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Baylor Institute for Rehabilitation

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Traumatic Brain Injury Research 

Our traumatic brain injury (TBI) research efforts are led by “clinician-researchers,” whose hands-on expertise with patient care keeps their research focus relevant to real-life needs. Below are brief descriptions of select projects that are currently ongoing, several of which are part of the Traumatic Brain Injury Model System Project (TBIMS).

Comparative Effectiveness Research (Traumatic Brain Injury Model System Project)

The broad aim of our research is to improve functional outcomes of patients with TBI utilizing comparative effectiveness research. We are currently identifying variations in clinical practices and patient outcomes as well as evidence-based best clinical practices in acute rehabilitation of TBI patients.  

Dopamine (Traumatic Brain Injury Model System Project)

Some patients who have had a severe TBI are in a minimally conscious state after their accident. It is common practice to prescribe medications like Methylphenidate to help stimulate the brain and increase the patient’s memory recovery and rehabilitation endurance. Although there are observational reports and small case studies that support the practice of prescribing these types of medications, a study has not yet been conducted to show that the brain has structural changes in the dopaminergic pathways that are caused by the head injury and affected by this medication. To address this issue, we are implementing SPECT imaging of the brain as patients begin rehabilitation in order to assess damage to these pathways and the effectiveness of Methylphenidate.

TWILIGHT (Collaborative Traumatic Brain Injury Model System Project – University of Washington Lead Center)

Most studies looking at treatment of sleep disturbances and wakefulness after TBI have focused on pharmacologic interventions and have reported limited efficacy in improving sleep. There are case reports of improved sleep in the chronic phase of TBI recovery with cognitive behavioral therapy and light exposure but these treatments have not been studied in the acute rehabilitation phase. This study will help elucidate both the effects of light exposure after TBI in the inpatient rehabilitation setting as well as clinical feasibility of delivering light exposure in this case setting. 

Internet Use Post-TBI (Collaborative Traumatic Brain Injury Model System Project – Craig Lead Center)

The Traumatic Brain Injury Model Systems (TBIMS) is conducting a supplemental study to explore various aspects of Internet use and online social participation among individuals with TBI. For the general population, the prevalence of the Internet, and particularly social media, have significantly redefined mechanisms of communication and social participation that enable social interactions otherwise limited by various barriers. However, despite ongoing advancements in Internet technology and access, disparities in online participation still remain for individuals living with disability.

Seizure Prophylaxis Usage

A known complication of head trauma is the development of post-traumatic seizures. Past efforts to prevent and lessen the impacts of seizures following head trauma led to the widespread use of prophylactic anti-epileptic drugs over extended periods of time. However, guidelines may not be followed closely in patients with TBI in an acute care setting and no studies have examined the rate of seizure prophylaxis in an inpatient setting.  

Thus, this study aims to determine whether guidelines for starting and stopping seizure prophylaxis following moderate to severe TBI are followed.

Reliability of Dual Task Measures in an Inpatient Setting 

The study of dual-task conditions is an expanding area of rehabilitation research as dual-task deficits have been linked to an increased risk of falls following TBI. Although several measurement tools have been proposed to assess dual-task performance, the majority of research has been completed with chronic populations and completed in laboratory settings. This study will determine which measures of dual-task are most feasible and reliable for the acute brain injury population.