Patient Characterization Protocols for Psychophysiological Studies of Traumatic Brain Injury and Post-TBI Psychiatric Disorders

Psychophysiological investigations of traumatic brain injury (TBI) are being conducted for several reasons, including the objective of learning more about the underlying physiological mechanisms of the pathological processes that can be initiated by a head injury. Additional goals include the development of objective physiologically based measures that can be used to monitor the response to treatment and to identify minimally symptomatic individuals who are at risk of delayed-onset neuropsychiatric disorders following injury. Research programs studying TBI search for relationships between psychophysiological measures, particularly ERP (event-related potential) component properties (e.g., timing, amplitude, scalp distribution), and a participant s clinical condition. Moreover, the complex relationships between brain injury and psychiatric disorders are receiving increased research attention, and ERP technologies are making contributions to this effort. This review has two objectives supporting such research efforts. The first is to review evidence indicating that TBI is a significant risk factor for post-injury neuropsychiatric disorders. The second objective is to introduce ERP researchers who are not familiar with neuropsychiatric assessment to the instruments that are available for characterizing TBI, post-concussion syndrome, and psychiatric disorders. Specific recommendations within this very large literature are made. We have proceeded on the assumption that, as is typically the case in an ERP laboratory, the investigators are not clinically qualified and that they will not have access to participant medical records. Published in Frontiers in Neurology, v4 article 91, 22 July 2013. The original document contains color images. Prepared in collaboration with the Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD. Prepared in cooperation with Aquinas, LLC, Berwyn, IL, the Physics Department, Bryn Mawr College, Bryn Mawr, PA, the Neurology Department, Vanderbilt University, Nashville, TN, Arnold and Porter, LLP, Washington, DC, the Department of Epidemiology and Preventive Medicine, University of Maryland, College Park, and the Psychology Department, University of Northern Colorado, Greeley. Sponsored in part by the the Traumatic Injury Research Program of the Uniformed Services University of the Health Sciences, and the Defense Medical Research and Development Program.