Outcome 3 to 5 years after moderate to severe traumatic brain injury11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

Dikmen, Sureyya; Machamer, Joan; Powell, Janet M.; Temkin, Nancy

doi:10.1016/s0003-9993(03)00287-9

Cited by 388 publications

(67 citation statements)

References 43 publications

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“…The PQOL is an 18-item questionnaire that quantitatively measures QOL by asking individuals to assess different life domains on a scale of 0–100, with higher scores indicating better QOL. 22 Individuals’ scores for these questions were averaged for analysis. The Percent Back to Normal measure, previously used in TBI, 23 is a single question asking individuals how close they feel to being back to normal, on a scale of 0–100.…”

Section: Methodsmentioning

confidence: 99%

Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction

Barton¹,

Kumar²,

McCullough³

et al. 2016

Journal of Head Trauma Rehabilitation

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Objective (1) Examine relationships between persistent hypogonadotropic hypogonadism (PHH) and long-term outcomes after severe traumatic brain injury (TBI); (2) determine if sub-acute testosterone levels can predict PHH. Setting Level 1 trauma center at a university hospital. Participants Consecutive sample of men with severe TBI between 2004 and 2009. Design Prospective cohort study. Main Measures Post-TBI blood samples were collected during week 1, every 2 weeks until 26 weeks, and at 52 weeks. Serum hormone levels were measured, and individuals were designated as having PHH if ≥50% of samples met criteria for hypogonadotropic hypogonadism. At 6 and 12 months post-injury, we assessed global outcome, disability, functional cognition, depression, and quality-of-life. Results We recruited 78 men; median (IQR) age was 28.5 (22–42) years. 34 patients (44%) had PHH during the first year post-injury. Multivariable regression, controlling for age, demonstrated PHH status predicted worse global outcome scores, more disability, and reduced functional cognition at 6 and 12 months post-TBI. Two-step testosterone screening for PHH at 12–16 weeks post-injury yielded a sensitivity of 79% and specificity of 100%. Conclusion PHH status in men predicts poor outcome after severe TBI, and PHH can accurately be predicted at 12–16 weeks.

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Section: Methodsmentioning

confidence: 99%

Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction

Barton¹,

Kumar²,

McCullough³

et al. 2016

Journal of Head Trauma Rehabilitation

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“…Injury severity was categorized as mild, moderate or severe based on a method used in our previous studies (Strangman et al, 2008b). In brief, 85% of cases were based on duration of loss of consciousness (LOC), (Ruff et al, 1993; Katz and Alexander, 1994; Dikmen et al, 2003) where mild was 0–30 min LOC (unless post traumatic amnesia exceeded 24 h); moderate was 30 min < LOC ≤ 24 h, and >24 h LOC was designated severe. In the absence of LOC data, the determination was made based on Glasgow coma scale scores (<9 = severe, 9–12 = moderate, 13–15 = mild) (Katz and Alexander, 1994; Temkin et al, 1995).…”

Section: Methodsmentioning

confidence: 99%

Regional Brain Morphometry Predicts Memory Rehabilitation Outcome after Traumatic Brain Injury

Strangman¹,

OʼNeil-Pirozzi²,

Supelana³

et al. 2010

Front. Hum. Neurosci.

