1
|
Yang S, Kim JW. Electrophysiological Markers Predicting Antipsychotic Treatment Response in Patients with Schizophrenia: A Retrospective Study. Neuropsychiatr Dis Treat 2024; 20:1387-1394. [PMID: 39007072 PMCID: PMC11246663 DOI: 10.2147/ndt.s467180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/29/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose This study aimed to provide an objective means of predicting treatment responses in patients with schizophrenia using quantitative electroencephalography (qEEG) as an electrophysiological indicator. We obtained qEEG recordings from patients with schizophrenia and explored them for patterns indicative of treatment responsiveness. Patients and Methods The study included 68 patients had been diagnosed with schizophrenia spectrum disorder. After retrospectively gathering demographic information, clinical data such as qEEG, Positive and Negative Syndrome Scale (PANSS), a multiple regression analysis was performed. This analysis employed baseline qEEG findings as independent variables and PANSS score changes as dependent variables to discern causal relationships. Results The mean age of the participants was 38.4 years(SD =13.73). The mean PANSS score on admission was 92.97, decreasing to 67.41 at discharge. Multiple regression analysis revealed that delta waves in T4 (β=0.346, t=3.165, p=0.002), and high-beta waves in Fp2 (β=0.231, t=2.361, p=0.021) were associated with PANSS changes in absolute power. In addition, the delta waves of O2 (β=0.250, t=3.288, p=0.002); beta waves of T3 (β=-1.463, t=-5.423, p<0.001) and O2 (β=0.551, t=3.366, p=0.001); high beta waves of Fp1 (β=0.307, t=4.026, p<0.001), T3 (β=0.855, t=4.414, p<0.001) and T6 (β=-0.838, t=-4.559, p<0.001) of absolute power using the Z-score were also related to PANSS changes. Pearson's correlation analysis showed that only delta waves at Cz (r= 0.246, p=0.043) in absolute power correlated with changes in the PANSS. Conclusion We found that certain qEEG wave patterns in patients with schizophrenia prior to antipsychotic treatment were linked to PANSS changes before and after treatment. Delta waves and beta waves, primarily in the frontal and temporal regions, were found to be significantly associated with changes in PANSS scores. In the future, the qEEG indicators identified in this study could serve as electrophysiological markers for predicting antipsychotic treatment responses in patients with schizophrenia.
Collapse
Affiliation(s)
- Seungheon Yang
- Department of Psychiatry, Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Daegu Catholic University Medical Center, Daegu, Republic of Korea
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| |
Collapse
|
2
|
Chiang HS, Motes M, Afkhami-Rohani B, Adhikari A, LoBue C, Kraut M, Cullum CM, Hart J. Verbal retrieval deficits due to traumatic brain injury are associated with changes in event related potentials during a Go-NoGo task. Clin Neurophysiol 2024; 163:1-13. [PMID: 38663098 PMCID: PMC11216819 DOI: 10.1016/j.clinph.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Verbal retrieval (VR) deficits often occur after traumatic brain injury (TBI), but the mechanisms remain unclear. We examined how event-related potentials (ERPs) during a Go-NoGo task were associated with VR deficits. METHODS Sixty veterans with a history of TBI underwent a neuropsychological battery and a Go-NoGo task with concurrent EEG recording. We compared task performance and ERP measures (N2, P3) between those with and those without persistent injury-related VR deficits. We then used generalized linear modeling to examine the relationship between ERP measures and scores on measures of executive function and processing speed. RESULTS Go-NoGo task performance was comparable between the groups. Those with VR deficits had larger N2 amplitude in NoGo than in Go conditions. In participants with VR deficits, larger NoGo N2/P3 amplitude predicted faster processing speed. Furthermore, larger P3 amplitude and shorter P3 latency of the difference wave (NoGo - Go) predicted faster processing speed in those with VR deficits. CONCLUSIONS Despite no difference in Go-NoGo task performance, ERP amplitude and latency measures associated with cognitive control during Go-NoGo distinguished TBI individuals with VR deficits from those without. SIGNIFICANCE This study furthers our understanding of VR deficits in TBI and implicates potential application of ERP measures in monitoring and treating such deficits.
Collapse
Affiliation(s)
- Hsueh-Sheng Chiang
- University of Texas Southwestern Medical Center, Department of Neurology, USA; The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Michael Motes
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Borna Afkhami-Rohani
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Ashna Adhikari
- The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA.
| | - Christian LoBue
- University of Texas Southwestern Medical Center, Department of Psychiatry, USA; University of Texas Southwestern Medical Center, Department of Neurological Surgery, USA.
| | - Michael Kraut
- The Johns Hopkins School of Medicine, Department of Radiology, USA.
| | - C Munro Cullum
- University of Texas Southwestern Medical Center, Department of Neurology, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, USA; University of Texas Southwestern Medical Center, Department of Neurological Surgery, USA.
| | - John Hart
- University of Texas Southwestern Medical Center, Department of Neurology, USA; The University of Texas at Dallas, School of Behavioral and Brain Sciences, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, USA.
| |
Collapse
|
3
|
Lebely C, Lepron E, Villepinte C, Scannella S, De Boissezon X. Assessment of executive function impairments in adults with acquired brain injury across single-case experimental design: A scoping review of primary outcomes. Neuropsychol Rehabil 2024:1-35. [PMID: 38739463 DOI: 10.1080/09602011.2024.2345410] [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: 10/07/2022] [Accepted: 04/12/2024] [Indexed: 05/16/2024]
Abstract
The use of single-case experimental design (SCED) to evaluate cognitive remediation is growing. SCEDs require rigorous methodology and appropriate choice of primary outcomes. To review primary outcomes that assess executive function impairments in patients with acquired brain injury (ABI). A scoping review was conducted using the Arksey and O'Malley framework and the PRISMA extension for scoping review (PRISMA-ScR). Five databases were searched resulting in the inclusion of twenty-one studies. Primary outcomes were extracted and classified according to the type of measure, ecological setting and sources of possible bias. A wide variety of primary outcomes were identified; the majority of which evaluated behavioural performance during a real-life activity or in a real-life simulated setting. The most frequent bias observed across outcomes was the coaching effect. The findings of this scoping review highlight the importance of selecting appropriate outcomes for repeated measures in SCED studies. Direct observation of the target behaviour is a potential gold standard for assessing the effectiveness of a cognitive intervention.
