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International Conference on Mild Traumatic Brain Injury

I was pleased to be a featured speaker at the International Conference on Mild Traumatic Brain Injury held last week in Vancouver, Canada.  The MTBI 2009 assembled experts from a multiplicity of specialties working with brain injury, welcomed a diverse group of experts to collaborate in synthesizing new knowledge.  The conference brought together delegates from around the world, working in areas ranging from the medical and legal implications of MTBI to those working mental health/addiction issues as well as representatives from programs that provide acute, chronic rehabilitation and recovery services.

I spoke on the topic of mild traumatic brain injury and the courtroom.  Also speaking on the program were such internationally renowned experts as Gregory O’Shanick, medical director of BIAA who spoke on the topic “What is so mild about MTBI?”  Also speaking was Erin Bigler, Ph.D., who spoke on neuroimaging and persistent post concussion syndrome; Thomas Kay, Ph.D., who spoke on using the neuropsychological evaluation to understand the person with mild traumatic brain injury; as well as Grant Iverson, Ph.D., who spoke on clinical and methodological challenges associated with identifying residual cognitive deficits.

The conference was organized by Raymond Ancill, M.A. and Stephen Holliday, Ph.D. both of Vancouver, Canada. 

Loss of Identity After a Brain Injury

I read an interesting article on The New York Time’s website last week which discusses a rarely seen but yet devastating side effect of brain injuries: patients who  become profoundly suspicious of their closest relationships, often cutting themselves off from those who love them and care for them. They may insist that their spouse is an impostor; that their grown children are body doubles; that a caregiver, a close friend, even their entire family is fake, a duplicate version. Doctors believe these delusions are symptoms of schizophrenia, however recently, researchers have found similar delusions in hundreds of people who are not schizophrenic but have neurological problems including dementia, brain surgery and traumatic blows to the head.

Now a small group of scientists are researching what makes a person’s identity in their brain. Learning what makes identity, researchers say, will help doctors understand how some people preserve their identities in the face of creeping dementia, and how others are sometimes able to reconstitute one.

You can read the full article online here.

North American Brain Injury Society Presents 22nd Conference on Legal Issues in Brain Injury

The North American Brain Injury Society is pleased to announce that the 22nd Conference on Legal Issues in Brain Injury will be held October 14-17, 2009, at the Austin Downtown Hilton Hotel. The program for the Conference is now available on the NABIS website and includes information on the topics to be discussed, a list of presenters scheduled to attend, and information on continuing legal education credits.

You can access all of the Conference's information online here.

Resources for the College Bound with Traumatic Brain Injuries

The below entry is an article from a guest-blogger,  Emily Thomas, who writes about the Associates Degree. She welcomes your feedback at Emily.Thomas31@ yahoo.com.

While a traumatic brain injury can be a life changing and often difficult obstacle to over come, it is in many cases by no means an impediment from attending an institution of higher learning, getting a degree and pursing an independent career. There are a number of great resources out there that can help ease the transition into college life and help students who have problems with memory and abstract thinking. Here are a few that you can utilize and research before making the leap into college life.

1. College Living Experience – While based out of Maryland, this is only one of the many larger programs across the nation that offer support and help for TBI college students. Through it, students will get tutoring, help with time management, adaptive computer technology and assistance with household tasks. Additionally, staff members will help pave the way for students to engage actively in social activities on campus as well.
2. Brain Injury Association of America -This great organization has put out a pamphlet all about the challenges and rewards associated with attending college for those with brain injuries. Read it to learn how to choose a school, get assistance paying for it and to better access your options.
3. Post Injury Academics – One of the best ways to prepare for your own academic career is to learn from those who’ve been there and done it before you. Try reading this article from determined student Paul Gianni about his experiences as a student and where he failed and succeeded.
4. AHEAD: The Association for Higher Education and Disability can be an invaluable resource for families looking to learn more about their options and ways to make the transition easier.
5. DO-IT: Check out some of the programs and resources offered through this University of Washington organization dedicated to making it easier for those with disabilities to attend college and get jobs.
6. Peterson’s Online Degree Search: For some, going to school online may be a simpler way to ease into college life, as not everything needs to change at once. See what your options are on this site.
7. Brain Injury Resource Center: Through this site you can find out just about anything about your rights and opportunities as a college student with a TBI.
8. Scholarships for Disabled Students: You may be able to qualify for a range of scholarships when you attend school, greatly reducing the cost. This link will highlight a few and show you where you can search for others.

Binder’s Mild Traumatic Brain Injury Meta-Analysis Refuted

Defense attorneys and their courtroom doctors often rely on the Mild Traumatic Brain Injury meta-analyses conducted by Binder, Rohling and Larrabee and updated by Frencham, Fox and Maybery (2005) to argue that mild traumatic brain injury has no lasting effect on neuropsychological status. 
 
Most recently, Erin D. Bigler, along with Jon L. Pertab and James M. Kelly reanalyzed the meta-analytic data sets utilized by Binder and Frencham.
 
This new study published in Brain Injury (June 2009; 23(6):498-508) revisited the data combined in the meta analyses of Binder et al and Frencham et al, specifically addressing four areas: (1) mechanism of injury, (2) diagnostic criteria employed, (3) type of neuropsychological assessment to employ and (4) whether symptomatic or nonsymptomatic MTBI subjects were assessed separately.
 
After reviewing all of the studies utilized by Binder and Frencham, Bigler et al stated:
 
 As indicated in the introduction, the Binder et al and Frencham et al studies have been cited to support the non-effect of any lasting sequelae of MTBI as a general principle for the outcome of all MTBIs.  From the total group standpoint, that likely remains a true statement but not one that necessarily applies to an individual within that sample.
 
The authors conclude that since the Binder and Frencham meta-analyses only employed 25 articles in the meta-analysis, while the National Library of Medicine now lists more than a 100 mild TBI articles published since 2005 that examine neuropsychological outcome in mild TBI cases, “there should now be sufficient sample size to utilize meta-analytic techniques to better answer the residual and neurobehavioral effects of having sustained an MTBI by controlling for and examining the variables identified in this critique.”
 
This new study analyzing and recognizing the limitations of mild TBI meta-analyses by both Binder et al and Frencham et al will help dis-spell the notion and testimony of defense courtroom neuropsychologists and other medical doctors that everyone recovers from mild traumatic brain injuries. Clearly this study refutes that argument.