma Rehabil 2024; 39:E70-E82. [PMID: 37335217 DOI: 10.1097/htr.0000000000000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To determine whether differences exist in mid-adulthood cognitive functioning in people with and without history of mild traumatic brain injury (mTBI). SETTING Community-based study. PARTICIPANTS People born between April 1, 1972, and March 31, 1973, recruited into the Dunedin Multidisciplinary Health and Development Longitudinal Study, who completed neuropsychological assessments in mid-adulthood. Participants who had experienced a moderate or severe TBI or mTBI in the past 12 months were excluded. DESIGN Longitudinal, prospective, observational study. MAIN MEASURES Data were collected on sociodemographic characteristics, medical history, childhood cognition (between 7 and 11 years), and alcohol and substance dependence (from 21 years of age). mTBI history was determined from accident and medical records (from birth to 45 years of age). Participants were classified as having 1 mTBI and more in their lifetime or no mTBI. The Wechsler Adult Intelligence Scale (WAIS-IV) and Trail Making Tests A and B (between 38 and 45 years of age) were used to assess cognitive functioning. T tests and effect sizes were used to identify any differences on cognitive functioning domains between the mTBI and no mTBI groups. Regression models explored the relative contribution of number of mTBIs and age of first mTBI and sociodemographic/lifestyle variables on cognitive functioning. RESULTS Of the 885 participants, 518 (58.5%) had experienced at least 1 mTBI over their lifetime, with a mean number of 2.5 mTBIs. The mTBI group had significantly slower processing speed ( P < .01, d = 0.23) in mid-adulthood than the no TBI controls, with a medium effect size. However, the relationship no longer remained significant after controlling for childhood cognition, sociodemographic and lifestyle factors. No significant differences were observed for overall intelligence, verbal comprehension, perceptual reasoning, working memory, attention, or cognitive flexibility. Childhood cognition was not linked to likelihood of sustaining mTBI later in life. CONCLUSION mTBI histories in the general population were not associated with lower cognitive functioning in mid-adulthood once sociodemographic and lifestyle factors were taken into account.
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Affiliation(s)
- Alice Theadom
- Author Affiliations: Traumatic Brain Injury Network (TBIN), School of Clinical Sciences, Faculty of Health and Environment Sciences, Auckland University of Technology, Auckland, New Zealand (Dr Theadom); School of Psychology, University of Auckland, Auckland, New Zealand (Dr Barker-Collo); National Institute for Health Innovation, University of Auckland, Auckland, New Zealand (Dr Parag); Dunedin Multidisciplinary Health & Development Research Unit, University of Otago, Otago, New Zealand (Mr Hogan and Drs Ramrakha and Poulton); and Department of Psychology and Neuroscience, Duke University, Durham, North Carolina (Drs Caspi and Moffitt)
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Jones A, Ali MU, Kenny M, Mayhew A, Mokashi V, He H, Lin S, Yavari E, Paik K, Subramanian D, Dydynsky R, Aryal K, Correia RH, Dash D, Manis DR, O'Connell M, Liu-Ambrose T, Taler V, McMillan JM, Hogan DB, Kirkland S, Costa AP, Wolfson C, Raina P, Griffith L. Potentially Modifiable Risk Factors for Dementia and Mild Cognitive Impairment: An Umbrella Review and Meta-Analysis. Dement Geriatr Cogn Disord 2024; 53:91-106. [PMID: 38346414 DOI: 10.1159/000536643] [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: 09/15/2023] [Accepted: 01/31/2024] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION The prevalence of mild and major neurocognitive disorders (NCDs), also referred to as mild cognitive impairment and dementia, is rising globally. The prevention of NCDs is a major global public health interest. We sought to synthesize the literature on potentially modifiable risk factors for NCDs. METHODS We conducted an umbrella review using a systematic search across multiple databases to identify relevant systematic reviews and meta-analyses. Eligible reviews examined potentially modifiable risk factors for mild or major NCDs. We used a random-effects multi-level meta-analytic approach to synthesize risk ratios for each risk factor while accounting for overlap in the reviews. We further examined risk factors for major NCD due to two common etiologies: Alzheimer's disease and vascular dementia. RESULTS A total of 45 reviews with 212 meta-analyses were synthesized. We identified fourteen broadly defined modifiable risk factors that were significantly associated with these disorders: alcohol consumption, body weight, depression, diabetes mellitus, diet, hypertension, less education, physical inactivity, sensory loss, sleep disturbance, smoking, social isolation, traumatic brain injury, and vitamin D deficiency. All 14 factors were associated with the risk of major NCD, and five were associated with mild NCD. We found considerably less research for vascular dementia and mild NCD. CONCLUSION Our review quantifies the risk associated with 14 potentially modifiable risk factors for mild and major NCDs, including several factors infrequently included in dementia action plans. Prevention strategies should consider approaches that reduce the incidence and severity of these risk factors through health promotion, identification, and early management.
