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TBI: Substrates Of Dementia

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Smith, D., Johnson, V., & Stewart, W. (2013). Chronic neuropathologies of single and repetitive TBI: Substrates of dementia? Nature Reviews Neurology, 9, 211-221. doi:10.1038/nmeurol.2013.29

Dementia is frequently associated and at times, confused with Alzheimer’s disease (AD), but many fail to consider other potential causes of dementia. One of the strongest environmental (and preventable) risk factors in developing dementia, and in particular early onset dementia, is traumatic brain injury (TBI). In this article by Smith, Johnson, and Stewart (2013) this is addressed, focusing primarily on athletes of contact sports such as boxing, football, hockey and professional wrestling. Contact sports have a much higher risk of TBI and a much higher …show more content…

The severity of the TBI, history of loss of consciousness associated with the TBI, among others suggest that TBI may actually accelerate the onset of dementia. Many questions still are left unanswered such as do patients whom have suffered TBI develop dementia that is distinct from what is considered typical AD. Also to be considered is potential genetic predisposition as well as sex or age differences. It is very possible that some people can suffer TBI and not develop dementia. The reasons for this are still unknown at this …show more content…

Some area’s affected by neuronal loss are the cerebral cortex, the hippocampus, locus coeruleus, and cerebellum. Even with a single TBI, neuronal loss does occur, and evidence suggests this neuronal loss continues beyond the initial injury phase. White matter degeneration does occur as well, and while this study has little information on this, it is noted that white matter injury as well as axonal pathology has been suggested as a mechanism of rapid Aβ genesis. Also seen in neurodegeneration is neuroinflammation that is beyond repair. This inflammation continues after the initial injury in the white matter region, including the corpus callosum. Finally, changes in the cerebellar pathology are noted, in particular loss of cerebellar neurons. Smith, Johnson, & Stewart (2013) note atrophy and demyelination of the folial white matter present in those affected by

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