from the
guest editors
Traumatic Brain Injury (TBI) can result in lasting changes in cognition, mood, behavior, and physical functioning. It has long been assumed that after an individual recovers for a year or so, things don’t change much – the injury has taken its course. But in recent years, research has begun to quantify something that people living with brain injury, their families, and doctors have suspected for a while: that the effects of a TBI are not static. Some people keep improving for years and years following injury, and sadly others begin to decline after a period of recovery. And for some people, the TBI seems to serve as a catalyst for a wide variety of health problems. Research has highlighted high rates of chronic health conditions experienced by long-term survivors of TBI, drawn associations between TBI and dementia, and consistently found evidence for a shortened lifespan – even among those who survive more than a year following injury. John D. Corrigan, PhD
Kristen Dams-O’Connor, PhD
Ten years ago some of these findings were summarized in a paper published in the Journal of Neurotrauma, and the authors wondered: should TBI be considered a chronic disease? This was a provocative question indeed. The TBI community was activated by the dialog that ensued, and researchers across the globe have begun to investigate the myriad questions that arose: How might a TBI initiate or exacerbate diseases of other body systems? What happens in the brain years after injury to allow a neurodegenerative process to unfold? And most importantly: how can we treat it? As these questions continue to be explored, researchers and clinicians and survivors began searching for treatments, tools, tips and tricks – things that can be done now to maximize health, productivity, life quality, and longevity. In the current issue of Brain Injury Professional, we attempt to summarize the current state of knowledge with respect to TBI as a chronic health condition. Evidence has accumulated to support the notion that individuals with TBI have increased risk for a variety of pre-existing and post-injury chronic health conditions, and there appears to be a link between TBI and some types of neurodegenerative processes. But we’ve also seen clear evidence that a substantial minority of people with TBI continue to recover for years longer than we traditionally believed possible. We don’t yet know why outcomes can differ so greatly. In this issue, we have selected topical articles that present evidence-based and clinically-supported answers for those who wonder how they can be in the group that continues to recover, grow, and thrive. Our team of authors discuss the power of resilience and how to build it, strategies for vocational success (not just how to get a job, but how to keep it!), and specific strategies for health selfmanagement. We consider the support needs of care partners, and the importance of sexuality education in post-TBI rehabilitation. We sought input from experts in living with brain injury who graciously shared their wisdom and advice for living well. We hope that the content of this issue encourages ongoing dialogue about healthy living after TBI. The research summarized here can and should be used to advocate for intensive rehabilitation, long-term health management, and other supports that TBI survivors need and deserve. And the advice contained herein, whether based in empirical science, clinical expertise, or lived experience – is offered with encouragement and admiration for all those who are striving to live well with TBI.
Editors' Bios John D. Corrigan, PhD, is a Professor in the Department of Physical Medicine and Rehabilitation at Ohio State University and Director of the Ohio Valley Center for Brain Injury Prevention and Rehabilitation, which, among other activities, is the designated lead agency in the state of Ohio for TBI policy and planning. Kristen Dams-O’Connor, PhD, is Director of the Brain Injury Research Center of Mount Sinai and Associate Professor in the Departments of Rehabilitation Medicine and Neurology at Icahn School of Medicine at Mount Sinai in New York, NY. She leads the Late Effects of TBI (LETBI) Project, a TBI brain donor program focused on characterizing the clinical and pathological signatures of post-traumatic neurodegeneration. She is also Project Director of the New York Traumatic Brain Injury Model System of care at Mount Sinai.
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