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Affiliation(s)
- Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Muhammad Usman Ali
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Meghan Kenny
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
| | - Vishal Mokashi
- School of Life Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Henry He
- Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada
| | - Sabrina Lin
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ehsan Yavari
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karen Paik
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Robert Dydynsky
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Komal Aryal
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca H Correia
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Darly Dash
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Derek R Manis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Megan O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Vanessa Taler
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Jacqueline M McMillan
- Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan Kirkland
- Department of Community Health and Epidemiology and Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrew P Costa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Christina Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health and Department of Medicine, McGill University, QC, Montreal, Canada
- Research Institute of the McGill University Health Centre, QC, Montreal, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
| | - Lauren Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
- Labarge Centre for Mobility in Aging, Hamilton, Ontario, Canada
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Park J, Lee SH, Shin D, Kim Y, Kim YS, Seong MY, Lee JJ, Seo HG, Cho WS, Ro YS, Kim Y, Oh BM. Multiplexed Quantitative Proteomics Reveals Proteomic Alterations in Two Rodent Traumatic Brain Injury Models. J Proteome Res 2024; 23:249-263. [PMID: 38064581 DOI: 10.1021/acs.jproteome.3c00544] [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] [Indexed: 01/06/2024]
Abstract
In many cases of traumatic brain injury (TBI), conspicuous abnormalities, such as scalp wounds and intracranial hemorrhages, abate over time. However, many unnoticeable symptoms, including cognitive, emotional, and behavioral dysfunction, often last from several weeks to years after trauma, even for mild injuries. Moreover, the cause of such persistence of symptoms has not been examined extensively. Recent studies have implicated the dysregulation of the molecular system in the injured brain, necessitating an in-depth analysis of the proteome and signaling pathways that mediate the consequences of TBI. Thus, in this study, the brain proteomes of two TBI models were examined by quantitative proteomics during the recovery period to determine the molecular mechanisms of TBI. Our results show that the proteomes in both TBI models undergo distinct changes. A bioinformatics analysis demonstrated robust activation and inhibition of signaling pathways and core proteins that mediate biological processes after brain injury. These findings can help determine the molecular mechanisms that underlie the persistent effects of TBI and identify novel targets for drug interventions.
