Studies have shown that the presence of acute inflammation during recovery is indicative of poor outcomes after a traumatic brain injury (TBI); however, the role of chronic inflammation in predicting post-TBI-related symptoms remains poorly understood. The purpose of this study was to compare inflammatory biomarkers (tumor necrosis factor [TNF]-α, interleukin [IL]-6, and IL-10) in active duty personnel who either sustained or did not sustain a TBI. Service members were also assessed for post-traumatic stress disorder (PTSD), depression, and quality of life through self-reported measures. IL-6 and TNF-α concentrations were greater in the TBI group than in the control group. Of those with a TBI, IL-6 and TNF-α concentrations were greater in the high-PTSD group than the low-PTSD group. No significant differences were found in IL-10 or the IL-6/IL-10 ratios between those with low and high PTSD. Exploratory factor analysis was conducted to describe the latent structure of variables relating to emotional and physical health (i.e., Short Form 36 subcomponents, etc.) and their relationships within the TBI group with inflammatory cytokines. Four symptom profiles were found, with the third component most relating to PTSD and depression symptoms and high inflammation. This study indicates that the comorbidity of TBI and PTSD is associated with inflammation in a military sample, emphasizing the necessity for intervention in order to mitigate the risks associated with inflammation.
Posttraumatic stress disorder (PTSD) affects many returning combat veterans, but underlying biological mechanisms remain unclear. In order to compare circulating micro RNA (miRNA) of combat veterans with and without PTSD, peripheral blood from 24 subjects was collected following deployment, and isolated miRNA was sequenced. PTSD was associated with 8 differentially expressed miRNA. Pathway analysis shows that PTSD is related to the axon guidance and Wnt signaling pathways, which work together to support neuronal development through regulation of growth cones. PTSD is associated with miRNAs that regulate biological functions including neuronal activities, suggesting that they play a role in PTSD symptomatology.
Background Computer-based interventions have been developed to improve cognitive performance after mild traumatic brain injury, however, a thorough evaluation of this body of research has not been addressed in the literature. Objectives To provide a synthesis and critical review of current research studies that have tested the efficacy of computer-based interventions on cognitive performance after mild traumatic brain injury. Methods A critical review was conducted by identifying relevant studies in the electronic databases PubMed/Medline, PsycInfo and CINAHL from 2011 to the present. Due to the limited number of publications focused exclusively on mild traumatic brain injury, research studies that assessed the impact of computer-based interventions on cognitive outcomes in populations with acquired brain injury were included. Results Of the 58 studies identified, only 10 publications included participants with mild traumatic brain injury. Overall, the identified studies did not use a standard method for assessing the severity of traumatic brain injury, many studies included participants with a wide variety of etiologies for acquired brain injury and used multiple measures of cognitive performance, which made comparisons difficult across studies. In addition to small sample sizes, the study samples were heterogeneous in regard to the number of prior traumatic brain injuries, time elapsed since injury, as well as age and gender distributions. Pre-injury comorbidities that may affect cognitive performance, such as depression, anxiety or learning disabilities, were often not assessed. Discussion There is weak evidence that computer-based interventions can improve working memory and cognitive function in individuals following mild traumatic brain injury. Due to the low-quality evidence, seminal questions remain regarding the optimal format, dosage, timing and duration of computer-based intervention for improving cognitive performance. Future studies should focus on using a strong research design, such as a prospective longitudinal, repeated measures study, with an adequate number of participants that meet mild traumatic brain injury criteria. Pre-injury comorbidities, cognitive reserve, time since injury, age and gender, should be addressed in the design as there may be differences in recovery time and mechanisms of cognitive plasticity among populations. Conclusions Overall, computer-based interventions appear promising as an approach to improve working memory in individuals with acquired brain injury. There is no evidence that currently available interventions are specific to mild traumatic brain injury. Well-designed research studies with adequate sample sizes are needed to assess the effect of computer-based interventions on cognitive performance after mild traumatic brain injury.
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