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Author: Nathan D Zasler (35)



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Dec
1969

There is an increasing interest in sexual and gender diversity in neurorehabilitation. Healthcare professionals wanting to improve their practice know the importance of understanding the needs and expectations of specific communities.
To critically review the literature about neurological disorders in people who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and people with other sexual orientations and forms of gender expression (LGBTQIA+).

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May
2017

Medicolegal Issues in Traumatic Brain Injury.

Phys Med Rehabil Clin N Am 2017 May;28(2):379-391
Nathan D Zasler, Erin Bigler
The role of the physiatrist in provision of medicolegal expert testimony in cases involving traumatic brain injury is challenging and complex. This article provides an overview of how such work should be conducted from a practical perspective including discussion of ethical, legal, medical, and business aspects of such activities. Additionally, pointers are provided with regards to how information including preinjury, injury, and postinjury (including neuroimaging and neuropsychological data) should be considered and integrated into medicolegal opinions and testimony.

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Dec
1969

To create a profile of individuals with traumatic brain injury (TBI) who received inpatient rehabilitation and were discharged to an institutional setting using characteristics measured at rehabilitation discharge.
The Traumatic Brain Injury Model Systems National Database is a prospective, multicenter, longitudinal database for people with moderate to severe TBI. We analyzed data for participants enrolled from January 2002 to June 2012 who had lived in a private residence before TBI.

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Dec
1969

The primary aim of this study was to investigate changes in sexual function in males and their partners following severe TBI. Secondary aims of the study were to explore the relationship between selected sociodemographic, emotional/behavioural and sexual function variables.
Twenty males with a history of severe TBI and 20 healthy controls (HC) and their respective partners were recruited.

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Dec
1969

The assessment of any patient or examinee with neurological impairment, whether acquired or congenital, provides a key set of data points in the context of developing accurate diagnostic impressions and implementing an appropriate neurorehabilitation program. As part of that assessment, the neurological physical exam is an extremely important component of the overall neurological assessment.
In the aforementioned context, clinicians often are confounded by unusual, atypical or unexplainable physical exam findings that bring into question the organicity, veracity, and/or underlying cause of the observed clinical presentation.

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Dec
1969

Sports concussion headache.

Brain Inj 2015 7;29(2):207-20. Epub 2014 Oct 7.
Nathan D Zasler
Sports concussion headache (SCH) is common; yet poorly researched and understood. Somatic complaints including headache are frequently reported by both amateur and professional athletes. Although the literature is replete with reports of a high incidence of headache following sports concussive injuries, there is a dearth of evidence-based medicine to provide practitioners with an understanding of sports concussion headache risk factors, epidemiology, biomechanical risk factors and/or injury thresholds, aetiology, assessment, treatment or prognosis.

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Feb
2015

Risk factors contributing to institutionalization after inpatient rehabilitation for people with traumatic brain injury (TBI) have not been well studied and need to be better understood to guide clinicians during rehabilitation. We aimed to develop a prognostic model that could be used at admission to inpatient rehabilitation facilities to predict discharge disposition. The model could be used to provide the interdisciplinary team with information regarding aspects of patients' functioning and/or their living situation that need particular attention during inpatient rehabilitation if institutionalization is to be avoided.

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Dec
1969

Over the last two decades, there has been a considerable increase in knowledge of brain function in patients with disorders of consciousness following a coma. Differentiating between patients in unresponsive wakefulness syndrome and in minimally conscious state still represents a major clinical, legal and ethical challenge.
This review focuses on recent behavioural and neuroimaging studies in this specific population.

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Dec
1969

Posttraumatic parkinsonism.