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Affiliation(s)
- Junho Park
- Department of Pharmacology, School of Medicine, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
- Proteomics Research Team, CHA Future Medicine Research Institute, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
- Research Institute for Basic Medical Science, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
| | - Seung Hak Lee
- Department of Rehabilitation Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Dongyoon Shin
- Proteomics Research Team, CHA Future Medicine Research Institute, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
| | - Yeongshin Kim
- Department of Life Science, School of Medicine, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
| | - Young Sik Kim
- Proteomics Research Team, CHA Future Medicine Research Institute, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
| | - Min Yong Seong
- Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jin Joo Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Won-Sang Cho
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Young Sun Ro
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Youngsoo Kim
- Proteomics Research Team, CHA Future Medicine Research Institute, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
- Department of Life Science, School of Medicine, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Institute of Aging, Seoul National University College of Medicine, 71 Ihwajang-gil, Jongno-gu, Seoul 03080, Republic of Korea
- Neuroscience Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- National Traffic Injury Rehabilitation Hospital, 260 Jungang-ro, Yangpyeong-gun 12564, Gyeonggi-do, Republic of Korea
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7
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Neale KJ, Reid HMO, Sousa B, McDonagh E, Morrison J, Shultz S, Eyolfson E, Christie BR. Repeated mild traumatic brain injury causes sex-specific increases in cell proliferation and inflammation in juvenile rats. J Neuroinflammation 2023; 20:250. [PMID: 37907981 PMCID: PMC10617072 DOI: 10.1186/s12974-023-02916-5] [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] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Childhood represents a period of significant growth and maturation for the brain, and is also associated with a heightened risk for mild traumatic brain injuries (mTBI). There is also concern that repeated-mTBI (r-mTBI) may have a long-term impact on developmental trajectories. Using an awake closed head injury (ACHI) model, that uses rapid head acceleration to induce a mTBI, we investigated the acute effects of repeated-mTBI (r-mTBI) on neurological function and cellular proliferation in juvenile male and female Long-Evans rats. We found that r-mTBI did not lead to cumulative neurological deficits with the model. R-mTBI animals exhibited an increase in BrdU + (bromodeoxyuridine positive) cells in the dentate gyrus (DG), and that this increase was more robust in male animals. This increase was not sustained, and cell proliferation returning to normal by PID3. A greater increase in BrdU + cells was observed in the dorsal DG in both male and female r-mTBI animals at PID1. Using Ki-67 expression as an endogenous marker of cellular proliferation, a robust proliferative response following r-mTBI was observed in male animals at PID1 that persisted until PID3, and was not constrained to the DG alone. Triple labeling experiments (Iba1+, GFAP+, Brdu+) revealed that a high proportion of these proliferating cells were microglia/macrophages, indicating there was a heightened inflammatory response. Overall, these findings suggest that rapid head acceleration with the ACHI model produces an mTBI, but that the acute neurological deficits do not increase in severity with repeated administration. R-mTBI transiently increases cellular proliferation in the hippocampus, particularly in male animals, and the pattern of cell proliferation suggests that this represents a neuroinflammatory response that is focused around the mid-brain rather than peripheral cortical regions. These results add to growing literature indicating sex differences in proliferative and inflammatory responses between females and males. Targeting proliferation as a therapeutic avenue may help reduce the short term impact of r-mTBI, but there may be sex-specific considerations.
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Affiliation(s)
- Katie J Neale
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Hannah M O Reid
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Barbara Sousa
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Erin McDonagh
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Jamie Morrison
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Sandy Shultz
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
- Vancouver Island University, 900 Fifth Street, Nanaimo, BC, V9R 5S5, Canada
- Monash Trauma Group, Monash University, Melbourne, Australia
| | - Eric Eyolfson
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Brian R Christie
- Division of Medical Sciences, University of Victoria, Medical Sciences Building,3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
- Institute for Aging and Life Long Health, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
- Island Medical Program, Cellular and Physiological Sciences, University of British Columbia, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
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8
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Herrero Babiloni A, Baril AA, Charlebois-Plante C, Jodoin M, Sanchez E, De Baets L, Arbour C, Lavigne GJ, Gosselin N, De Beaumont L. The Putative Role of Neuroinflammation in the Interaction between Traumatic Brain Injuries, Sleep, Pain and Other Neuropsychiatric Outcomes: A State-of-the-Art Review. J Clin Med 2023; 12:jcm12051793. [PMID: 36902580 PMCID: PMC10002551 DOI: 10.3390/jcm12051793] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Sleep disturbances are widely prevalent following a traumatic brain injury (TBI) and have the potential to contribute to numerous post-traumatic physiological, psychological, and cognitive difficulties developing chronically, including chronic pain. An important pathophysiological mechanism involved in the recovery of TBI is neuroinflammation, which leads to many downstream consequences. While neuroinflammation is a process that can be both beneficial and detrimental to individuals' recovery after sustaining a TBI, recent evidence suggests that neuroinflammation may worsen outcomes in traumatically injured patients, as well as exacerbate the deleterious consequences of sleep disturbances. Additionally, a bidirectional relationship between neuroinflammation and sleep has been described, where neuroinflammation plays a role in sleep regulation and, in turn, poor sleep promotes neuroinflammation. Given the complexity of this interplay, this review aims to clarify the role of neuroinflammation in the relationship between sleep and TBI, with an emphasis on long-term outcomes such as pain, mood disorders, cognitive dysfunctions, and elevated risk of Alzheimer's disease and dementia. In addition, some management strategies and novel treatment targeting sleep and neuroinflammation will be discussed in order to establish an effective approach to mitigate long-term outcomes after TBI.
