Incidence of anxiety after traumatic brain injury: a systematic review and meta-analysis.

BACKGROUND: Traumatic brain injury (TBI) is defined as acquired cerebral damage caused by an external mechanical impact, which has the potential to lead to transient or enduring debilitation. TBI is associated with many forms of long-lasting psychiatric conditions, including anxiety disorders. As anxiety is highly debilitating by causing impaired social functioning and decreased quality of life for the afflicted, especially in the form of anxiety disorders such as generalized anxiety disorder, certain efforts have been made to explore the factors associated with it, and one such factor is TBI. METHODS: We searched PubMed, Scopus, and Web of Science on January 26th, 2024 for observational case-control or cohort or cross-sectional studies assessing the incidence of anxiety symptoms or disorders in patients with TBI compared to healthy individuals or the same individuals if pre-TBI information regarding anxiety was available. We calculated the pooled incidence and relative risk (RR) and 95% confidence interval (95CI) using the inverse variance method. Publication bias was assessed using Eggers's regression test. Quality assessment was performed using the Newcastle-Ottawa scale. Sub-group analyses were conducted for the type of anxiety (anxiety disorder vs anxiety symptoms), TBI severity, and type of anxiety disorders. RESULTS: The incidence rate of anxiety after traumatic brain injury was 17.45% (95CI: 12.59%, 22.31%) in a total of 705,024 individuals. Moreover, TBI patients were found to be 1.9 times as likely to have anxiety compared to their non-TBI counterparts [Random effects model RR = 1.90 [1.62; 2.23], p-value < 0.0001] using a population of 569,875 TBI cases and 1,640,312 non-TBI controls. Sub-group analysis revealed TBI severity was not associated with anxiety and generalized anxiety disorder was the most common type of anxiety disorder reported post-TBI. CONCLUSION: Patients who have experienced a TBI exhibit a significantly greater incidence of anxiety symptoms and anxiety disorders in the aftermath when compared to healthy individuals.

Depression after traumatic brain injury: A systematic review and Meta-analysis.

BACKGROUND: Traumatic brain injury (TBI) afflicts 69 million individuals annually, resulting in numerous neuropsychiatric sequelae. Here, we investigate the possible relation between TBI and depression. METHODS: an online database search of Pubmed, Scopus, and Web of Science was conducted on November 3rd, 2023 for observational studies investigating post-TBI depressive symptoms incidence or comparing the prevalence of depressive symptoms between TBI and non-TBI individuals. RESULTS: a total of 43 studies were included in our review, 15 of which reported novel cases of depressive symptomology post-TBI and 34 of which compared depressive symptoms in TBI participants with non-TBI participants. Our meta-analysis showed an incidence of 13 % among 724,842 TBI participants, and a relative risk of 2.10 when comparing 106,083 TBI patients to 323,666 non-TBI controls. 11 of the 43 included studies were deemed as having a high risk of bias. Sensitivity analysis showed our findings to be robust and no publication bias was detected using Egger's regression test. CONCLUSION: Individuals suffering from TBI are almost twice as likely to develop depressive symptomology compared to non-TBI individuals.

Dexmedetomidine administration as a possible cognitive enhancer through increasing the level of brain-derived neurotrophic factors in surgical patients: a systematic review and meta-analysis.

OBJECTIVE: This meta-analysis aimed to investigate the effect of dexmedetomidine on brain-derived neurotrophic factor (BDNF) levels in individuals undergoing various medical procedures. We systematically searched electronic databases and manually identified relevant articles to assess the impact of dexmedetomidine on BDNF levels in surgical patients. METHODS: A comprehensive literature search was conducted in PubMed, Scopus, Embase, and Web of Science databases with no language restrictions. Studies that examined the effects of dexmedetomidine administration on BDNF levels in surgical patients were included. RESULTS: The overall analysis revealed a statistically significant increase in BDNF levels in individuals receiving dexmedetomidine compared to controls (Standardized Mean Difference SMD = 1.65, 95% CI: 1.02 to 2.28; I2: 89%). Subgroup analyses based on the anesthesia method (p < 0.01), and the type of surgery (p < 0.01) showed significant between-group differences (Fig. 3). The results of the sensitivity analyses indicated that individual studies did not significantly affect the overall results. CONCLUSION: This meta-analysis indicates that dexmedetomidine administration is associated with a significant increase in BDNF levels in individuals undergoing surgical procedures. These findings highlight the potential role of dexmedetomidine in modulating BDNF levels, which may have implications for optimizing perioperative neuroprotective strategies and improving patient outcomes.