Neuropsychologists' perspectives of chronic traumatic encephalopathy (CTE).

: Chronic Traumatic Encephalopathy (CTE) has received significant media coverage as a major health concern for collision sport athletes and combat veterans. This survey study investigated neuropsychologists' perspectives of CTE. Neuropsychologists ( = 325) were contacted electronic advertisement posted to popular neuropsychology professional listservs and completed a survey regarding their perspectives of: the proposed sequelae of repeated concussions, the strength of the CTE research base, and its media coverage.

Feasibility and acceptability of a brief intervention to improve mild traumatic brain injury recovery: Problem-solving training-concussion.

Objective: Mild traumatic brain injuries (mTBIs) are common among Veterans. Although the majority of neurobehavioral symptoms resolve following mTBI, studies with Veteran samples demonstrate a high frequency and chronicity of neurobehavioral complaints (e.g.

The management and rehabilitation of post-acute mild traumatic brain injury.

Description: In June 2021, the U.S. Department of Veterans Affairs (VA) and U.

Stimulation Induced Changes in Ratio Scaling Between and Within Hemispheres.

Objectives: This paper examines if ratio scaling, the principle behind the psychophysical Power Law, is similarly performed by the left and right cerebral hemispheres and how magnitude estimates derived in each hemisphere are integrated.

Method: Three models of hemispheric integration were tested (dominance, summation, and inhibition) using a cross-modal matching procedure in right-handed, male subjects. Visual stimuli were presented to one or both hemispheres using a tachistoscopic method to test each model.

Health Conditions Among Special Operations Forces Versus Conventional Military Service Members: A VA TBI Model Systems Study.

Objective: To examine traumatic brain injury (TBI) characteristics and comorbid medical profiles of Special Operations Forces (SOF) Active Duty Service Member/Veterans (ADSM/Vs) and contrast them with conventional military personnel.

Setting: The 5 Veterans Affairs (VA) Polytrauma Rehabilitation Centers.

Participants: A subset of participants in the VA TBI Model Systems multicenter longitudinal study with known SOF status.

Anosognosia in moderate-to-severe traumatic brain injury: A review of prevalence, clinical correlates, and diversity considerations.

Method: A comprehensive search of peer-reviewed articles was conducted from September to November 2020 using Google Scholar and PubMed databases. Key terms included "anosognosia," "self-awareness," "traumatic brain injury," and variants thereof. Our search was restricted to articles published in English within the last 25 years, although a few historical articles were included due to scientific merit.

Accumulation of Good Intentions: How Individual Practice Guidelines Lead to Polypharmacy in the Treatment of Patients with Polytrauma.

Polytrauma clinical triad (PCT) is the comorbid occurrence of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and pain after trauma. No clinical practice guidelines for postacute care of patients with PCT currently exist; instead, clinical practice guidelines have been published for the three conditions (TBI, PTSD, and pain) as distinct clinical entities. Using multiple, individual practice guidelines for a patient with PCT may lead to unintended prescription of multiple and potentially adversely interacting medications (ie, polypharmacy).

Unique Features of the US Department of Defense Multidisciplinary Concussion Clinics.

The US Department of Defense (DoD) and the Department of Veterans Affairs (VA) actively address care needs for a subset of service members (SMs) who experience prolonged symptoms and adverse sequelae interfering with their usual level of function after sustaining mild traumatic brain injury. The development of multidisciplinary concussion clinics and implementation of several reinforcing policies within the DoD and the VA address this unique patient population. A network known as the National Intrepid Center of Excellence and Intrepid Spirit Centers and the VA, primarily support these patients through intensive outpatient programs.

Neurobehavioral Management of the Polytrauma Veteran.

