Central auditory processing in children after traumatic brain injury

ObjectiveThis study describes the association between history of lifetime traumatic brain injury (TBI) and current disabling functional restrictions among Ontario adults.Setting and designA two-stage rolling cross-sectional sample of 6,048 adults aged 18 to 93 were interviewed by computer assisted telephone interviewing between 2011–2013 regarding their mental health and substance use in Ontario, Canada. TBI criteria were defined by loss of consciousness for minimum five minutes or at least one overnight hospitalization. Dimensions of functionality restrictions in the last 30 days were measured with the WHO Disability Assessment Schedule (WHODAS).ResultsThe estimated mean for global disability in this sample of Ontario adults was 2.75 (SD = 5.4, range 0–40). The estimated means of global disability for individuals who reported a history of lifetime TBI was 4.16 (SD = 7.12) and compared with 2.46 (SD = 4.98) for individuals who never had a TBI (p < 0.001). Adults with a history of lifetime TBI had greater odds of global and item disability including restricted cognition, decreased self-care, difficulties with social relationships, fewer life activities and reduced participation in society compared to adults without a history of TBI (p < 0.001), even after adjusting for values of age, sex, marital status, household income and education.ConclusionThe co-occurrence of history of lifetime TBI with self-reported disability within the past 30 days provide evidence that careful consideration, planning and understanding of short and long term health needs of TBI survivors are critical.

Traumatic brain injury, driver aggression and motor vehicle collisions in Canadian adults

Objective:History of traumatic brain injury (TBI) is associated with increased risk of dementia, but few studies have evaluated whether TBI history alters the course of neurocognitive decline, and existing literature on this topic is limited to short follow-up and smaller samples. The primary aim of this study was to evaluate whether a history of TBI (TBI+) influences neurocognitive decline later-in-life among older adults with or without cognitive impairment [i.e., normally aging, Mild Cognitive Impairment (MCI), or dementia].Participants and Methods:Participants included individuals from the National Alzheimer’s Coordinating Center (NACC) who were at least 50 years old and with 3 to 6 visits (M number of visits = 4.43). Participants with any self-reported history of TBI (n = 1,467) were matched 1:1 to individuals with no reported history of TBI (TBI-) from a sample of approximately 45,000 participants using case-control matching based on age (+/- 2 years), sex, education, race, ethnicity, cognitive diagnosis [cognitively normal (CN), MCI, or all-cause dementia], etiology of cognitive impairment, functional decline (Clinical Dementia Rating Scale, CDR), number of Apolipoprotein E4 (APOE ε4) alleles, and number of annual visits (3 to 6). Mixed linear models were used to assess longitudinal neuropsychological test composites (using NACC normative data) of executive functioning/attention/speed (EFAS), language, and memory in TBI+ and TBI- participants. Interactions between TBI and demographics, APOE ε4 status, and cognitive diagnosis were also examined.Results:Following matching procedures, TBI+ (n=1467) and TBI- (n=1467) groups were nearly identical in age (TBI+ M = 71.59, SD = 8.49; TBI- M = 71.63, SD = 8.44), education (TBI+ M = 16.12, SD = 2.59; TBI- M = 16.10, SD = 2.52), sex (both 55% male), race (both 90% White), ethnicity (both 98% non-Hispanic), APOE ε4 alleles (both 0 = 62%, 1 = 33%, 2 = 5%), baseline cognitive diagnoses (both CN = 60%, MCI = 18%, dementia = 12%), and global CDR (TBI+ M = 0.30, SD = 0.38, TBI- M = 0.30, SD = 0.38). At baseline, groups had similar Z-scores of in EFAS (TBI+ Mefas = -0.02, SD = 1.21; TBI- Mefas = -0.04, SD = 1.27), language (TBI+ MLanguage = -0.48, SD = 0.98; TBI- MLanguage = -0.55, SD = 1.05), and memory (TBI+ MMemory = -0.45, SD = 1.28; TBI- MMemory = -0.45, SD =1.28). The course of change in neuropsychological functioning worsened longitudinally, but did not differ between TBI groups (p’s &gt; .110). There were no significant interactions between TBI history and age, sex, education, race/ethnicity, number of APOE ε4 status, or cognitive diagnosis (all p’s &gt; .027).Conclusions:In this matched case-control design, our findings suggest that a history of TBI, regardless of demographic factors, APOE ε4 status, and cognitive diagnosis, does not significantly alter the course of neurocognitive functioning later-in-life in older adults with and without cognitive impairment. Future clinicopathological longitudinal studies with well characterized TBI histories and the associated clinical course are needed to help clarify the mechanism by which TBI may increase dementia risk for some individuals, without affecting course of decline.

