Abstract

We characterized traumatic brain injury (TBI) and studied its associations with mental and physical health in a community cohort of homeless and vulnerably housed individuals. Detailed mental and physical health structured interviews, neuropsychological testing, and multimodal magnetic resonance imaging (MRI) were performed on 283 participants. Two TBI participant groups were defined for primary analyses: those with a self-reported history of TBI and those with MRI confirmation of TBI. By self-report, 174 participants (61.5%) reported a previous serious head or face injury (symptomatic or asymptomatic), with 100 (35.3%) experiencing symptoms consistent with TBI (any post-injury loss of consciousness, confusion, or memory loss). Persons self-reporting TBI had poorer current mental and physical health, more ongoing neurological symptoms, and a higher rate of mood disorders, compared to those with no TBI. The presence of a mood disorder, a TBI history, and an interaction between these factors contributed to lower mental health. There was evidence of TBI in 20 participants (6.9%) on clinical MRI sequences. These participants had globally lower cortical gray matter volumes and lower white matter fractional anisotropy (FA) values. Neurocognitive test scores positively correlated with both FA and cortical gray matter volumes in participants with MRI evidence of trauma. Previous TBI is associated with poorer mental and physical health in homeless and vulnerably housed individuals and interacts with mood disorders to exacerbate poor mental health. Focal traumatic lesions evident on MRI are associated with diffusely lower gray matter volumes and white matter integrity, which predict cognitive functioning.

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Information & Authors

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Published In

cover image Journal of Neurotrauma
Journal of Neurotrauma
Volume 34Issue Number 23December 1, 2017
Pages: 3301 - 3310
PubMed: 28741437

History

Published in print: December 1, 2017
Published online: 1 December 2017
Published ahead of print: 25 September 2017
Published ahead of production: 25 July 2017

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Affiliations

Toby Schmitt
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Allen E. Thornton
Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.
Iris Rawtaer
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Alasdair M. Barr
Department of Pharmacology, University of British Columbia, Vancouver, British Columbia, Canada.
Kristina M. Gicas
Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.
Donna J. Lang
Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
A. Talia Vertinsky
Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
Alexander Rauscher
Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
Ric M. Procyshyn
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Tari Buchanan
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Alex Cheng
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Sarah MacKay
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Olga Leonova
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Verena Langheimer
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Thalia S. Field
Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.
Manraj K. Heran
Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
Fidel Vila-Rodriguez
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Tiffany A. O'Connor
Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.
G. William MacEwan
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
William G. Honer
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
William J. Panenka
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
British Columbia Neuropsychiatry Program, Simon Fraser University, Burnaby, British Columbia, Canada.

Notes

Address correspondence to:William J. Panenka, MDBritish Columbia Children's Hospital Research Building3rd Floor, Room A3-123938 West 28th AvenueVancouver, British ColumbiaCanada B5Z 4H4E-mail: [email protected]

Author Disclosure Statement

William Honer has received consulting fees or sat on Advisory Boards for In Silico, Eli Lilly, Roche, Lundbeck, and Otsuka. Alasdair Barr has received consulting fees or sat on Advisory Boards for Bristol-Myers Squibb, Eli Lilly, and Roche. Ric Procyshyn has received speaking and Advisory Board fees from AstraZeneca, Bristol-Myers Squibb, Janssen, Otsuka, Pfizer, and Sunovion. William MacEwen has received speaking or consulting fees, or sat on Advisory Boards for Apotex, AstraZeneca, Bristol-Myers Squibb, Janssen, Lundbeck, Otsuka, Pfizer, and Sunovion and research grant support from Janssen. Alexander Rauscher has received Advisor Board fees from Hofmann-La Roche. Thalia Field has received speaking or advisory board fees from Bayer Canada and Pfizer and research funds from Bayer Canada and Boehringer Ingleheim Canada. William Panenka has a practice in forensic neuropsychiatry and is a director of Abbatis bioceuticals, an early stage biotech company.

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