Collapse
Affiliation(s)
- C Lebely
- Physical Medicine and Rehabilitation Department, University of Toulouse Hospital, Toulouse, France
- ToNIC, NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - E Lepron
- ISAE-SUPAERO, University of Toulouse, Toulouse, France
| | - C Villepinte
- ToNIC, NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
- Physiological Explorations Department, University of Toulouse Hospital, Toulouse, France
| | - S Scannella
- ISAE-SUPAERO, University of Toulouse, Toulouse, France
| | - X De Boissezon
- Physical Medicine and Rehabilitation Department, University of Toulouse Hospital, Toulouse, France
- ToNIC, NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| |
Collapse
|
4
|
Liu T, Yu S, Liu M, Zhao Z, Yuan J, Sha Z, Liu X, Qian Y, Nie M, Jiang R. Cognitive impairment in Chinese traumatic brain injury patients: from challenge to future perspectives. Front Neurosci 2024; 18:1361832. [PMID: 38529265 PMCID: PMC10961372 DOI: 10.3389/fnins.2024.1361832] [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: 12/27/2023] [Accepted: 02/27/2024] [Indexed: 03/27/2024] Open
Abstract
Traumatic Brain Injury (TBI) is a prevalent form of neurological damage that may induce varying degrees of cognitive dysfunction in patients, consequently impacting their quality of life and social functioning. This article provides a mini review of the epidemiology in Chinese TBI patients and etiology of cognitive impairment. It analyzes the risk factors of cognitive impairment, discusses current management strategies for cognitive dysfunction in Chinese TBI patients, and summarizes the strengths and limitations of primary testing tools for TBI-related cognitive functions. Furthermore, the article offers a prospective analysis of future challenges and opportunities. Its objective is to contribute as a reference for the prevention and management of cognitive dysfunction in Chinese TBI patients.
Collapse
Affiliation(s)
- Tao Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Shaohui Yu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mingqi Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhihao Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiangyuan Yuan
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhuang Sha
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuanhui Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yu Qian
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Meng Nie
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Rongcai Jiang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
5
|
Coyle HL, Bailey NW, Ponsford J, Hoy KE. A comprehensive characterization of cognitive performance, clinical symptoms, and cortical activity following mild traumatic brain injury (mTBI). APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-17. [PMID: 38015637 DOI: 10.1080/23279095.2023.2286493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVE The objective of this study was to investigate clinical symptoms, cognitive performance and cortical activity following mild traumatic brain injury (mTBI). METHODS We recruited 30 individuals in the sub-acute phase post mTBI and 28 healthy controls with no history of head injury and compared these groups on clinical, cognitive and cortical activity measures. Measures of cortical activity included; resting state electroencephalography (EEG), task related EEG and combined transcranial magnetic stimulation with electroencephalography (TMS-EEG). Primary analyses investigated clinical, cognitive and cortical activity differences between groups. Exploratory analyses investigated the relationships between these measures. RESULTS At 4 weeks' post injury, mTBI participants exhibited significantly greater post concussive and clinical symptoms compared to controls; as well as reduced cognitive performance on verbal learning and working memory measures. mTBI participants demonstrated alterations in cortical activity while at rest and in response to stimulation with TMS. CONCLUSIONS The present study comprehensively characterized the multidimensional effect of mTBI in the sub-acute phase post injury, showing a broad range of differences compared to non-mTBI participants. Further research is needed to explore the relationship between these pathophysiologies and clinical/cognitive symptoms in mTBI.
Collapse
Affiliation(s)
- Hannah L Coyle
- Central Clinical School Department of Psychiatry, Monash University, Melbourne, Australia
| | - Neil W Bailey
- Central Clinical School Department of Psychiatry, Monash University, Melbourne, Australia
- Monarch Research Institute Monarch Mental Health Group, Sydney, Australia
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Jennie Ponsford
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Kate E Hoy
- Central Clinical School Department of Psychiatry, Monash University, Melbourne, Australia
- Bionics Institute of Australia, East Melbourne, Australia
| |
Collapse
|
6
|
Mertens N, Cavanagh J, Brandt E, Fratzke V, Story-Remer J, Rieger R, Wilson JK, Gill D, Campbell R, Quinn DK. Effects of anodal tDCS on electroencephalography correlates of cognitive control in mild-to-moderate traumatic brain injury. NeuroRehabilitation 2023; 53:209-220. [PMID: 37638454 DOI: 10.3233/nre-230014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) may provide a potential therapy for cognitive deficits caused by traumatic brain injury (TBI), yet its efficacy and mechanisms of action are still uncertain. OBJECTIVE We hypothesized that anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) would boost the influence of a cognitive training regimen in a mild-to-moderate TBI (mmTBI) sample. Cognitive enhancement was measured by examining event-related potentials (ERPs) during cognitive control tasks from pre- to post-treatment. METHODS Thirty-four participants with mmTBI underwent ten sessions of cognitive training with active (n = 17) or sham (n = 17) anodal tDCS to the left DLPFC. ERPs were assessed during performance of an auditory oddball (3AOB), N-back, and dot pattern expectancy (DPX) task before and after treatment. RESULTS P3b amplitudes significantly decreased from baseline to post-treatment testing, regardless of tDCS condition, in the N-back task. The active tDCS group demonstrated a significantly increased P3a amplitude in the DPX task. No statistically significant stimulation effects were seen during the 3AOB and N-back tasks. CONCLUSION Active anodal tDCS paired with cognitive training led to increases in P3a amplitudes in the DPX, inferring increased cognitive control. P3b decreased in the N-back task demonstrating the effects of cognitive training. These dissociated P3 findings suggest separate mechanisms invoked by different neuroplasticity-inducing paradigms (stimulation versus training) in brain networks that support executive functioning.
