scholarly journals Psychotropic and pain medication use in individuals with traumatic brain injury—a Swedish total population cohort study of 240 000 persons

2021 ◽  
Vol 92 (5) ◽  
pp. 519-527
Author(s):  
Yasmina Molero ◽  
David James Sharp ◽  
Brian Matthew D'Onofrio ◽  
Henrik Larsson ◽  
Seena Fazel
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Total Population ◽  
Medication Use ◽  
Population Based ◽  
Pain Medication ◽  
Short Term ◽  
Pain Medications ◽  
Before And After

ObjectiveTo examine psychotropic and pain medication use in a population-based cohort of individuals with traumatic brain injury (TBI), and compare them with controls from similar backgrounds.MethodsWe assessed Swedish nationwide registers to include all individuals diagnosed with incident TBI between 2006 and 2012 in hospitals or specialist outpatient care. Full siblings never diagnosed with TBI acted as controls. We examined dispensed prescriptions for psychotropic and pain medications for the 12 months before and after the TBI.ResultsWe identified 239 425 individuals with incident TBI, and 199 658 unaffected sibling controls. In the TBI cohort, 36.6% had collected at least one prescription for a psychotropic or pain medication in the 12 months before the TBI. In the 12 months after, medication use increased to 45.0%, an absolute rate increase of 8.4% (p<0.001). The largest post-TBI increases were found for opioids (from 16.3% to 21.6%, p<0.001), and non-opioid pain medications (from 20.3% to 26.6%, p<0.001). The majority of prescriptions were short-term; 20.6% of those prescribed opioids and 37.3% of those with benzodiazepines collected prescriptions for more than 6 months. Increased odds of any psychotropic or pain medication were associated with individuals before (OR: 1.62, 95% CI: 1.59 to 1.65), and after the TBI (OR: 2.30, 95% CI: 2.26 to 2.34) as compared with sibling controls, and ORs were consistently increased for all medication classes.ConclusionHigh rates of psychotropic and pain medications after a TBI suggest that medical follow-up should be routine and review medication use.

Traumatic brain injury: Designing and implementing a population-based follow-up system

1997 ◽  
Vol 78 (8) ◽  
pp. S26-S30 ◽  
Author(s):  
Cynthia A. Brooks ◽  
Barbara Gabella ◽  
Richard Hoffman ◽  
Dan Sosin ◽  
Gale Whiteneck
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Population Based

scholarly journals Change in Headache Suffering and Predictors of Headache after Mild Traumatic Brain Injury: A Population-Based, Controlled, Longitudinal Study with Twelve-Month Follow-Up

2019 ◽  
Vol 36 (23) ◽  
pp. 3244-3252 ◽  
Author(s):  
Lena H. Nordhaug ◽  
Mattias Linde ◽  
Turid Follestad ◽  
Øystein Njølstad Skandsen ◽  
Vera Vik Bjarkø ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Longitudinal Study ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Population Based

scholarly journals Use of general practice before and after mild traumatic brain injury: a nationwide population-based cohort study in Denmark

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017735 ◽  
Author(s):  
Stine Fjendbo Galili ◽  
Bodil Hammer Bech ◽  
Claus Vestergaard ◽  
Morten Fenger-Gron ◽  
Jakob Christensen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
General Practice ◽  
Cohort Study ◽  
Brain Injury ◽  
Population Based ◽  
First Year ◽  
Blurred Vision ◽  
Lower Socioeconomic ◽  
Before And After ◽  
N 93

ObjectivesTraumatic brain injury (TBI) is commonly seen in the emergency department (ED). Approximately 85%–90% of TBIs are mild (mTBI). Some cause symptoms such as headache, dizziness, anxiety, blurred vision, insomnia and concentration difficulties, collectively known as postconcussion syndrome (PCS). Some studies suggest that recovery from mTBI is complete. Others find that symptoms persist for months, even years. The aim of this study was to describe the use of general practice, before and after mTBI, as a proxy for symptoms in a large cohort.DesignNationwide population-based matched cohort study.SettingDanish EDs and general practice.ParticipantsAll patients (aged ≥18 years), first-time diagnosed with mTBI in a Danish ED between 1 January 1998 and 31 December 2010 (n=93 517). Ten reference persons per patient with mTBI were randomly matched on gender, age and general practice (n=935 170).Primary outcomeOverall use of general practice; consultations relating to mental and physical health.ResultsWe found higher use of general practice during the first year after mTBI for all ages, both genders and all types of contacts. Age 18–40 years: women, incidence rate ratio (IRR) 1.59 (95% CI 1.57 to 1.61); men, IRR 1.82 (95% CI 1.80 to 1.85). Age 41–65 years: women, IRR 1.75 (95% CI 1.72 to 1.78); men, IRR 1.85(95% CI 1.82 to 1.89). Age 66+ years: women, IRR 1.55 (95% CI 1.52 to 1.58); men, IRR 1.55 (95% CI 1.51 to 1.59). After the first year, the use decreased to the level before mTBI. Individuals with mTBI and higher use of general practice before mTBI had lower socioeconomic status and more comorbidities (P<0.001).ConclusionsThe use of general practice was higher in the first year after mTBI, specifically in the first 3 months. Patients with mTBI had different healthcare-seeking behaviour several years before diagnosis than their matched reference persons. Pretraumatic morbidity should be considered in the evaluation of PCS.

