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NBIRTT is currently supporting the updating of the Luria Neuropsychological Evaluation test.
The work on updating the Luria is being led by Professor Anne-Lise Christensen of Demark with
the support of an international team. The Luria is a bedside assessment tool used at the acute stages
of brain injury recovery. The revised Luria will be published in 2004. NBIRTT is supporting the
development of an instrument to measure quality of life following brain injury. Currently nothing
specific for brain injury exists. The new QOL tool is being developed by an international group
chaired by Jean-Luc Truelle of the Foch Institute in Paris, he is being assisted by Eddie
Neugabuer, PhD of Germany. Klaus von Wild.MD of Germany, Jess Kraus PhD, of the USA, Anne Lise
Christensen, PhD of Demark, Andres Maas,MD of the Netherlands, Claudio Perrino, MD of Italy,
Jane Powell, PhD of The United Kingdom, George Zitnay, PhD of the USA and others. The QOLBRI
as it is called is culturally sensitive and is being translated into German, Italian, Russian,
French, Danish, and Spanish. The QOLBRI is being field tested in 2003 and will be published and
ready for use in 2004.
Future plans
NBIRTT will be sponsoring in collaboration with the World Health Organization an international
forum on Violence and Neurotrauma. Violence is increasingly becoming a cause of traumatic brain
injury. NBIRTT will focus on stem cell research over the next five years with the goal of finding
a "cure" for some forms of brain injury. Currently NBIRTT is planning a two day SUMMIT ON STEM
CELL RESEARCH and BRAIN INJURY.
For the next 5 years, the Foundation is focusing its resources on the development of a 'Manhattan-Like
Project in Stem Cell Research and Brain Injury'. The foundation will be working with leading scientists
from around the world to coordinate an international effort to develop a means to repair damaged brain cells.
The following research is available from NBIRTT. Please complete this form.
A Randomized Within Dose Escalation Study to Determine the Safety of D-cycloserine in Patients with TBI
University of Florida
Ron Hayes, Ph.D.
Cognitive impairments are a prominent and debilitating consequence of traumatic brain injury (TBI). These impairments
prevent the person with a brain injury from returning to a productive lifestyle, often make them dependent on others
to perform daily activities and considerably reduce the quality of their lives and that of their families.
There are data strongly suggesting that enhancement of neurotransmitter function could substantially
improve cognitive function following TBI. Moreover, currently available drugs, widely prescribed in other
contexts, could potentially be useful in treating cognitive deficits in TBI patients. The purpose of the current
proposal is to assess tolerance of a drug (D-cycloserine) that enhances glutamineric function. These data
would lay the necessary foundation for subsequent grant submission to the National Institutes of
Health and/or the Veteran's Administration to support a multicenter, randomized prospective clinical
trial. Equally important, this research would lay the infrastructure for future studies
examining interactions between pharmacological and behaviorally based therapies to treat cognitive deficits.
Treatment of Chronic Executive Deficits with AMH Following Pediatric Head Trauma
University of Pittsburgh Medical Center
Sue R. Beers, Ph.D.
The neurobehavioral sequelae of traumatic brain injury, or TBI, (e.g., poor working memory,
difficulty in allocation of attention, depression) suggest the presence of executive deficits that
are consistent with trauma commonly affecting the frontal brain regions. Treatment with amantadinehydrochloride (AMH),
a dopamine agonist, improves behavioral symptoms and executive function in adults after brain injury. The goal of this
clinical study is to evaluate the safety and efficacy of AMH in treatment of children who have experienced TBI. In addition
to demonstrating the safety and efficacy of AMH, the study expects to identify complex interactions among injury and
treatment-related variables (age at injury, age at treatment, medication status, and injury severity).
Neuroradiologic Evaluation of the Adult Patient with Acute Mild Traumatic Brain Injury
International Brain Injury Association
Andrew Jagoda, MD - Mt. Sinai School of Medicine
In the United States, it is estimated that 444 per 100,000 persons are treated annually for traumatic brain injury (TBI)
in emergency departments (EDs); this is approximately 1.1% of all ED visits. In contrast, an estimated 98 per 100,000 persons are
hospitalized each year for TBI. The majority of patients presented to the ED with TBI have minor injuries and are discharged
directly from the ED thus explaining the difference between the number of patients seen in the ED and the number of patients actually
hospitalized.
Successful evidence-based guideline development is dependent on identifying a specific patient population of interest and asking well
defined, focused questions. For the purpose of this Practice Guideline, MTBI will be defined using the following criteria:
- Blunt trauma to the head within 24 hours of presentation to the ED
- A period of post-traumatic loss of consciousness or post-traumatic amnesia
- A Glasgow Coma Scale score in the ED of 15
- A nonfocal neurologic examination
This project will consist of searching the English language scientific literature, followed by a review by qualified professionals
utilizing recognized methodology adopted by the American Medical Association to establish scientifically based practice guidelines for
the neuroradiologic evaluation of adult patients with acute mild traumatic brain injury.
Bowel Management Program in Patients with ABI
Virginia Commonwealth University
Amy Foxx-Orenstein, MD
Fecal incontinence is often mis-diagnosed as diarrhea, though in reality it occurs because continence mechanisms
are overwhelmed and the ability to store material and selectively release gas or solid material is lost. While incontinence
in the general population is often under-diagnosed, incontinence in the brain injured patient is recognized early and addressed
by placing patients on a standard bowel management regime. In the general population, once treatable causes of incontinence are
determined, focused therapies such as retraining of pelvic floor function and institution of a comprehensive bowel management
program have been successful in normalizing bowel frequency, maintaining continence and restoring independence. A similar
approach to regaining control in the brain injured patient has not been studied, and it is not known whether this type of
re-education program will be beneficial for those with mixed degrees of cognitive, sensory and motor deficits due to brain
injury. The aims of this study are to determine the incidence and causes of fecal incontinence in the acquired brain injury (ABI)
population and evaluate the effectiveness of a comprehensive bowel management program in patients with ABI.
Urinary Incontinence and Moderate to Severe Traumatic Brain Injury: Improved Assessment and Intervention
University of Virginia
Jeffrey T. Barth, Ph.D.
Incontinence is a prevalent complication in moderate to severe TBI with ramifications for physical and psychosocial functioning,
as well as caregiver and financial burden. To our knowledge, this is the first proposal that is directly related to developing a treatment
plan specific to a patient's difficulties with urinary incontinence. By the end of the first project year, we will have a working assessment
and treatment model for direct application to individuals with moderate to severe TBI. For the proposed second year of the project,
we will initiate an intervention program for UI at a larger (250 patients) TBI treatment site. Based on this empirical data, general
treatment protocols will be given to the families, primary care physicians and other treatment/caregivers of patients with moderate to
severe TBI.
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