J Head Trauma Rehabil 2014 Jul-Aug;29(4):387-90
Rita Formisano, Nathan D Zasler
Amantadine hydrochloride is one of the most commonly used drugs in the pharmacotherapeutic treatment of disorders of consciousness (DOCs) following traumatic brain injury (TBI). Indeed, its actions as a pro-dopaminergic drug and as an N-methyl-D-aspartate antagonist makes amantadine an interesting candidate to improve consciousness and responsiveness in individuals with DOC, including vegetative state and minimally conscious state. Giacino et al (N Engl J Med.

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Aug
2013

Life care planning after traumatic brain injury.

Phys Med Rehabil Clin N Am 2013 Aug 11;24(3):445-65. Epub 2013 May 11.
Nathan D Zasler, Arthur Ameis, Susan N Riddick-Grisham
A life care plan is a detailed and comprehensive analysis of impairments, realistic needs, and associated costs relevant to providing a lifetime of care to patients. Physicians have a central role in advising life care planners. Within an expertly prepared life care plan, issues must correspond directly with proposed goods and services.

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Aug
2013

The importance of effectively identifying and managing sexuality issues following acquired brain injury is being increasingly recognized within clinical and research domains. However, a tool specifically developed to measure sexuality following brain injury is yet to be validated.
In this study, the reliability and validity of the Brain Injury Questionnaire of Sexuality (BIQS) was evaluated.

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Dec
1969

Neurobehavioral disorders are composed of a large group of behavioral impairments seen in association with brain disease (e.g., stroke, multiple sclerosis, dementia, and neuro-oncological conditions), transient as well as permanent brain impairments (e.

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Dec
1969

To characterize overall and cause-specific mortality and life expectancy among persons who have completed inpatient traumatic brain injury rehabilitation and to assess risk factors for mortality.
Prospective cohort study.
The Traumatic Brain Injury Model Systems.

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Dec
1969

The sodium amobarbital (amytal) (SA) interview is a technique that has been utilized in the treatment of a variety of disorders since its introduction in 1929. Since that time, there has been an assortment of research conducted showing its value in both differential diagnosis and treatment of multiple conditions. Notwithstanding the substantive amount of experience with the technique and its application to a myriad number of clinical conditions, it remains a seldom used procedure in clinical practice and certainly in neurorehabilitation.

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Dec
1969

The primary goal in the developing field of community based rehabilitation (CBR) for individuals with TBI / ABI is community participation and integration. At present, CBR is less than clearly defined and is represented by a set of interventions with varied types, degrees of clinical support and models of intervention that are conducted for a diverse and complex set of individuals, situations, deficits and settings. Nonetheless, holistic neurorehabilitation programs should be considered both evidence based and a practice standard.

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Dec
1969

Pharmacotherapy and posttraumatic cephalalgia.

J Head Trauma Rehabil 2011 Sep-Oct;26(5):397-9
Nathan D Zasler

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Dec
1969


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Dec
1969

This article will review current knowledge germane to understanding estimations of survival time of persons following severe traumatic brain injury (STBI). Nomenclature issues relevant to biostatistics and the neuroscientific investigation of survival after STBI will also be explored. Biostatistical methods used for determining survival time will be reviewed.

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Dec
1969

Persistent cognitive, emotional and behavioral dysfunction following brain injury present formidable challenges in the area of neurorehabilitation. This paper reviews a model and practical methodology for community based neurorehabilitation based upon: 1. Evidence from the "automatic learning" and "errorless learning" literature for skills relearning after brain injury; 2.

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Dec
2007

Pain and suffering controversies in persons with disorders of consciousness continue to be debated by the scientific, legal and medical ethics communities. This review examines the current knowledge base for guiding decisions regarding assessment and management of pain in persons with disorders of consciousness.
Studies have shown that brain processing linked to pain in persons in a vegetative state is incomplete and is processed only at a primary and not higher secondary level.

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Sep
2007

To describe pharmacological preference for the treatment of neurobehavioural sequela of traumatic brain injury (TBI).
Survey.
TBI physiatrists were divided into specialists (completed a TBI fellowship or commit >70% of clinical practice time to TBI) and non-specialists.