Collapse
Affiliation(s)
- Nickolas Mertens
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, USA
| | - James Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Emma Brandt
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, USA
| | - Violet Fratzke
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, USA
| | | | - Rebecca Rieger
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, USA
| | - J Kevin Wilson
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, USA
| | - Darbi Gill
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, USA
| | - Richard Campbell
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Davin K Quinn
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| |
Collapse
|
7
|
Fernandes C, Pasion R, Gonçalves AR, Almeida R, Garcez H, Ferreira-Santos F, Barbosa F, Marques-Teixeira J. Awareness to utilitarian responses in later life: an ERP study with moral dilemmas. Neurosci Lett 2022; 787:136824. [PMID: 35917838 DOI: 10.1016/j.neulet.2022.136824] [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: 01/12/2022] [Revised: 06/28/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022]
Abstract
The current study aims to provide the first insights into the neural correlates of utilitarian and deontological responses to moral dilemmas across the lifespan.To this purpose, younger (n=30), middle-aged (n=29), and older adults (n=29) completed moral dilemmas during an EEG recording.Behaviorally, groups did not differ in the number of utilitarian responses and reaction times. However, at the neural level, older adults had higher Error Positivity (Pe) amplitudes than younger adults after utilitarian responses.As this effect was specific to utilitarian responses, it suggests that utilitarian decisions may induce increased conflict in the older group. These findings highlight that older adults may be more aware of the harmful outcomes of utilitarian decisions during moral decision-making.
Collapse
Affiliation(s)
- Carina Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab.
| | - Rita Pasion
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab; Lusófona University Lisbon, Portugal; Lusófona University of Porto, Porto, Portugal
| | - Ana R Gonçalves
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab
| | - Rita Almeida
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab
| | - Helena Garcez
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab
| | - Fernando Ferreira-Santos
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab
| | - João Marques-Teixeira
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto. Digital Human-Environment Interaction Lab
| |
Collapse
|
8
|
Quantitative multimodal imaging in traumatic brain injuries producing impaired cognition. Curr Opin Neurol 2021; 33:691-698. [PMID: 33027143 DOI: 10.1097/wco.0000000000000872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Cognitive impairments are a devastating long-term consequence following traumatic brain injury (TBI). This review provides an update on the quantitative mutimodal neuroimaging studies that attempt to elucidate the mechanism(s) underlying cognitive impairments and their recovery following TBI. RECENT FINDINGS Recent studies have linked individual specific behavioural impairments and their changes over time to physiological activity and structural changes using EEG, PET and MRI. Multimodal studies that combine measures of physiological activity with knowledge of neuroanatomical and connectivity damage have also illuminated the multifactorial function-structure relationships that underlie impairment and recovery following TBI. SUMMARY The combined use of multiple neuroimaging modalities, with focus on individual longitudinal studies, has the potential to accurately classify impairments, enhance sensitivity of prognoses, inform targets for interventions and precisely track spontaneous and intervention-driven recovery.
Collapse
|
9
|
Olsen A, Babikian T, Bigler ED, Caeyenberghs K, Conde V, Dams-O'Connor K, Dobryakova E, Genova H, Grafman J, Håberg AK, Heggland I, Hellstrøm T, Hodges CB, Irimia A, Jha RM, Johnson PK, Koliatsos VE, Levin H, Li LM, Lindsey HM, Livny A, Løvstad M, Medaglia J, Menon DK, Mondello S, Monti MM, Newcombe VFJ, Petroni A, Ponsford J, Sharp D, Spitz G, Westlye LT, Thompson PM, Dennis EL, Tate DF, Wilde EA, Hillary FG. Toward a global and reproducible science for brain imaging in neurotrauma: the ENIGMA adult moderate/severe traumatic brain injury working group. Brain Imaging Behav 2021; 15:526-554. [PMID: 32797398 PMCID: PMC8032647 DOI: 10.1007/s11682-020-00313-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The global burden of mortality and morbidity caused by traumatic brain injury (TBI) is significant, and the heterogeneity of TBI patients and the relatively small sample sizes of most current neuroimaging studies is a major challenge for scientific advances and clinical translation. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Adult moderate/severe TBI (AMS-TBI) working group aims to be a driving force for new discoveries in AMS-TBI by providing researchers world-wide with an effective framework and platform for large-scale cross-border collaboration and data sharing. Based on the principles of transparency, rigor, reproducibility and collaboration, we will facilitate the development and dissemination of multiscale and big data analysis pipelines for harmonized analyses in AMS-TBI using structural and functional neuroimaging in combination with non-imaging biomarkers, genetics, as well as clinical and behavioral measures. Ultimately, we will offer investigators an unprecedented opportunity to test important hypotheses about recovery and morbidity in AMS-TBI by taking advantage of our robust methods for large-scale neuroimaging data analysis. In this consensus statement we outline the working group's short-term, intermediate, and long-term goals.
Collapse
Affiliation(s)
- Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, 7491, Trondheim, Norway.
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
| | - Erin D Bigler
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, Australia
| | - Virginia Conde
- Department of Psychology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ekaterina Dobryakova
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ, USA
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Helen Genova
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ, USA
| | - Jordan Grafman
- Cognitive Neuroscience Laboratory, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Neurology, Department of Psychiatry & Department of Psychology, Cognitive Neurology and Alzheimer's, Center, Feinberg School of Medicine, Weinberg, Chicago, IL, USA
| | - Asta K Håberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs Hopsital, Trondheim University Hospital, Trondheim, Norway
| | - Ingrid Heggland
- Section for Collections and Digital Services, NTNU University Library, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torgeir Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Cooper B Hodges
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Andrei Irimia
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Ruchira M Jha
- Departments of Critical Care Medicine, Neurology, Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
- Safar Center for Resuscitation Research, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, Pittsburgh, PA, USA
| | - Paula K Johnson
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Vassilis E Koliatsos
- Departments of Pathology(Neuropathology), Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Neuropsychiatry Program, Sheppard and Enoch Pratt Hospital, Baltimore, MD, USA
| | - Harvey Levin
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Lucia M Li
- C3NL, Imperial College London, London, UK
- UK DRI Centre for Health Care and Technology, Imperial College London, London, UK
| | - Hannah M Lindsey
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychology, Brigham Young University, Provo, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Abigail Livny
- Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
- Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Marianne Løvstad
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - John Medaglia
- Department of Psychology, Drexel University, Philadelphia, PA, USA
- Department of Neurology, Drexel University, Philadelphia, PA, USA
| | - David K Menon
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Martin M Monti
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurosurgery, Brain Injury Research Center (BIRC), UCLA, Los Angeles, CA, USA
| | | | - Agustin Petroni
- Department of Psychology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
- Department of Computer Science, Faculty of Exact & Natural Sciences, University of Buenos Aires, Buenos Aires, Argentina
- National Scientific & Technical Research Council, Institute of Research in Computer Science, Buenos Aires, Argentina
| | - Jennie Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - David Sharp
- Department of Brain Sciences, Imperial College London, London, UK
- Care Research & Technology Centre, UK Dementia Research Institute, London, UK
| | - Gershon Spitz
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, USC, Los Angeles, CA, USA
| | - Emily L Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Frank G Hillary
- Department of Neurology, Hershey Medical Center, State College, PA, USA.
