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Huerta de la Cruz S, Santiago-Castañeda C, Rodríguez-Palma EJ, Rocha L, Sancho M. Lateral fluid percussion injury: A rat model of experimental traumatic brain injury. Methods Cell Biol 2024; 185:197-224. [PMID: 38556449 DOI: 10.1016/bs.mcb.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Traumatic brain injury (TBI) represents one of the leading causes of disability and death worldwide. The annual economic impact of TBI-including direct and indirect costs-is high, particularly impacting low- and middle-income countries. Despite extensive research, a comprehensive understanding of the primary and secondary TBI pathophysiology, followed by the development of promising therapeutic approaches, remains limited. These fundamental caveats in knowledge have motivated the development of various experimental models to explore the molecular mechanisms underpinning the pathogenesis of TBI. In this context, the Lateral Fluid Percussion Injury (LFPI) model produces a brain injury that mimics most of the neurological and systemic aspects observed in human TBI. Moreover, its high reproducibility makes the LFPI model one of the most widely used rodent-based TBI models. In this chapter, we provide a detailed surgical protocol of the LFPI model used to induce TBI in adult Wistar rats. We further highlight the neuroscore test as a valuable tool for the evaluation of TBI-induced sensorimotor consequences and their severity in rats. Lastly, we briefly summarize the current knowledge on the pathological aspects and functional outcomes observed in the LFPI-induced TBI model in rodents.
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Affiliation(s)
- Saúl Huerta de la Cruz
- Department of Pharmacology, University of Vermont, Burlington, VT, United States; Departamento de Farmacobiología, Cinvestav Sede Sur, Ciudad de México, México.
| | | | - Erick J Rodríguez-Palma
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, Sede Sur, Mexico City, Mexico
| | - Luisa Rocha
- Departamento de Farmacobiología, Cinvestav Sede Sur, Ciudad de México, México
| | - Maria Sancho
- Department of Pharmacology, University of Vermont, Burlington, VT, United States; Department of Physiology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
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2
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Kim JS, Hong SB, Park KW, Lee ATC. Psychotic Symptoms in Patients With Major Neurological Diseases. J Clin Neurol 2024; 20:153-165. [PMID: 38433485 PMCID: PMC10921039 DOI: 10.3988/jcn.2023.0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 03/05/2024] Open
Abstract
Neurological diseases often manifest with neuropsychiatric symptoms such as depression, emotional incontinence, anger, apathy and fatigue. In addition, affected patients may also experience psychotic symptoms such as hallucinations and delusions. Various factors contribute to the development of psychotic symptoms, and the mechanisms of psychosis are similar, but still differ among various neurological diseases. Although psychotic symptoms are uncommon, and have been less well investigated, they may annoy patients and their families as well as impair the patients' quality of life and increase the caregiver burden. Therefore, we need to appropriately identify and treat these psychotic symptoms in patients with neurological diseases.
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Affiliation(s)
- Jong S Kim
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
| | - Seung-Bong Hong
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keun-Woo Park
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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3
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Skromanis S, Padgett C, Matthewson M, Honan CA. Social disinhibition in acquired brain injury and neurological disease: a concept analysis. BRAIN IMPAIR 2023; 24:529-547. [PMID: 38167359 DOI: 10.1017/brimp.2022.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social disinhibition is becoming increasingly recognised in the neuropsychological literature as a complex and debilitating sequalae associated with acquired frontal lobe damage. Despite this, the term has been inconsistently defined and described in both clinical and research contexts. The purpose of this paper was to explore and examine the concept of social disinhibition in the context of brain injury and other organic neurological conditions. METHOD A literature search for articles published in the English language from journal inception to June 2021 was conducted using MEDLINE, PsycInfo, Embase, CINAHL and Web of Science. A 'concept analysis' was conducted on the identified literature using Walker & Avant's (2019) framework. RESULTS The analysis suggested that while several terms are often used interchangeably with social disinhibition, including impulsivity and behavioural dysregulation, these terms may be differentiated and defined separately within the broader domain of 'behaviours of concern'. Attributes, antecedents and consequences of social disinhibition were also identified and discussed. CONCLUSIONS Clarifying the concept of social disinhibition has important implications in both clinical and research contexts, including increased understanding of the behaviours, more accurate estimates of incidence and prevalence, and the development and implementation of targeted rehabilitation programmes.
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Affiliation(s)
- Sarah Skromanis
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
| | - Christine Padgett
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Mandy Matthewson
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Cynthia A Honan
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
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4
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Chen PY, Su IC, Shih CY, Liu YC, Su YK, Wei L, Luh HT, Huang HC, Tsai PS, Fan YC, Chiu HY. Effects of Neurofeedback on Cognitive Function, Productive Activity, and Quality of Life in Patients With Traumatic Brain Injury: A Randomized Controlled Trial. Neurorehabil Neural Repair 2023:15459683231170539. [PMID: 37125901 DOI: 10.1177/15459683231170539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Cognitive impairment is common in patients with traumatic brain injury (TBI). Studies that have examined the effectiveness of neurofeedback (NFB) on cognitive function following TBI have had poor study designs and small sample sizes. OBJECTIVES This randomized controlled trial assessed the effects of low-resolution tomography Z-score NFB (LZNFB) and theta/beta NFB on cognitive impairment, return to productive activity, and quality of life in patients with TBI. METHODS We randomly assigned 87 patients with TBI with cognitive impairment to LZNFB, theta/beta NFB, or usual care (UC) groups. Patients in both NFB groups received weekly 60-minute treatment for 10 weeks, and those in the control group received UC and telephone interviews for 10 weeks. The primary outcome was cognitive function as measured by performance on cognitive tasks; the secondary outcomes included productive activity and quality of life based on the Community Integration Questionnaire-revised (CIQ-R) and the Quality of Life after Brain Injury (QOLIBRI), respectively, at baseline and immediately after the last intervention. RESULTS The LZNFB group exhibited significantly greater improvements in immediate recall, delayed recall, recognition memory, and selective attention compared with the UC group; the theta/beta NFB group exhibited improvements in only immediate memory and selective attention (P < .05). The total CIQ-R scores of the LZNFB group after treatment were significantly improved than those of the UC group were. CONCLUSION Consecutive LZNFB achieved therapeutic effects in memory, attention, and productive activity, whereas theta/beta NFB improved memory and attention in patients with TBI.This trial was prospectively registered at ClinicalTrial.gov (registration number: NCT03515317; https://clinicaltrials.gov/ct2/show/NCT03515317).
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Affiliation(s)
- Pin-Yuan Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital Keelung Branch, Keelung City, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung Branch, Keelung City, Taiwan
| | - I-Chang Su
- Taipei Neuroscience Institute, Taipei Medical University, Taipei City, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Chun-Ying Shih
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Yen-Chun Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Yu-Kai Su
- Taipei Neuroscience Institute, Taipei Medical University, Taipei City, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li Wei
- Taipei Neuroscience Institute, Taipei Medical University, Taipei City, Taiwan
- Division of Neurosurgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei City, Taiwan
| | - Hui-Tzung Luh
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei City, Taiwan
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei City, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei City, Taiwan
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5
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Abstract
OBJECTIVE Disorders of social cognition, such as difficulties with emotion perception, alexithymia, Theory of Mind (ToM), empathy and disorders of emotion regulation, are prevalent and pervasive problems across many neurological, neurodevelopmental and neuropsychiatric conditions. Clinicians are familiar with how these difficulties present but assessment and treatment has lagged behind other traditional cognitive domains, such as memory, language and executive functioning. METHOD In this paper, we review the prevalence and degree of impairment associated with disorders of social cognition and emotion regulation across a range of clinical conditions, with particular emphasis on their relationship to cognitive deficits and also real-world functioning. We reported effects sizes from published meta-analyses for a range of clinical disorders and also review test usage and available tests. RESULTS In general, many clinical conditions are associated with impairments in social cognition and emotion regulation. Effect sizes range from small to very large and are comparable to effect sizes for impairments in nonsocial cognition. Socio-emotional impairments are also associated with social and adaptive functioning. In reviewing prior research, it is apparent that the standardized assessment of social cognition, in particular, is not routine in clinical practice. This is despite the fact that there are a range of tools available and accruing evidence for the efficacy of interventions for social cognitive impairments. CONCLUSION We are using this information to urge and call for clinicians to factor social cognition into their clinical assessments and treatment planning, as to provide rigorous, holistic and comprehensive person-centred care.
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Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Travis Wearne
- School of Psychology, University of Western Sydney, Penrith South, Australia
| | - Michelle Kelly
- School of Psychological Sciences, University of Newcastle, Callaghan, Australia
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6
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Salas CE, Rojas-Líbano D, Castro O, Cruces R, Evans J, Radovic D, Arévalo-Romero C, Torres J, Aliaga Á. Social isolation after acquired brain injury: Exploring the relationship between network size, functional support, loneliness and mental health. Neuropsychol Rehabil 2022; 32:2294-2318. [PMID: 34139944 DOI: 10.1080/09602011.2021.1939062] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Social isolation can be a consequence of acquired brain injury (ABI). Few studies have examined the relationship between social isolation and mental health after ABI. In this cross-sectional and case-control study, we compared 51 ABI survivors and 51 matched healthy controls on measures of social isolation (network size, social support and loneliness) mental health and mental health problems. We explored the relationship between structural, functional and subjective components of social isolation and examined whether they were associated with mental health outcomes. No group differences were found on size of the network and perceived social support. The ABI group exhibited marginally higher levels of loneliness. The ABI group presented higher levels of depression, lower levels of quality of life and emotional wellbeing. In both groups, perception of social support was inversely related to subjective experience of loneliness. The relationship between network size and loneliness was only significant in the ABI group. Only loneliness significantly predicted quality of life, emotional wellbeing, depression and anxiety in people with brain injury. The relationship between social isolation variables in ABI is discussed, as well as the theoretical and clinical implications of focusing on loneliness to improve mental health after brain injury.
