scholarly journals Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

2020 ◽  
Vol 9 (6) ◽  
pp. 2007
Author(s):  
Juan Arango-Lasprilla ◽  
Marina Zeldovich ◽  
Laiene Olabarrieta-Landa ◽  
Marit Forslund ◽  
Silvia Núñez-Fernández ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Employment Status ◽  
Injury Severity ◽  
European Countries ◽  
Post Injury ◽  
Early Predictors ◽  
One Year ◽  
Prospective Longitudinal ◽  
Psychiatric Problems

Sustaining a traumatic brain injury (TBI) often affects the individual’s ability to work, reducing employment rates post-injury across all severities of TBI. The objective of this multi-country study was to assess the most relevant early predictors of employment status in individuals after TBI at one-year post-injury in European countries. Using a prospective longitudinal non-randomized observational cohort (The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project), data was collected between December 2014–2019 from 63 trauma centers in 18 European countries. The 1015 individuals who took part in this study were potential labor market participants, admitted to a hospital and enrolled within 24 h of injury with a clinical TBI diagnosis and indication for a computed tomography (CT) scan, and followed up at one year. Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe.

White Matter Disruption in Pediatric Traumatic Brain Injury: Results from ENIGMA Pediatric Moderate to Severe Traumatic Brain Injury

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012222
Author(s):  
Emily L Dennis ◽  
Karen Caeyenberghs ◽  
Kristen R Hoskinson ◽  
Tricia L Merkley ◽  
Stacy J Suskauer ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Behavioral Problems ◽  
Child Behavior Checklist ◽  
Injury Severity ◽  
Meta Analysis ◽  
Post Injury ◽  
Severe Tbi ◽  
Future Work

Objective:Our study addressed aims: (1) test the hypothesis that moderate-severe TBI in pediatric patients is associated with widespread white matter (WM) disruption; (2) test the hypothesis that age and sex impact WM organization after injury; and (3) examine associations between WM organization and neurobehavioral outcomes.Methods:Data from ten previously enrolled, existing cohorts recruited from local hospitals and clinics were shared with the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric msTBI working group. We conducted a coordinated analysis of diffusion MRI (dMRI) data using the ENIGMA dMRI processing pipeline.Results:Five hundred and seven children and adolescents (244 with complicated mild to severe TBI [msTBI] and 263 controls) were included. Patients were clustered into three post-injury intervals: acute/subacute - <2 months, post-acute - 2-6 months, chronic - 6+ months. Outcomes were dMRI metrics and post-injury behavioral problems as indexed by the Child Behavior Checklist (CBCL). Our analyses revealed altered WM diffusion metrics across multiple tracts and all post-injury intervals (effect sizes ranging between d=-0.5 to -1.3). Injury severity is a significant contributor to the extent of WM alterations but explained less variance in dMRI measures with increasing time post-injury. We observed a sex-by-group interaction: females with TBI had significantly lower fractional anisotropy in the uncinate fasciculus than controls (𝞫=0.043), which coincided with more parent-reported behavioral problems (𝞫=-0.0027).Conclusions:WM disruption after msTBI is widespread, persistent, and influenced by demographic and clinical variables. Future work will test techniques for harmonizing neurocognitive data, enabling more advanced analyses to identify symptom clusters and clinically-meaningful patient subtypes.

scholarly journals A-125 An Analysis of the Traumatic Brain Injury Outcomes and Needs of People in Urban, Rural and Remote Areas

2020 ◽  
Vol 35 (6) ◽  
pp. 918-918
Author(s):  
Sullivan K ◽  
Hennessy M
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Rural Communities ◽  
Injury Severity ◽  
Community Integration ◽  
Rural And Remote ◽  
Post Injury ◽  
Patient Reported ◽  
Rural And Remote Areas ◽  
Urban Rural

Abstract Objective Little is known about the traumatic brain injury (TBI) outcomes for people returning to urban versus rural communities. These communities typically differ in terms of the availability of formal and informal supports. We compared patient-reported TBI outcomes for three communities (urban, rural, and remote) and modelled their predictors. Method Six hundred and sixty-two cases with mild-to-severe TBI were identified from hospital records. These individuals received a mail-out survey comprised of standardized outcome measures. The measures assessed: symptoms, quality-of-life, service obstacles, unmet needs, mental health, and community integration. Ninety-one people who were less than two years post-injury returned a usable survey (18% response rate). The location of communities was coded using the Accessibility Remoteness Index of Australia (urban n = 22, rural n = 43, remote n = 26). Results There were no differences in the outcomes due to location (p’s &gt; .05). The significant individual predictors of five of the six outcomes were the participant’s sex, age, and the injury severity; but location did not play a role. TBI outcomes were typically worse if the injury was severe, or if the injured person was older or female. For one outcome (community integration) males fared worse than females. Conclusion Contrary to expectations, location did not affect patient-reported TBI outcomes. This could indicate that the same supports are available to patients, despite their location or; that the different supports were relied on to achieve the same outcomes. The overall findings urge continued investment in TBI rehabilitation, particularly for the subgroups that experienced the worst outcomes.

