PTOTSLPCohortThe Journal of head trauma rehabilitation2024

Associations of Prior Head Injury With Mild Behavioral Impairment Domains.

Lisa N Richey, Nicholas O Daneshvari, Lisa Young and 6 others

PMID 37335212

WHAT IT FOUND

Multiple prior head injuries are associated with higher rates of impulse dyscontrol and affective dysregulation in older adults.

These behavioral symptoms appeared decades after the injury. Single injuries showed no such association. Screen for mood and behavioral changes in patients with a history of repeated head trauma.

Key findings

01History of two or more head injuries, but not one, was associated with increased odds of impairment in affective dysregulation and impulse dyscontrol domains.

02When analyzing specific symptoms, two or more head injuries were associated with increased odds of depression/dysphoria and irritability/lability.

03Associations between head injury and impulse dyscontrol were stronger among women and younger participants.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Head injury status was determined by self-report and ICD codes, which may lack detail on injury severity or mechanism. The MBI domains were derived from an algorithm applied to the NPI-Q, not the original Mild Behavioral Impairment Checklist (MBI-C). The study is observational, so it cannot prove that head injury caused the behavioral symptoms. Participants were selected for the neurocognitive study based on age and cognitive status, which may limit generalizability to the broader population despite weighting. Analysis of injury severity was limited by low power due to few cases with documented moderate/severe injuries.

Declared interests

The authors declare there are no conflicts of interest.

The easy way to misread this

Do not assume a single head injury carries the same behavioral risk. The study found that increased odds for impulse dyscontrol and affective dysregulation were associated only with a history of two or more prior head injuries, not with a single injury.

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