LATEST TRAUMATIC BRAIN INJURY NEWS

September, 2018: JAMA - Journal of the American Medical Association

Disturbing report from Denmark links traumatic brain injuries to suicide. In nearly 35,000 deaths reported over a 35 years period, more than 10% had seen a physician for a either a mild or severe brain injury prior to committing suicide. Severe injuries are those that produce evidence of structural brain injury.  The general population risk is less than 2%. The research reported the risk was more than three-fold higher in the first six months after a concussion and lasted up to two years after the injury.

 

August, 2018: Human Brain Mapping

Study at the University of Texas at Dallas indicates that depressed patients who received cognitive training saw significantly reduced depressive symptoms which were associated with improvements in daily life functioning. MRI scans indicated that the improvements were due to related changes in cortical thickness and resting-state functional connectivity. While limited , the study does suggest that the brain is more adaptable and repairable than many people realize.

 

Journal of the American Medical Assoc.

New study links TBI to a higher risk of suicide particularly in the first six months after the brain injury. The researchers found the suicide risk was more than three-fold elevated the first six months after a concussion and lasted for as much as two years after the injury.

 

July, 2018: University of Rochester

Reports on the Banyon Brain Trauma Indicator which is a blood test that can predict traumatic head injuries detecting two brain proteins that are present in the blood soon after a hit to the head. If the brain proteins are not present, it is highly unlikely a traumatic intracranial injury exists and a head CT can be avoided. If the test is positive, a head CT is recommended to further assess the damage and guide treatment. The test is effective up to 12 hours post injury.

 

June, 2018: Veteran’s Health Administration (also cited in PD news) 

Veterans with traumatic brain injury had a 71% relative increase in the risk for Parkinson’s disease compared to those without TBI. Results varied from those with moderate or severe injury at an 83% greater risk to those with mile TBI showing a 56% greater risk. Of the 20 million vets alive today, it is estimated that 40% have some history of TBI and 82% of those are considered mild TBI. However, to keep this in perspective, after the age of 60, Parkinson’s affects 1 in 100 people, so if we extrapolate the data for those with mild TBI, the rate of Parkinson’s would only go up 1.56 on 100 people.

 

April, 2108: Neurology

A new study out of UC San Francisco and SF Veterans Medical Center states that risk of developing Parkinson’s goes up by 56% if you ever had even a mild concussion. Any type of TBI raises the risk to 71% higher. The lifetime risk for developing Parkinson’s is probably about 1 to 2 percent, so a greater that 50 percent increase in that risk is not as alarming as it sounds however, the findings lend credence to the idea that some professional athletes have developed Parkinson’s as a result of their chosen careers.

 

The researchers speculate that possibly TBI could cause abnormal proteins to accumulate in the brain, or that a brain injury might make the brain less resilient to aging. Another possibility is that a head injury might cause damage to dopamine-producing cells.

 

Lancet Psychiatry

Studying 2.8 million patient records, researchers found people with a history of brain injury had a 24 percent high risk of dementia than those who did not. A single TBI defined as severe increased the risk of developing dementia by 35% while a mild incident increased risk by 17%. The number of brain injuries greatly increases the risk. Two or more had an increased chance of 33%, four or more increases risk to 61% and five or more increases chances 138%.

 

March, 2108: University of Texas Southwestern

Study links TBI with the onset of Alzheimer’s disease by examining cases of Alzheimer’s that had been confirmed postmortem. They found that persons who experienced a TBI accompanied by a loss of consciousness for more than 5 minutes were, on the whole, diagnosed 2.5 years earlier than peers who had not sustained head injuries. This associative link raises many questions which will take years to resolve.

 

February, 2018: PLOS Medicine

A study spanning nearly 50 years links TBI with the likelihood of being diagnosed with dementia even 30 years later. This Swedish study reported on a data set of about 3.3 million persons. The results showed that the risk for developing dementia is increased by four to six times in the first year after a TBI. The risk increased by 80% in the 15 years after the injury and thirty years later there remained a 25% increased risk. Risks were similar for men and women and severity of injury had a stronger link to dementia.