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Affiliation(s)
- Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, QC H3A 0C7, Canada
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Correspondence:
| | - Andrée-Ann Baril
- Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada
| | | | - Marianne Jodoin
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Department of Psychology, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Erlan Sanchez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Faculty of Medicine, University of Montreal, Montreal, QC H3T 1C5, Canada
- Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium
| | - Caroline Arbour
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Gilles J. Lavigne
- Division of Experimental Medicine, McGill University, Montreal, QC H3A 0C7, Canada
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Faculty of Dental Medicine, University of Montreal, Montreal, QC H3T 1C5, Canada
| | - Nadia Gosselin
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
| | - Louis De Beaumont
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Department of Surgery, University of Montreal, Montreal, QC H3T 1J4, Canada
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9
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Wilson RJ, Bell MR, Giordano KR, Seyburn S, Kozlowski DA. Repeat subconcussion in the adult rat gives rise to behavioral deficits similar to a single concussion but different depending upon sex. Behav Brain Res 2023; 438:114206. [PMID: 36356721 DOI: 10.1016/j.bbr.2022.114206] [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: 06/22/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022]
Abstract
Although concussions are a popular focus of neurotrauma research, subconcussions occur with higher frequency but are less well-studied. A subconcussion is an impact to the head that does not result in immediately diagnosable concussion but can result in later neurological consequences. Repeat subconcussions can produce behavioral impairments and neuropathology that is similar to or worse than those seen following a single concussion. The current study modified a previously established closed head injury model of concussion to create a subconcussion model and examines sex differences in behavioral responses to repeated subconcussion in the adult rat. Rats received a single concussion, single or repeat subconcussions, or no impact and behavior was monitored from 2 h through 31 days post-injury. A single concussion or repeat subconcussion resulted in deficits in locomotion, righting reflexes, and recognition memory. The degree of deficit induced by repeat subconcussions were either similar (righting reflexes) or greater/more persistent (locomotor deficits and recognition memory) than that of a concussion. Single subconcussion resulted in acute deficits that were mild and limited to righting reflexes and locomotion. Sex differences were observed in responses to repeat subconcussion: females showed greater deficits in righting reflexes, locomotion, and vestibular function, while males showed greater alterations in anxiety and depressive-like behavior. This study established a model of subconcussive impact where a single subconcussive impact resulted in minimal behavioral deficits but repeat subconcussions resulted in deficits similar to or worse than a single concussion. Our data also suggest sex differences in behavioral responses to both concussive and subconcussive impacts.
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Affiliation(s)
- Rebecca J Wilson
- Department of Biological Sciences, DePaul University, 2325 N. Clifton, Chicago, IL, USA.
| | - Margaret R Bell
- Department of Biological Sciences, DePaul University, 2325 N. Clifton, Chicago, IL, USA; Department of Health Sciences, DePaul University, 1110 W. Belden, Chicago, IL, USA.
| | - Katherine R Giordano
- Department of Biological Sciences, DePaul University, 2325 N. Clifton, Chicago, IL, USA.
| | - Serena Seyburn
- Department of Biological Sciences, DePaul University, 2325 N. Clifton, Chicago, IL, USA.
| | - Dorothy A Kozlowski
- Department of Biological Sciences, DePaul University, 2325 N. Clifton, Chicago, IL, USA; Neuroscience Program, DePaul University, 2325 N. Clifton, Chicago, IL, USA.
