Acquired brain injury

TBI incidence, causes, and costs over time and service access in New Zealand (BIONIC 2)

Contact:
Principal Investigator: Associate Professor Kelly Jones
Study manager: Leah Haumaha

Aim

Traumatic brain injury (TBI) is a leading cause of disability worldwide that can significantly impact the lives of those affected and their family/whānau. Recent evidence suggests that the number of people sustaining some types of TBI may be changing over time. Using proven methods, a new population-based study of TBI will confirm the current nature of TBI in New Zealand. This information will be compared to similar population data from 2010-2011 to determine the true extent of any changes in TBI over time. An additional focus will be on improving understanding of the limited access to initial TBI healthcare services that we observed in our prior research. Findings will help to make sure that TBI guidelines and services align with the true nature of TBI in New Zealand, and that services become more accessible and equitable for all New Zealanders to improve outcomes and reduce the national burden of TBI.

Project team leaders/collaborators

• Professor Valery Feigin, AUT
• Dr Kelly Jones, AUT
• Professor Alice Theadom, AUT
• Dr Irene Zeng, AUT
• Professor Shanthi Ameratunga, University of Auckland
• Dr Braden Te Ao, University of Auckland
• Professor Nicola Starkey, University of Waikato
• Dr Laura Wilkinson, AUT

Timeline: 1 October 2020 to 30 September 2023
Funder: Health Research Council of New Zealand
Budget: $1.2million

Study newsletters

• 1. December 2021
• 2. March 2022

COVID-19 impacts among a multinational cohort of children and youth with brain injury

Principal Investigator (New Zealand): Dr. Kelly Jones

The overarching aim of this study is to undertake a multinational survey to determine the impacts of COVID-19 on children and youth with brain injury (BI) to identify opportunities to support well-being. It will use a cross-sectional, observational, multinational online survey examining parent /caregiver and self-reported effects of COVID-19 on children and youth with BI.

This project is a collaboration between Kelly Jones (PI NZ) and paediatric researchers based in the UK, Italy Canada and the USA.

Findings will provide a snapshot of the impacts of COVID-19 and related restrictions in a multinational setting and may reveal opportunities to support children, youth, and their families during the pandemic to support well-being.

Contact: Kelly Jones

Aim

Adolescents with a history of acquired brain injury (ABI; e.g., due to traumatic brain injury, stroke, infection) face increased risks for poor social, emotional, behavioural and cognitive outcomes that adversely impact mental health. Yet, access to proven interventions to support mental health and well-being of adolescents with ABI is limited. An effective, evidenced-based ‘Teen Online Problem-Solving’ (TOPS) intervention has been adapted for use in New Zealand (NZ). This pilot study aims to study the clinical implementation of TOPS-NZ into standard clinical care, and to examine its effectiveness for improving adolescent mental health and well-being when delivered clinically in New Zealand.

Timeline

3 February 2025 - 2 February 2026

Funder

Vic Davis Memorial Trust

Contact

Associate Professor Kelly Jones

The Pediatric Traumatic Brain Injury Consortium New Zealand (PTBIC) aims to expand understanding of traumatic brain injury during childhood and adolescence, and improve outcomes of affected children and their families by promoting a collaborative approach to research.

Members:

Researchers

Dr Kelly Jones, National Institute for Stroke and Applied Neurosciences (NISAN), AUT 
Dr Kelly Jones is a registered psychologist who has extensive experience in the neuropsychological assessment of children, spanning infancy to adolescence.Kelly's research interests surround the emotional, behavioural and social development of children during early childhood, with particular interests in emotion regulation and peer relations.

Following the completion of a PhD in developmental psychology undertaken at the University of Canterbury, Kelly relocated to the Waikato to join the BIONIC team and she now manages the day-to -day operations of the study.


Associate Professor Nicola Starkey, School of Psychology, University of Waikato
At the School of Psychology, University of Waikato, current research projects span a variety of areas including traumatic brain injury (supported by the Health Research Council of New Zealand and the Lottery Grants Board), stroke and driver behaviour and education. Nicola has a keen interest in neuropsychology and psychological assessment more generally, and is involved in a small amount of animal behaviour research.


