1
|
Boyko M, Gruenbaum BF, Oleshko A, Merzlikin I, Zlotnik A. Diet's Impact on Post-Traumatic Brain Injury Depression: Exploring Neurodegeneration, Chronic Blood-Brain Barrier Destruction, and Glutamate Neurotoxicity Mechanisms. Nutrients 2023; 15:4681. [PMID: 37960334 PMCID: PMC10649677 DOI: 10.3390/nu15214681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Traumatic brain injury (TBI) has a profound impact on cognitive and mental functioning, leading to lifelong impairment and significantly diminishing the quality of life for affected individuals. A healthy blood-brain barrier (BBB) plays a crucial role in guarding the brain against elevated levels of blood glutamate, making its permeability a vital aspect of glutamate regulation within the brain. Studies have shown the efficacy of reducing excess glutamate in the brain as a treatment for post-TBI depression, anxiety, and aggression. The purpose of this article is to evaluate the involvement of dietary glutamate in the development of depression after TBI. We performed a literature search to examine the effects of diets abundant in glutamate, which are common in Asian populations, when compared to diets low in glutamate, which are prevalent in Europe and America. We specifically explored these effects in the context of chronic BBB damage after TBI, which may initiate neurodegeneration and subsequently have an impact on depression through the mechanism of chronic glutamate neurotoxicity. A glutamate-rich diet leads to increased blood glutamate levels when contrasted with a glutamate-poor diet. Within the context of chronic BBB disruption, elevated blood glutamate levels translate to heightened brain glutamate concentrations, thereby intensifying neurodegeneration due to glutamate neurotoxicity.
Collapse
Affiliation(s)
- Matthew Boyko
- Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben-Gurion of the Negev, Beer-Sheva 84101, Israel
| | - Benjamin F Gruenbaum
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Anna Oleshko
- Department of Biology and Methods of Teaching Biology, A. S. Makarenko Sumy State Pedagogical University, Sumy 40002, Ukraine
| | - Igor Merzlikin
- Department of Biology and Methods of Teaching Biology, A. S. Makarenko Sumy State Pedagogical University, Sumy 40002, Ukraine
| | - Alexander Zlotnik
- Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben-Gurion of the Negev, Beer-Sheva 84101, Israel
| |
Collapse
|
2
|
Starkey NJ, Duffy B, Jones K, Theadom A, Barker-collo S, Feigin V, on behalf of the BIONIC8 Research Group. Sex differences in outcomes from mild traumatic brain injury eight years post-injury. PLoS One 2022; 17:e0269101. [PMID: 35622845 PMCID: PMC9140230 DOI: 10.1371/journal.pone.0269101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/16/2022] [Indexed: 11/19/2022] Open
Abstract
The long-term effects of mild TBI (mTBI) are not well understood, and there is an ongoing debate about whether there are sex differences in outcomes following mTBI. This study examined i) symptom burden and functional outcomes at 8-years post-injury in males and females following mTBI; ii) sex differences in outcomes at 8-years post-injury for those aged <45 years and ≥45 years and; iii) sex differences in outcomes for single and repetitive TBI. Adults (≥16 years at injury) identified as part of a population-based TBI incidence study (BIONIC) who experienced mTBI 8-years ago (N = 151) and a TBI-free sample (N = 151) completed self-report measures of symptoms and symptom burden (Rivermead Post-Concussion Symptom Questionnaire, Hospital Anxiety and Depression Scale, Post-traumatic Stress Disorder Checklist), and functional outcomes (Participation Assessments with Recombined Tools, Work Limitations Questionnaire). The mTBI group reported significantly greater post-concussion symptoms compared to the TBI-free group (F(1,298) = 26.84, p<.01, ηp2 = .08). Females with mTBI were twice as likely to exceed clinical cut-offs for post-concussive (X2 (1)>5.2, p<.05, V>.19) and PTSD symptoms (X2(1) = 6.10, p = .014, V = .20) compared to the other groups, and reported their health had the greatest impact on time-related work demands (F(1,171) = 4.36, p = .04, ηp2 = .03. There was no interaction between sex and age on outcomes. The repetitive mTBI group reported significantly greater post-concussion symptoms (F(1,147) = 9.80, p<.01, ηp2 = .06) compared to the single mTBI group. Twice the proportion of women with repetitive mTBI exceeded the clinical cut-offs for post-concussive (X2(1)>6.90, p<.01, V>.30), anxiety (X2(1)>3.95, p<.05, V>.23) and PTSD symptoms (X2(1)>5.11, p<.02, V>.26) compared with males with repetitive TBI or women with single TBI. Thus, at 8-years post-mTBI, people continued to report a high symptom burden. Women with mTBI, particularly those with a history of repetitive mTBI, had the greatest symptom burden and were most likely to have symptoms of clinical significance. When treating mTBI it is important to assess TBI history, particularly in women. This may help identify those at greatest risk of poor long-term outcomes to direct early treatment and intervention.
