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Personality change after traumatic brain injury: a systematic review and meta-analysis.

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Τίτλος: Personality change after traumatic brain injury: a systematic review and meta-analysis.
Συγγραφείς: Burns L; Clinical, Educational and Health Psychology, University College London, London, UK., Jones K; University of Swansea, Swansea, UK., Kerr K; Clinical, Educational and Health Psychology, University College London, London, UK., Brennan N; Headway London, London, UK., Clapshaw N; Headway London, London, UK., Green H; Department of Neuropsychology, Addenbrooke's Hospital, Cambridge, UK., Farrimond H; Department of Social and Political Sciences, Philosophy, and Anthropology, University of Exeter, Exeter, UK., Stone C; Headway London, London, UK., Wilkinson S; Department of Social and Political Sciences, Philosophy, and Anthropology, University of Exeter, Exeter, UK., Members Of Headway London; Headway London, London, UK., Bell V; Clinical, Educational and Health Psychology, University College London, London, UK. vaughan.bell@ucl.ac.uk.; Dept of Neuropsychiatry, South London and Maudsley NHS Foundation Trust, London, UK. vaughan.bell@ucl.ac.uk.
Πηγή: Journal of neurology [J Neurol] 2026 Aug 03; Vol. 273 (8). Date of Electronic Publication: 2026 Aug 03.
Τύπος έκδοσης: Journal Article; Systematic Review; Meta-Analysis
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 0423161 Publication Model: Electronic Cited Medium: Internet ISSN: 1432-1459 (Electronic) Linking ISSN: 03405354 NLM ISO Abbreviation: J Neurol Subsets: MEDLINE
Imprint Name(s): Original Publication: Berlin ; New York, Springer-Verlag
Ιατρικοί όροι (MeSH): Brain Injuries, Traumatic*/complications , Brain Injuries, Traumatic*/psychology , Personality Disorders*/etiology , Personality Disorders*/epidemiology, Humans
Περίληψη: Background: Personality change is a debilitating consequence of traumatic brain injury (TBI), yet its prevalence, characteristics, and treatment remain poorly understood.
Methods: We completed a pre-registered (CRD42023440990) systematic review and meta-analysis searching four databases (MEDLINE, PsycINFO, EMBASE and CINAHL) for primary studies assessing personality change after TBI. We synthesized conceptualization, prevalence, longitudinal outcome, lesion location, and treatment. Prevalence was estimated using a random effect meta-analysis using the Paule-Mandel estimator, with subgroup, meta-regression and robustness analyses.
Results: A total of 101 studies were included in this review, seventeen of which were suitable for meta-analysis. Personality change was defined inconsistently although common symptoms involved the emergence or increase of affective, behavioral, and social disturbances, including irritability, depression, emotional instability, anger outbursts, social withdrawal, anxiety, impulsivity, restlessness, aberrant motor behaviors, and aggression. The prevalence of secondary personality disorder was estimated as 29.1% (CIs 22.5% - 36.2%) and prevalence of broad personality change was 68.1% (CIs 53.4% - 81.2%). Robustness analyses showed that the estimate for broad personality change should be treated with caution as it was unstable when adjusted for risk of bias and potential publication bias. Follow-up studies, although of varying quality, consistently showed personality change remained stable over long follow-up periods. The relationship between personality change and specific lesion locations in TBI remains unclear, likely due to the poor methodological quality of studies examining this association. Perhaps most concerning, there is limited evidence and very few systematic studies addressing treatment.
Conclusion: Personality change is a common and persistent consequence of TBI. Varying definitions, and the lack of high-quality lesion mapping studies and systematic investigations into treatment highlights critical gaps in understanding and management.
(© 2026. The Author(s).)
Competing Interests: Declarations. Conflicts of interest: The authors have no conflicts of interest to declare.
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Contributed Indexing: Keywords: Disinhibition; Neuropsychiatry; Organic personality disorder; Personality change; Secondary personality disorder; Traumatic brain injury
Entry Date(s): Date Created: 20260803 Date Completed: 20260804 Latest Revision: 20260923
Update Code: 20260923
PubMed Central ID: PMC13433385
DOI: 10.1007/s00415-026-14028-0
PMID: 42547613
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1432-1459
DOI:10.1007/s00415-026-14028-0