Prevalence, Risk Factors, and Correlates of Anxiety at 1 Year After Moderate to Severe Traumatic Brain Injury

Hart, Tessa; Fann, Jesse R.; Chervoneva, Inna; Juengst, Shannon B.; Rosenthal, Joseph; Krellman, Jason W.; Dreer, Laura E.; Kroenke, Kurt

doi:10.1016/j.apmr.2015.08.436

Cited by 53 publications

(42 citation statements)

References 48 publications

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“…It has been well studied that after moderate and severe TBI, children from lower-SES families develop more behavioral and social problems, with lower achievement than their advantaged counterparts. 6,13,[24][25][26] SES has previously been defined in many ways. One study used a Socioeconomic Composite Index composed of annual family income, social resources, and maternal education, 25 similar to our study.…”

Section: Discussionmentioning

confidence: 99%

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Socioeconomic status and outcomes after sport-related concussion: a preliminary investigation

Zuckerman

Zalneraitis

Totten

et al. 2017

PED

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OBJECTIVEA significant proportion of patients experience long-term symptoms after sport-related concussion (SRC), and several factors have been associated with this protracted recovery. Limited data exist on the role of socioeconomic status (SES) on SRC outcomes. The objective in this study was to conduct a preliminary investigation to determine the effect of SES on outcomes after SRC in student-athletes treated at a regional sports concussion center.METHODSA retrospective cohort study of 282 middle school, high school, and collegiate student-athletes was conducted. An attempt was made to contact all patients seen at a comprehensive SRC center between January 2012 and May 2015 for in-depth interviews. Subsequent demographic data were collected. The SES was defined as follows: cost of living percentile, median income percentile, percentage of college graduates, percentage of homeowners, county type, and insurance status. Outcomes after SRC were defined as follows: days of symptom duration, days of missed school, and days of missed practice. Statistically controlled covariates included sex, race, age, body mass index, concussion history, neuropsychiatric history, and type of sport.RESULTSA total of 282 student-athletes consented and were studied. The median age was 15.8 years (range 11.6–22.2 years) and 61.4% of student-athletes were male. A previous concussion was incurred by 34.0% of student-athletes. Football was the most common sport (32.3%), followed by soccer (16.3%), and basketball (15.6%). The median symptom duration was 21 days (range 1–365 days); the median missed school days was 2 (range 0–90 days); and median for days of missed practice was 10 (range 0–150 days). After multivariate Cox regression analysis, no relationship between any of the 6 SES variables and symptom duration or missed practice was seen. However, individuals with private insurance had more missed days of school than those with public insurance (hazard ratio 0.46, 95% CI 0.26–0.83, p = 0.009).CONCLUSIONSIn a preliminary study of middle school, high school, and collegiate student-athletes, SES had no impact on the outcomes of symptom duration and missed practice. However, for individuals with private insurance, the return to school was slower than for those with public insurance. This pilot study reveals the complex relationship between SES and SRC recovery, which demands further study with more accurate and validated assessments of SES.

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Section: Discussionmentioning

confidence: 99%

“…Socioeconomic status has been studied mostly in moderate and severe traumatic brain injury (TBI), in which lower SES has been generally associated with worse social outcomes, 6,32 although the literature is mixed. 24 In one of the few studies specific to mild TBI (mTBI), lower SES significantly predicted a poor cognitive outcome at 3 months postinjury.…”

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confidence: 99%

Socioeconomic status and outcomes after sport-related concussion: a preliminary investigation

Zuckerman

Zalneraitis

Totten

et al. 2017

PED

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“…Compounding this problem is the lack of FDA-approved treatments for acute injury, consequentially driving long-term costs due to the chronic effects of TBI. These chronic effects can include epileptogenesis, cognitive deficits, and neuropsychiatric conditions (McIntosh et al, 1996;Bombardier et al, 2010;Hart et al, 2011Hart et al, , 2016.…”

Section: Introductionmentioning

confidence: 99%

Contributions of Interleukin-1 Receptor Signaling in Traumatic Brain Injury

Thome

Reeder

Collins

et al. 2020

Front. Behav. Neurosci.

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Traumatic brain injury (TBI) in various forms affects millions in the United States annually. There are currently no FDA-approved therapies for acute injury or the chronic comorbidities associated with TBI. Acute phases of TBI are characterized by profound neuroinflammation, a process that stimulates the generation and release of proinflammatory cytokines including interleukin-1α (IL-1α) and IL-1β. Both forms of IL-1 initiate signaling by binding with IL-1 receptor type 1 (IL-1R1), a receptor with a natural, endogenous antagonist dubbed IL-1 receptor antagonist (IL-1Ra). The recombinant form of IL-1Ra has gained FDA approval for inflammatory conditions such as rheumatoid arthritis, prompting interest in repurposing these pharmacotherapies for other inflammatory diseases/injury states including TBI. This review summarizes the currently available preclinical and clinical literature regarding the therapeutic potential of inhibiting IL-1-mediated signaling in the context of TBI. Additionally, we propose specific research areas that would provide a greater understanding of the role of IL-1 signaling in TBI and how these data may be beneficial for the development of IL-1-targeted therapies, ushering in the first FDA-approved pharmacotherapy for acute TBI.

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“…The highest risk for MDD occurs within the first year following injury, where over half of individuals who sustain a complicated mild to severe TBI experience MDD. 1 MDD is significantly associated with comorbid anxiety 2 and substance abuse 1 and decreased quality of life. 1,3 Despite the high rate of MDD and associated adverse outcomes during this post-acute period, less than half of those with MDD receive any medication or psychotherapeutic treatment for their depression.…”

Section: Introductionmentioning

confidence: 99%

Sertraline for Major Depression During the Year Following Traumatic Brain Injury: A Randomized Controlled Trial

Fann

Bombardier

Temkin

et al. 2017

Journal of Head Trauma Rehabilitation

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Objective Major depressive disorder (MDD) is common and associated with impaired functioning after traumatic brain injury (TBI). Few placebo-controlled antidepressant trials exist in this population. We evaluated the efficacy and tolerability of sertraline for MDD within one year of sustaining a TBI. Setting Level I trauma center. Participants Adults with MDD within one year of hospitalization for complicated mild to severe TBI. Design Randomized, double-blind, placebo-controlled trial. Main Measures 12-week treatment response on 17-item Hamilton Depression Rating Scale. We also assessed symptom improvement and remission. Results We randomized 62 participants: 32% sustained a severe TBI, 68% had significant anxiety, 63% had history of prior MDD, 69% had history of alcohol or drug dependence. Depression significantly improved from baseline to 12 weeks in both treatment groups (P<.001). There were no significant differences between the sertraline and placebo groups over 12 weeks on depression severity, response or remission. The sertraline group had significant improvement on speed of information processing compared to the placebo group (P<.006). Conclusion Sertraline monotherapy was not superior to placebo for MDD in people with post-acute complicated mild to severe TBI. Research is needed on the effectiveness of interventions that also address the significant psychosocial needs of this population.

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Prevalence, Risk Factors, and Correlates of Anxiety at 1 Year After Moderate to Severe Traumatic Brain Injury

Cited by 53 publications

References 48 publications

Socioeconomic status and outcomes after sport-related concussion: a preliminary investigation

Socioeconomic status and outcomes after sport-related concussion: a preliminary investigation

Contributions of Interleukin-1 Receptor Signaling in Traumatic Brain Injury

Sertraline for Major Depression During the Year Following Traumatic Brain Injury: A Randomized Controlled Trial

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