Psychopharmacology for Neurobehavioral Dysfunction after TBI

1.5 CE Credits

Presented by:
Nathan D. Zasler, MD, FAAPM&R, FAADEP, DAAPM, CBIST
CEO & Medical Director, Concussion Care Centre of Virginia, Ltd.
CEO & Medical Director, Tree of Life Services, Inc.
Professor, affiliate, VCU Department of Physical Medicine and Rehabilitation, Richmond, Virginia
Associate Professor, adjunct, Department of Physical Medicine and Rehabilitation, University of Virginia, Charlottesville, Virginia
Vice-chairperson, IBIA

This webinar will review current practices, research and advances in the use of psychopharmacological agents to modulate impairment in persons with neurobehavioral impairment following TBI.  This plenary session will focus on presenting current information on psychopharmacologic assessment and management principles and practices. 

After the webinar, participants will be able to:

  1. Recite caveats regarding holistic behavioral assessment and treatment principles. 
  2. Discuss drug treatment paradigms for persons with TBI and compare proposed methodologies for choosing drug interventions and the role of multidimensional nature of assessment.
  3. Explain the common types of neurobehavioral impairments that are theorized to be causally related to TBI and list pharmacological management of each as relevant based on current literature and EBM.
  4. List caveats regarding drug use, side-effects, lab monitoring and drug interactions as related to psychotropic medication use in persons with TBI. 
  5. Describe the importance of adequate differential diagnosis of behavioral change following TBI and the myriad factors that need to be considered across the TBI severity spectrum prior to implementing psychopharmacological prescription. 

Target Audience:Clinical neuropsychologists, psychologists, Ph.D. students in training and non-psychologists

Instructional Level:Intermediate-to-Advanced

About Nathan D. Zasler, M.D. 
Nathan D. Zasler, MD, FAAPM&R, FAADEP, DAAPM, CBIST is an internationally respected physician specialist in acquired brain injury (ABI) care and rehabilitation.  He is CEO and Medical Director of the Concussion Care Centre of Virginia, an outpatient neurorehabilitation practice, as well as Tree of Life Services, Inc., a living assistance and transitional neurorehabilitation program for persons with acquired brain injury in Richmond, Virginia. 

He is board certified in Physical Medicine and Rehabilitation and fellowship trained in brain injury.  Dr. Zasler is an affiliate professor in the Department of Physical Medicine and Rehabilitation at VCU in Richmond, Virginia, as well as associate professor, adjunct, in the Department of Physical Medicine and Rehabilitation at the University of Virginia, Charlottesville, Virginia where he also serves on the UVA Brain Injury and Sports Concussion Institute Professional Advisory Board.  Dr. Zasler is a fellow of the American Academy of Disability Evaluating Physicians and a diplomate of the American Academy of Pain Management. 

Dr. Zasler has lectured and written extensively on neurorehabilitation issues related to acquired brain injury.  He has won numerous awards for his work in TBI research, clinical care, and advocacy.  He was the NHIF’s (now BIAA) first recipient of the “Young Investigator Award.”  He was the recipient of the Sheldon Berrol Clinical Services award from BIAA in 2011.  He has also been, repeatedly, nationally recognized by “Best Doctors” for practice excellence in brain injury medicine.  Dr. Zasler is active in local, national and international organizations dealing with acquired brain injury and neurodisability, serving in numerous consultant and board member roles.  He has edited six books including “Rehabilitation of Post-Concussive Disorders,” “Medical Rehabilitation of Traumatic Brain Injury,” “Rehabilitation of Functional Disorders,” “Brain Injury Medicine:  Principles and Practice”, Editions 1 and 2, and “Clinical Manual for the Management of Adults with Traumatic Brain Injury”.  He currently serves as a reviewer for over 10 peer reviewed scientific journals.  Dr. Zasler is chief editor of the international scientific publications, “Brain Injury” and  “NeuroRehabilitation”.  He also serves as associate editor of the IBIA’s “Neurotrauma Letter.”  Dr. Zasler recently completed almost a decade of service as the chairperson of the International Brain Injury Association (IBIA) for which he now serves as Vice-Chairperson. 