Treatment for posttraumatic stress disorder in patients with a history of traumatic brain injury: A systematic review

Journal of NeurotraumaVol. 37, No. 1 Short CommunicationOpioid Use among Individuals with Traumatic Brain Injury: A Perfect Storm?Rachel Sayko Adams, John D. Corrigan, and Kristen Dams-O'ConnorRachel Sayko AdamsInstitute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.VHA Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, Colorado.Search for more papers by this author, John D. CorriganDepartment of Physical Medicine and Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, Ohio.Search for more papers by this author, and Kristen Dams-O'ConnorAddress correspondence to: Kristen Dams-O'Connor, PhD, Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1163, New York, NY 10029 E-mail Address: Kristen.Dams-O'Connor@mountsinai.orgDepartment of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.Search for more papers by this authorPublished Online:11 Dec 2019https://doi.org/10.1089/neu.2019.6451AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited byCaring again: Support for parent caregivers of wounded, ill, and/or injured adult children veteransNeuroRehabilitation, Vol. 52, No. 1Associations between early sleep-disordered breathing following moderate-to-severe traumatic brain injury and long-term chronic pain status: a Traumatic Brain Injury Model Systems studyJournal of Clinical Sleep Medicine, Vol. 19, No. 1Association between traumatic brain injury and suicidality using a mediation approach and MarketScan5 December 2022 | Injury Prevention, Vol. 26Association of pre-admission opioid abuse and/or dependence on major complications in traumatic brain injury (TBI) patientsJournal of Clinical Anesthesia, Vol. 79Peer Support at the Intersection of Disability and Opioid (Mis)Use: Key Stakeholders Provide Essential Considerations5 August 2022 | International Journal of Environmental Research and Public Health, Vol. 19, No. 15Preinjury Health Status of Adults With Traumatic Brain Injury: A Preliminary Matched Case-Control Study15 June 2021 | Journal of Head Trauma Rehabilitation, Vol. 37, No. 3Repeated blast mild traumatic brain injury and oxycodone self‐administration produce interactive effects on neuroimaging outcomes18 January 2022 | Addiction Biology, Vol. 27, No. 2Impact of opioid use disorder on resource utilization and readmissions after operative traumaSurgery, Vol. 171, No. 2Pregnancy, Fetal, and Neonatal Outcomes Among Women With Traumatic Brain Injury14 October 2022 | Journal of Head Trauma Rehabilitation, Vol. Publish Ahead of PrintExamining differences in prescription opioid use behaviors among U.S. adults with and without disabilitiesPreventive Medicine, Vol. 153Reported History of Traumatic Brain Injury Among Suicide Decedents: National Violent Death Reporting System, 2003–2017American Journal of Preventive Medicine, Vol. 61, No. 4When triggers become tigers: taming the autonomic nervous system via sensory support system modulation7 September 2021 | Journal of Social Work Practice in the Addictions, Vol. 37Risk Factors Associated With the Prescription of Opioids Among Service Members Following a First Mild Traumatic Brain InjuryJournal of Head Trauma Rehabilitation, Vol. 36, No. 5Opioid and Sedative-Hypnotic Prescriptions Among Post-9/11 Veteran VA Users Nationwide With Traumatic Brain Injury, 2012-2020Journal of Head Trauma Rehabilitation, Vol. 36, No. 5Scoping Review of Opioid Use After Traumatic Brain InjuryJournal of Head Trauma Rehabilitation, Vol. 36, No. 5Receipt of Concurrent VA and Non-VA Opioid and Sedative-Hypnotic Prescriptions Among Post-9/11 Veterans With Traumatic Brain InjuryJournal of Head Trauma Rehabilitation, Vol. 36, No. 5Association of Lifetime History of Traumatic Brain Injury With Prescription Opioid Use and Misuse Among AdultsJournal of Head Trauma Rehabilitation, Vol. 36, No. 5Traumatic Brain Injury and Opioid Use: Additional Evidence Supporting the “Perfect Storm” of Cascading VulnerabilitiesJournal of Head Trauma Rehabilitation, Vol. 36, No. 5Association between Lifetime History of Traumatic Brain Injury, Prescription Opioid Use, and Persistent Pain: A Nationally Representative Study Raj G. Kumar, Katherine A. Ornstein, John D. Corrigan, Rachel Sayko Adams, and Kristen Dams-O'Connor26 July 2021 | Journal of Neurotrauma, Vol. 38, No. 16Addressing Pain for a Proper Rehabilitation Process in Patients With Severe Disorders of Consciousness17 February 2021 | Frontiers in Pharmacology, Vol. 12 Volume 37Issue 1Jan 2020 InformationCopyright 2020, Mary Ann Liebert, Inc., publishersTo cite this article:Rachel Sayko Adams, John D. Corrigan, and Kristen Dams-O'Connor.Opioid Use among Individuals with Traumatic Brain Injury: A Perfect Storm?.Journal of Neurotrauma.Jan 2020.211-216.http://doi.org/10.1089/neu.2019.6451Published in Volume: 37 Issue 1: December 11, 2019Online Ahead of Print:August 16, 2019Online Ahead of Editing: July 23, 2019PDF download