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Affiliation(s)
- Christian E Salas
- Centre for Research in Human Neuroscience and Neuropsychology, Faculty of Psychology, Diego Portales University, Santiago, Chile.,Clinical Neuropsychology Unit, Faculty of Psychology, Diego Portales University, Santiago, Chile
| | - Daniel Rojas-Líbano
- Centre for Research in Human Neuroscience and Neuropsychology, Faculty of Psychology, Diego Portales University, Santiago, Chile
| | - Osvaldo Castro
- School of Occupational Therapy, Universidad Autónoma de Chile, Santiago, Chile
| | - Ramiro Cruces
- Clinical Neuropsychology Unit, Faculty of Psychology, Diego Portales University, Santiago, Chile
| | - Jonathan Evans
- Institute of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Darinka Radovic
- Faculty of Physical and Mathematical Sciences, University of Chile, Santiago, Chile
| | - Camilo Arévalo-Romero
- Centre for Research in Human Neuroscience and Neuropsychology, Faculty of Psychology, Diego Portales University, Santiago, Chile
| | - Julio Torres
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,Department of Neuroscience, Faculty of Medicine, University of Chile, Santiago, Chile.,Service of Physical and Rehabilitation Medicine, Clínica Davila, Santiago Chile
| | - Álvaro Aliaga
- Clinical Neuropsychology Unit, Faculty of Psychology, Diego Portales University, Santiago, Chile
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7
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Alderman N, Williams C, Wood RL. Using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) to determine prevalence and predictors of neurobehavioural disability amongst survivors with traumatic brain injury in the community. Neuropsychol Rehabil 2022; 32:2342-2369. [PMID: 34180770 DOI: 10.1080/09602011.2021.1946092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Studies using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) confirm neurobehavioural disability (NBD) is highly prevalent in inpatient Neurobehavioural Rehabilitation and Stroke samples. However, a recent study amongst a Danish community sample of acquired brain injury survivors found a relative paucity of NBD symptoms; and when symptoms were present, they tended to be of mild severity. The current observational study employed the SASNOS to explore prevalence of NBD in survivors with traumatic brain injury (TBI) living in the community, the extent of survivors' self-awareness of NBD symptoms, and constructed prediction models of NBD. A de-identified data set was compiled, comprising data for 97 TBI survivors (74.2% men, mean time since injury 2.8 years). In addition to SASNOS self- and proxy-ratings, various demographic, clinical and injury-related characteristics were captured. NBD was found to be highly characteristic, although severity varied depending on subtype. Statistical comparison of self- and proxy-ratings did not support reduced self awareness regarding NBD, whereas treating the problem as one of inter-rater reliability suggested this was an issue. Executive impairment, depressed mood and sex were especially prognostic of NBD. Reasons accounting for differences in NBD between the community samples are discussed and recommendations for future research made.
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Affiliation(s)
- Nick Alderman
- Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, Swindon, UK.,Department of Psychology, Swansea University, Swansea, UK
| | - Claire Williams
- Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, Swindon, UK.,Department of Psychology, Swansea University, Swansea, UK
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8
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Current Clinical Trials in Traumatic Brain Injury. Brain Sci 2022; 12:brainsci12050527. [PMID: 35624914 PMCID: PMC9138587 DOI: 10.3390/brainsci12050527] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 12/10/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the leading causes of morbidity, disability and mortality across all age groups globally. Currently, only palliative treatments exist, but these are suboptimal and do little to combat the progressive damage to the brain that occurs after a TBI. However, multiple experimental treatments are currently available that target the primary and secondary biochemical and cellular changes that occur after a TBI. Some of these drugs have progressed to clinical trials and are currently being evaluated for their therapeutic benefits in TBI patients. The aim of this study was to identify which drugs are currently being evaluated in clinical trials for TBI. A search of ClinicalTrials.gov was performed on 3 December 2021 and all clinical trials that mentioned “TBI” OR “traumatic brain injury” AND “drug” were searched, revealing 362 registered trials. Of the trials, 46 were excluded due to the drug not being mentioned, leaving 138 that were completed and 116 that were withdrawn. Although the studies included 267,298 TBI patients, the average number of patients per study was 865 with a range of 5–200,000. Of the completed studies, 125 different drugs were tested in TBI patients but only 7 drugs were used in more than three studies, including amantadine, botulinum toxin A and tranexamic acid (TXA). However, previous clinical studies using these seven drugs showed variable results. The current study concludes that clinical trials in TBI have to be carefully conducted so as to reduce variability across studies, since the severity of TBI and timing of therapeutic interventions were key aspects of trial success.
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Twomey DM, Allen N, Agan MLF, Hayes AM, Higgins A, Carton S, Roche R, Hevey D, Bramham J, Brady N, O'Keeffe F. Self-reported outcomes and patterns of service engagement after an acquired brain injury: a long-term follow-up study. Brain Inj 2021; 35:1649-1657. [PMID: 34898342 DOI: 10.1080/02699052.2021.2004617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PRIMARY OBJECTIVE To describe the clinical characteristics, self-reported outcomes in domains relating to activities of daily living and patterns of service engagement in the survivors of a moderate-to-severe acquired brain injury over seven years. RESEARCH DESIGN A longitudinal research design was used. METHODS AND PROCEDURES Thirty-two individuals who sustained a moderate-to-severe acquired brain injury completed a Sociodemographic and Support Questionnaire at one (t1) and seven years (t2) after completing a publicly funded inpatient neurorehabilitation program. MAIN OUTCOMES AND RESULTS There were minimal changes in independent living, mobility, ability to maintain key relationships and in return to work in the interval between t1 and t2. Sixty-nine percent of participants engaged with two or more allied health professional services and 75% engaged with support services in the community over the seven years. CONCLUSIONS There were minimal additional gains in outcomes relating to activities of daily-living and there was a high level of service need in the first decade postinjury. Young and middle-aged individuals who sustain an ABI may continue to live in the community for decades with some level of disability and may require ongoing access to services.
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Affiliation(s)
- Deirdre M Twomey
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Niamh Allen
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | | | - Aoife M Hayes
- Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Andrea Higgins
- Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Simone Carton
- Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Richard Roche
- Department of Psychology, Maynooth University, Ireland
| | - David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland.,Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | - Nuala Brady
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Fiadhnait O'Keeffe
- School of Psychology, University College Dublin, Dublin, Ireland.,School of Psychology, Trinity College Dublin, Dublin, Ireland.,Psychology and Clinical Neuropsychology Services, National Rehabilitation Hospital, Dun Laoghaire, Ireland.,Psychology Department St. Vincent's University Hospital, Dublin, Ireland
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10
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Abstract
OBJECTIVE To examine the stability of marriage from the time of traumatic brain injury (TBI) to 10 years postinjury. DESIGN Retrospective cohort. SETTING TBI Model Systems centers. PARTICIPANTS In total, 1423 participants in the TBI Model Systems National Database who experienced TBI 10 years prior and were married at the time of injury. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Remaining married to the same partner from the time of injury to 10-year follow-up. RESULTS At 10 years, 66% (938) remained married to the same person. Significant associations were found with age at injury (P < .0001), sex (P = .0028), and preinjury problematic substance use (P = .0092). Marital stability over the 10-year period was higher for those who were older, were female, and had no problematic substance use history. Marital instability was greatest in the first year postinjury. CONCLUSIONS Most married adults who received inpatient rehabilitation for TBI remained married to the same individual 10 years later. Those who were younger, were male, and had a history of problematic substance use were at a highest risk for relationship dissolution. Findings have implications for content, timing, and delivery of marital interventions. Substance use education and prevention appear to be important aspects of marital support.
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11
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Solomon NP, Brungart DS, Wince JR, Abramowitz JC, Eitel MM, Cohen J, Lippa SM, Brickell TA, French LM, Lange RT. Syllabic Diadochokinesis in Adults With and Without Traumatic Brain Injury: Severity, Stability, and Speech Considerations. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1400-1409. [PMID: 33630660 DOI: 10.1044/2020_ajslp-20-00158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Syllabic diadochokinesis (DDK) is a standard assessment task for motor speech disorders. This study aimed to compare rate and regularity of DDK according to the presence or absence of traumatic brain injury (TBI) and severity of TBI, examine the stability of DDK over time, and explore associations between DDK and extemporaneous speech. Method Military service members and veterans were categorized into three groups: no history of TBI (control), uncomplicated mild TBI (mTBI), and moderate through severe (including penetrating) TBI (msTBI). Participants produced rapid alternating-motion and sequential-motion syllable repetitions during one or two sessions. A semi-automated protocol determined syllabic rate and regularity. Perceptual ratings of selected participants' connected speech samples were compared to DDK results. Results Two hundred sixty-three service members and veterans provided data from one session and 69 from two sessions separated by 1.9 years (SD = 1.0). DDKs were significantly slower overall for mTBI and msTBI groups compared to controls. Regularity of productions did not differ significantly across groups. A significant Group × Task interaction revealed that the msTBI group produced sequential-motion syllable repetitions but not alternating-motion repetitions with greater regularity, whereas the opposite occurred for control and mTBI groups. DDK results did not differ significantly between sessions. Perceptual speech analysis for 30 participants, including 20 with atypical or questionable DDK performance, revealed two participants with mildly abnormal speech. Conclusions Overall, DDK productions are slower than normal in adults with moderate, severe, and penetrating TBI and are stable over time. Regularity of productions did not differentiate groups, although this result differed according to task. There were surprisingly few people identified with disordered speech, making comparisons to DDK data tenuous, and indicating that dysarthria is a rare complication in a population of adults with mostly uncomplicated mTBI who are not selected from referrals to a speech-language pathology clinic.
