Findings have implications for wounded military personnel and others with traumatic brain injury

Toronto (Dec. 18, 2008) - A wealth of groundbreaking research on traumatic brain injury has been showcased in one of the world's most highly respected rehabilitation journals. The Archives of Physical Medicine and Rehabilitation devoted an entire edition in December 2008 to research conducted by Toronto Rehabilitation Institute scientist Dr. Robin Green and colleagues.

The seminal work offers new insights into traumatic brain injury (TBI), a leading cause of death and disability. TBI can have devastating consequences that range from an inability to think clearly, pay attention and retain information to problems with mood and personality.

"There are very concrete clinical implications to all the research," says Dr. Green, guest editor of the special supplement, head of the Cognitive Neurorehabilitation Sciences lab at Toronto Rehab and leader of the Social and Cognitive Sciences field of the Graduate Department of Rehabilitation Sciences at the University of Toronto.

Military personnel who are sustaining brain injuries in Iraq and Afghanistan are among those who stand to benefit from the findings reported here, Dr. Green notes. "There is increased awareness of and concern about traumatic brain injury due to the large number of such injuries being sustained by soldiers in Iraq and Afghanistan. Some of our findings are highly relevant to those individuals."

For example, one study shows the inadequacies of conventional diagnostic approaches for people with the milder, yet still debilitating, brain injuries of the kind many soldiers are sustaining. Another study reports on the development of a psychological treatment for people with brain injury and psychological distress.

In all, there are 11 papers in the publication, including studies on the mechanisms of recovery following TBI and new diagnostic and treatment approaches. Some of the topics:

  • a "Cognitive-Behaviour Therapy" treatment that can be delivered by telephone
  • the clinical and economic consequences of sustaining a TBI along with a spinal cord injury
  • long–term outcomes of TBI, including deterioration in some cases
  • risk factors for poor outcomes, such as not getting back to productive activities
  • One consistent theme relates to the value of stimulating the brain to improve recovery.

"The upshot of these findings may be that you've got to keep your brain stimulated on an ongoing basis after brain injury," says Dr. Green, a clinical neuropsychologist. "This means doing exactly the opposite of what many people feel like doing, which is withdrawing."

At Toronto Rehab, these findings are already having an impact in the clinic, where patients are encouraged to get "as much stimulation as possible" in a study Dr. Green is leading on intensification of therapy. The results will show, for instance, what happens when therapy hours are doubled — and whether the benefits of extra stimulation to the brain are permanent or whether stimulation must be continued to keep up the benefit.

Says Dr. Green: "The ultimate goal is to improve people's functioning in the world. Some of the interventions that come from our research are going to do just that."

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