PDF(Pubmed)
Abstract：
UNASSIGNED: Traumatic brain injuries (TBI) represent an important, potentially modifiable risk factor for dementia. Despite frequently observed vascular imaging changes in individuals with TBI, the relationships between TBI-associated changes in brain imaging and clinical outcomes have largely been overlooked in community cases of TBI.
UNASSIGNED: To assess whether TBI are associated with and interact with midlife changes in neuroimaging and clinical features in otherwise healthy individuals.
UNASSIGNED: This cross-sectional analysis used baseline data from the PREVENT Dementia program collected across 5 sites in the UK and Ireland between 2014 and 2020. Eligible participants were cognitively healthy midlife adults aged between 40 and 59 years. Data were analyzed between January 2023 and April 2024.
UNASSIGNED: Lifetime TBI history was assessed using the Brain Injury Screening Questionnaire.
UNASSIGNED: Cerebral microbleeds and other markers of cerebral small vessel disease (white matter hyperintensities [WMH], lacunes, perivascular spaces) were assessed on 3T magnetic resonance imaging. Clinical measures were cognition, sleep, depression, gait, and cardiovascular disease (CVD) risk, assessed using Computerized Assessment of Information Processing (COGNITO), Pittsburgh Sleep Quality Index, Center for Epidemiologic Studies Depression Scale, clinical interviews, and the Framingham Risk Score, respectively.
UNASSIGNED: Of 617 participants (median [IQR] age, 52 [47-56] years; 380 female [61.6%]), 223 (36.1%) had a history of TBI. TBI was associated with higher microbleed count (β = 0.10; 95% CI, 0.01-0.18; P = .03), with a dose-response association observed with increasing number of TBI events (β = 0.05; 95% CI, 0.01-0.09; P = .03). Conversely, TBI was not associated with other measures of small vessel disease, including WMH. Furthermore, TBI moderated microbleed associations with vascular risk factors and clinical outcomes, such that associations were present only in the absence of TBI. Importantly, observations held when analyses were restricted to individuals reporting only mild TBI.
UNASSIGNED: In this cross-sectional study of healthy middle-aged adults, detectable changes in brain imaging and clinical features were associated with remote, even mild, TBI in the general population. The potential contribution of vascular injury to TBI-related neurodegeneration presents promising avenues to identify potential targets, with findings highlighting the need to reduce TBI through early intervention and prevention in both clinical care and policymaking.
UNASSIGNED: To assess whether TBI are associated with and interact with midlife changes in neuroimaging and clinical features in otherwise healthy individuals.
UNASSIGNED: This cross-sectional analysis used baseline data from the PREVENT Dementia program collected across 5 sites in the UK and Ireland between 2014 and 2020. Eligible participants were cognitively healthy midlife adults aged between 40 and 59 years. Data were analyzed between January 2023 and April 2024.
UNASSIGNED: Lifetime TBI history was assessed using the Brain Injury Screening Questionnaire.
UNASSIGNED: Cerebral microbleeds and other markers of cerebral small vessel disease (white matter hyperintensities [WMH], lacunes, perivascular spaces) were assessed on 3T magnetic resonance imaging. Clinical measures were cognition, sleep, depression, gait, and cardiovascular disease (CVD) risk, assessed using Computerized Assessment of Information Processing (COGNITO), Pittsburgh Sleep Quality Index, Center for Epidemiologic Studies Depression Scale, clinical interviews, and the Framingham Risk Score, respectively.
UNASSIGNED: Of 617 participants (median [IQR] age, 52 [47-56] years; 380 female [61.6%]), 223 (36.1%) had a history of TBI. TBI was associated with higher microbleed count (β = 0.10; 95% CI, 0.01-0.18; P = .03), with a dose-response association observed with increasing number of TBI events (β = 0.05; 95% CI, 0.01-0.09; P = .03). Conversely, TBI was not associated with other measures of small vessel disease, including WMH. Furthermore, TBI moderated microbleed associations with vascular risk factors and clinical outcomes, such that associations were present only in the absence of TBI. Importantly, observations held when analyses were restricted to individuals reporting only mild TBI.
