Traumatic Brain Injury Findings Research Articles

Imaging Findings in Acute Traumatic Brain Injury: a National Institute of Neurological Disorders and Stroke Common Data Element-Based Pictorial Review and Analysis of Over 4000 Admission Brain Computed Tomography Scans from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study.

In 2010, the National Institute of Neurological Disorders and Stroke (NINDS) created a set of common data elements (CDEs) to help standardize the assessment and reporting of imaging findings in traumatic brain injury (TBI). However, as opposed to other standardized radiology reporting systems, a visual overview and data to support the proposed standardized lexicon are lacking. We used over 4000 admission computed tomography (CT) scans of patients with TBI from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study to develop an extensive pictorial overview of the NINDS TBI CDEs, with visual examples and background information on individual pathoanatomical lesion types, up to the level of supplemental and emerging information (e.g., location and estimated volumes). We documented the frequency of lesion occurrence, aiming to quantify the relative importance of different CDEs for characterizing TBI, and performed a critical appraisal of our experience with the intent to inform updating of the CDEs. In addition, we investigated the co-occurrence and clustering of lesion types and the distribution of six CT classification systems. The median age of the 4087 patients in our dataset was 50 years (interquartile range, 29-66; range, 0-96), including 238 patients under 18 years old (5.8%). Traumatic subarachnoid hemorrhage (45.3%), skull fractures (37.4%), contusions (31.3%), and acute subdural hematoma (28.9%) were the most frequently occurring CT findings in acute TBI. The ranking of these lesions was the same in patients with mild TBI (baseline Glasgow Coma Scale [GCS] score 13-15) compared with those with moderate-severe TBI (baseline GCS score 3-12), but the frequency of occurrence was up to three times higher in moderate-severe TBI. In most TBI patients with CT abnormalities, there was co-occurrence and clustering of different lesion types, with significant differences between mild and moderate-severe TBI patients. More specifically, lesion patterns were more complex in moderate-severe TBI patients, with more co-existing lesions and more frequent signs of mass effect. These patients also had higher and more heterogeneous CT score distributions, associated with worse predicted outcomes. The critical appraisal of the NINDS CDEs was highly positive, but revealed that full assessment can be time consuming, that some CDEs had very low frequencies, and identified a few redundancies and ambiguity in some definitions. Whilst primarily developed for research, implementation of CDE templates for use in clinical practice is advocated, but this will require development of an abbreviated version. In conclusion, with this study, we provide an educational resource for clinicians and researchers to help assess, characterize, and report the vast and complex spectrum of imaging findings in patients with TBI. Our data provides a comprehensive overview of the contemporary landscape of TBI imaging pathology in Europe, and the findings can serve as empirical evidence for updating the current NINDS radiologic CDEs to version 3.0.

The Role of Neuroplasticity in the Neuro-Optometric Rehabilitation of Traumatic Brain Injury

Athletic communities have begun to take pre­ cautions to mitigate traumatic brain injury, such as using protective gear, increasing medical oversight, and establishing better return­to­play rules to protect athletes. As awareness increases, there will be a correspondingly higher frequency of people with traumatic brain injury seeking neuro­optometric evaluation and treatment. Therefore, it is imperative for optometrists to understand the signs, symptoms, and treatment of associated visual sequelae of traumatic brain injury. There are many optometric conditions caused by traumatic brain injury, including, but not limited to: convergence insufficiency, accommodative insufficiency, oculomotor dys­ function, visual motion sensitivity and light sensitivity. In particular, the functional vision problems associated with traumatic brain injury can be addressed with neuro­-optometric rehabilitation therapy. They are often due to diffuse axonal injury throughout the brain caused by shearing and tearing of the axons. People with diffuse axonal injury tend to have slower processing speeds due to impaired function at the synapse and longer neuronal pathways. Neuro­-optometric rehabilitation therapy creates an environment to facilitate neuroplastic changes within the brain, such as axonal sprouting or dendritic plasticity. This article explores possible correlation between improved clinical findings in traumatic brain injury after neuro­ optometric rehabilitation therapy and increased neurophysiological changes in brain activity after vision therapy for convergence insufficiency.