Collapse
|
3
|
Mureșanu IA, Grad DA, Mureșanu DF, Hapca E, Benedek I, Jemna N, Strilciuc Ș, Popescu BO, Perju-dumbravă L, Cherecheș RM. The Effect of Cerebrolysin on Anxiety, Depression, and Cognition in Moderate and Severe Traumatic Brain Injury Patients: A CAPTAIN II Retrospective Trial Analysis. Medicina (B Aires) 2022; 58:648. [PMID: 35630065 PMCID: PMC9147297 DOI: 10.3390/medicina58050648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Traumatic brain injuries represent an important source of disease burden requiring emergency inpatient care and continuous outpatient tailored rehabilitation. Although most TBIs are mild, patients are still developing post-TBI depression, anxiety, and cognitive impairments. Our secondary retrospective trial analysis aimed to (1) analyze correlations between HADS-Anxiety/HADS-Depression and scales that measure cognitive and motor processes in patients treated with Cerebrolysin compared to the placebo group and (2) compare anxiety and depression scores among the two treatment groups. Materials and Methods: Our secondary retrospective analysis focused on TBI patients with moderate and severe disability divided into two groups: Cerebrolysin (treatment) and saline solution (procedural placebo). We analyzed data from 125 patients. We computed descriptive statistics for nominal and continuous variables. We used Spearman’s correlation to find associations between HADS and other neuropsychological scales and the Mann–Whitney U test to compare HADS-Anxiety and HADS-Depression scores among the two study arms. Results: Our sample consisted of patients with a mean age of 45.3, primarily men, and with a 24 h GCS (Glasgow Coma Scale) mean of 12.67. We obtained statistically significant differences for HADS-Anxiety during the second and third visits for patients treated with Cerebrolysin. Our results show that Cerebrolysin has a large effect size (0.73) on anxiety levels. In addition, there are positive and negative correlations between HADS-Anxiety and Depression subscales and other neuropsychological scales. Conclusions: Our secondary database analysis supports the existing body of evidence on the positive effect of Cerebrolysin on post-TBI mental health status. Future confirmatory trials are necessary to clarify the link between the intervention and measured outcomes.
Collapse
|
4
|
Brouillette MJ, Koski L, Scott S, Austin-Keiller A, Fellows LK, Mayo NE. Factors Influencing Psychological Distress During the COVID-19 Pandemic in People Aging with HIV. AIDS Res Hum Retroviruses 2022; 38:421-430. [PMID: 34714115 DOI: 10.1089/aid.2021.0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Older adults living with HIV may be at increased risk of experiencing distress during the coronavirus disease 2019 (COVID-19) pandemic. We took advantage of a cohort study in older adults living with HIV in Canada (The Positive Brain Health Now [+BHN]) to study the psychological impact of the first wave of the COVID-19 pandemic. A longitudinal study was conducted in which participants in the +BHN study who had access to the internet and agreed to be contacted were queried on symptoms of psychological distress and its predictors each week between mid-April and the end of June 2020. Evolution of distress, measured with the Hospital Anxiety and Depression Scale (HADS), was modeled using Group Based Trajectory Analysis and logistic regression was used to identify factors predictive of psychological distress in the clinical range. The study was approved by the Research Ethics Board of the McGill University Health Center and all participants provided informed consent. The 77 +BHN participants who took part in this study were mostly men (92%) and on average 57.3 years of age. Over the study period, 32.5% experienced psychological distress in the clinical range at one or more weekly surveys. In the transition between the pre-COVID-19 and the COVID-19 periods, the HADS scores followed five distinct trajectories: (1) 39.5 % of the sample, with normal HADS scores in the several months preceding the pandemic, experienced an increase in HADS scores; (2) 30.6% of the sample had normal prepandemic HADS scores, remained stable; and (3) 29.9%, with prepandemic presence of distress, had a decrease in HADS scores. During the first wave of COVID-19, some attenuation in distress was seen over time. Feeling lonely and financial insecurity were associated with distress. Presence of psychological distress during the first wave of the COVID-19 pandemic was not universal among older adults with HIV, with as many as one third of the participants reporting an improvement in mental health. Distress was predicted by loneliness and financial insecurity.
