Publications by authors named "Kristen Dams-OʼConnor"

Article Synopsis
  • Recent autopsy studies show that interface astroglial scarring (IAS) can occur at the gray-white matter junction in military personnel who experience repeated blast brain injuries.
  • There is currently no neuroimaging test available to detect IAS, making it difficult to diagnose and treat these injuries.
  • In a study of 27 U.S. Special Operations Forces personnel, five individuals (18.5%) showed elevated neuroinflammation signals at the gray-white matter interface compared to healthy controls, suggesting that TSPO PET scans may help identify repeated blast brain injury.
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Background And Objective: Alzheimer's disease and related dementias (ADRDs) are progressive conditions that substantially impact individuals and families. Timely diagnosis and early support are critical for long-term adjustment. However, current dementia care models do not meet needs of patients and families.

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Article Synopsis
  • Researchers developed prediction models to estimate the risk of posttraumatic epilepsy (PTE) in individuals who experienced moderate-to-severe traumatic brain injuries (TBI) during a two-year recovery period.
  • The study utilized data from over 6,000 participants in the TBI Model Systems National Database, performing analyses to create models that account for various factors influencing seizure risk post-injury.
  • Key findings indicated that Model 3, which focused on predicting new or recurrent seizures in the second year, had the highest sensitivity (86.63%) and effectiveness, with factors like cranial surgeries and traumatic hemorrhages being significant risk predictors across all models.
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Importance: Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive head impacts (RHIs). Prior research suggests a dose-response association between American football play duration and CTE risk and severity, but this association has not been studied for ice hockey.

Objective: To investigate associations of duration of ice hockey play with CTE diagnosis and severity, functional status, and dementia.

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Article Synopsis
  • Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to frequent head injuries, often seen in athletes and military personnel, with a focus on its relationship with aggression and family mental health history.
  • The study analyzed data from deceased male brain donors with CTE, aiming to determine if the presence of CTE affects the relationship between first-degree family history of mental illness (1°FHMI) and aggression, using structured assessments and various demographic controls.
  • Results indicated that 1°FHMI was significantly correlated with aggression scores in individuals with CTE, suggesting that CTE pathology may influence aggression differently than previously understood, while no such association was found in those without CTE.
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Background: Due to significant injury heterogeneity, outcome prediction following traumatic brain injury (TBI) is challenging. This study aimed to develop a simple model for high-accuracy mortality risk prediction after TBI.

Study Design: Data from the American College of Surgeons (ACS) Trauma Quality Program (TQP) from 2019 to 2021 was used to develop a summary score based on age, the Glasgow Coma Scale (GCS) component subscores, and pupillary reactivity data.

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Objective: To examine risk factors associated with homeboundness 1-year after traumatic brain injury (TBI) and to explore associations between homebound status and risk of future mortality and nursing home entry.

Design: Secondary analysis of a longitudinal prospective cohort study.

Setting: TBI Model Systems centers.

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Purpose/objective: Brain injuries are often "invisible" injuries that can have lifelong consequences including changes in identity, functional independence, relationships, and reduced participation in daily activities. Survivors of brain injury experience stigma and challenges related to the misattribution of symptoms to other causes that are significant barriers to recovery and adjustment. Changes in policy and other large-scale interventions are cited as an underexplored, yet critical path to reducing the impact of brain injury.

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Article Synopsis
  • This study aimed to explore how cognitive changes following inpatient rehabilitation impact participation and life satisfaction one year later for individuals with traumatic brain injury (TBI).
  • The analysis included 499 participants from a larger dataset, focusing on their performance in cognitive assessments (BTACT) at discharge and one year post-injury.
  • Results indicated that while changes in episodic memory were linked to better participation and life satisfaction outcomes, changes in executive function did not show a significant association once controlled for other factors.
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Purpose/objective: Psychometric network analysis (PNA) is an application of dynamic systems theory that can inform measurement of complex rehabilitation phenomena such as depressive symptom patterns in veterans and service members (V/SMs) after traumatic brain injury (TBI). This study applied PNA to the Patient Health Questionnaire-9 (PHQ-9), a common measure of depressive symptoms, in a sample of V/SMs with TBI at Years 1 and 2 (Y1-2) postinjury.

Research Method/design: A sample of 808 V/SMs with TBI participated, 594 contributing PHQ-9 data at Y1 and 585 at Y2.

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Objective: To create a census-based composite neighborhood socioeconomic deprivation index (NSDI) from geocoded residential addresses and to quantify how NSDI aligns with individual-level socioeconomic factors among people with traumatic brain injury (TBI).

Setting: Community.

Participants: People enrolled in the TBI Model Systems National Database (TBIMS NDB).

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Deficits in memory performance have been linked to a wide range of neurological and neuropsychiatric conditions. While many studies have assessed the memory impacts of individual conditions, this study considers a broader perspective by evaluating how memory recall is differentially associated with nine common neuropsychiatric conditions using data drawn from 55 international studies, aggregating 15,883 unique participants aged 15-90. The effects of dementia, mild cognitive impairment, Parkinson's disease, traumatic brain injury, stroke, depression, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder on immediate, short-, and long-delay verbal learning and memory (VLM) scores were estimated relative to matched healthy individuals.