| |
Collapse
|
10
|
DeLaRosa BL, Spence JS, Motes MA, To W, Vanneste S, Kraut MA, Hart J. Identification of selection and inhibition components in a Go/NoGo task from EEG spectra using a machine learning classifier. Brain Behav 2020; 10:e01902. [PMID: 33078586 PMCID: PMC7749513 DOI: 10.1002/brb3.1902] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 09/09/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Prior Go/NoGo studies have localized specific regions and EEG spectra for which traditional approaches have distinguished between Go and NoGo conditions. A more detailed characterization of the spatial distribution and timing of the synchronization of frequency bands would contribute substantially to the clarification of neural mechanisms that underlie performance of the Go/NoGo task. METHODS The present study used a machine learning approach to learn the features that distinguish between ERSPs involved in selection and inhibition in a Go/NoGo task. A single-layer neural network classifier was used to predict task conditions for each subject to characterize ERSPs associated with Go versus NoGo trials. RESULTS The final classifier accurately identified individual task conditions at an overall rate of 92%, estimated by fivefold cross-validation. The detailed accounting of EEG time-frequency patterns localized to brain regions (i.e., thalamus, pre-SMA, orbitofrontal cortex, and superior parietal cortex) corroborates and also elaborates upon previous findings from fMRI and EEG studies, and expands the information about EEG power changes in multiple frequency bands (i.e., primarily theta power increase, alpha decreases, and beta increases and decreases) within these regions underlying the selection and inhibition processes engaged in the Go and NoGo trials. CONCLUSION This time-frequency-based classifier extends previous spatiotemporal findings and provides information about neural mechanisms underlying selection and inhibition processes engaged in Go and NoGo trials, respectively. This neural network classifier can be used to assess time-frequency patterns from an individual subject and thus may offer insight into therapeutic uses of neuromodulation in neural dysfunction.
Collapse
Affiliation(s)
- Bambi L DeLaRosa
- School of Brain and Behavioral Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | - Jeffrey S Spence
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
| | - Michael A Motes
- Callier Center - Dallas, The University of Texas at Dallas, TX, USA
| | - Wing To
- Callier Center - Dallas, The University of Texas at Dallas, TX, USA
| | - Sven Vanneste
- Callier Center - Dallas, The University of Texas at Dallas, TX, USA
| | - Michael A Kraut
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John Hart
- Callier Center - Dallas, The University of Texas at Dallas, TX, USA
| |
Collapse
|
11
|
Cavanagh JF, Rieger RE, Wilson JK, Gill D, Fullerton L, Brandt E, Mayer AR. Joint analysis of frontal theta synchrony and white matter following mild traumatic brain injury. Brain Imaging Behav 2020; 14:2210-2223. [PMID: 31368085 PMCID: PMC6992511 DOI: 10.1007/s11682-019-00171-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Some of the most disabling aspects of mild traumatic brain injury (mTBI) include lingering deficits in executive functioning. It is known that mTBI can damage white matter tracts, but it remains unknown how this structural brain damage translates into cognitive deficits. This experiment utilized theta band phase synchrony to identify the dysfunctional neural operations that contribute to cognitive problems following mTBI. Sub-acute stage (< 2 weeks) mTBI patients (N = 52) and healthy matched controls (N = 32) completed a control-demanding task with concurrent EEG. Structural MRI was also collected. While there were no performance-specific behavioral differences between groups in the dot probe expectancy task, the degree of theta band phase synchrony immediately following injury predicted the degree of symptom recovery two months later. Although there were no differences in fractional anisotropy (FA) between groups, joint independent components analysis revealed that a smaller network of lower FA-valued voxels contributed to a diminished frontal theta phase synchrony network in the mTBI group. This finding suggests that frontal theta band markers of cognitive control are sensitive to sub-threshold structural aberrations following mTBI.
Collapse
Affiliation(s)
- James F Cavanagh
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA.
| | - Rebecca E Rieger
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - J Kevin Wilson
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - Darbi Gill
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - Lynne Fullerton
- Department of Emergency Medicine, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 116025, Albuquerque, NM, 87131, USA
| | - Emma Brandt
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - Andrew R Mayer
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA
- Mind Research Network, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA
- Departments of Neurology and Psychiatry, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| |
Collapse
|
12
|
Holiday KA, Clark AL, Merritt VC, Nakhla MZ, Sorg S, Delano-Wood L, Schiehser DM. Response inhibition in Veterans with a history of mild traumatic brain injury: The role of self-reported complaints in objective performance. J Clin Exp Neuropsychol 2020; 42:556-568. [PMID: 32657255 DOI: 10.1080/13803395.2020.1776847] [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: 10/23/2022]
Abstract
INTRODUCTION Although objective deficits in response inhibition (RI) have been detected in civilians with mild traumatic brain injury (mTBI), it remains unclear whether objective RI is worse in military Veterans with mTBI despite the prevalence of self-reported disinhibition. Assessing RI in Veterans is critical due to their unique characteristics, including combat and blast exposure, in addition to the prevalence of psychiatric comorbidity. Therefore, the aims of this study were to (1) examine RI performance in Veterans with mTBI compared to non-mTBI Veterans and (2) compare RI performance in well-defined subgroups of mTBI Veterans with and without self-reported complaints of disinhibition to non-mTBI Veterans. METHOD 53 mTBI Veterans and 37 non-mTBI Veterans completed a Go/No-Go RI task and measures of self-reported disinhibition (Frontal Systems Behavior Scale) and psychiatric symptoms. ANCOVAs covarying for mood and demographics compared RI performances of the non-mTBI Veterans to (1) the total sample of mTBI Veterans (n= 53) and to (2) mTBI Veterans with elevated (t-score ≥ 60; mTBI-SubjDis; n= 23) and low (t-score < 60; mTBI-NoSubjDis; n= 30) levels of self-reported disinhibition. RESULTS There were no significant differences in RI between the mTBI group as a whole and the non-mTBI Veterans group. However, when Veterans with mTBI were divided into groups by clinically-significant concern about their disinhibition, the mTBI-SubjDis group demonstrated significantly worse RI than the mTBI-NoSubjDis and non-mTBI Veteran groups. No significant differences in RI performance were observed between the mTBI-NoSubjDis and non-mTBI Veteran groups. CONCLUSIONS Results indicate that mTBI Veterans with elevated levels of self-reported disinhibition show diminished performance on objective measures of RI, independent of mood. Findings highlight the unique contribution of subjective complaints on executive functioning in mTBI, and they underscore the importance of assessing cognitive complaints in order to identify those most at risk for poor-long term outcomes.
