Traumatic brain injury causes physical, neurobehavioral, and cognitive-linguistic deficits including problems related to pragmatic functioning and emotional processing. This study investigated the ability of 10 (9 male and 1 female) adults with traumatic brain injury and 10 neurotypical participants to identify errors in pragmatic behavior embedded in 25 videotaped interactions presented by computer. Statistical analysis revealed that the neurotypical participants identified significantly more violations of pragmatic rules than the participants with traumatic brain injury for two of the five deficit categories, excessive interruption and two deficits. Limitations of the study and directions for future research are discussed. / text

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. / Sports-related mild traumatic brain injuries (mTBIs) have become an increasingly popular topic. Cognitive and physical rest are the mainstays of management, but effective evidence-based therapies do not exist. Very few studies report mean recovery times from mTBI and even less for intercollegiate athletes. The primary aim is to retrospectively compare the recovery time in athletes from a large Division I University that suffered a sports-related mTBI during 2010 - 2012 to published data for quality assessment and improvement. Since the institution's concussion management follows current guidelines, no significant difference was expected. Secondary aims included comparing recovery times between gender, sport, and league. As reported in current literature, no significant gender differences were expected. 53 athletes with sports-related mTBI (27 male and 26 female) showed a mean recovery time of 10.11 days (95 % confidence interval [CI] = 8.58 - 11.65 days), statistically different than the time reported in 1 study of 7 days, but not in another of 7 - 10 days. Mean recovery time in males and females was 9.74 days (95 % CI = 7.38 - 12.1 days) and 10.5 days (95 % CI = 8.4 - 12.6 days), respectively. Mean recovery time in National Collegiate Athletic Association (NCAA) and non-NCAA (club) athletes was 9.91 days (95 % CI = 8.27 - 11.55) and 11.25 days (95 % CI = 5.87 - 16.63), respectively. A nonparametric Wilcoxon rank-sum test showed no significant variation between genders and between NCAA and non-NCAA athletes. Subgroup statistics of 13 sports were inconclusive due to inadequate power. However, the subgroup of male football athletes showed a mean recovery time of 6.5 days (95 % CI = 4.86 - 8.14 days), which was not significantly different than published rates. Multiple confounding variables were not well controlled for including: sport, gender, concussion severity, multiple concussions, etc. However, this study did highlight areas for quality improvement in the institution's concussion management plan. Further investigation with increased power and confounding variable control is indicated for a more definitive mean time to recovery. This study is the first to detail the mean time to recovery from sports-related mTBI in an intercollegiate athletic program. Similar studies should be done at other institutions for quality assessment and improvement of 4 concussion management. Such data will be useful in establishing a baseline for measure of efficacy in future investigations of therapeutic interventions.

No description available.

Systemic injections of the neurosteroid progesterone (P) have been shown to improve cognitive, sensory and motor recovery after traumatic brain injury (TBI). Progesterone withdrawal (PW), however, increases the risk of ischemia, anxiety, seizure, and excitotoxicity. Given these side effects, it is possible that acute PW during recovery from TBI may retard the healing process. In this project, we investigated the effect of acute PW for short and long-term intervals, and optimized post-TBI P treatment through tapered P injections and slow-release implanted capsules. Male Sprague-Dawley rats received either frontal-bilateral cortical contusion injury or sham surgery. P-treated animals displayed increased anxiety in the elevated plus maze at the peak of acute withdrawal compared to tapered P doses or vehicle. Inflammation and apoptosis, as measured by TNF and #61537;, NF and #61547;B, and active caspase-3, among others, were decreased for all P-treated animals; these effects were further reduced with tapered treatment. Three weeks after injury, animals that received tapered P administration displayed fewer sensory deficiencies and increased motor activity. In addition, reducing the effects of acute PW increased the activity of HSP70 and BDNF while decreasing necrotic lesion size and reactive astrocyte staining, indicating increased neuroprotection. Finally, the beneficial effects of P administration after TBI were further enhanced through a steady-state release of P from a subcutaneously implanted silastic capsule. Compared to animals receiving a daily bolus through subcutaneous injections, capsule animals demonstrated decreased anxiety and edema. All P-treated animals, regardless of delivery method, had reduced inflammation and apoptosis compared to vehicle-treated animals. This system also serves as a model of steady-state intravenous P administration used in human clinical trials. In conclusion, all P treatment enhances both short and long term recovery after TBI. Acute PW, however, has a negative effect on both behavior and tissue recovery. At the peak of withdrawal, animals undergoing acute PW exhibit an increase in anxiety, sensory deficits, inflammation and apoptosis, and a decrease in locomotor activity, all of which are further exacerbated by injury. Tapered withdrawal enhances neuroprotection and plasticity, while a steady-steady application of P further decreases edema and the anxiogenic effects of withdrawal.

