The role of cognitive reserve in traumatic brain injury: a systematic review of observational studies.

OBJECTIVE: Evaluate the role of cognitive reserve (CR) on cognitive and physical sequelae in traumatic brain injury (TBI). METHODS: A comprehensive search strategy was conducted in four databases in English and Spanish in the last 12 years (2011-2023). Inclusion criteria: original cross-sectional and longitudinal studies whose main or secondary objective was to evaluate the effect of CR in adult patients with TBI. PRISMA guidelines were used to report the search and selection method and STROBE checklist was used to evaluate the quality of studies. RESULTS: Eighteen observational studies were included in this review. Multiple sources of variability were observed: number of patients, time of evolution, severity of the TBI, type of CR proxy, cognitive assessment instrument, etc. However, the most commonly used indicators of CR were premorbid IQ and educational attainment. A positive and consistent association between CR and performance on cognitive tests after injury was found. CONCLUSIONS: CR has a consistent positive effect on cognition and on some other aspects of recovery in traumatic brain injury. In future studies, it will be necessary to promote the use of CR indices based on various indicators and explore the effects of CR on other aspects related to the recovery of brain trauma.

Crosstalk between Exercise-Derived Endocannabinoidome and Kynurenines: Potential Target Therapies for Obesity and Depression Symptoms.

The kynurenine pathway (KP) and the endocannabinoid system (ECS) are known to be deregulated in depression and obesity; however, it has been recognized that acute physical exercise has an important modulating role inducing changes in the mobilization of their respective metabolites-endocannabinoids (eCBs) and kynurenines (KYNs)-which overlap at some points, acting as important antidepressant, anti-nociceptive, anti-inflammatory, and antioxidant biomarkers. Therefore, the aim of this review is to analyze and discuss some recently performed studies to investigate the potential interactions between both systems, particularly those related to exercise-derived endocannabinoidome and kynurenine mechanisms, and to elucidate how prescription of physical exercise could represent a new approach for the clinical management of these two conditions.

Education Level Modulates the Presence of Poststroke Depression and Anxiety, But It Depends on Age.

ABSTRACT: Depression and anxiety are common complications after stroke and little is known about the modulatory roles of education and age. Our study aimed to evaluate the modulatory effects of education level on anxiety and depression after stroke and their effect on each age group. Adults with first stroke took part in this cross-sectional observational clinical study. We used the following instruments: Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Scale, Pittsburgh Sleep Quality Index, Barthel index, and Functional Independence Measure. There were 89 patients. The mean (SD) age was 58.01 (13) years, mean (SD) years of education was 9.91 (5.22), 55.1% presented depression symptoms and 47.2% anxiety symptoms, 56.2% were young adults and 43.8% were older adults. We identified a negative association between education and anxiety score ( r = -0. 269, p = 0.011) and depression score ( r = -0.252, p = 0.017). In the linear regression analysis, we found that education is negatively associated with HADS, but this influence was more consistent in young adults. In conclusion, a higher education level reduces the risk of depression and anxiety, but their effect is less consistent in older adults.

Family Functioning and Suicide Attempts in Mexican Adolescents.

Suicide is considered a public health problem that affects families worldwide. Family functioning is the capability of the family system to fulfill needs during the stages of its development. In this study, we focused on evaluating family cohesion and adaptability in a group of adolescents who had attempted suicide and were hospitalized at a hospital for mental health disorders, compared to a control group. Methods: based on Olson's circumplex model, we used the FACES III scale to gain insights into the family functioning of both suicidal and control groups. Results: The case group presented lower scores in cohesion and adaptability compared to the control group, with moderate effect-size for cohesion (Cohen's d/r test = 1.217/0.52) and low effect-size for adaptability (Cohen's d/r test = 0.746/0.35) (p < 0.001 for both variables), and also presented predominantly disengaged families (72.5% in the case group vs. 27.5% in the control group) and structured families (45% in the case group vs. 23.8% in the control group). The type of family described by the adolescents with a history of suicide attempts may explain the presence of low self-esteem and little emotional support usually present in this type of patient.