Collapse
Affiliation(s)
- Kelsey A Holiday
- San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology , San Diego, CA, USA.,Psychology and Research Services, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA
| | - Alexandra L Clark
- Psychology and Research Services, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA
| | - Victoria C Merritt
- Psychology and Research Services, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA
| | - Marina Z Nakhla
- San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology , San Diego, CA, USA.,Psychology and Research Services, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA
| | - Scott Sorg
- Psychology and Research Services, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA.,Department of Psychiatry, University of California , San Diego, CA, USA
| | - Lisa Delano-Wood
- Psychology and Research Services, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA.,Department of Psychiatry, University of California , San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA
| | - Dawn M Schiehser
- Psychology and Research Services, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA.,Department of Psychiatry, University of California , San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System (VASDHS) , San Diego, CA, USA
| |
Collapse
|
13
|
Bertozzi G, Maglietta F, Sessa F, Scoto E, Cipolloni L, Di Mizio G, Salerno M, Pomara C. Traumatic Brain Injury: A Forensic Approach: A Literature Review. Curr Neuropharmacol 2020; 18:538-550. [PMID: 31686630 PMCID: PMC7457403 DOI: 10.2174/1570159x17666191101123145] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 08/27/2019] [Accepted: 10/31/2019] [Indexed: 12/11/2022] Open
Abstract
Traumatic brain injury (TBI) is the principal cause of invalidity and death in the population under 45 years of age worldwide. This mini-review aims to systematize the forensic approach in neuropathological studies, highlighting the proper elements to be noted during external, radiological, autoptical, and histological examinations with particular attention paid to immunohistochemistry and molecular biology. In the light of the results of this mini-review, an accurate forensic approach can be considered mandatory in the examination of suspected TBI with medico-legal importance, in order to gather all the possible evidence to corroborate the diagnosis of a lesion that may have caused, or contributed to, death. From this point of view, only the use of an evidence-based protocol can reach a suitable diagnosis, especially in those cases in which there are other neuropathological conditions (ischemia, neurodegeneration, neuro-inflammation, dementia) that may have played a role in death. This is even more relevant when corpses, in an advanced state of decomposition, are studied, where the radiological, macroscopic and histological analyses fail to give meaningful answers. In these cases, immune-histochemical and molecular biology diagnostics are of fundamental importance and a forensic neuropathologist has to know them. Particularly, MiRNAs are promising biomarkers for TBI both for brain damage identification and for medico-legal aspects, even if further investigations are required to validate the first experimental studies. In the same way, the genetic substrate should be examined during any forensic examination, considering its importance in the outcome of TBI.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Cristoforo Pomara
- Address correspondence to this author at the Department of Medical and Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy; Via S. Sofia 78, 95123 Catania, Italy; Tel: (39) 095.3782153; E-mail:
| |
Collapse
|
14
|
Hershaw JN, Hill-Pearson CA, Arango JI, Souvignier AR, Pazdan RM. Semi-Automated Neurofeedback Therapy for Persistent Postconcussive Symptoms in a Military Clinical Setting: A Feasibility Study. Mil Med 2019; 185:e457-e465. [DOI: 10.1093/milmed/usz335] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Abstract
Introduction
Neurofeedback therapy (NFT) has demonstrated effectiveness for reducing persistent symptoms following traumatic brain injury (TBI); however, its reliance on NFT experts for administration and high number of treatment sessions limits its use in military medicine. Here, we assess the feasibility of live Z-score training (LZT)—a variant of NFT that requires fewer treatment sessions and can be administered by nonexperts—for use in a military clinical setting.
Materials and Methods
A single group design feasibility study was conducted to assess acceptability, tolerance, treatment satisfaction, and change in symptoms after a 6-week LZT intervention in 38 Service Members (SMs) with persistent symptoms comorbid with or secondary to mild TBI. Acceptance and feasibility were assessed using treatment completion and patients’ satisfaction with treatment. To evaluate changes in symptom status, a battery of self-report questionnaires was administered at baseline, posttreatment, and 3-month follow-up to evaluate changes in psychological, neurobehavioral, sleep, pain, and headache symptoms, as well as self-efficacy in symptom management and life satisfaction.
Results
Participants tolerated the treatment well and reported a positive experience. Symptom improvement was observed, including depressive, neurobehavioral, and pain-related symptoms, with effects sustained at 3-month follow-up.
Conclusion
LZT treatment appears to be a feasible, non-pharmacological therapy amenable to SMs. Results from this pilot study promote further investigation of LZT as an intervention for SMs with persistent symptoms following TBI.
