Restoration of aberrant shape of caudate sub-regions associated with cognitive function improvement in mild traumatic brain injury

Purpose This study examined auditory deficits and symptom reporting in individuals with long-term postconcussion symptoms following a single mild traumatic brain injury (mTBI) compared to age- and gender-matched controls without a history of mTBI. Method Case history interviews, symptom questionnaires, and a battery of central auditory and neuropsychological tests were administered to 2 groups. The mTBI group was a civilian population recruited from a local concussion management program who were seeking rehabilitation for postconcussion-related problems in a postacute period between 3 and 18 months following injury. Symptom validity testing was included to assess the rate of possible insufficient test effort and its influence on scores for all outcome measures. Analyses of group differences in test scores were performed both with and without the participants who showed insufficient test effort. Rates of symptom reporting, correlations among symptoms and behavioral test outcomes, and the relationships between auditory and cognitive test performance were analyzed. Results The mTBI group reported a high rate of auditory symptoms and general postconcussion symptoms. Performance on neuropsychological tests of cognitive function showed some differences in raw scores between groups, but when effort was considered, there were no significant differences in the rate of abnormal performance between groups. In contrast, there were significant differences in both raw scores and the rate of abnormal performance between groups for some auditory tests when only considering participants with sufficient effort. Auditory symptoms were strongly correlated with other general postconcussion symptoms. Conclusions Significant auditory symptoms and evidence of long-term central auditory dysfunction were found in a subset of individuals who had chronic postconcussion symptoms after a single mTBI unrelated to blast trauma. The rate of abnormal performance on auditory behavioral tests exceeded the rate of abnormal performance on tests of cognitive function. Supplemental Material https://doi.org/10.23641/asha.8329955

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Social support buffers against cognitive decline in single mild traumatic brain injury with loss of consciousness: Results from the Canadian Longitudinal Study on Aging

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa213 ◽

2020 ◽

Author(s):

Marc Bedard ◽

Vanessa Taler

Keyword(s):

Social Support ◽

Traumatic Brain Injury ◽

Longitudinal Study ◽

Brain Injury ◽

Cognitive Function ◽

Cognitive Decline ◽

Mild Traumatic Brain Injury ◽

Loss Of Consciousness ◽

Initial Examination

Abstract Objectives We investigated rates of cognitive decline at three-year follow-up from initial examination in people reporting mild traumatic brain injury (mTBI) with loss of consciousness (LOC) more than a year prior to initial examination. We examined the role of social support as predictors of preserved cognitive function in this sample. Method Analyses were conducted on 440 participants who had self-reported LOC of < 1 min, 350 with LOC of 1-20 min, and 10,712 healthy controls, taken from the Canadian Longitudinal Study on Aging (CLSA), a nationwide study on health and aging. Results People who reported at baseline that they had experienced mTBI with LOC of 1-20 min more than a year prior were 60% more likely to have experienced global cognitive decline than controls at three-year follow-up. Cognitive decline was most apparent on measures of executive functioning. Logistic regression identified increased social support as predictors of relatively preserved cognitive function. Discussion mTBI with longer time spent unconscious (i.e., LOC 1-20 min) is associated with greater cognitive decline years after the head injury. Perceived social support, particularly emotional support may help buffer against this cognitive decline.

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Interval-censored survival analysis of mild traumatic brain injury with outcome based neuroimaging clinical applications

Journal of Concussion ◽

10.1177/2059700220947194 ◽

2020 ◽

Vol 4 ◽

pp. 205970022094719

Author(s):

Cheryl Vanier ◽

Trisha Pandey ◽

Shaunaq Parikh ◽

Alan Rodriguez ◽

Thomas Knoblauch ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Function ◽

Mild Traumatic Brain Injury ◽

Cognitive Deficits ◽

Clinical Presentation ◽

Emotional Lability ◽

Symptom Presentation ◽

Interval Censored ◽

Balance Problems

Objective The purpose of this study was to assess the relationship between MRI findings and clinical presentation and outcomes in patients following mild traumatic brain injury (mTBI). We hypothesize that imaging findings other than hemorrhages and contusions may be used to predict symptom presentation and longevity following mTBI. Methods Patients (n = 250) diagnosed with mTBI and in litigation for brain injury underwent 3T magnetic resonance imaging (MRI). A retrospective chart review was performed to assess symptom presentation and improvement/resolution. To account for variable times of clinical presentation, nonuniform follow-up, and uncertainty in the dates of symptom resolution, a right censored, interval censored statistical analysis was performed. Incidence and resolution of headache, balance, cognitive deficit, fatigue, anxiety, depression, and emotional lability were compared among patients. Image findings analyzed included white matter hyperintensities (WMH), Diffusion Tensor Imaging (DTI) fractional anisotropy (FA) values, MR perfusion, auditory functional MRI (fMRI) activation, hippocampal atrophy (HA) and hippocampal asymmetry as defined by NeuroQuant ® volumetric software. Results Patients who reported LOC were significantly more likely to present with balance problems (p < 0.001), cognitive deficits (p = 0.010), fatigue (p = 0.025), depression (p = 0.002), and emotional lability (p = 0.002). Patients with LOC also demonstrated significantly slower recovery of cognitive function than those who did not lose consciousness (p = 0.044). Patients over the age of 40 had significantly higher odds of presenting with balance problems (p = 0.006). Additionally, these older patients were slower to recover cognitive function (p = 0.001) and less likely to experience improvement of headaches (p = 0.007). Abnormal MRI did not correlate significantly with symptom presentation, but was a strong indicator of symptom progression, with slower recovery of balance (p = 0.009) and cognitive deficits (p < 0.001). Conclusion This analysis demonstrates the utility of clinical data analysis using interval-censored survival statistical technique in head trauma patients. Strong statistical associations between neuroimaging findings and aggregate clinical outcomes were identified in patients with mTBI.

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