Changes in weight after traumatic brain injury in adult patients: A longitudinal study

Crenn, Pascal; Hamchaoui, Sabrina; Bourget-Massari, Aliette; Hanachi, Mouna; Melchior, Jean‐Claude; Azouvi, Philippe

doi:10.1016/j.clnu.2013.06.003

Cited by 46 publications

(27 citation statements)

References 23 publications

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“…In a prospective study assessing functional outcome in patients with TBI, 32% presented hypothyroidism at 3months postinjury (62). This parallels a longitudinal follow-up of adults with TBI showed over a median period of 38months, 42% of TBI patients had gained weight (65). In the current study, brain-injured rats lost weight immediately following injury, but had an overall significant increase in weight at 58 DPI compared with uninjured shams.…”

Section: Discussionsupporting

confidence: 75%

Diffuse traumatic brain injury affects chronic corticosterone function in the rat

Rowe

Rumney

May

et al. 2016

Endocrine Connections

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As many as 20–55% of patients with a history of traumatic brain injury (TBI) experience chronic endocrine dysfunction, leading to impaired quality of life, impaired rehabilitation efforts and lowered life expectancy. Endocrine dysfunction after TBI is thought to result from acceleration–deceleration forces to the brain within the skull, creating enduring hypothalamic and pituitary neuropathology, and subsequent hypothalamic–pituitary endocrine (HPE) dysfunction. These experiments were designed to test the hypothesis that a single diffuse TBI results in chronic dysfunction of corticosterone (CORT), a glucocorticoid released in response to stress and testosterone. We used a rodent model of diffuse TBI induced by midline fluid percussion injury (mFPI). At 2months postinjury compared with uninjured control animals, circulating levels of CORT were evaluated at rest, under restraint stress and in response to dexamethasone, a synthetic glucocorticoid commonly used to test HPE axis regulation. Testosterone was evaluated at rest. Further, we assessed changes in injury-induced neuron morphology (Golgi stain), neuropathology (silver stain) and activated astrocytes (GFAP) in the paraventricular nucleus (PVN) of the hypothalamus. Resting plasma CORT levels were decreased at 2months postinjury and there was a blunted CORT increase in response to restraint induced stress. No changes in testosterone were measured. These changes in CORT were observed concomitantly with altered complexity of neuron processes in the PVN over time, devoid of neuropathology or astrocytosis. Results provide evidence that a single moderate diffuse TBI leads to changes in CORT function, which can contribute to the persistence of symptoms related to endocrine dysfunction. Future experiments aim to evaluate additional HP-related hormones and endocrine circuit pathology following diffuse TBI.

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Section: Discussionsupporting

confidence: 75%

Diffuse traumatic brain injury affects chronic corticosterone function in the rat

Rowe

Rumney

May

et al. 2016

Endocrine Connections

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“…The decrease of underweight from admission to discharge is in line with previous reports (Aadal et al, 2015; Crenn et al, 2014) and may indicate sufficient nutritional nursing care during subacute neurorehabilitation. As such, the number of underweight individuals at discharge from subacute rehabilitation has potential as a nursing‐sensitive indicator that monitors the nutritional nursing care during subacute rehabilitation.…”

Section: Discussionsupporting

confidence: 90%

“…However, despite the focus on nutritional support individuals with severe TBI generally lose weight during acute care (Aadal, Mortensen, & Nielsen, 2015; Crenn et al, 2014; Krakau et al, 2007) resulting in some individuals being underweight at admission to subacute rehabilitation. As such, underweight at admission ranges from 9% in the USA (Le et al, 2015) to 28% in a European country (Sweden) (Krakau et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, although lack of weight regain after TBI may be considered a problem (Aadal et al, 2015; Krakau et al, 2007), it is not desirable that the postinjury weight increase result in overweight or obesity. However, compared to the preinjury weight, 42% of TBI survivors in a French study gained weight after the injury achieving a mean BMI of over 25 kg/m 2 (Crenn et al, 2014). No study has reported estimates of the prevalence of overweight and obesity after TBI in Europe; however, the prevalence in the USA has been reported to be 40% at admission to subacute rehabilitation (Le et al, 2015) and 55% at 1 year postinjury (Dreer et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Using clinical quality databases to monitor the quality of fundamental care: Example with weight status after severe traumatic brain injury

