New Guidelines to Treat Behavior Problems Following Traumatic Brain Injury Published in Journal of Neurotrauma.

NEW ROCHELLE, N.Y. -- Important new, evidence-based guidelines for the pharmacologic treatment of behavior problems associated with traumatic brain injury are published in the October issue (Volume 23, Number 10) of Journal of Neurotrauma, a peer-reviewed journal published by Mary Ann Liebert, Inc. (www.liebertpub.com). These guidelines are available free online at www.liebertpub.com/neu.

Neurobehavioral disorders including psychiatric and cognitive problems and aggression are common after traumatic brain injury (TBI). They can contribute to lifelong disability, impede rehabilitation and recovery, and negatively affect an individual's ability to work and pursue normal family and social relationships.

Made up of three panels of experts on TBI, the Guidelines Working Group reviewed the medical literature and concluded that, with some exceptions, the quality of the evidence was insufficient to support specific therapeutic standards but could be used to guide pharmacologic treatment recommendations. Overall, the flawed methodology used in many published studies greatly limits their use as evidence on which to base treatment standards. The working group emphasized the need for well-designed studies that could guide future efforts to establish treatment guidelines.

The group did present several evidence-based recommendations in the report entitled, "Guidelines for the Pharmacologic Treatment of Neurobehavioral Sequelae of Traumatic Brain Injury," including guidelines for the use of the beta blockers propanolol and pindolol to treat aggression in TBI patients. The report also supports the optional use of methylphenidate, cranial electrical stimulation, homeopathy, serotonin reuptake inhibitors, valproate, lithium, tricyclic antidepressants, and buspirone to treat TBI-related aggression.

For the treatment of problems with attention and speed of information processing, the report proposes guidelines for the use of methylphenidate and outlines other treatment options. Similarly, the report describes therapeutic options for treating depression, bipolar disorder/mania, psychosis, and deficits in general cognitive functions following TBI.

"While the results of this critical assessment are disappointing, it does provide a valuable resource to the readership of the journal," says John T. Povlishock, Ph.D., Editor-in-Chief of Journal of Neurotrauma, and Chair of the Department of Anatomy and Neurobiology at Virginia Commonwealth University's Medical College of Virginia Campus in Richmond. "This report should prove invaluable to those involved in the treatment of such patients, while inspiring them to conduct further well designed, randomized, controlled trials."

"These guidelines will not only assist clinicians treating persons with TBI, but also suggest areas where limited research dollars can be directed to augment existing evidence," says Deborah Warden, MD, National Director, Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC, and Professor of Neurology and Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD.

Journal of Neurotrauma is an authoritative peer-reviewed journal published monthly in print and online that focuses on the latest advances in the clinical and laboratory investigation of traumatic brain and spinal cord injury. Emphasis is on the basic pathobiology of injury to the nervous system, and the papers and reviews evaluate preclinical and clinical trials targeted at improving the early management and long-term care and recovery of patients with traumatic brain injury. Journal of Neurotrauma is the official journal of the National Neurotrauma Society and the International Neurotrauma Society. A complete table of contents and a free sample issue may be viewed online at www.liebertpub.com/neu.

Mary Ann Liebert, Inc., is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research. Its biotechnology trade magazine, Genetic Engineering News (GEN), was the first in its field and is today the industry's most widely read publication worldwide. A complete list of the firm's 60 journals, books, and newsletters is available at www.liebertpub.com.