North American Brain Injury Society

Dear Colleagues, It is with great pleasure that we present the accepted abstracts from the North American Brain Injury Society's Brain Injury Across the Age Spectrum: Improving Outcomes for Children, Adolescents, and Adults in this issue of the Journal of Head Trauma Rehabilitation. The conference is scheduled to take place in Houston, Texas, on March 14—17, 2018. This year we were delighted to have received over 110 abstracts from investigators and researchers from over 11 countries and from some of the world's leading academic and research institutions. Moreover, we continue to be pleased with the high quality of the research submitted and with the broad range of topics that truly reflect the advances now being made across the continuum of care in the field of brain injury. For those of you unable to attend the NABIS meeting, we hope that the abstracts presented in the following pages will at least give you a feel for our annual event. In addition, the oral and poster presentations abstracted in this issue of the Journal of Head Trauma Rehabilitation, over 50 invited speakers will present on the latest advances in the science, rehabilitation and treatment of traumatic brain injury. The conference planning committee has developed an integrated educational program that promises to be of interest to researchers, clinicians, administrators, and other brain injury professionals. Emphasis will be placed on a multidisciplinary approach in the management of patients with brain injury from acute care through to community re-entry and beyond. The conference will be a four-day, multi-track event that will cover a variety of brain injury topics including medical best practices, rehabilitation, research, life-long living, pediatrics, and advocacy. The preliminary conference program is posted on the conference website, www.abi2018.org. We encourage you to consider becoming a member of our multi-disciplinary society by visiting www.nabis.org. Whether it is in the area of research or clinical care, NABIS stands behind the premise that advances in science and practices based on application of the scientific evidence will ultimately provide the best outcomes for those with brain injuries and the community as a whole. Sincerely, Jonathan Silver, MD Conference Chair Mariusz Ziejewski, PhD NABIS Chair Abstract Chair 0002 Importance of Multidisciplinary Approach to Mild Traumatic Brain Injury With Post-Concussive Syndrome Sampathkumar H1, Akinpelu T2, Lopez E2 1University of Texas at Houston, Houston, United States, 2New York Medical College, New York, United States Case Presentation A 45-year-old African male presented to our Physical Medicine and Rehabilitation (PM&R) clinic on January 20, 2017 for electro-diagnostic study to rule out cervical radiculopathy. He complained of neck pain radiating to left arm, jaw pain, headache, and dizziness with certain movements, confusion, along with physical and mental fatigue. Physical exam showed impairment in attention, executive function, and recent memory/recall. On further questioning patient reported that while he was at work he was hit by a heavy machinery on the posterior aspect of the head causing brief loss of consciousness on October 2016. His head CT and cervical spine MRI that was done prior to our clinic visit did not show any acute pathology. Prior to our clinic visit he had tried multiple medications for headache and pain with poor control. Electro-diagnostic study was normal. He was provided referral to physical therapy, speech therapy and neuropsychology. On his follow-up visit a week later accompanied by a family member who reported that patient sleeps most of the time, misplaces things and has not been himself since the incident. We felt comfortable diagnosing him with mild TBI with post-concussive syndrome. Patient and family member provided extensive education on natural history and symptoms of TBI. Since then he has been compliant with treatment plan. After multiple visits with physical and speech therapist, neuropsychologist, trials of multiple analgesic medications, trigger point injections his headache and jaw pain improved significantly, neck pain became less intense and more localized to the left lateral aspect of the neck, dizziness was gradually improving but continued to have persistent cognitive deficits. He was able to mitigate this somewhat by keeping memory logs containing clinic appointments and medication schedule with the assistance of his relatives. After starting neurostimulants improvement has been noted in overall cognition as well. Discussion This is a classic case of mild TBI subsequently developing post concussive syndrome. This patient was referred to us for neck pain and prior to our clinic visit a diagnosis of mild TBI was overlooked. Certain percentage of patients with mild TBI do not recover completely. Various studies have showed that early access to multidisciplinary (MD) rehabilitation improves functional activity of patients hence timely referral is important in the management. Early intervention will help decrease the severity of complication suffered by patients with mild TBI. MD rehabilitation team involves a physician providing direct care as well as coordinating care through referrals to various disciplines and integrating treatment plans. Conclusion Clinicians should be educated on accurately diagnosing mild TBI. Once such diagnosis is made timely referral to a multidisciplinary team can improve patient outcome. 