The Utility of Brain CT in Highlighting the Etiological Patterns and Incidental Findings of Traumatic Brain Injury

Aim: To find the utility of brain CT in highlighting the etiological patterns and incidental findings of traumatic brain injury. Methods: From January 2022 to March 2022, 110 patients presenting to emergency department of Pakistan Institute of Neurosciences with brain traumatic injury was present in this study. Patients go through long clinical evaluation and computed tomography on every trauma criteria. Results: The most affected age (group) was 30 to 42 years (37.05%) male (78.2%) to female (21.8%) ratio was 8:2. Injuries were predominantly caused by RTA (72.7%), less commonly caused by fall (11.8%), pedestrial (6.4%), assault (5.5%), and sports (3.6%). Among those with RTA less than 6% people was wearing helmet. The common CT scan evaluation was brain contusion (35%), fracture (13%), Edema (13%), SDH (10%), EDH (8%), SAH (4%), pneumocephalus (5%) and others (3%). Prediction of true prevalence of incidental findings is tough. In this study, we found that enlarged cisterna magna (3.6%) and calcification (3.6%) were the common incidental (findings), and brain tumor (0.9%) and hydrocephalus (0.9%). Conclusion: Road traffic accidents (RTA) are a major cause of TBI. This can be avoided by wearing helmet, but it is less used. Moreover, there is a proper need to put strict system amongst hospitals citywide to lessen the effects of severe TBI. At last every person had to check up on themselves for any minor physical or mental change. Keywords: Traumatic Brain Injury, CT scan, Etiological patterns, Incidental findings.

Electroencephalography Findings in Traumatic Brain Injury

Traumatic Brain Injury (TBI) or also known as a head injury is one of the leading causes of death among young people and is also one of the health problems defined as impact, penetration, and rapid movement of the brain within the skull that can result in changes in mental status and is often referred to as the silent epidemic. Head injuries can also result in electrophysiological abnormalities seen on electroencephalography (EEG) recordings. Electroencephalography was the first clinical neurodiagnostic assessment to reveal abnormal brain function after a head injury. For detecting brain injury, EEG may be more sensitive than clinical neurologic examination. In general conditions, electroencephalography is performed on patients with moderate to severe head injuries to provide information about the severity of the head injury, and establish a diagnosis of non-convulsive status epilepticus. This diagnosis often follows head injuries because patients with loss of consciousness are difficult to identify without an EEG examination. This also helps determine a prognosis for recovery and the likelihood of post-traumatic seizures. Electroencephalography features in head injuries depend on the severity of the injury and the location of the head itself. Electroencephalography after head injury shows slowing of the posterior dominant rhythm and increasing diffuse theta slowing, which returns to normal within hours or may subside more slowly over several weeks. Electroencephalography changes are not the same in each individual, due to differences in the severity of head injuries. It is important to know that there is no clear or specific EEG for mild traumatic brain injury.

Magnetic Resonance Spectroscopy of Traumatic Brain Injury and Subconcussive Hits: A Systematic Review and Meta-Analysis.

Magnetic resonance spectroscopy (MRS) is a non-invasive technique used to study metabolites in the brain. MRS findings in traumatic brain injury (TBI) and subconcussive hit literature have been mixed. The most common observation is a decrease in N-acetyl-aspartate (NAA), traditionally considered a marker of neuronal integrity. Other metabolites, however, such as creatine (Cr), choline (Cho), glutamate+glutamine (Glx) and myo-inositol (mI) have shown inconsistent changes in these populations. The objective of this systematic review and meta-analysis was to synthesize MRS literature in brain injury and explore factors (biological factors such as brain region, injury severity, time since injury, demographics and technical methodological factors such as field strength, acquisition parameters, analysis approach) that may contribute to differential findings. One hundred and thirty-eight studies met inclusion criteria for the systematic review and of those, 62 NAA, 24 Cr, 49 Cho, 18 Glx, and 21 mI studies met inclusion criteria for meta-analysis. A random effects model was used for meta-analyses with brain region as a subgroup for each of the five metabolites studied. Meta-regression was used to examine the influence of potential moderators including injury severity, time since injury, age, sex, tissue composition, and methodological factors. In this analysis of 1428 unique brain-injured subjects and 1132 controls, the corpus callosum was identified as a brain region highly susceptible to metabolite alteration. NAA was consistently decreased in TBI of all severities, but not in subconcussive hits. Cho and mI were found to be increased in moderate-to-severe TBI but not in mild TBI. Glx and Cr were largely unaffected, but did show alterations in certain conditions.

Computed Tomography Findings of Traumatic Brain Injury in Patients with Head Trauma Presenting at the Tamale Teaching Hospital, Ghana

Purpose: The purpose of this study is to report computed tomography (CT) findings of traumatic brain injury (TBI) in patients who underwent head CT at the Tamale Teaching Hospital (TTH) due to head trauma.