Odgaard

Aadal

Eskildsen

et al. 2020

Journal of Clinical Nursing

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Aims and objectives:To determine weight status and risk of overweight up to 1 year after severe traumatic brain injury (TBI) as basis for defining nursing-sensitive indicators of fundamental nutritional nursing care in a clinical quality database.Background: Patients' nutritional needs are recognised as fundamental care during hospitalisation, but less attention has been given to nutritional status after discharge.Design: Nationwide cohort study. The STROBE checklist was used to ensure reporting quality. Methods: Data were retrieved from the Danish Head Trauma Database, a clinical quality database aiming at improving the quality of neurorehabilitation. Individuals aged ≥ 15 years with severe TBI 2011-2015 (N = 424) were included. Normal weight, underweight and overweight were described according to the body mass index (BMI) at admission to subacute rehabilitation, at discharge and at 1 year postinjury. The probability of transition between weight groups from admission to 1 year postinjury was calculated. Multivariable binominal regression analyses compared risk of overweight between age groups. Results: The prevalence of underweight decreased from 13% at admission to 6% and 3% at discharge and 1 year postinjury, respectively. The prevalence of overweight was stable at 26%-27% at admission and discharge and increased to 44% at 1 year postinjury. Of the individuals not overweight at admission, 28% became overweight by 1 year postinjury. Overweight was significantly more prevalent in older compared to younger individuals. The risk of becoming overweight among those not overweight at admission did not differ between age groups. Conclusion: Underweight individuals achieved normal weight during inpatient rehabilitation. By 1 year postinjury, individuals were increasingly overweight. Relevance to clinical practice: Weight status has potential as nursing-sensitive indicators that may be included in clinical quality databases to inform the organisational and policy level on the state of fundamental nutritional nursing care. The inclusion emphasise requested responsibilities of nursing care. This facilitates health economic attention and influences nursing professional execution.

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“…Additionally, our sample of older adolescents represents an age group with increased susceptibility for traumatic brain injury (TBI; Faul, Xu, Wald, & Coronado, 2010). Research suggests that not only are individuals with obesity at risk for greater severity of TBI (Tagliaferri, Compagnone, Yoganandan, & Gennarelli, 2009), but that nearly half of individuals with TBI demonstrate weight gain following the injury (Crenn et al, 2014). Incorporating findings from this study into practice, the neuropsychologist should be attentive to the role that sleep quality may play in the cognition of patients with obesity, with the understanding that poor sleep quality may be a contributor to an individual’s cognitive profile and that recommendations for improving sleep may be of particular importance for these patients.…”

Section: Discussionmentioning

confidence: 99%

Body Mass Index Moderates the Association between Sleep Quality and Vigilance on a Test of Inhibitory Control

Galioto

Lechner

Meister

et al. 2015

The Clinical Neuropsychologist

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Objective Sleep problems are common among college students and related to numerous adverse outcomes including impaired cognitive performance. Obesity may confer an elevated risk of cognitive deficits with poor sleep given its relationship with poorer sleep quality and impaired cognition. This study examined whether the relationship between reduced sleep quality and poorer vigilance and inhibitory control were moderated by elevated body mass index (BMI). Method Participants were 85 college students who completed a computerized task of inhibitory control that required vigilance (go/no-go [GNG] task) and the Pittsburgh Sleep Quality Index, a measure of sleep quality. Results Poor sleep quality was observed in 63.5% of the sample and was related to more omission errors on the GNG task and increased BMI. Results further revealed that BMI moderated the relationship between sleep quality and performance on the GNG task such that individuals in the severely obese range of BMI had more omission errors with poorer sleep quality, while there was no association between sleep and GNG performance among normal weight and overweight individuals. Conclusions These findings highlight the likely contribution of obesity to decreased vigilance with poor sleep. Future research is needed to confirm these findings using objective measures of sleep quality (e.g., actigraphy, polysomnography).

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Changes in weight after traumatic brain injury in adult patients: A longitudinal study

Cited by 46 publications

References 23 publications

Diffuse traumatic brain injury affects chronic corticosterone function in the rat

Diffuse traumatic brain injury affects chronic corticosterone function in the rat

Using clinical quality databases to monitor the quality of fundamental care: Example with weight status after severe traumatic brain injury

Body Mass Index Moderates the Association between Sleep Quality and Vigilance on a Test of Inhibitory Control

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