0003 Emotionally Empathic Responses Improves Emotion Recognition Accuracy to Film Clips After Brain Injury Neumann D1,2, Zupan B3 1Indiana University, Indianapolis, United States, 2Rehabilitation Hospital of Indiana, Indianapolis, United States, 3CQUniversity Australia, North Rockhampton, Australia Objective Emotion recognition is often impaired after a traumatic brain injury (TBI). Currently, little is known about the mechanisms underlying this deficit. One theory behind affect recognition is that it is easier to identify others' emotions if you have firsthand experience with those emotions. This suggests that the occurrence of a shared emotional response to others' feelings could facilitate affect identification. Thus, the study objective is to compare, in participants with a TBI and Healthy controls (HCs), emotional responses to affective film clips that were congruent with the emotions portrayed by the characters (i.e., felt the same emotion as the character) and examine associations of emotional congruence with affect recognition accuracy and empathy. Design Cross sectional study using a quasi-experimental design. Setting Multi-site study conducted at a post-acute rehabilitation facility in the U.S. and a University in Ontario. Participants A convenience sample of 60 adults with moderate to severe TBI and 60 HCs, frequency matched for age and Film Clips were to examine emotional responses to the and accuracy at emotions. emotional responses that were the same as the affect in the were was with the of the Participants with TBI had congruent responses and this was with emotion recognition accuracy emotional responses were congruent with the recognition for that emotion was of the time, to of the emotional responses were Participants with TBI who had had emotional responses that were congruent with the emotions It has been that recognition of others' emotions is by and those same emotions in This is the study to a of this in participants with TBI and with emotion recognition and empathy. important and treatment Traumatic Brain The of a to United States, University of United States In recent to the and of traumatic brain have about the and of injury to the most of this has on TBI and an of research suggests that of should be of at a high for TBI. the of TBI is studies that it from to in this most and on the with have not the of TBI in have the of the symptoms with TBI on the to and to and medical following the event. In community with this often of the for TBI and do not the cognitive and a not referred to the medical to the assistance The of this study were to of TBI in a in the of the United States and to work with the community in developing a to identify at This research has and a design. and education was provided to community and of the community were and various of an TBI were provided about the and the using and from a variety of disciplines and in the community in a in the of the United on and a was and will be In this will be by the Discussion is a of physical in the of by a or One of the of is TBI a community will to in the of those at for TBI that the and in University of Rehabilitation and of University, United States, of and University, New United States is a of in the United States year experience a with a of in research suggests that overall neck and neck a in head the and to brain neck and is of show a of to This is by work neck and to be to evidence that have head to Objective The of our work was to in neck and in and in overall and to and and in and cervical spine cervical spine was using in trials of the following and left and in in neck and were in male and as well as in neck and based on neck was across in to showed in the left to were noted in reported a history of were in on with a history of showed in the left and with left being Discussion research work in neck and but that be to in in the our work suggests that in neck be with but work in of with is for With an Brain Injury A University of United States education can be for with brain This to the of with who often with following memory and not brain injuries the not work for education or practices for is Brain Importance of the of Brain Injury in the Rehabilitation Setting Rehabilitation United States male in in early with at Patient suffered and injury with left left multiple and left of patient had history of and and was a Once patient was to Rehabilitation the care physical and rehabilitation speech and neuropsychologist, care, and and team and medication and of patient himself in if physical with and Patient had been or was on and the medications were and patient on and subsequently patient had following to physical and had his and Patient continued to improve and was to an family patient and family were in patient was noted to be well in and was well with family community and Conclusion management is an important of brain injury rehabilitation, and patients care is of to in the A Case H1, 1University of Texas Houston, Houston, United States, of Houston, United States Setting care rehabilitation Case with a brain injury following an Patient had Brain CT and MRI in the and On to rehabilitation, patient was in a but unable to or functional exam was range of for the spine and to being the patient was noted to have of and and out and acute brain injury. The based on clinical the diagnosis of The a for of was including of poor with of in moderate severe and Patient was on Patient had clinical improvement after attention, and of was of the patient of prior was and ultimately at With to Patient was to post-acute assistance with had improved and was now to with Discussion is by the of and of is but it can be The treatment of should the underlying in to have been the Conclusion It is important for patients with brain injuries and to be of the of as a cognitive as can brain injury. In be the diagnosis brain is in brain injury. as A for and in Mild Traumatic Brain A H1, 1University of United States, Medical The University, United States, of Medical United States Mild traumatic brain injury is a leading of and with an annual of in the U.S. of patients continue to symptoms year after injury. to