Does neuroinflammation drive the relationship between tau hyperphosphorylation and dementia development following traumatic brain injury?

Objective: To examine the relationship between clinical characteristics and cognitive performance in service members and veterans with histories of blast-related mild traumatic brain injury (mTBI).Design: This study consisted of 40 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) service members and veterans; 20 participants reported blast exposure and alteration of mental status consistent with mTBI and 20 participants denied blast exposure and had no history of traumatic brain injury (TBI), but could have experienced extra-cranial injuries. Measures of simple reaction time, processing speed, visual attention, working memory and mathematical processing were used to assess long-term effects of mTBI. Measures of post-traumatic stress symptom severity, pain intensity, sleep difficulty and subjective appraisal of cognition at time of testing were also obtained. Multivariate analyses were conducted with clinical characteristics and mTBI history as predictors of cognitive performance.Results: There was no evidence of an effect of mTBI history on cognitive performance in this sample. However, post-traumatic stress symptom severity was significantly related to two measures of cognitive performance.Conclusions: This study demonstrated the importance of considering the effects of current clinical symptoms (e.g. post-traumatic stress) as possibly having greater influence on current cognitive functioning than the effects of a remote history of mTBI.

There is a history of debate and controversy about the assessment and intervention of children diagnosed with auditory processing disorder (APD). Professionals in communication sciences and disorders view APD from different perspectives. Speech-language pathologists (SLPs) tend to view APD from the language and literacy perspective, or a top-down model, whereas audiologists tend to view APD from an auditory perception perspective, or a bottom-up model. Professionals who assess and treat children with APD need to bridge the gap and merge their different perspectives to plan effective intervention for children with APD. A panel of audiologists who demonstrated expertise in the area of Central Auditory Processing Disorders (CAPDs) developed The American Speech-Language-Hearing Association's (ASHA's) technical report on APDs (ASHA, 2005). This report was approved by ASHA's Executive board in 2005. In this report, central auditory processing refers to the efficiency and effectiveness by which the central nervous system uses auditory information. Central auditory processing includes the auditory mechanisms underlying the skills of sound localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition, including temporal integration, temporal discrimination, temporal ordering, and temporal masking; auditory performance in competing acoustic signals; and auditory performance with degraded acoustic signals (ASHA, 1996; Bellis, 2003; Chermak &amp; Musiek, 1997; Jerger, 2009). A CAPD is a deficit in processing auditory input that is not due to higher-order language, cognitive, or related factors (Musiek, Bellis, &amp; Chermak, 2005; Musiek &amp; Chermak, 2007). However, children diagnosed with CAPD may experience difficulties in academic learning, speech, language, social skills, and literacy (e.g., encoding, decoding, reading comprehension, reading fluency, and written language).

