Umi Venkatesan, PhD, who directs the Brain Trauma and Behavior (BraTBehavior) Laboratory, recently launched a project examining social factors that may affect the recovery of adults with traumatic brain injury (TBI). This exciting work is funded by the Albert Einstein Society, and it focuses on pre-injury, early life experiences that may shape how individuals recover from TBI sustained in adulthood.

Why do pre-injury experiences matter? Oftentimes what we think of as “brain injury outcomes” are in fact much more than that. When we ask someone how they are doing emotionally or about their social relationships, we are not just capturing their life now (since their injury) but the effects of all their life experiences (before and after injury) combined. For example, it is well documented that TBI can negatively affect mental health, but a person’s emotional functioning is also influenced by whether they may have struggled with psychological problems in the past. As one might expect, problems present before injury do not stop being relevant after injury; in fact, they are at risk of worsening. In other words, TBI changes someone’s life, but it does not erase who they were before their brain injury.

Previous research has centered mostly on demographic factors that influence TBI outcomes, such as sex, race, and socioeconomic status, but these do not tell us much about a person’s “lived experience” before injury. We know that social experiences earlier in life can have significant impacts on how people approach daily life activities and, importantly, how they cope with stress. Indeed, recovering from TBI can be a major source of stress!

In his current work, Dr. Venkatesan is asking survivors of TBI about negative childhood family and social experiences that may ultimately affect how well they recover from TBI. In the general population, these experiences have been shown to have a number of negative health effects later in life, including increasing the risk for sustaining a TBI. Dr. Venkatesan’s lab is examining whether these kinds of experiences may have similar effects on outcomes after TBI. The long-range goal is to bring us closer to a more holistic understanding of each patient, which would allow clinicians to better personalize treatment to reflect the life perspectives of each individual. Dr. Venkatesan argues that while demographic factors and the effects of injury on the brain are not easily changed, we can better understand and modify attitudes and behaviors that could interfere with recovery potential. This approach may prove fruitful in improving the quality of life of those impacted by TBI.

Recruitment for this study is underway, and several participants have already been enrolled. The project will run through 2021, and Dr. Venkatesan expects to collect data on 80-90 individuals living with TBI in the Philadelphia region. The study is believed to be the first of its kind, and it has already led to collaborations with other TBI investigators across the country. With these scientists, Dr. Venkatesan recently founded a research workgroup devoted to characterizing pre-injury functioning in individuals with TBI. This initiative, known as Lives Before Brain Injury (LiBBI), meets monthly to discuss methodological and conceptual issues, share current research projects of its members, and identify collaborative opportunities.

Dr. Venkatesan’s research program at MRRI hopes to address a critical gap in the literature regarding individual life trajectories and how they may be modified by TBI. The BraTBehavior Laboratory is fortunate to be able to conduct this work within the diverse population of the Delaware Valley and looks forward to expanding its scientific mission with future research partnerships.

Learn more about Dr. Venkatesan and the BraTBehavior Laboratory.