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Projects of the TBINDC Registry by Keyword
25 projects available at this time for traumatic brain injury
Subacute changes in metabolism following TBI
Abstract: Objectives: 1) to determine whether patients with recent TBI entering a rehabilitation facility are dehydrated, malnourished, and/or have an increased resting metabolic rate; 2) to determine whether resting metabolic rate is associated with severity of TBI; 3)to determine the duration of metabolic changes seen in BI patients admitted to a rehabilitation facility. Patient Population: Patients admitted to the inpatient TBI unit at SRH for treatment of head trauma. Methods: Patients had their caloric expenditure measured three times: once upon admission, and two times during their first week of stay. Resting energy expenditure data will be obtained using a portable metabolic unit (Cosmed, K4b2, Rome, Italy). Results: Data was collected on 21... more
Investigators: Burke D view full
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Lead Center: Spaulding Rehabilitation Hospital
Useful Field of View
Abstract: Useful field of view (UFOV) has been an effective assessment tool of attention for driving safety. This study compared the findings of the UFOV Test with those of conventional neuropsychologic tests to determine the utility of the UFOV Test as a measure of attention in an acute rehabilitation inpatient population with brain injury. Results indicated that the UFOV subtest UF2 correlated strongly with two other UFOV subtests, UF1 and UF3. Also, the UF2 subtest correlated strongly with neuropsychological paper-pencil tests of visual attention. The UF2 subtests predicted 52% of Functional Independence Measure(FIM) change and 60% of inpatient length of stay (LOS) variance second only to FIM admission scores, which predicted 75% and 80% of FIM... more
Investigators: Calvanio R view full
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Lead Center: Spaulding Rehabilitation Hospital
Social Communication Skills Training in Traumatic Brain Injury: A Treatment Efficacy Study
Abstract: This study is evaluating the efficacy of a treatment program addressing social communication skills following TBI. Social communication skills are frequently impaired after a TBI, and these impairments are believed to contribute to social isolation due to difficulty in establishing and maintaining interpersonal relationships with friends, family and co-workers. Research suggests that social communication skills for individuals with TBI can be relearned through practice and repetition in functional situations. Most of the reported research in this area has been conducted using small sample sizes, with very limited use of randomized controlled studies. The actual treatment intervention for social skills used in these studies is most... more
Investigators: Dahlberg C, Newman J, Hawley L, Morey C, Harrison-Felix C, Whiteneck G view full
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Lead Center: Craig Hospital
Outcomes and Environmental Factors in the Decades After Traumatic Brain Injury
Abstract: While the TBI Model Systems Database has documented many of the important outcomes occurring after Traumatic Brain Injury (TBI), it is only beginning to document truly long-term outcomes. As stated in NIDRR.s Long Range Plan, the Maintenance of Health and Function and Full Access to Community Life are key outcomes of interest with particular objectives to .identify predictors of community participation. and .examine the impact of environment and attitudinal barriers on the outcomes of individuals with TBI.. This study is designed to take advantage of Craig Hospital.s four decade history of rehabilitating people with TBI, to allow a cross-sectional analysis of the changing pattern of TBI outcomes and environmental barriers occurring... more
Investigators: Whiteneck G, Brooks C, Harrison-Felix C, Gerhart K view full
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Lead Center: Craig Hospital
Apolipoprotein E Genotype and Outcome Following TBI
Abstract: Investigations suggest a link between the ApoE e4 allele, a genetic risk factor for AlzheimerÂ’s disease and outcome from brain injury. ApoE e4 is associated with excessive beta amyloid protein deposits in autopsy studies of severe brain injury. Animal studies demonstrate the role of ApoE in neuronal repair after head injury. ApoE-deficient brain injured mice are less able to produce antioxidant reducing substances than control mice, and exhibit more pronounced motor and spatial memory deficits. To date, there have been no prospective investigations examining patients over time to determine whether ApoE e4 is a risk factor for decreased recovery following brain injury. A prospective, longitudinal study is proposed, with patients... more
Investigators: Goldstein F, Gearing M, Greenspan A, Stringer A view full
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Lead Center: Emory University/Shepherd Center
Value-driven cognitive remediation for persons with TBI
Abstract: While the concept of using patients' stated goals to determine treatment strategies in neuropsy-chological treatment programs is widely accepted in principle, in practice such "holistic" programs often lack the sensitivity or ability to achieve this. This issue becomes acute as the patients' cognitive deficits interact with goal setting process. Treatment designed predominantly from the professional's perspective can be reviewed by the consumer as irrelevant with resultant poor treatment compliance and premature termination of services.