Collapse
Affiliation(s)
- Marie-Josee Brouillette
- Department of Psychiatry, McGill University, Montreal, Canada
- Chronic Viral Illness Service, McGill University Health Centre (MUHC), Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, MUHC-RI, Montreal, Canada
| | - Lisa Koski
- Department of Psychology, McGill University, Montreal, Canada
| | - Susan Scott
- Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Center for Outcomes Research and Evaluation, Montreal, Canada
| | | | - Lesley K. Fellows
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
- Montreal Neurological Hospital and Institute, McGill University, Montreal, Canada
| | - Nancy E. Mayo
- Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Center for Outcomes Research and Evaluation, Montreal, Canada
- Department of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Division of Geriatrics, McGill University Health Centre (MUHC), Montreal, Canada
| |
Collapse
|
5
|
Song Y, Han X, Li G, Tong W, Fan M, Chen X, Yin J, Chen S, Huang J, Gao D, Gao L, Dong Y, D'alessandris QG. Decreased Interhemispheric Functional Connectivity and Its Associations with Clinical Correlates following Traumatic Brain Injury. BioMed Research International 2022; 2022:1-9. [PMID: 35437509 PMCID: PMC9012975 DOI: 10.1155/2022/3408660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022]
Abstract
Objective To explore the interhemispheric functional coordination following traumatic brain injury (TBI) and its association with posttraumatic anxiety and depressive symptoms. Methods This was a combination of a retrospective cohort study and a cross-sectional observational study. We investigated the functional coordination between hemispheres by voxel-mirrored homotopic connectivity (VMHC). Grey matter volumes were examined by voxel-based morphometry (VBM), and microstructural integrity of the corpus callosum (CC) was assessed by diffusion tension imaging (DTI). The anxiety and depressive symptoms were evaluated with the Hospital Anxiety and Depression Scale. Results The VMHC values of the bilateral middle temporal gyrus (MTG) and orbital middle frontal gyrus (MFG) were significantly decreased in TBI patients versus the healthy controls. Weakened homotopic functional connectivity (FC) in the bilateral orbital MFG is moderate positively correlated with anxiety and depressive symptoms. The white matter integrity in the CC was extensively reduced in TBI patients. In the receiver operating characteristic analysis, the VMHC value of the orbital MFG could distinguish TBI from HC with an area under the curve of 0.939 (sensitivity of 1 and specificity of 0.867). Conclusion TBI disrupts the interhemispheric functional and structural connection, which is correlated with posttraumatic mood disorders. These findings may serve as a clinical indicator for diagnosis.
Collapse
|
6
|
Koski L, Brouillette MJ, Mayo NE, Scott SC, Fellows LK, Sookman D. A Short-term Psychological Intervention for People Living with HIV During the First Wave of COVID-19. Int J Cogn Ther 2021;:1-21. [PMID: 34804328 DOI: 10.1007/s41811-021-00127-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 12/21/2022]
Abstract
Research on the psychosocial impact of COVID-19 has found significant levels of distress among the general population, and among those especially vulnerable due to chronic social or health challenges. Among these are individuals aging with HIV infection, who are encountering COVID-19 as a new infectious threat to their health and wellbeing. In a longitudinal observational study of the psychosocial impact of COVID-19 in middle-aged and older people living with HIV, we identified a subset of participants who expressed heightened levels of distress and were referred for clinical intervention. This paper describes the supportive and contemporary cognitive-behavioral interventions that were provided and presents data on changes in distress in this case series. This work provides a model for identifying people in at-risk groups in acute need of psychological intervention and for implementing an individualized clinical response that can be safely delivered in the context of COVID-19 and future crisis situations.
Collapse
|
7
|
Li G, Han X, Gao L, Tong W, Xue Q, Gong S, Song Y, Chen S, Dong Y. Association of Anxiety and Depressive Symptoms with Memory Function following Traumatic Brain Injury. Eur Neurol 2021; 84:340-347. [PMID: 34182550 DOI: 10.1159/000513195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/17/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Memory impairment and mood disorders are among the most troubling sequelae following traumatic brain injury (TBI). The relationships between comorbid psychiatric disorders and memory function have not been well illustrated. The aim of the study was to explore the relationships of comorbid anxiety and depressive symptoms with memory function following TBI. METHODS A total of 46 TBI participants across all levels of injury and 23 healthy controls were enrolled in this case-control study. Wechsler Memory Scale-Chinese Revision (WMS-CR) picture, recognition, associative learning, comprehension memory, and digit span were administered to evaluate several categories of memory capacity. The Hospital Anxiety and Depression Scale (HADS) was employed to evaluate the anxiety and depressive symptoms. Stepwise multiple linear regressions were conducted. RESULTS Compared to healthy controls, the participants with TBI reported more anxiety and depressive symptoms. In the meanwhile, they performed more poorly on memory tests, showing 1.84 SDs, 1.07 SDs, and 0.68 SDs below healthy participants on visuospatial memory, working memory, and verbal memory, respectively. A variety of variables, including HADS depression, HADS anxiety, age, GCS, and education were associated with posttraumatic memory function in the bivariate models. The stepwise multiple linear regressions demonstrated a negative association between HADS depression and posttraumatic memory function, especially performance on visuospatial and verbal memory and a positive association between education and posttraumatic memory function. CONCLUSION More depressive symptoms rather than anxiety symptoms and less years of education are significant predictors for posttraumatic memory dysfunction.
