ABSTRACT
The authors aim to determine if a history of traumatic brain injury (TBI) assessed before dementia onset is associated with a higher risk of neuropsychiatric symptoms after dementia onset. A population-based incident series of people with dementia were assessed for TBI prior to onset of dementia and for neuropsychiatric symptoms after the onset, using the Neuropsychiatric Inventory. Participants with predementia TBI were more likely to exhibit disinhibition (12.7% versus 5.4%, OR=2.8, p=0.02), but not other neuropsychiatric symptoms. Traumatic brain injury may increase the risk of disinhibition in patients with dementia.
Subject(s)
Brain Injuries/epidemiology , Dementia/epidemiology , Mental Disorders/epidemiology , Aged, 80 and over , Alzheimer Disease/epidemiology , Alzheimer Disease/genetics , Apolipoprotein E4/genetics , Brain Injuries/genetics , Dementia/genetics , Female , Humans , Impulsive Behavior/epidemiology , Impulsive Behavior/genetics , Logistic Models , Male , Mental Disorders/genetics , Neuropsychological Tests , Prospective Studies , Psychiatric Status Rating Scales , Risk Factors , Time Factors , United States/epidemiologyABSTRACT
The authors present preliminary results from a pilot study on patterns of brain injury associated with incident major depression after traumatic brain injury (TBI). Brain metabolite ratios, regional brain volumes, and cognitive performance were compared between 10 subjects with incident major depression post-TBI and seven TBI patients without major depression. TBI-depressed participants performed poorly on tests of frontotemporal functioning, had lower choline/creatine and N-acetylaspartate/creatine ratios in the right basal ganglia and had lower regional brain volumes in the right frontal, left occipital, and temporal lobes. The results suggest a possible role of frontotemporal lobe and basal ganglia pathology in depression after TBI.
Subject(s)
Brain Injuries/metabolism , Brain Injuries/pathology , Brain/metabolism , Brain/pathology , Depressive Disorder, Major/metabolism , Depressive Disorder, Major/pathology , Adult , Aspartic Acid/analogs & derivatives , Aspartic Acid/metabolism , Basal Ganglia/metabolism , Basal Ganglia/pathology , Brain Injuries/complications , Case-Control Studies , Choline/metabolism , Cognition Disorders/complications , Cognition Disorders/metabolism , Cognition Disorders/pathology , Creatine/metabolism , Depressive Disorder, Major/complications , Frontal Lobe/metabolism , Frontal Lobe/pathology , Humans , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Middle Aged , Neuropsychological Tests , Organ Size , Pilot Projects , Time FactorsABSTRACT
Mild traumatic brain injury (TBI) is the most common form of TBI. Most people recover after mild TBI, but a small percentage continues to have persistent problems, predominantly depression. There is, however, minimal literature on the risk factors associated with mild TBI depression. In a sample of 43 mild TBI patients, followed longitudinally for 1 year, the prevalence of new-onset depression was found to be 18%. Older age and presence of frontal subdural hemorrhage were the only two significant findings noted in the depressed group compared with the nondepressed group. Identifying risk factors for mild TBI depression can aid in early diagnosis and treatment.
Subject(s)
Brain Injuries/psychology , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/etiology , Adult , Brain Injuries/epidemiology , Depressive Disorder, Major/epidemiology , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Incidence , Male , Predictive Value of Tests , Severity of Illness IndexABSTRACT
Aggression after traumatic brain injury (TBI) is common but not well defined. Sixty-seven participants with first-time TBI were evaluated for aggression within 3 months of injury. The prevalence of aggression was found to be 28.4%, predominantly verbal aggression. Post-TBI aggression was associated with new-onset major depression (p=0.02), poorer social functioning (p=0.04), and increased dependency in activities of daily living (p=0.03), but not with a history of substance abuse or adult/childhood behavioral problems. Implications of the study include early screening for aggression, evaluation for depression, and consideration of psychosocial support in aggressive patients.