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Sep
2007

Forensic assessment of persons in low-level neurological state (LLNS) is fraught with limitations and caveats. Examiners must be aware of the nuances of forensic evaluation in the context of the conditions of examination, ethics and responsibilities that they have been charged with as an independent evaluator and fact seeker in the context of litigation-oriented dispute resolution. This article provides an overview of the independent medical evaluation (IME) of persons in LLNS including ethics, contextual limitations, history gathering, corroboratory interviews and suggested examination, as well as report format, among other important issues.

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Sep
2007

To examine the utility of the Neurobehavioral Functioning Inventory (NFI) for diagnosing depression in a rehabilitation setting.
In a prospective study, a structured clinical interview (Structured Clinical Interview for DSM-IV-TR) was used to identify DSM-IV-defined major depressive disorder (MDD) symptoms among patients with traumatic brain injury (TBI). NFI Depression scale items were compared with DSM-IV diagnosis obtained by the Structured Clinical Interview for DSM-IV Axis I Disorders.

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Dec
1969

Over the past 30 years, there has been an ongoing evolution in the nomenclature used to describe individuals in low-level neurological states. The appropriateness of historically well-entrenched nomenclature germane to persons in low level neurological states following brain injury continues to be debated. The effort to develop a cross disciplinary uniform set of descriptive terms for individuals in such states has continued to evolve as efforts for interdisciplinary collaborative consensus and guideline development has continued to make progress over the last decade.

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Dec
1969

Pain is a common yet challenging problem, particularly following traumatic injuries to the head or neck. It is a complex, multidimensional subjective experience with no clear or objective measures; yet it can have a significantly disabling effect across a wide range of functions. Persisting misconceptions owing to mind-body dualism have hampered advances in its understanding and treatment.

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Dec
1969

Mild traumatic brain injury (MTBI) accounts for approximately 80% of all brain injuries, and persistent sequelae can impede physical, emotional, social, marital, vocational, and avocational functioning. Evaluation of impairment and disability following MTBI typically can involve such contexts as social security disability application, personal injury litigation, worker's compensation claims, disability insurance policy application, other health care insurance policy coverage issues, and the determination of vocational and occupational competencies and limitations. MTBI is still poorly understood and impairment and disability assessment in MTBI can present a significant diagnostic challenge.

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May
2002

The independent medical examination.

Phys Med Rehabil Clin N Am 2002 May;13(2):259-86, ix
Arthur Ameis, Nathan D Zasler
The physiatrist, owing to expertise in impairment and disability analysis, is able to offer the medicolegal process considerable assistance. This chapter describes the scope and process of the independent medical examination (IME) and provides an overview of its component parts. Practical guidelines are provided for performing a physiatric IME of professional standard, and for serving as an impartial, expert witness.

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Jan
2002

There are an estimated two million traumatic brain injuries (TBI) each year in the US. Behavioural and psychosocial sequelae are the most disabling consequences of TBI, but relatively little empirical data exist that identify factors underlying the variability in patient outcomes. There is an increasing appreciation that pre-injury coping liabilities are likely to contribute to persistent disability and that outcome reflects the combined effects of pre-morbid, injury-related, and post-injury factors.

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Dec
1969

Introduction.

NeuroRehabilitation 2000 ;15(1)
Nathan D. Zasler

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Dec
1969

The expanding Internet has become an increasingly valuable tool for world wide sharing of information. Health care professionals, patients, lay persons, family members and others are afforded instant access to masses of information and almost unlimited resources on virtually any topic, as well as an almost seamless vehicle for communication. This new medium offers tremendous implications for health care.

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Dec
1969

Introduction.

NeuroRehabilitation 2000 ;14(2):55
Michael F. Martelli, Nathan D. Zasler

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Dec
1969

Introduction.

NeuroRehabilitation 2000 ;14(1)
Michael F. Martelli, Nathan D. Zasler

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