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Front Hum Neurosci. 2013 Sep 24;7:506. doi: 10.3389/fnhum.2013.00506. eCollection 2013.

Environmental enrichment may protect against hippocampal atrophy in the chronic stages of traumatic brain injury.

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1
Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto Toronto, ON, Canada.

Abstract

OBJECTIVE:

To examine the relationship between environmental enrichment (EE) and hippocampal atrophy in the chronic stages of moderate to severe traumatic brain injury (TBI).

DESIGN:

Retrospective analysis of prospectively collected data; observational, within-subjects.

PARTICIPANTS:

Patients (N = 25) with moderate to severe TBI.

MEASURES:

Primary predictors: (1) An aggregate of self-report rating of EE (comprising hours of cognitive, physical, and social activities) at 5 months post-injury; (2) pre-injury years of education as a proxy for pre-morbid EE (or cognitive reserve).

PRIMARY OUTCOME:

bilateral hippocampal volume change from 5 to 28 months post-injury.

RESULTS:

As predicted, self-reported EE was significantly negatively correlated with bilateral hippocampal atrophy (p < 0.05), with greater EE associated with less atrophy from 5 to 28 months. Contrary to prediction, years of education (a proxy for cognitive reserve) was not significantly associated with atrophy.

CONCLUSION:

Post-injury EE may serve as a buffer against hippocampal atrophy in the chronic stages of moderate-severe TBI. Clinical application of EE should be considered for optimal maintenance of neurological functioning in the chronic stages of moderate-severe TBI.

KEYWORDS:

adult; environmental enrichment; moderate to severe; subacute atrophy; traumatic brain injury

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