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What is the Relationship of Traumatic Brain Injury to Dementia?

Abstract

There is a long history linking traumatic brain injury (TBI) with the development of dementia. Despite significant reservations, such as recall bias or concluding causality for TBI, a summary of recent research points to several conclusions on the TBI-dementia relationship. 1) Increasing severity of a single moderate-to-severe TBI increases the risk of subsequent Alzheimer's disease (AD), the most common type of dementia. 2) Repetitive, often subconcussive, mild TBIs increases the risk for chronic traumatic encephalopathy (CTE), a degenerative neuropathology. 3) TBI may be a risk factor for other neurodegenerative disorders that can be associated with dementia. 4) TBI appears to lower the age of onset of TBI-related neurocognitive syndromes, potentially adding "TBI cognitive-behavioral features". The literature further indicates several specific risk factors for TBI-associated dementia: 5) any blast or blunt physical force to the head as long as there is violent head displacement; 6) decreased cognitive and/or neuronal reserve and the related variable of older age at TBI; and 7) the presence of apolipoprotein E ɛ4 alleles, a genetic risk factor for AD. Finally, there are neuropathological features relating TBI with neurocognitive syndromes: 8) acute TBI results in amyloid pathology and other neurodegenerative proteinopathies; 9) CTE shares features with neurodegenerative dementias; and 10) TBI results in white matter tract and neural network disruptions. Although further research is needed, these ten findings suggest that dose-dependent effects of violent head displacement in vulnerable brains predispose to dementia; among several potential mechanisms is the propagation of abnormal proteins along damaged white matter networks.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Department of Neurology, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA. Department of Neurology, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

    Source

    MeSH

    Apolipoprotein E4
    Brain
    Brain Injuries, Traumatic
    Databases, Bibliographic
    Dementia
    Disease Progression
    Humans
    Neurodegenerative Diseases
    Risk Factors

    Pub Type(s)

    Journal Article
    Review
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    28269777

    Citation

    Mendez, Mario F.. "What Is the Relationship of Traumatic Brain Injury to Dementia?" Journal of Alzheimer's Disease : JAD, vol. 57, no. 3, 2017, pp. 667-681.
    Mendez MF. What is the Relationship of Traumatic Brain Injury to Dementia? J Alzheimers Dis. 2017;57(3):667-681.
    Mendez, M. F. (2017). What is the Relationship of Traumatic Brain Injury to Dementia? Journal of Alzheimer's Disease : JAD, 57(3), pp. 667-681. doi:10.3233/JAD-161002.
    Mendez MF. What Is the Relationship of Traumatic Brain Injury to Dementia. J Alzheimers Dis. 2017;57(3):667-681. PubMed PMID: 28269777.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - What is the Relationship of Traumatic Brain Injury to Dementia? A1 - Mendez,Mario F, PY - 2017/3/9/pubmed PY - 2017/8/26/medline PY - 2017/3/9/entrez KW - Alzheimer’s disease chronic traumatic encephalopathy KW - dementia KW - traumatic brain injury SP - 667 EP - 681 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 57 IS - 3 N2 - There is a long history linking traumatic brain injury (TBI) with the development of dementia. Despite significant reservations, such as recall bias or concluding causality for TBI, a summary of recent research points to several conclusions on the TBI-dementia relationship. 1) Increasing severity of a single moderate-to-severe TBI increases the risk of subsequent Alzheimer's disease (AD), the most common type of dementia. 2) Repetitive, often subconcussive, mild TBIs increases the risk for chronic traumatic encephalopathy (CTE), a degenerative neuropathology. 3) TBI may be a risk factor for other neurodegenerative disorders that can be associated with dementia. 4) TBI appears to lower the age of onset of TBI-related neurocognitive syndromes, potentially adding "TBI cognitive-behavioral features". The literature further indicates several specific risk factors for TBI-associated dementia: 5) any blast or blunt physical force to the head as long as there is violent head displacement; 6) decreased cognitive and/or neuronal reserve and the related variable of older age at TBI; and 7) the presence of apolipoprotein E ɛ4 alleles, a genetic risk factor for AD. Finally, there are neuropathological features relating TBI with neurocognitive syndromes: 8) acute TBI results in amyloid pathology and other neurodegenerative proteinopathies; 9) CTE shares features with neurodegenerative dementias; and 10) TBI results in white matter tract and neural network disruptions. Although further research is needed, these ten findings suggest that dose-dependent effects of violent head displacement in vulnerable brains predispose to dementia; among several potential mechanisms is the propagation of abnormal proteins along damaged white matter networks. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/28269777/What_is_the_Relationship_of_Traumatic_Brain_Injury_to_Dementia L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-161002 DB - PRIME DP - Unbound Medicine ER -