Professor Valery Feigin, National Institute for Stroke and Applied Neurosciences (NISAN), AUT 
Professor of Epidemiology and Neurology, Director of the National Institute for Stroke and Applied Neurosciences (NISAN), School of Rehabilitation and Occupation Studies, School of Public Health and Psychosocial Studies, Faculty of Health and Environmental Sciences, AUT, Auckland, New Zealand.


Dr Alice Theadom, National Institute for Stroke and Applied Neurosciences (NISAN), AUT 
Alice is a NZ Registered Psychologist. She undertook her training in the UK, completing her undergraduate honours degree in Psychology at the University of Essex and MSc in Health Psychology at Surrey University. Since joining AUT, Alice completed her PhD which explored sleep difficulties in Fibromyalgia Syndrome. Alice leads the traumatic brain and spinal cord injury programme at NISAN and is also involved in developing research into neuromuscular conditions and fibromyalgia syndrome.


Associate Professor Suzanne Barker-Collo, School of Psychology, University of Auckland
A registered neuropsychologist and senior lecturer in the Psychology Department at the University of Auckland, Suzanne's research interests lie in the areas of neuropsychological assessment and rehabilitation. She has a track record of research in the area with over $10 million of funding.  She has published extensively in the area of neuropsychological assessment, and already developed some normative data sets for New Zealand.

Dr Margaret Jones, Dept. of Occupational Science & Therapy, AUT 
Margaret is currently completing her PhD studies into Participation for Aotearoa New Zealand Children after Traumatic Brain Injury. Her Masters research used a grounded theory methodology, and focused on caregiving for children after traumatic brain injury. It generated a theory explaining the processes involved for parents called Structuring for Security. Margaret's current research interests include children's participation, paediatric traumatic brain injury, paediatric rehabilitation, and children’s occupations and health.

Marion Baird – Field Officer
Marion has 20 years experience in the health and disability sector, with 10 years working alongside clients with neurological conditions, providing support, information and advocacy, within a community social service.  Marion has completed the Community Based Rehabilitation for Acquired Brain Injury courses by Dr Barry Willer and Duncan Babbage through AUT.  Marion attends regular training/professional development courses relevant to her role.

Clinicians

Dr Rosalind Case
Dr Rosalind Case is a registered clinical psychologist and research fellow in the Department of Epidemiology and Preventive Medicine at Monash University in Melbourne, Australia. At Monash, Rosalind's research is focused around the chain of survival and outcomes related to out-of-hospital cardiac arrest, as part of the Australian Resuscitation Outcomes Consortium (Aus-ROC), a Centre for Research Excellence. Prior to moving to Melbourne, Rosalind was awarded a Health Research Council Clinical Research Fellowship to conduct PhD research investigating the developmental outcomes of children following mild TBI, in association with the Brain Injury Outcomes New Zealand in the Community (BIONIC) and Consequences of Brain Injury in Childhood (COBIC) projects, and maintains a special interest in pediatric neurodevelopmental outcomes.

Dr Grant Christey, General, Hepatobiliary and Trauma surgeon, Waikato Hospital

Jessica Hannah

Dr Audrey McKinlay, Clinical Psychologist, University of Melbourne

Dawn Willix-Payne, Clinical Psychologist, Waikato District Health Board

Other members

• Amy Fallaize, University of Bath (UK), placement student
• Kathryn Giles, University of Waikato
• David Hollands
• Karen Murphy, University of Waikato
• Jennie Parsons
• Katie Pocock, University of Bath (UK), placement student
• Samantha Williams, University of Waikato
• Professor Shari Wade, Cincinnati Children's Hospital

Supporting organisations

Brain Injury - Waikato

Empowers people affected by brain injury through the provision of information, education and advocacy support and raise awareness and prevention in the community.

We assist children with TBI by educating teacher’s aides and teachers about the effects TBI have on the child, strategies to maximise learning and how to manage the student’s fatigue.  We provide information to families including siblings on dealing with the child with TBI, and how to avoid further injury.

We assist and work with families and services, including ACC, to meet a broad range of needs.

