Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progression
Abstract Introduction Traumatic brain injury (TBI) may alter dementia progression, although co‐occurring neuropsychiatric symptoms (NPS) have received less attention. Originally designed to evaluate behavioral disruption prior to dementia diagnosis, the mild behavioral impairment (MBI) construct rel...
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Wiley
2022-01-01
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| Series: | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
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| Online Access: | https://doi.org/10.1002/trc2.12364 |
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| author | Michael J. C. Bray Barry R. Bryant Aaron I. Esagoff Lisa N. Richey Carla Rodriguez Akshay Krieg Gardner McCullough Jerry Tsai William Tobolowsky Sahar Jahed C. Munro Cullum Christian LoBue Zahinoor Ismail Haijuan Yan Constantine G. Lyketsos Matthew E. Peters |
| author_facet | Michael J. C. Bray Barry R. Bryant Aaron I. Esagoff Lisa N. Richey Carla Rodriguez Akshay Krieg Gardner McCullough Jerry Tsai William Tobolowsky Sahar Jahed C. Munro Cullum Christian LoBue Zahinoor Ismail Haijuan Yan Constantine G. Lyketsos Matthew E. Peters |
| author_sort | Michael J. C. Bray |
| collection | DOAJ |
| description | Abstract Introduction Traumatic brain injury (TBI) may alter dementia progression, although co‐occurring neuropsychiatric symptoms (NPS) have received less attention. Originally designed to evaluate behavioral disruption prior to dementia diagnosis, the mild behavioral impairment (MBI) construct relates NPS to underlying neural circuit disruptions, with probable relevance across the progression of neurodegenerative disease. Therefore, the MBI construct may represent a valuable tool to identify and evaluate related NPS both preceding diagnosis of all‐cause dementia throughout the progression of disease, representing an important area of inquiry regarding TBI and dementia. This investigation sought to evaluate the effect of TBI on NPS related by the MBI construct in participants progressing from normal cognitive status to all‐cause dementia. Methods Using National Alzheimer's Coordinating Center data, individuals progressing from normal cognition to all‐cause dementia (clinician diagnosed) over 7.6 ± 3.0 years were studied to estimate prevalence of MBI domains in 124 participants with prior TBI history (57 with loss of consciousness [LOC] <5 minutes, 22 with LOC >5 min, 45 unknown severity) compared to 822 without. MBI domain prevalence was evaluated (1) prior to dementia onset (including only time points preceding time at dementia diagnosis, as per MBI's original definition) and (2) throughout dementia progression (evaluating all available time points, including both before and after dementia diagnosis). Results More severe TBI (LOC >5 minutes) was associated with the social inappropriateness MBI domain (adjusted odds ratio = 4.034; P = 0.024) prior to dementia onset, and the abnormal perception/thought content domain looking across dementia progression (adjusted hazard ratio [HRadj] = 3.703; P = 0.005). TBI (all severities) was associated with the decreased motivation domain looking throughout dementia progression (HRadj. = 1.546; P = 0.014). Discussion TBI history is associated with particular MBI profiles prior to onset and throughout progression of dementia. Understanding TBI's impact on inter‐related NPS may help elucidate underlying neuropathology with implications for surveillance, detection, and treatment of behavioral concerns in aging TBI survivors. Highlights The mild behavioral impairment (MBI) construct links related neuropsychiatric symptoms (NPS) by probable underlying neural network dysfunction. Traumatic brain injury (TBI) with loss of consciousness (LOC) > 5 minutes was associated with pre‐dementia social inappropriateness. TBI was associated with decreased motivation looking across dementia progression. TBI with LOC > 5 minutes was associated with abnormal perception/thought content. The MBI construct may be useful for examining related NPS across dementia progression. |
| format | Article |
| id | doaj-art-7c48d958324b47c1aa706db42073f5e0 |
| institution | Kabale University |
| issn | 2352-8737 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
