Current health status and history of traumatic brain injury among Ohio adults

Manchester, Kara; Corrigan, John; Singichetti, Bhavna; Huang, Lihong; Bogner, Jennifer; Yi, Honggang; Yang, Jingzhen

doi:10.1136/injuryprev-2018-043056

Cited by 3 publications

(2 citation statements)

References 36 publications

(54 reference statements)

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“…In one clinical survey, nearly a quarter of participants reported a lifetime history of TBI, which was associated with decreased quality of life (171). Aspects that contributed to this decreased quality of life include disability and lower incomes as well as increased risk of chronic poor health and more days of limited activities.…”

Section: Future Steps In Pre-clinical and Clinical Trauma Researchmentioning

confidence: 99%

A Tilted Axis: Maladaptive Inflammation and HPA Axis Dysfunction Contribute to Consequences of TBI

2019

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Each year approximately 1.7 million people sustain a traumatic brain injury (TBI) in the US alone. Associated with these head injuries is a high prevalence of neuropsychiatric symptoms including irritability, depression, and anxiety. Neuroinflammation, due in part to microglia, can worsen or even cause neuropsychiatric disorders after TBI. For example, mounting evidence demonstrates that microglia become “primed” or hyper-reactive with an exaggerated pro-inflammatory phenotype following multiple immune challenges. Microglial priming occurs after experimental TBI and correlates with the emergence of depressive-like behavior as well as cognitive dysfunction. Critically, immune challenges are various and include illness, aging, and stress. The collective influence of any combination of these immune challenges shapes the neuroimmune environment and the response to TBI. For example, stress reliably induces inflammation and could therefore be a gateway to altered neuropathology and behavioral decline following TBI. Given the increasing incidence of stress-related psychiatric disorders after TBI, the degree in which stress affects outcome is of particular interest. This review aims to highlight the role of the hypothalamic-pituitary-adrenal (HPA) axis as a key mediator of stress-immune pathway communication following TBI. We will first describe maladaptive neuroinflammation after TBI and how stress contributes to inflammation through both anti- and pro-inflammatory mechanisms. Clinical and experimental data describing HPA-axis dysfunction and consequences of altered stress responses after TBI will be discussed. Lastly, we will review common stress models used after TBI that could better elucidate the relationship between HPA axis dysfunction and maladaptive inflammation following TBI. Together, the studies described in this review suggest that HPA axis dysfunction after brain injury is prevalent and contributes to the dynamic nature of the neuroinflammatory response to brain injury. Experimental stressors that directly engage the HPA axis represent important areas for future research to better define the role of stress-immune pathways in mediating outcome following TBI.

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Section: Future Steps In Pre-clinical and Clinical Trauma Researchmentioning

confidence: 99%

A Tilted Axis: Maladaptive Inflammation and HPA Axis Dysfunction Contribute to Consequences of TBI

2019

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“…After discharge from the hospital, medical and social support aimed at preventing eventual delayed negative consequences comes to the fore [16,17]. These interventions include medication therapy and rehabilitation [4].…”

Section: Basic Measures For Tbi Preventionmentioning

confidence: 99%

Prevention of Traumatic Brain Injury in the United States: Significance, New Findings, and Practical Applications

Zvonarev

Rodas²

2020

Cureus

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Traumatic brain injury (TBI) prevention programs aim to reduce trauma-related head injuries across the United States. In addition to epidemiological challenges, patients with TBI have a greater burden of disease and worse health outcomes than the general population. In these circumstances, the prevention of TBI is an important element in reducing the occurrence of post-traumatic health consequences in all settings and beyond. We completed a high-quality overview of TBI prevention programs using the public health approach to identify the most compelling risks to individuals through surveillance, data analysis, and field assessment. We explored the evidence-based programs that are proven to help individuals reduce the risk of TBI. To date, TBI programs have been very efficient, as evidenced by a sustained downturn in TBI incidence. However, recent socioeconomic and epidemiological challenges in the United States are affecting state and local TBI prevention efforts. This article is focused on strategies and solutions to reduce risks and/or consequences associated with head injuries from motor vehicle accidents in New York City. We believe this report is essential to guide the design and implementation of adequate preventive strategies and providing safe and high-quality patient care across all settings where healthcare is delivered.

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Physical and Functional Impairment Among Older Adults With a History of Traumatic Brain Injury

Kornblith

Langa

Yaffe

et al. 2020

Journal of Head Trauma Rehabilitation

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Objectives: To examine the association of lifetime history of traumatic brain injury (TBI) with later-life physical impairment (PI) and functional impairment (FI) and to evaluate the impact of neurobehavioral symptoms that frequently co-occur with TBI on these relations. Participants: A total of 1148 respondents to the 2014 Wave of the Health and Retirement Study, a nationally representative survey of older community-dwelling adults, randomly selected to participate in a TBI exposure survey. They reported no prior TBI (n = 737) or prior TBI (n = 411). Design: Cross-sectional survey study. Main Measures: Physical impairment (self-reported difficulty with ≥1 of 8 physical activities); FI (self-reported difficulty with ≥1 of 11 activities of daily living); self-reported current neurobehavioral symptoms (pain, sleep problems, depression, subjective memory impairment); The Ohio State University TBI Identification Method (OSU-TBI-ID)—short form. Analyses: Stepwise logistic regression models ([1] unadjusted; [2] adjusted for demographics and medical comorbidities; [3] additionally adjusted for neurobehavioral symptoms) compared PI and FI between TBI groups. Results: Traumatic brain injury—exposed (mean: 33.6 years postinjury) respondents were younger, less likely to be female, and reported more comorbidities and neurobehavioral symptoms. Although TBI was significantly associated with increased odds of PI and FI in unadjusted models and models adjusted for demographics/comorbidities (adjusted odds ratio, 95% confidence interval: PI 1.62, 1.21-2.17; FI 1.60, 1.20-2.14), this association was no longer statistically significant after further adjustment for neurobehavioral symptoms. Conclusion: History of TBI is associated with substantial PI and FI among community-dwelling older adults. Further research is warranted to determine whether aggressive management of neurobehavioral symptoms in this population may mitigate long-term PI and FI in this population.

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Current health status and history of traumatic brain injury among Ohio adults

Cited by 3 publications

References 36 publications

A Tilted Axis: Maladaptive Inflammation and HPA Axis Dysfunction Contribute to Consequences of TBI

A Tilted Axis: Maladaptive Inflammation and HPA Axis Dysfunction Contribute to Consequences of TBI

Prevention of Traumatic Brain Injury in the United States: Significance, New Findings, and Practical Applications

Physical and Functional Impairment Among Older Adults With a History of Traumatic Brain Injury

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