Sleep is often disrupted in traumatic brain injury (TBI) and may be related to persistent behaviour problems; however, little is known about this relationship in young adults. This study explored associations between TBI, behavioural problems and sleep disturbances in 247 university students (197 non-TBI, 47 mild TBI, two moderate TBI, one severe TBI) aged 18-25 years, who completed validated measures for behaviour, sleep quality and history of TBI. Because of small group numbers, participants reporting moderate to severe TBI were excluded from the analyses. Results indicated that students with mild TBI reported higher levels of daytime dysfunction, somatic complaints, withdrawal, other behavioural complaints and internalizing behaviours compared with students with no TBI history. A correlational analysis indicated a moderate relationship between the above significant variables. Our results suggest that university students with a history of mild TBI are more likely to experience certain ongoing daytime behavioural problems, which are likely to negatively influence their academic functioning in tertiary education. This study highlights the importance of research on long-term problems following mild TBI in young adults aged 18-25 years--an age group often overlooked within the literature.

Auditory event related potentials in children with peripheral hearing loss

Traumatic brain injury (TBI) has been increasingly linked in population research to psychiatric problems as well as substance use and related harms, suggesting that individuals with TBI may also present more frequently to mental health and addictions (MHA) services. Little is known, however, about TBI history among MHA service users. The objectives of this review were to understand (i) the prevalence of TBI history among MHA service users; (ii) how TBI history is identified in MHA service settings; and (iii) predictors or outcomes of TBI that have been reported in MHA service users. A scoping review was conducted in accordance with PRISMA Scoping Review Extension guidelines. A search for relevant literature was conducted in MEDLINE, PsycINFO, SPORTDiscus, CINAHL, and Embase as well as various gray literature sources. Twenty-eight relevant studies were identified. TBI was defined and operationalized heterogeneously between studies, and TBI history prevalence rates ranged considerably among the study samples. The included studies used varied methods to identify TBI history in MHA settings, such as clinical chart audits, single-item questions, or structured questionnaires (eg, Brain Injury Screening Questionnaire or Ohio State University TBI Identification Method). TBI history was most consistently associated with indicators of more severe substance use problems and mental health symptoms as well as increased aggression or risk to others. Studies reported less consistent findings regarding the relationship of TBI to physical health, cognitive impairment, functioning, risk to self, and type of psychiatric diagnosis. Screening for TBI history in MHA settings may contribute important information for risk assessment and care planning. However, to be clinically useful, assessment of TBI history will require consistent operationalization of TBI as well as use of validated screening methods.

ABSTRACTObjectives: To explore the differences in negative psychiatric outcomes (i.e. type and number of psychiatric diagnoses, suicide risk) among Veterans with and without a history of traumatic brain injury (TBI) seeking homeless services.Methods: Observational design with data collected at one time-point. Veterans seeking homeless services from two Veteran Affairs (VA) Medical Centres completed study measures (n = 309; 282 with a history of TBI and 27 without a history of TBI). Veterans participated in structured clinical interviews regarding psychiatric and TBI histories.Results: Those with a history of TBI met the criteria for significantly more psychiatric diagnoses (p = 0.0003), and were more likely to be at risk for suicide (p = 0.007) than those without a history of TBI.Conclusions: Even among the high-risk cohort of homeless Veterans, those with a history of TBI were found to be at even greater risk for negative psychiatric outcomes. Further research is required to determine if and how the history of TBI contributes to the inability to maintain stable housing. Moreover, the findings highlight both the importance of assessing for history of TBI among this cohort, and educating providers regarding how to address the needs related to injury sequelae.