 

It is likely that in some cases, the onset of dementia cause these types of accidents to begin with. Also people who have brain injuries may be more closely monitored by family members which may increase the chances of being diagnosed with dementia. Dementia s very common and the fact that most people develop it if they live long enough may distort the data.

 

January, 2018: Cleveland Law Review

Approximately half of all individuals with a cranial injury will suffer depression within the first year, regardless of the severity of the injury. Depression is more than a mood disorder associated with sadness but may include many mental and bodily complaints – such as insomnia, fatigue, anxiety, appetite changes, aches and pains, lack of interest in previously enjoyable activities –an particularly when combined with despair and hopelessness, can lead to suicide.

 

Recent studies have identified specific biochemical and structural factors that can cause depression. Biochemically, TBI can trigger changes in key neurotransmitters such as serotonin and dopamine. TBI may case structural damage to vulnerable brain circuits linked to depression.

 

The primary source of depression is loss – and those who have suffered TBI have experienced the most overwhelming loss of all – the loss of his well-being. Acute depression is generally treatable and most patients react positively to proper care.

 

Boston University

Reports publish the strongest link yet that repetitive hits to the head – not just those that produce a concussion- can lead to the debilitating brain disease chronic traumatic encephalopathy – CTE.  The study provides insight into why about 20% of the brains found to have CTE have never reported a concussion.

 

This suggests that the problem goes beyond athletics and could how affect other vulnerable populations – from domestic abuse victims to members of the military are treated. 

 

 November, 2017: News from the Cleveland Clinic

Researchers have enrolled close to 700 mixed martial arts fighters and boxers, both active and retired, over the past six years to learn to identify early signs of trauma-induced brain damage from subtle changes in blood chemistry, brain imaging, and performance tests – changes that may show up decades before visible symptoms such as cognitive impairment, depression and impulsive behavior. By repeating a series of tests year after year, they hope to pick up changes that might predict development of CTE.

 

The study has identified that active fighters have higher levels of two brain proteins, called neurofilament light and tau, compared to retired fighters or non-fighters. It is unclear if those signal a higher risk but that does provide a focus for further research. Additionally, fighters with greater exposure to head trauma have lower brain volumes and a cavity in their brain. This study is in early stages so we must be cautious in over interpreting changes as signs of injury or damage.

 

News from SAMHSA (Substance Abuse and Mental Health Services Administration)

TBI is unique in that the symptoms may be misdiagnosed as behavioral health issues while at the same time TBI patients are at risk for comorbid depression and addiction disorders. When considering risks, the behavioral health of a TBI patient must be evaluated both as a symptom of the injury and as a pre-existing condition. Estimates are that as many as half of brain injured individuals have some history of substance abuse disorder and about 30% of injuries happen while under the influence of alcohol or substances.

 

In addition clinical teams must evaluate patients for attention deficit, learning disabilities, depression, stress and pain. Suicide risk should also be assessed.

 

October, 2017: News from the University of Dundee, Scotland

Breakthrough in uncovering the 3D structure of and enzyme, PINK 1, may allow scientists to start working on drugs that allow the enzyme to function properly and slow the progression of Parkinson’s or even stop it entirely.  

 

Mutations is the gene encoding PINK1 have been identified in patients with early-onset Parkinson’s alerting researchers to it as a potential therapeutic target. PINK1 encodes a kinase enzyme that plays an important role in protecting brain cells against stress. Its main role is to detect damage to the mitochondria of cells which act as the energy center. A protective pathway using two key proteins – ubiquitin and Parkin – is switched on, which reduces damage. In Parkinson’s sufferers, PINK1 loses its protective function, which leads to the degeneration of the cells in the brain that control movement. Understanding the structure and inner workings could help scientists to find a way to turn the protective function back on.