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Affiliation(s)
- Nancy Pearl Solomon
- Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Douglas S Brungart
- Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jessica R Wince
- Walter Reed National Military Medical Center, Bethesda, MD
- Towson University, Baltimore, MD
| | - Jordan C Abramowitz
- Walter Reed National Military Medical Center, Bethesda, MD
- University of Maryland, College Park, MD
| | - Megan M Eitel
- Walter Reed National Military Medical Center, Bethesda, MD
- Henry M. Jackson Foundation, Rockville, MD
- Defense and Veterans Brain Injury Center, Silver Spring, MD
| | - Julie Cohen
- Walter Reed National Military Medical Center, Bethesda, MD
- University of Maryland, College Park, MD
- Henry M. Jackson Foundation, Rockville, MD
| | - Sara M Lippa
- Walter Reed National Military Medical Center, Bethesda, MD
- Defense and Veterans Brain Injury Center, Silver Spring, MD
- National Intrepid Center of Excellence, Bethesda, MD
| | - Tracey A Brickell
- Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
- Defense and Veterans Brain Injury Center, Silver Spring, MD
- National Intrepid Center of Excellence, Bethesda, MD
- General Dynamics Information Technology, Falls Church, VA
| | - Louis M French
- Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
- Defense and Veterans Brain Injury Center, Silver Spring, MD
- National Intrepid Center of Excellence, Bethesda, MD
| | - Rael T Lange
- Walter Reed National Military Medical Center, Bethesda, MD
- Defense and Veterans Brain Injury Center, Silver Spring, MD
- National Intrepid Center of Excellence, Bethesda, MD
- General Dynamics Information Technology, Falls Church, VA
- University of British Columbia, Vancouver, Canada
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12
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McDonald S, Genova H. The effect of severe traumatic brain injury on social cognition, emotion regulation, and mood. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:235-260. [PMID: 34389120 DOI: 10.1016/b978-0-12-822290-4.00011-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This chapter provides a review of the emotional and psychosocial consequences of moderate to severe traumatic brain injury (TBI). Many of the disorders affecting socioemotional function arise from damage to frontotemporal systems, exacerbated by white matter injury. They include disorders of social cognition, such as the ability to recognize emotions in others, the ability to attribute mental states to others, and the ability to experience empathy. Patients with TBI also often have disorders of emotion regulation. Disorders of drive or apathy can manifest across cognitive, emotional, and behavioral domains. Likewise, disorders of control can lead to dysregulated emotions and behavior. Other disorders, such as loss of self-awareness, are also implicated in poor psychosocial recovery. Finally, this chapter overviews psychiatric disorders associated with TBI, especially anxiety and depression. For each kind of disorder, the nature of the disorder and its prevalence, as well as theoretical considerations and impact on every day functions, are reviewed.
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Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.
| | - Helen Genova
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
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13
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Ferraro S, Nigri A, D'Incerti L, Rosazza C, Sattin D, Rossi Sebastiano D, Visani E, Duran D, Marotta G, Demichelis G, Catricala' E, Kotz S, Verga L, Leonardi M, Cappa S, Bruzzone MG. Preservation of Language Processing and Auditory Performance in Patients With Disorders of Consciousness: A Multimodal Assessment. Front Neurol 2020; 11:526465. [PMID: 33408679 PMCID: PMC7779550 DOI: 10.3389/fneur.2020.526465] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 10/22/2020] [Indexed: 11/23/2022] Open
Abstract
The impact of language impairment on the clinical assessment of patients suffering from disorders of consciousness (DOC) is unknown or underestimated and may mask the presence of conscious behavior. In a group of DOC patients (n = 11; time post-injury range: 5–252 months), we investigated the main neural functional and structural underpinnings of linguistic processing, and their relationship with the behavioral measures of the auditory function using the Coma Recovery Scale-Revised (CRS-R). We assessed the integrity of the brainstem auditory pathways, of the left superior temporal gyrus and arcuate fasciculus, the neural activity elicited by passive listening of an auditory language task, and the mean hemispheric glucose metabolism. Our results support the hypothesis of a relationship between the level of preservation of the investigated structures/functions and the CRS-R auditory subscale scores. Moreover, our findings indicate that patients in minimally conscious state minus (MCS−): (1) when presenting the auditory startle (at the CRS-R auditory subscale) might be aphasic in the receptive domain, being severely impaired in the core language structures/functions; (2) when presenting the localization to sound might retain language processing, being almost intact or intact in the core language structures/functions. Despite the small group of investigated patients, our findings provide a grounding of the clinical measures of the CRS-R auditory subscale in the integrity of the underlying auditory structures/functions. Future studies are needed to confirm our results that might have important consequences for the clinical practice.
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Affiliation(s)
- Stefania Ferraro
- School of Life Science and Technology, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,Neuroradiology Department, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Anna Nigri
- Neuroradiology Department, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Ludovico D'Incerti
- Neuroradiology Department, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Cristina Rosazza
- Neuroradiology Department, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Davide Sattin
- Neurology, Public Health, Disability Unit and Coma Research Centre, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Davide Rossi Sebastiano
- Department of Neurophysiology and Diagnostic Epileptology Unit, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Elisa Visani
- Department of Neurophysiology and Diagnostic Epileptology Unit, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Dunja Duran
- Department of Neurophysiology and Diagnostic Epileptology Unit, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Giorgio Marotta
- Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Greta Demichelis
- Neuroradiology Department, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | | | - Sonja Kotz
- Department of Psychology, Maastricht University, Maastricht, Netherlands
| | - Laura Verga
- Department of Psychology, Maastricht University, Maastricht, Netherlands
| | - Matilde Leonardi
- Neuroradiology Department, Fondazione IRCCS Neurologico Carlo Besta, Milan, Italy
| | - Stefano Cappa
- Department of Psychology, Scuola Universitaria Superiore, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
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14
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Grayson L, Brady MC, Togher L, Ali M. The impact of cognitive-communication difficulties following traumatic brain injury on the family; a qualitative, focus group study. Brain Inj 2020; 35:15-25. [PMID: 33327774 DOI: 10.1080/02699052.2020.1849800] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Primary Objective: To identify how families experience cognitive-communication difficulties following Traumatic Brain Injury (TBI). Experiences of information, training and support for managing communication changes were also explored. Research Design: Qualitative focus group methodology using thematic analysis. Method: 15 family members of individuals with cognitive-communication difficulties following severe TBI participated in the study; four parents, six spouses, three siblings and two offspring. The majority of participants were female (80%, n = 12), with a mean age of 51 (range 19-71). Four focus groups were held with family members at 0-12 months, 12-36 months and 36+ months post-injury. The data were transcribed verbatim and analyzed using NVIVO 12.Results: Cognitive-communication difficulties were found to impact upon family functioning and psychological wellbeing for several years post-injury. Changes to social cognition, insight and the "filter switch" of the person following TBI were key areas of distress. Participants highlighted the need for information about communication changes to be provided at several time points post-injury. The need for peer support from other families with experience of cognitive-communication difficulties was also identified.Conclusion: Cognitive-communication difficulties impact upon family functioning for many years following injury with families continuing to have support needs for communication well beyond the acute rehabilitation stage.
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Affiliation(s)
- Lynn Grayson
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, Scotland.,NHS Lanarkshire, Carluke, Scotland
| | - Marian C Brady
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, Scotland
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Myzoon Ali
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, Scotland
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15
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Establishing 'proof of concept' for a social cognition group treatment program (SIFT IT) after traumatic brain injury: two case studies. Brain Inj 2020; 34:1781-1793. [PMID: 33180565 DOI: 10.1080/02699052.2020.1831072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Social cognitive deficits are prevalent after traumatic brain injury (TBI). Despite this, few remediation studies exist. This study aimed to demonstrate 'proof of concept' for a novel group treatment that comprehensively targeted the core processes of social cognition. DESIGN Pre-post case study with two participants, "Greg" and "Aaron", living with severe TBI, with three assessment time points. METHOD Participants were screened at baseline to confirm social cognitive deficits: Greg exhibited difficulties with emotion perception and detecting hints; Aaron with detecting sarcasm and hints. Both reported everyday social problems. Participants then completed the 14-week group treatment program (SIFT IT). Feasibility and outcome measures were repeated post-group and at three-month follow-up. RESULTS The study procedure was implemented with 100% assessment and 89% SIFT IT session attendance, albeit with a lack of proxy-report measures. Both participants described procedures as acceptable, although suggested more group participants could be beneficial. They both demonstrated reliable improvements (RCI > 1.96) on relevant social cognitive measures. Qualitative feedback corroborated findings: Greg reported generalization of therapeutic gains, Aaron reported increased self-awareness but nominal generalization. CONCLUSION Feasibility and limited efficacy outcomes established 'proof of concept' of SIFT IT. Findings will inform the study protocol for a larger randomized-controlled trial.
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Jones AC, Hilton R, Ely B, Gororo L, Danesh V, Sevin CM, Jackson JC, Boehm LM. Facilitating Posttraumatic Growth After Critical Illness. Am J Crit Care 2020; 29:e108-e115. [PMID: 32929457 PMCID: PMC7646602 DOI: 10.4037/ajcc2020149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The theory of posttraumatic growth arose from accounts of various trauma survivors experiencing not only distress but also growth and change. An intensive care unit admission is an unplanned, sudden, and traumatic experience, and many survivors have posttraumatic stress that can lead to posttraumatic stress disorder. Survivors leave the intensive care unit with new functional impairments that drive depression, and they frequently experience anxiety. Amidst the stress of understanding the trauma of an intensive care unit admission, survivors can grow in their world views, relationships, and sense of self. Understanding posttraumatic growth in intensive care unit survivors will inform health care providers on how to help survivors understand their new difficulties after an intensive care unit stay and facilitate growth. This article is a conceptual review of posttraumatic growth, identifiers of posttraumatic growth, and how the tenets of the posttraumatic growth theory apply to intensive care unit survivors. Health care professionals, specifically nurses, can incorporate practices into their care during and after the intensive care unit stay that encourage understanding and positive accommodation of new difficulties brought on by the intensive care unit hospitalization to support survivor growth. Opportunities for research include incorporating posttraumatic growth assessments into post-intensive care unit clinics, self-help materials, and various programs or therapies. Outcomes associated with posttraumatic growth are listed to suggest directions for research questions concerning posttraumatic growth in intensive care unit survivors.
