Research Updates

Scientists have learned more about the brain — how it works and how it heals — in the last decade or two than ever before. And, there has been a dramatic increase in the amount of research being done specifically on traumatic brain injury (TBI). BrainLine’s Research Update is an ongoing series of short synopses describing the recent research on TBI and links for further information. We created this series to help keep people with brain injuries, families, and other professionals up to date on the latest brain injury research.

Association of Professional Football Cumulative Head Impact Index Scores With All-Cause Mortality Among National Football League Players

Question  Are repetitive head impacts during a professional football career associated with mortality among National Football League players?

Findings  In this cohort study of 13 912 National Football League players, a 25% increase in repetitive head impacts during a professional football career was associated with a statistically significant increase in the hazard ratio of death.

Meaning  The findings suggest that repetitive head impacts are associated with an increase in the risk of all-cause mortality among professional football players.

Multiclass semantic segmentation and quantification of traumatic brain injury lesions on head CT using deep learning: an algorithm development and multicentre validation study

CT is the most common imaging modality in traumatic brain injury (TBI). However, its conventional use requires expert clinical interpretation and does not provide detailed quantitative outputs, which may have prognostic importance. We aimed to use deep learning to reliably and efficiently quantify and detect different lesion types.

Traumatic brain injury in homeless and marginally housed individuals: a systematic review and meta-analysis

Homelessness is a global public health concern, and traumatic brain injury (TBI) could represent an underappreciated factor in the health trajectories of homeless and marginally housed individuals. We aimed to evaluate the lifetime prevalence of TBI in this population, and to summarise findings on TBI incidence and the association between TBI and health-related or functioning-related outcomes.

Dispositional optimism and cognitive functioning following traumatic brain injury

The association of dispositional optimism with health-related factors has been well established in several clinical populations, but little is known about the role of optimism in recovery after traumatic brain injury (TBI). Given the high prevalence of cognitive complaints after TBI, the present study examined the association between optimism and cognitive functioning after TBI.

Health Problems Precede Traumatic Brain Injury in Older Adults

Traumatic brain injury (TBI) is a leading cause of death and disability. Older adults are more likely than younger individuals to sustain TBIs and less likely to survive them. TBI has been called the “silent epidemic,” and older adults are the “silent population” within this epidemic. This study evaluates whether indicators of preinjury health and functioning are associated with risk of incident traumatic brain injury (TBI) with loss of consciousness (LOC) and to evaluate health‐related factors associated with mortality in individuals with incident TBI.

The chronic and evolving neurological consequences of traumatic brain injury

Traumatic brain injury (TBI) can have lifelong and dynamic effects on health and wellbeing. Research on the longterm consequences emphasises that, for many patients, TBI should be conceptualised as a chronic health condition. Evidence suggests that functional outcomes after TBI can show improvement or deterioration up to two decades after injury, and rates of all-cause mortality remain elevated for many years. Furthermore, TBI represents a risk factor for a variety of neurological illnesses, including epilepsy, stroke, and neurodegenerative disease. With respect to neurodegeneration after TBI, post-mortem studies on the long-term neuropathology after injury have identified complex persisting and evolving abnormalities best described as polypathology, which includes chronic traumatic encephalopathy. Despite growing awareness of the lifelong consequences of TBI, substantial gaps in research exist. Improvements are therefore needed in understanding chronic pathologies and their implications for survivors of TBI, which could inform long-term health management in this sizeable patient population.

Risk of Repeat Concussion Among Patients Diagnosed at a Pediatric Care Network

Concussion is a common childhood injury that may lead to long-term physical, behavioral, and neurocognitive effects, affecting learning and school performance. There is increasing concern about the potential for repeat concussions among professional and high school athletes, with specific attention focused on understanding how sustaining a concussion alters future concussion risk. Addressing repeat concussion risk among youth has substantial implications for clinical practice in terms of managing exposure — particularly regarding youth sports participation — and long-term health and development.

Genome-wide association study of post-traumatic stress disorder reexperiencing symptoms in >165,000 US veterans

Post-traumatic stress disorder (PTSD) is a major problem among military veterans and civilians alike, yet its pathophysiology remains poorly understood. We performed a genome-wide association study and bioinformatic analyses, which included 146,660 European Americans and 19,983 African Americans in the US Million Veteran Program, to identify genetic risk factors relevant to intrusive reexperiencing of trauma, which is the most characteristic symptom cluster of PTSD. In European Americans, eight distinct significant regions were identified. Three regions had values of P < 5 × 10−10CAMKV; chromosome 17 closest to KANSL1, but within a large high linkage disequilibrium region that also includes CRHR1; and TCF4. Associations were enriched with respect to the transcriptomic profiles of striatal medium spiny neurons. No significant associations were observed in the African American cohort of the sample. Results in European Americans were replicated in the UK Biobank data. These results provide new insights into the biology of PTSD in a well-powered genome-wide association study.