Uc health traumatic brain injury clinical trials — california brain anoxia

Mild traumatic brain injury (mtbi) is a prevalent and costly public health problem with disabling consequences. More than one million civilians with mtbi are treated in US hospitals and emergency departments each year (faul, et al., 2010). While the exact number is debated, approximately 10-15% of individuals with mtbi will experience prolonged and disabling post-concussive symptoms (stranjalis, et al., 2008; ruff and weyer jamora, 2009), and 34% will experience a psychiatric illness in the first year after injury (fann, et al., 2004). In addition, at least 188,270 military service members sustained a TBI from 2000 to mid august 2010, and nearly 77% of these injuries were mild (defense and veterans brain injury center, 2010).Brain anoxia


many individuals require treatment for resulting mtbi symptoms. The proposed study builds on preliminary research conducted by the investigators to develop and test the effectiveness of a social work delivered education and reassurance intervention for adults with mtbi (SWIFT-acute) against usual care. The proposed study will assess acceptability and obtain preliminary effectiveness data for an enhanced social work assessment and intervention for adults with mtbi (SWIFT) discharged from the emergency department (ED). SWIFT includes early education, reassurance, coping strategies, resources and a brief alcohol use intervention in the ED plus follow up telephone counseling, needs assessment and case management referral to necessary services.Brain anoxia the intervention targets cognitive, physical, psychiatric and functional outcomes; specifically, post-concussive symptoms, depression, anxiety, posttraumatic stress disorder, alcohol use, community functioning and successful linkage to community resources. It is hypothesized that SWIFT will be acceptable to patients and that participants in the SWIFT group will report superior outcomes on measures of post-concussive symptoms, depression and anxiety, alcohol use and community functioning and will report increased successful linkages to needed resources when compared to the SWIFT-acute group. The specific aims of the study are: 1. Implement an innovative social work intervention for adults with mtbi (SWIFT). 2.Brain anoxia assess acceptability of SWIFT using qualitative interviews with participants. 3. Assess preliminary effectiveness of SWIFT compared to SWIFT-acute alone on reduction or prevention of post-concussive symptoms, depression, anxiety, posttraumatic stress disorder (PTSD) symptoms, and alcohol use, and on improvement of community functioning and successful linkage to community resources. 80 participants will be randomized to receive SWIFT or SWIFT-acute. Preliminary intervention effectiveness will be assessed using standard measures of post-concussive symptoms, the primary outcome, depression, anxiety, PTSD, alcohol use, and community functioning. A structured survey will be used to assess linkage to community resources.Brain anoxia

At UCSF

• transforming research and clinical knowledge in traumatic brain injury

Difficulties with intellectual functioning, particularly memory functions, are common and source of long-term disability after traumatic brain injury (TBI). However, there is very little information about pharmacologic (i.E., medication) treatments targeting these deficits. There are growing data showing brain abnormalities in acetylcholine, the chemical system that manages memory, in TBI. These findings provide the rationale for the use of cholinesterase inhibitors, medications that modulate this system, in TBI patients. As the prevalence of TBI among veterans of recent military conflicts increases, becoming a signature injury of the iraq and afghanistan conflicts, it is of utmost importance to the veterans health administration to collect scientific data on the efficacy of pharmacological treatments for intellectual difficulties in TBI patients.Brain anoxia this study will evaluate the effects of the cholinesterase inhibitor rivastigmine transdermal patch in veterans with TBI and posttraumatic memory problems. Results will provide much needed data that will help treat veterans with TBI.