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Affiliation(s)
- Abigail C Jones
- Abigail C. Jones is a research assistant, School of Nursing, Vanderbilt University and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt, Nashville, Tennessee
| | - Rachel Hilton
- Rachel Hilton is a research assistant, School of Nursing, Vanderbilt University
| | - Blair Ely
- Blair Ely is a research assistant, Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
| | - Lovemore Gororo
- Lovemore Gororo is an intensive care unit survivor and former patient at Vanderbilt University Hospital, Nashville, Tennessee
| | - Valerie Danesh
- Valerie Danesh is an assistant professor, School of Nursing, University of Texas at Austin, Austin, Texas, and a research scientist, Center for Applied Health Research, Baylor Scott & White Health, Dallas, Texas
| | - Carla M Sevin
- Carla M. Sevin is an assistant professor, Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
| | - James C Jackson
- James C. Jackson is a professor of medicine, Division of Allergy, Pulmonary, and Critical Care Medicine and Center for Health Services Research, Department of Medicine, Vanderbilt University School of Medicine; a professor, Geriatric Research, Education and Clinical Center Service and Clinical Research Center of Excellence, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System; and a professor, Department of Psychiatry, Vanderbilt Medical Center
| | - Leanne M Boehm
- Leanne M. Boehm is an assistant professor, School of Nursing, Vanderbilt University, and the Critical Illness, Brain Dysfunction, and Survivorship Center at Vanderbilt
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Early Brain Injury and Adaptive Functioning in Middle Childhood: The Mediating Role of Pragmatic Language. J Int Neuropsychol Soc 2020; 26:835-850. [PMID: 32336311 DOI: 10.1017/s1355617720000399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Traumatic brain injuries (TBIs) often adversely affect adaptive functioning (AF). However, the cognitive mechanisms by which AF is disrupted are not well understood in young children who sustain TBI. This study examined pragmatic language (PL) and executive functioning (EF) as potential mechanisms for AF disruption in children with early, predominantly mild-complicated, TBI. METHOD The sample consisted of 76 children between the ages of 6 and 10 years old who sustained a TBI (n = 36) or orthopedic injury (OI; n = 40) before 6 years of age and at least 1 year prior to testing (M = 4.86 years, SD = 1.59). Children's performance on a PL and an expressive vocabulary task (which served as a control task), and parent report of child's EF and AF were examined at two time points 1 year apart (i.e., at age 8 and at age 9 years). RESULTS Injury type (TBI vs. OI) significantly predicted child's social and conceptual, but not practical, AF. Results indicated that PL, and not expressive vocabulary or EF at time 1, mediated the relationship between injury type and both social and conceptual AF at time 2. CONCLUSIONS A TBI during early childhood appears to subtly, but uniquely, disrupt complex language skills (i.e., PL), which in turn may disrupt subsequent social and conceptual AF in middle childhood. Additional longitudinal research that examines different aspects of PL and adaptive outcomes into adolescence is warranted.
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18
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Howell S, Beeke S, Pring T, Varley R. Measuring outcomes of a peer-led social communication skills intervention for adults with acquired brain injury: A pilot investigation. Neuropsychol Rehabil 2020; 31:1069-1090. [PMID: 32408795 DOI: 10.1080/09602011.2020.1760892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Reduced social competence following severe acquired brain injury (ABI) is well-documented. This pilot study investigated a peer-led group intervention based on the claim that peer models may be a more effective mechanism for behaviour change than clinician-led approaches. Twelve participants with severe ABI were recruited from a post-acute neurorehabilitation setting and randomly assigned to either a peer-led intervention or a staff-led activity group (usual care) (Clinicaltrials.gov: NCT02211339). The groups met twice a week for 8 weeks. A peer was trained separately to facilitate interaction in the intervention group. Training comprised 16 individual sessions over 4 weeks. Group behaviour was measured twice at baseline, after intervention and at maintenance (4 weeks), using the Adapted Measure of Participation in Conversation (MPC) and the Interactional Network Tool (INT), a newly devised measure of group conversational interaction. Outcome measures showed differential sensitivity. The groups did not differ in baseline behaviour. Findings showed a significant improvement in the treated group on the MPC transaction scale post-intervention (p = .02). The intervention group showed more balanced interaction post-intervention on the INT and at follow-up. Findings show preliminary evidence of the advantage for peer-led groups. The INT shows promise as a method to detect a change in group communication behaviour.Trial registration: ClinicalTrials.gov identifier: NCT02211339.
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Affiliation(s)
- Susan Howell
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Suzanne Beeke
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Tim Pring
- Division of Language and Communication Science, City, University of London, London, UK
| | - Rosemary Varley
- Division of Psychology and Language Sciences, University College London, London, UK
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19
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Salas C, Casassus M, Rowlands L, Pimm S. Developing a model of long-term social rehabilitation after traumatic brain injury: the case of the head forward centre. Disabil Rehabil 2020; 43:3405-3416. [PMID: 32212984 DOI: 10.1080/09638288.2020.1741697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Social isolation and inactivity are highly problematic long-term consequences of Traumatic Brain Injury. They are rarely addressed by rehabilitation programmes, which focus on early phases of recovery. Day centres, or "drop-in" peer support groups, have emerged as an informal solution to social rehabilitation needs. However, there is a lack of knowledge regarding the therapeutic ingredients of these services.Methods: Twelve survivors of Traumatic Brain Injury that attended a social rehabilitation service (Head Forward Centre, UK; HFC), were interviewed to explore the meanings attached to the service and its activities. Thematic analysis was used to describe emerging themes and build a model of social rehabilitation.Results: Four therapeutic functions were attached to HFC: (a) HFC as a safe and predictable milieu; (b) HFC as a space where identity can be reconstructed; (c) HFC as a place where survivors can remain cognitive and socially active; (d) HFC as a network of continuous support.Conclusion: A model of long-term social rehabilitation should consider both psychological and practical/functional ingredients. Such a model can help informal rehabilitation services reflect upon their goals and activities, as well as articulate therapeutic actions along the rehabilitation path. The conceptualization of these four therapeutic ingredients in holistic rehabilitation models is described, and contrasted with its use in long-term social rehabilitation.IMPLICATIONS FOR REHABILITATIONSocial isolation and inactivity are important problems in the long-term rehabilitation of people with TBI. Both problems can be addressed by social rehabilitation services (day centres and peer support groups).Participation in social rehabilitation can promote a sense of normality and belongingness, which contribute to the long-term process of identity reconstruction.Social rehabilitation can help maintaining people with TBI cognitive and socially active, as well as developing a network of continuous support.
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Affiliation(s)
- Christian Salas
- Unidad de Neuropsicología Clínica, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile.,Laboratorio de Neurociencia Cognitiva y Social, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile.,Head Forward Centre, Manchester, UK
| | - Martin Casassus
- Head Forward Centre, Manchester, UK.,Time Perception Laboratory, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | | | - Steve Pimm
- Head Forward Centre, Manchester, UK.,Rehabilitation Without Walls, Milton Keynes, UK
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20
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O’Keeffe F, Dunne J, Nolan M, Cogley C, Davenport J. “The things that people can’t see” The impact of TBI on relationships: an interpretative phenomenological analysis. Brain Inj 2020; 34:496-507. [DOI: 10.1080/02699052.2020.1725641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Fiadhnait O’Keeffe
- School of Psychology, Trinity College Dublin, College Green, Dublin 2, Ireland
- Department of Clinical Psychology, National Rehabilitation Hospital, Dun Laoghaire, Co Dublin, Ireland
- Department of Psychology, St Vincent’s University Hospital, Dublin 4, Ireland
- School of Psychology, University College Dublin, Dublin 4, Ireland
| | - Johann Dunne
- School of Psychology, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Maeve Nolan
- Department of Clinical Psychology, National Rehabilitation Hospital, Dun Laoghaire, Co Dublin, Ireland
| | - Clodagh Cogley
- Department of Psychology, St Vincent’s University Hospital, Dublin 4, Ireland
| | - John Davenport
- School of Psychology, Trinity College Dublin, College Green, Dublin 2, Ireland
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21
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Jacobsson L, Lexell J. Functioning and disability from 10 to 16 years after traumatic brain injury. Acta Neurol Scand 2020; 141:115-122. [PMID: 31705523 DOI: 10.1111/ane.13194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/23/2019] [Accepted: 11/06/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES With increased long-term survival after traumatic brain injury (TBI), there is a need to understand the life situation many years after the injury. In this study, we have assessed persons on average 16 years after their injury and determined changes over 6 years in overall outcome, living condition, marital status and vocational situation, and in their functioning and disability. MATERIALS & METHODS Individuals (n = 49, mean age 45 years, 28-70 years) who were assessed 6-15 years (average 10 years) post-TBI were reassessed 12-21 years after their injury (average 16 years) using internationally established TBI outcome measures. RESULTS From the first to the second assessment, overall outcome using the Glasgow Outcome Scale (GOS) was stable for a large majority and no significant changes in marital status or vocational situation were found. There was some significant, but very small, decline regarding cognitive function, home integration and social integration. In the multiple regression analysis, there was a small significant decline in the Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment subscale score for women with a moderate-to-severe injury. CONCLUSIONS The very small changes over 6 years imply that persons with a TBI can reach and maintain a stable level of functioning many years post-TBI. Women with a moderate-to-severe TBI seem to be more vulnerable and may experience a small decline in some aspects of their functioning related to anxiety, depression, irritability, pain and headache and fatigue. The relatively small sample requires further studies to confirm these findings.
