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Neurobehavioral Changes Resulting from Recurrent Head Injuries

Received: 23 May 2024     Accepted: 19 June 2024     Published: 29 June 2024
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Abstract

In recent years, there has been a significant focus on the potential link between traumatic brain injury (TBI) due to recurrent head injuries (RHI) and the development of Traumatic Encephalopathy Syndrome (TES), whichcould lead to chronic traumatic encephalopathy (CTE). Recurrent head injuries may cause neurobehavioral changes, significantly impacting an individual's cognitive and behavioral functioning. These changes can lead to various challenges, including difficulties in social interactions, work performance, and overall quality of life. CTE is a progressive disease characterized by Axonal injury tau neurofibrillary tangles (NFTs) and, in some cases, transactive response DNA binding protein 43 (TDP43). This case report discusses a patient who experienced auditory verbal hallucinations (AVH) and cognitive symptoms with behavioral issues due to recurrent RHI. The aim is to investigate this presentation further to examine the relationship between recurrent head injury (RHI) and chronic traumatic encephalopathy (CTE) and to understand the psychological impact of physical brain trauma. A 43-year-old white male with a history of RHI from multiple sports-related concussions was admitted to the psychiatric unit for cognitive difficulties with auditory verbal hallucinations and associated mood symptoms for the past four years, impacting both his sleep and productivity at work. This article will discuss the different types of auditory hallucinations seen in patients with RHI and CTE, along with exploring the evidence to support our determination due to repeated RHI, which led to symptomatology suggestive of CTE. Differential diagnoses will be considered, and evidence is provided to rule them out based on the patient's history. This case report underscores the diagnostic challenges associated with CTE, which can manifest with a spectrum of psychiatric symptoms encompassing mood, cognition, and behavior. The medical diagnosis of Chronic Traumatic Encephalopathy (CTE) in living patients is still a challenge, as effective biomarkers for this condition have yet to be discovered. Although research diagnostic criteria have been proposed, there is no definitive way to diagnose CTE in living patients. Therefore, further investigation is necessary to develop accurate diagnostic tools and effective treatments for CTE.

Published in American Journal of Psychiatry and Neuroscience (Volume 12, Issue 2)
DOI 10.11648/j.ajpn.20241202.14
Page(s) 46-51
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neurofibrillary Tangles (NFTs), Recurrent Head Injuries (RHI), Traumatic Brain Injury (TBI), Traumatic Encephalopathy Syndrome (TES), Chronic Traumatic Encephalopathy (CTE)

References
[1] Traumatic Brain Injury (TBI). Medical Psychiatry. 2021, 28: 2021-2023.
[2] T Dierks 1, D E Linden, M Jandl, E Formisano, R Goebel, H Lanfermann, W Singer: Activation of Heschl's gyrus during auditory hallucinations. Neuron. 1999, 22: 615-621.
[3] K Achté 1, L Jarho, T Kyykkä, E Vesterinen: Paranoid disorders following war brain damage. Preliminary report. Psychopathology. 1991, 24: 309-15.
[4] Brandon Peter Lucke-Wold 1, Ryan Coddington Turner, Aric Flint Logsdon, Julian Edwin Bailes, Jason Delwyn Huber, Charles Lee Rosen: Linking traumatic brain injury to chronic traumatic encephalopathy: identification of potential mechanisms leading to neurofibrillary tangle development. J Neurotrauma. 2014, 31: 1129-38.
[5] Kevin Pierre, Kyle Dyson, Abeer Dagra, Eric Williams, Ken Porche, and Brandon Lucke-Wold: Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management. Biomedicines. 2021, 9:
[6] Johns LC, Kompus K, Connell M, Humpston C, Lincoln TM, Longden E, Preti A, Alderson-Day B, Badcock JC, Cella M, Fernyhough C, McCarthy-Jones S, Peters E, Raballo A, Scott J, Siddi S, Sommer IE, Larøi F. Auditory verbal hallucinations in persons with and without a need for care. Schizophr Bull. 2014 Jul; 40 Suppl 4(Suppl 4): S255-64PMID: 24936085; PMCID: PMC4141313.
[7] Fricchione, G. L., L. Carbone, and W. I. Bennett: Psychotic disorder caused by a general medical condition, with delusions. Secondary "organic" delusional syndromes. Psychiatr Clin North Am. 1995, 18: 363-78.
[8] Daalman K, Boks MP, Diederen KM, de Weijer AD, Blom JD, Kahn RS, Sommer IE. The same or different? A phenomenological comparison of auditory verbal hallucinations in healthy and psychotic individuals. J Clin Psychiatry. 2011 Mar; 72(3): 320-5. PMID: 21450152.
[9] Sundman, M., P. M. Doraiswamy, and R. A. Morey,: Morey, Neuroimaging assessment of early and lateneurobiological sequelae of traumatic brain injury: implications for CTE. Front Neurosci. 2015, 9: 334.
[10] Simonetto, D. and Tucsok, M. (2023), Former Athletes' Illness Stories of Brain Injuries: Suspected Chronic Traumatic Encephalopathy and the Entanglement of Never-Aging Masculinities. Symbolic Interaction, 46: 182-206.
[11] Bergauer, A., van Osch, R., van Elferen, S., Gyllvik, S., Venkatesh, H., and Schreiber, R. (2022). The diagnostic potential of fluid and imaging biomarkers in chronic traumatic encephalopathy (CTE). Biomed. Pharmacother. 146: 112602.
Cite This Article
  • APA Style