Collapse
Affiliation(s)
- Jamie N Hershaw
- Defense and Veterans Brain Injury Center, Building 7489, Sutherland Circle, Fort Carson, Colorado 80913
| | - Candace A Hill-Pearson
- Defense and Veterans Brain Injury Center, Building 7489, Sutherland Circle, Fort Carson, Colorado 80913
| | - Jorge I Arango
- Defense and Veterans Brain Injury Center, Building 7489, Sutherland Circle, Fort Carson, Colorado 80913
| | - Alicia R Souvignier
- Defense and Veterans Brain Injury Center, Building 7489, Sutherland Circle, Fort Carson, Colorado 80913
- Warrior Recovery Center, Evans Army Community Hospital, Fort Carson, Colorado 80913
| | - Renee M Pazdan
- Defense and Veterans Brain Injury Center, Building 7489, Sutherland Circle, Fort Carson, Colorado 80913
- Warrior Recovery Center, Evans Army Community Hospital, Fort Carson, Colorado 80913
| |
Collapse
|
15
|
Neal J, Strothkamp S, Bedingar E, Cordero P, Wagner B, Vagnini V, Jiang Y. Discriminating Fake From True Brain Injury Using Latency of Left Frontal Neural Responses During Old/New Memory Recognition. Front Neurosci 2019; 13:988. [PMID: 31611760 PMCID: PMC6777439 DOI: 10.3389/fnins.2019.00988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/02/2019] [Indexed: 11/13/2022] Open
Abstract
Traumatic brain injury (TBI) is a major public health concern that affects 69 million individuals each year worldwide. Neuropsychologists report that up to 40% of individuals undergoing evaluations for TBI may be malingering neurocognitive deficits for a compensatory reward. The memory recognition test of malingering detection is effective but can be coached behaviorally. There is great need to develop a novel neural based method for discriminating fake from true brain injury. Here we test the hypothesis that decision making of faking memory deficits prolongs frontal neural responses. We applied an advanced method measuring decision latency in milliseconds for discriminating true TBI from malingerers who fake brain injury. To test this hypothesis, latencies of memory-related brain potentials were compared among true patients with moderate or severe TBI, and healthy age-matched individuals who were assigned either to be honest or faking memory deficit. Scalp signals of electroencephalography (EEG) were recorded with a 32-channel cap during an Old/New memory recognition task in three age- and education-matched groups: honest (n = 12), malingering (n = 15), and brain injured (n = 14) individuals. Bilateral fractional latencies of late positive ERP at frontal sites were compared among the three groups under both studied (Old) and non-studied (New) memory recognition conditions. Results show a significant difference between the fractional latencies of the late positive component during recognition of studied items in malingerers (averaged latencies = 396 ms) and the true brain injured subjects (mean = 312 ms) in the frontal sites. Only malingers showed asymmetrical frontal activity compared to the two other groups. These new findings support the hypothesis that that additional frontal processing of malingering individuals is measurably different from those of actual patients with brain injury. In contrast to our previous reported method using difference waves of amplitudes at frontal to posterior midline sites during new items recognition (Vagnini et al., 2008), there was no significant latency difference among groups during recognition of New items. The current method using delayed left frontal neural responses during studied items reached sensitivity of 80% and specificity of 79% in detecting malingers from true brain injury.
Collapse
Affiliation(s)
- Jennifer Neal
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Stephanie Strothkamp
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Esias Bedingar
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Patrick Cordero
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Benjamin Wagner
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Victoria Vagnini
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
- Louisville VA Medical Center, Louisville, KY, United States
| | - Yang Jiang
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
| |
Collapse
|
16
|
Shen IH, Lin YJ, Chen CL, Liao CC. Neural Correlates of Response Inhibition and Error Processing in Individuals with Mild Traumatic Brain Injury: An Event-Related Potential Study. J Neurotrauma 2019; 37:115-124. [PMID: 31317830 DOI: 10.1089/neu.2018.6122] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Individuals with a mild traumatic brain injury (mTBI) often have executive control deficits; however, the underlying neural mechanisms of such deficits are yet to be clarified. Inhibitory control and cognitive monitoring are two fundamental aspects of executive control processes. This study investigated the executive control of mTBI by using the Stop-signal task. Eighteen adults with mTBI and 18 age-, sex-, and education level-matched controls were recruited. Behavioral performance and event-related potential correlates of response inhibition and error processing were compared between groups. The mTBI group tended to have a lower probability of inhibition and a longer stop signal reaction time. N1 amplitude was greater on successful trials. Also on successful trials, N2 and P3 peaked earlier than on failed trials. The N2 amplitude of the mTBI group tended to be smaller than that of the controls. The control group had larger P3 amplitude on successful trials than on failed trials, whereas the mTBI group exhibited no P3 amplitudes difference between the two trial types. In addition, the mTBI group showed significantly longer error positivity latency than did the controls. These results suggest that inhibitory control and error processing were inefficient in the mTB group even more than three months after injury. Electrophysiological markers of cognitive dysfunction can be used as a sensitive tool for determining executive control after mTBI.
Collapse
Affiliation(s)
- I-Hsuan Shen
- Department of Occupational Therapy, Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan
| | - Ying-Ju Lin
- Department of Occupational Therapy, Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Northern Service Center, Sunshine Social Welfare Foundation, Taipei, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan.,Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Chih Liao
- Department of Neurosurgery, Division of Neurospine, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan.,Department of Neurospinal Surgery, Mennonite Christian Hospital, Hualien, Taiwan
| |
Collapse
|
17
|
Drapeau J, Gosselin N, Peretz I, McKerral M. Electrophysiological Responses to Emotional Facial Expressions Following a Mild Traumatic Brain Injury. Brain Sci 2019; 9:E142. [PMID: 31216634 PMCID: PMC6627801 DOI: 10.3390/brainsci9060142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to measure neural information processing underlying emotional recognition from facial expressions in adults having sustained a mild traumatic brain injury (mTBI) as compared to healthy individuals. We thus measured early (N1, N170) and later (N2) event-related potential (ERP) components during presentation of fearful, neutral, and happy facial expressions in 10 adults with mTBI and 11 control participants. Findings indicated significant differences between groups, irrespective of emotional expression, in the early attentional stage (N1), which was altered in mTBI. The two groups showed similar perceptual integration of facial features (N170), with greater amplitude for fearful facial expressions in the right hemisphere. At a higher-level emotional discrimination stage (N2), both groups demonstrated preferential processing for fear as compared to happiness and neutrality. These findings suggest a reduced early selective attentional processing following mTBI, but no impact on the perceptual and higher-level cognitive processes stages. This study contributes to further improving our comprehension of attentional versus emotional recognition following a mild TBI.
