Provider Identified Access Barriers to Delivering Acupuncture to Persons with Traumatic Brain Injury and Chronic Pain: A Cross-Sectional Self-Report Survey.

Traumatic brain injury (TBI) clinical practice guidelines for pain management and rehabilitation support the use of nonpharmacologic complementary and integrative health (CIH) modalities, such as acupuncture for remediating pain. Barriers to delivering CIH modalities, such as acupuncture warrant examination. The objective of this study is to explore provider perspectives on challenges to accessing acupuncture treatment for chronic pain in persons with TBI and describe differences across health care settings.

Computational Prognostic Modeling in Traumatic Brain Injury.

Traumatic brain injury is the leading cause of death and disability worldwide. Despite this large impact, no predictive models are in widespread use due to tedious data collection requirements, lack of provider trust, and poor performance. Furthermore, these models use simple, often binary, data elements that fail to capture the complex heterogeneity of traumatic brain injury.

Declaration of Computational Neurosurgery.

Computational neurosurgery is a novel and disruptive field where artificial intelligence and computational modeling are used to improve the diagnosis, treatment, and prognosis of patients affected by diseases of neurosurgical relevance. The field aims to bring new knowledge to clinical neurosciences and inform on the profound questions related to the human brain by applying augmented intelligence, where the power of artificial intelligence and computational inference can enhance human expertise. This transformative field requires the articulation of ethical considerations that will enable scientists, engineers, and clinical neuroscientists, including neurosurgeons, to ensure that the use of such a powerful application is conducted based on the highest moral and ethical standards with a patient-centric approach to predict and prevent mistakes.

Emotional awareness and expression difficulties in relation to pain experiences in people with brain injury and chronic pain: preliminary investigation.

Objectives: Preliminary examination of emotional awareness/expression relationships with pain in people with traumatic brain injury (TBI) and chronic pain (CP) and exploration of psychological factors as mediators or moderators of these relationships.

Methods: Cross-sectional study in adults ( = 59) with chronic TBI and CP using Toronto Alexithymia Scale-20 Difficulty Identifying and Describing Feelings subscales; Ambivalence over Emotional Expressiveness Questionnaire; Emotional Approach Coping Scale; PROMIS Pain Intensity and Pain Interference scales, Michigan Body Map (pain widespreadness); headache frequency; Pain Catastrophizing Scale; Brief Symptom Inventory-18 (psychological distress), and Post-traumatic Stress Checklist-Civilian.

Results: Difficulty Identifying Feelings was positively associated with pain intensity, pain interference, and headache frequency.

Training to Reconnect With Emotional Awareness Therapy: A Randomized Controlled Trial in Participants With Traumatic Brain Injury.

Objective: To examine the efficacy of an intervention, Training to Reconnect with Emotional Awareness Therapy (TREAT) at improving alexithymia, emotion dysregulation, anxiety, depression, anger, and global positive and negative affect in participants with traumatic brain injury (TBI).

Design: Randomized, waitlist control (WLC) trial with 3-month follow-up.

Setting: Outpatient brain injury rehabilitation center.

Model of Care for Chronic Brain Injury.

There is growing evidence that long-term outcomes after traumatic brain injury (TBI) are more dynamic than stable. People continue to change, both improving and declining, many years postinjury. Research, practice, and medical education have not yet fully embraced the implications of TBI as a chronic, dynamic condition.

Alexithymia Prevalence, Characterization, and Associations With Emotional Functioning and Life Satisfaction: A Traumatic Brain Injury Model System Study.

Objectives: Alexithymia an emotional processing deficit that interferes with a person's ability to recognize, express, and differentiate emotional states. Study objectives were to (1) determine rates of elevated alexithymia among people with moderate-to-severe traumatic brain injury (TBI) 1-year post-injury, (2) identify demographic and injury-related variables associated with high versus low-average levels of alexithymia, and (3) examine associations among alexithymia with other aspects of emotional functioning and life satisfaction.

Setting: Data were collected during follow-up interviews across four TBI Model System (TBIMS) centers.

Acute Inpatient Rehabilitation Functional Outcomes and Disposition After Liver Transplant.

Objective: To describe the outcomes (change in functional independence and discharge disposition) of patients who after liver transplantation received acute inpatient rehabilitation in a freestanding rehabilitation hospital.

Design: A retrospective chart review was conducted of patients admitted to an acute inpatient rehabilitation hospital within 6 months of undergoing liver transplantation between January 2014 and December 2018. Change in function from rehabilitation admission to discharge was measured using FIM Change and FIM Efficiency.

Mortality Among Veterans Following Traumatic Brain Injury: A Veterans Administration Traumatic Brain Injury Model System Study.

Few studies have examined long-term mortality following traumatic brain injury (TBI) in a military population. This is a secondary analysis of a prospective, longitudinal study that examines long-term mortality (up to 10 years) post-TBI, including analyses of life expectancy, causes of death, and risk factors for death in service members and veterans (SM/V) who survived the acute TBI and inpatient rehabilitation. Among 922 participants in the study, the mortality rate was 8.

Prevalence of Self-Reported COVID-19 Infection in Persons with Complicated Mild to Severe Traumatic Brain Injury (TBI): A TBI Model Systems Study.

