Under-recognised traumatic brain injury (TBI) may elevate the risk of both cardiovascular and cognitive dysfunction, a new study has revealed. TBI is a leading cause of long-term disability and premature death, especially among military personnel and those playing contact sports.
Existing research has identified a strong link between TBI and neurological conditions, such as Alzheimer’s disease and dementia. However, the mechanisms driving neurological disease after TBI remain poorly understood.
Now a new study, published in The Lancet Neurology journal finds that non-neurological effects of TBI, such as cardiovascular, cardiometabolic and endocrine dysfunction, may act as intermediaries contributing to neurological disease decades after TBI.
“Despite decades of extensive traumatic brain injury focused research, surprisingly, there has been minimal progress in mitigating long-term outcomes and mortality following injuries,” said first author Saef Izzy, from the Stroke and Cerebrovascular Center of Brigham and Women’s Hospital in the US.
“The cardiovascular effects of TBI may be a missing link in advancing our efforts to improve long-term quality of life and reducing mortality rates in TBI patients,” said Izzy.
Also, the weight gain and sleep disturbances after an injury could pose independent or additive risks and disruptions to connections between the nervous and gastrointestinal systems could throw off the balance of microbes in the gut, contributing to cognitive and cardiovascular effects.
However, it remains unclear how single versus repetitive injuries, age at injury, TBI severity, and other comorbidities impact cardiovascular risk.
“This review is a clarion call to conduct better assessments and earlier intervention for survivors of TBI who may have increased cardiovascular risk. It calls for new or expanded datasets that capture, over time, changes in biomarkers and targets associated with cardiovascular disease,” said Ross Zafonte, the corresponding author, Chief of the Departments of Physical Medicine and Rehabilitation at Massachusetts General Hospital and Brigham and Women’s Hospital.
“There is a growing recognition that many systems interact to produce multilevel dysfunction after TBI, with a series of nuanced comorbidities,” Zafonte concluded.
