RESUMO

BACKGROUND: Targeted Evaluation Action and Monitoring of Traumatic Brain Injury (TEAM-TBI) is a monitored, multiple interventional research identifying clinical profiles and assigns individualized, evidence-based treatment program. The objective of the current study was to assess overall participant satisfaction of the multi-disciplinary care team and approach. METHODS: Between 2014 and 2017, 90 participants completed the 4-day TEAM-TBI clinical intake evaluation resulting in individualized treatment recommendations followed by a six-month intervention phase follow-up. Inclusion criteria were: age 18-60, history of chronic TBI (>6 months post-injury) with refractory clinical sequelae at screening (Post-Concussion Symptom Scale [PCSS] score >30). RESULTS: A total of 85/90 (94%) participants completed the survey at baseline focusing on intake evaluation and approach; 90% of eligible participants also completed the follow-up time-point. Hundred percent of participants had a mean score of >4 across all questions at the initial time point." CONCLUSIONS: The multi-disciplinary care approach and individualized treatment plans of the TEAM-TBI study yielded high participant retention and satisfaction scores. The Clinical Coach component of the trial was one of the highest rated aspects of the program and was associated with participant motivation and high retention rates.

Assuntos

Ensaios Clínicos como Assunto/métodos , Seleção de Pacientes , Qualidade da Assistência à Saúde/normas , Sujeitos da Pesquisa/psicologia , Adulto , Ensaios Clínicos como Assunto/normas , Ensaios Clínicos como Assunto/estatística & dados numéricos , Feminino , Humanos , Masculino , Satisfação Pessoal , Qualidade da Assistência à Saúde/estatística & dados numéricos , Sujeitos da Pesquisa/estatística & dados numéricos , Inquéritos e Questionários

RESUMO

Brain-based behavioral interventions targeting specific neurocognitive mechanisms show initial promise in the treatment of emotional disorders, but personalization of such approaches will be facilitated if brain targets are empirically established. As a preliminary step, we conducted a proof-of-concept study to test whether particular emotion regulatory neural circuitry can be differentially targeted by specific neurocognitive tasks, and whether these tasks effectively inhibit amygdala activity. Eleven healthy individuals underwent an idiographic sadness and guilt induction. Brain response was measured via fMRI during 4 subsequent emotion regulation conditions: fixation, cognitive reappraisal (selected to target the ventrolateral prefrontal cortex), working memory practice (selected to target the dorsolateral prefrontal cortex), and visual distraction (Tetris; selected to target occipital cortex). In whole-brain comparisons to fixation, hypotheses were upheld. Reappraisal uniquely activated left ventrolateral prefrontal cortex, working memory practice uniquely activated left dorsolateral prefrontal cortex, and Tetris uniquely activated bilateral occipitoparietal cortex, activations that were largely robust at the single-subject level. All tasks inhibited amygdala activity relative to fixation. Data support examining whether repeated exposure to these tasks in psychiatric patients affects neural abnormalities implicated in emotional disorders. Ideally, psychiatric treatment will be accelerated by matching specific treatments to patients with specific neural profiles.