Gender Differences in Adolescents' Affective Symptoms and Behavioral Disorders After Mild Traumatic Brain Injury

Mild Traumatic Brain Injury and Criminal Charges and Convictions in Mid and Late Adolescence

Importance

Childhood exposure to mild traumatic brain injury (mTBI) is common. Individuals with a childhood history of mTBI experience more frequent criminal justice involvement in mid to late adolescence and adulthood. No study had been conducted to examine whether the link is causal or spurious.

Objective

To determine whether mTBI in childhood causes criminal justice involvement in mid to late adolescence.

Design, Setting, and Participants

This cohort study used population-based data for all children born between 1995 and 2000 in Denmark, with data linked to emergency department (ED) visits and hospitalizations before age 10 years and all criminal charges and convictions from ages 15 to 20 years. The exposure group contained all individuals diagnosed with mTBI before age 10 years without other intracranial or extracranial injuries; the comparison group was individuals not diagnosed with mTBI or intracranial or extracranial injuries. Sibling and twin fixed-effects models were used to evaluate the association after controlling for family-level confounding. Data were analyzed from May 2021 to July 2024.

Exposures

Mild TBI before age 10 years without other intracranial or extracranial injuries before or at the time of diagnosis.

Main Outcomes and Measures

Associations between mTBI before age 10 years and criminal charges and convictions from ages 15 to 20 for the entire study population and separately by sex at birth, controlling for additional covariates.

Results

The final analytic sample consisted of 343 027 individuals, 13 514 in the exposure group and 329 513 in the comparison group. Of the total sample, 166 455 (49%) were female and 176 572 were male (51%). A total of 326 191 participants (95%) had at least 1 parent with Danish citizenship, and 79 386 mothers (23%) held a college degree. There was a positive association between mTBI and criminal charges (odds ratio [OR], 1.26; 95% CI, 1.19-1.34) and convictions (OR, 1.24; 95% CI, 1.16-1.33). When controlling for family-level confounding, the associations became statistically insignificant and, in most models, greatly reduced. Results were robust across multiple model specifications.

Conclusions and Relevance

This study found that although mTBI in childhood was predictive of adolescent criminal justice involvement, there was no evidence that mTBI caused criminal charges or convictions.

mTBI Biological Biomarkers as Predictors of Postconcussion Syndrome-Review

Postconcussion syndrome (PCS) is one of the leading complications that may appear in patients after mild head trauma. Every day, thousands of people, regardless of age, gender, and race, are diagnosed in emergency departments due to head injuries. Traumatic Brain Injury (TBI) is a significant public health problem, impacting an estimated 1.5 million people in the United States and up to 69 million people worldwide each year, with 80% of these cases being mild. An analysis of the available research and a systematic review were conducted to search for a solution to predicting the occurrence of postconcussion syndrome. Particular biomarkers that can be examined upon admission to the emergency department after head injury were found as possible predictive factors of PCS development. Setting one unequivocal definition of PCS is still a challenge that causes inconsistent results. Neuron Specific Enolase (NSE), Glial Fibrillary Acidic Protein (GFAP), Ubiquitin C-terminal Hydrolase-L1 (UCH-L1), Serum Protein 100 B (s100B), and tau protein are found to be the best predictors of PCS development. The presence of all mentioned biomarkers is confirmed in severe TBI. All mentioned biomarkers are used as predictors of PCS. A combined examination of NSE, GFAP, UCH-1, S100B, and tau protein should be performed to detect mTBI and predict the development of PCS.

Traumatic brain injury, working memory-related neural processing, and alcohol experimentation behaviors in youth from the ABCD cohort

Adolescent traumatic brain injury (TBI) has long-term effects on brain functioning and behavior, impacting neural activity under cognitive load, especially in the reward network. Adolescent TBI is also linked to risk-taking behaviors including alcohol misuse. It remains unclear how TBI and neural functioning interact to predict alcohol experimentation during adolescence. Using Adolescent Brain Cognitive Development (ABCD) study data, this project examined if TBI at ages 9-10 predicts increased odds of alcohol sipping at ages 11-13 and if this association is moderated by neural activity during the Emotional EN-Back working memory task at ages 11-13. Logistic regression analyses showed that neural activity in regions of the fronto-basal ganglia network predicted increased odds of sipping alcohol by ages 11-13 (p < .05). TBI and left frontal pole activity interacted to predict alcohol sipping (OR = 0.507, 95% CI [0.303 - 0.846], p = .009) - increased activity predicted decreased odds of alcohol sipping for those with a TBI (OR = 0.516, 95% CI [0.314 - 0.850], p = .009), but not for those without (OR = 0.971, 95% CI [0.931 -1.012], p = .159). These findings suggest that for youth with a TBI, increased BOLD activity in the frontal pole, underlying working memory, may be uniquely protective against the early initiation of alcohol experimentation. Future work will examine TBI and alcohol misuse in the ABCD cohort across more time points and the impact of personality traits such as impulsivity on these associations.

The Rehabilitation Potential of Neurostimulation for Mild Traumatic Brain Injury in Animal and Human Studies

Neurostimulation carries high therapeutic potential, accompanied by an excellent safety profile. In this review, we argue that an arena in which these tools could provide breakthrough benefits is traumatic brain injury (TBI). TBI is a major health problem worldwide, with the majority of cases identified as mild TBI (mTBI). MTBI is of concern because it is a modifiable risk factor for dementia. A major challenge in studying mTBI is its inherent heterogeneity across a large feature space (e.g., etiology, age of injury, sex, treatment, initial health status, etc.). Parallel lines of research in human and rodent mTBI can be collated to take advantage of the full suite of neuroscience tools, from neuroimaging (electroencephalography: EEG; functional magnetic resonance imaging: fMRI; diffusion tensor imaging: DTI) to biochemical assays. Despite these attractive components and the need for effective treatments, there are at least two major challenges to implementation. First, there is insufficient understanding of how neurostimulation alters neural mechanisms. Second, there is insufficient understanding of how mTBI alters neural function. The goal of this review is to assemble interrelated but disparate areas of research to identify important gaps in knowledge impeding the implementation of neurostimulation.