To examine the impact of military service on health literacy. Prospective, cross-sectional study. The validated Brief Health Literacy Screen (BHLS) with military supplement was administered to sequential adult patients (military and civilian) treated at two outpatient academic military otolaryngology clinics between November and December 2019. Inadequate health literacy, defined by a BHLS score ≤9, was the primary outcome measure. Secondary outcome measures included comparisons of inadequate BHLS scores with patient demographics and history of military service. Three hundred and eighty-two patients were evaluated during the study period. The median age was 48-57 years, with a majority being male (230, 60.2%), White (264, 69.1%), married (268, 70.2%), and active duty military (303, 79.3%). A minority reported history of PTSD (39, 13%) or traumatic brain injury (29, 9.6%). Overall, very few subjects (10, 2.6%) demonstrated inadequate health literacy. Patients with prior (1.6% vs 6.3%, P < .05) or current (0% vs 5.0%, P < .05) military service had lower rates of inadequate health literary as compared to civilians. Gender, race, marital status, history of PTSD, and history of traumatic brain injury did not significantly impact health literacy. In a multivariate regression model exploring history of military service, age was not predictive of inadequate health literacy. Both history of and current military service predict higher health literacy rates for patients treated at military otolaryngology clinics. Widely accessible health care and mandatory health evaluations for service members to maintain deployment readiness may contribute to this finding but warrant additional study.

A history of traumatic brain injury (TBI) is associated with an increased risk of developing neurodegenerative disorders, including Parkinson's Disease (PD). However, TBI's influences on disease progression remain underassessed. This study explored whether a history of TBI influences the progression of pathological and clinical outcomes up to 5 years of follow-up in individuals with early PD. Longitudinal data were extracted from the Parkinson's Progression Markers Initiative (PPMI) and the PostCEPT observational study. Participants in PostCEPT had complete head injury data, while PPMI participants were eligible if they completed the head injury section of the PD Risk Factor Questionnaire (n = 208). Principal component analysis was used to derive composite scores of cognitive ability and mood dysfunction, with motor outcomes calculated using the Movement Disorders Society Unified Parkinson's Disease Rating Scale. Progression of clinical and pathological outcomes up to 5 years and 4 years following study entry were compared, including subset analyses in PPMI examining injury severity. Individuals with a history of TBI in the PPMI dataset exhibited a younger age of onset; however, a history of TBI did not affect progression rates of any assessed variables across both cohorts. Exploratory analysis determined that injury severity significantly predicted striatal dopamine transporter binding but accounted for only a small portion of outcome variance. While the history of TBI was associated with earlier PD onset, it did not correspond to a differential disease course. However, given differences in TBI characterisation between cohorts, additional research must be conducted to validate these findings.

BackgroundThe aim was to electrophysiologically evaluate changes in the peripheral and central auditory systems in individuals with neurofibromatosis type 1 who underwent formal auditory training.Material and methodsThe sample consisted of 6 individuals aged between 9 and 15 years. The procedures involved anamnesis, meatoscopy, brainstem auditory potentials and long-latency evoked potentials, and behavioral tests of central auditory processing. All individuals were given 9 weekly sessions of formal auditory training.ResultsAfter therapeutic intervention we observed improved performance in auditory closure (&lt;i&gt;p&lt;/i&gt; = 0.014) and figure–background discrimination for verbal sounds (&lt;i&gt;p&lt;/i&gt; = 0.025). There were no significant changes in brainstem auditory evoked potentials. However, the P300 of the longlatency auditory evoked potential showed significant differences for the left ear in terms of latencies of waves N2 (&lt;i&gt;p&lt;/i&gt; = 0.05) and P3 (&lt;i&gt;p&lt;/i&gt; = 0.05) and the amplitude of N2–P3 (&lt;i&gt;p&lt;/i&gt; = 0.05).ConclusionsTherapeutic intervention by means of formal auditory training is effective in rehabilitating central auditory processing disorder. There were improved responses in both behavioral and electrophysiological assessments, which were maintained for at least 4 months.