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      Evaluation and Treatment of Mild Traumatic Brain Injury: The Role of Neuropsychology

      review-article
      Author(s): 1 , * , 2
      Publication date (Electronic):
      Journal: Brain Sciences
      Publisher: MDPI
      Keywords: mTBI, concussion, PCS, neuropsychology, cognitive rehabilitation

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          Abstract

          Awareness of mild traumatic brain injury (mTBI) and persisting post-concussive syndrome (PCS) has increased substantially in the past few decades, with a corresponding increase in research on diagnosis, management, and treatment of patients with mTBI. The purpose of this article is to provide a narrative review of the current literature on behavioral assessment and management of patients presenting with mTBI/PCS, and to detail the potential role of neuropsychologists and rehabilitation psychologists in interdisciplinary care for this population during the acute, subacute, and chronic phases of recovery.

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          Incidence, risk factors and prevention of mild traumatic brain injury: results of the who collaborating centre task force on mild traumatic brain injury

          J David Cassidy, Linda J Carroll, Paul Peloso … (2004)
          Article 0 comments Cited 280 times – based on 0 reviews     Review now
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            Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008.

            Keith Cicerone, Donna M Langenbahn, Cynthia A Braden … (2011)
            To update our clinical recommendations for cognitive rehabilitation of people with traumatic brain injury (TBI) and stroke, based on a systematic review of the literature from 2003 through 2008. PubMed and Infotrieve literature searches were conducted using the terms attention, awareness, cognitive, communication, executive, language, memory, perception, problem solving, and/or reasoning combined with each of the following terms: rehabilitation, remediation, and training for articles published between 2003 and 2008. The task force initially identified citations for 198 published articles. One hundred forty-one articles were selected for inclusion after our initial screening. Twenty-nine studies were excluded after further detailed review. Excluded articles included 4 descriptive studies without data, 6 nontreatment studies, 7 experimental manipulations, 6 reviews, 1 single case study not related to TBI or stroke, 2 articles where the intervention was provided to caretakers, 1 article redacted by the journal, and 2 reanalyses of prior publications. We fully reviewed and evaluated 112 studies. Articles were assigned to 1 of 6 categories reflecting the primary area of intervention: attention; vision and visuospatial functioning; language and communication skills; memory; executive functioning, problem solving and awareness; and comprehensive-holistic cognitive rehabilitation. Articles were abstracted and levels of evidence determined using specific criteria. Of the 112 studies, 14 were rated as class I, 5 as class Ia, 11 as class II, and 82 as class III. Evidence within each area of intervention was synthesized and recommendations for Practice Standards, Practice Guidelines, and Practice Options were made. There is substantial evidence to support interventions for attention, memory, social communication skills, executive function, and for comprehensive-holistic neuropsychologic rehabilitation after TBI. Evidence supports visuospatial rehabilitation after right hemisphere stroke, and interventions for aphasia and apraxia after left hemisphere stroke. Together with our prior reviews, we have evaluated a total of 370 interventions, including 65 class I or Ia studies. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for cognitive disability after TBI and stroke. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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              Recommendations for diagnosing a mild traumatic brain injury: a National Academy of Neuropsychology education paper.

              Donna Broshek, Kristin R Ruff, J Barth … (2009)
              A special interest group of the American Congress of Rehabilitation Medicine [ACRM; Mild Traumatic Brain Injury Committee. (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (3), 86-87.] was the first organized interdisciplinary group to advocate four specific criteria for the diagnosis of a mild traumatic brain injury (TBI). More recently, the World Health Organization (WHO) Collaborative Center Task Force on Mild Traumatic Brain Injury [Carroll, L. J., Cassidy, J. D., Holm, L., Kraus, J., & Coronado, V. G. (2004). Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, (Suppl. 43), 113-125.] conducted a comprehensive review of the definitions utilized in evidence-based studies with mild TBI patients. Based on this review, the WHO task force maintained the same four criteria but offered two modifications. The similarities and differences between these two definitions are discussed. The authors of the ACRM and the WHO definitions do not provide guidelines or specific recommendations for diagnosing the four criteria. Thus, we provide recommendations for assessing loss of consciousness, retrograde and post-traumatic amnesia, disorientation and confusion as well as clarification of the neurologic signs that can be indicative of a diagnosis of mild TBI. Finally, confounding factors mentioned in both definitions that should exclude a mild TBI diagnosis are summarized.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Brain Sci
                Journal ID (iso-abbrev): Brain Sci
                Journal ID (publisher-id): brainsci
                Title: Brain Sciences
                Publisher: MDPI
                ISSN (Electronic): 2076-3425
                Publication date (Electronic): 17 August 2017
                Publication date Collection: August 2017
                Volume: 7
                Issue: 8
                Electronic Location Identifier: 105
                Affiliations
                [1 ]JFK Johnson Rehabilitation Institute, Center for Brain Injuries, Edison, NJ 08820, USA
                [2 ]Alta Bates Summit Medical Center, Oakland, CA 94609, USA; BruhnsM@ 123456sutterhealth.org
                Author notes
                [* ]Correspondence: prin9087@ 123456pacificu.edu ; Tel.: +1-732-906-2640 (ext. 42242)
                Article
                Publisher ID: brainsci-07-00105
                DOI: 10.3390/brainsci7080105
                PMC ID: 5575625
                PubMed ID: 28817065
                SO-VID: 6af9b807-6e0e-4d0c-84fe-23c348c21292
                Copyright © © 2017 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 01 July 2017
                Date accepted : 09 August 2017
                Categories
                Subject: Review

                Keywords: mtbi,concussion,pcs,neuropsychology,cognitive rehabilitation
                Data availability:
                Keywords: mtbi, concussion, pcs, neuropsychology, cognitive rehabilitation

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