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Traumatic brain injury (TBI) is a risk factor for neurodegeneration and cognitive decline, yet the underlying pathophysiologic mechanisms are incompletely understood. This gap in knowledge is in part related to the lack of analytic methods to account for cortical lesions in prior neuroimaging studies. The objective of this study was to develop a lesion detection tool and apply it to an investigation of longitudinal changes in brain structure among individuals with chronic TBI.

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Purpose/objective: To examine the association of changes in homebound status (i.e., never/rarely leaving the home) with life satisfaction in the first 10 years after traumatic brain injury (TBI).

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Traumatic brain injuries (TBIs) can lead to long-lasting cognitive impairments, and some survivors experience cognitive decline post-recovery. Early detection of decline is important for care planning, and understanding risk factors for decline can elucidate targets for prevention. While neuropsychological testing is the gold standard approach to characterizing cognitive function, there is a need for brief, scalable tools that are capable of detecting clinically significant changes in post-TBI cognition.

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Objective: The long-term consequences of traumatic brain injury (TBI) on brain structure remain uncertain. Given evidence that a single significant brain injury event increases the risk of dementia, brain-age estimation could provide a novel and efficient indexing of the long-term consequences of TBI. Brain-age procedures use predictive modeling to calculate brain-age scores for an individual using structural magnetic resonance imaging (MRI) data.

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Objective: To ascertain patient and caregiver satisfaction with an individualized case management intervention to improve transition from inpatient rehabilitation care to the community after traumatic brain injury (TBI).

Setting: Participants from 6 National Institute on Disability, Independent Living, and Rehabilitation Research-funded TBI Model Systems sites in the United States.

Participants: Adult, English-speaking patients with TBI who had moderate-to-severe TBI and were discharged from a TBI Model Systems site and who were in the intervention arm of the Brain Injury Rehabilitation: Improving the Transition Experience pragmatic clinical trial, as well as their caregivers.

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Article Synopsis
  • The effects of repeated blast exposure (RBE) on the brain health of US Special Operations Forces (SOF) are not fully understood, and currently, there is no test to diagnose injury from such exposures.
  • A study involving 30 active-duty US SOF found that higher blast exposure correlates with changes in brain structure and cognitive performance, particularly affecting the rostral anterior cingulate cortex (rACC).
  • These findings indicate that increased blast exposure can lead to health-related issues and suggest that a comprehensive, network-based diagnostic method may be beneficial for identifying brain injuries in SOF personnel.
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Objective: The objectives of this study were to characterize and identify correlates of healthy days at home (HDaH) before and after TBI requiring inpatient rehabilitation.

Setting: Inpatient hospital, nursing home, and home health services.

Participants: Average of n = 631 community-dwelling fee-for-service age 66+ Medicare beneficiaries across 30 replicate samples who were hospitalized for traumatic brain injury (TBI) between 2012 and 2014 and admitted to an inpatient rehabilitation facility (IRF) within 72 hours of hospital discharge.

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Article Synopsis
  • - The study analyzed data from 447 individuals with moderate to severe traumatic brain injury (TBI) to investigate the frequency and timing of repetitive head impacts (RHI) and their influence on mental health outcomes.
  • - Findings revealed that most RHI incidents were sports-related (61.1%), with post-injury exposures linked to increased depression and anxiety symptoms compared to pre-injury exposures.
  • - The research underscores the importance of evaluating RHI in the context of TBI for better mental health assessments and the development of targeted interventions to support affected individuals.
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Traumatic brain injury (TBI) has evolved from a topic of relative obscurity to one of widespread scientific and lay interest. The scope and focus of TBI research have shifted, and research trends have changed in response to public and scientific interest. This study has two primary goals: first, to identify the predominant themes in TBI research; and second, to delineate "hot" and "cold" areas of interest by evaluating the current popularity or decline of these topics.

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Repetitive head impacts (RHIs) from football are associated with the neurodegenerative tauopathy chronic traumatic encephalopathy (CTE). It is unclear whether a history of traumatic brain injury (TBI) is sufficient to precipitate CTE neuropathology. We examined the association between TBI and CTE neuropathology in 580 deceased individuals exposed to RHIs from football.

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Intimate partner violence (IPV) is a significant, global public health concern. Women, individuals with historically underrepresented identities, and disabilities are at high risk for IPV and tend to experience severe injuries. There has been growing concern about the risk of exposure to IPV-related head trauma, resulting in IPV-related brain injury (IPV-BI), and its health consequences.

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Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by hyperphosphorylated tau (p-tau) accumulation. The clinical features associated with CTE pathology are unclear. In brain donors with autopsy-confirmed CTE, we investigated the association of CTE p-tau pathology density and location with cognitive, functional, and neuropsychiatric symptoms.

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This study examined the frequency of chronic traumatic encephalopathy-neuropathologic change (CTE-NC) and aging-related tau astrogliopathy (ARTAG) in community-dwelling older adults and tested the hypothesis that these tau pathologies are associated with a history of moderate-to-severe traumatic brain injury (msTBI), defined as a TBI with loss of consciousness >30 minutes. We evaluated CTE-NC, ARTAG, and Alzheimer disease pathologies in 94 participants with msTBI and 94 participants without TBI matched by age, sex, education, and dementia status TBI from the Rush community-based cohorts. Six (3%) of brains showed the pathognomonic lesion of CTE-NC; only 3 of these had a history of msTBI.

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