title: A prospective study of the influence of acute alcohol intoxication versus chronic alcohol consumption on outcome following traumatic brain injury.
abstract: The purpose of the study was to disentangle the relative contributions of day-of-injury alcohol intoxication and pre-injury alcohol misuse on outcome from TBI. Participants were 142 patients enrolled from a Level 1 Trauma Center (in Vancouver, Canada) following a traumatic brain injury (TBI; 43 uncomplicated mild TBI and 63 complicated mild-severe TBI) or orthopedic injury [36 trauma controls (TC)]. At 6-8 weeks post-injury, diffusion tensor imaging (DTI) of the whole brain was undertaken using a Phillips 3T scanner. Participants also completed neuropsychological testing, an evaluation of lifetime alcohol consumption (LAC), and had blood alcohol levels (BALs) taken at the time of injury. Participants in the uncomplicated mild TBI and complicated mild-severe TBI groups had higher scores on measures of depression and postconcussion symptoms (d = 0.45-0.83), but not anxiety, compared with the TC group. The complicated mild-severe TBI group had more areas of abnormal white matter on DTI measures (all p < .05; d = 0.54-0.61) than the TC group. There were no difference between groups on all neurocognitive measures. Using hierarchical regression analyses and generalized linear modeling, LAC and BAL did provide a unique contribution toward the prediction of attention and executive functioning abilities; however, the variance accounted for was small. LAC and BAL did not provide a unique and meaningful contribution toward the prediction of self-reported symptoms, DTI measures, or the majority of neurocognitive measures. In this study, BAL and LAC were not predictive of mental health symptoms, postconcussion symptoms, cognition, or white-matter changes at 6-8 weeks following TBI.
authors: Defense and Veterans Brain Injury Center, Bethesda, MD, USA Walter Reed National Military Medical Center, Bethesda, MD, USA University of British Columbia, Vancouver, Canada rael.t.lange@us.army.mil rael.lange@gmail.com.
authors: Rael T
authors: RT
authors: Lange
authors: University of British Columbia, Vancouver, Canada Vancouver General Hospital, BC, Canada.
authors: Jason R
authors: JR
authors: Shewchuk
authors: University of British Columbia, Vancouver, Canada UBC MRI Research Center, Vancouver, BC, Canada UBC Brain Research Center, Vancouver, BC, Canada.
authors: Alexander
authors: A
authors: Rauscher
authors: University of British Columbia, Vancouver, Canada UBC MRI Research Center, Vancouver, BC, Canada.
authors: Michael
authors: M
authors: Jarrett
authors: University of British Columbia, Vancouver, Canada Vancouver General Hospital, BC, Canada.
authors: Manraj K S
authors: MK
authors: Heran
authors: University of British Columbia, Vancouver, Canada Vancouver General Hospital, BC, Canada.
authors: Jeffrey R
authors: JR
authors: Brubacher
authors: Harvard Medical School, Boston, MA, USA Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, MA, USA.
authors: Grant L
authors: GL
authors: Iverson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000097:blood / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D000435:Alcoholic Intoxication / Q000097:blood / Q000209:etiology* / Q000473:pathology; D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D057566:Self Report; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Alcohol intoxication; Concurrent; Diffusion tensor imaging; Lifetime alcohol abuse; Traumatic brain injury