abstract: Emotion recognition through facial expression plays a critical role in communication. Review of studies investigating individuals with traumatic brain injury (TBI) and emotion recognition indicates significantly poorer performance compared to controls. The purpose of the study was to determine the effects of different media presentation on emotion recognition in individuals with TBI, and if results differ depending on severity of TBI. Adults with and without TBI participated in the study and were assessed using the The Awareness of Social Inferences Test: Emotion Evaluation Test (TASIT:EET) and the Facial Expressions of Emotion-Stimuli and Tests (FEEST) The Ekman 60 Faces Test (E-60-FT). Results indicated that individuals with TBI perform significantly more poorly on emotion recognition tasks compared to age and education matched controls. Additionally, emotion recognition abilities greatly differ between mild and severe TBI groups, and TBI participants performed better with the static presentation compared to dynamic presentation. / Dissertation/Thesis / M.S. Speech and Hearing Science 2011

The clinical relevance of vitamin B3, nicotinamide (NAm), has been demonstrated in a variety of injury models to exert a number of therapeutic benefits in the protection against and treatment of traumatic brain injury (TBI). This study investigated its efficacy on recovery from TBI in animals of differing ages (6- and 10-months old) that were injured using the controlled cortical impact model and tested for motor and cognitive recovery following injury. Injured animals were treated with NAm or saline following injury and sham-injured animals were included as a control group. It was hypothesized that increasing age reduces the potentiality of recovery from injury as well as a decreased therapeutic benefit derived from the post-injury administration of NAm. The results found that neither the 6- nor 10-month old animals treated with NAm demonstrated improved functional recovery, indicating that age is an important factor in the vitamin's efficacy. These results indicate that the success of possible treatments for TBI needs to also consider the effects of an individual's age on the drug's effectiveness.

The goal of this study was to investigate the therapeutic potential of memantine on functional recovery following a cortical contusion impact (CCI) traumatic brain injury (TBI) in a rodent model. A unilateral parietal injury was induced and compared to open sham surgeries under controlled experimental conditions. Animals were randomly assigned to a sham group, vehicle-treated injured group, or memantine-treated injured group. Dosage regimens were designed to provide serum concentrations in the range obtained with clinically approved doses, using both a low (5 mg/kg) and high (20 mg/kg) dose for 48 h. Functional recovery was assessed using five behavioral assessments, as well as neuropathological measurements. Motor function was observed using the locomotor placing task, the rotor-rod procedure, and a photobeam activity monitoring system. Cognitive function as learning ability was assessed through the Morris Water Maze and a passive avoidance assessment. Memantine did not improve motor or cognitive function in any of the behavioral assessments. These results indicate that while memantine may provide benefits at a neurobiological level, its therapeutic potential on the recovery of behavioral function following TBI is severely limited.

No description available.

Traumatic Brain Injury (TBI) is a major concern for health professionals as it is a leading cause of death and disability in the United States. Patients can experience difficulties that include intellectual impairment, memory impairment, and executive functioning deficits. Psychometric tests have been used to assist in the diagnosis of head injuries. Specifically, the Wechsler scales are recognized in the scientific and medical communities as the most widely utilized measure of general intellectual function in older adolescents and adults. The recently published Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) is a revision of the WAIS-III. No studies have been published to date relevant to the effects of head trauma or other neurological disorders due to the recent introduction of the test. The purpose of the study was to understand the immediate intellectual consequences of head injury in adults along a continuum of severity, evaluate whether new additions to the WAIS-IV provide additional information about the effects of head trauma, and determine if the length of recovery affects the WAIS-IV indices differently. A total of 47 participants between the ages of 18-89 were selected from inpatient and outpatient admissions at a major trauma center. Participants who had sustained a closed-head injury were selected and tested between 1 month and 36 months post-injury (once any post traumatic amnesia had resolved). Patients were administered the Galveston Orientation Amnesia Test, Wechsler Test of Adult Reading, and WAIS-IV. The main question addressed by the current study was the extent to which brain injured adults display intellectual deficits and if these were consistent with those observed on prior versions of the Wechsler scales. An examination of the pattern of intellectual impairments and the effects of demographic corrections on the WAIS-IV was also conducted. Results indicated that the WAIS-IV IQ and indexes were reduced significantly by traumatic brain injury, and that more severe injuries were likely to show the most pronounced effect on the Processing Speed Index. Abnormalities visualized by brain CT or MRI scans were associated with lower IQ's and index scores than were shown by patients with traumatic head injury that had normal CT scans. There was no evidence that corrections for educational level, ethnicity, and gender improved the sensitivity of the WAIS-IV to injury severity beyond that obtained by corrections for age.

The purpose of this study is to investigate an animal model of distress (conditioned suppression) to assess the effects of magnesium (MAG) and nicotinamide (B3) administration on recovery of anxiety-like behavior following traumatic brain injury (TBI). Post-traumatic stress disorder (PTSD) is comorbid with TBI and both affects a victim’s ability to maintain daily activities and have a good quality of life. Administration of MAG decreases swelling of the brain considerably and lessens cell death. B3 is a neuroprotective precursor to NAD+ and enhances energy levels as well has help reduce free radicals after TBI. A conditioned suppression procedure is an established method for generating disruptive fearful anxiety-like responses in animals and these treatments may help to reduce anxiety responses.