Mood Disorders After TBI

Jorge, Ricardo E.; Arciniegas, David B.

doi:10.1016/j.psc.2013.11.005

Cited by 109 publications

(64 citation statements)

References 88 publications

(98 reference statements)

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“…Jorge and Arciniegas posit that when a clear temporal association cannot be made, it is best to consider TBI as a treatment-informing comorbidity rather than an etiological factor, and we agree with this position. 9 Additionally, there are many symptoms of TBI per se that are also common in idiopathic psychiatric disorders, such as fatigue, sleep disturbance, changes in appetite, disinhibition, impulsivity, and difficulties with attention and concentration. This overlap can lead to overdiagnosis.…”

Section: Unique Features In Approach To Diagnosismentioning

confidence: 99%

“…1,3 In a more recent review, the one-year frequency of post-TBI depression was estimated to range from 25 to 50%, with a lifetime prevalence of 26 to 64%. 9 The unusually wide range in reported rates of TBI depression may be attributed to differences in sampling and methodology, but the exact impact of these factors on prevalence rates is unknown. 14…”

Section: Ratesmentioning

confidence: 99%

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Neuropsychiatric Disturbances Associated with Traumatic Brain Injury: A Practical Approach to Evaluation and Management

et al. 2015

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Traumatic brain injury (TBI) causes a wide variety of neuropsychiatric disturbances associated with great functional impairments and low quality of life. These disturbances include disorders of mood, behavior, and cognition, and changes in personality. The diagnosis of specific neuropsychiatric disturbances can be difficult because there is significant symptom overlap. Systematic clinical evaluations are necessary to make the diagnosis and formulate a treatment plan that often requires a multipronged approach. Management of TBI-associated neuropsychiatric disorders should always include nonpharmacological interventions, including education, family involvement, supportive and behavioral psychotherapies, and cognitive rehabilitation. Pharmacological treatments include antidepressants, anticonvulsants, antipsychotics, dopaminergic agents, and cholinesterase inhibitors. However, evidence-based treatments are extremely limited, and management relies on clinical empiricism and resemblance of TBI neuropsychiatric symptom profiles with those of idiopathic psychiatric disorders. Although the understanding of TBI-associated neuropsychiatric disorders has improved in the last decade, further research is needed including prospective, longitudinal studies to explore biomarkers that will assist with management and prognosis as well as randomized-controlled studies to validate pharmacological and nonpharmacological treatments. The current review summarizes the available literature in support of a structured, systematic evaluation approach and treatment options as well as recommendations for further research directions.

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Section: Unique Features In Approach To Diagnosismentioning

confidence: 99%

Section: Ratesmentioning

confidence: 99%

Neuropsychiatric Disturbances Associated with Traumatic Brain Injury: A Practical Approach to Evaluation and Management

et al. 2015

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“…We also do not review management of neuropsychiatric disorders following TBI, which are more fully reviewed elsewhere. 17 After a first-level assessment, it is beneficial to carry out a more in-depth assessment with these potential targets in mind. For example, it is worth assessing everyday aspects of neurobehavioral functioning beyond quantitative testing or spontaneous personal complaints.…”

Section: Overall Approach To the Management Of This Casementioning

confidence: 99%

Mild–Moderate TBI: Clinical Recommendations to Optimize Neurobehavioral Functioning, Learning, and Adaptation

Chen

Loya

2014

Semin Neurol

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Traumatic brain injury (TBI) can result in functional deficits that persist long after acute injury. The authors present a case study of an individual who experienced some of the most common debilitating problems that characterize the chronic phase of mild-to-moderate TBI-difficulties with neurobehavioral functions that manifest via complaints of distractibility, poor memory, disorganization, poor frustration tolerance, and feeling easily overwhelmed. They present a rational strategy for management that addresses important domain-general targets likely to have far-ranging benefits. This integrated, longitudinal, and multifaceted approach first addresses approachable targets and provides an important foundation to enhance the success of other, more specific interventions requiring specialty intervention. The overall approach places an emphasis on accomplishing two major categories of clinical objectives: optimizing current functioning and enhancing learning and adaptation to support improvement of functioning in the long-term for individuals living with brain injury.

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“…Since 2000, over 350,000 US service members have been clinically diagnosed with TBI; a total of 23% of 4000 soldiers from a brigade combat team deployed in Iraq were reported to have blast-related TBIs [8]. TBI history is associated with significant comorbidities, including posttraumatic stress disorder [9,10], mood disorders [11], sleep disturbances [12], and increased risk for neurodegenerative diseases such as AD [13] and Parkinson's disease (PD) [14].…”

Section: Introductionmentioning

confidence: 99%

Beneficial association of angiotensin-converting enzyme inhibitors and statins on the occurrence of possible Alzheimer’s disease after traumatic brain injury

Reisman

Morris-Eppolito

et al. 2020

Alz Res Therapy

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Background: Pathological analysis of brain tissue from animals and humans with a history of traumatic brain injury (TBI) suggests that TBI could be one of the risk factors facilitating onset of dementia with possible Alzheimer's disease (AD), but medications to prevent or delay AD onset are not yet available. Methods: This study explores four medication classes (angiotensin-converting enzyme inhibitors (ACEI), beta blockers, metformin, and statins) approved by the Food and Drug Administration (FDA) for other indications and evaluates their influence when used in combination on the risk of possible AD development for patients with a history of TBI. We identified patients with history of TBI from an existing Department of Veterans Affairs (VA) national database. Among 1, 660,151 veterans who used VA services between the ages of 50 to 89 years old, we analyzed 733,920 patients, including 15,450 patients with a history of TBI and 718,470 non-TBI patients. The TBI patients were followed for up to 18.5 years, with an average of 7.7 ± 4.7 years, and onset of dementia with possible AD was recorded based on International Statistical Classification of Diseases (ICD) 9 or 10 codes. The effect of TBI on possible AD development was evaluated by multivariable logistic regression models adjusted by age, gender, race, and other comorbidities. The association of ACEI, beta blockers, metformin, statins, and combinations of these agents over time from the first occurrence of TBI to possible AD onset was assessed using Cox proportional hazard models adjusted for demographics and comorbidities. Results: Veterans with at least two TBI occurrences by claims data were 25% (odds ratio (OR) = 1.25, 95% confidence intervals (CI) (1.13, 1.37)) more likely to develop dementia with possible AD, compared to those with no record of TBI. In multivariable logistic regression models (propensity score weighted or adjusted), veterans taking a combination of ACEI and statins had reduced risk in developing possible AD after suffering TBI, and use of this medication class combination was associated with a longer period between TBI occurring and dementia with possible AD onset, compared to patients who took statins alone or did not take any of the four target drugs after TBI.

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Mood Disorders After TBI

Cited by 109 publications

References 88 publications

Neuropsychiatric Disturbances Associated with Traumatic Brain Injury: A Practical Approach to Evaluation and Management

Neuropsychiatric Disturbances Associated with Traumatic Brain Injury: A Practical Approach to Evaluation and Management

Mild–Moderate TBI: Clinical Recommendations to Optimize Neurobehavioral Functioning, Learning, and Adaptation

Beneficial association of angiotensin-converting enzyme inhibitors and statins on the occurrence of possible Alzheimer’s disease after traumatic brain injury

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