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Cognitive deficits following traumatic brain injury (TBI) commonly include difficulties with memory, attention, and executive dysfunction. These deficits are amenable to cognitive rehabilitation, but optimally selecting rehabilitation programs for individual patients remains a challenge. Recent methods for quantifying regional brain morphometry allow for automated quantification of tissue volumes in numerous distinct brain structures. We hypothesized that such quantitative structural information could help identify individuals more or less likely to benefit from memory rehabilitation. Fifty individuals with TBI of all severities who reported having memory difficulties first underwent structural MRI scanning. They then participated in a 12 session memory rehabilitation program emphasizing internal memory strategies (I-MEMS). Primary outcome measures (HVLT, RBMT) were collected at the time of the MRI scan, immediately following therapy, and again at 1-month post-therapy. Regional brain volumes were used to predict outcome, adjusting for standard predictors (e.g., injury severity, age, education, pretest scores). We identified several brain regions that provided significant predictions of rehabilitation outcome, including the volume of the hippocampus, the lateral prefrontal cortex, the thalamus, and several subregions of the cingulate cortex. The prediction range of regional brain volumes were in some cases nearly equal in magnitude to prediction ranges provided by pretest scores on the outcome variable. We conclude that specific cerebral networks including these regions may contribute to learning during I-MEMS rehabilitation, and suggest that morphometric measures may provide substantial predictive value for rehabilitation outcome in other cognitive interventions as well.

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“…When considering impairment in groups of people, those with severe brain injuries are likely to have some degree of persisting or permanent cognitive impairment, and those who sustain mild TBIs are unlikely to have persisting impairment (Christensen et al, 2008; Dikmen, Machamer, & Temkin, 2001; Dikmen, Machamer, Winn, & Temkin, 1995; Draper & Ponsford, 2008; Karr et al, 2014; Levin, Grossman, Rose, & Teasdale, 1979; Ruttan, Martin, Liu, Colella, & Green, 2008; Schretlen & Shapiro, 2003). Attention, concentration, working memory, speed of processing, and memory are often most affected (Dikmen et al, 2001; Dikmen, Machamer, Powell, & Temkin, 2003; Dikmen et al, 1995; Dikmen, McLean, Temkin, & Wyler, 1986; Iverson, 2005; Lezak, Howieson, & Loring, 2004; Mearns & Lees-Haley, 1993; Spikman, Timmerman, Zomeren van, & Deelman, 1999; Whyte, Schuster, Polansky, Adams, & Coslett, 2000). Most neuropsychological recovery following moderate or severe TBI occurs within the first year (Christensen et al, 2008; Dikmen et al, 1995), although some additional recovery can occur thereafter (Millis et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

NIH toolbox cognition tests following traumatic brain injury: Frequency of low scores.

Holdnack¹,

Silverberg²,

Tulsky³

et al. 2017

Rehabilitation Psychology

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Purpose/Objective To apply multivariate base rate analyses to the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) to facilitate the identification of cognitive impairment in individuals with traumatic brain injury (TBI). Research Method/Design In a multisite cross-sectional design, 158 participants who sustained a complicated mild or moderate TBI (n=74) or severe TBI (n=84) at least one year earlier were administered the NIHTB-CB. The NIHTB-CB is comprised of two crystallized cognition tests (reflecting premorbid ability) and five fluid cognition tests, measuring processing speed, memory, and executive functioning. Base rates for obtaining 0 to 5 low fluid cognition scores were calculated across a range of cutoffs for defining a low test score (≤25th to 5th percentiles). Base rates of low scores in the TBI sample were compared to the NIHTB-CB normative sample using diagnostic accuracy statistics. Results The proportion of the TBI sample obtaining low scores decreased as the cutoff for defining a low score decreased. Individuals with lower premorbid cognitive ability, as measured by NIHTB-CB crystallized composite score, tended to produce more low scores on the NIHTB-CB fluid cognition tests, even when using fully demographically-adjusted scores. Certain patterns of low scores were associated with TBI (defined as Likelihood Ratio>2.0), whereas others were non-specific, occurring almost as often in participants without TBI. Conclusions/Implications Premorbid ability stratified base rate tables provided in this article can guide researchers and clinicians in the interpretation of NIHTB-CB performance in adults with TBI.

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Outcome 3 to 5 years after moderate to severe traumatic brain injury11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

Cited by 388 publications

References 43 publications

Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction

Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction

Regional Brain Morphometry Predicts Memory Rehabilitation Outcome after Traumatic Brain Injury

NIH toolbox cognition tests following traumatic brain injury: Frequency of low scores.

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