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10
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Fitts MS, Cullen J, Kingston G, Johnson Y, Wills E, Soldatic K. Understanding the Lives of Aboriginal and Torres Strait Islander Women with Traumatic Brain Injury from Family Violence in Australia: A Qualitative Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1607. [PMID: 36674368 PMCID: PMC9861732 DOI: 10.3390/ijerph20021607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 06/16/2023]
Abstract
Globally, there is growing recognition of the connection between violence and head injuries. At present, little qualitative research exists around how surviving this experience impacts everyday life for women, particularly Aboriginal and Torres Strait Islander women. This project aims to explore the nature and context of these women's lives including living with the injury and to identify their needs and priorities during recovery. This 3-year exploratory project is being conducted across three Australian jurisdictions (Queensland, Northern Territory, and New South Wales). Qualitative interviews and discussion groups will be conducted with four key groups: Aboriginal and Torres Strait Islander women (aged 18+) who have acquired a head injury through family violence; their family members and/or carers; and hospital staff as well as government and non-government service providers who work with women who have experienced family violence. Nominated staff within community-based service providers will support the promotion of the project to women who have acquired a head injury through family violence. Hospital staff and service providers will be recruited using purposive and snowball sampling. Transcripts and fieldnotes will be analysed using narrative and descriptive phenomenological approaches. Reflection and research knowledge exchange and translation will be undertaken through service provider workshops.
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Affiliation(s)
- Michelle S. Fitts
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW 2751, Australia
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT 0871, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD 4878, Australia
| | - Jennifer Cullen
- Synapse Australia, Brisbane, QLD 3356, Australia
- College of Healthcare Sciences, James Cook University, Cairns, QLD 4878, Australia
| | - Gail Kingston
- Townsville Hospital and Health Service, Townsville, QLD 4814, Australia
| | - Yasmin Johnson
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW 2751, Australia
| | - Elaine Wills
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW 2751, Australia
| | - Karen Soldatic
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW 2751, Australia
- School of Social Sciences, Western Sydney University, Parramatta, NSW 2751, Australia
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11
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Grasset L, Power MC, Crivello F, Tzourio C, Chêne G, Dufouil C. How Traumatic Brain Injury History Relates to Brain Health MRI Markers and Dementia Risk: Findings from the 3C Dijon Cohort. J Alzheimers Dis 2023; 92:183-193. [PMID: 36710672 PMCID: PMC10041415 DOI: 10.3233/jad-220658] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The long-term effects of traumatic brain injury (TBI) with loss of consciousness (LOC) on magnetic resonance imaging (MRI) markers of brain health and on dementia risk are still debated. OBJECTIVE To investigate the associations of history of TBI with LOC with incident dementia and neuroimaging markers of brain structure and small vessel disease lesions. METHODS The analytical sample consisted in 4,144 participants aged 65 and older who were dementia-free at baseline from the Three City -Dijon study. History of TBI with LOC was self-reported at baseline. Clinical Dementia was assessed every two to three years, up to 12 years of follow-up. A subsample of 1,675 participants <80 years old underwent a brain MRI at baseline. We investigated the associations between history of TBI with LOC and 1) incident all cause and Alzheimer's disease (AD) dementia using illness-death models, and 2) neuroimaging markers at baseline. RESULTS At baseline, 8.3% of the participants reported a history of TBI with LOC. In fully-adjusted models, participants with a history of TBI with LOC had no statistically significant differences in dementia risk (HR = 0.90, 95% CI = 0.60-1.36) or AD risk (HR = 1.03, 95% CI = 0.69-1.52), compared to participants without TBI history. History of TBI with LOC was associated with lower white matter volume (β= -4.58, p = 0.048), but not with other brain volumes, white matter hyperintensities volume, nor covert brain infarct. CONCLUSION This study did not find evidence of an association between history of TBI with LOC and dementia or AD dementia risks over 12-year follow-up, brain atrophy, or markers of small vessel disease.
