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Diagnosis and Treatment of Mild Traumatic Brain Injury (mTBI)

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Abstract

Incidence of mTBI has become increasingly detectible with advances in technology and clinical assessment. This paper reviews basic clinical examination, treatment considerations for common neurobehavioral manifestations of mTBI, and techniques shown effective in managing neuropsychological symptoms. Predictable patterns of psychological maladjustment that may exacerbate morbidity are introduced. The author discusses integration of psychotherapeutic methods with cognitive rehabilitation, physiologic recording, mindfulness, and self-management to optimize outcome.

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References

  • Anderson, T., Heitger, M. & Macleod, A.D. (2006). Concussion and mild head Injury. Practical Neurology. 6, 342–357.

    Article  Google Scholar 

  • Backhaus, S.L., Ibarra, S.L., Klyce, D., Trexler, L.E., & Malec, J.F. (2010). Brain injury coping skills group: A preventative intervention for patients with brain injury and their caregivers. Archives of Physical Medicine and Rehabilitation. 91, 840–848.

    Article  Google Scholar 

  • Beck, A.T., Steer, R.A., & Brown, G.K. (1996). The Beck Depression Inventory-II. San Antonio, Texas: Psychological Corporation.

    Google Scholar 

  • Beck, A.T., & Steer, R.A. (1993). The Beck Anxiety Scale. San Antonio, Texas: The Psychological Corporation.

    Google Scholar 

  • Batchelor, E.S., & Taylor, E. (Workshop). (2006). Proceedings from APA’ 06. Theory, Research and Practice: Psychotherapy with Neurologic Adults. Oxfordshire, UK: Taylor & Francis.

    Google Scholar 

  • Batchelor, E.S. & Connell, Brian. (1995). Proceedings from NAN’ 95. Success Rates from Mild and Moderate Brain Injury Using a Community Re-Integration Model. Oxford, UK: Oxford.

    Google Scholar 

  • Bazaraian, J., Mclung, J., Shah, M.N., Cheng, Y.T., Flesher, W., & Kraus, J. (2005). Mild traumatic brain injury in the United States, 1998–2000. Brain Injury, 19 (2), 85–91.

    Article  Google Scholar 

  • Bazarian, J., McClung, J., Cheng, Y.T., Flesher, W., & Schneider, S. M. (2005). Emergency department management of mild traumatic brain injury in the USA. Emergency Medicine Journal. 22, 473–477. doi: 10.1136/emj.2004.019273.

    Article  CAS  Google Scholar 

  • Belanger, H. G., Curtiss, G., Demery, J. A., Lebowitz, B. K., & Vanderploeg, R. D. (2005). Factors moderating neuropsychological outcome following mild traumatic brain injury: A metaanalysis. Journal of the International Neuropsychological Society. 11, 215–22.

    Article  Google Scholar 

  • Bryant R.A., Moulds, M., Guthrie R., & Nixon R.D. (2003). Treating acute stress disorder following mild traumatic brain injury. American Journal of Psychiatry Psychiatry. 160, 585–587.

    Article  Google Scholar 

  • Carroll, L.J., Cassidy, J.D., Peloso, P.D., Borg, J., von Holst, H., Holm, L., Paniak, C., & Pépin, M. (2004). Prognosis for mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitative Medicine. 43, 84–105.

    Article  Google Scholar 

  • Cassidy, D.J., Cancelliere, C., Carroll, L.J., Côté, P., Hincapié, C.A., Holm, L.W., Hartvigsen, J., Donovan, J., Nygren-de Boussard, K., Kristman, V.L., & Borg, J. (2014). Systematic review of self-reported prognosis, in adults after mild traumatic brain injury: Results of the international collaboration on mild traumatic brain injury prognosis. Archives of Physical Medicine and Rehabilitation. 95 (3 Supp. 2), S132–S151.

    Article  Google Scholar 

  • Cicerone, K. D., Dahlberg, C., Kalmar, K., Langenbahn, D. M., Malec, J. F., & Bergquist, T. F., et al. (2000). Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives of Physical Medicine and Rehabilitation. 81, 1596–1615.

    Article  CAS  Google Scholar 

  • Cicerone, K., Levin, H., Malec, J., Stuss, D. & Whyte, J. (2006). Cognitive Rehabilitation Interventions for Executive Function: Moving from Bench to Bedside in Patients with Traumatic Brain Injury. Journal of Cognitive Neuroscience. 18 (7), 1212–1222.

    Article  Google Scholar 

  • Cicerone, K.D. (1989). Psychotherapeutic interventions with traumatically brain-injured patients. Rehabilitation Psychology, 34(2), 105–114.

    Article  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic Statistical Manual - V. Arlington, VA.

    Google Scholar 

  • Ellison, R. L., & Stika, M. (2018). Feedback on invalid neuropsychological testing: Mild traumatic brain injury (mTBI). Journal of Health Service Psychology. 44, 19–23.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2010). Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002–2006. Atlanta, GA: Faul, M., Xu, L.Wald, M.D, & Coronado, V.G.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2015). Traumatic Brain Injury In the United States: Epidemiology and Rehabilitation. Atlanta, GA. Friedman T.R., Houry, D., & Baldwin, G.

    Google Scholar 

  • Gardner, R.C., Byers, A., Barnes, D.E., Yixia, L. Boscardin, J., & Yaffe, K., (2018). Mild TBI and risk for Parkinson’s Disease: A chronic effects of neurotrauma consortium study. Neurology. 90, (20), 1771–1779.

    Article  Google Scholar 

  • Gardner, R.C., & Yaffe K., (2015). Epidemiology of mild traumatic brain injury and neurodegenerative disease. Molecular Cell Neuroscience. 66 (10), 75–80.

