August 5, 2008

• Medical decision-making suffers following head injury.

• Effects can last long after hospitalization.

BIRMINGHAM, Ala. - People who have suffered a traumatic brain injury (TBI) often have diminished decision-making skills during recovery. UAB researchers have launched a study to better understand when patients with TBI regain that ability as it relates to medical decision-making.

The Reclaimed study (Recovering Lost Abilities in Medical Decision-making) is supported by a five-year, $1.2 million grant from the National Institute of Child Health and Human Development, part of the National Institutes of Health.

"Recovery after TBI is frequently a long, slow process and the cognitive ability needed to make well-reasoned decisions can take months to return," said Daniel Marson, Ph.D., J.D., professor of neurology and principal investigator of the Reclaimed study. "This can have serious consequences for TBI patients during recovery as they cope with complications, secondary injuries and long-term treatment. The goal is to help persons with head injury, their families and physicians, better understand the process as it relates to medical decision-making abilities."

Reclaimed will assess TBI patients against a control group with a capacity assessment instrument, a clinical evaluation of capacity by a psychiatrist, and a battery of neuropsychological tests. Researchers will enroll patients within six weeks of injury and follow them for one year.

"We don't have a good barometer for when medical decision-making skills return following head injury," said Roy Martin, Ph.D., associate professor of neurology and a primary co-investigator. "Since many TBI's occur in young people, the impact on society can be high. In Alabama alone, more than 1,500 people are disabled each year due to a head injury."

In addition to medical decision-making, the researchers say TBI patients also show impairment in other cognitive functions, including the ability to drive a vehicle, understand financial matters and live independently.

"Caregivers, medical professionals and patients themselves need a reliable measure for the recovery of reasoning and understanding skills," Marson said. "Cognitive impairments following head injury can persist long after acute hospitalization."

Alabama Head Injury Foundation says a person suffers a head injury every 21 seconds in the United States. Leading causes are falls, vehicle crashes, being struck by an object or assaults. Males are 1.5 times more likely than females to have a head injury. Over 5.3 million Americans live with a disability caused by head injury.