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Affiliation(s)
- Lars Jacobsson
- Rehabilitation Medicine Research Group Department of Health Sciences Lund University Lund Sweden
- Department of Rehabilitation Medicine Sunderby Hospital Luleå Sweden
- Department of Health Sciences Luleå University of Technology Luleå Sweden
| | - Jan Lexell
- Rehabilitation Medicine Research Group Department of Health Sciences Lund University Lund Sweden
- Department of Rehabilitation Medicine Sunderby Hospital Luleå Sweden
- Department of Neuroscience, Rehabilitation Medicine Uppsala University Uppsala Sweden
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22
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Evaluation of a Brief, Skill-Building, Supportive, and Educational Intervention for Couples After Brain Injury. J Head Trauma Rehabil 2019; 35:175-186. [PMID: 31479075 DOI: 10.1097/htr.0000000000000519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the effectiveness of an intervention (Therapeutic Couples Intervention, TCI) designed to improve relationship quality for couples after acquired brain injury. SETTING Outpatient brain injury rehabilitation center. PARTICIPANTS Persons with brain injury (n = 75) and their intimate partners (n = 75). DESIGN Two-arm parallel, randomized, controlled trial with wait-listed control. METHODS Composed of 5 to 6 2-hour sessions, the TCI is a manualized, treatment program designed to enhance relationship quality by addressing issues and concerns most often identified by persons with brain injury and their partners. MAIN MEASURE Revised Dyadic Adjustment Scale completed by the persons with brain injury and their partners. RESULTS Persons with brain injury and their partners in the treatment group showed an improvement in relationship quality, both compared with their own baseline values and the control group. CONCLUSIONS Investigation provided evidence that a curriculum-based education, skill-building, and supportive intervention can benefit couples for up to 3 months after treatment. Additional research is needed to ascertain the long-term benefits of intervention and the efficacy of alternative delivery methods (eg, Internet, telephone, and group).
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23
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Gates TM, Baguley IJ, Nott MT, Simpson GK. External causes of death after severe traumatic brain injury in a multicentre inception cohort: clinical description and risk factors. Brain Inj 2019; 33:821-829. [PMID: 30958696 DOI: 10.1080/02699052.2019.1600020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To characterize the clinical profile of patients dying from external causes (EC) following severe traumatic brain injury (TBI). Design and Methods: Data from 2545 patients forming the NSW-BIRP inception cohort discharged from post-acute inpatient rehabilitation between 1 July 1990 and 1 October 2007 were retrospectively reviewed. Standardized mortality ratios (SMRs) were calculated for EC sub-categories. Demographic, clinical and rehabilitation service factors were compared between deaths from EC, deaths from other causes (OC), and non-deceased. Clinical profiles of EC sub-categories were analysed descriptively. Results: Overall, patients with TBI were 5.2x more likely to die from EC relative to the general population. Risk of death was elevated in all EC sub-categories examined, with the largest risks relating to other accidental threats to breathing (SMR = 33.0; 95%CI = 13.79-60.45) and falls (SMR = 14.3; 95%CI = 5.01-28.39). The EC group were younger, more likely to have pre-injury psychiatric histories, less severe injuries, greater functional independence, and die earlier than the OC group. There was considerable heterogeneity in the clinical profiles of patients dying from different EC sub-categories. Conclusions: EC constitutes one of the largest causes of mortality following TBI in patients surviving beyond the post-acute phase. Potential implications for risk modification and prevention of premature and avoidable deaths are discussed.
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Affiliation(s)
- Thomas M Gates
- a Liverpool Brain Injury Rehabilitation Unit , Liverpool Hospital , Sydney , New South Wales , Australia
| | - Ian J Baguley
- b Brain Injury Rehabilitation Service , Westmead Hospital , Sydney , New South Wales , Australia
| | - Melissa T Nott
- c School of Community Health , Charles Sturt University , Albury , New South Wales , Australia
| | - Grahame K Simpson
- a Liverpool Brain Injury Rehabilitation Unit , Liverpool Hospital , Sydney , New South Wales , Australia.,d Brain Injury Rehabilitation Research Group , Ingham Institute of Applied Medical Research , Sydney , New South Wales , Australia.,e John Walsh Centre for Rehabilitation Research, Kolling Institute , University of Sydney , Sydney , New South Wales , Australia
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24
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Ruet A, Bayen E, Jourdan C, Ghout I, Meaude L, Lalanne A, Pradat-Diehl P, Nelson G, Charanton J, Aegerter P, Vallat-Azouvi C, Azouvi P. A Detailed Overview of Long-Term Outcomes in Severe Traumatic Brain Injury Eight Years Post-injury. Front Neurol 2019; 10:120. [PMID: 30846966 PMCID: PMC6393327 DOI: 10.3389/fneur.2019.00120] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/29/2019] [Indexed: 11/29/2022] Open
Abstract
Background and aims: Severe traumatic brain injury is a leading cause of acquired persistent disabilities, and represents an important health and economic burden. However, the determinants of long-term outcome have rarely been systematically studied in a prospective longitudinal study of a homogeneous group of patients suffering exclusively from severe TBI Methods: Prospective observational study of an inception cohort of adult patients with severe traumatic brain injury in the Parisian area (PariS-TBI). Outcome was assessed with face-to-face interview 8 years after Traumatic Brain Injury, focusing on impairments, activity limitations, and participation restriction. Results: Five hundred and four patients were included between 2005 and 2007. At 8-year follow-up, 261 patients were deceased, 128 were lost to follow-up, 22 refused to participate, and 86 were finally evaluated. Age, gender, initial injury severity did not significantly differ between evaluated patients and lost to follow-up, but the latter were more frequently students or unemployed. Mean age was 41.9 (SD 13.6), 79% were male, median initial Glasgow Coma Scale Score was 6. The most frequent somatic complaints concerned balance (47.5%), motricity (31%), and headaches (36%), but these were less frequent than cognitive complaints (Memory 71%, Slowness 68%, Concentration 67%). According to the Hospital Anxiety and Depression Scale (HADS), 25 % had a score >8 for anxiety and 23.7% for depression. According to the Extended Glasgow Outcome Scale, 19.8% remained severely disabled, 46.5% moderately disabled, 33.7% had a good recovery. Older age, longer education duration, lower functional status upon intensive care discharge, and more severe 8-year dysexecutive problems were significantly associated with a lower Extended Glasgow Outcome Scale score in multivariable analysis. At 8 years, 48.7% of patients were employed in a productive job. Of those, 38% declared a salary loss since traumatic brain injury. Unemployment was significantly associated with lower 1-year GOSE score and more severe 8-year dysexecutive problems. Conclusions: These results from an inception cohort study highlight the fact that long-term outcome after severe TBI is determined by a complex combination of injury-related, demographic and neuropsychological factors. Long after the injury, persisting impairments still interfere with social integration, and participation.
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Affiliation(s)
- Alexis Ruet
- Physical Medicine and Rehabilitation Department, CHRU, Caen, France.,Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,EPHE, INSERM, U1077, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Eléonore Bayen
- Physical Medicine and Rehabilitation Department, Pitie-Salpetriere Hospital, APHP, Paris, France.,Sorbonne Université GRC18, Paris, France
| | - Claire Jourdan
- Physical Medicine and Rehabilitation Department, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Idir Ghout
- Unité de Recherche Clinique Paris Ile-de-France Ouest, Ambroise Paré Hospital, APHP, Boulogne, France
| | - Layidé Meaude
- Unité de Recherche Clinique Paris Ile-de-France Ouest, Ambroise Paré Hospital, APHP, Boulogne, France
| | - Astrid Lalanne
- Physical Medicine and Rehabilitation Department, APHP, Raymond-Poincaré Hospital, Garches, France
| | - Pascale Pradat-Diehl
- Physical Medicine and Rehabilitation Department, Pitie-Salpetriere Hospital, APHP, Paris, France.,Laboratoire d'Imagerie Biomedicale Inserm U1146, Sorbonne Université GRC18, Paris, France
| | - Gaëlle Nelson
- Regional Reference Center for Bain Injury in the Parisan Area, CRFTC, Paris, France
| | - James Charanton
- Regional Reference Center for Bain Injury in the Parisan Area, CRFTC, Paris, France
| | - Philippe Aegerter
- Unité de Recherche Clinique Paris Ile-de-France Ouest, Ambroise Paré Hospital, APHP, Boulogne, France
| | - Claire Vallat-Azouvi
- Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France.,Laboratoire de Psychopathologie et Neuropsychologie, EA 2027, Université Paris 8, Saint-Denis, France
| | - Philippe Azouvi
- Laboratoire de Recherches Cliniques et en Santé publique sur les Handicaps Psychiques, Cognitifs et Moteurs (HANDIReSP, EA4047), Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Physical Medicine and Rehabilitation Department, APHP, Raymond-Poincaré Hospital, Garches, France
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de Haan EHF, Seijdel N, Kentridge RW, Heywood CA. Plasticity versus chronicity: Stable performance on category fluency 40 years post-onset. J Neuropsychol 2019; 14:20-27. [PMID: 30768853 PMCID: PMC7079005 DOI: 10.1111/jnp.12180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 01/17/2019] [Indexed: 12/17/2022]
Abstract
What is the long-term trajectory of semantic memory deficits in patients who have suffered structural brain damage? Memory is, per definition, a changing faculty. The traditional view is that after an initial recovery period, the mature human brain has little capacity to repair or reorganize. More recently, it has been suggested that the central nervous system may be more plastic with the ability to change in neural structure, connectivity, and function. The latter observations are, however, largely based on normal learning in healthy subjects. Here, we report a patient who suffered bilateral ventro-medial damage after presumed herpes encephalitis in 1971. He was seen regularly in the eighties, and we recently had the opportunity to re-assess his semantic memory deficits. On semantic category fluency, he showed a very clear category-specific deficit performing better that control data on non-living categories and significantly worse on living items. Recent testing showed that his impairments have remained unchanged for more than 40 years. We suggest cautiousness when extrapolating the concept of brain plasticity, as observed during normal learning, to plasticity in the context of structural brain damage.