injury and patients from the and in Traumatic Brain Injury study with and with and cognitive function, were was as of prior medical injury and on brain were was for and for and and was at patients were and patients and prior TBI and education and did not by On for with functional symptoms and symptoms were for cognitive or by is with prior and education in patients at for functional and and symptoms on outcome. and should be to mitigate the further of and in With for Rehabilitation, United States, United States and to in patients with and the and of other injuries injury or acute in patients with Design The of patients were at of the of or other injuries were with were using the through the was a of patients with the diagnosis of The was not in patients or not in the were further to if this was for prior history of and of patients the and were in the had and had the patients the patients with left of had at least and those with had at least was a of other injuries in those with was in those In the the of the and the of had the This suggests that patients with be at for in the and should be of Head Injury is of of H1, University, of Medicine and of University, United States, of United States to concussive head injury at or at high in brain and in cognitive well of head injury at high as to not In this we at of high and the on head injury at were to high of in an at for for The of the was at The to and was at at at or were provided and was in and by an through a from over the an of over the any The injury and in in the left as to the to after the In to and was with using brain on was to showed that in in of brain and to injuries in the and as to at of or with to after was able to in at this was in brain following in On the other was with or after in the and injuries were in our the to point out that in in of brain and such of to not reported Outcomes and for Brain Injury After Rehabilitation Rehabilitation United States A study was conducted at an rehabilitation the medical of brain injury patients over for at of on and It was that and made functional across of of consciousness on of consciousness on were to the community at a while patients with impaired consciousness to the community of the patients with those to the community made functional those with with severe brain injuries can functional while to of with functional of on Head and University, United States (i.e., is a by across has from to such as is an (i.e., that can to in the less to with The of with the of participants at of multiple and concussive Currently, is a of research head and on Objective examine the of on head and Design design. trials were and post Head was after an The was post Head were and using a a 60 to were with and using The were of of and and and and symptoms and and point of The and range of of and were to to to and to were and severity to to and in to was a over for was This is the study to our to head and that multiple and to in research is to the functional of Recognition of Prior to in A A Case University of Texas Houston, Houston, United States Setting Rehabilitation Case we the case of a male with a history of with brief of his and about over the of a on for were and to an and A was to rule out the patient functional and cognitive and to the Rehabilitation showed of mild Brain MRI had acute including that for Patient continued to have while in therapy his A the diagnosis of with The patient was to the for treatment with and oral with of his Discussion is a of that is with the that the of the and not at but to the with present with brief and to of cognitive impairment with is to treatment with but has a response to Early recognition and treatment with can to and Conclusion is an with clinical of memory cognitive and Brain MRI show of the and After patients with and clinical is With this case we hope to of as a to and the for for the for and With Traumatic Brain for and University, United States Traumatic brain injury is the leading of and for and and is often as a it is not as as who a TBI by the medical community but year more experience a TBI that not by medical such as in the in a or community care This has direct for who a mild traumatic brain injury or has provided the of a TBI can and can be or and some have a direct on the academic and of a with a TBI. (i.e., and a in as well as in a have or be or and feel a of the overall mental of a with a TBI and the response and intervention the age at the injury the of of brain of family and the mental as a of a TBI can on the with The in the mental of and who have a for educational and is to the academic and overall of this Traumatic Brain Injury in and University, United States Traumatic brain injury is the leading of and for and and is often as a it is not as as who a TBI by the medical community but year more experience a TBI that not by medical such as in the in a or community care This has direct for who a mild traumatic brain injury or has provided the of a TBI can and can be or and some have a direct on the academic and of a with a TBI. (i.e., and a in as well as in a have or be or and feel a of the overall mental of a with a TBI and the response and intervention the age at the injury the of of brain of family and the mental as a of a TBI can on the with The in the mental of and who have a for educational and is to the academic and overall of this of Traumatic Brain Injury in of College, United States often physical to the the of and a traumatic brain injury can be a of of not be that have a TBI. who have TBI present with a variety of such as impaired memory and attention, emotional and to certain or This study was done to of have a and TBI in of is with post a of and were to participants who had participants for a TBI based on the brain injury about to the loss of consciousness or confusion, and other in Participants