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Affiliation(s)
- Leslie Grasset
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; CIC1401-EC, Bordeaux, France
| | - Melinda C Power
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Christophe Tzourio
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Bordeaux, France
| | - Geneviève Chêne
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; CIC1401-EC, Bordeaux, France.,Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Carole Dufouil
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; CIC1401-EC, Bordeaux, France.,Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
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12
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Graham A, Livingston G, Purnell L, Huntley J. Mild Traumatic Brain Injuries and Future Risk of Developing Alzheimer’s Disease: Systematic Review and Meta-Analysis. J Alzheimers Dis 2022; 87:969-979. [DOI: 10.3233/jad-220069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Traumatic brain injury (TBI) increases the risk of future dementia and Alzheimer’s disease (AD). However, it is unclear whether this is true for mild TBI (mTBI). Objective: To explore the association between mTBI and subsequent risk of developing AD. Method: We systematically searched four electronic databases from January 1954 to April 2020. We included studies reporting primary data and where mTBI preceded AD by≥5 years. We meta-analyzed included studies for both high quality studies and studies with a follow up of > 10 years. Result: We included 5 of the 10,435 results found. Meta-analysis found a history of mTBI increased risk of AD (pooled relative risk = 1.18, 95% CI 1.11–1.25, N = 3,149,740). The sensitivity analysis including only studies in which mTBI preceded AD by > 10 years, excluded two very large studies and resulted in wider confidence intervals (RR = 2.02, 95% CI 0.66–6.21, N = 2307). Conclusion: There is an increased risk of AD following mTBI. Our findings of increased risk even with mTBI means it cannot be assumed that mild head injuries from sports are harmless. The sensitivity analysis suggests that we cannot exclude reverse causation, and longer follow up times are needed. Implementation of policy to reduce mTBIs, including in children and sportsmen, are urgently needed. Further research is needed on the effect of frequency and age at injury of mTBIs.
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13
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Monteiro CEMDP, Moreira-Pinto J, Queiroga AC. Injury patterns in competitive and recreational surfing: a systematic review. Inj Prev 2022; 28:280-287. [PMID: 35361666 DOI: 10.1136/injuryprev-2021-044511] [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: 12/17/2021] [Accepted: 03/10/2022] [Indexed: 11/05/2022]
Abstract
CONTEXT Despite the growing evidence regarding surf-related injuries, investigation seems to overlook the differences between professional and recreational surfers' injuries and their specific risk factors. OBJECTIVE This review aimed at identifying differences in injuries sustained by recreational and competitive surfers. It also presents research gaps and suggests recommendations for future injury research and prevention. METHODS Study search was conducted on MEDLINE/PubMed, SportDiscus and Web of Science databases. To be included studies needed to report original data, clearly specify if recreational and/or competitive surfers were included, provide information regarding acute surfing injuries and/or analyse data concerning those injuries. RESULTS 17 studies were included in the analysis. All included studies had at least Oxford Centre for Evidence-Based Medicine level of evidence 3. The percentage of recreational surfers sustaining at least one injury ranged from 31% to 35% in the 12 months prior to data collection and from 88% to 100% in lifetime while 42% to 49% and 81% to 100% of competitors were injured over the same periods. Competitive surfers appear to have a higher injury risk. Both recreational and competitive surfers appear to sustain more frequently skin, joint/ligament and muscle/tendon injuries affecting the lower limbs and caused by contact with their own equipment. CONCLUSIONS Competitive status, less surfing experience, older age and prior surgical injuries are risk factors for sustaining injuries while surfing. The most common types, anatomical locations and mechanisms of injury seem to be similar between recreational and competitive surfers.