Since the inception of the Afghanistan and Iraq wars, an increasing number of veterans have sought treatment from the Department of Veterans Affairs for combat-related injuries. Many veterans experience postconcussive symptoms, traumatic stress, chronic pain, sensory deficits, and/or headaches. The goal of this article was to highlight some of the challenges treatment providers may face, while providing rehabilitation specialists with important evaluation and treatment considerations in working with this population to maximize outcomes for these veterans.

Postrehabilitation Mental Health Treatment Utilization in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study.

Objective: To identify preinjury variables related to mental health treatment utilization at 2 years post-traumatic brain injury (TBI).

Setting: Veterans Affairs (VA) TBI Model Systems includes 5 VA Polytrauma Rehabilitation Centers.

Participants: Veterans and service members enrolled in TBI Model Systems who completed the year 2 follow-up assessment and provided mental health information.

Comorbid Posttraumatic Stress Disorder and Traumatic Brain Injury: Generalization of Prolonged-Exposure PTSD Treatment Outcomes to Postconcussive Symptoms, Cognition, and Self-Efficacy in Veterans and Active Duty Service Members.

Objectives: To examine (a) generalization of the effectiveness of prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) in improving postconcussive symptoms (PCSs) and other outcomes in military service members and Veterans (VA) with histories of mild to severe traumatic brain injury (TBI), and (b) factors associated with PCS reduction.

Setting: VA polytrauma medical center.

Participants: Consecutive referrals for PTSD treatment of Active Duty (n = 17) or Veterans (n = 27) diagnosed with PTSD and TBI (N = 44).

EEG slow waves in traumatic brain injury: Convergent findings in mouse and man.

Objective: Evidence from previous studies suggests that greater sleep pressure, in the form of EEG-based slow waves, accumulates in specific brain regions that are more active during prior waking experience. We sought to quantify the number and coherence of EEG slow waves in subjects with mild traumatic brain injury (mTBI).

Methods: We developed a method to automatically detect individual slow waves in each EEG channel, and validated this method using simulated EEG data.

Patient, Therapist, and System Factors Influencing the Effectiveness of Prolonged Exposure for Veterans With Comorbid Posttraumatic Stress Disorder and Traumatic Brain Injury.

In contrast to concerns that cognitive limitations and neurobehavioral symptoms (NBS) associated with traumatic brain injury (TBI) may inhibit treatment effectiveness, a recent study found prolonged exposure (PE) led to large reductions in posttraumatic stress disorder (PTSD) symptoms among Iraq-Afghanistan veterans with a range of TBI severity (article by Wolf, Kretzmer, Crawford, Thors, Wagner, Strom, Eftekhari, Klenk, Hayward, and Vanderploeg [J Trauma Stress 28:339-347, 2015]). We further examined this sample of 69 veterans to determine whether system, veteran, and therapist factors predicted clinically significant responses. Results of hierarchical, logistic regressions revealed that therapist training in PE and lower service connection were associated with increased odds of large decreases in PTSD symptoms after adjusting for the robust effect of PE sessions completed.

EEG slow waves in traumatic brain injury: Convergent findings in mouse and man.

Objective: Evidence from previous studies suggests that greater sleep pressure, in the form of EEG-based slow waves, accumulates in specific brain regions that are more active during prior waking experience. We sought to quantify the number and coherence of EEG slow waves in subjects with mild traumatic brain injury (mTBI).

Methods: We developed a method to automatically detect individual slow waves in each EEG channel, and validated this method using simulated EEG data.

Community Reintegration Problems Among Veterans and Active Duty Service Members With Traumatic Brain Injury.

Objectives: To examine community reintegration problems among Veterans and military service members with mild or moderate/severe traumatic brain injury (TBI) at 1 year postinjury and to identify unique predictors that may contribute to these difficulties.

Setting: VA Polytrauma Rehabilitation Centers.

Participants: Participants were 154 inpatients enrolled in the VA TBI Model Systems Program with available injury severity data (mild = 28.

Insomnia symptoms and behavioural health symptoms in veterans 1 year after traumatic brain injury.

