Page 83 - NNS 2014 Program & Abstract Book

were excluded from this analysis. In 248 patients, 41% had GOSE 8

(Upper Good Recovery), 31% had GOSE 7 (Lower Good Recovery),

and 28% had GOSE 5-6 (Moderate Disability). Twenty-nine percent

received outpatient care (18% of GOSE 8, 32% of GOSE 7, and 40%

of GOSE 5-6). These results show that the majority of mobile patients

without full recovery (GOSE 5-7) on their global outcome have not

had any form of outpatient follow-up. Detailed reasons for this lack of

follow-up is not well understood, and more granular information re-

garding outpatient services should be collected to better triage and

allocate resources to this population.

Key words

human studies, outcome measures, outpatient care, traumatic brain

injury

B1-20

ATTENTION, MEMORY AND EXECUTIVE FUNCTION

DEFICITS IN PATIENTS WITH COMPLICATED VS UN-

COMPLICATED MILD TRAUMATIC BRAIN INJURY

Narayanan, V.

1

,

Veeramuthu, V.

1

, Ramli, N.

2

, Waran, V.

1

, Bondi,

M.W.

3

, Ganesan, D.

1

Division of Neurosurgery, Department of Surgery, Faculty of Med-

icine, University of Malaya, Kuala Lumpur, Malaysia

2

University Malaya Research Imaging Centre, University of Malaya,

Kuala Lumpur, Malaysia

3

Psychology Service, VA San Diego Healthcare System & Department

of Psychiatry, University of California, San Diego, United States of

America

Neuropsychological deficits are a common but under-reported sequel

of traumatic brain injury. This phenomenon is more pronounced

among patients with mild traumatic brain injury (mTBI) who are not

formally assessed, thereby missing an opportunity for early neu-

ropsychological intervention.

We sought to examine the early neuropsychological deficits ob-

served in patients with complicated mTBI (presence of intracranial

lesions on radiological imaging) and uncomplicated mTBI (no intra-

cranial lesions on radiological imaging).

We prospectively recruited 60 patients with mTBI (Glasgow Coma

scores of 13 to 15) due to road traffic accidents presenting to the

Emergency Department of a Level 1 Trauma Centre. The patients

were selected based on the preset inclusion and exclusion criteria.

Neuropsychological evaluation was performed using the Screening

Module of Neuropsychological Assessment Battery (S-NAB) within

the same admission.

The mean score differences of neuropsychological performance

between the complicated versus uncomplicated groups were calcu-

lated. The differences were adjusted for age, gender, level of educa-

tion, injury severity (GCS) and outcome (GOSE) at discharge. There

were significant differences between the groups (complicated vs un-

complicated) in terms of their age range and also gender distribu-

tion.Independent samples t-tests found significantly lower S-NAB

Index overall scores in patients with complicated mTBI compared

with uncomplicated mTBI. These patients had a higher preponderance

of attention, executive function and memory related impairments.

Classifying mild traumatic brain injury as complicated or uncom-

plicated may help further identify patients who are likely to develop

significant neuropsychological sequelae. A larger cohort of patients

and a longer period of review is needed to verify these findings.

Key words

attention, brain imaging, complicated vs uncomplicated, executive

function, mild traumatic brain injury, neuropsychological outcome

B1-21

ATTENUATED ELECTROPHYSIOLOGICAL RESPONSE TO

FEEDBACK FOLLOWING SPORTS CONCUSSIONS

Bourassa, M.E.

1

, Fortin, J.

2

, Beaulieu, C.

3

, Brisson, B.

3

, Jolicoeur, P.

4

,

De Beaumont, L.

1,3

1

Sacred Heart Hospital, Montreal, Canada

2

Laval University, Quebec, Canada

3

University of Quebec at Trois-Rivie`res, Trois-Rivie`res, Canada

4

University of Montreal, Montreal, Canada

Among a growing number of studies suggesting that concussions af-

fect cognition in the long term, a recent study showed that the elec-

trophysiological response to errors in both visuospatial attention and

working memory task was significantly altered in multiply concussed

athletes.

The aim of the present study was to investigate the long term and

cumulative effects of concussions on the neurophysiological corre-

lates of feedback processing in asymptomatic concussed athletes.

For this purpose, the

Feedback-related negativity

(FRN) component

was recorded during a visual short-term memory task in which a

feedback on the performance was provided after each trial. Thirteen

concussed athletes (number of concussion ranging from 1 to 5) and 13

athletes with no history of concussion participated in the study.

Athletes with a history of concussion showed a significant

FRN amplitude reduction compared to control athletes (

F

1,25

=

4.34,

p

<

.05,

=

.1532). Moreover, a subsequent correlational analysis sug-

gested that the number of concussions sustained was predictive of the

amplitude of the FRN (

r

=

0.40; p

<

0.05), such that those athletes

whose FRN amplitude was more suppressed were those who had

sustained more concussions. These findings suggest that the neuro-

physiological response to performance feedback is significantly af-

fected following concussions and that this alteration increases with the

number of concussions sustained.

Key words

cognitive control, event-related potentials (ERPs), feedback-related

negativity, sports concussion

B1-22

FEDERAL COORDINATION FOR TRAUMATIC BRAIN IN-

JURY RESEARCH: THE NATIONAL RESEARCH ACTION

PLAN

Curley, K.C.

1

, Greenspan, A.

2

, Hicks, R.A.

3

, Hoffman, S.W.

4

, Miller,

A.C.

5

1

US Army MRMC, Fort Detrick, USA

2

Centers for Disease Control and Prevention, Atlanta, USA

3

NIH/NINDS, Rockville, USA

4

Department of Veterans Affairs, Washington, USA

5

U.S. Department of Education, Washington, USA

On August 31, 2012, President Obama promulgated an Executive

Order (EO) directing the Departments of Defense (DoD), Veterans

Affairs (VA), Health and Human Services (HHS), and Education, with

additional coordination with the Centers for Disease Control, to de-

velop and execute a National Research Action Plan (NRAP) on

posttraumatic stress disorder (PTSD), other mental health conditions,

and Traumatic Brain Injury (TBI) ‘‘to improve the coordination of

agency research into these conditions and reduce the number of af-

fected men and women through better prevention, diagnosis, and

treatment.’’

1,2

The NRAP outlines short, mid and long-term research

A-51