Value-Driven Cognitive Rehabilitation (VCDR) is a proposed clinical intervention which is hypothesized to improve cognitive remediation programs by allowing for a systematic incorporation of... more
Investigators: Carnevale G, Johnston M view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
The Effect of Aricept® in Persons with Persistent Memory Disorder Following Traumatic Brain Injury: A Pilot Study.
Abstract: PRIMARY OBJECTIVE: To investigate effectiveness of donepezil hydrochloride (Aricept®) in treating persistent memory deficits in persons with traumatic brain injury.

RESEARCH DESIGN: Single subject ABAC design was used so that each participant could serve as their own control.

METHODS AND PROCEDURES: Seven TBI survivors with persistent memory dysfunction, at least 1 ½ years post-injury, underwent two, six-month trials of Aricept®. The following tests were used to assess memory and cognition: Brief Visual Memory Test-Revised (BVMT-R), Hopkins Verbal Learning Test, Digit Span and Letter Number Sequence subtest of the Wechsler Adult Intelligence Scale-III, Controlled Oral Word Association Test, and Memory Functioning... more
Investigators: Cilo M, Morey C, Berry J, Cusick C view full
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Lead Center: Craig Hospital
Modafinil for the Treatment of Fatigue and Excessive Daytime Sleepiness in Individuals with Traumatic Brain Injury
Abstract: It is estimated that there are 5.3 million Americans living with a traumatic brain injury (TBI) related disability today. Fatigue and excessive daytime sleepiness appear to be common problems reported by individuals who have sustained TBI. These symptoms have a detrimental effect on all aspects of a person.s daily life. Modafinil is an FDA-approved wakefulness promoting agent for individuals with excessive daytime sleepiness associated with narcolepsy. It has also been found to be effective in reducing fatigue and sleepiness in persons with multiple sclerosis, fibromyalgia, Parkinson.s disease and depression. Some evidence suggests that if Modafinil is effective in reducing fatigue and sleepiness that this may lead to improved... more
Investigators: Weintraub A, Harrison-Felix C, Morey C, Jha A, Whiteneck G view full
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Lead Center: Craig Hospital
Evaluation of the Home and Community-based Services Brain Injury Medicaid Waiver Program in Colorado
Abstract: Primary Objectives: To evaluate ColoradoÂ’s Traumatic Brain Injury (TBI) Waiver program in terms of functional, community integration, and other key psychosocial outcomes.

Research Design: Results of telephone surveys of 66 TBI survivors who had received services through the Colorado Medicaid program were compared with those of a matched sample not receiving such services.

Methods and Procedures: Participants were identified by ColoradoÂ’s Medicaid program, and a control group was randomly selected from the population-based Colorado Traumatic Brain Injury Registry and Follow-up System. Groups were matched on Glasgow Coma Scale score at injury, age, gender, whether inpatient rehabilitation had been received, and the number of years... more
Investigators: Gerhart K, Cusick C, Mellick D, Breese P, Towle V, Whiteneck G view full
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Lead Center: Craig Hospital
Neuromedical complications of persons treated in the traumatic brain injury model systems programs
Abstract: This study aims to document the neuromedical complications and associated injuries of persons treated in the traumatic brain injury model systems programs. Several developments have occurred since the publication of Bontke et al’s paper on the similar topic in 1993, among them: 1) Increase in the number of model systems; 2) Further streamlining of emergency medical services; 3) Publication of the “Guidelines for the Management of Severe Head Injury” by the AANS; 4) Changes in managed care reflected by shorter length of stay in acute and rehabilitation hospitals; and 5) Use of new therapies for various neurologic and behavioral sequela of TBI Thus, it is likely that there will be a change in the incidence of complications previously... more
