Insights into the Long-Term Effects of Traumatic Brain Injury

Doctors are beginning to get answers to the question that every parent whose child has had a TBI wants to know: What will my child be like 10 years from now?

More than 630,000 children and teenagers in the United States are treated in emergency rooms for traumatic brain injury (TBI) each year. Doctors are beginning to get answers to the question that every parent whose child has had a TBI wants to know: What will my child be like 10 years from now?

In a study to be presented at the annual meeting of the Association of Academic Physiatrists in Las Vegas, researchers from Cincinnati Children's will present research on long-term effects of TBI - an average of seven years after injury.

Head Injury | Brain Injury Overview Types Causes Symptoms Diagnosis Treatment
Head injury or traumatic brain injury is a leading cause of disability among children and young adults that leads to varying degrees of physical and mental stability. Fortunately, it is also one of the preventable brain disorder.

‘Patients with mild to moderate brain injuries are two times more likely to have developed attention problems, and those with severe injuries are five times more likely to develop secondary ADHD.’

Patients with mild to moderate brain injuries are two times more likely to have developed attention problems, and those with severe injuries are five times more likely to develop secondary ADHD. These researchers are also finding that the family environment influences the development of these attention problems.

- Parenting and the home environment exert a powerful influence on recovery. Children with severe TBI in optimal environments may show few effects of their injuries while children with milder injuries from disadvantaged or chaotic homes often demonstrate persistent problems.
- Early family response may be particularly important for long-term outcomes suggesting that working to promote effective parenting may be an important early intervention.
- Certain skills that can affect social functioning, such as speed of information processing, inhibition, and reasoning, show greater long-term effects.
- Many children do very well long-term after brain injury and most do not have across the board deficits.

But predictors of recovery following TBI, particularly the roles of genes and environment, are unclear. These environmental factors include family functioning, parenting practices, home environment, and socioeconomic status. Researchers at Cincinnati Children's are working to identify genes important to recovery after TBI and understand how these genes may interact with environmental factors to influence recovery.

GFAP, UCH-L1 Biomarkers are Not Reliable for Diagnosing Mild Traumatic Brain Injury
In patients who suffered mild traumatic brain injury (mTBI), two proposed biomarkers were unable to distinguish between patients who did or did not have mTBI.

- They will be collecting salivary DNA samples from more than 330 children participating in the Approaches and Decisions in Acute Pediatric TBI Trial.
- The primary outcome will be global functioning at three, six, and 12 months post injury, and secondary outcomes will include a comprehensive assessment of cognitive and behavioral functioning at 12 months post injury.
- This project will provide information to inform individualized prognosis and treatment plans.

Using neuroimaging and other technologies, scientists are also learning more about brain structure and connectivity related to persistent symptoms after TBI. In a not-yet-published Cincinnati Children's study, for example, researchers investigated the structural connectivity of brain networks following aerobic training. The recovery of structural connectivity they discovered suggests that aerobic training may lead to improvement in symptoms.

Geneticist Explores Lessons About Traumatic Brain Injury
Facing news of brain damage and suicides in former professional football players, geneticist Barry Ganetzky bemoaned the lack of model systems for studying the insidious and often delayed consequences linked to brain injuries.

Over the past two decades, investigators at Cincinnati Children's have conducted a series of studies to develop and test interventions to improve cognitive and behavioral outcomes following pediatric brain injury. They developed an innovative web-based program that provides family-centered training in problem-solving, communication, and self-regulation.

- Across a series of randomized trials, online family problem-solving treatment has been shown to reduce behavior problems and executive dysfunction (management of cognitive processes) in older children with TBI, and over the longer-term improved everyday functioning in 12-17 year olds.
- Web-based parenting skills programs targeting younger children have resulted in improved parent-child interactions and reduced behavior problems. In a computerized pilot trial of attention and memory, children had improvements in sustained attention and parent-reported executive function behaviors. These intervention studies suggest several avenues for working to improve short- and long-term recovery following TBI.

Potential Targets for Preventing Long-term Effects of Traumatic Brain Injury Identified
Potential approach for preventing the development of neurological problems associated with traumatic brain injury (TBI) has been discovered by University of Iowa researchers.

Source-Eurekalert