Cross-sectional imaging of head trauma: a retrospective analysis of the incidence, and imaging findings of traumatic brain injury in King Fahad Hospital, Al-Ahsa, Saudi Arabia

Cross-sectional imaging of head trauma: a retrospective analysis of the incidence, and imaging findings of traumatic brain injury in King Fahad Hospital, Al-Ahsa, Saudi Arabia

Correlation between optic nerve sheath diameter and Rotterdam computer tomography scoring in pediatric brain injury.

Pediatric head trauma is the most common presentation to emergency departments. Increased intracranial pressure (ICP) may lead to secondary brain damage in head trauma and early diagnosis of increased ICP is very important. Measurement of optic nerve sheath diameter (ONSD) is a method that can be used for determining increased ICP. In this study, we aimed to evaluate the relationship between optic nerve sheath diameter (ONSD) and Rotterdam computer tomography scores (RCTS) in pediatric patients for severe head trauma. During January 2017-April 2018, medical records and imaging findings of children aged 0-18 years who underwent computed tomography (CT) imaging for head trauma (n=401) and non-traumatic (convulsions, respiratory disorders, headache) (n=255) complaints, totally 656 patient were evaluated retrospectively. Patients' age, sex, presentation and trauma type (high energy-low energy) were identified. Non-traumatic patients with normal cranial CT findings were considered as the control group. CT findings of traumatic brain injury were scored according to Rotterdam criteria. Patients were divided into groups according to their age as follows: 0-3 years, 3-6 years, 6-12 years and 12-18 years. In our study, tomographic reference measurements of the ONSD in pediatric cases were presented according to age. There was a statistically significant difference between ONSD of severe traumatic patients and the control group. Correlation between RCTS and ONSD was determined and age-specific cut-off values of ONSD for severe traumatic scores (score 4-5-6) were presented. In our study, reference ONSDs of the pediatric population for CT imaging was indicated. Our study also showed that ONSD measurement is a parameter that can be used in addition to the RCTS to determine the prognosis of the patient in severe head trauma, by reflecting increased intracranial pressure.

Ubiquitin C-Terminal Hydrolase-L1 (UCH-L1) in Prediction of Computed Tomography Findings in Traumatic Brain Injury; a Meta-Analysis.

Ubiquitin C-terminal hydrolase-L1 (UCH-L1) is one of the promising candidates, with an acceptable diagnostic value for predicting head computed tomography (CT) scan findings. However, there has been a controversy between studies and still, there is no general overview on this. Therefore, the current systematic review and meta-analysis attempted to estimate the value of UCH-L1 in predicting intracranial lesions in traumatic brain injury. Two independent reviewers screened records from the search of four databases Medline, Embase, Scopus and Web of Science. The data were analyzed in the STATA 14.0 statistical program and the findings were reported as a standardized mean difference (SMD), summary receiver performance characteristics curve (SROC), sensitivity, specificity, and diagnostic odds ratio with 95% confidence interval (95% CI). Finally, the data of 13 articles were entered into the meta-analysis. The mean serum level of UCH-L1 was significantly higher in patients with CT-positive than in TBI patients with CT negative (SMD = 1.67, 95% CI: 1.12 to 2.23, I2 = 98.1%; p <0.0001). The area under the SROC curve for UCH-L1 in the prediction of intracranial lesions after mild TBI was 0.83 (95% CI: 0.80 to 0.86). Sensitivity, specificity and diagnostic odds ratio of serum UCH-L1 was 0.97 (95% CI: 0.92 to 0.99), 0.40 (95% CI: 0.30 to 0.51) and 19.37 (95% CI: 7.25 to 51.75), respectively. When the analysis was limited to assessing the serum level of UCH-L1 within the first 6 hours after mild TBI, its sensitivity and specificity increased to 0.99 (95% CI: 0.94 to 1.0) and 0.44 (95% CI: 0.38 to 0.052), respectively. In addition, the diagnostic odds ratio of 6-hour serum level of UCH-L1 in the prediction of intracranial lesions was 680.87 (95% CI: 50.50 to 9197.97). Moderate level of evidence suggests that serum/plasma levels of UCH-L1 have good value in prediction of head CT findings. It was also found that evaluation of serum/plasma level of UCH-L1 within the first 6 hours following TBI would increase its predictive value. However, there is a controversy about the best cutoffs of the UCH-L1.

