Neuro TBI

Neurocognitive Disorder Due to Traumatic Brain

InjurySean Edwards

Neurocognitive Disorder Due to Traumatic Brain Injury

Also Known as “TBI” The DSM-5 states that neurocognitive disorders

“go beyond the issues of normal aging”There must be changes that impact cognitive

functioning Approximately 1.7 million suffer TBI (Center for

Disease Control, 2012)

EtiologyTBI usually caused by

FallsStruck by/againstMotor Vehicle – TrafficAssaultOther Unknown

(Center for Disease Control, 2012)

EtiologyTBI is caused by

acceleration-deceleration of the brain inside the skull with an impacto Shearing force causes

axons to sever o Messages cannot be sent

thought the brain when axons are severed

o Excitatory actions occur in the brain – sodium potassium pump begins over working

o Potassium creates neuronal depolarization releasing more

neurotransmitters creating an energy crisis

(De Ribaupierre, 2011)

Symptoms Impairment in motor & cognitive functioning (Khan,

Baguley, & Cameron, 2003) Difficulties with memory, attention, speed and processing

of thoughts If severe enough could have physical impairment Inability to control judgment

Personality and behavioral changes (Rush, Malec, Brown, & Moessner, 2006) Little self-awareness Apathetic Personality itself may not change but the behaviors due to

the situation and trauma

SymptomsMemory (Vanderploeg, Schinke, Curtiss, &

Lanham, 2001)Difficulty with past, present and future

Inability to pick up on emotional cues or feeling emotions themselves (Saunders, McDonald, & Richardson, 2006)

TreatmentsPatient centered rehabilitation (Pegg, Auerbach, Kiesler,

Plybon, Seel, & Buenaver 2005)Study using patients admitted into a Veteran Medical

Center Involving patients in their own treatment showed that it

motivated them to work harder in rehabMotivational therapy (using adolescents and children)

(McCauley, Pedroza, Levin, McDaniel, & Chapman 2009)Patients earned rewards for performing an action correctly

using PM (perspective memory)

TreatmentsUsing hypothermia after initial injury (Marion et al.,

1997)Patients who had scored low on the Glasgow coma scale,

GCS (meaning they had more severe injuries, or unconsciousness for a longer period of time), did not benefit from hypothermia but those who scored mid level did seem to benefit

Combination hypothermia & stem cells (Tu et al., 2012)Hypothermia keeps stem cells aliveStem cells have ability to become neuronal cells,

improving the affected or dead cells

Did you know...

ReferencesCenter for Disease Control and Prevention. (2013, March 27). Traumatic Brain Injury. Retrieved from

http://www.cdc.gov/traumaticbraininjury/statistics.html#1

De Ribaupierre, S. MD, (2011). Trauma and impaired consciousness. Neurologic Clinics, 29(4), 833-902. Retrieved from http://www.mdconsult.com/das/article/body/437613593-2/jorg=journal&source=&sp=24727356&sid=0/N/928519/1.html?issn=0733-8619

Khan, F., Baguley, I. J., & Cameron, I., D. (2003). Rehabilitation after Traumatic Brain Injury. The Medical Journal of Australia, 178(6), 290-295. Retrieved from https://www.mja.com.au/journal/2003/178/6/4-rehabilitation-after-traumatic-brain-injury

McCauley, S. R., Pedroza, C., Levin, H. S., McDaniel, M. A., & Chapman, S. B. (2009). Incentive Effects on Event-Based Prospective Memory Performance in Children and Adolescents with Traumatic Brain Injury. Neuropyschology, 23(2), 201-209. DOI:10.1037/a0014192

Marion, D. W., Penrod, L. E., Kelsey, S. F., Obrist, W. D., Kochanek, P. K., Palmer, A. M., … DeKosky, S. T. (1997). Treatment of Traumatic Brain Injury with Moderate Hypothermia. The New England Journal of Medicine, 336(8), 1-7. Retrieved fromhttp://www.nejm.org/doi/full/10.1056/nejm199702203360803

Pegg Jr, P. O., Auerbach, S. M., Kiesler, D. J., Plybon, L. E., Seel, R. T., & Buenaver L. F. (2005). The Impact of Patient-Centered Information on Patients’ Treatment Satisfaction and Outcomes in Traumatic Brain Injury Rehabilitation. Rehabilitation Psychology, 50(4), 366-374. DOI: 10.1037/0090-5550.50.4.366

Rush, B. K., Malec, J. F., Brown, A. W., & Moessner, A. M. (2006). Personality and Functional Outcome Following Traumatic Brain Injury. Rehabilitation Psychology, 51(3), 257-264. DOI: 10.1037/0090-5550.51.3.257

Saunders, J. C., McDonald, S., & Richardson, R. (2006). Loss of Emotional Experience after Traumatic Brain Injury: Findings with the Startle Probe Procedure. Neuropsychology, 20(2), 224-231. DOI: 10.1037/0894-4105.20.2.224

ReferencesTu, Y., Chen, C., Sun, H., Cheng, S., Liu, X., Qu, Y., Li, X., Zhang, S. (2012). Combination of Temperature-

Sensitive Stem Cells and Mild Hypothermia: A New Potential Therapy for Severe Traumatic Brain Injury. Journal of Neurotrauma, 29, 2393-2403. DOI: 10.1089/neu.2012.2374

Vanderploeg, R. D., Schinka, J. A., Curtiss, G., & Lanham Jr., R. A., (2001). Material-Specific Memory in Traumatic Brain Injury: Differential Effects During Acquisition, Recall, and Retention. Neuropsychology, 15(2), 174-184. DOI: 10.1037//0894-4105.15.2.174