Mild Traumatic Brain Injury with Social Defeat Stress Alters Anxiety, Contextual Fear Extinction, and Limbic Monoamines in Adult Rats

Recent studies on military breachers in training environments suggest that there are neurocognitive risks from exposure to repeated low-level blasts. However, the dose accumulation effects from multiple low-level blast exposures and their relation to mild traumatic brain injury (mTBI) are not well understood. This paper presents a controlled neurobehavioral study of behavioral effects from repeated low-level blasts delivered at ten second intervals using a rat model. A custom designed shock tube was developed to deliver repeated low-level blasts to rats at short intervals on the order of seconds. A total of 192 rats were divided into three cohorts of 64 for testing. Each cohort was exposed to a different blast intensity (7.5, 15, or 25 psi reflective pressure with durations <0.25 ms), and each cohort was further divided into four levels of blast repetition (0, 5, 10, or 15 repeats). Shock tube blasts were directed at the rat’s head, and startle with prepulse inhibition (PPI) and fear learning and extinction behavioral tests were performed to evaluate the blast effects. Behavioral testing results showed that repeated low-level blasts can affect PPI and contextual fear recall. PPI was not affected by repeated exposures to 7.5 psi blasts, but repeated 15 and 25 psi blasts disrupted PPI. All cohorts showed significant fear learning, but the highest blast group (25 psi, 15 repeats) had disruptions in spatial memory recall. None of the cohorts showed effects on cued fear recall or fear extinction and retention. The data collected are being used in continuous research to understand how the behavioral changes relate to mTBI, and how these animal tests can be scaled and modeled to interpret possible outcomes for humans.

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The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0296 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1363-1370 ◽

Cited By ~ 2

Author(s):

Jessica Brown ◽

Katy O'Brien ◽

Kelly Knollman-Porter ◽

Tracey Wallace

Keyword(s):

High School ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Disease Control ◽

Mild Traumatic Brain Injury ◽

School Age Children ◽

School Age ◽

Speech Language Pathologists ◽

Control And Prevention ◽

Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

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A Case of Functionally Based Rehabilitation Following a Mild Traumatic Brain Injury

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld8.2.3-a ◽

1998 ◽

Vol 8 (2) ◽

pp. 3-8

Author(s):

Kathleen Ralph Cazzato

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury

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Assessment of Cognitive-Communicative Disorders of Mild Traumatic Brain Injury Sustained in Combat

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld19.2.47 ◽

2009 ◽

Vol 19 (2) ◽

pp. 47-57 ◽

Cited By ~ 10

Author(s):

Christine Parrish ◽

Carole Roth ◽

Brooke Roberts ◽

Gail Davie

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Psychological Health ◽

Communication Disorders ◽

Service Members ◽

Patient Questionnaire ◽

Speech Language Pathologists ◽

Test Protocol ◽

Communication Deficits

Abstract Background: Mild traumatic brain injury (mTBI) is recognized as the signature injury of the current conflicts in Iraq and Afghanistan, yet there remains limited understanding of the persisting cognitive deficits of mTBI sustained in combat. Speech-language pathologists (SLPs) have traditionally been responsible for evaluating and treating the cognitive-communication disorders following severe brain injuries. The evaluation instruments historically used are insensitive to the subtle deficits found in individuals with mTBI. Objectives: Based on the limited literature and clinical evidence describing traditional and current tests for measuring cognitive-communication deficits (CCD) of TBI, the strengths and weaknesses of the instruments are discussed relative to their use with mTBI. It is necessary to understand the nature and severity of CCD associated with mTBI for treatment planning and goal setting. Yet, the complexity of mTBI sustained in combat, which often co-occurs with PTSD and other psychological health and physiological issues, creates a clinical challenge for speech-language pathologists worldwide. The purpose of the paper is to explore methods for substantiating the nature and severity of CCD described by service members returning from combat. Methods: To better understand the nature of the functional cognitive-communication deficits described by service members returning from combat, a patient questionnaire and a test protocol were designed and administered to over 200 patients. Preliminary impressions are described addressing the nature of the deficits and the challenges faced in differentiating the etiologies of the CCD. Conclusions: Speech-language pathologists are challenged with evaluating, diagnosing, and treating the cognitive-communication deficits of mTBI resulting from combat-related injuries. Assessments that are sensitive to the functional deficits of mTBI are recommended. An interdisciplinary rehabilitation model is essential for differentially diagnosing the consequences of mTBI, PTSD, and other psychological and physical health concerns.

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Review for "Analyzing the changes in the brain material properties after a mild traumatic brain injury—A pilot study"

10.1002/eng2.12332/v2/review2 ◽

2020 ◽

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Pilot Study ◽

Mild Traumatic Brain Injury ◽

Material Properties ◽

Brain Material ◽

The Brain

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Posttraumatic Stress Disorder Exacerbates Emotional Complaints but not Cognitive Impairments in Individuals Suffering from Postconcussional Disorder after Mild Traumatic Brain Injury

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x/a000132 ◽

2015 ◽

Vol 26 (1) ◽

pp. 35-50 ◽

Cited By ~ 1

Author(s):

Sara C. Schroeder ◽

Ronald M. Ruff ◽

Lutz Jäncke

Keyword(s):

Traumatic Brain Injury ◽

Posttraumatic Stress Disorder ◽

Brain Injury ◽

Posttraumatic Stress ◽

Mild Traumatic Brain Injury ◽

Test Performance ◽

Stress Disorder ◽

Negative Impact ◽

Neuropsychological Test ◽

Composite Scale

The aim of this study was to examine the effect of posttraumatic stress disorder (PTSD) on (a) neuropsychological test performance and (b) self-reported emotional complaints within individuals suffering from postconcussional disorder (PCD) after a mild traumatic brain injury (MTBI). A two-group comparative research design was employed. Two MTBI samples with and without PTSD were assessed with a neuropsychological test battery and the Ruff Neurobehavioral Inventory (RNBI). On the neurocognitive test performances no significant between group differences were found, but the MTBI group with PTSD endorsed a significantly greater number of emotional complaints, especially in the RNBI subscales of anxiety and depression. The patients with PTSD also endorsed a significantly greater number of premorbid sequelae in the RNBI emotional composite scale as well as the RNBI premorbid subscales of pain, anxiety and abuse. In sum, PTSD has a negative impact on emotional but not cognitive functioning within individuals suffering from PCD after a mild TBI.

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