France establishes guidelines for treating neurobehavioral disorders following traumatic brain injury.
This paper comments on the report by a committee of La Société Française de Médecine Physique et de Réadaptation (SOFMER) in response to the Haute Autorité de santé in France concerning the classification and clinical management of disorders of comportment following moderate to severe traumatic brain injury (TBI). In view of the large number of patients and families affected by these disorders, there is a strong rationale for these guidelines to ensure that clinical assessment and treatment is evidence-based. The report is viewed from the perspective of current research on disorders of comportment and in relation to recent reviews and meta-analyses on this topic. Comments on the classification draw on pathophysiology and brain imaging in addition to the clinical literature. The SOFMER report and recent projects in North America are compared for trends in the development of recommended assessment scales and standard, evidence-based treatment protocols for pharmacologic and non-pharmacologic interventions. Collaborative, multinational investigations of TBI are also noted, which are advancing progress toward guidelines for clinical management.
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, One Baylor Plaza, mailstop 637, TX 77030 Houston, United States. Electronic address: hlevin@bcm.edu.
Harvey
H
Levin
D001930:Brain Injuries / Q000523:psychology*; D005602:France; D006801:Humans; D001523:Mental Disorders / Q000209:etiology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D014481:United States
Neurobehavioral disorder; Rehabilitation; Traumatic brain injury