Traumatic brain injury: Comparison between autopsy and ante-mortem CT

PurposeThe aim of this study was to compare pathological findings after traumatic brain injury between autopsy and ante-mortem computed tomography (CT). A second aim was to identify changes in these findings between the primary posttraumatic CT and the last follow-up CT before death. MethodsThrough the collaboration between clinical radiology and forensic medicine, 45 patients with traumatic brain injury were investigated. These patients had undergone ante-mortem CT as well as autopsy. During autopsy, the brain was cut in fronto-parallel slices directly after removal without additional fixation or subsequent histology. Typical findings of traumatic brain injury were compared between autopsy and radiology. Additionally, these findings were compared between the primary CT and the last follow-up CT before death. ResultsThe comparison between autopsy and radiology revealed a high specificity (≥80%) in most of the findings. Sensitivity and positive predictive value were high (≥80%) in almost half of the findings. Sixteen patients had undergone craniotomy with subsequent follow-up CT. Thirteen conservatively treated patients had undergone a follow-up CT. Comparison between the primary CT and the last ante-mortem CT revealed marked changes in the presence and absence of findings, especially in patients with severe traumatic brain injury requiring decompression craniotomy. ConclusionThe main pathological findings of traumatic brain injury were comparable between clinical ante-mortem CT examinations and autopsy. Comparison between the primary CT after trauma and the last ante-mortem CT revealed marked changes in the findings, especially in patients with severe traumatic brain injury. Hence, clinically routine ante-mortem CT should be included in the process of autopsy interpretation.

Traumatic brain injury: An EEG point of view.

Traumatic brain injury (TBI) is a silent epidemic. Mild traumatic brain injury (mTBI) causes brain injury that results in electrophysiologic abnormalities visible on electroencephalography (EEG) recordings. The purpose of this brief review was to discuss the importance of EEG findings in traumatic brain injury. Relevant articles published during the 1996-2016 period were retrieved from Medline (PubMed). The keywords were in English and included "traumatic brain injury", "EEG" and "quantitative EEG". We found 460 articles, analyzed 52 and selected 13 articles. EEG after TBI shows slowing of the posterior dominant rhythm and increased diffuse theta slowing, which may revert to normal within hours or may clear more slowly over many weeks. There are no clear EEG or quantitative EEG (qEEG) features unique to mild traumatic brain injury. Although the literature indicates the promise of qEEG in reaching a diagnosis and indicating prognosis of mTBI, further study is needed to corroborate and refine these methods.

Unusual FDG-PET Findings in Traumatic Brain Injury; Did Traumatic Brain Injury Provoke Rapid Progression of Alzheimer's Disease?

Traumatic brain injury (TBI) is common, and is often the leading cause of disability and death. Complications after TBI include increased risk for chronic central nervous system disease, such as Alzheimer's disease (AD). However, the pathophysiology relating acute injury to neurodegeneration is unclear. Here we present a case of a patient whose cognition declined after TBI, and whose 18F fluorodeoxyglucose positron emission tomography scan showed an AD pattern.

Diffusion tensor tractography-based analysis of the cingulum: clinical utility and findings in traumatic brain injury with chronic sequels.

To evaluate the clinical utility of quantitative diffusion tensor tractography (DTT) and tractography-based core analysis (TBCA) of the cingulum by defining the reproducibility, normal values, and findings in traumatic brain injury (TBI). Eighty patients with TBI and normal routine MRI and 78 controls underwent MRI at 3T. To determine reproducibility, 12 subjects were scanned twice. Superior (SC) and inferior (IC) cingulum were analyzed separately by DTT (fractional anisotropy (FA) thresholds 0.15 and 0.30). TBCA was performed from volumes defined by tractography with gradually changed FA thresholds. FA values were correlated with clinical and neuropsychological data. The lowest coefficient of variation was obtained at DTT threshold 0.30 (2.0 and 2.4% for SC and IC, respectively), but in proportion to standard deviations of normal controls, the reproducibility of TBCA was better in SC and similar to that of DTT in IC. In patients with TBI, volume reduction with loss of peripheral fibers was relatively common; mean FA was mostly normal in these tractograms. The frequency of FA reductions (>2 SD) was in DTT smaller than in TBCA, in which FA decrease was present in 42 (13.1%) of the 320 measurements. Central FA values in SC predicted visuoperceptual ability, and those in left IC predicted cognitive speed, language, and communication ability (p < 0.05). Tractography-based measurements have sufficient reproducibility for demonstration of severe abnormalities of the cingulum. TBCA is preferential for clinical FA analysis, because it measures corresponding areas in patients and controls without inaccuracies due to trauma-induced structural changes.

