Navigating Neurobehavioral Rehabilitation: Understanding Behavior Change and Deficits through Brain Region Impact

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Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Speaker

Jerome Quellier, MS, CCC-SLP Related seminars and products

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Jerome Quellier, MS, CCC-SLP, is a clinical specialist in traumatic brain injury and communication disorders at a 450+ bed level 1 trauma hospital in Saint Paul, MN with almost 25 years of acute, residential, and outpatient rehabilitation experience. He has focused on neuro-based diagnostics and intervention for dysphagia, cognitive-linguistic deficits, head and neck cancer management, patient advocacy, and curriculum development. Mr. Quellier completed advanced training in brain dissection at Marquette University, actively engages in staff development training, and recently joined a surgery team in preserving language function during tumor resections.

Mr. Quellier is excited to bring this topic to the forefront after working with the interdisciplinary team’s challenges in understanding the “what and why” of traumatic brain injury, stroke, neurodegenerative diseases and tumor resections as they apply to behavioral changes.

 

Speaker Disclosures:
Financial: Jerome Quellier has an employment relationship with Regions Hospital. He receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Jerome Quellier is a member of the American Speech-Language and Hearing Association.

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Objectives

1. Categorize the anatomy and function of lobes of the brain as they apply to neuro-behavioral control.  
2. Evaluate the neurophysiology of memory and the impact of fear/anger on new learning and memory.   
3. Examine the functional impact of both traumatic and nontraumatic injuries on cognitive centers within the brain to improve participation in physical activity.  
4. Develop communication between neurotransmitters and the relevant communication system in the brain to improve function.  
5. Evaluate the optic system and lesion locations that affect engagement, attention, and accuracy in therapy.  
6. Utilize neuroanatomy-based interventions to de-escalate stress for patients and caretakers.

Outline

NEUROANATOMY AND THE IMPACT ON COGNITIVE PROCESSING

• Neuronal anatomy
• Brain wiring: Association, projection, and commissural fiber tracts
• Brain lobes locations and ties to cognitive processes
• Cerebellum and impact upon cognition
• Case Study 1: Jacob’s anxiety and how pacing the halls became therapeutic

 
OPTIC SYSTEM AND VISUAL PERCEPTION

• Optic constructs, anterior-posterior fiber tracts
• Visual cortices and unique roles in visual processing and execution of IADL’s
• Effect of tumors, shear injuries, CVA lesions upon visual perception
• Case study 2: Why can’t my patient just see the whole worksheet like I do?
• Group Exercise: Review of vision diagnostics by discipline (PT/OT/SLP)

 
HOW NEUROTRANSMITTERS DRIVE THE BUS

• Internal communication systems within the brain
• Dopamine pathways and effects on cognition and reward systems
• Serotonin pathways and mood modulations

 
EXECUTIVE FUNCTIONS OF THE FRONTAL LOBE

• The Cognitive Pyramid and moving patients upward
• Skull anatomy and effects of shear injury
• Shear injury as it affects anxiety and behavioral health
• Therapy implications for PT/OT/SLP
• Group Exercise: Review of executive function diagnostics by discipline (PT/OT/SLP)
• Impact of executive functions such a planning, organization, and problem solving for participation and performance of meaningful ADL’s

 
COMMUNICATION AND THE LEFT HEMISPHERIC FUNCTIONS

• Broca’s vs. Wernike’s areas
• Function of the arcuate fasciculus upon communication

 
SPATIAL PROCESSING AND THE RIGHT HEMISPHERIC FUNCTIONS

• Neurophysiology vs neuropathology, understanding patients’ nonverbal challenges
• Inferential language and social cognition
• Recognize social deficits and impact on community independence
• A sense of time and spatial organization revealed

 
THE HIDDEN PROCESSORS-THALAMIC INFLUENCES

• Auditory pathways and neuroanatomy
• Thalamic engagement on sensory information
• Modulation of sleep and vigilance

 
MEMORY: HOW THE HIPPOCAMPUS AND THE AMYGDALA PARTNER

• Memory processes
• Memory types: Right vs left hippocampal functions
• Hypoxia and anoxia upon memory function
• Sleep and memory consolidation, effect of exercise on memory structures
• Amygdala’s influence upon fear-based learning and hijacking executive control
• Case study 3: Nile’s hypoxia and long-term rehab outcomes

  
RECOVERY FROM ACCELERATION/ DECELERATION INJURIES: DIFFUSE AXONAL INJURY (DAI)

• Microanatomical features of DAI
• CTE: Chronic Traumatic Encephalopathy
• Where medications have failed

 
AGITATION MANAGEMENT STRATEGIES

• Review how working knowledge of the Rancho Los Amigos levels and practitioner tips can avoid confrontation
• Learn trick of the trade for avoiding escalation
• Structure therapy sessions to mitigate escalation and improve engagement in interventions
• Identify underlying causes of escalation to reduce impact on daily living and QOL
• Confabulation and denial—addressing the elephant in the room

 
ENRICHING PATIENT AND CLINCIAN RELATIONSHIPS

• The science behind mediations and mindfulness
• Reigning in the runaway situation

Target Audience

• Physical Therapists
• Physical Therapist Assistants
• Occupational Therapists
• Occupational Therapy Assistants
• Speech-Language Pathologists
• Certified Brain Injury Specialists
• Recreational Therapists
• Nurses
• Nurse Practitioners