National Institute of Neurological Disorders and Stroke (NINDS)
TBI is a major public health problem, especially among male adolescents and young adults ages 15 to 24, and among elderly people of both sexes age 75 and older. Children age 5 and younger are also at high risk for TBI. TBI, a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain.
This section provides examples of recent scientific advances from National Institutes of Health (NIH)-sponsored research and is not intended to be a comprehensive list.
Children with Cushing syndrome may be at higher risk for suicide as well as for depression, anxiety, and other mental health conditions long after their disease has been successfully treated, according to a study by researchers at the NIH. Cushing syndrome results from high levels of the hormone cortisol. Researchers reviewed the case histories of all children and youth treated for Cushing syndrome at the NIH from 2003 to 2014, a total of 149 patients. They found that, months after treatment, nine children (roughly 6 percent) had thoughts of suicide and experienced outbursts of anger and rage, depression, irritability, and anxiety. "Our results indicate that physicians who care for young people with Cushing syndrome should screen their patients for depression-related mental illness after the underlying disease has been successfully treated," said the study’s senior author, Constantine Stratakis, M.D., director of the Division of Intramural Research at NICHD.
Researchers identified several genes in blood whose activity is related to suicidal thoughts and actions in men with psychiatric disorders. More than 41,000 Americans commit suicide each year. Finding a way to objectively measure a person’s risk for suicide is thus an important area of research. Researchers at the Indiana University School of Medicine assessed suicidal thoughts and took blood samples of 217 male psychiatric patients. They identified 37 patients whose thoughts of suicide increased between visits. Those patients’ blood samples were analyzed to find genes whose activity, or expression, changed between visits. The team also developed 2 apps that use questionnaires to measure risk factors for suicide. These questionnaires were combined with the most predictive gene biomarkers to create a universal predictive measure called UP-Suicide. When tested on a separate group of 108 psychiatric patients, the tool predicted which patients would go on to have serious suicidal thoughts with 92% accuracy. "We believe that widespread adoption of risk prediction tests based on these findings during health care assessments will enable clinicians to intervene with lifestyle changes or treatments that can save lives," said the study’s lead researcher Dr. Alexander B. Niculescu.
A large-scale genomic study uncovered novel genetic variants and led researchers to an unexpected gene that affects bone density and fracture risk. Over 10 million people nationwide have osteoporosis, a condition in which bones become susceptible to fracture. An international team of researchers led by Dr. Brent Richards at McGill University compared genome sequencing data with bone mineral density measurements and actual bone fracture rates. The team identified variants in a region near the engrailed homeobox-1 (EN1) gene that were associated with bone mineral density in the lumbar area of the spine. One variant was also associated with bone mineral density in the thigh bone at the hip. Using a mouse model, the team genetically altered En1 levels and confirmed that En1 plays an important role in bone physiology. The researchers also found several other variants associated with bone mineral density in specific areas. These discoveries indicate that more comprehensive sequencing of diverse populations can lead to the discovery of rare variants influencing common diseases.
U.S. Army soldiers hospitalized with a psychiatric disorder have a significantly elevated suicide risk in the year following discharge from the hospital, according to research from the Army Study to Assess Risk and Resilience in Service members (Army STARRS ), a partnership between the Army and the NIMH. The yearly suicide rate for this group, 264 per 100,000 soldiers, was far higher than the rate of 18.5 suicides per 100,000 in the Regular Army for the same study period. Administrative data show that 40,820 soldiers (0.8% of all Regular Army soldiers) were hospitalized with a psychiatric disorder in 2004–2009. Suicides occurring in this group during the year after a hospital discharge accounted for 12% of all Regular Army suicides during this period. Some of the strongest predictors of suicide include being male, having enlisted at an older age, having a history of criminal offenses during Army service, having had prior suicidal thoughts or actions, having disorders diagnosed during hospitalization, and having prior psychiatric treatment. This is the first publication from Army STARRS that demonstrates that Army/Department of Defense data can be used to identify specific subgroups within the Army that have very significantly elevated suicide risk. The high concentration of suicide risk among this study group, and particularly in the smaller highest-risk groups, might justify targeting expanded post-hospital interventions for such people.
Studies in Pakistan have shown that young children face a high burden of lifelong disability or death due to accidental injury in their homes, where they spend most of their time. Much harm could be avoided if adults were aware of the danger inherent in hazards such as uncovered water vats, unattended knives, open fires, and accessible toxins. A team of scientists led by Dr. Uzma Rahim Khan, a senior instructor at Aga Khan University, used assessment and education tools tailored to a low-income community to investigate whether disseminating risk information to caregivers of a child aged 1 to 5 years reduced hazards around the home. In a community-based pilot study, the team visited homes to assess hazards and to educate caretakers on how to lower injury risk by providing safety pamphlets and verbal tutorials during the home assessment. The team found that tutorials were more effective than pamphlets in mitigating the numbers of hazards. The applicability of the study's tools to low-income settings has inspired similar research projects in Malaysia and Nepal.
Bullying is a serious issue with lasting emotional, physical, and behavioral consequences. A new study found that bullying among students in grades six through ten declined significantly between 1998 and 2010. Fighting among students also declined, although less dramatically. Increased attention to bullying and responses by anti-bullying campaigns may be connected to the observed decline in bullying. The study focused on bullying in school and did not capture the impact of cyber-bullying, which may show a different trend, particularly as technology is increasing. An important future goal would be to investigate the consequences of bullying and the different forms it can take.
A new NIAAA- and NIDA-funded study shows an increased number of marijuana-positive Colorado drivers involved in fatal motor vehicle crashes since Colorado's legalization of medical marijuana in 2009. By comparison, no similar increase was seen in the 34 states that did not have medical marijuana laws when this study was conducted. During the same time period, there was no change in the number of alcohol-impaired drivers in fatal motor vehicle crashes in either Colorado or the 34 states with no legalization of marijuana. Although this study did not determine a cause-and-effect relationship between the marijuana use and the vehicle accidents, research shows that both alcohol and marijuana impair driving. The authors suggest that these findings underscore the need for enhanced education about the dangers of driving under the influence of drugs, including marijuana.
The largest study of mental health risk and resilience ever conducted among U.S. military personnel today released its first findings related to suicide attempts and deaths in a series of three JAMA Psychiatry articles. Findings from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) include: the rise in suicide deaths from 2004 to 2009 occurred not only in currently and previously deployed soldiers, but also among soldiers never deployed; nearly half of soldiers who reported suicide attempts indicated their first attempt was prior to enlistment; and soldiers reported higher rates of certain mental disorders than civilians, including attention deficit hyperactivity disorder (ADHD), intermittent explosive disorder (recurrent episodes of extreme anger or violence), and substance use disorder.
Drivers eat, reach for the phone, text, or otherwise take their eyes off the road about 10 percent of the time they are behind the wheel, according to a study using video technology and in-vehicle sensors. Risks of distracted driving were greatest for newly licensed teen drivers, who were substantially more likely than adults to be involved in a crash or near miss while texting or engaging in tasks secondary to driving, according to the researchers from the NIH and Virginia Tech. "Anything that takes a driver's eyes off the road can be dangerous," said study co-author Bruce Simons-Morton, Ed.D., M.P.H., of the NICHD. "But our study shows these distracting practices are especially risky for novice drivers, who haven't developed sound safety judgment behind the wheel."