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.

Post-traumatic stress disorder (PTSD): A differential diagnostic consideration for COVID-19 survivors

Image of a COVID-19 virion, grey with red coronas

Heightened risk of PTSD occurred in MERS and SARS survivors. While data concerning COVID-19 is lacking, PTSD is known to occur in patient groups who undergo similar hospital courses, including ICU survivors, patients who are intubated and mechanically ventilated, and those that experience delirium. Research with patients who develop PTSD in the context of mild traumatic brain injury further suggests that PTSD may account for some or all of a patient’s subjective cognitive complaints and neuropsychological test performance. Recommendations are provided for assessing PTSD in the context of COVID-19.

Association of Symptoms of Posttraumatic Stress Disorder (PTSD) With Posttraumatic Psychological Growth Among US Veterans During the COVID-19 Pandemic

Graphic representation of a coronavirus knocking over white walls

Military veterans may be at elevated risk for COVID-19–associated psychiatric issues given high rates of preexisting psychiatric conditions, such as posttraumatic stress disorder (PTSD) and suicidal ideation (SI). In this survey study, we analyzed data from a national sample of US military veterans to examine (1) the prevalence of COVID-19–associated PTG among veterans with and without COVID-19–associated PTSD symptoms and (2) the incremental association between PTG and SI during the pandemic.

Posttraumatic Stress Disorder (PTSD) and Racial Trauma

PTSD and Racial Trauma, Racism linked to negative mental health conditions

Racial trauma can be defined as the cumulative traumatizing impact of racism on a racialized individual, which can include individual acts of racial discrimination combined with systemic racism, and typically includes historical, cultural, and community trauma as well.

Racism has been linked to a host of negative mental health conditions, but the connection between racial discrimination and PTSD symptoms appears to be the most robust.

Patients with Traumatic Brain Injuries Face Challenges Navigating Healthcare System

A stethoscope surrounded by wooden cutouts of people.

Patients who suffer from traumatic brain injuries (TBI) often need a great deal of healthcare services after the injury, but the extent of care utilization is unknown. A new study from research scientists affiliated with the U.S. Department of Veterans Affairs (VA), Regenstrief Institute and IUPUI is one of the first to analyze how much care TBI patients use and identify areas of unmet need.

A mediating role for mental health in associations between COVID‐19‐related self‐stigma, PTSD, quality of life, and insomnia among patients recovered from COVID‐19

Effects of the Coronavirus (COVID-19) Pandemic on PTSD, single virion with no background

Patients with COVID‐19 often suffer from psychological problems such as post‐traumatic stress disorder (PTSD) and self‐stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self‐stigmatization and PTSD to quality of life and sleep.

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

Two football helmets leaning against each other at the forehead.

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

Female doctor looking at CT scan results.

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

A homeless man in Phoenix pulls an overladen shopping cart along a path next to the Arizona Canal. At the time of the photo the canal was drained for cleaning.

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

balloons with smiley faces

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

older woman talking with a doctor

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

graphic representation of a neuron

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

kid looking at doctor who is holding up two fingers

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

man in sweatshirt and a hat that says veteran

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.