Midland Trauma System (MTS) 

Over 5000 people in the Midland health region are hospitalised each year due to injury; 300 of whom will sustain severe or life-threatening injuries. While this represents an estimated $50m in hospital costs alone across the Midland health region, the true burden is many times this for the patients, their families/whanau, and our communities.  Established in 2010, Midland Trauma System (MTS) has made significant progress in delivering the critical elements of an efficient trauma system. The registry collects comprehensive data on patients of all age groups and injury severities, allowing detailed analyses of injury events, patient factors, processes in care and outcomes. The ultimate goals are to improve the delivery of clinical care by using collected data to inform the refinement of systems and the delivery of cost-effective services and injury prevention. The aims of MTS align closely with those of the Pediatric TBI consortium and other supporting organisations, being to reduce the burden of trauma in our community.  A new project is now underway to examine data from the registry to determine trends in rates of hospitalised pediatric TBI in the region between 2012 and 2016. We look forward to sharing these findings with you. For further information about MTS visit http://www.midlandtrauma.nz/

Safekids Aotearoa

Links have recently been made with Safekids Aotearoa, a national injury prevention service that comes under the umbrella of Starship Child Health. Safekids Aotearoa and the Consortium have overlapping interests in children’s health and injury prevention. We look forward to liaising closely with the team at Safekids Aotearoa to identify collaborative efforts in the field of pediatric TBI.

Traumatic brain injury (TBI) represents one of the greatest unmet needs in medicine and public health worldwide. To help impact on the treatment and prevention of brain injury at an international level, NISAN is part of the European Union CENTER-TBI collaboration.

The collaboration includes researchers from over 40 centres from across 19 countries with expertise in brain injury. The collaboration aims improve characterization and classification of TBI, and to improve health care delivery and treatment by identifying the most effective clinical interventions to inform treatment recommendations and guidelines. This is the largest in the world TBI epidemiological project.

The collaboration is being funded by the European Union Commission. Through the sharing of anonymised data (to enable more intricate analyses which larger patient numbers), resources and expertise, this landmark project aims to greatly enhance knowledge and improve outcomes for people following a brain injury.

Contact: Alice Theadom

Traumatic brain injury burden in New Zealand: A population-based incidence and outcomes study

This is a prospective population-based study that aims to register all cases of traumatic brain injury that occur in the Hamilton and Waikato districts (a general population representative of New Zealand) between 1st March 2010 and 28th Feb 2011 (173,208 rural and urban residents). All new cases of TBI will be ascertained over a 12 month period using prospective and retrospective surveillance, and all participants will be followed up over 12 months.

Complete case ascertainment will be assured by multiple overlapping sources of information for all new hospitalised and non-hospitalised TBI cases (fatal and non-fatal). Capture-recapture analysis will be conducted.

This will include all private and public hospitals and emergency departments (e.g. surgery & neurosurgery departments), CT/MRI records, hospital discharge register, coroner/autopsy records, death certificates, community health services (GP practices, rehabilitation/outpatient clinics), Accident and Medical Centres in Hamilton and Waikato districts, ACC and NHIS databases for all fatal/non-fatal TBIs and self referral.

Funded by the Health Research Council, the study was completed November 2012.

Further information

• BIONIC infographics
• BIONIC TBI media activity
• BIONIC publication list (April 2018)
• BIONIC Newsletter March 2010
• BIONIC Newsletter June 2010
• BIONIC Newsletter September 2010
• BIONIC Newsletter December 2010
• BIONIC Newsletter March 2011
• BIONIC Newsletter July 2011
• BIONIC Newsletter October 2011
• BIONIC Newsletter December 2011
• BIONIC Newsletter March 2012
• BIONIC Newsletter July 2012

