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Symposium

Brain Injury

Clinical Practice

Post-traumatic Confusional State: Update on Pathophysiology and Biomarkers for Diagnosis and Prognosis 0593

Saturday, November 2, 2024
4:00 PM – 5:00 PM  
Location:  ROOM: Coronado C REGION: Tower Lobby Level >>> DIRECTIONS: From ACRM Registration desk, face the elephants and turn right. Proceed past the lobby elevators and turn right to enter the West Wing. Proceed down the corridor, turn right and then left. Proceed past the restrooms. Coronado C is the second room on the right.

    Corresponding Presenter(s)

  • Douglas I. Katz, MD (he/him/his)

    Professor / Medical Director
    Boston University / Encompass Health Braintree Rehab
    Newton Center, MA, United States

    Slides

    • Presenter(s)

  • Yelena G. Bodien, PhD

    Assistant Professor
    Massachusetts General Hospital/Spaulding Rehabilitation Hospital
    Boston, Massachusetts, United States

  • AF

    Afik Faerman

    Postdoctoral Scholar
    Stanford University
    Stanford, CA, United States

The case definition for the Post-Traumatic Confusional State (PTCS) was published in 2020, and a scoping review was performed by a workgroup of the Brain Injury Interdisciplinary Special Interest Group Disorders of Consciousness (DoC) Task Force to investigate the pathophysiology of PTCS. The review aimed to examine existing evidence and knowledge gaps on imaging, electrophysiogic, protein, genetic and other biomarkers in differentiating PTCS or posttraumatic amnesia (PTA) from other levels of consciousness, distinguishing traumatic and non-traumatic etiologies of confusional states, and predicting PTCS/PTA severity and outcome after traumatic brain injury (TBI). Systematic search and screening yielded 101 articles, most relating to diagnostic questions, e.g. biomarkers distinguishing PTCS from other DoCs, or, prognostic questions, e.g., biomarkers related to severity of PTCS/PTA. There is a need for further research to confirm these findings, to distinguish PTCS from other etiologies of confusional states, and to improve the PTCS case definition by including biomarkers.

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Learning Objectives:

  • Describe the clinical features of the post-traumatic confusional state (PTCS) with respect to post-traumatic amnesia and other disorders of consciousness based on the previously published case definition.
  • Analyze the range of available research on imaging, electrophysiologic, protein genetic and other biomarkers that inform recognition of the pathophysiology of the PTCS.
  • Describe key research findings on biomarkers that may help inform diagnosis and prognosis with respect to the PTCS in patients with TBI.
  • Describe knowledge gaps in understanding the pathophysiologic underpinnings of the PTCS and related disorders.
  • Discuss whether biomarkers have the potential to improve the diagnostic criteria for PTCS.
Disclosure(s):
Douglas I. Katz, MD: No financial relationships to disclose
Yelena G. Bodien, PhD: No financial relationships to disclose