scholarly journals Predicting Behavioral Deficits in Pediatric Traumatic Brain Injury Through Uncinate Fasciculus Integrity

2011 ◽  
Vol 17 (4) ◽  
pp. 663-673 ◽  
Author(s):  
Chad P. Johnson ◽  
Jenifer Juranek ◽  
Larry A. Kramer ◽  
Mary R. Prasad ◽  
Paul R. Swank ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Behavioral Problems ◽  
Injury Severity ◽  
Diffusion Tensor ◽  
Uncinate Fasciculus ◽  
Post Injury ◽  
Orthopedic Injury ◽  
Behavioral Dysregulation ◽  
The Relationship

AbstractBehavioral dysregulation is a common and detrimental consequence of traumatic brain injury (TBI) in children that contributes to poor academic achievement and deficits in social development. Unfortunately, behavioral dysregulation is difficult to predict from either injury severity or early neuropsychological evaluation. The uncinate fasciculus (UF) connects orbitofrontal and anterior temporal lobes, which are commonly implicated in emotional and behavioral regulation. Using probabilistic diffusion tensor tractography (DTT), we examined the relationship between the integrity of the UF 3 months post-injury and ratings of executive functions 12 months post-injury in children with moderate to severe TBI and a comparison group with orthopedic injuries. As expected, fractional anisotropy of the UF was lower in the TBI group relative to the orthopedic injury group. DTT metrics from the UF served as a biomarker and predicted ratings of emotional and behavior regulation, but not metacognition. In contrast, the Glasgow Coma Scale score was not related to either UF integrity or to executive function outcomes. Neuroanatomical biomarkers like the uncinate fasciculus may allow for early identification of behavioral problems and allow for investigation into the relationship of frontotemporal networks to brain-behavior relationships. (JINS, 2011, 17, 663–673)

scholarly journals Social Behavior and Impairments in Social Cognition Following Traumatic Brain Injury

2017 ◽  
Vol 23 (5) ◽  
pp. 400-411 ◽  
Author(s):  
Michelle May ◽  
Maarten Milders ◽  
Bruce Downey ◽  
Maggie Whyte ◽  
Vanessa Higgins ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Social Behavior ◽  
Emotion Recognition ◽  
Social Functioning ◽  
Injury Severity ◽  
Comparison Group ◽  
Response Selection ◽  
Community Integration ◽  
Post Injury

AbstractObjectives:The negative effect of changes in social behavior following traumatic brain injury (TBI) are known, but much less is known about the neuropsychological impairments that may underlie and predict these changes. The current study investigated possible associations between post-injury behavior and neuropsychological competencies of emotion recognition, understanding intentions, and response selection, that have been proposed as important for social functioning.Methods:Forty participants with TBI and 32 matched healthy participants completed a battery of tests assessing the three functions of interest. In addition, self- and proxy reports of pre- and post-injury behavior, mood, and community integration were collected.Results:The TBI group performed significantly poorer than the comparison group on all tasks of emotion recognition, understanding intention, and on one task of response selection. Ratings of current behavior suggested significant changes in the TBI group relative to before the injury and showed significantly poorer community integration and interpersonal behavior than the comparison group. Of the three functions considered, emotion recognition was associated with both post-injury behavior and community integration and this association could not be fully explained by injury severity, time since injury, or education.Conclusions:The current study confirmed earlier findings of associations between emotion recognition and post-TBI behavior, providing partial evidence for models proposing emotion recognition as one of the pre-requisites for adequate social functioning. (JINS, 2017,23, 400–411)

Adaptation Following Serious Brain Injury: An Assessment After One Year

1988 ◽  
Vol 19 (3) ◽  
pp. 3-8 ◽  
Author(s):  
Steven P. Kaplan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Functioning ◽  
Return To Work ◽  
Clinical Usefulness ◽  
Psychosocial Variables ◽  
Post Injury ◽  
Adjustment Problems ◽  
One Year ◽  
Major Adjustment

This study's major purposes were to identify preinjury psychosocial variables effecting social and vocational adjustment to serious traumatic brain injury (TBI) and to test the reliability and clinical usefulness of The Portland Adaptability Inventory (PAI). Twenty-five individuals with serious TBI served as subjects. Results showed the participants major adjustment problems at 13 months post-injury were psychosocial and family oriented, and that return to work or school was heavily dependent upon an individual's ability to engage in socially appropriate interactions. Predisability family functioning was associated with both the subject's return to work or school and with post-disability family functioning. The PAI was shown to be a reliable and useful measure of post TBI problem areas.

