Journal of neurotrauma
-
Journal of neurotrauma · Oct 2023
Association between Insomnia and Mental Health and Neurocognitive Outcomes Following Traumatic Brain Injury.
We previously described five trajectories of insomnia (each defined by a distinct pattern of insomnia severity over 12 months following traumatic brain injury [TBI]). Our objective in the present study was to estimate the association between insomnia trajectory status and trajectories of mental health and neurocognitive outcomes during the 12 months after TBI. In this study, participants included N = 2022 adults from the Federal Inter-agency Traumatic Brain Injury Repository database and Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. ⋯ Notably, severe insomnia at 3 or 6 months post-TBI was a risk factor for poor recovery at 12 months post-injury. In conclusion, in this well-characterized sample of individuals with TBI, insomnia severity generally tracked severity of depression, pain, PTSD, quality of life, and neurocognitive outcomes over 12 months post-injury. More intensive sleep assessment is needed to elucidate the nature of these relationships and to help inform best strategies for intervention.
-
Journal of neurotrauma · Oct 2023
Observational StudyAssociations between peer relationships and self-esteem after childhood traumatic brain injury: exploring the mediating role of loneliness.
Pediatric traumatic brain injury (TBI) can impact psycho-social functioning, including friendships and experiences of loneliness; however, few studies have explored associations between these factors and self-esteem. To address this gap, the objective of this study was to document inter-relationships between friendship quality, peer-related loneliness, and self-esteem 12 months post-injury. The sample in this prospective, longitudinal observational study consisted of 135 children, including 92 children with TBI (57 mild, 35 moderate-severe TBI) and 43 typically developing control (TDC) children. ⋯ In mediation models, poorer quality friendships were associated with greater peer-related loneliness, and greater peer-related loneliness was related to reduced athletic and social self-esteem, at 12 months post-TBI. Loneliness with peers mediated the effects of both friendship support and friendship satisfaction on children's social self-esteem. Our preliminary findings suggest that regular monitoring of social interactions post-TBI might facilitate early identification of children who are likely to benefit from interventions targeting peer-related loneliness, which in turn may lower risk for poorer self-esteem.
-
Journal of neurotrauma · Oct 2023
Review Meta AnalysisCognitive outcome following complicated mild Traumatic Brain Injury: A literature review and meta-analysis.
Cognitive outcome for mild traumatic brain injury (mTBI) with positive brain imaging (complicated mTBI) was compared with that for mTBI with normal imaging (uncomplicated mTBI) and with moderate to severe TBI, using meta-analysis. Twenty-three studies utilizing objective neurocognitive tests were included in the analysis. At less than 3 months post-injury, complicated mTBI was associated with poorer cognitive outcomes than uncomplicated mTBI, but deficits were not comparable to those with moderate-severe TBI. ⋯ The extent of cognitive deficit in complicated mTBI was small and unlikely to cause significant disability. However, patients with complicated mTBI constitute a broad category encompassing individuals who may differ markedly in the nature and extent of intracranial imaging abnormality, and further studies are warranted. Limitations of the available studies include small, selected samples; variations in TBI severity classification; absence of validity ("effort") testing; differing imaging methodology; and lack of long-term follow-up.
-
Journal of neurotrauma · Oct 2023
Task-based and Resting-state Cortical Functional Differences after Spinal Cord Injury: A Pilot Functional Near-Infrared Spectroscopy Study.
Brain reorganization following spinal cord injury (SCI) has been well-established using animal and human studies. Yet, much is unknown regarding functional recovery and adverse secondary outcomes after SCI. Functional near-infrared spectroscopy (fNIRS) is a neuroimaging technique that offers methodological flexibility in a real-world setting. ⋯ Lower FC of these regions was associated with longer injury durations. Additionally, we found a general decrease in resting state FC of the SCI group, specifically in the Slow-3 frequency range (0.073 to 0.1 Hz). These results, though preliminary, are consistent with past studies and highlight the potential of fNIRS in SCI and rehabilitative research.