His main areas of clinical and research interest include neuromedical issues in acquired brain injury (particularly mild TBI), neuropsychopharmacology and disorders of consciousness, differential diagnosis in ABI, community-based care issues, as well as chronic post-traumatic pain rehabilitation including headaches.  Dr. Zasler is an advocate, educator, clinical researcher, entrepreneur, inventor and busy practicing clinician who is involved with community based neurorehabilitation and neuromedical assessment in management of persons with acquired brain injury, neurodisability, as well as chronic pain.  He is also involved in international ABI healthcare consultation, including clinical and technical programmatic development, as well as medicolegal consultation.

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Risk Factors for Later-in-life Dementia: The Science and Challenges Behind Traumatic Brain Injury

1.5 CE Credits




C. Munro Cullum, PhD, ABPP/Cn

Professor of Psychiatry, Neurology & Neurotherapeutics, and
Neurological Surgery
Pamela Blumenthal Distinguished Professor of Clinical Psychology
Vice Chair and Chief, Psychology Division, Dept. of Psychiatry
Senior Neuropsychologist, O’Donnell Brain Institute
University of Texas Southwestern Medical Center

Christian LoBue, Ph.D.

Assistant Professor in Psychiatry and Neurological Surgery
The University of Texas Southwestern Medical Center

William B. Barr, PhD, ABPP

Associate Professor
Director, Neuropsychology Division
Department of Neurology
NYU Grossman School of Medicine
 

The later-in-life effects of traumatic brain injury have been controversial and debated. Some research points to a higher risk of developing dementia years after a traumatic brain injury, though some studies report no such association. The complexities and limitations of this area of research are numerous, and the media attention to some high-profile cases in the news have contributed to potentially premature conclusions about long-term consequences of mild brain injury. The purpose of this seminar is to review and integrate the scientific research suggesting traumatic brain injury can serve as a risk factor for developing dementia, and present some of the methodological limitations inherent in those studies with an in-depth discussion of the important gaps and limitations in understanding the later-in-life effects of traumatic brain injury.

After the webinar, participants will be able to:

1. Describe the science identifying traumatic brain injury as a risk factor for developing dementia later in life.
2. Discuss the critical gaps in understanding how traumatic brain injury may relate to developing dementia.
3. Explain popular theoretical mechanisms linking traumatic brain injury to later-in-life dementia.

Target Audience: Neuropsychologists and clinicians/scientists in other fields

Instructional Level: Intermediate

Dr. Barr
is the Director of the Neuropsychology Division in the Department of Neurology at NYU-Langone Health. He is an Associate Professor of Neurology at the NYU Grossman School of Medicine. He is board-certified in Clinical Neuropsychology through the American Board of Professional Psychology and has over 30 years of experience in clinical practice, training, and research in that field. Dr. Barr has been on the editorial boards of multiple professional journals and has served as an officer and board member of a number of professional societies, including a term as President of the Society for Clinical Neuropsychology (Division 40) of the American Psychological Association (APA).  He has an active clinical practice in neuropsychological assessment, involving both clinical and forensic cases, with ongoing research programs on cognitive and behavioral aspects of epilepsy in addition to other programs in mild traumatic brain injury and forensic neuropsychology. He has served as a professional consultant to professional sports leagues, including the NFL and NHL. He has a long history of research studies on concussion in athletes and is an active participant in current studies on chronic traumatic encephalopathy (CTE).   

Christian LoBue, Ph.D.
, is a Licensed Psychologist with the Texas State Board of Examiners of Psychologists. Dr. LoBue is an Assistant Professor in the Departments of Psychiatry and Neurological Surgery at UT Southwestern Medical Center. He specializes in neuropsychological assessment and management of behaviors related to concussion, severe traumatic brain injury, Alzheimer’s disease and related dementias, cerebrovascular disorders, and brain tumors, performing evaluations to characterize thinking skills such as memory, attention, and language in people with suspected or diagnosed brain conditions and collaborating closely with neurologists, neurosurgeons, and psychiatrists to identify and treat patients in both ambulatory and inpatient settings. Dr. LoBue completed both his doctorate in clinical psychology and postdoctoral fellowship in neuropsychology at UT Southwestern before joining the faculty in 2018. His research interests include exploring factors related to concussion recovery, the long-term effects of head trauma during aging, and neurostimulation interventions after brain injury. He has received research funding from the Alzheimer’s Association and the Department of Defense. His lab is also involved in the development of new tests for assessing symptoms and thinking skills in those with brain conditions. Dr. LoBue is a member of the American Psychological Association, the International Neuropsychological Society, the National Academy of Neuropsychology, and the Society for Clinical Neuropsychology.