Contrast-Enhanced FLAIR (Fluid-Attenuated Inversion Recovery) for Evaluating Mild Traumatic Brain Injury

PurposeTo evaluate whether adding a contrast-enhanced fluid-attenuated inversion recovery (FLAIR) sequence to routine magnetic resonance imaging (MRI) can detect additional abnormalities in the brains of symptomatic patients with mild traumatic brain injury.Materials and MethodsFifty-four patients with persistent symptoms following mild closed head injury were included in our retrospective study (M∶F = 32∶22, mean age: 59.8±16.4, age range: 26–84 years). All MRI examinations were obtained within 14 days after head trauma (mean: 3.2±4.1 days, range: 0.2–14 days). Two neuroradiologists recorded (1) the presence of traumatic brain lesions on MR images with and without contrast-enhanced FLAIR images and (2) the pattern and location of meningeal enhancement depicted on contrast-enhanced FLAIR images. The number of additional traumatic brain lesions diagnosed with contrast-enhanced FLAIR was recorded. Correlations between meningeal enhancement and clinical findings were also evaluated.ResultsTraumatic brain lesions were detected on routine image sequences in 25 patients. Three additional cases of brain abnormality were detected with the contrast-enhanced FLAIR images. Meningeal enhancement was identified on contrast-enhanced FLAIR images in 9 cases while the other routine image sequences showed no findings of traumatic brain injury. Overall, the additional contrast-enhanced FLAIR images revealed more extensive abnormalities than routine imaging in 37 cases (p<0.001). In multivariate logistic regression analysis, subdural hematoma and posttraumatic loss of consciousness showed a significant association with meningeal enhancement on contrast-enhanced FLAIR images, with odds ratios 13.068 (95% confidence interval 2.037 to 83.852), and 15.487 (95% confidence interval 2.545 to 94.228), respectively.ConclusionMeningeal enhancement on contrast-enhanced FLAIR images can help detect traumatic brain lesions as well as additional abnormalities not identified on routine unenhanced MRI. Therefore contrast-enhanced FLAIR MR imaging is recommended when a contrast MR study is indicated in a patient with a symptomatic prior closed mild head injury.

Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder

Advances in imaging technology, coupled with military personnel returning home from Iraq and Afghanistan with traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD), have increased interest in the neuropsychology and neurobiology of these two conditions. There has been a particular focus on differential diagnosis. This paper provides an overview of findings regarding the neuropsychological and neurobiological underpinnings of TBI and for PTSD. A specific focus is on assessment using neuropsychological measures and imaging techniques. Challenges associated with the assessment of individuals with one or both conditions are also discussed. Although use of neuropsychological and neuroimaging test results may assist with diagnosis and treatment planning, further work is needed to identify objective biomarkers for each condition. Such advances would be expected to facilitate differential diagnosis and implementation of best treatment practices.