Collapse
Affiliation(s)
- Joanie Drapeau
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Nathalie Gosselin
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Isabelle Peretz
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Michelle McKerral
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
| |
Collapse
|
18
|
Galicia-Alvarado M, Alducin-Castillo J, Ramírez-Flores MJ, Sánchez Quezada AL, Yáñez-Suárez O, Flores-Ávalos B. Cognitive and spectral coherence of EEG alterations in resting state in children with chronic TBI. SALUD MENTAL 2019. [DOI: 10.17711/sm.0185-3325.2019.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction. TBI is associated with alterations in cortico-subcortical connectivity. However, little attention has been paid to its clinical characteristics and functional connectivity in pediatric patients with chronic TBI. Objective. To evaluate the cognitive performance and spectral coherence of a group of children with TBI in non-acute phase. Method. Cross-sectional study of 15 children with chronic TBI and 17 healthy children. The Neuropsychological Assessment of Children (Evaluación Neuropsicológica Infantil, ENI) was used and the resting activity of the EEG with eyes-closed was recorded. Offline, two-second epochs of the EEG of each participant were chosen and the spectral coherence was estimated in a range of 1.6 to 30 Hz. The cognitive performance between groups was compared with T-test/Mann-Whitney U Test and MANOVA for the coherence values. Results. The TBI group showed a lower performance (p ≤ 0.05) in metalinguistic, visuospatial skills, attention, memory, non-verbal flexibility, planning, and organization. Differences (p ≤ 0.000) were found both inter and intrahemispherically in the spectral coherence between the groups, particularly on F1-F3 (95% CI: 0.543 - 0.557) over the whole frequency range and F3-C3 (95% CI: 0.503 - 0.515) in delta, theta, alpha2, and beta frequencies. Discussion and conclusión. Our findings suggest alterations of hypo and hyper functional connectivity, particularly on the frontal and parietal lobes of both hemispheres, even after several years of a TBI. It is possible that a subtle difference in the degree of connectivity is crucial in the genesis or successful development of attentional, mnesic, executive, and visuospatial processes.
Collapse
Affiliation(s)
- Marlene Galicia-Alvarado
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico
| | | | | | | | | | | |
Collapse
|
19
|
Interactive effects of Traumatic Brain Injury and Anxiety Sensitivity Cognitive Concerns on Post-traumatic Stress among Active Duty Soldiers. COGNITIVE THERAPY AND RESEARCH 2018; 41:902-910. [PMID: 30220753 DOI: 10.1007/s10608-017-9863-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
20
|
Albanese BJ, Macatee RJ, Boffa JW, Bryan CJ, Zvolensky MJ, Schmidt NB. Interactive effects of traumatic brain injury and anxiety sensitivity on PTSD symptoms: A replication and extension in two clinical samples. COGNITIVE THERAPY AND RESEARCH 2018; 42:510-523. [PMID: 29881128 PMCID: PMC5986097 DOI: 10.1007/s10608-017-9883-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Brian J Albanese
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
| | - Richard J Macatee
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
| | - Joseph W Boffa
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
| | - Craig J Bryan
- National Center for Veterans Studies, Salt Lake City, UT, USA
- Department of Psychology, University of Utah, UT, USA
| | | | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
| |
Collapse
|
21
|
Albanese BJ, Macatee RJ, Stentz LA, Schmidt NB, Bryan CJ. Interactive effects of cumulative lifetime traumatic brain injuries and combat exposure on posttraumatic stress among deployed military personnel. Cogn Behav Ther 2018; 48:77-88. [PMID: 29932812 DOI: 10.1080/16506073.2018.1478446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Growing research links Traumatic Brain Injury (TBI) with greater posttraumatic stress disorder (PTSD) symptoms. Much of this research has focused on the influence of the presence or severity of a single TBI while neglecting the potential cumulative effects of multiple TBIs incurred across an individual's lifetime on combat-related PTSD. The present study addressed this gap using a sample of 157 military service members and 4 civilian contractors who underwent structured TBI interviews at a military hospital in Iraq and completed the Combat Experiences Scale (CES) and Posttraumatic Checklist - Military (PCL-M). Results indicated that a greater number of lifetime TBIs were associated with greater PTSD symptoms when accounting for the presence and severity of a recent, deployment-related TBI. Additionally, a significant interaction of number of lifetime TBIs and combat exposure emerged, indicating that exposure to combat yielded greater PTSD symptoms among those with multiple lifetime TBIs compared to those with one or zero lifetime TBIs. These data suggest that incurring multiple TBIs may amplify the link between combat exposure and PTSD and underscore the need to screen for lifetime TBI history.
Collapse
Affiliation(s)
- Brian J Albanese
- a Department of Psychology , Florida State University , Tallahasssee , FL , USA
| | - Richard J Macatee
- a Department of Psychology , Florida State University , Tallahasssee , FL , USA
| | - Lauren A Stentz
- a Department of Psychology , Florida State University , Tallahasssee , FL , USA
| | - Norman B Schmidt
- a Department of Psychology , Florida State University , Tallahasssee , FL , USA
| | - Craig J Bryan
- b National Center for Veterans Studies , Salt Lake City , UT , USA.,c Department of Psychology , University of Utah , Salt Lake City , UT , USA
| |
Collapse
|
22
|
Sun H, Luo C, Chen X, Tao L. Assessment of cognitive dysfunction in traumatic brain injury patients: a review. Forensic Sci Res 2017; 2:174-179. [PMID: 30483638 PMCID: PMC6197081 DOI: 10.1080/20961790.2017.1390836] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the major causes of human mortality and morbidity in the world. Brain injury could affect the core of a person's being - their thinking, memory, personality and behaviour. Electrophysiological markers from the human electroencephalogram and brain imaging provide a rich source of data which helps to elucidate specific processing impairments in TBI patients. To assess the cognitive and social function in traumatic brain injury patients, this review will focus on some of methods for assessing the disabling cognitive and social function deficits induced by TBI. There are many new technologies available to address TBI and recognition related questions. Integration of the various techniques will help to facilitate our comprehending of TBI, cognitive function and social function, and improve treatment and rehabilitation.
