Traumatic brain injury (TBI) is a major public health problem with over 2.5 million people seeking medical care annually of which 85% suffer from mild TBI (mTBI). It is further estimated that 5.3 million Americans are living with a TBI-related disability, costing the United States over $60 billion in annual direct and indirect medical costs. mTBI constitutes a heterogeneous population for a variety of reasons, including significant variance in the severity and duration of post-injury symptoms. Although the large majority of patients with mTBI recover by one month, a measurable minority (~10-15%) experience persistent neuropsychiatric symptoms that lead to chronic impairment in social, occupational and interpersonal functioning.
By reviewing the most recent research findings in the field of mTBI and presenting data from their ongoing studies, the presenters will explore key unresolved dilemmas in the diagnosis and treatment of mTBI. Topics covered include: prognostic and risk factors for mTBI symptoms in civilian and military populations; the use of neuroimaging biomarkers for post-mTBI neuropsychiatric complications; and multi-modal treatment of post-concussive sequelae.
Overview of mTBI: Dr. Fann will review recent large, population-based longitudinal studies in mTBI that have improved our understanding of the risk factors, prognostic factors, and epidemiology of neuropsychiatric conditions in this population. Dr. Fann will also discuss methodological challenges and research opportunities in the field.
Clinical Management of Postconcussive Symptoms: Post-mTBI symptoms constitute a wide array of both psychiatric and neurological phenomena, which are often quite debilitating. Clinical diagnosis is always in flux, and symptoms are often subjective. Dr. Erickson will review the most current approaches and management strategies for postconcussive symptoms after mTBI, including collaborative care, psychotherapy, pharmacotherapy ,and lifestyle interventions (i.e., exercise, nutrition).
Neuroimaging Biomarkers: Neuropsychiatric symptoms, (particularly depression) are the most common cause for disability after mTBI. While current clinical imaging techniques can provide information about structural changes after brain injury, they lack sufficient resolution to deduce pathophysiologic mechanisms of postconcussive symptoms. Dr. Roy will present her NARSAD-funded research on the application of diffusion tensor imaging and resting state functional magnetic resonance imaging to better understand how micro-structural changes and connectivity dysfunction may play a role in post-TBI depression.
Sensory Symptoms in Military mTBI: Service members and veterans exposed to military mTBI (such as from blasts) may experience chronic auditory, visual, and vestibular deficits despite normal peripheral organ function. Dr. Quinn will present research elucidating the cause of these neurosensory deficits and describe his ongoing DoD-funded study of therapeutic interventions utilizing virtual reality and noninvasive brain stimulation.
Conclusion: By the end of the symposium, participants will have a better appreciation for the cutting-edge research being performed in the field of mTBI, as well as risk factors, prognostic factors and treatment approaches for these symptoms.