BIONIC–Related Publications

1. Jones, K.M., Prah, P., Starkey, N., Theadom, A., Barker-Collo, S.,  Ameratunga, S., & Feigin V.L., for the BIONIC Study Group (2019). Longitudinal patterns of behavior, cognition, and quality of life after mild traumatic brain injury in children: BIONIC study findings, Brain Injury, DOI: 10.1080/02699052.2019.1606445
2. Theadom, A., Starkey, N., Barker-Collo, S., Jones, K., Ameratunga, S., & Feigin, V. On behalf of the BIONIC4you Research group. (2018). Population-based cohort studies of the impacts of mild traumatic brain injury in adults four years post-injury. PLoS One 13(1), e0191655. doi: https://doi.org/10.1371/journal.pone.0191655.
3. Jones, K., Barker-Collo, S., Parmar, P., Starkey, N., Theadom, A., Ameratunga, S., & Feigin, V.L.,on behalf of the BIONIC study group. (2018). Trajectories in health recovery in the 12 months following a mild traumatic brain injury in children: Findings from the BIONIC Study. Journal of Primary Health Care, 10(1), 81-89. doi: 10.1071/HC17038.
4. Theadom, A., Barker-Collo, S., Greenwood, A., Parmar, P., Jones, K., Starkey, N., McPherson, K., & Feigin, V.L., on behalf of the BIONIC Study Group. (2017). Do mild traumatic brain injuryseverity sub-classification systems help to identify people who go on to experience long term symptoms. Brain Impairment. doi: 10.1017/BrImp.2017.11.
5. Theadom, A., Barker-Collo, S., Jones, K., Kahan, M., Te Ao, B., McPherson, K., Starkey, N., & Feigin, V. on behalf of the BIONIC4you Research Group. (2017). Work limitations four years following mild traumatic brain injury: A cohort study. Archives of Physical Medicine and Rehabilitation, 98(8):1560-1566. doi: 10.1016/j.apmr.2017.01.010.
6. Jones, K., Theadom, A., Barker-Collo, S., Broadbent, E., & Feigin, V.L. on behalf of the BIONICResearch Group.(2017). Associations between brain drawings following mild traumatic brain injury and negative illness perceptions and post-concussion symptoms at 4 years. Journal of Health Psychology, 1-11. doi: org/10.1177/1359105317695430.
7. Theadom, A., Starkey, N., Jones, K., Cropley, M., Parmar, P., Barker-Collo, S., & Feigin, V.L. (2016). Sleep difficulties and their impact on recovery following mild traumatic brain injury inchildren. Brain Injury, 30(10):1243-1248. doi: 10.1080/02699052.2016.1183171.
8. Barker-Collo, S., Theadom, A., Jones, K., Ameratunga, S., Feigin, V., Starkey, N., Dudley, M., & Kahan, M. (2016). Reliable individual change in post-concussive symptoms in the year followingmild traumatic brain injury: Data from the longitudinal population-based Brain InjuryIncidence and Outcomes New Zealand in the Community (BIONIC) study. JSM Burns and Trauma, 1(1): 1006.
9. Barker-Collo, S., Theadom, A., Jones, K., Feigin, V.L., & Kahan, M. (2016). Accuracy of an international classification of diseases code surveillence system in the identification of traumatic braininjury. Neuroepidemiology, 47, 46-52.doi: 10.1159/000448403.
10. Theadom, A,, Parag, V., Dowell, A., McPherson, K., Starkey, N., Barker-Collo, S., Jones, K., Ameratunga, S., & Feigin, V.L., on behalf of the BIONIC Research Group. (2016). Persistent problems one year following mild traumatic brain injury. British Journal of General Practice, 66(642), e16-23. doi: http://bjgp.org/content/66/642/e16.
11. Barker-Collo, S., Jones, K., Theadom, A., Starkey, N., Dowell, A., McPherson, K., Ameratunga, S., Dudley, M., Te Ao, B,, & Feigin, V.L. on behalf of the BIONIC Research Group. (2015). Neuropsychological outcome and its correlates in the year after adult mild traumatic brain injury: A population based New Zealand study. Brain Injury, 29(13-14), 1604-1616. doi:10.3109/02699052.2015.1075143.
12. Theadom, A., Cropley, M., Parmar, P., Barker-Collo, S., Starkey, N., Jones, K., & Feigin, V.L. on behalf of the BIONIC Research Group. (2015). Sleep difficulties one year following mild traumatic brain injury in a population-based study. Sleep Medicine, 16(8), 926-932. doi: 10.1016/j.sleep.2015.04.013.
13. Te Ao, B., Tobias, M., Ameratunga, S., Barker-Collo, S., Brown, P., Dowell, A., Jones, K., McPherson, K., Starkey, N., Theadom, A., & Feigin, V.L., on behalf of the BIONIC study group. (2015). Burden of traumatic brain injury in New Zealand: incidence, prevalence anddisability-adjusted life years. Neuroepidemiology, 44(4), 255-261.doi: 10.1159/000431043.
14. Barker-Collo, S., Theadom, A., & Feigin, V. (2015). Prevalence, natural course, and predictors of depression one year following traumatic brain injury from a population–based study in New Zealand. Brain Injury, 29(7-8):859-865. doi: 10.3109/02699052.2015.1004759.
15. Theadom, A., Parmar, P., Jones, K., Barker-Collo, S., Starkey, N.J., McPherson, K.M., Ameratunga, S., & Feigin, V.L. on behalf of the BIONIC Research Group. (2015). Frequency and impact of recurrent traumatic brain injury in a population-based sample. Journal of Neurotrauma, 32(10), 674-681.doi: 10.1089/neu.2014.3579.
16. Lagolago, W., Theadom, A., Fairburn-Dunlop, P., Ameratunga, S., Dowell, A., McPherson, K.,Te Ao, B., Starkey, N., & Feigin, V.L. on behalf of the BIONIC Research Group. (2015). Traumatic brain injury within Pacific people of New Zealand. New Zealand Medical Journal, 128(1412), 29-38.
17. Te Ao, B., Brown, P., Tobias, M., Ameratunga, S., Barker-Collo, S., Theadom, A., McPherson,K., Starkey, N.,  Dowell, A,, Jones, K., & Feigin VL, on behalf of the BIONIC Study Group. (2014). The cost of traumatic brain injury: Evidence from a population-based study in New Zealand. The Lancet Neurology, 83(18), 1645-1652. doi: 10.1212/WNL.0000000000000933.
18. Theadom, A., Starkey, N., Dowell, A., Hume, P., Kahan, M., McPherson, K., & Feigin, V. (2014). Sports related brain injury in the general population: An epidemiological study. Journal of Science and Medicine in Sport, 17(6), 591-596. doi: 10.1016/j.jsams.2014.02.001.
19. Barker-Collo, S., Theadom, A., Ameratunga, S., Jones, K., Jones, A., Starkey, N., & Feigin, V. on behalf of the BIONIC Research Group.(2013). Prevalence and predictors of post-traumatic stress disorder in adults one year following traumatic brain injury: A population-based study. Brain Impairment,14(3), 425-435. doi: 10.1017/BrImp.2013.27.
20. Feigin, V.L., Theadom, A., Barker-Collo, S., Starkey, N.J., McPherson, K., Kahan, M., Dowell, A., Brown, P., Parag, V., Kydd, R., Jones, K., Jones, A., & Ameratunga, S. on behalf of the BIONIC Study Group. (2013). Incidence of traumatic brain injury in New Zealand: A population-based study. The Lancet Neurology, 12(1), 53-64.doi: 10.1016/S1474-4422(12)70262-4.
21. Barker-Collo, S., Starkey, N., Kahan, M., Theadom, A., & Feigin, V.L.(2012). Computerised tomography indices of raised intracranial pressure and traumatic brain injury severity in a New Zealand sample. New Zealand Medical Journal, 125(1360), 92-94.
22. Theadom, A., Barker-Collo, S., Feigin, V.L., Starkey, N., Jones, K., Jones, A., Amerataunga, S., & Barber, A., on behalf of the BIONIC Research Group. (2012). The spectrum captured: A methodological approach to studying incidence and outcomes of Traumatic Brain Injury on a population level. Neuroepidemiology, 38(1), 18-29. doi: 10.1159/000334746.