At UCSD

• transcranial electrical stimulation for mtbi

Mild traumatic brain injury (mtbi) is a leading cause of sustained physical, cognitive, emotional, and behavioral deficits in OEF/OIF/OND veterans and the general public. However, the underlying pathophysiology is not completely understood, and there are few effective treatments for post-concussive symptoms (PCS). In addition, there are substantial overlaps between PCS and post-traumatic stress disorder (PTSD) symptoms in mtbi.Brain anoxia IASIS is among a class of passive neurofeedback treatments that combine low-intensity pulses for transcranial electrical stimulation (LIP-tes) with electroencephalography (EEG) monitoring. LIP-tes techniques have shown promising results in alleviating PCS individuals with TBI. However, the neural mechanisms underlying the effects of LIP-tes treatment in TBI are unknown, owing to the dearth of neuroimaging investigations of this therapeutic intervention. Conventional neuroimaging techniques such as MRI and CT have limited sensitivity in detecting physiological abnormalities caused by mtbi, or in assessing the efficacy of mtbi treatments. In acute and chronic phases, CT and MRI are typically negative even in mtbi patients with persistent PCS.Brain anoxia in contrast, evidence is mounting in support of resting-state magnetoencephalography (rs-MEG) slow-wave source imaging (delta-band, 1-4 hz) as a marker for neuronal abnormalities in mtbi. The primary goal of the present application is to use rs-MEG to identify the neural underpinnings of behavioral changes associated with IASIS treatment in veterans with mtbi. Using a double-blind placebo controlled design, the investigators will study changes in abnormal MEG slow-waves before and after IASIS treatment (relative to a ‘sham’ treatment group) in veterans with mtbi. In addition, the investigators will examine treatment-related changes in PCS, PTSD symptoms, neuropsychological test performances, and their association with changes in MEG slow-waves.Brain anoxia the investigators for the first time will address a fundamental question about the mechanism of slow-waves in brain injury, namely whether slow-wave generation in wakefulness is merely a negative consequence of neuronal injury or if it is a signature of ongoing neuronal rearrangement and healing that occurs at the site of the injury. Specific aim 1 will detect the loci of injury in veterans with mtbi and assess the mechanisms underlying functional neuroimaging changes related to IASIS treatment using rs-MEG slow-wave source imaging. The investigators hypothesize that MEG slow-wave source imaging will show significantly higher sensitivity than conventional MRI in identifying the loci of injury on a single-subject basis.Brain anoxia the investigators also hypothesize that in wakefulness, slow-wave generation is a signature of ongoing neural rearrangement / healing, rather than a negative consequence of neuronal injury. Furthermore, the investigators hypothesize IASIS will ultimately reduce abnormal MEG slow-wave generation in mtbi by the end of the treatment course, owing to the accomplishment of neural rearrangement / healing. Specific aim 2 will examine treatment-related changes in PCS and PTSD symptoms in veterans with mtbi. The investigators hypothesize that compared with the sham group, mtbi veterans in the IASIS treatment group will show significantly greater decreases in PCS and PTSD symptoms between baseline and post-treatment assessments.Brain anoxia specific aim 3 will study the relationship among IASIS treatment-related changes in rs-MEG slow-wave imaging, PCS, and neuropsychological measures in veterans with mtbi. The investigators hypothesize that reduced MEG slow-wave generation will correlate with reduced total PCS score, individual PCS scores (e.G., sleep disturbance, post-traumatic headache, photophobia, and memory problem symptoms), and improved neuropsychological exam scores between post-IASIS and baseline exams. The success of the proposed research will for the first time confirm that facilitation of slow-wave generation in wakefulness leads to significant therapeutic benefits in mtbi, including an ultimate reduction of abnormal slow-waves accompanied by an improvement in PCS and cognitive functioning.Brain anoxia

At UCSD

• traumatic brain injury and risk for chronic traumatic encephalopathy

The project is designed to assess early diagnosis of chronic traumatic encephalopathy (CTE), a neurobehavioral syndrome manifested by failed relationships, marriages, and businesses, emotional disturbances, depression, alcohol and substance abuse, and suicide attempts and completions. CTE typically begins after a latency period of several years following single or repeated traumatic brain injuries (tbis). A history of cerebral concussion may or may not be present. This study builds upon prior work at UCLA using positron emission tomography (PET) to identify normal and abnormal functional patterns in the brain by studying persons with a history of TBI including but not limited to: amateur and professional athletes, active and veteran members of the armed forces, as well as victims of motor vehicle and work accidents, and physical battery/domestic violence.Brain anoxia this project aims to expand these findings to the population at large. Identification of the syndrome is critical for identifying potential individuals who are most likely to benefit from potential prevention and treatment.

At UCLA