Scientifically Unfounded Claims in Diagnosing and Treating Patients

Back to table of contents Previous article Next article Letter to the EditorFull AccessScientifically Unfounded Claims in Diagnosing and Treating PatientsBryon Adinoff, M.D., and Michael Devous, Ph.D.Bryon AdinoffSearch for more papers by this author, M.D., and Michael DevousSearch for more papers by this author, Ph.D.Published Online:1 May 2010https://doi.org/10.1176/appi.ajp.2010.10020157AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: We greatly appreciated the thoughtful book review by Andrew F. Leuchter, M.D. (1), published in the May 2009 issue of the Journal, on Daniel Amen's Healing the Hardware of the Soul: Enhance Your Brain to Improve Your Work, Love, and Spiritual Life (2). Dr. Amen claims that numerous psychiatric illnesses can be diagnosed and treatments prescribed based on resting single photon emission computerized tomography (SPECT) images. Dr. Leuchter correctly points out the absence of empirical data to support the claims of Dr. Amen. Several years ago, following conversations with Dr. Amen on how to address such concerns, the Brain Imaging Council of the Society of Nuclear Medicine offered Dr. Amen the opportunity to submit his analyses of a blinded set of SPECT scans (to have been prepared by the Brain Imaging Council) to determine how effective his technique is at correctly diagnosing subjects. Although this proposed study could have provided support for his approach, the offer was declined. Nevertheless, for more than two decades, Dr. Amen has persisted in using scientifically unfounded claims to diagnose and treat patients (over 45,000 by his own count).There are several dangers to patients that can accrue from this approach: 1) patients (including children) are administered a radioactive isotope without sound clinical rationale; 2) patients pursue treatments contingent upon an interpretation of a SPECT image that lacks empirical support; and 3) based on a presumed diagnosis provided by Dr. Amen's clinics, patients are guided toward treatment that may detract them from clinically sound treatments.Just as serious is the danger to our field. It is likely that, within the next decade, Dr. Amen's claims will be realized in that psychiatrists will enjoy the ability to diagnose and prescribe treatments based, in part, upon neuroimaging findings. Unfortunately, if previously led astray by unsupported claims, patients and their doctors may be less inclined to utilize scientifically proven approaches once these are shown in the peer-reviewed literature to be effective.It is therefore incumbent upon all of us to monitor and regulate our field. We encourage physicians to remain vigilant of unproven approaches practiced by our peers and to immediately report these trespasses to their state medical boards.Dallas, Tex.Dr. Adinoff has received grant/research support from the Department of Veterans Affairs, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse; he has served as a consultant to GlaxoSmithKline, the Hershewe Law Firm, Phillips Lytle (for GlaxoSmithKline), Shook, Hardy and Bacon, Simon Pissante, and Teva Pharmaceutical Industries; and he has received honoraria from the American Academy of Addiction Psychiatry, the Medical University of South Carolina, and the University of New Mexico. Dr. Devous has received research support from Alseres and AVID Radiopharmaceuticals, and he has served on the scientific advisory board of AVID Radiopharmaceuticals.References1 Leuchter AF : Healing the hardware of the soul: enhance your brain to improve your work, love, and spiritual life, by Daniel Amen (book review). Am J Psychiatry 2009; 166:625 Link, Google Scholar2 Amen D : Healing the Hardware of the Soul: Enhance Your Brain to Improve Your Work, Love, and Spiritual Life. New York, Simon and Schuster, 2008 Google Scholar FiguresReferencesCited byDetailsCited ByEthical and Legal Considerations of Alternative Neurotherapies24 March 2021 | AJOB Neuroscience, Vol. 12, No. 4International Journal of Law and Psychiatry, Vol. 65RICERCHE DI PSICOLOGIA, No. 4In Search of “Anything That Would Help”22 May 2012 | Journal of Attention Disorders, Vol. 18, No. 5The Potential for Medicolegal Abuse: Diffusion Tensor Imaging in Traumatic Brain Injury18 March 2014 | AJOB Neuroscience, Vol. 5, No. 2Triangulating perspectives on functional neuroimaging for disorders of mental health8 August 2013 | BMC Psychiatry, Vol. 13, No. 1AJOB Neuroscience, Vol. 3, No. 4Journal of Neurotrauma, Vol. 29, No. 14Journal of Neurotrauma, Vol. 29, No. 14Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder1 April 2022 | Dialogues in Clinical Neuroscience, Vol. 13, No. 3AJOB Neuroscience, Vol. 2, No. 4Response to Amen LetterBryon Adinoff, M.D., and Michael D. DevousSr., PH.D.1 September 2010 | American Journal of Psychiatry, Vol. 167, No. 9Brain SPECT Imaging in Clinical PracticeDaniel Amen, M.D.1 September 2010 | American Journal of Psychiatry, Vol. 167, No. 9 Volume 167Issue 5 May 2010Pages 598-598 Metrics PDF download History Accepted 1 March 2010 Published online 1 May 2010 Published in print 1 May 2010

Functional Neuroimaging and Cognitive Rehabilitation for People with Traumatic Brain Injury

Cognitive deficits are a common consequence of traumatic brain injury. Although such deficits are amenable to rehabilitation, methods for individualizing cognitive interventions are still unrefined. Functional neuroimaging methods such as positron emission tomography and functional magnetic resonance imaging are emerging as possible technologies for measuring and monitoring the cerebral consequences of plasticity associated with brain injury and for evaluating the effectiveness of rehabilitation interventions. Functional neuroimaging may even enable more customized and efficient selection, design, or adaptation of individual cognitive rehabilitation programs. We review the current literature on functional neuroimaging after traumatic brain injury, relating these findings to cognitive rehabilitation. Overall, functional neuroimaging after traumatic brain injury has shown reliable differences in brain activity within several regions of frontal cortex, partly but not uniformly consistent with neuropsychological and structural findings in traumatic brain injury. We also outline a number of promising research opportunities for applying functional neuroimaging in traumatic brain injury settings, along with associated challenges.