2022 Joint Conference Abstracts Brain Injury

3 Long-term Outcomes From Child TBI: Tracking Recovery Across 20 Years Vicki Anderson1-3; Louise Crowe, Cathy Catroppa1-3; Nicholas Ryan1,4 1Murdoch Children's Research Institute, Parkville, Victoria, Australia; 2University of Melbourne, Parkville, Victoria, Australia; 3Royal Children's Hospital, Parkville, Victoria, Australia; 4Deakin University, Burwood, Victoria, Australia Traumatic brain injury (TBI) sustained in childhood can be considered a chronic condition, due to its lifelong consequences, impacting multiple functional domains: physical abilities, academic achievement, mental health status, and social competence. The impact of injury severity is well established, with poorer outcomes associated with more severe TBI. However, emerging evidence suggests that the nature of postinjury deficits, and the mechanisms underlying them, may vary across childhood, characterized by a complex interplay of biopsychosocial factors. Thus, from a clinical perspective, the targets for intervention may not be static but, rather, change along with developmental demands and environmental influences. To date, few studies have systematically tracked child TBI into adulthood using a multidomain framework. This presentation (i) describes the findings of a 20-year prospective, longitudinal research program, which has tracked children's recovery across 7 time points, exploring both biological (injury severity indices, neuroimaging, blood biomarkers) and environmental influences (socioeconomic status, family function, parent mental health and burden), and multiple functional domains (adaptive, cognitive, academic, social, mental health), quality of life; (ii) considers the implications of our findings for building a dynamic rehabilitation model that takes into account key mechanisms underpinning child function at major developmental stages; and (iii) introduces recent evidence-based child and family-focused intervention models applicable following child TBI. 5 Initial Clinical Presentation and Rehabilitation Pathways for Young, School Aged-Children With Concussion Elizabeth Teel McGill University, Montreal, Canada Objectives Concussions are common among elementary school-aged children (5-12 years old). Few studies have investigated the clinical presentation and recovery needs of young children with concussion, which is necessary to optimize recovery strategies to their developmental needs. Therefore, the purpose of this study was to describe and compare initial physiotherapy findings and prescribed rehabilitation pathways for elementary school-aged children with concussion. Methods Prospectively collected clinical data from young children presenting to the Montreal Children's Hospital Concussion Clinic between September 2017 and August 2019 were analyzed. Outcomes of interest included (1) findings from the initial physiotherapy examination (cervical range of motion, Post-Concussion Symptom Inventory [PCSI], Bruininks-Oseretsky Test of Motor Proficiency Edition 2 [BOT-2] Body Coordination domain, composed of Bilateral Coordination and Balance subtests, and a modified version of the Vestibular/Ocular Motor Screen [VOMS], where, in addition to documenting symptom provocation, the physiotherapist reports any abnormal eye movement pattern [eg, nystagmus, overshoot/undershoot] observed during the test); and (2) rehabilitation pathways (exercise, vestibular, and cervical therapy) prescribed to patients. We compared patients across several age groupings (5-7 years: n = 52; 8-10 years: n = 146; 11-12 years: n = 183) using Kruskal-Wallis (continuous) or Chi-square (categorical) tests, with roughly equal numbers of boys (n = 208) and girls (n = 179) represented in the sample. Results The 11- to 12-year-olds were significantly more likely to have 1 or more clinician-observed abnormal finding during the VOMS (5-7 years: n = 0, 0%; 11-12 years: n = 27, 16%; χ12 = 7.69, P = .006) and cervical examination (5-7 years: n = 1, 2%; 11-12 years: n = 35, 21%; χ12 = 7.69, P = .006) than 5- to 7-year-olds only. The 5- to 7-year-old group had significantly better norm-referenced BOT-2 Bilateral Coordination scale scores than the 8- to 10-year-old and 11- to 12-year-old groups: median scaled scores (IQR): 5-7 years = 20 (18-21); 8-10 years = 18.5 (16-20); 11-12 years = 19 (17-20); χ12 = 9.11, P = .01). No group differences in BOT-2 balance, BOT-2 body coordination, or postinjury PCSI scores were observed. For rehabilitation outcomes, significant differences were observed for exercise-based therapy (5-7 years: n = 8, 15.4%; 8-10 years: n = 61, 41.8%; 11-12 years: n = 80, 43.7%; χ12 = 14.36, P < .001), vestibular therapy (5-7 years: n = 0, 0%; 8-10 years: n = 14, 9.6%; 11-12 