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Understanding Traumatic Brain Injury
Understanding Traumatic
Brain Injury: Current
Research and Future
Directions

Edited by

Harvey S. Levin, David H. K. Shum,

and Raymond C. K. Chan

1
 1
Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide.

Oxford New York

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With offices in
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Oxford is a registered trademark of Oxford University Press

in the UK and certain other countries.

Published in the United States of America by

Oxford University Press
198 Madison Avenue, New York, NY 10016

© Oxford University Press 2014

All rights reserved. No part of this publication may be reproduced, stored in a

retrieval system, or transmitted, in any form or by any means, without the prior
permission in writing of Oxford University Press, or as expressly permitted by law,
by license, or under terms agreed with the appropriate reproduction rights organization.
Inquiries concerning reproduction outside the scope of the above should be sent to the
Rights Department, Oxford University Press, at the address above.

You must not circulate this work in any other form

and you must impose this same condition on any acquirer.

Library of Congress Cataloging-in-Publication Data

Understanding traumatic brain injury : current research and future
directions / edited by Harvey S. Levin, David H.K. Shum & Raymond C.K. Chan.
p. ; cm.
Includes bibliographical references and index.
ISBN 978–0–19–973752–9 (alk. paper)
I. Levin, Harvey S., editor of compilation. II. Shum, David, editor of
compilation. III. Chan, Raymond C. K., editor of compilation.
[DNLM: 1. Brain Injuries. WL 354]
RC387.5
617.4′81044—dc23
2013034628

1 2 3 4 5 6 7 8 9
Printed in the United States of America
on acid-free paper
 Contents

Preface vii
Acknowledgments ix
Contributors xi

1 Introduction
1. Recent Advances in Traumatic Brain Injury Research: Introduction 3
Harvey S. Levin, David H. K. Shum, and Raymond C. K. Chan
2. Traumatic Brain Injury: Some History and Some Epidemiology 8
David L. McArthur
3. Traumatic Brain Injury Disease: Long-term Consequences of Traumatic Brain Injury 28
Brent E. Masel and Douglas S. DeWitt

II Neuropsychological Functions
4. Attentional Problems after Traumatic Brain Injury 57
Jia Huang, David H. K. Shum, Raymond C. K. Chan, and Allana L. Canty
5. Memory Impairments after Traumatic Brain Injury 71
Allana L. Canty, David H. K. Shum, Harvey S. Levin, and Raymond C. K. Chan
6. Executive Function Impairments after Traumatic Brain Injury 99
Ya Wang, Raymond C. K. Chan, and David H. K. Shum
7. High-Level Language in Traumatic Brain Injury: Promising Metrics to
Advance Brain Repair 116
Sandra B. Chapman and Lori G. Cook
8. Disorders of Emotion and Social Cognition Following Traumatic Brain Injury 133
Skye McDonald, Jacqueline Rushby, Michelle Kelly, and Arielle de Sousa

III Outcomes and Rehabilitation

9. Measuring Outcomes Using the International Classification of Functioning, Disability and
Health (ICF) Model, with Special Reference to Participation and Environmental Factors 163
Robyn L. Tate

v
vi Contents

10. Short and Long-Term Outcomes in Survivors of Traumatic Brain Injury 190
Jennie Ponsford
11. Cognitive Rehabilitation Following Traumatic Brain Injury 215
Tom Manly, Jonathan J. Evans, Jessica E. Fish, Fergus Gracey, and Andrew Bateman
12. Community Adjustment and Re-engagement 235
Tamara Ownsworth and Jennifer Fleming
13. The Neurobiological Basis of Pharmacological Approaches for Patients
with Traumatic Brain Injury 255
Rashed Harun and Amy K. Wagner

IV Methodological and Technological Advances

14. Advanced Neuroimaging in Traumatic Brain Injury 301
Elisabeth A. Wilde, Kareem W. Ayoub, Erin D. Bigler, Jill V. Hunter, and Harvey S. Levin

V Special Populations
15. Children and Adolescents 333
Vicki Anderson and Keith Owen Yeates
16. Traumatic Brain Injury in Older Adults: Does Age Matter? 356
Glynda J. Kinsella, John Olver, Ben Ong, Eleanor Hammersley, and Bethan Plowright
17. Mild Traumatic Brain Injury 370
Sarah A. Raskin, David W. Lovejoy, Michael C. Stevens, Marta Zamroziewicz,
and Howard J. Oakes
18. Blast-Related Traumatic Brain Injury: Pathophysiology, Comorbidities, and
Neurobehavioral Outcomes 413
Ralph G. De Palma, Gerald M. Cross, Clifford J. Buckley, James M. Ecklund,
and William Gunnar

