We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Diagnosis and Treatment of Traumatic Brain Injury

Joseph J. Fins, MD; Nicholas D. Schiff, MD
JAMA. 2000;283(18):2392. doi:10.1001/jama.283.18.2387.
Text Size: A A A
Published online


To the Editor: The National Institutes of Health (NIH) Consensus Development Panel on Rehabilitation of Persons With Traumatic Brain Injury,1 as forward thinking as it was, failed to address the increasing role of advances in neuroimaging and neuromodulation in the diagnosis and treatment of traumatic brain injury (TBI).

In the past several years, there has been a revolution in cognitive neuroscience that may soon transform the diagnosis, treatment, and rehabilitation of persons with TBI. For instance, diagnostic functional positron emission tomography has demonstrated a heterogeneity of brain states that can lead to impaired consciousness such as coma and the persistent vegetative state.2,3 Kennedy and Bakay4 have reported restoring communication for a patient with locked-in syndrome using an implantable electrode grafted to the motor cortex. Rinaldi et al5 demonstrated that stimulation of the left medial thalamus can modulate working memory and verbal fluency in patients with chronic pain. This observation suggests that impaired cognitive abilities can be augmented. Bejjani et al6 found that deep-brain stimulation, intended to treat the motor function of a patient with Parkinson disease, unexpectedly caused a transient depression. This serendipitous finding has the potential for developing new treatments for affective disorders and providing insight into their basic mechanisms.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.