Contact: Kelly Jones

Fatigue is a persistent problem that affects 73% of people after traumatic brain injury (TBI). Interventions have been found to improve levels of fatigue in other populations (e.g., cancer, multiple sclerosis and stroke) but there is little evidence on interventions for people following brain injury.

Aims

This pilot randomised controlled trial aims to explore whether an Cognitive behaviour based educational and behavioural intervention or physical activity group interventions are feasible to implement for people after a brain injury and to explore if there are any trends in improvement.

Methods

Participants will be recruited through TBI service providers in Auckland. A sample of n=20 (N=10 per group) will be recruited.

Inclusion criteria

1. Aged over 18 years;
2. who have moderate to severe fatigue (defined as a Fatigue Severity Scale score >3.9) will be recruited into the study;
3. 3- months to five years post-TBI.

Participants who consent to participate in the study will be randomised to receive either a CBT based educational and behavioural intervention or, physical activity therapy intervention.

Interventions

Both the physical activity and educational interventions will be delivered weekly, for 60 minutes over six weeks duration either in an individual or group (up to 5) format. Participants will be encouraged to bring a supportive friend/family member with them to the sessions. The sessions will include a 10 minute break and will be facilitated by a trained physiotherapist or OT.

Educational group sessions

All sessions will include a combination of information provision about fatigue and fatigue management strategies, task focused activities and discussions. In the first session, each participant will receive a Participant Booklet, which includes information to accompany each session, as well as a fatigue and activity diary.

