Page 91 - NNS 2014 Program & Abstract Book

B3-10
EFFECTS OF FRONTAL TBI ON SIMPLE RESPONSE RE-
QUIREMENTS IN RATS
Vonder Haar, C., Winstanley, C.A.
University of British Columbia, Vancouver, Canada
Previous work has suggested that operant chambers may provide
sensitive assessments of function following TBI. However, TBI may
alter basic functions that have wide-ranging effects across reinforce-
ment-based tasks. Simple schedules of reinforcement have been used
to evaluate basic changes in function for many years in the fields of
experimental analysis of behavior and behavioral pharmacology.
These have not been widely explored following TBI and never in a
model of frontal injury. Schedules of reinforcement evaluate how a
response changes when the requirement for the reinforcer is increased
or decreased.
The current study evaluated the lever-pressing performance of
sham versus frontal TBI rats on fixed ratio, variable ratio, fixed
interval and variable interval schedules of reinforcement. Behavior
was conducted in standard operant chambers. Frontal injury was
induced using controlled cortical impact centered at + 3.0, 0.0 mm
from bregma, to a depth of - 2.5 mm at a velocity of 3 m/s. Rats
were then tested on successive sessions of fixed ratio values 1, 3, 5,
10 and 20. This was followed by variable ratio at the same values.
Following ratio testing, fixed interval testing occurred with values
of 5, 15, 30, 60 and 120. Variable interval followed at the same
values.
There were no large differences in injured versus sham performance
in terms of total number of reinforcers obtained or overall efficiency at
completing the schedule on any of the schedules tested. Response
rates were also similar across the groups.
The relative lack of impairment in injured rats shows that these very
basic behavioral functions are still intact following TBI. These results
bode well for the evaluation of more complex function using more
complicated behavioral measures. Future studies can use these basic
building blocks to design more complex tasks to assess cognitive
functioning following frontal TBI.
Key words
behavior, cognition, controlled cortical impact, reward/reinforcement,
TBI
B4-01
ACUTE CARE AFTER PEDIATRIC TRAUMATIC BRAIN IN-
JURY: A QUALITATIVE STUDY OF THE FAMILY PER-
SPECTIVE
Moore, M.2,4, Robinson, G.2,4, Mink, R.1,3, Hudson, K.2, Dotolo, D.2,
Gooding, T.4 , Ramirez, A.3 , Zatzick, D.2,4, Vavilala, M.2,4
1Harbor-UCLA Medical Center, Los Angeles, USA
2University of Washington, Seattle, USA
3Los Angeles BioMedical Research Institute, Los Angeles, USA
4Harborview Injury Prevention and Research Center, Seattle, USA
Previous studies have linked high quality patient and family cen-
tered care to improved patient outcomes, family satisfaction and
decreased health care costs. Specific factors associated with quality
care for pediatric patients with traumatic brain injury (TBI) have
not been identified. This study aimed to explore the family expe-
rience of acute care after pediatric TBI to 1) identify specific
factors and barriers associated with high quality care unique to this
population and 2) develop a model of quality acute care. We
conducted in-depth interviews with 15 parents of patients who
were < 18 years old and who had an acute hospital stay within the
last 5 years. English, Spanish and Cantonese speaking families
were recruited from 2 large, urban trauma centers. Interviews were
transcribed verbatim and qualitative content analysis was used to
develop a taxonomy of domains and factors associated with quality
patient and family centered care. Three major domains associated
with high quality care were identified: 1) thorough, timely and
compassionate communication, 2) capacity building for families
and providers, and 3) coordination of care transitions. Parents
reported valuing detailed, frequent and understandable commu-
nication that set realistic expectations and prepared them for de-
cision-making and outcomes. They identified areas for capacity
building including methods to increase parent participation in care
and strategies to increase provider cultural humility and institu-
tional flexibility. Coordinated care transitions were highlighted as
important, especially continuity of information and maintenance of
partnerships with families and new care teams. Understanding the
family perspective and integrating it into practice are important
steps to improving patient outcomes. Results from this study will
be used to inform development of new care pathways for pediatric
TBI patients.
Key words
acute care, family perspective, pediatric traumatic brain injury,
qualitative study
B4-02
PLAYGAME: A RANDOMIZED, DOUBLE BLIND, PLACEBO
CONTROLLED TRIAL OF MELATONIN FOR THE TREAT-
MENT OF POST CONCUSSION SYNDROME IN YOUTH
Barlow, K.M., Dewey, D., Urban, K.J., Seeger, T., Kirton, A.,
MacMaster, F., Brooks, B., Mikrogianakis, A., Crawford, S., Netel-
Aguirre, A., Johnson, D., Kirk, V., Zemek, R., Buchhalter, J.
University of Calgary, Calgary, Canada
Fourteen percent of school-aged children with mTBI have post
concussion syndrome (PCS) for at least 3 months. PCS is associ-
ated with significant disability in children and burden on families,
and yet there are no evidence-based medical treatments available.
Although Melatonin is best known for its chronobiological actions,
its therapeutic potential is being explored in neurobehavioural
conditions such as headache and anxiety. Biological activities of
melatonin are both receptor-mediated (at physiological levels) and
non-receptor mediated (especially at supraphysiological levels).
Proposed neuroprotective mechanisms include decreasing oxida-
tive damage, improving mitochondrial function and decreasing the
neuroinflammation.
The aim of this study is to determine if Melatonin improves PCS
following mTBI in youth.
Does the treatment of children with PCS symptoms following
mTBI with 3mg sublingual melatonin or 10mg of sublingual mela-
tonin for 28 days result in a decrease in PCS (physical, cognitive and
behavioural) symptoms as compared with placebo?
Is there a dose-response relationship?
Is the treatment effect independent of the effect on sleep?
This study will be conducted as a randomized, double blind,
placebo controlled trial. Three parallel treatment groups will be
examined: 1) sublingual placebo, 2) sublingual melatonin 3mg, and
3) sublingual melatonin 10mg. The design allows for dose depen-
dent response assessment. This is a single center study which will
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