    Mogallapu, R., Chudasama, R., King, M., Bosley, J., Ang-Rabanes, M., et al. (2024). Neurobehavioral Changes Resulting from Recurrent Head Injuries. American Journal of Psychiatry and Neuroscience, 12(2), 46-51. https://doi.org/10.11648/j.ajpn.20241202.14

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    ACS Style

    Mogallapu, R.; Chudasama, R.; King, M.; Bosley, J.; Ang-Rabanes, M., et al. Neurobehavioral Changes Resulting from Recurrent Head Injuries. Am. J. Psychiatry Neurosci. 2024, 12(2), 46-51. doi: 10.11648/j.ajpn.20241202.14

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    AMA Style

    Mogallapu R, Chudasama R, King M, Bosley J, Ang-Rabanes M, et al. Neurobehavioral Changes Resulting from Recurrent Head Injuries. Am J Psychiatry Neurosci. 2024;12(2):46-51. doi: 10.11648/j.ajpn.20241202.14

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  • @article{10.11648/j.ajpn.20241202.14,
      author = {Raja Mogallapu and Ravirajsinh Chudasama and Madelynne King and Julie Bosley and Michael Ang-Rabanes and Carla Toolan},
      title = {Neurobehavioral Changes Resulting from Recurrent Head Injuries
    },
      journal = {American Journal of Psychiatry and Neuroscience},
      volume = {12},
      number = {2},
      pages = {46-51},
      doi = {10.11648/j.ajpn.20241202.14},
      url = {https://doi.org/10.11648/j.ajpn.20241202.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20241202.14},
      abstract = {In recent years, there has been a significant focus on the potential link between traumatic brain injury (TBI) due to recurrent head injuries (RHI) and the development of Traumatic Encephalopathy Syndrome (TES), whichcould lead to chronic traumatic encephalopathy (CTE). Recurrent head injuries may cause neurobehavioral changes, significantly impacting an individual's cognitive and behavioral functioning. These changes can lead to various challenges, including difficulties in social interactions, work performance, and overall quality of life. CTE is a progressive disease characterized by Axonal injury tau neurofibrillary tangles (NFTs) and, in some cases, transactive response DNA binding protein 43 (TDP43). This case report discusses a patient who experienced auditory verbal hallucinations (AVH) and cognitive symptoms with behavioral issues due to recurrent RHI. The aim is to investigate this presentation further to examine the relationship between recurrent head injury (RHI) and chronic traumatic encephalopathy (CTE) and to understand the psychological impact of physical brain trauma. A 43-year-old white male with a history of RHI from multiple sports-related concussions was admitted to the psychiatric unit for cognitive difficulties with auditory verbal hallucinations and associated mood symptoms for the past four years, impacting both his sleep and productivity at work. This article will discuss the different types of auditory hallucinations seen in patients with RHI and CTE, along with exploring the evidence to support our determination due to repeated RHI, which led to symptomatology suggestive of CTE. Differential diagnoses will be considered, and evidence is provided to rule them out based on the patient's history. This case report underscores the diagnostic challenges associated with CTE, which can manifest with a spectrum of psychiatric symptoms encompassing mood, cognition, and behavior. The medical diagnosis of Chronic Traumatic Encephalopathy (CTE) in living patients is still a challenge, as effective biomarkers for this condition have yet to be discovered. Although research diagnostic criteria have been proposed, there is no definitive way to diagnose CTE in living patients. Therefore, further investigation is necessary to develop accurate diagnostic tools and effective treatments for CTE.
    },
     year = {2024}
    }
    

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    AU  - Raja Mogallapu
    AU  - Ravirajsinh Chudasama
    AU  - Madelynne King
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    JO  - American Journal of Psychiatry and Neuroscience
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