Environmental enrichment may protect against hippocampal atrophy in the chronic stages of traumatic brain injury

Abstract

Objective: To examine the relationship between environmental enrichment (EE) and hippocampal atrophy in the chronic stages of moderate to severe traumatic brain injury (TBI).Design: Retrospective analysis of prospectively collected data; observational, within-subjects.Participants: Patients (N = 25) with moderate to severe TBI.Measures: Primary predictors: (1) An aggregate of self-report rating of EE (comprising hours of cognitive, physical, and social activities) at 5 months post-injury; (2) pre-injury years of education as a proxy for pre-morbid EE (or cognitive reserve). Primary outcome: bilateral hippocampal volume change from 5 to 28 months post-injury.Results: As predicted, self-reported EE was significantly negatively correlated with bilateral hippocampal atrophy (p < 0.05), with greater EE associated with less atrophy from 5 to 28 months. Contrary to prediction, years of education (a proxy for cognitive reserve) was not significantly associated with atrophy.Conclusion: Post-injury EE may serve as a buffer against hippocampal atrophy in the chronic stages of moderate-severe TBI. Clinical application of EE should be considered for optimal maintenance of neurological functioning in the chronic stages of moderate-severe TBI.

Environmental enrichment and the sensory brain: the role of enrichment in remediating brain injury

“…Additionally, Miller et al (2013) have also recently demonstrated a decrease in hippocampal volume loss in TBI patients, with increased engagement with cognitively, physically and socially demanding activities, supporting the role of EE in directly preventing neuronal death.…”

Social cure and social curse: Social identity resources and adjustment to acquired brain injury

“…Families were the site of social enrichment, facilitating engagement with services and transport to and from important health care and rehabilitation activities (Miller, Colella, & Green, 2013). Postinjury adjustment is driven by social identity processes that can cut both ways.…”

Enriched Environment and Effects on Neuropathic Pain: Experimental Findings and Mechanisms

“…On the other hand, recent clinical research has demonstrated the efficacy of EE in promoting neurorehabilitation, such as in stroke and traumatic brain injury (TBI) patients . Of note, neuropathic pain is prevalent after stroke and TBI .…”

“…More importantly, a clinical magnetic resonance imaging (MRI) study revealed that EE could prevent bilateral hippocampal atrophy in patients for up to 28 months post‐TBI, with cognitive activity variations playing the dominant role in eliciting the neuroanatomical changes . Meanwhile, hippocampal shrinkage was recognized as an intriguing feature that appeared specific to neuropathic pain.…”

“…On the other hand, recent clinical research has demonstrated the efficacy of EE in promoting neurorehabilitation, such as in stroke [119][120][121][122] and traumatic brain injury (TBI) patients. 51,123 Of note, neuropathic pain is prevalent after stroke 103 and TBI. 124 Similar to chronic pain, cognitive decline, depression, and other affective disorders commonly emerge in these patients 71,125,126 and may share common neurological mechanisms.…”