Investigators: view full
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Lead Center: The Institute for Rehabilitation and Research
Mortality and Life Expectancy After TBI Rehabilitation
Abstract: Abstract from Project Phase I - Objective: To investigate mortality, life expectancy, risk factors for death, and causes of death in individuals with traumatic brain injury (TBI). Methods: Retrospective cohort study utilizing data from the TBI Model Systems National Database, the Social Security Death Index and death certificates. Participants: 2,178 individuals with TBI completing inpatient rehabilitation in one of 15 National Institute on Disability and Rehabilitation Research-funded TBI Model Systems of care between 1988 and 2001. Results: Individuals with TBI were twice as likely to die compared to individuals in the general population of similar age, gender and race, resulting in an estimated average life expectancy reduction of 7... more
Investigators: Harrison-Felix C, Whiteneck G, Devivo M, Hammond F, Jha A view full
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Lead Center: Craig Hospital
Collaborating Centers: Carolinas Rehabilitation, Emory University/Shepherd Center, Mayo Medical Center, Ohio State University, University of Alabama, Oregon Health Sciences University, University of Missouri, Moss Rehabilitation Research Institute, Rehabilitation Institute of Michigan, Spaulding Rehabilitation Hospital, Virginia Commonwealth University/Medical College of Virginia, Santa Clara Valley Medical Center, University of Washington
Changes in gait and oxygen consumption after Botox for unilateral spasticity for individuals with traumatic or acquired brain injury
Abstract: Limited evidence is available regarding the quantitative effects of Botox® on energy expenditure as measured by oxygen consumption during functional gait. The purpose of this study is to measure metabolic energy expenditures and determine its relationship to the changes in spasticity and gait after botulinum toxin type A. Dynamic EMG will be used to quantify muscle over activity, direct therapy and assess efficacy of treatment. Oxygen consumption will be measured using a portable metabolic system. Other measures to be used to assess spasticity will be the pendulum drop test when quadriceps hyperactivity is present and the standard clinical modified Ashworth score. Gait will be measured using a 3D motion analysis system, resulting... more
Investigators: Elovic E, Beng J, Bond Q view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
The Effect of Modafinil on brain injury related fatigue: A double-blind, crossover study
Abstract: Objectives: The studies objectives are to evaluate the prevalence of fatigue in the outpatient brain injury rehabilitation population and to assess the efficacy of modafinil in treating brain injury related fatigue.
Hypothesis: Fatigue will be identified in over 50% of patients who have traumatic injury and are attending an outpatient cognitive rehabilitation program as measured by subjective reporting measures. In addition there will be an improvement demonstrated on both subjective and objective measures of fatigue when these subjects are given modafinil (Provigil?), but not be seen when they are on placebo. This improvement in fatigue will be independent of any effect on mood. In addition there will be correlation between subjective... more
Investigators: Elovic E, Carnevale G, Fellus J, DeLuca J, Averill A, Ricker J, Millis S view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
The Structure of functional and community outcomes following TBI
Abstract: Objectives: To identify the dimensionality of outcomes following serious TBI. To determine whether outcomes are highly multidimensional, or not. To determine which items fit which dimension, what items are redundant, and what items do not “fit”. To determine whether there are anomalous cases of TBI whose outcome cannot be measured using usual methods.

