Page 77 - NNS 2014 Program & Abstract Book

This study demonstrated an initial convergent validity between
MFAP tasks and clinical assessment scores. The MFAP shows
promise for augmenting decision making related to RTD and Soldier
skills. These findings support additional research efforts to determine
the effectiveness of this program in predicting RTD success.
Key words
fitness-for-duty, military, return-to-duty
B1-02
BARRIERS TO RECOVERY AFTER CONCUSSION
Shetty, T.1, Cummings, K.2, Villegas, C.3, Manning, E.1, Voigt, N.4,
Singer, M.5, Nguyen, J.1
1Hospital for Special Surgery, New York, USA
2New York University, New York, USA
3NJ Medical School, Newark, USA
4Brown University, Providence, USA
5Princeton University, Princeton, USA
This study examines factors influencing recovery from concussion and
investigates the correlation between duration and quality of prescribed
rest and recovery time. The prescribed treatment for a concussion is
physical and cognitive rest. Both physicians and patients struggle with
defining the prescription of ‘‘rest’’ and compliance. Few other studies
have evaluated the optimal amount and type of prescribed rest necessary
to influence recovery. Any patient between the ages 10 and 50 years
diagnosed with concussion was asked to complete a questionnaire re-
garding their activity during their recovery period. A total of 170 pa-
tients were asked to participate between November 2011 and September
2013 and 34 had completed it by this time. Football (29%) was the most
common sport played, followed by baseball (13%) and soccer (13%).
On average, females had a longer recovery time compared to males (125
versus 86 days, respectively) and all females had recovery periods of 14
days or longer. Mechanism of injury was associated with longer re-
covery period. Those who hit their head on stationary or moving objects
were more likely to have recovery periods 14 days or longer compared
to collision injuries (p = 0.015 and 0.004, respectively). While many
activities were associated with longer average recovery times, only
reading (p = 0.024) and listening to audio books, talk radio, or podcasts
(p = 0.003) were statistically significant. Patients who had previous
concussions had a recovery length nearly four times longer than first
time concussion patients (p = 0.011). Gender, mechanism of injury,
pastimes during recovery and concussion history all have a significant
impact on concussion recovery time. Females have a more difficult time
recovering than males. The mechanism of injury influences the duration
of symptoms, possibly related to the degree of rotational acceleration the
brain is subject to. Cumulative injury from concussions is of concern.
Key words
activity, barriers, recovery, screen time
B1-03
EFFECTS OF DUAL MODE NON INVASIVE BRAIN STIMU-
LATION ON MOTOR FUNCTION IN PATIENTS WITH
CHRONIC TRAUMATIC BRAIN INJURY
Tae Gun, K., Joun Gul, D., Eun Hee, P.
1Department of Physical and Rehabilitation Medicine, Sungkyunkwan
University School of Medicine, Seoul, Republic of Korea
2Miryang Public Healh Center, Miyang, Republic of Korea
Transcranial magnetic stimulation (rTMS) or transcranial direct cur-
rent stimulation (tDCS), when provided to brain injured patients in
combination with motor training, enhances therapeutic efficacy and
motor function. However, a majority of studies only examined a
stroke patient.
The authors investigated the modulating influence of the combi-
nation of dual-mode brain stimulation over bihemi%ADspheric
stimulation with motor training in TBI patients.
Twenty TBI patients with hemiparesis received five randomly ar-
ranged sessions of diverse combinations of tDCS and rTMS. We
applied cathodal or anodal tDCS over the contralesional primary
motor cortex (cM1) with 10Hz rTMS over the ipsilesional primary
motor cortex (iM1) in a simultaneous or preconditioning method in-
cluding sham stimulation. Immediately after dual mode stimulation,
5 minutes of sequential hand motor trainings were performed. The
total pulses of rTMS and duration of tDCS and motor training was the
same in all sessions. Cortical excitabilities and sequential motor
performances were evaluated before and after each session.
Motor function and corticomotor excitabilities following simulta-
neous stimulation of cathodal tDCS with 10Hz rTMS were signifi-
cantly increased after intervention with significantly greater motor
improvements than other conditions (P < 0.05).
Conclusions. For the combination of bihemispheric tDCS and
rTMS with motor training, simultaneous stimulation of cathodal tDCS
over cM1 combined with 10Hz rTMS over iM1 followed by motor
training results in better motor performance in TBI patients than other
combinations of dual-mode stimulation. This may be due to mecha-
nisms associated with interhemispheric interaction.
Key words
dual mode non invasive brain stimulation, motor training, rehabilita-
tion, TBI, training induced plasticity
B1-04
MILD EXPERIMENTAL TBI INCREASES ETHANOL CON-
SUMPTION IN THE DELAYED POST-TBI PERIOD
Lowing, J.L.1,2, Susick, L.L.1,2, Matchynski, J.J.1,2, Schneider, B.L.1,2,
Conti, A.C.1,2
1John D. Dingell VA Medical Center, Detroit, USA
2Wayne State University, Detroit, USA
Alcohol intake patterns vary after traumatic brain injury (TBI), with
initial decreases transitioning into delayed increases in consumption.
To investigate this, our lab has focused on developing a model of mild
TBI-induced changes in ethanol (EtOH) intake. Our previous studies
demonstrated reduced binge-pattern drinking in the early post-TBI
period. Here, we investigated the effects of mild TBI on chronic high-
level EtOH consumption in the delayed post-TBI period using a
chronic, intermittent access paradigm. C57BL/6 mice (6–8 wks old)
received sham surgery or mild TBI over the midline suture of the
intact skull. Beginning at 15 d post-injury, mice were evaluated for
chronic high-level EtOH consumption using a chronic, intermittent
EtOH access paradigm. Each 7-day cycle consisted of 24-h concurrent
access to 20% EtOH (v/v in water) and water on days 1, 3, and 5, with
access to water only on days 2, 4, 6 and 7. Mice were maintained on
this consumption schedule for 44 days during which EtOH and water
intake volumes were recorded daily. On the 45th day of consumption,
mice were allowed only 2 h of EtOH/water access after which whole
brains and blood samples were harvested. Brain-injured mice con-
sumed significantly more EtOH than controls over the study duration.
Interestingly, this result was driven by a delayed increase in con-
sumption by TBI mice compared to shams that began only after 10
A-45