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Affiliation(s)
- Edward H F de Haan
- Department of Psychology, University of Amsterdam, The Netherlands.,Amsterdam Brain and Cognition (ABC) Center, University of Amsterdam, The Netherlands
| | - Noor Seijdel
- Department of Psychology, University of Amsterdam, The Netherlands.,Amsterdam Brain and Cognition (ABC) Center, University of Amsterdam, The Netherlands
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Rogers A, McKinlay A. The long-term effects of childhood traumatic brain injury on adulthood relationship quality. Brain Inj 2019; 33:649-656. [PMID: 30664366 DOI: 10.1080/02699052.2019.1567936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PRIMARY OBJECTIVE To investigated the long-term effect of childhood Traumatic Brain Injury (TBI) on adulthood Relationship Quality (RQ), examining injury severity, age of injury, and markers of prefrontal cortex (PFC) functioning, apathy, disinhibition, and executive dysfunction. RESEARCH DESIGN Longitudinal, between-subjects, cross-sectional design using retrospective and current data. METHODS AND PROCEDURES Participants (N = 169; 61 mild TBI (mTBI); 65 moderate to severe TBI (MSTBI); 43 orthopaedic injury (OI); Injury age: 1-17 years; Testing age: 18-31 years) completed a structured interview regarding their injury, demographic characteristics and RQ, the National Adults Reading Test, and Frontal Systems Behaviour Scale. Data were analyzed using IBM SPSS 25. MAIN OUTCOMES AND RESULTS Adults who had experienced childhood TBI had significantly poorer RQ than adults who had experienced childhood OI. Severity of TBI did not impact adulthood RQ. Earlier age of injury predicted reduced adulthood RQ in the MSTBI group. Greater PFC dysfunction predicted poorer RQ in adults with a history of childhood TBI. While elevated levels of apathy, disinhibition, and executive dysfunction were associated with poorer RQ, no individual marker had predictive value. CONCLUSION Experiencing a childhood TBI can have a long-term negative influence on adulthood RQ. Such RQ deficits can underpin reduced life satisfaction and increased health issues.
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Affiliation(s)
- Alana Rogers
- a Melbourne School of Psychological Sciences , The University of Melbourne , Melbourne , Australia.,b School of Psychological Sciences , University of Melbourne , Melbourne , Australia
| | - Audrey McKinlay
- b School of Psychological Sciences , University of Melbourne , Melbourne , Australia.,c Department of Psychology , University of Canterbury , Melbourne , Australia
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Cristofori I, Pal S, Zhong W, Gordon B, Krueger F, Grafman J. The lonely brain: evidence from studying patients with penetrating brain injury. Soc Neurosci 2018; 14:663-675. [DOI: 10.1080/17470919.2018.1553798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Irene Cristofori
- Institute of Cognitive Science Marc Jeannerod CNRS, UCBL, Bron, France
| | - Sanya Pal
- Brain Injury Research, Cognitive Neuroscience Laboratory, Chicago, IL, USA
| | - Wanting Zhong
- Brain Injury Research, Cognitive Neuroscience Laboratory, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Baltimore, MD, USA
| | - Barry Gordon
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | - Frank Krueger
- School of Systems Biology, George Mason University, VA, USA
- Department of Psychology, University of Mannheim, Mannheim, Germany
| | - Jordan Grafman
- Brain Injury Research, Cognitive Neuroscience Laboratory, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Baltimore, MD, USA
- Departments of Neurology, Psychiatry, and Cognitive Neurology & Alzheimer’s Disease, Feinberg School of Medicine, Department of Psychology, Northwestern University, Chicago, IL, USA
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Byom L, Duff M, Mutlu B, Turkstra LS. Facial emotion recognition of older adults with traumatic brain injury. Brain Inj 2018; 33:322-332. [PMID: 30526138 PMCID: PMC8351800 DOI: 10.1080/02699052.2018.1553066] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 08/29/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The objective of this study was to examine the effects of traumatic brain injury (TBI) and age on facial emotion recognition abilities in adults. Age and TBI were expected to have negative effects on emotion recognition and a TBI by age interaction was hypothesized such that older adults with TBI would have the lowest emotion recognition scores. METHODS A prospective cohort study was conducted. Participants were 26 adults with moderate-severe TBI (13 older and 13 younger) and 26 uninjured peers matched for age, sex, and education. Emotion recognition was measured using the Emotion Recognition Task, which is comprised of dynamically morphed facial expressions of the six basic emotions, presented at different intensity levels. RESULTS TBI and older age were associated with poorer recognition of both subtle and intense expressions, but only for expressions of anger and sadness. There was no interaction of age and TBI. CONCLUSIONS Results add to the growing evidence of emotion recognition impairments after TBI, particularly for select negative emotions, and extend this finding to adults over the age of 60. Further research is needed to better understand social cognitive effects of TBI across the adult lifespan.
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Affiliation(s)
- Lindsey Byom
- University of North Carolina at Chapel Hill School of Medicine, Division of Speech and Hearing Sciences, Department of Allied Health Sciences
- University of Wisconsin-Madison, Department of Communication Sciences and Disorders
| | - Melissa Duff
- Vanderbilt University, Department of Hearing and Speech Sciences
| | - Bilge Mutlu
- University of Wisconsin-Madison, Department of Computer Sciences
| | - Lyn S. Turkstra
- University of Wisconsin-Madison, Department of Communication Sciences and Disorders
- McMaster University, School of Rehabilitation Science
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Williams C, Wood RL, Howe H. Alexithymia is associated with aggressive tendencies following traumatic brain injury. Brain Inj 2018; 33:1-9. [PMID: 30373401 DOI: 10.1080/02699052.2018.1531302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 06/21/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Aggressive behavior is a frequent legacy of traumatic brain injury (TBI). This study explores the question of how alexithymia, which is associated with deficits in social cognition and empathy, may predispose individuals to aggressive tendencies after head trauma. METHOD A total of 47 individuals referred for routine neuropsychological assessment and advice on the management of long-term neuropsychological sequelae after TBI and 72 demographically matched controls completed the 20-Item Toronto Alexithymia Scale (TAS-20) and Buss Perry Aggression Questionnaire (BPAQ; self and proxy). RESULTS The incidence of alexithymia and aggressive tendencies was significantly higher in the group with TBI. After controlling for covariates, alexithymia explained an additional 29% of variance in BPAQ total scores in the group with TBI and 11.1% in the control group. Of the three TAS-20 sub-scales, 'difficulty describing feelings' emerged as a consistent unique predictor of aggression scores. CONCLUSIONS Higher levels of alexithymia are associated with greater aggressive tendencies post-TBI. The findings offer important theoretical and empirical insights into the prediction of aggression after TBI.
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Affiliation(s)
- Claire Williams
- a Department of Psychology, College of Human and Health Sciences , Swansea University , Swansea , Wales , UK
| | | | - Holly Howe
- a Department of Psychology, College of Human and Health Sciences , Swansea University , Swansea , Wales , UK
- c Neurodevelopment Assessment Unit , Cardiff University , Cardiff , Wales , UK
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Backhaus S, Neumann D, Parrott D, Hammond FM, Brownson C, Malec J. Investigation of a New Couples Intervention for Individuals With Brain Injury: A Randomized Controlled Trial. Arch Phys Med Rehabil 2018; 100:195-204.e1. [PMID: 30195986 DOI: 10.1016/j.apmr.2018.08.174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 08/01/2018] [Accepted: 08/21/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to (1) examine the efficacy of a treatment to enhance a couple's relationship after brain injury particularly in relationship satisfaction and communication; and (2) determine couples' satisfaction with this type of intervention. DESIGN Randomized waitlist-controlled trial. SETTING Midwestern outpatient brain injury rehabilitation center. PARTICIPANTS Participants (N=44; 22 persons with brain injury and their intimate partners) were randomized by couples to the intervention or waitlist-controlled group, with 11 couples in each group. INTERVENTIONS The Couples Caring and Relating with Empathy intervention is a 16-week, 2-hour, manualized small group treatment utilizing psychoeducation, affect recognition, empathy training, cognitive-behavioral and dialectical-behavioral strategies, communication skills training, and Gottman's theoretical framework for couples adjusted for individuals with brain injury. MAIN OUTCOME MEASURES The Dyadic Adjustment Scale, Quality of Marriage Index (QMI), and the Four Horsemen of the Apocalypse communication questionnaire were implemented. Measures were completed by the person with brain injury and that person's partner at 3 time points: baseline, immediate postintervention, 3-month follow-up. RESULTS The experimental group showed significant improvement at posttest and follow-up on the Dyadic Adjustment Scale and the Horsemen questionnaire compared to baseline and to the waitlist-controlled group which showed no significant changes on these measures. No significant effects were observed on the QMI for either group. Satisfaction scores were largely favorable. CONCLUSIONS Results suggest this intervention can improve couples' dyadic adjustment and communication after brain injury. High satisfaction ratings suggest this small group intervention is feasible with couples following brain injury. Future directions for this intervention are discussed.