Design: One year follow up data from the National TBI Model Systems database were analyzed. We selected all items indicative of global outcomes, social activities, disability, and handicap or community participation (excluding items indicating highly specific neuropsychological or medical impairment). Data were analyzed using Rasch analysis (WinSteps), an advanced form of... more
Investigators: Johnston M, Shawaryn M, Malec J, Hammond F, Kreutzer J view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
Coordinated and adequately funded state streams for rehabilitation of newly injured persons with TBI
Abstract: Traumatic brain injury (TBI) rates are highest among families with the lowest income levels. A paucity of appropriate funding streams for low-income, recently injured TBI patients is reported to cause delays in provision of early postacute rehabilitation or to cause patients to be discharged without receiving rehabilitation. There are also reports of patients remaining in hospitals with minimal care or being returned home, both because of a lack of a discharge site. The purposes of this exploratory study were to: (1) identify model aspects of existing publicly supported and administered programs for postacute individuals with TBI; (2) present results of a survey measuring to what extent state Medicaid programs fund postacute... more
Investigators: Page S, Reynolds W, Johnston M view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
Factors affecting changes in substance use following TBI
Abstract: The National Head Injury Foundation Task Force concluded in a 1988 summary report that substance abuse is a major etiological factor in 50%-70% of persons who sustain a traumatic brain injury (TBI). It has also been found that the effects of substance abuse on cognition can potentially compromise the recovery and rehabilitation as well as reintegration into family, work, and community of nearly two-thirds of TBI survivors. Some research has found that individuals who abuse substances after TBI are usually abusers prior to injury although the extent of abuse generally declines after injury to a level equal to age cohorts. A more recent study found that there was an increase in quantity and frequency of use over time. Other research has... more
Investigators: Johnston M, Galski T, Cernich A, Alverzo J, Wood K view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
Relationship of financial resources to rehabilitative treatments and outcomes following TBI
Abstract: Changes in the organization of health care have heightened issues of the cost of rehabilitative care, and their relationships to quality and outcomes to persons served. The provider-dominated system of the past has given way to increased initiative and dominance of payers. Managed care companies frequently enter into risk sharing or other contractual arrangements with rehabilitation programs to which they refer selected individuals. Capitated payment systems entail powerful incentives to deliver less care to persons with disabilities and chronic conditions, who are actuarially likely to require much more care than the average enrollee. Managed care and government cutbacks have decimated rehabilitation in some parts of the country... more
Investigators: Johnston M, Wood K, Collins B, Sebolski M view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
A trial of neuropsychological rehabilitation in mild & moderate TBI
Abstract: Persisting affective, somatic, cognitive and sensory symptoms are often reported by a significant subset of people who sustain mild or moderate TBI. Objective neuropsychological impairments have been documented in survivors of mild and moderate traumatic brain injuries. These difficulties result in substantial handicap, as people are unable to sustain employment or meet demands of daily living.
Integrated neuropsychological rehabilitation programs that address subjective symptoms, objective neuropsychological deficits, and general functional disability following brain injury have been developed across the nation over the last 15 years. Many of these programs integrate cognitive remediation techniques with psychotherapeutic treatment... more
Investigators: Tiersky L, Anselmi E, Carnevale G, DeLuca J, Johnston M view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
Natural setting behavior management: an alternative approach to community stabilization following TBI
Abstract: Many people with moderate and severe TBI continue to display significant cognitive and behavioral disruption following acute medical care and formal rehabilitation. Behavioral problems can produce adverse psychosocial, vocational and intra-familial effects that can threaten their community tenure and personal sufficiency. People who remain dependent on families or other and those who experience significant role disruption in post-injury life are especially susceptible to these effects. Research suggests that these disruptive events often occur a year or more post-injury at a time when there is no longer active involvement with rehabilitation programs and professionals who are trained to address these challenges. Caregivers rarely have... more
Investigators: Carnevale G, Anselmi E, Johnston M view full
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Lead Center: Kessler Medical Rehabilitation Research and Education Corporation
Early Interventions to Preserve Viable Employment Options
Abstract: The ability to return to a previous job has been shown to be a key predictor of job success following traumatic brain injury (TBI); however this outcome is relatively rare. Although many TBI survivors do appear to have jobs waiting for them, early intervention is crucial for their success, even if actual return to work was not planned until much later. Craig Hospital uses an intervention-consultation approach in which rehabilitation specialists provide individualized consultation to help employers and design customized work reintegration plans with gradual buildup of expectations, endurance and complexity. The study hypothesis was that a work reintegration program focusing on early intervention, a return to preinjury employment, and an... more