Physical activity group sessions

These sessions will be supervised by a Qualified Physiotherapist and the physical activity programme tailored to meet the individual needs of the research participants. The focus will be on increasing participants activity levels (as a way of reducing fatigue), education on the relationships between activity and fatigue and discussions around how to implement the strategies in everyday life.

Outcome assessment

Participants will complete a range of outcome measures exploring fatigue, quality of life, mood and rehabilitation outcome on three occasions: baseline assessment, a post-treatment assessment and a follow up assessment (12 weeks) post treatment. Participants will also be given the opportunity to talk openly about their experiences of the intervention and their perceptions of its acceptability at the post-intervention assessment.

Funded by an AUT Faculty of Health and Environmental Studies Contestable Grant, the study was completed in November 2012.

Contact: Alice Theadom

This pilot study aimed to explore the safety of a herbal supplement, Enzogenol, in people who had experienced a mild traumatic brain injury (injury caused by an external force to the head).  This study was carried out as the herbal supplement, Enzogenol has not previously been tested in this population.  We also wanted to see if there were any trends between use of the supplement and cognitive functioning (memory) to identify if a full clinical trial is warranted.

60 adults who were 6-12 months post mild-TBI and who had been experiencing persisting cognitive deficits were recruited through ABI Rehabilitation Management and Integrated Partners in Health concussion clinics in Auckland and through self-referral via local media.

Participants were chosen at random to receive either the Enzogenol supplement or a placebo for a six-week period. All participants then received the supplement for the subsequent six weeks before taking a placebo (dummy pill) for the final 4 weeks. Assessments of cognitive functioning were conducted at baseline, 6, 12 and 16 week follow up. A significant decrease in the frequency of cognitive failures was revealed in the group taking the supplement for the first 6 weeks in comparison to those taking placebo. Improvements in cognitive functioning continued to be observed for those taking the supplement for a subsequent 6 weeks period.

Although the findings were positive, as this was a pilot study of a small number of participants, a full clinical trial will be needed to determine if Enzogenol does improve memory for people following brain injury. The supplement was only tested in people following a mild brain injury and further testing will be required to ensure safety in people following moderate to severe brain injury, stroke and other neurological conditions.

Collaborators

• V Feigin (AUT)
• A Theadom (AUT)
• S, Barker-Collo (Auckland)
• S Mahon (AUT)
• K McPherson (AUT)
• E Rush (AUT)

This project was funded by ENZO Nutraceuticals, and was completed in 2012.

In the BIONIC study we revealed that rates of brain injury were far higher than we had previously thought. We also revealed that the short term burden of brain injury had been grossly underestimated with many people experiencing moderate to severe levels of cognitive impairment, emotional disturbance and post concussive symptoms one year following injury even including those who had experienced a ‘so called’ mild injury. The long-term impact of initial and recurrent TBI in the NZ Community study aims to follow up that cohort of patients 4 years post-injury to see how they are doing.

Timeline: October 2013 to September 2016

Funded by The Health Research Council of New Zealand

Contact: Alice Theadom

This feasibility study aims to explore if two online programmes designed to improve sleep for people with traumatic brain injury (TBI) are useful and effective. Following some initial consultation work with people who have experienced a brain injury and health professionals, some online programmes have been developed based on evidence based treatments for insomnia. This study will recruit 36 people who have experienced a brain injury and have sleep problems to see if the programmes can help to improve their sleep quality. The programmes can be used at home or alongside a health professional. One module of the programme takes about 15 minutes to be completed each week for 6 weeks.

Lead investigator: Dr Alice Theadom

Funded by Health Research Council of New Zealand

Contact: Caroline Holder

Classification of mild traumatic brain injury (TBI) is currently problematic.  This study aims to review a TBI cohort classified using different classification symptoms to explore the most effective system, or to develop a revised system.

Funded by AUT Dean's Café

Contact: Alice Theadom

Many people who experience a traumatic brain injury (caused by an external force to the head such as from a car accident or fall) often find that they have difficulties with memory, fatigue and headaches. NeuroAid II is a 100% natural herbal supplement that could potentially improve cognitive functioning and fatigue after brain injury. Previous testing has shown that NeuroAid II protects cells from dying after injury as well as stimulating the generation of new neural cells, connections and pathways.