    Article  CAS  Google Scholar 

  • Green, P., Allen, L.M., & Astner, K. (1996). The Word Memory Test. Durham, North Carolina: Cognisyst.

    Google Scholar 

  • Iverson, G.L., Barthe, J., Bush. S., Brosheke, D.K., and the NAN Policy and Planning Committee. (2009). Recommendations for Diagnosing a Mild Traumatic Brain Injury: A National Academy of Neuropsychology Education Paper. Archives of Clinical Neuropsychology. 24, 3–10.

    Article  Google Scholar 

  • David W. Lawrence, D.W., Comper, P., Hutchison, M.G., & Sharma, B. (2015). The role of apolipoprotein E episilon (e)-4 allele on outcome following traumatic brain injury: A systematic review. Brain Injury. Early Online: 1–14. Informa UK Ltd. DOI: 10.3109/02699052.2015.1005131

    Google Scholar 

  • Link, J.S., Barker, T., Serpa, S., Pinjala, M., Oswald, T., & Lashley, L. (2016). Mild traumatic brain injury and mindfulness-based stress reduction: A review. Archives of Assessment Psychology. 6, (1). 7–32.

    Google Scholar 

  • Levin H.S., McCauley, S.R., Josic, C.P., Boake, C., Brown, S.A., Goodman, H.S., Merrit, S.G., & Brundage S.I., (2005). Predicting depression following mild traumatic brain injury. Archives of General Psychiatry. 62, 523–528.

    Article  Google Scholar 

  • Kumar, S., Jahawar, A., Shaw, P., and Kumar, M. (2015). Montreal Cognitive Assessment: A screening tool for mild traumatic brain injury (P7.185). Neurology. 84 (4 Supp. 14).

    Google Scholar 

  • McAllister, T.W. (2011). Neurobiological consequences of traumatic brain injury. Retrieved from www.dialogues-cns.org

    Google Scholar 

  • McInnes, K. Friesen, C.L., Diane E. MacKenzie, D.E., Westwood, D.A., Boel, S.G. (2017). Mild traumatic brain injury (mTBI) and chronic cognitive impairment: A scoping review. PLoS ONE 12 (4), e0174847. https://doi.org/10.1371/journal.pone.0174847

    Article  Google Scholar 

  • Nakese-Richardson, R. Yablon, S.A. & Sherer, M. (2007). Prospective comparison of acute confusion severity with duration of post-traumatic amnesia in predicting employment outcome after traumatic brain injury. Journal of Neurology, Neurosurgery and Psychiatry. 78. 872–876.

    Article  Google Scholar 

  • Paniak, C., Toller-Lobe, G., Reynolds, S., Melnyk, A., & Nagy, J. (2000). A randomized trial of two treatments for mild traumatic brain injury: A one year followup. Brain Injury. 14, (3), 219–226.

    Article  CAS  Google Scholar 

  • Sherer, M., Struchen, M.A., Yablon, S.A. Yang, Y, & Nick, T.G., (2008). Comparison of indices of brain injury severity: Glasgow Coma Scale, length of coma, and post traumatic amnesia. Journal of Neurology, Neurosurgery and Psychiatry. 79. 678–685.

    Article  CAS  Google Scholar 

  • Shobhit, J., and Iverson, L.M. (2018). Glasgow Coma Scale. Retrieved from https://www.ncbi.nlm.nih.gov

    Google Scholar 

  • Slemmer, J.E., Matser, E.J.T., De Zeeuw, C.I., & Weber, J.T., (2002). Repeated mild injury causes cumulative damage to hippocampal cells. Brain. 125, 2699–2709.

    Article  Google Scholar 

  • Strasburger, L.H., Gutheil, T.G., & Brodsky, A. (1997). On wearing two hats: role conflict in serving as both psychotherapist and expert witness. American Journal of Psychiatry. 154,(4), 448–456.

    Article  CAS  Google Scholar 

  • Stokes, L.T. (2009). Evidence for the effectiveness of Multi-disciplinary rehabilitation following acquired brain injury: A synthesis of two systematic approaches. Journal of Rehabilitative Medicine. 40, 691–701.

    Article  Google Scholar 

  • Stulemeijer, M., van der Werf, S.P., Borm, G.F., & Vos, P.E. (2007). Early prediction of favorable recovery six-months after mild traumatic brain injury. Journal of Neurology, Neurosurgery, & Psychiatry. 79, 936–942.

    Article  Google Scholar 

  • Till, C., Colella, B., Verwegen, J., & Green, R.E. (2008). Postrecovery Cognitive Decline in Adults With Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation. 89 (12 Supp. 2), S25–34.

    Article  Google Scholar 

  • Wade, D.T., King, N.S., Wenden, F.J., Crawford, S., & Caldwell, F.E. (1998). Routine follow up after head injury: a second randomized controlled trial. Journal of Neurology, Neurosurgery, & Psychiatry. 65, 177–183.

    Article  CAS  Google Scholar 

  • Zhang, J.Y., & Feinstein, A. (2016). Screening for cognitive impairments after traumatic brain injury: A comparison of a brief computerized battery with the Montreal Cognitive Assessment. Neuropsychiatry & Clinical Neuroscience. 28, 328–331. doi: 10.1176.

    Article  Google Scholar 

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Authors
  1. Ervin S. Batchelor
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Additional information

Ervin S. Batchelor, PhD, ABPPCN, founded Carolina Center for Development and Rehabilitation in Charlotte, NC, in 1992, an outpatient rehabilitation facility for patients with neurologic and neuropsychiatric disorders. Retired from the role of Executive Director, he is still involved in research and consultation.

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Batchelor, E.S. Diagnosis and Treatment of Mild Traumatic Brain Injury (mTBI). J Health Serv Psychol 45, 29–37 (2019). https://doi.org/10.1007/BF03544678

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