No description available.

Brain injury affects nearly 1.5 million people in the United States every year and estimated that 124,000 of those affected will have some form of long-term disability. Impaired Self Awareness (ISA) has been identified as one of the largest obstacles to successful brain injury rehabilitation and adaption to living with a brain injury. Research on the relationship between the awareness of individuals with acquired brain injury (IwABI) and their significant others has been inconsistent. This study examined the role IwABI and their significant others perception concordance&mdashagreement concerning functioning&mdashhas on maintenance of rehabilitation gains at a follow-up date after completion of adolescent brain injury rehabilitation services. Contrary to the hypotheses, the data showed a strong correlation (.872, p&le.01) and significant relationship (t=35, p&le.001) between IwABI and their significant others Functional Area Outcomes Menu (FAOM) scores at follow-up. There was no relationship between functioning at discharge and perception concordance at follow-up or time post-discharge and perception concordance at follow-up. Several explanations for the findings are provided along with suggestions for future investigation of the research subject.

Cognitive rehabilitation has been shown to have beneficial effects on functional recovery following traumatic brain injury. In the present study, the rehabilitative effects of cognitive training in the T-maze on functional recovery of behavior and cortical sparing following a cortical impact injury (CCI) were examined. T-maze alternation has a widespread application in detecting cognitive dysfunction, and alternation in particular utilizes working memory. 47 male Sprague-Dawley rats were divided into six groups (sham trained, sham yoked, sham control, injured trained, injured yoked, injured control). Injured animals received a bilateral frontal craniotomy (1.0 A/P, 0.0 M/L from Bregma). The cortices were depressed at a depth of 2.5 mm at a velocity of 3 m/s. T-maze training began on post surgery day 2 and continued daily through post surgery day 19. Following this rehabilitative T-maze training, cognition was assessed using two different memory tasks in the Morris water maze (MWM).

This two-phase grant proposal utilizes a group waitlist and single subjects multiple baseline design to evaluate In the Classroom with Brain Injury for Educators, which is a digitally applied online professional development series that can be used to increase knowledge, skills, and awareness of educators to provide effective school-based supports for students with brain injuries using cognitive behavior change theories. Phase 1 evaluates the series employing a group waitlist design with a delayed posttest. Phase 2 utilizes a single subjects multiple baseline design study to analyze student behavioral outcomes related to the intervention and change in teacher behavior. This project has impactful implications. The evaluation of the In the Classroom with Brain Injury for Educators series will establish an evidence base in support of the professional development series and fill the void that exists in available evidence based resources for educators working with students who have brain injuries. In addition, this evaluation has the potential to improve the school experience for both students with brain injury and their teachers by providing evidence that In the Classroom with Brain Injury for Educators is a professional development series that improves teacher and student behavioral outcomes.

abstract: Specificity and affinity towards a given ligand/epitope limit target-specific delivery. Companies can spend between $500 million to $2 billion attempting to discover a new drug or therapy; a significant portion of this expense funds high-throughput screening to find the most successful target-specific compound available. A more recent addition to discovering highly specific targets is the application of phage display utilizing single chain variable fragment antibodies (scFv). The aim of this research was to employ phage display to identify pathologies related to traumatic brain injury (TBI), particularly astrogliosis. A unique biopanning method against viable astrocyte cultures activated with TGF-β achieved this aim. Four scFv clones of interest showed varying relative affinities toward astrocytes. One of those four showed the ability to identify reactive astroctyes over basal astrocytes through max signal readings, while another showed a statistical significance in max signal reading toward basal astrocytes. Future studies will include further affinity characterization assays. This work contributes to the development of targeting therapeutics and diagnostics for TBI. / Dissertation/Thesis / M.S. Bioengineering 2013

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.

Traumatic brain injury (TBI) is a progressive disorder, in which the primary injury results in the initiation of a complex cascade of secondary biochemical and metabolic changes resulting in lasting neurological dysfunction and cognitive impairment. The heterogeneous nature of the disease has complicated the development of pharmacological agents to improve the outcomes of TBI; to date, no therapeutic treatment has been shown to be effective in clinical trials. Treatments targeting multiple secondary outcomes (cell death, axonal degeneration, and inflammation) may provide enhanced therapeutic efficacy following TBI. Small Ras family GTP-binding proteins govern diverse cellular processes by directing the relay of extracellular stimuli to the activation of select intracellular signaling pathways. Rin (RIT2) is a member of the Rit subfamily of Ras-related family of GTPases, and is expressed solely within neurons of the CNS. Early cell culture models demonstrated that Rin signaled upstream of the stress-activated protein kinase, p38, and lacked the transformative abilities displayed by other members of the Ras family, suggesting functions for Rin other than cell growth and proliferation. To begin to define the physiological function of Rin, we generated a RIT2 knockout mouse and examined the impact of Rin loss in the CNS following brain trauma. Our data demonstrates that Rin deficiency is neuroprotective following a controlled cortical impact (CCI) injury, reducing both acute hippocampal neurodegeneration and promoting sustained neuronal survival, without affecting post-CCI neurogenesis. Hippocampal neuroprotection achieved by Rin loss was accompanied by improved cognitive function in injured mice. Furthermore, we demonstrated that Rin loss led to blunting of axonal degeneration and microglial activation in the optic nerve following optic nerve stretch injury. The molecular interaction between Rin and dual leucine zipper kinase suggested a potential role for Rin in the regulation of a novel stress MAPK-dependent neuronal death cascade. Lastly, we demonstrated through diffuse closed head injury, that Rin loss mitigates cytokine release as a result of injury without altering glial activation. Together, these studies establish Rin as a novel regulator of neuronal cell death, cognitive decline, axonal degeneration, and cytokine production following traumatic brain injury.