Collapse
Affiliation(s)
- Gaoyi Li
- Department of Neurosurgery, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Xi Han
- Department of Neurosurgery, Shanghai Hushan Hospital, Fudan University, Shanghai, China
| | - Liang Gao
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wusong Tong
- Department of Neurosurgery, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Qiang Xue
- Department of Neurosurgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Shun Gong
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Yu Song
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Songyu Chen
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan Dong
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Shanghai Tenth People's Hospital Clinical Medicine Scientific and Technical Innovation Park, Shanghai, China
| |
Collapse
|
8
|
Li Y, Liu J, Peng Z, Sheng C, Kim M, Yap PT, Wee CY, Shen D. Fusion of ULS Group Constrained High- and Low-Order Sparse Functional Connectivity Networks for MCI Classification. Neuroinformatics 2020; 18:1-24. [PMID: 30982183 DOI: 10.1007/s12021-019-09418-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Functional connectivity networks, derived from resting-state fMRI data, have been found as effective biomarkers for identifying mild cognitive impairment (MCI) from healthy elderly. However, the traditional functional connectivity network is essentially a low-order network with the assumption that the brain activity is static over the entire scanning period, ignoring temporal variations among the correlations derived from brain region pairs. To overcome this limitation, we proposed a new type of sparse functional connectivity network to precisely describe the relationship of temporal correlations among brain regions. Specifically, instead of using the simple pairwise Pearson's correlation coefficient as connectivity, we first estimate the temporal low-order functional connectivity for each region pair based on an ULS Group constrained-UOLS regression algorithm, where a combination of ultra-least squares (ULS) criterion with a Group constrained topology structure detection algorithm is applied to detect the topology of functional connectivity networks, aided by an Ultra-Orthogonal Least Squares (UOLS) algorithm to estimate connectivity strength. Compared to the classical least squares criterion which only measures the discrepancy between the observed signals and the model prediction function, the ULS criterion takes into consideration the discrepancy between the weak derivatives of the observed signals and the model prediction function and thus avoids the overfitting problem. By using a similar approach, we then estimate the high-order functional connectivity from the low-order connectivity to characterize signal flows among the brain regions. We finally fuse the low-order and the high-order networks using two decision trees for MCI classification. Experimental results demonstrate the effectiveness of the proposed method on MCI classification.
Collapse
|
9
|
Hoang CL, Vu HM, Pham HQ, Nguyen HLT, Vu LG, Tran BX, Latkin CA, Ho RCM, Ho CSH. Psychological Distress of Patients Experiencing Different Types of Road Traffic Injuries in Vietnam. Int J Environ Res Public Health 2020; 17:E3429. [PMID: 32423067 DOI: 10.3390/ijerph17103429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 12/02/2022]
Abstract
Road-related injuries are often catastrophic, and the eighth leading cause of all-aged mortality. While psychological problems, including anxiety, driving phobia, and post-traumatic stress have been found to be common among injured survivors, the literature in this area is still limited. This study aimed to evaluate the prevalence of distress between different types of road injuries among 413 patients in Thai Binh hospitals from October to December 2018. The Kessler Psychological Distress Scale (K6) was used to assess mental health status. Sociodemographic and clinical characteristics were also collected. The results of Multiple Logistic and Tobit regression models were utilized. Psychological issues were found in 13.8% of the participants. In terms of K6 profile, nervous, restless/fidgety, and “everything was an effort” were the three most frequently endorsed aspects. Having soft-tissue injuries had a 0.32-time lower likelihood of psychological distress compared to those having other injuries. Additionally, patients who were diagnosed with fractures were 4.5-times more likely to report psychological distress. Our finding highlights the need for psychological screening to reduce disabilities associated with non-fatal injury related to road traffic crashes.
Collapse
|