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| series | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| spelling | doaj-art-7c48d958324b47c1aa706db42073f5e02024-12-03T12:37:32ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372022-01-0181n/an/a10.1002/trc2.12364Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progressionMichael J. C. Bray0Barry R. Bryant1Aaron I. Esagoff2Lisa N. Richey3Carla Rodriguez4Akshay Krieg5Gardner McCullough6Jerry Tsai7William Tobolowsky8Sahar Jahed9C. Munro Cullum10Christian LoBue11Zahinoor Ismail12Haijuan Yan13Constantine G. Lyketsos14Matthew E. Peters15Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry University of Texas Southwestern Medical Center Dallas Texas USADepartment of Psychiatry University of Texas Southwestern Medical Center Dallas Texas USADepartment of Psychiatry, Cumming School of Medicine University of Calgary Calgary Alberta CanadaDepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USADepartment of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USAAbstract Introduction Traumatic brain injury (TBI) may alter dementia progression, although co‐occurring neuropsychiatric symptoms (NPS) have received less attention. Originally designed to evaluate behavioral disruption prior to dementia diagnosis, the mild behavioral impairment (MBI) construct relates NPS to underlying neural circuit disruptions, with probable relevance across the progression of neurodegenerative disease. Therefore, the MBI construct may represent a valuable tool to identify and evaluate related NPS both preceding diagnosis of all‐cause dementia throughout the progression of disease, representing an important area of inquiry regarding TBI and dementia. This investigation sought to evaluate the effect of TBI on NPS related by the MBI construct in participants progressing from normal cognitive status to all‐cause dementia. Methods Using National Alzheimer's Coordinating Center data, individuals progressing from normal cognition to all‐cause dementia (clinician diagnosed) over 7.6 ± 3.0 years were studied to estimate prevalence of MBI domains in 124 participants with prior TBI history (57 with loss of consciousness [LOC] <5 minutes, 22 with LOC >5 min, 45 unknown severity) compared to 822 without. MBI domain prevalence was evaluated (1) prior to dementia onset (including only time points preceding time at dementia diagnosis, as per MBI's original definition) and (2) throughout dementia progression (evaluating all available time points, including both before and after dementia diagnosis). Results More severe TBI (LOC >5 minutes) was associated with the social inappropriateness MBI domain (adjusted odds ratio = 4.034; P = 0.024) prior to dementia onset, and the abnormal perception/thought content domain looking across dementia progression (adjusted hazard ratio [HRadj] = 3.703; P = 0.005). TBI (all severities) was associated with the decreased motivation domain looking throughout dementia progression (HRadj. = 1.546; P = 0.014). Discussion TBI history is associated with particular MBI profiles prior to onset and throughout progression of dementia. Understanding TBI's impact on inter‐related NPS may help elucidate underlying neuropathology with implications for surveillance, detection, and treatment of behavioral concerns in aging TBI survivors. Highlights The mild behavioral impairment (MBI) construct links related neuropsychiatric symptoms (NPS) by probable underlying neural network dysfunction. Traumatic brain injury (TBI) with loss of consciousness (LOC) > 5 minutes was associated with pre‐dementia social inappropriateness. TBI was associated with decreased motivation looking across dementia progression. TBI with LOC > 5 minutes was associated with abnormal perception/thought content. The MBI construct may be useful for examining related NPS across dementia progression.https://doi.org/10.1002/trc2.12364acquired brain injuryAlzheimer's diseaseapathydementiageriatric psychiatryimpulsivity |
| spellingShingle | Michael J. C. Bray Barry R. Bryant Aaron I. Esagoff Lisa N. Richey Carla Rodriguez Akshay Krieg Gardner McCullough Jerry Tsai William Tobolowsky Sahar Jahed C. Munro Cullum Christian LoBue Zahinoor Ismail Haijuan Yan Constantine G. Lyketsos Matthew E. Peters Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progression Alzheimer’s & Dementia: Translational Research & Clinical Interventions acquired brain injury Alzheimer's disease apathy dementia geriatric psychiatry impulsivity |
| title | Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progression |
| title_full | Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progression |
| title_fullStr | Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progression |
| title_full_unstemmed | Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progression |
| title_short | Effect of traumatic brain injury on mild behavioral impairment domains prior to all‐cause dementia diagnosis and throughout disease progression |
| title_sort | effect of traumatic brain injury on mild behavioral impairment domains prior to all cause dementia diagnosis and throughout disease progression |
| topic | acquired brain injury Alzheimer's disease apathy dementia geriatric psychiatry impulsivity |
| url | https://doi.org/10.1002/trc2.12364 |
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