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Affiliation(s)
- Samantha Backhaus
- Rehabilitation Hospital of Indiana, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.
| | - Dawn Neumann
- Rehabilitation Hospital of Indiana, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN
| | - Devan Parrott
- Rehabilitation Hospital of Indiana, Indianapolis, IN
| | - Flora M Hammond
- Rehabilitation Hospital of Indiana, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN
| | | | - James Malec
- Rehabilitation Hospital of Indiana, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN
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Bivona U, Formisano R, Mastrilli L, Zabberoni S, Caltagirone C, Costa A. Theory of Mind after Severe Acquired Brain Injury: Clues for Interpretation. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5205642. [PMID: 30069471 PMCID: PMC6057350 DOI: 10.1155/2018/5205642] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/24/2018] [Accepted: 06/04/2018] [Indexed: 11/30/2022]
Abstract
Background. Recently, increased interest has been shown in Theory of Mind (ToM) abilities of individuals with severe acquired brain injury (sABI). ToM impairment following sABI can be associated with altered executive functioning and/or with difficulty in decoding and elaborating emotions. Two main theoretical models have been proposed to explain the mechanisms underlying ToM in the general population: Theory Theory and Simulation Theory. This review presents and discusses the literature on ToM abilities in individuals with sABI by examining whether they sustain the applicability of the Theory Theory and/or Simulation Theory to account for ToM deficits in this clinical population. We found 32 papers that are directly aimed at investigating ToM in sABI. Results did not show the univocal predominance of one model with respect to the other in explaining ToM deficits in sABI. We hypothesised that ToM processes could be explained by coinvolvement of the two models, i.e., according to personal experience, cognitive features, or the emotional resources of the persons with sABI.
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Affiliation(s)
- U. Bivona
- Fondazione Santa Lucia, IRCCS, Rome, Italy
| | | | | | - S. Zabberoni
- Fondazione Santa Lucia, IRCCS, Rome, Italy
- Università telematica Niccolò Cusano, Rome, Italy
| | - C. Caltagirone
- Fondazione Santa Lucia, IRCCS, Rome, Italy
- Università Tor Vergata, Rome, Italy
| | - A. Costa
- Fondazione Santa Lucia, IRCCS, Rome, Italy
- Università telematica Niccolò Cusano, Rome, Italy
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Mas MF, Mathews A, Gilbert-Baffoe E. Rehabilitation Needs of the Elder with Traumatic Brain Injury. Phys Med Rehabil Clin N Am 2018; 28:829-842. [PMID: 29031347 DOI: 10.1016/j.pmr.2017.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The incidence of traumatic brain injury (TBI) in older adults is increasing. As the expected life expectancy increases, there is a heightened need for comprehensive rehabilitation for this population. Elderly patients with TBI benefit from rehabilitation interventions at all stages of injury and can achieve functional gains during acute inpatient rehabilitation. Clinicians should be vigilant of unique characteristics of this population during inpatient rehabilitation, including vulnerability to polypharmacy, posttraumatic hydrocephalus, neuropsychiatric sequelae, sleep disturbances, and sensory deficits. Long-term care should include fall prevention, assessment of cognitive deficits, aerobic activity, community reintegration, and caretaker support. Life expectancy is reduced after TBI.
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Affiliation(s)
- Manuel F Mas
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, TIRR Memorial Hermann, 1333 Moursund Street, Houston, TX 77030, USA.
| | - Amy Mathews
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, 7200 Cambridge Street, Suite 10C, Houston, TX 77030, USA
| | - Ekua Gilbert-Baffoe
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, 7200 Cambridge Street, Suite 10C, Houston, TX 77030, USA
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Relationship Stability After Traumatic Brain Injury Among Veterans and Service Members: A VA TBI Model Systems Study. J Head Trauma Rehabil 2018; 32:234-244. [PMID: 28520674 DOI: 10.1097/htr.0000000000000324] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explore stability of relationships and predictors of change in relationship status 2 years following TBI/polytrauma. SETTING Five Department of Veterans Affairs Polytrauma Rehabilitation Centers (VA PRCs). PARTICIPANTS A total of 357 active duty service members and Veterans enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers Traumatic Brain Injury Model Systems database with complete marital status information at 2 years postinjury. DESIGN Prospective, longitudinal, multisite. MAIN MEASURES Relationship status change was defined as change in marital status (single/never married; married; divorced/separated) at 2-year follow-up, compared with status at enrollment. RESULTS At the time of enrollment, 134 participants (38%) were single/never married; 151 (42%) were married, and 72 (20%) were divorced/separated. Of those married at enrollment, 78% remained married at year 2 while 22% underwent negative change. Multivariable analyses revealed that age and education at the time of injury and mental health utilization prior to injury were significant predictors of relationship change. Among those who were single/divorced/separated at the time of enrollment, 87% remained so at year 2 while 13% underwent positive change. Injury during deployment significantly predicted positive relationship change. CONCLUSIONS The unmalleable, preinjury characteristics identified may be used as potential triggers for education, prevention, surveillance, and couples therapy, if needed.
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Stubbs E, Togher L, Kenny B, Fromm D, Forbes M, MacWhinney B, McDonald S, Tate R, Turkstra L, Power E. Procedural discourse performance in adults with severe traumatic brain injury at 3 and 6 months post injury. Brain Inj 2017; 32:167-181. [DOI: 10.1080/02699052.2017.1291989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Elin Stubbs
- Discipline of Speech Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Leanne Togher
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Davida Fromm
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Margaret Forbes
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Skye McDonald
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Robyn Tate
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Lyn Turkstra
- Department of Communicative Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Emma Power
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
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Chesnel C, Jourdan C, Bayen E, Ghout I, Darnoux E, Azerad S, Charanton J, Aegerter P, Pradat-Diehl P, Ruet A, Azouvi P, Vallat-Azouvi C. Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study. Clin Rehabil 2017; 32:692-704. [DOI: 10.1177/0269215517734294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: To evaluate the patient’s awareness of his or her difficulties in the chronic phase of severe traumatic brain injury (TBI) and to determine the factors related to poor awareness. Design/Setting/Subjects: This study was part of a larger prospective inception cohort study of patients with severe TBI in the Parisian region (PariS-TBI study). Intervention/Main measures: Evaluation was carried out at four years and included the Brain Injury Complaint Questionnaire (BICoQ) completed by the patient and his or her relative as well as the evaluation of impairments, disability and quality of life. Results: A total of 90 patient-relative pairs were included. Lack of awareness was measured using the unawareness index that corresponded to the number of discordant results between the patient and relative in the direction of under evaluation of difficulties by the patient. The only significant relationship found with lack of awareness was the subjective burden perceived by the relative (Zarit Burden Inventory) ( r = 0.5; P < 0.00001). There was no significant relationship between lack of awareness and injury severity, pre-injury socio-demographic data, cognitive impairments, mood disorders, functional independence (Barthel index), global disability (Glasgow Outcome Scale), return to work at four years or quality of life (Quality Of Life after Brain Injury scale (QOLIBRI)). Conclusion: Lack of awareness four years post severe TBI was not related to the severity of the initial trauma, sociodemographic data, the severity of impairments, limitations of activity and participation, or the patient’s quality of life. However, poor awareness did significantly influence the weight of the burden perceived by the relative.
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Affiliation(s)
- Camille Chesnel
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Claire Jourdan
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Eleonore Bayen
- Laboratoire d’Économie et de Gestion des Organisations de Santé (LEDa-LEGOS), Université Paris-Dauphine, Paris, France
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Idir Ghout
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - Emmanuelle Darnoux
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Sylvie Azerad
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - James Charanton
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Philippe Aegerter
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
- UMR-S 1168, Université de Versailles Saint-Quentin, Versailles, France
| | - Pascale Pradat-Diehl
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Philippe Azouvi
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Claire Vallat-Azouvi
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
- Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France
- EA 2027: Laboratoire de Psychopathologie et Neuropsychologie, Université Paris 8, Saint-Denis, France
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Schulz-Heik RJ, Poole JH, Dahdah MN, Sullivan C, Adamson MM, Date ES, Salerno R, Schwab K, Harris O. Service needs and barriers to care five or more years after moderate to severe TBI among Veterans. Brain Inj 2017; 31:1287-1293. [DOI: 10.1080/02699052.2017.1307449] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- R. Jay Schulz-Heik
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - John H. Poole
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Marie N. Dahdah
- Baylor Institute for Rehabilitation, Dallas, TX, USA
- Baylor Regional Medical Center at Plano, Plano, TX, USA
| | - Campbell Sullivan
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Maheen M. Adamson
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Rose Salerno
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Karen Schwab
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
| | - Odette Harris
- Defense and Veterans Brain Injury Center, Palo Alto, CA and Rockville, MD, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
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De Guzman E, Ament A. Neurobehavioral Management of Traumatic Brain Injury in the Critical Care Setting: An Update. Crit Care Clin 2017; 33:423-440. [PMID: 28601130 DOI: 10.1016/j.ccc.2017.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Traumatic brain injury (TBI) is an alteration in brain function, or other evidence of brain pathology, caused by an external force. TBI is a major cause of disability and mortality worldwide. Post-traumatic amnesia, or the interval from injury until the patient is oriented and able to form and later recall new memories, is an important index of TBI severity and functional outcome. This article will discuss the updates in the epidemiology, definition and classification, pathophysiology, diagnosis, and management of common acute neuropsychiatric sequelae of traumatic brain injury that the critical care specialist may encounter.
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Affiliation(s)
- Earl De Guzman
- Psychosomatic Medicine, Department of Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Palo Alto, CA 94305, USA
| | - Andrea Ament
- Psychosomatic Medicine, Department of Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Palo Alto, CA 94305, USA.
