Streamlining Participant Recruitment for TBI and PTSD Research Studies

Joshi, Shristi; Dunbar, Kerri; Taylor, Patricia; Sullivan, Kelli L.; Afzal, Mariam M.; Song, Christina; Purohit, Maulik P.; Roy, Michael J.

doi:10.7205/milmed-d-16-00282

Cited by 6 publications

(4 citation statements)

References 4 publications

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“…Yaffe et al have shown that military personnel with PTSD are twice as likely to develop dementia as those without PTSD [ 10 ]. TBI and PTSD are highly comorbid conditions in civilian life and among veterans [ 7 , 9 ], and both conditions are associated with an increased risk of developing dementia later in life [ 5 ]. This link between TBI and PTSD may result from the physical injury and consequent cognitive impairments arising from TBI [ 33 ], or may be due to persistent trauma-related memory [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is increasingly recognized that traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) increase the risk of cognitive decline and dementia [ 5 , 6 ], suggesting a link with AD. In addition, there is considerable comorbidity of PTSD with TBI in both civilian and military settings [ 7 – 9 ], which raises the possibility of synergistic effects favouring the risk of dementia.…”

Section: Introductionmentioning

confidence: 99%

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Tauopathy in veterans with long-term posttraumatic stress disorder and traumatic brain injury

Mohamed

Cumming

Götz

et al. 2019

Eur J Nucl Med Mol Imaging

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Purpose Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) have emerged as independent risk factors for an earlier onset of Alzheimer’s disease (AD), although the pathophysiology underlying this risk is unclear. Postmortem studies have revealed extensive cerebral accumulation of tau following multiple and single TBI incidents. We hypothesized that a history of TBI and/or PTSD may induce an AD-like pattern of tau accumulation in the brain of nondemented war veterans. Methods Vietnam War veterans (mean age 71.4 years) with a history of war-related TBI and/or PTSD underwent [ 18 F]AV145 PET as part of the US Department of Defense Alzheimer’s Disease Neuroimaging Initiative. Subjects were classified into the following four groups: healthy controls ( n = 21), TBI ( n = 10), PTSD ( n = 32), and TBI+PTSD ( n = 17). [ 18 F]AV1451 reference tissue-normalized standardized uptake value (SUVr) maps, scaled to the cerebellar grey matter, were tested for differences in tau accumulation between groups using voxel-wise and region of interest approaches, and the SUVr results were correlated with neuropsychological test scores. Results Compared to healthy controls, all groups showed widespread tau accumulation in neocortical regions overlapping with typical and atypical patterns of AD-like tau distribution. The TBI group showed higher tau accumulation than the other clinical groups. The extent of tauopathy was positively correlated with the neuropsychological deficit scores in the TBI+PTSD and PTSD groups. Conclusion A history of TBI and/or PTSD may manifest in neurocognitive deficits in association with increased tau deposition in the brain of nondemented war veterans decades after their trauma. Further investigation is required to establish the burden of increased risk of dementia imparted by earlier TBI and/or PTSD. Electronic supplementary material The online version of this article (10.1007/s00259-018-4241-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tauopathy in veterans with long-term posttraumatic stress disorder and traumatic brain injury

Mohamed

Cumming

Götz

et al. 2019

Eur J Nucl Med Mol Imaging

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“…This suitability aspect of screening was important to ensure client wellbeing, and aligned with previously reported safety considerations to exclude clients based on the risk of stress-related reactions in a comparable study of CA use for participants with dementia. 28 Challenges recruiting clients with TBI 29 and stroke 30 for clinical research have been previously reported. Similarly, a scoping review of studies of CAs for participants with brain-related conditions revealed low sample sizes: for example, a CA study for severe TBI had one participant, 31 and research of CAs for dementia have had one participant, 32 five participants 33 and 28 participants.…”

Section: Discussionmentioning

confidence: 99%

Mixed methods, single case design, feasibility trial of a motivational conversational agent for rehabilitation for adults with traumatic brain injury

Hocking,

Maeder,

Powers

et al. 2023

Clin Rehabil

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Objective Rehabilitation for adults with traumatic brain injury (TBI) incorporates client-centred goal-setting and motivational support to achieve goals. However, face-to-face rehabilitation is time-limited. New therapy approaches which leverage care are warranted. Conversational agents (CAs) offer a human–computer interface with which a person can converse. This study tested the feasibility, usability and acceptability of using a novel CA – RehabChat – alongside brain injury rehabilitation. Design Mixed methods, single case design, feasibility pilot trial. Setting Ambulatory and community brain injury rehabilitation. Participants Adults with TBI receiving brain injury rehabilitation and clinicians providing this care. Intervention Following 1:1 training, client–clinician dyads used RehabChat for two weeks alongside usual care. Main measures Pre-post clinical measures (Motivation for Traumatic Brain Injury Rehabilitation Questionnaire, Rehabilitation Therapy Engagement Scale, Brain Injury Rehabilitation Trust Motivation Questionnaire-Relative, Brain Injury Rehabilitation Trust Motivation Questionnaire-Self) repeated measures (Hospital Anxiety and Depression Scale, researcher-developed wellbeing screening questions); and post-intervention (System Usability Scale (SUS), semi-structured 1:1 interview). Results Six participants (two clients and four clinicians) completed training. Two client–clinician dyads completed the intervention. Two other clinicians used RehabChat in a mock client–clinician session. SUS scores indicated good usability. Client well-being did not deteriorate. No adverse events were experienced. Interviews indicated RehabChat was feasible, acceptable and easy to use; and supported motivation, goal-setting and completing practice activities. Conclusions RehabChat was feasible and acceptable to use alongside usual ambulatory and community brain injury rehabilitation, had good usability and supported client needs. Further testing of RehabChat with a larger cohort for longer duration is warranted.

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“…First, despite considerable efforts, the oneyear follow-up rate of recruited patients was relatively low at 38%. The difficulties in recruitment in TBI studies are a subject addressed in a growing body of literature with proposed solutions to be implemented in the future, [64][65][66] because this low recruitment rate can introduce a bias in the results and weaken the development of knowledge within the field. Second, we used psychomotor vigilance testing to assess mean reaction time.…”

Section: Study Limitationsmentioning

confidence: 99%

Post-concussion symptoms and chronic pain after mild traumatic brain injury are modulated by multiple locus effect in the BDNF gene through the expression of antisense: A pilot prospective control study

Khoury

Segal

Parisien

et al. 2017

Canadian Journal of Pain

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Streamlining Participant Recruitment for TBI and PTSD Research Studies

Cited by 6 publications

References 4 publications

Tauopathy in veterans with long-term posttraumatic stress disorder and traumatic brain injury

Tauopathy in veterans with long-term posttraumatic stress disorder and traumatic brain injury

Mixed methods, single case design, feasibility trial of a motivational conversational agent for rehabilitation for adults with traumatic brain injury

Post-concussion symptoms and chronic pain after mild traumatic brain injury are modulated by multiple locus effect in the BDNF gene through the expression of antisense: A pilot prospective control study

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