Dr. Cullum is a Clinical Neuropsychologist who specializes in the assessment of cognitive disorders. He is board certified in Clinical Neuropsychology (ABPP/ABCN) and serves as the Vice Chair and Chief of the Division of Psychology in the Department of Psychiatry, where he holds the Pamela Blumenthal Distinguished Professorship in Clinical Psychology. He is the PI of the Concussion-Texas (ConTex) studies, serves as the Scientific Director of the Texas Alzheimer's Research and Care Consortium (TARCC), and is the Clinical Core leader in the UTSW Alzheimer's Disease Center. He is a past president of the Society for Clinical Neuropsychology and the National Academy of Neuropsychology and the incoming President of the Sports Neuropsychology Society. He is actively involved in research, teaching, and clinical practice in neuropsychology. His research includes investigations into short- and long-term effects of concussion and early detection and differential diagnosis of neurodegenerative conditions of aging. His clinical research lab is also involved in cognitive test development and in telemedicine applications of neuropsychology.


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Short- and Long-Term Outcomes After Pediatric Traumatic Brain Injury

1.5 CE Credits

Presented by:
Jacobus Donders, Ph.D.
Chief Psychologist
Mary Free Bed Rehabilitation Hospital

This webinar will review the behavioral, cognitive and psychosocial outcomes of children with traumatic brain injury (TBI) at various intervals.  The emphasis will be on empirical research within the last dozen years.  Key concepts pertaining to injury variables will be illustrated with reviews of various neuroimaging findings.  Moderators and mediators of various outcomes after pediatric TBI will also be addressed.  The presentation will end with a review of variables to consider in transition to adulthood, including assessment of civil capacity, illustrated with a case study.

After the webinar, participants will be able to:

  1. Describe predictors of recovery from pediatric TBI of various severities and at various intervals.
  2. Discuss the differences in predictors of outcomes in various domains.
  3. Explain the empirical base for assessment and intervention after pediatric TBI.
  4. List important factors to consider in transition to adulthood.

Target Audience: Graduate students, interns, postdoctoral residents and early career professionals

Instructional Level: Intermediate

Jacobus Donders, Ph.D. is the Chief Psychologist at Mary Free Bed Rehabilitation Hospital in Grand Rapids, MI.  He is board-certified in Clinical Neuropsychology as well as Rehabilitation Psychology through the American Board of Professional Neuropsychology.  In addition to being an active clinical practitioner, he has served on multiple editorial and executive boards, has authored or co-authored more than 100 publications in peer-reviewed journals, and has edited or co-edited five textbooks.  Dr. Donders is a current associate editor of the journals Child Neuropsychology and Archives of Clinical Neuropsychology.  He is also a Fellow of the American Psychological Association and of the National Academy of Neuropsychology.

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TBI in the Military: Is the Warrior Wounded?

1.5 CE Credits

Presented by:
Robert A. Seegmiller, Ph.D., ABPP
Director, Postdoctoral Residency in Clinical Neuropsychology
Staff Neuropsychologist, Department of Behavioral Medicine
Brooke Army Medical Center

This webinar will review a number of clinically significant issues relating to traumatic brain injury (TBI) in the military, with an emphasis on mild traumatic brain injuries sustained by service members who served in OIF/OEF. In addition to a brief review of prevalence statistics, topics to be covered will include an examination of blast versus conventional blunt-force trauma injuries, assessment and management of mild TBIs in military environments, factors that contribute to chronic postconcussive syndromes, the relationship between mTBIs and PTSD, military disability evaluations, malingering and somatoform presentations, and a brief discussion of intervention goals and strategies. The webinar will address a wide range of issues that are most likely to be encountered by neuropsychologists and other mental health providers who work with military members and veterans who have sustained the “signature injury of the war.” 

After the webinar, participants will be able to:

  1. Describe the prevalence and nature of traumatic brain injuries sustained by military personnel during OIF/OEF, including injury severity and key demographics.
  2. Summarize challenges associated with the assessment and management of mild traumatic brain injuries in different military environments.
  3. Delineate similarities and differences between blast-induced and blunt-force traumatic brain injuries.
  4. Discuss performance and symptom validity test “failures” in the context of mild traumatic brain injuries in a military population. 