VI Future Opportunities and Challenges

19. Future Challenges 433
Harvey S. Levin, David H. K. Shum, and Raymond C. K. Chan

Index 445
 Preface

Traumatic brain injury (TBI) research has especially severe diff use injury. The chronic
proliferated during the past decade reflecting effects of TBI have also become more apparent
trends in rehabilitation, technological advances as investigators have initiated multisite studies
in brain imaging, translational research, and of long-term outcomes. Harmonization of acute
the application of models from cognitive neu- TBI descriptors and outcome measures through
roscience and social cognition. Major epide- the consensus development of Common Data
miological studies have highlighted the public Elements stands to facilitate comparison of
health impact of TBI and the relation of age, results across studies. Although the morbidity
gender, and socioeconomic variables to inci- of TBI remains considerable despite advances in
dence and outcome. The recent wars in Iraq and acute management and rehabilitation, the emer-
Afghanistan along with global terrorism have gence of translational research portends break-
challenged emergency and military medicine throughs in diagnosis and treatment of TBI.
with acute care and rehabilitation of victims of The international representation of the edi-
blast-related TBI and its comorbidities. In civil- tors and chapter authors of this volume also
ian life, sports concussion has been increasingly points toward the global impact of TBI and the
recognized during the past decade as a less growing collaboration across disciplines and
benign injury than previously thought, espe- countries facilitated by electronic communi-
cially in the case of repetitive concussion associ- cations. This edited volume is intended to be
ated with subconcussive blows to the head. Early a reference for current research and clinical
brain injury, once thought to have a better prog- applications that is informative for investiga-
nosis than TBI in adults and adolescents, has tors, other academicians, clinicians, graduate
been shown to have poor long-term outcomes, students, and healthcare policy planners.

vii
 Acknowledgments

Development and administration of this book Sewell Visiting Fellowship to Raymond Chan;
project was supported by National Institute and a grant from the initiation fund of the CAS/
of Health Grants NS-21889 and NS05622 and SAFEA International Partnership Programme
the Department of Veterans Affairs grants for Creative Research Teams (Y2CX131003) to
B4596R and B6812C to Harvey S. Levin; an Raymond Chan and David Shum. The authors
Australian Academy of Science, Scientific would also like to acknowledge Allana Canty,
Visits to China Grant and a Queensland Lauren Spriggens, Sarah Walsh, and Yuling
International Fellowship to David Shum; the Zhang at Griffith University for their assis-
Project-Oriented Hundred Talents Programme tance in the preparation of this book. Finally,
(O7CX031003) and the Knowledge Innovation the three editors would like to acknowledge all
Project of the Chinese Academy of Sciences the contributing authors for making this book
(KSCX2-EW-J-8), the Griffith University Allan project possible.

ix
 Contributors

Vicki Anderson Allana L. Canty

Department of Psychology Griffith Health Institute
Royal Children’s Hospital Griffith University
Clinical Science Brisbane, Australia
Murdoch Childrens Research Institute
Raymond C. K. Chan
Psychological Science and Pediatrics
Institute of Psychology
University of Melbourne
Chinese Academy of Sciences
Melbourne, Australia
Beijing, China
Kareem W. Ayoub
Sandra B. Chapman
Physical Medicine and Rehabilitation Alliance
Center for BrainHealth
Baylor College of Medicine
University of Texas at Dallas
University of Texas-Houston Medical School
Dallas, Texas
Michael E. Debakey Veterans’ Affairs
Medical Center Lori G. Cook
Houston, Texas Center for BrainHealth
University of Texas at Dallas
Andrew Bateman
Dallas, Texas
Oliver Zangwill Centre for Neuropsychological
Rehabilitation Gerald M. Cross
Cambridge, United Kingdom Department of Veterans Affairs
VA Central Office
Erin D. Bigler
Washington, DC
Departments of Psychology and Neuroscience
Brigham Young University Ralph G. De Palma
Provo, Utah Department of Veteran Affairs
Department of Psychiatry VA Central Office
Utah Brain Institute Washington, DC
University of Utah
Douglas S. DeWitt
Salt Lake City, Utah
Department of Anesthesiology
Clifford J. Buckley University of Texas Medical Branch
VHA Central Texas Health Care System The Moody Center of Traumatic Brain &
Temple, Texas Spinal Cord Injury Research/Mission Connect
Galveston, Texas

