BPSD following traumatic brain injury.

Renato Anghinah,Juliana Rhein Lacerda,Fernanda Coelho,Sergio Machado,Wellingson Silva Paiva,Robson Luis Amorim,Magali Taino Schmidt,Vanessa Tomé Gonçalves Calado,Pedro Ribeiro,Bruna Velasques,Luis Fernando Hindi Basile,Fabio Rios Freire,Jéssica Natuline Ianof

doi:10.1590/s1980-57642013dn70300007

Abstract

Annually, 700,000 people are hospitalized with brain injury acquired after traumatic brain injury (TBI) in Brazil.OBJECTIVEWe aim to review the basic concepts related to TBI, and the most common Behavioral and Psychological Symptoms of Dementia (BPSD) findings in moderate and severe TBI survivors. We also discussed our strategies used to manage such patients in the post-acute period.METHODSFifteen TBI outpatients followed at the Center for Cognitive Rehabilitation Post-TBI of the Clinicas Hospital of the University of São Paulo were submitted to a neurological, neuropsychological, speech and occupational therapy evaluation, including the Mini-Mental State Examination. Rehabilitation strategies will then be developed, together with the interdisciplinary team, for each patient individually. Where necessary, the pharmacological approach will be adopted.RESULTSOur study will discuss options of pharmacologic treatment choices for cognitive, behavioral, or affective disorders following TBI, providing relevant information related to a structured cognitive rehabilitation service and certainly will offer an alternative for patients and families afflicted by TBI.CONCLUSIONTraumatic brain injury can cause a variety of potentially disabling psychiatric symptoms and syndromes. Combined behavioral and pharmacological strategies, in the treatment of a set of highly challenging behavioral problems, appears to be essential for good patient recovery.

Highlights

Brazilian data indicate that about 700,000 people suffer traumatic brain injury (TBI) annually, of whom 20 to 30% suffer moderate or severe TBI
The data suggests that 80% of those who suffer mild TBI are able to return to work, whilst
Data from animal and human studies suggest that these drugs are safe when given during rehabilitation after traumatic or ischemic brain injury

Summary

INTRODUCTION

Brazilian data indicate that about 700,000 people suffer TBI annually, of whom 20 to 30% suffer moderate or severe TBI. Schneider et al (1999) found no difference in the rate of cognitive recovery with amantadine treatment in a double-blind, placebo-controlled crossover trial of 10 subjects with moderate to severe TBI.[18] A retrospective review by Passler et al (2001) reported that patients given bromocriptine recovered faster from a vegetative state secondary to TBI.[19]. Data from animal and human studies suggest that these drugs are safe when given during rehabilitation after traumatic or ischemic brain injury It is still unclear if serotonergic medication has only immediate effects on behavior or whether they have a long-lasting effect on neuronal recovery.[14]. More research is needed to better define the role of ACh in recovery after TBI

METHODS

RESULTS

DISCUSSION