This study will trial the supplement on adults aged 18-65 who experience a brain injury in the last 1-3 months ago over a period of 6 months to demonstrate whether NeuroAid II is effective at improving neurocognitive recovery within this population.

Contact: Rohit Bhattacharjee

This study aims to establish a reliable battery of eye tracking tests to identify alteration in oculomotor function of those with mild TBI.  It also aims to investigate whether neck muscle vibrations influence eye tracking in individuals with post-concussive symptoms, and which oculomotor tests are most useful in differentiating between those with post-concussive symptoms and healthy individuals based on eye movements alone.

Collaborators

Lead:

• Alice Cade (PhD candidate), University of Auckland

Co-investigators:

• Dr Phil Turnball, University of Auckland
• Dr Kelly Holt, New Zealand College of Chiropractic

Contact: Kelly Jones

Mild traumatic brain injury (mTBI) encompasses a wide spectrum of cerebral injury and functional deficit. However, there are no definitive assessments to confirm its presence or severity, as well as the impact on neuropsychological function. Magnetic Resonance Imaging (MRI) offers great potential for  the development and provision of methods to better understand, prevent, and manage these injuries. MRI  is able to probe aspects of deranged physiology in mTBI such as white matter integrity, microhaemorrhage,  brain swelling, altered blood flow, and alterations in tissue microstructure. However, current clinical MRI
methods do not offer fast high-resolution multiparametric scanning approaches that could identify early  changes in mTBI.

This study, focusing on cerebral trauma in rugby players, aims to develop novel, noninvasive,  and high-fidelity MRI techniques to image brain integrity. These images will jointly probe for  altered functional, anatomical, and biomechanical changes in mTBI, and will be correlated with kinematic  sensor data and neuropsychological measures to devise a definitive test for concussion. Specific objectives are to (1) define and validate our comprehensive set of MRI methods and models to find a sensitive and specific measure for mTBI, (2) predict neuropsychological outcomes, and (3) inform when mTBI patients can safely return to their normal routine.

Collaborators

Lead:

• Dr Samantha Holdsworth, University of Auckland

Co-investigators:

• Dr Vicki Shim
• Dr David Dubowitz
• Professor Poul Michael Fonss Nielsen
• Professor Alistair  Young
• Professor Richard Faull

Funded by Faculty Research Development Fund, University of Auckland

Contact: Kelly Jones

The effects of brain injury are vast and disabling and the full impact of injury is often not observed until several years later. Yet the full scope of the long term difficulties people may experience (particularly after mild brain injury) and how multiple injuries affect recovery is unknown.

This study aims to characterise the long term effects of brain injury during childhood by following up an existing New Zealand cohort of children (<16 years) at six years post injury. Children assessed as having a brain injury in a previous study and who were followed up for one year, will be invited to be assessed six years later to measure any long term effects on their cognitive functioning, emotional wellbeing and ability to participate in everyday activities. We will also find out whether children experienced any additional brain injuries.

Key research questions include: 1) How does children’s development proceed over time following TBI?; 2) Are there any differences in behavior, emotion, participation and social function in children at 6-years post-TBI compared to age-matched TBI-free peers?; and 3) What factors are associated with good and poor child recovery at 6-years post-TBI?

By identifying who is at highest risk of recurrent injury and determining what facilitates or hinders recovery, we can identify the best ways to prevent injury, optimise treatment and maximise long term outcomes.

Collaborators

Lead:

• Dr Kelly Jones

Co-investigators:

• Professor Valery Feigin (AUT)
• Professor Nicola Starkey (University of Waikato)
• Associate Professor Alice Theadom (AUT)
• Dr Priya Parmar (AUT)

Funded by:

• Waikato Medical Research Foundation
• Co-funding by University of Waikato, courtesy of Professor Nicola Starkey

Contact: Kelly Jones

This study involved the collection of saliva samples from children who participated in a longitudinal, population-based study of traumatic brain injury (TBI) incidence and outcomes in the Hamilton and Waikato region. The HRC-funded Brain Injury Outcomes New Zealand in the Community (BIONIC) study identified all cases of TBI between 01/03/2010 to 28/02/2011.

