Neurobehavioral disorders leading to agitation following brain injury

Abstract

Agitation is a common occurrence in the process of recovery following brain injury, with past research estimating the prevalence to be between 39-51% in patients recovering from brain injuries of various etiologies. Past research has focused on agitation as a single disorder, rather than several distinct disorders with distinguishable symptoms requiring differential treatment. As a result, the treatment of agitation in brain-injured individuals has often relied on polypharmacology and restraint devices which can prolong the rehabilitation process. The purpose of the present study was to explore the hypothesis that agitation is the result of a number of discrete neurobehavioral disorders leading to different clinical outcomes, requiring specific treatment. A retrospective chart review was conducted on 98 individuals with brain injuries who were hospitalized on an acute rehabilitation unit at Staten Island University Hospital in New York City. All agitated behaviors were recorded and a factor analysis was conducted to determine the presence of specific neurobehavioral subgroups. Results demonstrated the presence of several specific disorders correlating with significantly different clinical outcomes, specifically, statistically significant differences in length of rehabilitation stay and discharge placement based on type of agitation displayed. Treatment implications for targeting specific neurobehavioral disorders early in recovery following brain injury are discussed.