Investigators: McLaughlin E, Harrison-Felix C, Whiteneck G, Gerber D, Morey C, Cusick C view full
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Lead Center: Craig Hospital
A Study Of Post-TBI Fatigue
Abstract: Fatigue is associated with reduced participation in activities, reduced quality of life, health problems, and cognitive impairments in medical populations and individuals with TBI. However, little research has focused on Post-TBI Fatigue. This project will address this issue. The study is a three-year project designed to develop a betterl understanding of Post-TBI Fatigue and its correlates. Self-report data are collected from individuals with TBI and persons with no disability regarding fatigue and related (or hypothetically related) phenomena such as depression, pain, sleep problems, health problems, level of participation in activities, quality of life, and injury variables. In order to assess the nature of and measure the impact of... more
Investigators: Gordon W, Cantor J, Dijkers M, Flanagan S view full
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Lead Center: Mount Sinai School of Medicine
Genetic Factors in Outcome after Traumatic Brain Injury
Abstract: Recognized factors such as severity of the initial injury, age, or the occurrence of complications during the acute hospitalization are imperfect predictors of outcome after TBI (Jennett, Teasdale, et al. 1979; Dikmen, Temkin, et al. 1987; Dikmen, Ross, et al. 1995; Vollmer, Torner, et al. 1991). Recently, the possibility that genetic factors may influence functional outcome after TBI has been supported by the finding from several independent groups that inheritance of the APOE-e4 allele increases the risk of poor neurologic recovery (Teasdale, Nicoll, et al. 1997; Sorbi, Nacmias, et al. 1995; Friedman, Froom, et al. 1999; Jordan, Relkin, et al. 1997). Recent progress in the Human Genome Project has identified common polymorphisms in a... more
Investigators: Diaz-Arrastia R, Carlile M, Frol A, Hudak A, Harper C, Wren T, Caesar R, Booker K view full
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Lead Center: North Texas Traumatic Brain Injury Model System
Evaluation of Diffuse Axonal Injury in patients with Traumatic Brain Injury Using Diffusion Tensor Imaging
Abstract: Abstract:
Diffuse Axonal Injury (DAI) results from high velocity deceleration and shear strain and is believed to be the predominant mechanism of injury in 40 – 50% of TBIs requiring hospital admission in the US. Diffusion Tensor Magnetic Resonance Imaging (DTI) is a novel imaging technique considered to be a more reliable indicator of DAI than standard structural MRI. DAI is difficult to determine from usual CT scans and, while structural MRI scanning may add some sensitivity, current neuroimaging methods have not been associated with severity of injury or predictive of outcome. The anatomy and integrity of white matter fiber tracts can be determined non-invasively with DTI, providing new information about brain networks and... more
Investigators: Diaz-Arrastia R, Hudak A, Carlile M view full
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Lead Center: North Texas Traumatic Brain Injury Model System
Brain injury severity as measured by the Glasgow Coma Scale & its influence on outcome as measured by Disability Rating Scale at acute rehabilitation discharge and long term follow-up after severe TBI
Abstract: This study will compare outcomes among those with severe injuries to determine how they differ at discharge from rehabilitation and at 1, 5 and 10 years after injury. The data from the model system national database will be reviewed to determine how the patterns and ultimate recovery differ by Glasgow Coma Scale (GCS) score. Severity of injury will be measured by GCS scores in the emergency room. Outcome will be measured by the Disability Rating Scale (DRS).... more
Investigators: Burke D, Hammond F, Rosenthal M, Glenn M, Meythaler J, Jacob L view full
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Lead Center: Spaulding Rehabilitation Hospital
Collaborating Centers: Carolinas Rehabilitation, University of Alabama
A Multicenter Prospective Randomized Controlled Trial of the Effectiveness of Amantadine Hydrochloride in Promoting Recovery of Function Following Severe Traumatic Brain Injury
Abstract: Severe traumatic brain injury may result in severe disorders of consciousness (DOC), including coma, the vegetative state (VS) and the minimally conscious state (MCS). The longer the duration of impaired consciousness, the worse the ultimate functional prognosis, with only about half of those individuals who remain unconscious for a month post-TBI regaining consciousness within a year. The severe functional disability associated with prolonged DOC places enormous emotional, financial, ethical, and logistical strains on caregivers and major resource demands on society. Numerous treatments have been recommended to hasten the return of consciousness or improve the ultimate level of recovery, including various psychotropic drugs, "coma... more
Investigators: Giacino J, Whyte J, Kalmar K, Yablon S, Sherer M, Bagiella E, Murathe S, Singh V, Long D, Murphy E, Merges B, Eifert B, Mauer P, Katz D, Edelstein M, Novak P, Wright L, Van Wie S, Childs N, Mercer W view full
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Lead Center: JFK Johnson Rehabilitation Institute
Collaborating Centers: Moss Rehabilitation Research Institute, Methodist Rehabilitation Center


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