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Affiliation(s)
| | - João Moreira-Pinto
- Department of Pediatric Surgery, Hospital-Escola da Universidade Fernando Pessoa, Porto, Portugal.,EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Instituto de Investigação, Inovação e Desenvolvimento (FP-I3ID), Fundação Fernando Pessoa, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Ana Catarina Queiroga
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,IDRA - The International Drowning Researchers' Alliance, Kuna, Idaho, USA.,ILS Drowning Prevention Commission, International Lifesaving Federation, Leuveen, Belgium
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14
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Brett BL, Gardner RC, Godbout J, Dams-O’Connor K, Keene CD. Traumatic Brain Injury and Risk of Neurodegenerative Disorder. Biol Psychiatry 2022; 91:498-507. [PMID: 34364650 PMCID: PMC8636548 DOI: 10.1016/j.biopsych.2021.05.025] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/26/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022]
Abstract
Traumatic brain injury (TBI), particularly of greater severity (i.e., moderate to severe), has been identified as a risk factor for all-cause dementia and Parkinson's disease, with risk for specific dementia subtypes being more variable. Among the limited studies involving neuropathological (postmortem) confirmation, the association between TBI and risk for neurodegenerative disease increases in complexity, with polypathology often reported on examination. The heterogeneous clinical and neuropathological outcomes associated with TBI are likely reflective of the multifaceted postinjury acute and chronic processes that may contribute to neurodegeneration. Acutely in TBI, axonal injury and disrupted transport influences molecular mechanisms fundamental to the formation of pathological proteins, such as amyloid-β peptide and hyperphosphorylated tau. These protein deposits may develop into amyloid-β plaques, hyperphosphorylated tau-positive neurofibrillary tangles, and dystrophic neurites. These and other characteristic neurodegenerative disease pathologies may then spread across brain regions. The acute immune and neuroinflammatory response involves alteration of microglia, astrocytes, oligodendrocytes, and endothelial cells; release of downstream pro- and anti-inflammatory cytokines and chemokines; and recruitment of peripheral immune cells. Although thought to be neuroprotective and reparative initially, prolongation of these processes may promote neurodegeneration. We review the evidence for TBI as a risk factor for neurodegenerative disorders, including Alzheimer's dementia and Parkinson's disease, in clinical and neuropathological studies. Further, we describe the dynamic interactions between acute response to injury and chronic processes that may be involved in TBI-related pathogenesis and progression of neurodegeneration.
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Affiliation(s)
- Benjamin L. Brett
- Department of Neurosurgery, Medical College of
Wisconsin,Corresponding author: Benjamin L.
Brett, 414-955-7316, , Medical College of
Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226
| | - Raquel C. Gardner
- Department of Neurology, Memory and Aging Center, Weill
Institute for Neurosciences, University of California San Francisco and the San
Francisco Veterans Affairs Medical Center
| | - Jonathan Godbout
- Department of Neuroscience, Chronic Brain Injury Program,
The Ohio State Wexner Medical Center, Columbus, OH
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance,
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York NY
| | - C. Dirk Keene
- Department of Laboratory Medicine and Pathology, University
of Washington School of Medicine, Seattle, WA
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15
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Fox ST, Reid N, Tornvall I, Weerasekera S, Gordon E, Hubbard RE. Anticipating the ageing trajectories of superheroes in the Marvel cinematic universe. BMJ 2021; 375:e068001. [PMID: 34903583 DOI: 10.1136/bmj-2021-068001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Sarah T Fox
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Natasha Reid
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Ida Tornvall
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Shavini Weerasekera
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Emily Gordon
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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16
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Dementia in military and veteran populations: a review of risk factors-traumatic brain injury, post-traumatic stress disorder, deployment, and sleep. Mil Med Res 2021; 8:55. [PMID: 34645526 PMCID: PMC8515715 DOI: 10.1186/s40779-021-00346-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/26/2021] [Indexed: 12/13/2022] Open
Abstract
The military population face a unique set of risk factors that may increase the risk of being diagnosed with dementia. Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) have a higher prevalence in this group in comparison to the civilian population. By delving into the individual relationships between TBI and dementia, and PTSD and dementia, we are able to better explore dementia in the military and veteran populations. While there are some inconsistencies in results, the TBI-dementia association has become more widely accepted. Moderate-to-severe TBI has been found to increase the risk of being diagnosed with Alzheimer's disease. A correlation between PTSD and dementia has been established, however, whether or not it is a causal relationship remains unclear. Factors such as blast, combat and chemical exposure may occur during a deployment, along with TBI and/or PTSD diagnosis, and can impact the risk of dementia. However, there is a lack of literature exploring the direct effects of deployment on dementia risk. Sleep problems have been observed to occur in those following TBI, PTSD and deployment. Poor sleep has been associated with possible dementia risk. Although limited studies have focused on the link between sleep and dementia in military and veteran populations, sleep is a valuable factor to study due to its association and interconnection with other military/veteran factors. This review aims to inform of various risk factors to the cognitive health of military members and veterans: TBI, PTSD, deployment, and sleep.
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