Higher Anxiety Symptoms Predict Progressive Hippocampal Atrophy in the Chronic Stages of Moderate to Severe Traumatic Brain Injury

Terpstra, Alex R; Girard, Todd A.; Colella, Brenda; Green, Robin

doi:10.1177/1545968317736817

Cited by 18 publications

(10 citation statements)

References 63 publications

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“…However, there is now extensive evidence that moderate-to-severe TBI is a progressive and deteriorative disorder. Our lab and others have found extensive evidence of progressive lesion expansion, grey and white matter atrophy, and loss of white matter integrity in the months and years following injury [12][13][14][15][16][17][18][19][20][21][22][23]. For example, our group observed significant atrophy from 5 to 20 months post-injury in at least one region of interest in 96% of 56 moderate-to-severe brain injury patients studied [13].…”

Section: Introductionsupporting

confidence: 49%

Prognostic-factors for neurodegeneration in chronic moderate-to-severe traumatic brain injury: a systematic review protocol

et al. 2020

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Background: Traumatic brain injury (TBI) is a leading cause of death and disability. Recently, a paradigm shift in our understanding of moderate-to-severe TBI has led to its reconceptualization as a progressive neurodegenerative disorder. Widespread progressive atrophy is observed in the months and years post-injury, long after the acute effects of the injury have resolved. Some studies have begun to examine prognostic demographic, injury-related, and post-injury risk factors that contribute to these declines. A synthesis of this information, and in particular, an increased understanding of post-injury factors that may be modifiable, would improve our ability to design interventions to reduce neurodegeneration in moderate-to-severe TBI. This systematic review aims to identify prognostic factors for neural deterioration in moderate-to-severe TBI, and thereby inform future intervention research in this population. Methods: This review protocol was informed by and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. Search strategies (designed to identify literature on prognostic factors of neurodegeneration in adults with moderate-to-severe TBI) optimized for MEDLINE, EMBASE PsychINFO, CINAHL, SportDiscus, and Cochrane Central Register of Controlled Trials will be developed with the assistance of a health sciences librarian. Retrieved studies will be screened by two team members. Studies must report on longitudinal neuroimaging (i.e., two or more scans in the same cohort) or neuroimaging in a cross-sectional study and potential prognostic factors for neurodegeneration, such as demographics (e.g., gender, age, education), injury (e.g., severity, etiology), or post-injury characteristics (e.g., type and length of therapy, activity level, mood). Discussion: By identifying prognostic factors for neurodegeneration, this systematic review can help inform injury management, as well as intervention research designed to offset the effects of modifiable prognostic factors, such as low levels of cognitive or physical activity. In turn, this systematic review can increase our understanding of how to improve outcome following moderate-to-severe TBI. Systematic review registration: PROSPERO CRD42019122389

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Section: Introductionsupporting

confidence: 49%

Prognostic-factors for neurodegeneration in chronic moderate-to-severe traumatic brain injury: a systematic review protocol

et al. 2020

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“…This difference of 1.46 years represents a substantial window, possibly presenting a valuable opportunity for early intervention and caregiver planning in this population. Moreover, evidence from moderate‐to‐severe TBI suggests that anxiety might even play an active role in exacerbating risk of degenerative change in the months and years after injury 15 . While neurobiological mechanisms underlying this risk warrant further study, previous work suggests post‐TBI neurodegeneration may be driven by neuroinflammatory processes 16 .…”

Section: Discussionmentioning

confidence: 99%

Traumatic brain injury alters neuropsychiatric symptomatology in all‐cause dementia

Bray

Richey

Bryant

et al. 2021

Alzheimer's & Dementia

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Introduction Traumatic brain injury (TBI) may alter the course of neuropsychiatric symptom (NPS) onset during dementia development. The connection among TBI, NPS, and dementia progression is of increasing interest to researchers and clinicians. Methods Incidence of NPS was examined in participants with normal cognition who progressed to all‐cause dementia based on whether TBI history was present (n = 130) or absent (n = 849). Survival analyses were used to examine NPS incidence across 7.6 ± 3.0 years of follow‐up. Results Participants with TBI history had increased prevalence and incidence of apathy (44.7% vs 29.9%, P = .0062; HRadj. = 1.708, P = .0018) and motor disturbances (17.2% vs 9.5%, P = .0458; HRadj. = 2.023, P = .0168), controlling for demographics and type of dementia diagnosis. Earlier anxiety onset was associated with TBI (692 days prior to dementia diagnosis vs 161 days, P = .0265). Discussion History of TBI is associated with increased risk for and earlier onset of NPS in the trajectory of dementia development.

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“…Anxiety disorders are also typical in post-TBI and CTE patients and include posttraumatic stress disorder, obsessive-compulsive disorder, and generalized anxiety disorder 15,46,[58][59][60] . Chronic anxiety has been specifically associated with brain trauma of the right hemispheric cortical lesions 61 .…”

Section: Behavioral Features From Tbi To Ctementioning

confidence: 99%

Chronic traumatic encephalopathy—a blueprint for the bridge between neurological and psychiatric disorders

Albayram

Mannix

2020

Transl Psychiatry

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Chronic traumatic encephalopathy (CTE) is a perplexing condition characterized by a broad and diverse range of neuropathology and psychopathology. While there are no agreed upon or validated clinical criteria for CTE, case series of CTE have described a wide range of neuropsychiatric symptoms that have been attributed to repetitive traumatic brain injuries (rTBI). However, the direct links between the psychopathology of psychiatric and neurological conditions from rTBI to CTE remains poorly understood. Prior studies suggest that repetitive cerebral injuries are associated with damage to neural circuitry involved in emotional and memory processes, but these studies do not offer longitudinal assessments that prove causation. More recent studies on novel targets, such as transmission of misfolded proteins, as well as newly advanced non-invasive imaging techniques may offer more direct evidence of the pathogenesis of CTE by tracing the progression of pathology and display of related behavioral impairments. Understanding this interface in the context of rTBI can play an important role in future approaches to the definition, assessment, prevention, and treatment of CTE and mental illnesses.

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Higher Anxiety Symptoms Predict Progressive Hippocampal Atrophy in the Chronic Stages of Moderate to Severe Traumatic Brain Injury

Abstract: These novel findings implicate anxiety symptoms as a possible predictor of progressive hippocampal volume loss in the chronic stages of moderate-severe TBI.

Cited by 18 publications

References 63 publications

Prognostic-factors for neurodegeneration in chronic moderate-to-severe traumatic brain injury: a systematic review protocol

Prognostic-factors for neurodegeneration in chronic moderate-to-severe traumatic brain injury: a systematic review protocol

Traumatic brain injury alters neuropsychiatric symptomatology in all‐cause dementia

Chronic traumatic encephalopathy—a blueprint for the bridge between neurological and psychiatric disorders

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