 

From the Cleveland Clinic: Early Warning Signs of Parkinson’s

Only a neurologist can diagnose Parkinson’s. Motor problems are quickly recognizable – tremors, rigidity, stiffness and slowness are hallmark signs along with balance and gait problems. But Parkinson’s symptoms start long before these problems emerge:

Stage 1: Parkinson’s attacks the base of the brain stem – the medulla initially. This may cause constipation and a loss of sense of smell.

Stage 2: Next is nerve deterioration in the pons – the brain’s message center leading to depression and REM sleep disorder.

Stage 3: Tremor and shuffle now appear because the disease is attacking the part of the brain responsible for movement.

 

Of course, not everyone experiencing these symptoms is at risk for Parkinson’s but if you have any of these symptoms along with the following risk factors, it would be a good idea to make an appointment with a Neurologist:

- First degree relative with Parkinson’s onset before the age of 60

- Resting tremor, stiffness, slowness, gait/balance problems

- Repeated head trauma

- REM sleep disorder

 

News from Colorado:

Says Medical Marijuana eases tremors for patients with Parkinson’s. Isreali researchers have seen a significant decrease in symptoms and an improvement in fine motor skills.

 

However, News from Canada:

Contrary to earlier reports, McGill University researcher found no benefit to coffee drinking. Earlier studies has shown possible short-term benefits but looking at the longer term, any benefits dissipate quickly.

 

October, 2017: News from the Cleveland Clinic

Researchers have enrolled close to 700 mixed martial arts fighters and boxers, both active and retired, over the past six years to learn to identify early signs of trauma-induced brain damage from subtle changes in blood chemistry, brain imaging, and performance tests – changes that may show up decades before visible symptoms such as cognitive impairment, depression and impulsive behavior. By repeating a series of tests year after year, they hope to pick up changes that might predict development of CTE.

The study has identified that active fighters have higher levels of two brain proteins, called neurofilament light and tau, compared to retired fighters or non-fighters. It is unclear if those signal a higher risk but that does provide a focus for further research. Additionally, fighters with greater exposure to head trauma have lower brain volumes and a cavity in their brain. This study is in early stages so we must be cautious in over interpreting changes as signs of injury or damage.

 

News from SAMHSA (Substance Abuse and Mental Health Services Administration)

TBI is unique in that the symptoms may be misdiagnosed as behavioral health issues while at the same time TBI patients are at risk for comorbid depression and addiction disorders. When considering risks, the behavioral health of a TBI patient must be evaluated both as a symptom of the injury and as a pre-existing condition. Estimates are that as many as half of brain injured individuals have some history of substance abuse disorder and about 30% of injuries happen while under the influence of alcohol or substances. In addition clinical teams must evaluate patients for attention deficit, learning disabilities, depression, stress and pain. Suicide risk should also be assessed.

 

September 2017: NFL Players and Brain Injuries

Published earlier this summer was the news that brain injuries were found in 99% of the brains donated by NFL players, 21% of high school players and 21% of college football players. This clearly indicates that further study and monitoring or injury should have a high priority in all football programs for all ages. 

 

July , 2017: TBI and Dementia: Link or no link?

A study by Finnish researchers comparing medical notes of working-age individuals under the age of 65 with mild or moderate to severe TBI who had developed dementia, Parkinson’s disease or ALS. They found the incidence of dementia in moderate to severe TBI patients was similar to that found in the general population. Since dementia occurs primarily in the elderly, this means that TBI shifts the risk from old age to working age. Data in this study was only available for TBI patients who had been admitted to hospital with a diagnosis of neurodegenerative symptoms possibly missing other patients. A study in Taiwan concurs with the Finnish study but numerous other studies have not been able to establish cause and effect which means there could be other biological mechanisms involved causing neurodegeneration.

Most studies agree that there is a need for long-term monitoring for TBI patients, especially those who have experienced moderate or severe TBI. There is also a call for more accurate diagnostic criteria that would allow physicians to spot the onset of TBI-associated neurodegeneration earlier.​

 

COMPASSIONATE, EFFECTIVE, AFFORDABLE CARE