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38
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Kolakowsky-Hayner SA, Bellon K, Yang Y. Unintentional injuries after TBI: Potential risk factors, impacts, and prevention. NeuroRehabilitation 2017; 39:363-70. [PMID: 27497469 DOI: 10.3233/nre-161368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The top three causes of fatal unintentional injuries are falls, motor vehicle crashes, and being struck against or struck by objects or persons. These etiologies also happen to be the leading causes of TBI, a serious public health problem, in the US. Reduced cognitive functioning, poor decision making, increased risk taking, disinhibition, diminished safety skills and substance use, place individuals with TBI at an increased risk for subsequent unintentional injuries. The caregiving, psychological, social and financial burden of initial injuries is enormous. Unintentional injuries post-TBI add to that burden significantly. Many unintentional injuries can be prevented with simple education and environment and lifestyle changes. Injury prevention requires collaboration among many. OBJECTIVE This literature review will share information regarding potential triggers or causes of unintentional injuries after TBI to identify potential issues. The many impacts of these injuries will be reviewed. Best practices in prevention will be presented. CONCLUSION Ultimately, education, discussion, and awareness across multiple stakeholders can aid in preventing unintentional injuries after TBI.
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Affiliation(s)
- Stephanie A Kolakowsky-Hayner
- Brain Trauma Foundation, Campbell, CA, USA.,Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA
| | - Kimberly Bellon
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA
| | - Yvonne Yang
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA
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39
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Francis HM, Osborne-Crowley K, McDonald S. Validity and reliability of a questionnaire to assess social skills in traumatic brain injury: A preliminary study. Brain Inj 2017; 31:336-343. [DOI: 10.1080/02699052.2016.1250954] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Heather M. Francis
- School of Psychology, The University of New South Wales, New South Wales, Australia
| | | | - Skye McDonald
- School of Psychology, The University of New South Wales, New South Wales, Australia
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Suzuki Y. Mental health services and related factors in health care of traumatic brain injury survivors. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2016.1273568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Yusuke Suzuki
- Faculty of Health & Medicalcare, Shonan University of Medical Sciences, 16-48, Kamisinano, Totuka-ku, Kanagawa, Yokohama City 244-0806, Japan
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Vathanalaoha K, Oearsakul T, Tunthanathip T. Predictive Factors of Survival and 6-Month Favorable Outcome of Very Severe Head Trauma Patients; a Historical Cohort Study. EMERGENCY (TEHRAN, IRAN) 2017; 5:e24. [PMID: 28286831 PMCID: PMC5325893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Very severe head trauma cases, defined as Glasgow Coma Scale (GCS) scores of less than 6, have a higher mortality rate and poorer outcome. The purpose of this study was to recognize factors associated with survival and 6-month favorable outcome of very severe head trauma patients presenting to emergency department. METHODS In this historical cohort study, the authors retrospectively reviewed medical records of head trauma patients who were admitted to the emergency department with post-resuscitation GCS scores of less than 6. Both univariate and multivariate analyses were used to test the association between various parameters with survival and 6-month outcome. RESULTS 103 cases with the mean age of 39 ± 16.5 years were studied (80% male). The overall survival rate was 41.7% and the rate of 6-month favorable outcome was 28.2%. In multivariate analysis, brisk pupil light reaction on admission and patent basal cistern on brain computed tomography (CT) scan were significant factors associated with both survival (OR 5.20, 95% CI 1.57-17.246, p = 0.007 and OR 3.65, 95% CI 1.22-10.91, p=0.02 respectively) and favorable outcome (OR 4.07, 95% CI 1.35-12.24, p=0.01 and OR 3.54, 95% CI 1.22-10.26, p 0.02), respectively. CONCLUSION Based on the results of present study, the survival rate of patients with very severe head trauma (GCS < 6) was 41.7%. The strong predictors of survival and 6-month favorable outcome of these patients were brisk pupillary reactivity and patent cistern on brain CT scan. It seems that very severe head trauma patients still have a reasonable chance to survive and aggressive management should be continued.
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Affiliation(s)
- Karin Vathanalaoha
- Neurosurgical unit, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thakul Oearsakul
- Neurosurgical unit, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thara Tunthanathip
- Neurosurgical unit, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Corresponding Author: Thara Tunthanathip; Neurosurgical Unit, Department of Surgery, Faculty of Medicine, Hatyai, Songkhla, Thailand, 90112. Phone: +66-85-8203334 Fax: +66-74-429384 ,
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Rosenberg H, McDonald S, Rosenberg J, Westbrook RF. Measuring emotion perception following traumatic brain injury: The Complex Audio Visual Emotion Assessment Task (CAVEAT). Neuropsychol Rehabil 2016; 29:232-250. [DOI: 10.1080/09602011.2016.1273118] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hannah Rosenberg
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Jacob Rosenberg
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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Cassel A, McDonald S, Kelly M, Togher L. Learning from the minds of others: A review of social cognition treatments and their relevance to traumatic brain injury. Neuropsychol Rehabil 2016; 29:22-55. [DOI: 10.1080/09602011.2016.1257435] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Anneli Cassel
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Skye McDonald
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Michelle Kelly
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of Newcastle, Newcastle, Australia
| | - Leanne Togher
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Salas CE, Casassus M, Rowlands L, Pimm S, Flanagan DAJ. “Relating through sameness”: a qualitative study of friendship and social isolation in chronic traumatic brain injury. Neuropsychol Rehabil 2016; 28:1161-1178. [DOI: 10.1080/09602011.2016.1247730] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Christian E. Salas
- Facultad de Psicología, Laboratorio Neurociencia Cognitiva y Social, Universidad Diego Portales, Santiago, Chile
- Head Forward Centre, Manchester, UK
- School of Psychology, Bangor University, Bangor, Wales, UK
| | - Martin Casassus
- Head Forward Centre, Manchester, UK
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | | | - Steve Pimm
- Rehabilitation Without Walls, Milton Keynes, UK
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Osborne-Crowley K, McDonald S. A review of social disinhibition after traumatic brain injury. J Neuropsychol 2016; 12:176-199. [DOI: 10.1111/jnp.12113] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/05/2016] [Indexed: 11/25/2022]
Affiliation(s)
| | - Skye McDonald
- School of Psychology; The University of New South Wales; Sydney New South Wales Australia
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O'Connor C, Colantonio A, Polatajko H. Long Term Symptoms and Limitations of Activity of People with Traumatic Brain Injury: A Ten-Year Follow-up. Psychol Rep 2016; 97:169-79. [PMID: 16279322 DOI: 10.2466/pr0.97.1.169-179] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the effect of Traumatic Brain Injury 10 years post-injury. Frequencies of head injury symptoms and activity limitation by level of severity were measured in a consecutive series of 61 adults who were admitted to a tertiary-care center for traumatic brain injury. Irritability and Anxiety were the most frequently reported symptoms from the Head Injury Symptom Checklist. Bothered by noise and Bothered by light were the least frequently reported. Trouble hearing what is said in a group conversation and Trouble hearing what is said in a one-to-one conversation were the most commonly reported limitations of activity from the Health and Activity Limitations Survey. Overall, this study illustrates that symptoms remain many years following brain injury, irrespective of the injury's severity.
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Affiliation(s)
- C O'Connor
- Rotman Research Institute, Baycrest Centre for Geriatric Care, Department of Psychology, University of Toronto, Canada
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Fleming J, Strong J. A Longitudinal Study of Self-Awareness: Functional Deficits Underestimated by Persons with Brain Injury. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/153944929901900101] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A longitudinal study of 55 adults with severe traumatic brain injury (TBI) investigated the areas of function for which they lacked self-awareness of their level of competency. Data were collected at 3 and 12 months post-injury using the Patient Competency Rating Scale. Self-awareness was measured by comparing patient self-ratings with the ratings of an informant. The results were consistent with previous studies, indicating that self-awareness was most impaired for activities with a large cognitive and socioemotional component, and least impaired for basic activities of daily living, memory activities, and overt emotional responses. For most areas of function that were overestimated at 3 months post-injury, self-awareness subsequently improved during the first year after injury.
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Turkstra LS, Clark A, Burgess S, Hengst JA, Wertheimer JC, Paul D. Pragmatic communication abilities in children and adults: implications for rehabilitation professionals. Disabil Rehabil 2016; 39:1872-1885. [DOI: 10.1080/09638288.2016.1212113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lyn S. Turkstra
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Allison Clark
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and TIRR Memorial Hermann, Houston, TX, USA
| | - Sloane Burgess
- Department of Speech Pathology and Audiology, Kent State University, Kent, OH, USA
| | - Julie A. Hengst
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jeffrey C. Wertheimer
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Diane Paul
- American Speech-Language-Hearing Association, Rockville, MD, USA
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Slater EJ, Kohr MA. Academic and Intellectual Functioning of Adolescents with Closed Head Injury. JOURNAL OF ADOLESCENT RESEARCH 2016. [DOI: 10.1177/074355488943007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescents with head injury often return to school and experience difficulty in their academic pursuits. A cademic and intellectual functioning of adolescents with closed head injury (CHI) was assessed immediately and six months posttrauma. Data on school and health history were also collected. T-tests and chi-square analyses were used to determine differences between the CHI group (n = 33) and their matched controls (n = 32). Results indicated that both initially and at six months postinjury the CHI group was functioning lower academically and intellectually in comparison to their peers. No differences were found in their developmental or psychiatric history. However, based upon data from a subset of the sample, the CHI group had lower English grades and grade point averages the year prior to their injury. Three areas for further research are discussed.
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McMillan TM, Greenwood RJ, Morris JR, Brooks DN, Murphy L, Dunn G. An introduction to the concept of head injury case management with respect to the need for service provision. Clin Rehabil 2016. [DOI: 10.1177/026921558800200409] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - RJ Greenwood
- Department of Neurological Sciences, St Bartholomew's Hospital, London
| | - JR Morris
- Department of Neurological Sciences, St Bartholomew's Hospital, London
| | - DN Brooks
- Department of Psychological Medicine, University of Glasgow
| | | | - G. Dunn
- Institute of Psychiatry, London
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