Objective: To describe the incidence of self-reported COVID-19 history in a longitudinal cohort of individuals with complicated mild to severe traumatic brain injury (TBI) and describe demographic, injury and functional differences based on history of COVID-19 infection.

Design: Individuals with complicated mild to severe TBI aged 16 or older at time of injury who were enrolled in the TBI Model Systems longitudinal cohort study, completed a baseline or follow-up interview between October 1, 2021-March 31, 2023, and provided information about COVID-19 history and timing of COVID-19 infection was collected.

Results: Of the 3,627 individuals included in the analysis, 29.

10-year variability in high and low life satisfaction trajectories post-traumatic brain injury: a TBI model systems study.

Purpose: To determine how life satisfaction changes across the first 10 years following traumatic brain injury (TBI).

Methods: Participants included 1,941 individuals from the TBI Model Systems database with life satisfaction data at 1-, 5-, and 10-years post-TBI. Based on Satisfaction With Life Scale scores, individuals were characterized as having one of the five 10-year life satisfaction trajectories: 'Stable High,' 'Stable Low,' 'Increased to High,' 'Decreased to Low,' and 'Unstable.

Longitudinal Investigation of Alexithymia as a Predictor of Empathy, Emotional Functioning, Resilience, and Life Satisfaction 2 Years After Brain Injury.

Objective: To examine the unique contribution of alexithymia at 1 year after traumatic brain injury (TBI) to the prospective prediction of emotional and social health outcomes at 2 years after injury.

Design: Multicenter, longitudinal cohort study.

Setting: Data were collected during year 1 and year 2 postinjury follow-up interviews across 4 TBI Model System centers.

Early Seizure Prophylaxis in Mild and Moderate Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

Importance: Guidelines recommend seizure prophylaxis for early posttraumatic seizures (PTS) after severe traumatic brain injury (TBI). Use of antiseizure medications for early seizure prophylaxis after mild or moderate TBI remains controversial.

Objective: To determine the association between seizure prophylaxis and risk reduction for early PTS in mild and moderate TBI.

Association Between Participation and Satisfaction With Life Over Time in Older Adults With Traumatic Brain Injury: A TBI Model Systems Study.

Objective: To examine the association between participation and satisfaction with life at 1, 2, 5, and 10 years after traumatic brain injury (TBI) in older adults.

Setting: Community.

Participants: Participants ( N = 2362) who sustained complicated mild to severe TBI, requiring inpatient rehabilitation, at age 60 years or older and had follow-up data on participation and satisfaction with life for at least 1 follow-up time point across 1, 2, 5, and 10 years.

Prognosis and enhancement of recovery in disorders of consciousness.

Disorders of consciousness after severe brain injury encompass conditions of coma, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. DoC clinical presentation pose perplexing challenges to medical professionals, researchers, and families alike. The outcome is uncertain in the first weeks to months after a brain injury, with families and medical providers often making important decisions that require certainty.

Provider Perspectives of Facilitators and Barriers to Reaching and Utilizing Chronic Pain Healthcare for Persons With Traumatic Brain Injury: A Qualitative NIDILRR and VA TBI Model Systems Collaborative Project.

Objective: To identify facilitators and barriers to reaching and utilizing chronic pain treatments for persons with traumatic brain injury (TBI) organized around an Access to Care framework, which includes dimensions of access to healthcare as a function of supply (ie, provider/system) and demand (ie, patient) factors for a specified patient population.

Setting: Community.

Participants: Clinicians (n = 63) with experience treating persons with TBI were interviewed between October 2020 and November 2021.

Provider Perceived Facilitators and Barriers to Identifying, Perceiving, and Seeking Healthcare for Chronic Pain After TBI: A Qualitative NIDILRR and VA TBI Model Systems Collaborative Project.

Objective: Identify determinants to chronic pain healthcare for persons with traumatic brain injury (TBI) informed by an Access to Care Framework. Findings related to the Access Framework's core domains of identifying a need, perceptions of the need, and seeking healthcare are reported.

Setting: Community.

The Interaction of Opiate Misuse and Marijuana Use on Behavioral Health Outcomes Using the Traumatic Brain Injury Model Systems Pain Collaborative Dataset.

Objective: To determine if the interaction of opiate misuse and marijuana use frequency is associated with behavioral health outcomes.

Setting: Community.

Participants: Three thousand seven hundred fifty participants enrolled in the Traumatic Brain Injury Model Systems who completed the Pain Survey and had complete opioid use and marijuana use information.

Assessing the benefits and risks of amantadine for irritability and aggression after traumatic brain injury.

Objective: To quantify the benefits versus harms of amantadine in the treatment of irritability and aggression following traumatic brain injury.

Methods: Secondary outcome data from a randomized controlled multisite trial of amantadine 100 mg twice daily were used to calculate number-needed-to-treat (NNT). Given prior findings of positive clinician-perceived effects and low incidence of adverse events, we hypothesized low number-needed-to-treat for benefit (NNTB; high benefit) and high number-needed-to-treat for harm (NNTH; low risk) based on the clinician ratings, supporting the use of amantadine in clinical practice.