have of the symptoms at least in to for a TBI. The most reported in were and The of the study that often in and that of TBI experience to the TBI in of an study on and brain will a of in the academic the of an Physical as a to in of Rehabilitation University, of United States This study to examine the of the and as a to in and and to the and on with of patient care, the or at were and had to and The was as the of was by the A was conducted to examine January and and were to with of the A of the in the study prior to of had an of symptoms the while to were of the and severity on and history of and of injury and Conclusion The identify who not to a of symptoms and a of to and that based on at physical should be to clinical of of Brain Injury 1University Medicine of University University, University of the University of of University of brain injury is a in or The and by the intense brain on the and severity and the and the using or in the in the of to showed brain of and of and after to studies on brain we have that a or using following brain injury by or Thus, we of following in a to were placed in a with head The was to from the were to of or using a the and to or Brain and injuries were using showed of the to and in the and by to from the on the of the The showed to after or The brain by to on the to in was on the left showed and in the brain that was most on the or and after brain following multiple injections of high of and after to after of and after brain at show that if in multiple is able to brain and has of With Head Injury of Brain in University University of Medicine University of the University of United States, of University of United States in often to in cognitive and mental Since to concussive head injury it that brain in we showed that or and brain that is by that treatment with has in and cognitive in brain injury. We that a of and through in on brain in Thus, we brain that is in could be by of with a to were to using an placed in a of at the that of After of in were by a of from a and injury of on the that in in of brain to after of In the in and and was by in after after showed on and of with for starting from week after in as to or of in improved in after the to show that a of with using has in brain in not reported and in and Outcomes Mild Traumatic Brain A H1, 1University of United States, of Houston, United States, of United States, Medical The of Medical United States, University, United States Mild traumatic brain injury and to of patients persistent and symptoms and as for impaired outcomes in in of improved patients with and outcomes were from the and in Traumatic Brain Injury were by and and by as of acute on and were for The was in and if not was from the and with at patients were did not by education were were did not by or On for to and with with functional were for executive or memory by or The with and symptoms On the to and showed that to and and of and a of and with for impairment on those in the to with for and be to brain responses to response and in at for from should be with for and further study in more of the and Outcomes in Brain Injury United States, New in following have been in studies have the of on outcomes of and from a brain injury. at that affect outcomes is improving medical This study the of on in functional from a brain injury. from a was at an rehabilitation Participants were for a brain injury. The for was to functional and were as or were of with patients in were patients with a of or the in University of about and adults with a injury will the in and in to recover as as The of this study is to of about the for to or other family One participants from and of and for the of experience of experience to a to and The being a or in a field or a of the of the and an age over to the of on in we a of to responses and in the of a with from to of the participants of that with a injury have access to in to facilitate a about is for and and that family do not have the after from the to help a with any of injury to about as a should be further in that with the and of the and family and should be further as with family A Case of and After Sampathkumar Medical Houston, United States is a over of a percentage of from to the leading to a of on the time, and best of we a case of and and and in management. A presented to head of and left and posterior CT of with in the to posterior Patient was and subsequently to rehabilitation showed mild impaired and and and in on and for and movements, and can be at or along to symptoms in to and that were at the and from take from to with a more studies of from of of has been in a case with to be poor is broad of other symptoms after along with multiple other from extensive at a more is at symptoms of and and involves head of injections in or to if for more to in our patient and less to and For patients with severe to the can be symptoms to the to with or of to can be and we that our patient will in the for Brain We by to Brain Injury and United States The is to with of who have brain but who do not that have a brain injury. this about brain injury has to about brain injury in as a of injuries with other and now Traumatic as well as brain injury in in injuries is being is that mild brain injuries have a and on not in a diagnosis of brain injury. a diagnosis of brain it is that will be for brain injury. cognitive or physical of mild brain but brain injury then the of is or to and do not the of brain injury treatment and that and as A of to the of brain injury professionals. In to and who of and in or in have a history of brain but not be of and have received treatment for In addition, be an of a history of brain injury for rehabilitation mental and and The issue for is that brain left can in any of that then the of

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