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PL03 Executive Function after Experimental and
Clinical TBI
PL03-01
A COMBINED THERAPY OF ENVIRONMENTAL ENRICH-
MENT AND CITALOPRAM AMELIORATES ATTENTIONAL
SET-SHIFTING PERFORMANCE AFTER BRAIN TRAUMA
Corina Bondi
, Megan LaPorte, Heather Tennant, Kristin Free, Jeffrey
Cheng, Anthony Kline
University of Pittsburgh, Physical Medicine and Rehabilitation, Safar
Center for Resuscitation Research, Pittsburgh, USA
Traumatic brain injury (TBI) models in the laboratory have been as-
sociated for decades with declines in long-term learning and memory,
although the types of behavioral tests performed to date did not focus on
the complex attention impairments related to the frontal lobe, which are
common in most brain injuries. Specifically, executive function and
cognitive flexibility represent sophisticated brain capabilities to use
environmental feedback to ‘‘unlearn’’ a previously valid set of rules,
switch gears and filter out unwanted distractions. We have begun to
employ the attentional set-shifting test (AST), a complex cognitive
paradigm analogous to the Wisconsin Card Sorting Test, which is used
to measure strategy-switching deficits in patients with frontal lobe
damage, TBI, and psychiatric disorders. Previously, we demonstrated
that a controlled cortical impact (CCI) injury produced significant im-
pairments in executive function and cognitive flexibility in the AST. In
the current study, clinically relevant therapies for cognitive performance
deficits after traumatic brain injury were used alone and in combina-
tion. Specifically, the enriched environment (EE) housing strategy is
an endorsed animal model of rehabilitation, while daily injections of
the antidepressant drug citalopram, a treatment known to alleviate
depressive-like symptoms and improve cognition in humans, were also
provided alone or in combination with EE. The combined treatment
aims to mimic simultaneous rehabilitation and pharmacological treat-
ments given to patients in a clinical setting. Four weeks post-surgery,
EE exposure provided significant cognitive recovery after injury, al-
though performance may further benefit from combined therapy
with citalopram, as preliminary findings indicate. Future studies will
continue to investigate in more detail the ideal cognitive recovery
timeline and specific brain pathways and mechanisms involved in re-
storing higher function after TBI.
Keywords: executive function, environmental enrichment, trau-
matic brain injury, antidepressants
PL03-02
MODELING CHRONIC COGNITIVE DYSFUNCTION AFTER
TBI: WHERE DO WE GO FROM HERE?
Cole Vonder Haar
Department of Psychology, University of British Columbia, British
Columbia, Canada
The long-term consequences of traumatic brain injury can be devas-
tating. While many patients exhibit considerable recovery of many
symptoms, a significant subset go on to develop chronic cognitive
impairments. These impairments span many modalities, including
poor decision-making, limited attention, impulse control problems,
reduced working memory and more. Additionally, recent studies have
begun to link TBI with numerous psychiatric disorders suggesting
that, for some patients, these symptoms may be prodromal to psy-
chiatric conditions. In order for therapeutic agents to appropriately
target many of these symptoms, we need to be able to effectively
model these in animals. This presentation will discuss recent devel-
opments in cognitive-behavioral assessment for experimental TBI.
Specifically, I will discuss data covering simple domains of func-
tioning such as cue discrimination to more complex functions such as
attention and impulsivity, as well as the implications of these be-
havioral changes as they apply to modeling psychiatric conditions in
rodent models. Over the last several years, the field of experimental
TBI has shown large advancements in numerous domains such as
injury modeling, biomarker measurements and imaging ability. In
order to progress as a field, we also need to implement improved
behavioral assessments. This will improve our understanding of the
cognitive consequences of brain injury in animal models and be more
effective for the assessment of therapeutic agents.
PL03-03
EXECUTIVE FUNCTION AFTER TRAUMATIC BRAIN IN-
JURY: CHALLENGES IN ITS ASSESSMENT&MANAGEMENT
William Barr
NYU School of Medicine, Neurology, New York, U.S.A.
Executive dysfunction provides one of the most common and debili-
tating features of traumatic brain injury (TBI), often leading to disability
in the home, school, and workplace. While trained clinicians are often
able to recognize the behavioral features of executive dysfunction over
the course of their management of patients with TBI, many challenges
remain in our ability to measure and track these behaviors in an accurate
and effective manner. The goal of this presentation is to conduct an
evidence-based review of the methods currently available for clinical
assessment and treatment of executive dysfunction in TBI patients. This
will include a critical analysis of the psychometric properties of in-
struments currently marketed as neuropsychological tests of executive
functions in addition to an update on the empirical support for the most
commonly used intervention strategies. The review will also address
many of the continuing obstacles that remain in our ability to measure
the impact of executive dysfunction across the entire spectrum of TBI.
Keywords: Neuropsychology, Executive Functions, Frontal Lobe,
Assessment
PL04 Patient Perspective
PL04-01
DOES THIS WHEELCHAIR MAKE MY BUTT LOOK BIG?
Briana Walker-Tavano
Briana Walker-Tavano Intl., Speaker and Writer, Temecula, USA
On a bright, sunny Sunday afternoon Briana Walker was driving on
the freeway when she fainted at the wheel, hitting a cement median at
75 miles per hour. A young, aspiring dancer, just 23 years old at the
time of her accident, Briana was determined to reinvent an amazing
life in spite of her new and challenging circumstances.
One year after her accident Briana became the first female ever to
be featured on the cover of Mobility Management magazine. Shortly
thereafter Briana became the Krypto Girl for Colours Wheelchairs.
Her images have now been used globally on buses and billboards to
change the face of disability.
After meeting another Colours’ model, a pioneer in the hip hop
world, Briana learned to transform her wheelchair into a dance prop,
and together they created one of the first ever wheelchair, hip hop
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