Early versus Late Profiles of Inflammatory Cytokines after Mild Traumatic Brain Injury and Their Association with Neuropsychological Outcomes

Both mild traumatic brain injuries (mTBI) and systemic injuries trigger a transient neuroinflammatory response that result in similar clinical outcome. The ensuing physical, cognitive, and emotional symptoms fail to subside in approximately 15–20% of the concussed population. Emotional impairments, particularly depression, anxiety, and post-traumatic stress disorder (PTSD), are commonly associated with poor recovery following mTBI. These emotional impairments also have a significant neuroinflammatory component. We hypothesized that the inflammatory cytokines seen in mTBI patients with emotional symptoms would coincide with those commonly seen in patients with emotional symptoms without mTBI. A systematic review was conducted to identify the most common neuroinflammatory cytokines in the mTBI population with psychological symptoms (depression, anxiety, PTSD). The electronic databases EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, and PSYCINFO were searched from data inception to 31 August 2021. A systematic screening approach was employed from screening to data analysis. A total of 994 articles were screened, 108 were selected for full article review, and 8 were selected for data analysis. The included studies consisted of 875 patients of which 81.3% were male. The mean sample size of patients with at least one mTBI was 73.8 ± 70.3 (range, 9–213), with a mean age of 33.9 ± 4.8 years. The most common cytokines associated with poor psychological outcomes involving PTSD and/or depression in the chronic mTBI population were IL-6, TNFα, IL-10, and CRP.

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“…Five of the eight included studies assessed IL-6 levels within the mTBI population ( Table 1 ) [ 26 , 34 , 37 , 38 , 39 ].…”

Section: Resultsmentioning

confidence: 99%

Correlation between Mild Traumatic Brain Injury-Induced Inflammatory Cytokines and Emotional Symptom Traits: A Systematic Review

et al. 2022

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“…The brain's immune response to mild TBI is also evident in the blood, as elevated c-reactive protein (CRP) levels at admission are independently associated with the increased risk of persistent psychological problems and cognitive impairment ( 29 ). Plasma interleukin (IL)-2 and IL-6 levels are also significantly higher for mild TBI patients compared with orthopedic injury controls, indicating a brain-specific injury initiated an immune response that is present in the periphery ( 126 ). Elevated IL-2, 24 h after injury, is associated more severe early post-concussive symptoms, while elevated plasma IL-10 level at 6 months is associated with more severe posttraumatic stress disorder (PTSD) and mood scores ( 126 ).…”

Section: The Immune Response To Mild Tbimentioning

confidence: 99%

“…Plasma interleukin (IL)-2 and IL-6 levels are also significantly higher for mild TBI patients compared with orthopedic injury controls, indicating a brain-specific injury initiated an immune response that is present in the periphery ( 126 ). Elevated IL-2, 24 h after injury, is associated more severe early post-concussive symptoms, while elevated plasma IL-10 level at 6 months is associated with more severe posttraumatic stress disorder (PTSD) and mood scores ( 126 ). Overall plasma levels of IL-1ß, IL-4, IL-6, and IFN-γ are reduced at 6 months compared to acute levels, indicating a subsiding of inflammation caused by the initial injury.…”

Section: The Immune Response To Mild Tbimentioning

confidence: 99%

The Immune System's Role in the Consequences of Mild Traumatic Brain Injury (Concussion)

2021

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Mild traumatic brain injury (mild TBI), often referred to as concussion, is the most common form of TBI and affects millions of people each year. A history of mild TBI increases the risk of developing emotional and neurocognitive disorders later in life that can impact on day to day living. These include anxiety and depression, as well as neurodegenerative conditions such as chronic traumatic encephalopathy (CTE) and Alzheimer's disease (AD). Actions of brain resident or peripherally recruited immune cells are proposed to be key regulators across these diseases and mood disorders. Here, we will assess the impact of mild TBI on brain and patient health, and evaluate the recent evidence for immune cell involvement in its pathogenesis.

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“…There is strong evidence to support that concussion involves a sterile inflammation of the brain [106], as indicated by elevated levels of plasma cytokines in patients. Notably, elevated inflammatory markers are seen in patients with migraine as well [107], raising the question of whether the two conditions may perpetuate each other.…”

Section: 14immunologicmentioning

confidence: 99%

From Provider to Advocate: The Complexities of Mild Traumatic Brain Injury Prompt the Evolution of Provider Engagement

Singman¹

2021

Preprint

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Treating a patient with traumatic brain injury requires an interdisciplinary approach because of the pervasive, profound and protean manifestations of this condition. In this review, key aspects of the medical history and review of systems will be described in order to highlight how the role of any provider must evolve to become a better patient advocate. Although this review is written from the vantage point of a vision care provider, it is hoped that patients, caregivers and providers will recognize the need for the team approach; it truly takes a village.

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Early versus Late Profiles of Inflammatory Cytokines after Mild Traumatic Brain Injury and Their Association with Neuropsychological Outcomes

Cited by 55 publications

References 47 publications

Correlation between Mild Traumatic Brain Injury-Induced Inflammatory Cytokines and Emotional Symptom Traits: A Systematic Review

Correlation between Mild Traumatic Brain Injury-Induced Inflammatory Cytokines and Emotional Symptom Traits: A Systematic Review

The Immune System's Role in the Consequences of Mild Traumatic Brain Injury (Concussion)

From Provider to Advocate: The Complexities of Mild Traumatic Brain Injury Prompt the Evolution of Provider Engagement

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