years: n = 43, 23.5%; χ12 = 22.94, P < .001), and cervical therapy (5-7 years: n = 0, 0%; 8-10 years: n = 5, 3.4%; 11-12 years: n = 20, 10.9%; χ12 = 11.69, P = .003), with 11- to 12-year-olds more frequently prescribed rehabilitation. Conclusions In our sample, 5- to 7-year-olds with concussion presented with fewer abnormalities on visual/vestibular and cervical assessments, as well as fewer rehabilitation needs, than 11- to 12-year-olds. The frequency and severity of deficits observed at the initial physiotherapy appointment, and the subsequent need for rehabilitation, in our sample appear lower than values reported for adolescents and young adults with concussion throughout the literature. These findings could be driven by several factors, including physiological differences influencing injury and recovery, mechanism of injury, or sample-specific differences, and should be explored in the future. 6 The Effect of Oral Mucosal Mesenchymal Stem Cells Administration on Inflammatory and Oxidative Stress Outcomes of Liver Following Experimental Traumatic Brain Injury Nazanin Sabet1; Behshad Mofid2; Mohammad Khaksari3,4; Zahra Soltani3,4; Eshagh Alizadeh2 1Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran; 2Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran; 3Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran; 4Dept. Physiology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran Introduction Traumatic brain injury (TBI)–induced inflammatory mediators are transferred from damaged brain tissue to the bloodstream and produce a systemic inflammatory response in peripheral organs, including liver. In this study, the effect of oral mucosal mesenchymal stem cell (MSC) treatment following TBI was evaluated on inflammatory and oxidative stress agents in liver. Materials and Methods In this study, 24 Wistar adult male were were into groups: and stem cell Oral mucosal were 1 and 24 Liver by the of and and oxidative stress by the of and were evaluated at Results TBI in a significant in and compared with the The of and following TBI. The of following TBI of and and of and in liver. The of from the oral following TBI could and oxidative Therefore, the of oral can be considered for more research to the in TBI patients. 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Rehabilitation Research Melbourne, Victoria, Australia; Rehabilitation Melbourne, Victoria, Australia; Melbourne, Victoria, Australia; Melbourne, Victoria, Australia Objectives To the and of a intervention that and to symptom Methods with and and to multiple or 6 was across with brain injury age = = time injury = The for and a as well as and and and therapy vestibular, and was severity of the Post-Concussion 3 during and treatment outcomes included of and physical quality of and and outcomes were at and and was during the treatment to of the intervention was by and treatment of of treatment and of with were and of the were explored Results was to be in of For of the effect in in of 7 and clinical These were at and and were by in of and and had significant in at with of therapy using Conclusions Results that may severity and and physical to quality of and at and at time points, to and that were that symptom is not of function can in and to the of in and to functional This data the of a of the in Traumatic Brain School of Medicine, of Medicine, Introduction of and can the quality of and in with brain injury The is a or to a The a a and oral mechanism is the the 3 or during or This prospective, study to for between studies and the in with TBI. were adults years with as the of than in the 24 injury, were for included the of a and the to in were the by 2 in were to the or during or Following a and a to the to in a Results for was for the and the on for was for the 2 on the and the of the the the on and not on for the = = = and = of and lower in the 24 of were associated with = and P = Conclusions The is for in patients with TBI. The of the in its that patients the have a of on The data from this study that the can be a and to for in the research is with a sample to better the for with TBI studies the Coordination Following TBI: Results From a and With of and The University, Children's Hospital of Clinical Rehabilitation of University of Objectives research is in the of brain injury (TBI) to of throughout and Methods This presentation on 2 that this The was a at the body of research to for children with needs to clinical and research for with TBI. The the and for with in the following and using the to our The with key to their and describe their to for children with TBI. Results of were for the and included were into 3 on studies for and their to (n =

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