TY - JOUR
T1 - Stress and traumatic brain injury
T2 - An inherent bi-directional relationship with temporal and synergistic complexities
AU - Brand, Justin
AU - McDonald, Stuart J.
AU - Gawryluk, Jodie R.
AU - Christie, Brian R.
AU - Shultz, Sandy R.
N1 - Funding Information:
JB is supported by a CIHR Canada Graduate Scholarship - Masters . SRS is supported by a Michael Smith Health Research BC Scholar Award.
Publisher Copyright:
© 2023 The Authors
PY - 2023/8
Y1 - 2023/8
N2 - Traumatic brain injury (TBI) and stress are prevalent worldwide and can both result in life-altering health problems. While stress often occurs in the absence of TBI, TBI inherently involves some element of stress. Furthermore, because there is pathophysiological overlap between stress and TBI, it is likely that stress influences TBI outcomes. However, there are temporal complexities in this relationship (e.g., when the stress occurs) that have been understudied despite their potential importance. This paper begins by introducing TBI and stress and highlighting some of their possible synergistic mechanisms including inflammation, excitotoxicity, oxidative stress, hypothalamic-pituitary-adrenal axis dysregulation, and autonomic nervous system dysfunction. We next describe different temporal scenarios involving TBI and stress and review the available literature on this topic. In doing so we find initial evidence that in some contexts stress is a highly influential factor in TBI pathophysiology and recovery, and vice versa. We also identify important knowledge gaps and suggest future research avenues that will increase our understanding of this inherent bidirectional relationship and could one day result in improved patient care.
AB - Traumatic brain injury (TBI) and stress are prevalent worldwide and can both result in life-altering health problems. While stress often occurs in the absence of TBI, TBI inherently involves some element of stress. Furthermore, because there is pathophysiological overlap between stress and TBI, it is likely that stress influences TBI outcomes. However, there are temporal complexities in this relationship (e.g., when the stress occurs) that have been understudied despite their potential importance. This paper begins by introducing TBI and stress and highlighting some of their possible synergistic mechanisms including inflammation, excitotoxicity, oxidative stress, hypothalamic-pituitary-adrenal axis dysregulation, and autonomic nervous system dysfunction. We next describe different temporal scenarios involving TBI and stress and review the available literature on this topic. In doing so we find initial evidence that in some contexts stress is a highly influential factor in TBI pathophysiology and recovery, and vice versa. We also identify important knowledge gaps and suggest future research avenues that will increase our understanding of this inherent bidirectional relationship and could one day result in improved patient care.
KW - Allostatic overload
KW - ANS, HPA-axis microglia
KW - Cytokines
KW - Glucocorticoids, treatment
KW - Glutamate
KW - Immune response
KW - Neuroinflammation
KW - Reactive oxygen species
UR - http://www.scopus.com/inward/record.url?scp=85160044065&partnerID=8YFLogxK
U2 - 10.1016/j.neubiorev.2023.105242
DO - 10.1016/j.neubiorev.2023.105242
M3 - Review Article
C2 - 37225064
AN - SCOPUS:85160044065
SN - 0149-7634
VL - 151
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
M1 - 105242
ER -