Brain Injury and Brain Functioning

Abstract A case analysis of a person with a traumatic brain injury (TBI) is presented in detail. The analysis employs the coordination allocation of resource (CAR) model of brain functioning and the activation quantitative EEG analysis of brain response patterns. This model states that individual cognitive tasks involve specific frequencies and locations for successful performance and employs a flashlight metaphor for conceptualization of spectral correlation coefficient relationships between locations. The employment of this model in this specific case resulted in dramatic improvements in auditory memory (+5.4 standard deviations) as well as other improvements in cognitive functioning, albeit not all cognitive functioning skills.

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Evaluating the cognitive consequences of mild traumatic brain injury and concussion by using electrophysiology

Neurosurgical FOCUS ◽

10.3171/2012.10.focus12253 ◽

2012 ◽

Vol 33 (6) ◽

pp. E7 ◽

Cited By ~ 40

Author(s):

Nadia Gosselin ◽

Carolina Bottari ◽

Jen-Kai Chen ◽

Sonja Christina Huntgeburth ◽

Louis De Beaumont ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Event Related Potential ◽

Lower Percentage ◽

Control Group ◽

Behavioral Performance ◽

Significant Group ◽

Brain Functioning ◽

Sports Concussion

Object Mild traumatic brain injury (MTBI), often referred to as concussion when it occurs in sports, produces persistent cognitive problems in at least 15% of patients. Unfortunately, conventional neuropsychological tests usually yield results within normal limits in this population. The main objective of this event-related potential (ERP) study was to understand brain functioning during the performance of a working memory (WM) task in patients who have sustained an MTBI, mostly due to motor vehicle accident or sports concussion. This study also aimed for a better understanding of the association between brain functioning as measured with ERP, behavioral performance on the WM task, postconcussion symptoms, type of injury (that is, sports concussion vs other types), and time since the injury. Methods Forty-four patients with MTBI (7.6 ± 8.4 months postinjury) were tested on a visual WM task with simultaneous recording of ERP, and were compared with 40 control volunteers who were their equivalent for age and sex. Amplitude and latency of frontal (N200 and N350) and parietal (P200 and P300) ERP waves were measured and were compared between groups. Correlation analyses were also performed between ERP characteristics, clinical variables, and behavioral performance. Results A significant group difference was found for behavioral performance on the WM task, in which the MTBI group had a lower percentage of correct answers than the control group (p < 0.05). The patients with MTBI also had smaller amplitudes of both frontal N350 and parietal P300 ERP components when compared with control volunteers (p < 0.05). No changes were found for latency of ERP components. Smaller ERP amplitudes were associated with slower reaction times and worse accuracy on the WM task among patients with MTBI (p < 0.05). Types of injury (that is, sports concussion vs other mechanisms) were not associated with different ERP characteristics. Conclusions Abnormal ERP results are observed in patients after MTBI or sports concussion, even for those in the nonacute stage after their injury. Current standard clinical evaluations most often fail to detect cerebral dysfunction after MTBI, even when patients or athletes report symptoms. Clinicians should be aware that patients with MTBI, including sports concussion, probably have underlying mild but persistent cerebral dysfunctions that require further investigation.

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Cognitive control constrains memory attributions

Behavioral and Brain Sciences ◽

10.1017/s0140525x19001869 ◽

2019 ◽

Vol 42 ◽

Author(s):

Colleen M. Kelley ◽

Larry L. Jacoby

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

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Confronting the grey zone after severe brain injury

Emerging Topics in Life Sciences ◽

10.1042/etls20190115 ◽

2019 ◽

Vol 3 (6) ◽

pp. 707-711 ◽

Cited By ~ 1

Author(s):

Andrew Peterson ◽

Adrian M. Owen

Keyword(s):

Brain Injury ◽

Ethical Issues ◽

Vegetative State ◽

Clinical Care ◽

Grey Zone ◽

Severe Brain Injury ◽

New Methods ◽

Legal Decision Making ◽

Technological Developments ◽

The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

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Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00092 ◽

2020 ◽

Vol 5 (1) ◽

pp. 88-96

Author(s):

Mary R. T. Kennedy

Keyword(s):

College Students ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Sense Of Self ◽

Scientific Evidence ◽

Sudden Onset ◽

Lessons Learned ◽

Speech Language Pathologists ◽

The Brain ◽

Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

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Maximizing Expertise and Collaboration to Support Students With Brain Injury: A Case Study in Speech-Language Pathology

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig2-2019-0003 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1267-1282

Author(s):

Jessica Salley ◽

Sarah Krusen ◽

Margaret Lockovich ◽

Bethany Wilson ◽

Brenda Eagan-Johnson ◽

...

Keyword(s):

Brain Injury ◽

Medical Setting ◽

Speech Language Pathology ◽

Speech Language Pathologists ◽

Team Members ◽

School Activities ◽

School Based ◽

Language Pathology ◽

Specialized Education

Purpose Through a hypothetical case study, this article aimed to describe an evidence-based approach for speech-language pathologists in managing students with moderate-to-severe traumatic brain injury (TBI), particularly within a formal statewide-supported school-based brain injury team model, such as the BrainSTEPS Brain Injury School Consulting Program operating in Pennsylvania and Colorado. Conclusion Upon transitioning from the medical setting back to school, children with TBI present with unique educational needs. Children with moderate-to-severe TBIs can demonstrate a range of strengths and deficits in speech, language, cognition, and feeding and swallowing, impacting their participation in various school activities. The specialized education, training, and insight of speech-language pathologists, in collaboration with multidisciplinary medical and educational team members, can enable the success of students with TBI when transitioning back to school postinjury ( DePompei & Blosser, 2019 ; DePompei & Tyler, 2018 ). This transition should focus on educational planning, implementation of strategies and supports, and postsecondary planning for vocations or higher education.

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The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0296 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1363-1370 ◽

Cited By ~ 2

Author(s):

Jessica Brown ◽

Katy O'Brien ◽

Kelly Knollman-Porter ◽

Tracey Wallace

Keyword(s):

High School ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Disease Control ◽

Mild Traumatic Brain Injury ◽

School Age Children ◽

School Age ◽

Speech Language Pathologists ◽

Control And Prevention ◽

Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

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