Target Audience:This webinar is intended for those with an interest in military traumatic brain injuries. The primary emphasis will be on military personnel who have sustained mild traumatic brain injuries (mTBIs) during Operations Enduring Freedom and Iraqi Freedom. Neuropsychologists and other mental health providers who assess and treat this population, and those who simply have an interest in how the military deals with patients with mTBIs, are invited to participate.

Instructional Level:Introductory to Intermediate

About Robert A. Seegmiller, Ph.D., ABPP 
Dr.  Robert Seegmiller is a clinical neuropsychologist and Director of the Postdoctoral Residency in Clinical Neuropsychology at Brooke Army Medical Center in San Antonio, Texas. He retired from the United States Air Force in July 2007, where he previously served as the Chief of Neuropsychology Services at Wilford Hall USAF Medical Center. He earned his Bachelor’s Degree in Psychology at Brigham Young University and his Master’s and Doctorate Degrees in Psychology at Iowa State University. Dr. Seegmiller completed a two year post-doctoral fellowship in clinical neuropsychology at the University of Virginia Health Sciences Center in 1998 and received his board certification in clinical neuropsychology from the American Board of Professional Psychology in 2000. He deployed twice to Qatar, once to Iraq, and once to Guantanamo Bay, Cuba in support of military operations following September 11th, 2001. He is married and has four sons.

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When Psychological and Brain Trauma Co-Occur: PTSD and Mild TBI in Adults

1.5 CE Credits



  Jennifer J. Vasterling, Ph.D.
Chief of Psychology, VA Boston Healthcare System
Professor of Psychiatry, Boston University School of Medicine
Affiliated Investigator, Behavioral Science Division of the National Center for PTSD

   
 
Laura J. Grande, Ph.D.
Director of Clinical Neuropsychology, Psychology Service, VA Boston Healthcare System
Assistant Professor of Psychiatry, Boston University School of Medicine
Adjunct Instructor of Psychology (Psychiatry), Harvard Medical School


Many events that lead to mild traumatic brain injury (mTBI) are also psychologically traumatic or occur in the broader context of ongoing psychological trauma.  In such cases, individuals may experience posttraumatic stress disorder (PTSD).  This presentation focuses on the clinical complexities of co-occurring mTBI and PTSD.  The presentation will cover the epidemiology of PTSD following TBI; cognitive, neural, psychological, and contextual mechanisms that may complicate recovery; the clinical presentation of mTBI and PTSD, with a focus on neuropsychological, emotional, and functional features; and implications for neuropsychological assessment and treatment/rehabilitation.  Case examples will be interwoven with discussion of the empirical literature.

After the webinar, participants will be able to:

  1. Describe common clinical features associated with co-occurring mild traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD).
  2. Discuss potential mechanisms that may complicate recovery from psychological and brain trauma following TBI events that are also psychologically traumatic.
  3. Utilize premorbid, post-injury, and assessment information in assessing patients with history of mild TBI and current PTSD. 
  4. Explain limitations in sole reliance on neuropsychological test data to make differential etiological attributions of mild TBI vs. PTSD.  

Target Audience: Neuropsychologists, rehabilitation psychologists, and other psychologists working with adult patients with history of mild traumatic brain injury

Instructional Level: Intermediate

Dr. Jennifer Vasterling is the Chief of Psychology at VA Boston Healthcare System, a Professor of Psychiatry at Boston University School of Medicine, and an affiliated investigator of the Behavioral Science Division of the National Center for PTSD.  Trained as a clinical neuropsychologist, Dr. Vasterling’s research has centered on neurocognitive correlates of PTSD and the longitudinal emotional and neuropsychological outcomes of war-zone participation.  She has edited several books, the most recent of which addresses co-morbid PTSD and mild traumatic brain injury.  Dr. Vasterling currently serves on the editorial boards of the journals Neuropsychology and Psychological Assessment, is a current member of the INS Board of Governors, and is a former president of APA Division 40 (Society for Clinical Neuropsychology).

Dr. Laura Grande is the Director of Clinical Neuropsychology at VA Boston Healthcare System, and an Assistant Professor of Psychiatry at Boston University School of Medicine.  Dr. Grande’s research interests include neuropsychology of aging, with a specific interest in selective attention and development of clinical assessment tools. Additional interest in memory and TBI and the impact of PTSD on cognitive and neuropsychological functioning.  She serves the Co-Director of the Clinical Neuropsychology Postdoctoral Fellowship at VA Boston Healthcare System.


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