Study finds lingering neurobehavioral symptoms after strangulation-related brain injury

In a federally funded study, Mass General Brigham investigators found self-reported vision problems and traumatic stress are experienced years after strangulation .

Around the globe, nearly one in three women have experienced intimate partner violence (IPV). Among those women, 68% experience strangulation, which blocks air and blood flow to the brain and can cause brain injury. A new study by investigators from Mass General Brigham of 139 women found that strangulation-related brain injury was negatively associated with women's health over time, including self-reported vision problems and traumatic stress. Their results are published in the Journal of Neurotrauma. 

This study highlights potential long-term consequences of IPV-related strangulation and reinforces the importance of IPV prevention and providing treatment for women in need."

Eve Valera, PhD, corresponding author, investigator, Mass General Brigham Department of Psychiatry

As part of their federally funded study, the researchers recruited 139 mostly white women through flyers, online advertisements, and social media. Strangulation does not always result in brain injury, so carefully designating study participants into groups based on their experience was critical to understand the varying severity of symptoms. Three major subgroups were identified: strangulation; strangulation with altered consciousness-seeing stars, tunnel vision; and strangulation with full loss of consciousness. Participants in either altered or loss of consciousness categories were assumed to have acquired brain injuries. 

Among the participants, 64% reported a history of IPV-related strangulation; 30% reported strangulation-related alterations in consciousness; and 15% reported strangulation-related loss of consciousness. The researchers asked the three subgroups to self-report symptoms like dizziness, vision and hearing problems, poor concentration, anxiety, depression, and traumatic stress, between July 2020 and February 2023. On average, the last strangulation event participants experienced was 8.7 years prior to the participant's interview. 

Vision problems and traumatic stress symptoms were greater in women who had experienced strangulation, with those that also experienced strangulation-related brain injury reporting more symptoms like stress, dizziness, and poor concentration. Strangulation-related alterations in consciousness were associated with escalated vision problems compared to strangulation alone, while full loss of consciousness was associated with escalated traumatic stress symptoms. The findings suggest self-reported neurobehavioral issues and traumatic stress may linger long after strangulation for all participants. 

"Strangulation is under-reported, and more work is needed to encourage disclosure, social interventions, and timely health care for those subjected to these violent events," said Valera.