Connections between intimate partner violence, traumatic brain injury, and neurological disease–but not CTE
By Lily Vargo. This article was initially published in our Concussion Update newsletter; please consider subscribing.
In a recent study of the brains of 84 deceased women who experienced intimate partner violence, Dr. Kristen Dams-O’Connor and colleagues found that the brains consistently showed signs of traumatic brain injury but that none met the criteria for chronic traumatic encephalopathy (CTE). Mount Sinai Medical Center emphasizes the groundbreaking nature of this study, saying, “Despite how common intimate partner violence is – it affects one in three women at some point in their lives – remarkably little is known about the neuropathology of partner violence.”
The study, published in Acta Neuropathologica, was divided into two case series. The first series examined the brains of 14 women from New York, obtained over two years. The second was an archival case series that examined 70 brains, 61 of which came from women from Manitoba and 9 of which came from Connect-TBI, a multi-center study. All of the brains in both series came from women who were confirmed to have experienced intimate partner violence. They also came from a racially diverse group of people and ranged in age from their 20s to their 70s.
Dams-O’Connor et al. obtained the women’s medical histories for the first case series and the brains obtained through Connect-TBI. They then evaluated the brains for neuropathologic changes indicative of CTE and other neurodegenerative diseases by staining samples and looking at specific slides via ex vivo neuroimaging. The brains from Manitoba were split into two groups; 29 had a complete examination by a neuropathologist, while the other 31 were photographed and stained.
Nearly all of the brains showed “vascular and white matter pathologies” associated with traumatic brain injury, as well as some evidence of neurological diseases. However, none showed signs of CTE, a progressive neurodegenerative disease commonly found in the brains of male contact athletes who have suffered repeated traumatic brain injuries and, in particular, repetitive head impacts of all levels. This finding raises questions about under what circumstances CTE can occur and shows that there is a need for more research into the long-term effects of traumatic brain injuries in populations who are underrepresented in concussion research, like survivors of intimate partner violence.
While this study does give some insight into the relationship between intimate partner violence and traumatic brain injury, Dams-O’Connor et al. acknowledge that the study was performed on a relatively small sample, so the generalizability of the results is unclear. However, this study does pave the way for further research into how traumatic brain injuries present in populations whose brains have not been studied extensively in this field.