Long-Term Impact of Mild Traumatic Brain Injuries on Multiple Functional Outcomes and Epigenetics: A Pilot Study with College Students

Abstract

People who suffer a mild traumatic brain injury (mTBI) have heterogeneous symptoms and disease trajectories, which make it difficult to precisely assess long-term complications. This pilot study assessed and compared deficits in cognitive, psychosocial, visual functions, and balance performance between college students with and without histories of mTBI. Global DNA methylation ratio (5-mC%) in blood was also compared as a peripheral epigenetic marker. Twenty-five volunteers participated, including 14 healthy controls (64.3% females; mean age of 22.0) and 11 mTBI cases (27.3% females; mean age of 28.7 years) who self-reported mTBI history (63.6% multiple; 2.5 ± 1.29 injuries) with 7.1 years on average elapsed following the last injury. Every participant was assessed for cognitive (executive function, memory, and processing speed), psychological (depression, anxiety, and sleep disturbances), and visual function (by King–Devick and binocular accommodative tests); force-plate postural balance performance; and blood 5-mC% levels. Students with mTBI showed poorer episodic memory, severe anxiety, and higher blood 5-mC% ratio, compared to controls (all p’s < 0.05), which were still significant after adjusting for age. No differences were detected in sleep problems (after adjusting for age), visual function, and postural balance. These findings identified changes in multiple functions and peripheral epigenetics long after mTBI.

Measurement of Human Walking Movements by Using a Mobile Health App: Motion Sensor Data Analysis

“…However, our proposed mHealth app and analysis methods support home-based measurements. The findings of this study support our mHealth app as a low-cost and easy-to-use alternative with minimal equipment required that provides sensitive walking balance assessment [ 6 ].…”

“…Multiple factors such as psychological factors, injury, or disease can affect these components [ 1 ]. Postural balance is commonly used for measurement in healthy and pathological participants and is used for diagnosing disorders related to the nervous system [ 2 ], such as ataxia [ 3 ], cognitive deficits [ 4 - 6 ], Parkinson disease [ 7 , 8 ], vision problems [ 9 ], Alzheimer [ 4 ], and so on. Walking balance is also a good method for measuring human postural balance, as it requires the coordinated use of the visual, vestibular, and musculoskeletal systems [ 10 ].…”

Saliva microRNA Biomarkers of Cumulative Concussion

“…For these acute pathologic processes to yield chronic impairment in brain function, individual neurons, glia, and astrocytes must undergo persistent dysregulation of cellular processes. Epigenetic mechanisms have the ability to alter cellular function in response to an external insult, and have been implicated in the chronic effects of mild traumatic brain injury [ 25 ]. Microribonucleic acids (miRNAs) are small epitranscriptional molecules that are critical to neuronal function [ 26 ], and regulate gene expression in response to traumatic brain injury [ 27 , 28 ].…”

Epigenetic Alterations in Sports-Related Injuries

“…Most knowledge about DNA methylation following TBI has been gained from animal studies. However, Lee et al recently quantified global DNA methylation by specifically measuring ratios of 5-methylcytosine (5-mc) in an enzyme-linked immunosorbent assay [ 246 ]. Blood samples were obtained from 25 volunteer college students, including 14 healthy controls (64.3% females; mean age of 22.0 years) and 11 mild TBI cases (27.3% females; mean age of 28.7 years) who self-reported TBI history (63.6% multiple; 2.5 ± 1.29 injuries), with 7.1 years on average elapsed following the last injury.…”

“…Moreover, 36.4% of traumatic cases were sports-related. The peripheral epigenetic marker comparison finding showed a significantly higher blood global methylation ratio (5-mC%) in mTBI cases than in the controls [ 246 ]. Hamdeh and co-workers have published a preliminary report that provides evidence of an altered DNA methylome in the injured human brain [ 247 ].…”