UNASSIGNED: In this cross-sectional study of healthy middle-aged adults, detectable changes in brain imaging and clinical features were associated with remote, even mild, TBI in the general population. The potential contribution of vascular injury to TBI-related neurodegeneration presents promising avenues to identify potential targets, with findings highlighting the need to reduce TBI through early intervention and prevention in both clinical care and policymaking.
摘要：
■创伤性脑损伤（TBI）是一个重要的，痴呆的潜在可改变的危险因素。尽管经常观察到TBI患者的血管影像学变化，在社区TBI病例中,TBI相关的脑影像学改变与临床结局之间的关系在很大程度上被忽视.
■评估TBI是否与其他健康个体的神经影像学和临床特征的中年变化相关并相互作用。
■此横截面分析使用了2014年至2020年在英国和爱尔兰的5个地点收集的PREVENTDementia计划的基线数据。符合条件的参与者是年龄在40至59岁之间的认知健康的中年成年人。数据在2023年1月至2024年4月之间进行了分析。
■使用脑损伤筛查问卷评估TBI病史。
■脑微出血和脑小血管病的其他标志物（白质高强度[WMH]，lacunes,血管周围间隙）在3T磁共振成像上进行评估。临床措施是认知，睡眠,抑郁症,步态,和心血管疾病（CVD）的风险，使用信息处理计算机评估(COGNITO)进行评估，匹兹堡睡眠质量指数，流行病学研究中心抑郁量表，临床访谈,和弗雷明汉风险评分,分别。
■617名参与者(年龄中位数，52[47-56]岁；380名女性[61.6%])，223（36.1％）有TBI病史。TBI与较高的微出血计数相关(β=0.10;95%CI,0.01-0.18;P=0.03),随着TBI事件数量的增加，观察到剂量反应相关（β=0.05;95％CI，0.01-0.09;P=0.03）。相反，TBI与小血管疾病的其他指标无关，包括WMH。此外，TBI缓和微出血与血管危险因素和临床结果的关联，因此，只有在没有TBI的情况下才存在关联。重要的是,当分析仅限于仅报告轻度TBI的个体时，观察结果成立。
■在这项针对健康中年人的横断面研究中，脑成像和临床特征的可检测变化与远程，即使是温和的，一般人群中的TBI。血管损伤对TBI相关神经变性的潜在贡献为确定潜在目标提供了有希望的途径。研究结果强调了在临床护理和决策中通过早期干预和预防来减少TBI的必要性。
■评估TBI是否与其他健康个体的神经影像学和临床特征的中年变化相关并相互作用。
■此横截面分析使用了2014年至2020年在英国和爱尔兰的5个地点收集的PREVENTDementia计划的基线数据。符合条件的参与者是年龄在40至59岁之间的认知健康的中年成年人。数据在2023年1月至2024年4月之间进行了分析。
■使用脑损伤筛查问卷评估TBI病史。
■脑微出血和脑小血管病的其他标志物（白质高强度[WMH]，lacunes,血管周围间隙）在3T磁共振成像上进行评估。临床措施是认知，睡眠,抑郁症,步态,和心血管疾病（CVD）的风险，使用信息处理计算机评估(COGNITO)进行评估，匹兹堡睡眠质量指数，流行病学研究中心抑郁量表，临床访谈,和弗雷明汉风险评分,分别。
■617名参与者(年龄中位数，52[47-56]岁；380名女性[61.6%])，223（36.1％）有TBI病史。TBI与较高的微出血计数相关(β=0.10;95%CI,0.01-0.18;P=0.03),随着TBI事件数量的增加，观察到剂量反应相关（β=0.05;95％CI，0.01-0.09;P=0.03）。相反，TBI与小血管疾病的其他指标无关，包括WMH。此外，TBI缓和微出血与血管危险因素和临床结果的关联，因此，只有在没有TBI的情况下才存在关联。重要的是,当分析仅限于仅报告轻度TBI的个体时，观察结果成立。
■在这项针对健康中年人的横断面研究中，脑成像和临床特征的可检测变化与远程，即使是温和的，一般人群中的TBI。血管损伤对TBI相关神经变性的潜在贡献为确定潜在目标提供了有希望的途径。研究结果强调了在临床护理和决策中通过早期干预和预防来减少TBI的必要性。