Objective: Insomnia and behavioural health symptoms 1 year after traumatic brain injury (TBI) were examined in a clinical sample representative of veterans who received inpatient treatment for TBI-related issues within the Veterans Health Administration.

Methods: This was a cross-sectional sub-study (n = 112) of the Polytrauma Rehabilitation Centres' traumatic brain injury model system programme. Prevalence estimates of insomnia, depression, general anxiety, nightmares, headache and substance use, stratified by injury severity, were derived.

Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury.

The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy.

Web-based psychoeducational intervention for postconcussion symptoms: a randomized trial.

The objective of this study was to investigate the effectiveness of a web-based educational intervention for reducing postconcussion symptoms. 158 participants with self-reported symptomatic mild traumatic brain injury were randomized to intervention versus control. There was no effect of intervention on symptom severity or attributions.

Using information from the electronic health record to improve measurement of unemployment in service members and veterans with mTBI and post-deployment stress.

Objective: The purpose of this pilot study is 1) to develop an annotation schema and a training set of annotated notes to support the future development of a natural language processing (NLP) system to automatically extract employment information, and 2) to determine if information about employment status, goals and work-related challenges reported by service members and Veterans with mild traumatic brain injury (mTBI) and post-deployment stress can be identified in the Electronic Health Record (EHR).

Design: Retrospective cohort study using data from selected progress notes stored in the EHR.

Setting: Post-deployment Rehabilitation and Evaluation Program (PREP), an in-patient rehabilitation program for Veterans with TBI at the James A.

Pilot of a novel intervention for postconcussive symptoms in active duty, veterans, and civilians.

Purpose/objective: The authors present a study aimed at pilot testing a novel delivery method, namely a computer intervention, for postconcussive symptom reduction in active duty, veteran, and civilian patients with acute and chronic complaints. Following a concussion/mild traumatic brain injury (MTBI), most individuals recover completely, but a significant proportion report postconcussive symptoms months to years following the injury. Psychoeducational intervention has shown to be effective in reducing postconcussive symptoms in studies done with acute civilian samples, but the efficacy of psychoeducational interventions with individuals who served in combat or have chronic complaints remains unclear.

Postconcussive symptom complaints and potentially malleable positive predictors.

The purpose of this study was to examine the relationship between postconcussion symptom complaint (PCS) severity and positive coping factors (knowledge, self-efficacy, and attributions) in a sample of individuals who have sustained a mild TBI, above and beyond the demographic and psychiatric predictors that have been most commonly examined. Ninety-one people with a history of reported mild TBI were surveyed. Hierarchical regression analyses revealed that demographic variables and psychiatric symptom severity predicted PCS severity.

Prospective evaluation of the nature, course, and impact of acute sleep abnormality after traumatic brain injury.

Objective: To prospectively characterize the prevalence, course, and impact of acute sleep abnormality among traumatic brain injury (TBI) neurorehabilitation admissions.

Design: Prospective observational study.

Setting: Freestanding rehabilitation hospital.

Symptom complaints following reports of blast versus non-blast mild TBI: does mechanism of injury matter?

Patients with a reported history of mild traumatic brain injury (mild TBI) due to blast (n = 298) or non-blast (n = 92) mechanisms were asked to complete the Neurobehavioral Symptom Inventory (NSI) and the Post-traumatic Stress Disorder Checklist (PCL). Mechanism of injury did not account for a significant amount of variance in post-concussion symptom reporting overall, nor did severity of mild TBI (i.e.

Symptom complaints following combat-related traumatic brain injury: relationship to traumatic brain injury severity and posttraumatic stress disorder.

Patients with a history of mild (n = 134) or moderate-to-severe (n = 91) TBI were asked to complete the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist. Consistent with prior research, significantly more postconcussion symptoms were endorsed by the mild group. After controlling for age, time since injury, and mechanism of injury, TBI severity continued to be significantly related to postconcussion complaints on the NSI.