The current study was completed in three consecutive stages:

1. Saliva samples were collected from children aged 3-7 years at the time of injury who had already participated in extensive BIONIC baseline and follow-up outcome assessments;
2. Saliva samples were then sent for DNA extraction and genetic analysis to the University of Auckland; and
3. Child genetic data will be added to the existing BIONIC data set containing extensive information about each child’s injury and recovery.

By adding genetic information to the data set, researchers will have the ability to begin to examine genetic contributions to recovery from childhood TBI.

Contact: Kelly Jones

Traumatic brain injury (TBI) is the single most common cause of death and disability in children worldwide, with enormous risks for subsequent cognitive deficits and behavioural problems associated with life-long implications, even after a mild injury.

Compared to older children, infants may be especially vulnerable to developmental impairment or delay after TBI due to increased physical and neurological vulnerability. However, the long-term effects of TBI in infants and factors that influence recovery are not well understood. In particular, almost nothing is known about the role of specific genetic contributions to recovery, as well as possible gene-gene and gene-environment interactions influencing children's development after TBI.

Before undertaking such a study, it is necessary to see whether it is possible to collect samples of saliva from infants aged less than 3-years-old that can be used for the examination of genetic makeup. This study also tested saliva collection processes to ensure cultural acceptability for Maori and non-Maori. The results from this study will guide future research involving the collection of saliva from infants and young children.

Collaborators

Lead:

• Dr Kelly Jones, NISAN, AUT University.

Co-collaborators

• Professor Rob Kydd (University of Auckland)
• Professor Valery Feigin (AUT)
• Professor  Suzanne Barker-Collo (University of Auckland)
• Associate Professor Alice Theadom (AUT)
• Professor Shari Wade (Cincinnati Children's Hospital)

Funded by:

• AUT University Faculty of Health and Environmental Sciences contestable funding with support from NISAN
• Co-funding by the University of Auckland, courtesy of Professor Rob Kydd

Contact: Kelly Jones

This study involved the collection of saliva samples from infants (aged 0-3 years at injury) who participated in a longitudinal, population-based study of traumatic brain injury (TBI) incidence and outcomes in the Hamilton and Waikato region. Infants were identified via the HRC-funded Brain Injury Outcomes New Zealand in the Community (BIONIC) study that examined the incidence and outcomes of TBI in Hamilton/Waikato between 01/03/2010 to 28/02/2011.

This sub-study was carried out in three consecutive stages:

1. Saliva samples were collected from children aged 4-8 years at the time of follow-up who have already participated in extensive BIONIC baseline and follow-up outcome assessments;
2. Saliva samples were sent for DNA extraction and genetic analysis to the University of Auckland; and
3. Child genetic data was added to the existing BIONIC data set containing extensive information about each child's injury and recovery.

By adding genetic information to the data set, researchers will have the ability to begin to examine genetic contributions to recovery from TBI during infancy.

Contact: Kelly Jones

Traumatic brain injury (TBI) is a leading cause of disability for young people in New Zealand, frequently resulting in long term difficulties with problem-solving, planning, organisation and maintaining social relationships. This study will evaluate an innovative internet-based problem-solving treatment programme developed specifically for adolescents after a head injury, and their families (Teen Online Problem Solving Intervention: TOPS).

Developed by Professor Shari Wade, a US-based international expert on paediatric TBI, this intervention aims to reduce the long-term consequences of head injury throughout adulthood and help people to achieve at school and in employment. This pilot study aims to examine the feasibility, preliminary efficacy, and participant satisfaction with a version of TOPS that has been specifically adapted for use in New Zealand. Adolescents (aged 11-18 years) and a parent/caregiver are currently being recruited for this study via a number of TBI service providers.

Key research questions include: Can a novel online problem solving intervention improve adolescent behaviour and family functioning post-TBI comparable to a usual care group? Is implementation of TOPS feasible within an existing rehabilitation setting? How satisfied are adolescents and their families with the TOPS programme?

Longer-term, if participation in TOPS is found to be effective in reducing the long term effects of brain injury, and it is more affordable to provide, and more accessible than traditional health services, this will mean more teens throughout New Zealand can access high quality treatment to improve the recovery following a head injury.

Collaborators

Lead:

• Dr Kelly Jones.

Co-investigators:

• Professor Suzanne Barker-Collo (University of Auckland)
• Professor Shari Wade (Cincinatti Children's Hospital)
• Associate Professor Alice Theadom (AUT)
• Professor Valery Feigin (AUT)

Contact: Kelly Jones