Personality Change Common and Persistent After Brain Injury

TOPLINEPersonality change was common and persistent after traumatic brain injury (TBI), with symptoms including irritability, mood changes, and anger outbursts, a meta-analysis showed. These changes tended to persist long-term, with limited evidence for effective treatments.METHODOLOGYResearchers conducted a systematic review and meta-analysis of studies published between July 1980 and June 2025 examining personality change following TBI in adults aged 16 years or older.A total of 101 studies were included, comprising case series, cohort studies, cross-sectional studies, retrospective observational studies, case-control studies, qualitative studies, and trials; 17 of these studies were included in the meta-analysis.Analysis focused on signs and symptoms associated with post-TBI personality change, prevalence estimates, long-term outcomes, treatment approaches, and lesion locations.Personality change was assessed using various methods including structured diagnostic assessments, validated questionnaires, and clinical diagnoses across studies.TAKEAWAYThe estimated prevalence of broad personality change was 68.1% (nine studies), with high heterogeneity between studies.The estimated prevalence of secondary personality disorder was 28.4% (eight studies).The most commonly reported symptoms included irritability/frustration, depression, mood swings/emotional instability, anger outbursts, and decreased social interaction or withdrawal.Personality change persisted over long-term follow-up in longitudinal studies, remaining prevalent at 5, 7, and even 18-60 years post-injury, though most studies were small and of variable quality. The relationship between personality change and specific lesion locations in TBI was unclear.IN PRACTICE"Personality change is a common and enduring consequence of TBI, yet remains poorly addressed clinically. The development of targeted interventions for individuals and families affected by these changes remains a priority," wrote the authors of the study.SOURCEThe study was led by Lauren Burns, University College London, London, UK. It was published online on August 3 in the Journal of Neurology.LIMITATIONSThe included studies used varied measures and diagnostic criteria for assessing personality change, potentially affecting prevalence estimates. The review excluded studies addressing related concepts such as disinhibition without explicitly mentioning personality change. Risk of bias was variable across studies, with inadequate control of confounding in many cohort studies.DISCLOSURESThe study received no specific funding. The authors reported having no conflicts of interest.This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.