Predictors of 1-Month and 1-Year Neurocognitive Functioning from the UCLA Longitudinal Mild, Uncomplicated, Pediatric Traumatic Brain Injury Study

2012 ◽  
Vol 19 (2) ◽  
pp. 145-154 ◽  
Author(s):  
Talin Babikian ◽  
David McArthur ◽  
Robert F. Asarnow
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Parental Education ◽  
Brain Injuries ◽  
Injury Severity ◽  
School Achievement ◽  
Body Part ◽  
Neurocognitive Deficits ◽  
Post Injury ◽  
Neurocognitive Impairments

AbstractAlthough more severe brain injuries have long been associated with persisting neurocognitive deficits, an increasing body of literature has shown that children/adolescents with single, uncomplicated mild traumatic brain injury (mTBI) do not exhibit long-lasting neurocognitive impairments. Nonetheless, clinical experience and our previous report (Babikian, 2011) showed that a minority of children/adolescents exhibit persistent cognitive problems using performance based measures following what appear to be relatively mild injuries. Predictors of poor neurocognitive outcomes were evaluated in 76 mTBI and 79 Other Injury subjects to determine the relative contributions of indices of injury severity, clinical symptomatology, demographic factors, and premorbid functioning in predicting 1-month and 12-month neurocognitive impairment on computerized or paper and pencil measures. Injury severity indicators or type of injury (head vs. other body part) did not predict either 1-month or 12-month cognitive impairment status. Rather, premorbid variables that antedated the injury (parental education, premorbid behavior and/or learning problems, and school achievement) predicted cognitive impairments. When post-injury neurocognitive impairments are observed in survivors of mild injuries (head or other body part), a sound understanding of their etiology is critical in designing appropriate intervention plans. Clinical and research implications are discussed. (JINS, 2012, 18, 1–10)

Cognitive recovery and predictors of functional outcome 1 year after traumatic brain injury

2009 ◽  
Vol 15 (5) ◽  
pp. 740-750 ◽  
Author(s):  
SOLRUN SIGURDARDOTTIR ◽  
NADA ANDELIC ◽  
CECILIE ROE ◽  
ANNE-KRISTINE SCHANKE
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcome ◽  
Injury Severity ◽  
Cognitive Measures ◽  
Related Factors ◽  
Predictive Values ◽  
Neuropsychological Measures ◽  
Cognitive Components ◽  
One Year

AbstractOutcome studies on traumatic brain injury (TBI) have shown that functional status can be predicted by demographic, injury severity, and trauma-related factors. Concurrent cognitive functions as one of the determinants of functional outcome is less documented. This study evaluated the effects of concurrent neuropsychological measures on functional outcome 1 year after injury. Neuropsychological data, employment status, self-reported fatigue, and the Glasgow Outcome Scale-Extended (GOSE) were collected from 115 persons with TBI (ranging from mild to severe) at 3 and 12 months postinjury. Principal components analysis was conducted with the neuropsychological measures and three components emerged. Multiple regression analysis, controlling for demographic and injury severity related factors, was used to test the effects of cognitive components at 12 months on functional outcome (GOSE). One year after injury, 64% were categorized as “good recovery” and 36% as “moderate disability” according to GOSE. Good functional recovery depended on shorter duration of posttraumatic amnesia, less fatigue, absence of intracranial pathology, higher education, and better performance on cognitive measures. The predictive values of Verbal/Reasoning and Visual/Perception components are supported; each added significantly and improved prediction of functional outcome. The Memory/Speed component showed a near-significant relationship to outcome. (JINS, 2009, 15, 740–750)

Return to Pre-Injury Work Following Mild Traumatic Brain Injury

2018 ◽  
Vol 19 (2) ◽  
pp. 153-165 ◽  
Author(s):  
Michael Kahan ◽  
Kelly M. Jones ◽  
Shivanthi Balalla ◽  
Kathryn McPherson ◽  
Elisabeth Stedman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Return To Work ◽  
Population Based ◽  
Post Injury ◽  
Mild Tbi ◽  
Prospective Longitudinal Study ◽  
Younger Workers ◽  
Younger Age ◽  
Prospective Longitudinal

Objective: Adults are at risk for unemployment following a moderate-severe traumatic brain injury (TBI). Less is known about employment patterns following mild TBI. This study aims to examine patterns of return to pre-injury job in adults following mild TBI over a 12-month post injury period, and to investigate factors associated with return to work. Methods: It is a prospective longitudinal study of 205 adults (aged ≥16 years at injury) identified as part of a larger population-based incidence study in the Waikato, New Zealand. In-person assessments were completed at baseline (within 14 days) and 1-, 6-, and 12-month post-injury. Results: A total of 159 (77.6%) adults returned to their pre-injury job at baseline and 185 (90.2%) returned within 12 months. Of those who did not return to their pre-injury job at baseline (n= 46), younger age at injury (≤30 years,p= .02) and poor overall neurocognitive functioning at 1-month (p= .02) was associated with non-return to pre-injury job at 12 months. Conclusion: In a sample of employed adults, the majority returned to their pre-injury job shortly after injury. Cognitive functioning and younger age at time of injury may be associated with delayed return to work. Interventions to support younger workers may facilitate their return to work.

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