xi
xii Contributors

James M. Ecklund Michelle Kelly

Department of Surgery Uniformed Services School of Psychology
University of the Health Sciences University of New South Wales
Bethesda, Maryland Sydney, Australia
Jonathan J. Evans Glynda J. Kinsella
Institute of Health and Wellbeing Psychological Science
University of Glasgow La Trobe University & Psychology Department
Glasgow, United Kingdom Caulfield Hospital
Melbourne, Australia
Jessica E. Fish
Institute of Psychiatry Harvey S. Levin
Kings College Departments of Physical Medicine &
London, United Kingdom Rehabilitation, Neurology, Neurosurgery,
Pediatrics, and Psychiatry
Jennifer Fleming
Baylor College of Medicine
University of Queensland
Michael E. Debakey Veterans Affairs
Brisbane, Australia
Medical Center
William Gunnar Houston, Texas
Department of Veterans Affairs
David W. Lovejoy
VA Central Office
Department of Neurosurgery and Department
Washington DC
of Psychiatry
Fergus Gracey Hartford Hospital/Institute of Living
Cambridge Centre for Paediatric Hartford, Connecticut
Neuropsychological Rehabilitation Department of Emergency Medicine and
Cambridge, United Kingdom Traumatology
University of Connecticut School of Medicine
Eleanor Hammersley
Farmington, Connecticut
Psychological Science
La Trobe University Tom Manly
Melbourne, Australia Medical Research Council
Cognition and Brain Sciences Unit
Rashed Harun
Cambridge, United Kingdom
Department of Physical Medicine and
Rehabilitation Brent E. Masel
Safar Center for Resuscitation Research Transitional Learning Centre
University of Pittsburgh Department of Neurology
Pittsburgh, Pennsylvania University of Texas Medical Branch
The Moody Center of Traumatic Brain and
Jia Huang
Spinal Cord Injury Research/Mission Connect
Institute of Psychology
Galveston, Texas
Chinese Academy of Sciences
Beijing, China David L. McArthur
Department of Neurosurgery
Jill V. Hunter
David Geffen School of Medicine
Department of Radiology and
University of California
Physical Medicine and Rehabilitation Alliance
Los Angeles, California
Baylor College of Medicine and
University of Texas-Houston Medical School Skye McDonald
Department of Pediatric Radiology School of Psychology
Texas Children’s Hospital University of New South Wales
Houston, Texas Sydney, Australia
Contributors xiii

Howard J. Oakes Michael C. Stevens

Department of Neurosurgery and Department Olin Neuropsychiatry Research Center
of Psychiatry Hartford Hospital/Institute of Living
Hartford Hospital/Institute of Living Hartford, Connecticut
Hartford, Connecticut Department of Psychiatry
Department of Emergency Medicine & Yale University School of Medicine
Traumatology New Haven, Connecticut
University of Connecticut School of Medicine
Robyn L. Tate
Farmington, Connecticut
Rehabilitation Studies Unit
John Olver University of Sydney
Clinical Institute of Rehabilitation Sydney, Australia
Epworth Healthcare & Rehabilitation Medicine
Amy K. Wagner
Monash University
Department of Physical Medicine and
Melbourne, Australia
Rehabilitation
Ben Ong Safar Center for Resuscitation Research
Psychological Science University of Pittsburgh
La Trobe University Pittsburgh, Pennsylvania
Melbourne, Australia
Ya Wang
Tamara Ownsworth Institute of Psychology
Griffith University Chinese Academy of Sciences
Brisbane, Australia Beijing, China
Bethan Plowright Elisabeth A. Wilde
Psychological Science Physical Medicine and Rehabilitation Alliance
La Trobe University Departments of Radiology and Neurology
Melbourne, Australia Baylor College of Medicine
University of Texas-Houston Medical School
Jennie Ponsford
Michael E. Debakey Veterans’ Affairs
School of Psychology and Psychiatry
Medical Center
Monash University
Houston, Texas
Melbourne, Australia
Keith Owen Yeates
Sarah A. Raskin
Department of Pediatrics
Department of Psychology and Neuroscience
The Ohio State University
Program
Department of Psychology
Trinity College
Nationwide Children’s Hospital
Hartfort, Connecticut
Centre for Biobehavioural Health
Jacqueline Rushby The Research Institute at Nationwide
School of Psychology Children’s Hospital
University of New South Wales Columbus, Ohio
Sydney, Australia
Marta Zamroziewicz
David H. K. Shum Neuroscience Program
Griffith Health Institute Trinity College
Griffith University Hartford, Connecticut
Brisbane, Australia
Arielle de Sousa
School of Psychology
University of New South Wales
Sydney, Australia
Understanding Traumatic Brain Injury
Part 1

Introduction
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