Class of 2015 Abstract / Objectives: Guidelines from the Brain Trauma Foundation recommend that after traumatic brain injury (TBI) patients should be given seizure prophylaxis for up to seven days. Currently, phenytoin is the first line therapy for this indication. However, levetiracetam is increasingly being used as an alternative because it does not require serum concentration monitoring and has a desirable safety profile. Studies evaluating levetiracetam have used a loading dose, followed by a maintenance dose of 1000 mg every 12 hours. The primary objective of this study was to evaluate the efficacy of low-dose (500 mg every 12 hours) levetiracetam for seizure prophylaxis after TBI. Methods: This was a retrospective cohort study conducted in a tertiary care, academic institution that is designated as a level 1 trauma center. Institutional review board approval was obtained prior to data collection. Consecutive patients with TBI between 2010 and 2012, who received levetiracetam for seizure prophylaxis, were included. Patients who met at least one of the following criteria were included: cortical contusion on computerized tomography scan, subdural hematoma, epidural hematoma, intracerebral hematoma, depressed skull fracture, penetrating head injury, or Glasgow Coma Scale (GCS) of 10 or less. Patients were excluded if they were less than 16 years of age, had a previous head injury, previous neurosurgery, history of seizure, or anti-seizure medication, or were given a loading dose of levetiracetam, or given a maintenance dose greater than 500 mg every 12 hours. The primary outcome was the occurrence of a seizure within seven days of TBI. A one-sample test of proportions was used to compare the rate of seizures while being treated with levetiracetam to a hypothesized value of 3.6 percent (from previous trials), using an a priori alpha for 0.05. Results: There were a total of 146 patients included in the study, who were treated with levetiracetam 500 mg every 12 hours. The median age was 51 years (interquartile range 31 to 65 years), 110 (75 percent) were male, and the median GCS on admission was 11 (interquartile range 5 to 14). The mechanisms of injury were fall (n equals 49), motor vehicle or motorcycle collisions (n equals 42), pedestrian or bicyclist (n equals19), assault (n equals16), suicide attempt (n equals 2), and other (n equals18). The median time to first dose of levetiracetam was 4 hours after injury (interquartile range 1 to 13 hours). After initiation of levetiracetam, there were 5 (3.4 percent) patients who had a seizure within seven days. This was not significantly different than the hypothesized population value (p equals 0.910). The median length of stay was 13 days (interquartile range 9 to 21) and 7 (4.8 percent) patients died during hospitalization. Conclusions: A low-dose of levetiracetam 500 mg every 12 hours after TBI was effective for early seizure prevention. This regimen may be an appropriate alternative to phenytoin or traditional dose levetiracetam for this indication. Future, prospective studies are needed to confirm these findings.

No description available.

Compromised validity of test data due to exaggeration or fabrication of cognitive deficits inhibits the capacity to establish appropriate conclusions and recommendations in neuropsychological examinations. Detection of feigned neurocognitive impairment presents a formidable challenge, particularly for evaluations involving possibilities of significant secondary gain. Among specific populations examined in this domain, litigating mild traumatic brain injury (mTBI) samples are among the most researched. One subpopulation with potential to contribute significantly to this body of literature is that of retired athletes undergoing fixed-battery neuropsychological evaluations within an assessment program. Given the considerable prevalence of concussions sustained by athletes in this sport and the substantial monetary incentives within this program, a unique opportunity exists to establish rates of feigning within this population to be compared to similar forensic mTBI samples. Further, a fixed battery with multiple validity tests (VT) offers a chance to evaluate the classification accuracy of an aggregated VT failure paradigm, as uncertainty abounds regarding the optimal approach to the recommended use of multiple VTs for effort assessment. The current study seeks to examine rates of feigned neurocognitive impairment in this population, demonstrate prediction accuracy equivalence between models based on aggregated VT failures and logistic regression, and compare classification performance of various individual VTs.