Monday, October 28, 2013

The Impact of Previous Traumatic Brain Injury on Health and Functioning: A TRACK-TBI Study

The Impact of Previous Traumatic Brain Injury on Health and Functioning: A TRACK-TBI Study
Neurosurgery Blog

Kristen Dams-O'Connor,1 Lisa Spielman,1 Ayushi Singh,1 Wayne A. Gordon,1 John K. Yue,1 Esther L. Yuh,5 Alex B. Valadka,4 Hester F. Lingsma,7 Pratik Mukherjee,5 Ava M. Puccio,3 David O. Okonkwo,3 David M. Schnyer,6 Andrew I.R. Maas,8 and Geoffrey T. Manley2 and the TRACK-TBI Investigators including Scott S. Casey,1 Shelly R. Cooper,1 Maxwell Cheong,5 Allison J. Hricik,3 Emily E. Knight,6 David K. Menon,9 Diane J. Morabito,2 Jennifer L. Pacheco,6 Tuhin K. Sinha,5 and Mary J. Vassar2

 

The idea that multiple traumatic brain injury (TBI) can have a
cumulative detrimental effect on functioning is widely accepted. Most
research supporting this idea comes from athlete samples, and it is not
known whether remote history of previous TBI affects functioning after
acute TBI (aTBI) in community-based samples. This study investigates
whether a previous history of TBI with loss of consciousness (LOC) is
associated with worse health and functioning in a sample of individuals
who require emergency department care for an aTBI. Twenty-three percent
of the 586 individuals with aTBI in the Transforming Research and
Clinical Knowledge in Traumatic Brain Injury study reported having
sustained a previous TBI with LOC. Individuals with previous TBI were
more likely to be unemployed (χ2=17.86; p=0.000), report a variety of chronic medical and psychiatric conditions (4.75≤χ2≥24.16; p<0.05), and report substance use (16.35≤χ2≥27.57; p<0.01)
before the acute injury, compared to those with no previous TBI
history. Those with a previous TBI had less-severe acute injuries, but
experienced worse outcomes at 6-month follow-up. Results of a series of
regression analyses controlling for demographics and acute injury
severity indicated that individuals with previous TBI reported more mood
symptoms, more postconcussive symptoms, lower life satisfaction, and
had slower processing speed and poorer verbal learning, compared to
those with no previous TBI history. These findings suggest that history
of TBI with LOC may have important implications for health and
psychological functioning after aTBI in community-based samples.

Kristen Dams-O'Connor,1 Lisa Spielman,1 Ayushi Singh,1 Wayne A. Gordon,1 John K. Yue,1 Esther L. Yuh,5 Alex B. Valadka,4 Hester F. Lingsma,7 Pratik Mukherjee,5 Ava M. Puccio,3 David O. Okonkwo,3 David M. Schnyer,6 Andrew I.R. Maas,8 and Geoffrey T. Manley2 and the TRACK-TBI Investigators including Scott S. Casey,1 Shelly R. Cooper,1 Maxwell Cheong,5 Allison J. Hricik,3 Emily E. Knight,6 David K. Menon,9 Diane J. Morabito,2 Jennifer L. Pacheco,6 Tuhin K. Sinha,5 and Mary J. Vassar2
1Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
2Department of Neurological Surgery, University of California, San Francisco, California.
3Department of Neurological Surgery University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
4Seton Brain and Spine Institute, Austin, Texas.
5Department of Radiology, University of California, San Francisco, California.
6Department of Psychology, University of Texas at Austin, Austin, Texas.
7Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
8Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.
9Division of Anesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom.
Address correspondence to:
Kristen Dams-O'Connor, PhD
Department of Rehabilitation Medicine

Icahn School of Medicine at Mount Sinai

One Gustave Levy Place
Box 1240B
New York, NY 10029

E-mail: kristen.dams-o'connor@mountsinai.org

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Original Article: http://neurocirurgiabr.com/the-impact-of-previous-traumatic-brain-injury-on-health-and-functioning-a-track-tbi-study/?utm_source=rss&utm_medium=rss&utm_campaign=the-impact-of-previous-traumatic-brain-injury-on-health-and-functioning-a-track-tbi-study

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