Initial TBI severity also may interact with other patientspecific factors, and particularly neurogenetics, in a manner that influences recovery course and treatment, needs.61,143,144 Genes that confer susceptibility to adverse outcomes – for example, the apolipoprotein ε4 allele – may interact, with injury

severity and/ or age such that individuals of certain ages and injury severities with these genes may be a greater risk for poor outcome than those with other Inhibitors,research,lifescience,medical genetic characteristics.145-147 Genes coding for enzymes that affect the metabolism of neurotransmitters involved in cognition also influence cognitive performance after TBI.61,148 Since the neurotransmitter Inhibitors,research,lifescience,medical systems in which these genetic effects are expressed are potential targets of pharmacotherapies, treatment response expectations and/or medication dosing requirements might require modification based on patient-specific neurogenetics. Additionally, the influence of neurogenetics on treatment response or dosing requirements may vary with initial TBI severity and the state of the cytotoxic cascade during with treatment is offered, highlighting

the Inhibitors,research,lifescience,medical need to entertain all of these factors whether one is treating an individual patient or designing a clinical trial. In summary, the challenges of treating cognitive, emotional, behavioral, and sensorimotor – that is, neuropsychiatric – disturbances after TBI requires Inhibitors,research,lifescience,medical evolution of the manner in which clinicians match treatments to clinical problems. The considerations offered above suggest that the oft-used approach of treating “problem X” (ie, impaired sustained attention) with “medication Y” (ie, a stimulant or other catecholaminergic agent) is overly simplified in general and potentially hazardous during the

early rehabilitation period after TBI more specifically. Rational pharmacotherapy of post-traumatic neuropsychiatric disturbances during TBI neurorehabilitation Inhibitors,research,lifescience,medical requires consideration of not, only the intended phénoménologie targets of treatment but, also initial TBI severity, time post-injury (ie, phase of the cytoxic cascade), stage of PTE, and the influence and interactions between these factors. Conclusion The care provided to persons hospitalized following TBI is intrinsically and unavoidably neuropsychiatric: cognitive, from emotional, behavioral, and sensorimotor (ie, neuropsychiatric) disturbances define TBI and remain the principal clinical manifestations of this condition throughout, the post-injury period. These problems GSK126 clinical trial present, substantial short- and long-term challenges to injured persons, their families, and the clinicians providing their care. In this article, a neuropsychiatrically informed, neurobiologically anchored approach to understanding and meeting challenges was outlined.