scholarly journals Cortical re-organization after traumatic brain injury elicited using functional electrical stimulation therapy: A case report

2020 ◽  
Author(s):  
Matija Milosevic ◽  
Tomoya Nakanishi ◽  
Atsushi Sasaki ◽  
Akiko Yamaguchi ◽  
Milos R. Popovic ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Electrical Stimulation ◽  
Brain Injury ◽  
Motor Function ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Short Term ◽  
Electrical Stimulation Therapy

AbstractFunctional electrical stimulation therapy (FEST) can improve motor function after neurological injuries. However, little is known about cortical re-organization after FEST and weather it can improve upper-limb motor function after traumatic brain injury (TBI). Therefore, our study examined cortical and motor changes in a single male participant with chronic TBI suffering from mild motor impairment during 3-months of FEST and at 3-months follow-up. FEST was applied to enable upper-limb grasping and reaching movements during each session, which was performed for 45-60 min, 3 days per week, over 12-weeks. Short-term assessments were examined before and after each session, while long-term assessments were performed at baseline, after 6- and 12-weeks of FEST, and during follow-up 6- and 12-weeks after completing FEST. Short-term assessments carried out using transcranial magnetic stimulation (TMS) showed reduced cortical silent period (CSP), which is related to cortical and/or subcortical inhibition. At the same time, no changes in motor evoked potentials (MEP) were observed, suggesting corticospinal excitability was unaffected. Long-term assessments indicate increased MEP corticospinal excitability after 12-weeks of FEST, which remained during both follow-ups, while no changes in CSP were observed. Similarly, long-term assessments using TMS mapping showed larger hand MEP area in the primary motor cortex (M1) after 12-weeks of FEST as well as during both follow-ups. Corroborating TMS results, fMRI imaging data showed M1, as well as sensory, premotor, parietal area, and supplementary motor area activations increased after 12-weeks of FEST and during both follow-ups. While clinical scores did not change considerably, writing test performance indicates mild improvements after FEST. Our results suggest that FEST can effectively increase cortical activations, while writing tests confirmed functional improvements in fine motor function even after chronic TBI. These results demonstrated long-term recovery mechanisms of FEST, which include cortical re-organization or neuroplasticity to improve motors function after neurological injury.

scholarly journals Association Between Male Use of Pain Medication and Fecundability

2020 ◽  
Vol 189 (11) ◽  
pp. 1348-1359
Author(s):  
Amelia K Wesselink ◽  
Kathryn A Bresnick ◽  
Elizabeth E Hatch ◽  
Kenneth J Rothman ◽  
Ellen M Mikkelsen ◽  
...  
Keyword(s):  
Medication Use ◽  
Pain Medication ◽  
Sociodemographic Characteristics ◽  
Low Doses ◽  
Pain Reliever ◽  
Pain Medications ◽  
Human Fertility ◽  
Males And Females ◽  
Monthly Dose

Abstract Administration of pain relievers has been associated with both lower and higher risks of adverse reproductive outcomes in animals. In the sole investigation of male pain-reliever use and human fertility carried out to date, Smarr et al. (Hum Reprod. 2016;31(9):2119–2127) found a 35% reduction in fecundability among males with urinary acetaminophen concentrations in the highest quartile (&gt;73.5 ng/mL) versus the lowest (&lt;5.4 ng/mL). We analyzed data from 1,956 males participating in Pregnancy Study Online, a preconception cohort study of North American couples enrolled between 2013 and 2019. Males and females completed baseline questionnaires on sociodemographic characteristics, lifestyle, medication use, and medical history; females completed bimonthly follow-up questionnaires for up to 12 months. We categorized pain medications by active ingredient (ibuprofen, acetaminophen, naproxen, aspirin) and cumulative monthly dose. We used proportional probabilities models to calculate fecundability ratios and 95% confidence intervals, adjusting for potential confounders. In the 4 weeks before baseline, 51.7% of males used pain medications. Adjusted fecundability ratios were 1.02 for ibuprofen (95% confidence interval (CI): 0.91, 1.13), 0.89 for acetaminophen (95% CI: 0.77, 1.03), 1.07 for naproxen (95% CI: 0.85, 1.35), and 1.05 for aspirin (95% CI: 0.81, 1.35), as compared with nonuse of each medication. In this study, male use of pain medications at low doses was not notably associated with fecundability.

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