Projects

Neurobehavioural predictors of community function in individuals living with a TBI

PROBLEM

Successful performance of daily activities requires executive control, a key cognitive function that allows humans to flexibly select and process sensory information to facilitate achievement of behavioral goals. Accumulating research indicates that cognitive function and oculomotor control are closely linked and they are both impaired following a Traumatic Brain Injury (TBI), even in relatively mild cases.  In parallel, impairments in the sensorimotor control balance and locomotion are also observed following TBI. However, the inter-relationships between measures of neurobehavioural function (cognition, oculomotor control, sensorimotor control of locomotion) and their relationships with community function have not been clearly determined.

OBJECTIVES

The overall goal of this project is to develop novel neurobehavioral interventions that optimize community function in individuals living with a TBI. To achieve this overall goal, the initial focus of our team is to develop a model of neurobehavioural assessment that may be integrated across multiple research/clinical settings. Within this context, in a population of individuals living with a TBI, the specific objectives are: Determine the inter-relationship between neurobehavioural measures of function (cognition, oculomotor control of eye movements, sensorimotor control of balance/locomotion).

Determine the predictive validity of neurobehavioural measures of function with community function.Expected results and potential significance: The present study will provide new insight into the potential relationship between neurobehavioural measures and community function of individuals living with a TBI. In particular, it will firstly identify the inter-relationship between neurobehavioural measures, and secondly their association with community function. This knowledge will guide the development of novel interventions that aim to enhance community function and integration. Establishing this protocol will provide the basis for integration into multi-centre studies that integrate multi-modal sources of data (eg., imaging, biomarkers).

METHODS

We propose to conduct a prospective observational study that will recruit adults living with a TBI in the community. Individuals recruited for this study will have no previous history of musculoskeletal or neurological conditions other than TBI, and live independently in the community, and are aged 18-65 years. Participants will undergo a neurobehavioural assessment that will evaluate cognitive and occulomotor function during the performance the Bathesda Eye & Attention Measure (Attention); Antisaccade Test (Inhibition); Corsi Block Test (Working Memory); Tower of London (Planning Ability) tests. Eye movement measures will include saccadic reaction time, fixation (scan) patterns, and memory span. In addition, cognitive and sensorimotor contributions to balance and locomotion will be determined through single and dual task (Stroop) tasks of standing balance and locomotion (with and without obstacles). Primary sensorimotor outcome measures will include spatial, temporal and frequency characteristics of the balance/locomotor tasks. Reaction time on the stroop task will reflect cognitive performance tasks. To address Objective 1, principle component analysis will be utilised as an analytical technique to explore potential associations between oculomotor control and sensorimotor control of locomotion. To address Objective 2, the same participants will complete the Multiple Errands Test, and the Mayo Portland Adaptability Inventory. A linear regression model will be developed to determine the predictive ability of specific measures obtained from neurobehavioural assessments (cognitive, oculomotor, sensorimotor). In light of the novelty of the associations explored in this study, a preliminary sample size of 20 adults living with a TBI is proposed. This sample will provide the basis for the development of a larger multi-centre study.

TIMELINES

The proposed time line and major milestones are as follows: Research Ethics Board approval (January –March 2018), pilot data collection (April 2018), data collection (May-September 2018), Analysis (June-October 2018), manuscript submission (October 2018-January 2019)

CO-INVESTIGATOR(S)

• Niechwiej-Szwedo E
• McFadyen B
• Swaine B
• Gagnon I
• Schneider C
• Nalder E
• Beauchamp M