Collapse
Affiliation(s)
- Huiyan Sun
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China.,Affiliated Hospital, Chifeng University, Inner Mongolia, China
| | - Chengliang Luo
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
| | - Xiping Chen
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
| | - Luyang Tao
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
| |
Collapse
|
23
|
Kontos AP, Reches A, Elbin RJ, Dickman D, Laufer I, Geva AB, Shacham G, DeWolf R, Collins MW. Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion. Brain Imaging Behav 2017; 10:594-603. [PMID: 26091725 DOI: 10.1007/s11682-015-9412-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Post-traumatic migraine (PTM) (i.e., headache, nausea, light and/or noise sensitivity) is an emerging risk factor for prolonged recovery following concussion. Concussions and migraine share similar pathophysiology characterized by specific ionic imbalances in the brain. Given these similarities, patients with PTM following concussion may exhibit distinct electrophysiological patterns, although researchers have yet to examine the electrophysiological brain activation in patients with PTM following concussion. A novel approach that may help differentiate brain activation in patients with and without PTM is brain network activation (BNA) analysis. BNA involves an algorithmic analysis applied to multichannel EEG-ERP data that provides a network map of cortical activity and quantitative data during specific tasks. A prospective, repeated measures design was used to evaluate BNA (during Go/NoGo task), EEG-ERP, cognitive performance, and concussion related symptoms at 1, 2, 3, and 4 weeks post-injury intervals among athletes with a medically diagnosed concussion with PTM (n = 15) and without (NO-PTM) (n = 22); and age, sex, and concussion history matched controls without concussion (CONTROL) (n = 20). Participants with PTM had significantly reduced BNA compared to NO-PTM and CONTROLS for Go and NoGo components at 3 weeks and for NoGo component at 4 weeks post-injury. The PTM group also demonstrated a more prominent deviation of network activity compared to the other two groups over a longer period of time. The composite BNA algorithm may be a more sensitive measure of electrophysiological change in the brain that can augment established cognitive assessment tools for detecting impairment in individuals with PTM.
Collapse
Affiliation(s)
- Anthony P Kontos
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA.
| | | | - R J Elbin
- Department of Health, Human Performance and Recreation/Office for Sport Concussion Research, University of Arkansas, Fayetteville, AR, 72701, USA
| | | | | | | | | | - Ryan DeWolf
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA
| | - Michael W Collins
- Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program, University of Pittsburgh, 3200 South Water St, Pittsburgh, PA, 15203, USA
| |
Collapse
|
24
|
Candrian G, Müller A, Dall'Acqua P, Kompatsiari K, Baschera GM, Mica L, Simmen HP, Glaab R, Fandino J, Schwendinger M, Meier C, Ulbrich EJ, Johannes S. Longitudinal study of a NoGo-P3 event-related potential component following mild traumatic brain injury in adults. Ann Phys Rehabil Med 2017; 61:18-26. [PMID: 28882543 DOI: 10.1016/j.rehab.2017.07.246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Event-related potentials have repeatedly revealed electrophysiological markers of cognitive dysfunction associated with Mild Traumatic Brain Injury (MTBI) and may represent a sensitive tool to guide cognitive rehabilitative interventions. We previously found patients with symptomatic MTBI characterized by smaller P300 (or P3) wave amplitudes in a NoGo-P3 subcomponent in the acute phase of the injury. The goal of this longitudinal study was to investigate whether this early NoGo-P3 subcomponent differs over time in symptomatic MTBI patients and healthy controls. METHODS We included adults with a diagnosis of MTBI and individually matched healthy controls tested at 1 week, 3 months, and 1 year after the MTBI. Symptoms were assessed by the Rivermead Post-Concussion Symptoms Questionnaire. NoGo-P3 was collected by using a cued Go/NoGo task and the relevant subcomponent was extracted by independent component analysis. RESULTS Among 53 adults with a diagnosis of MTBI and 53 controls, we included 35 with symptomatic MTBI and 35 matched healthy controls (18 females each group; mean age 34.06±13.15 and 34.26±12.98 years). Amplitudes for the early NoGo-P3 subcomponent were lower for symptomatic MTBI patients than controls (P<0.05) at 1 week post-injury. Furthermore, mixed ANOVA revealed a significant time by group interaction (P<0.05), so the effect of time differed for symptomatic MTBI patients and healthy controls. The amplitudes for MTBI patients normalized from 1 week to 3 months post-injury and were comparable to those of controls from 3 months to 1 year post-injury. However, amplitudes for 3 MTBI patients with particularly severe complaints 1 year post-injury did not normalize and were lower than those for the remaining MTBI sample (P<0.05). CONCLUSIONS Selected event-related potentials can be used as a sensitive and objective tool to illustrate the cognitive consequences of and recovery after MTBI.
Collapse
Affiliation(s)
- Gian Candrian
- Brain and Trauma Foundation Grisons, Poststrasse 22, CH-7000 Chur, Switzerland.
| | - Andreas Müller
- Brain and Trauma Foundation Grisons, Poststrasse 22, CH-7000 Chur, Switzerland
| | - Patrizia Dall'Acqua
- Bellikon Rehabilitation Clinic, CH-5454 Bellikon, Switzerland; Division Neuropsychology, Department of Psychology, University of Zurich, CH-8050 Zurich, Switzerland
| | - Kyveli Kompatsiari
- Brain and Trauma Foundation Grisons, Poststrasse 22, CH-7000 Chur, Switzerland
| | - Gian-Marco Baschera
- Brain and Trauma Foundation Grisons, Poststrasse 22, CH-7000 Chur, Switzerland
| | - Ladislav Mica
- Division of Trauma Surgery, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Hans-Peter Simmen
- Division of Trauma Surgery, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Richard Glaab
- Department of Traumatology, Cantonal Hospital Aarau, CH-5001 Aarau, Switzerland
| | - Javier Fandino
- Department of Neurosurgery, Cantonal Hospital Aarau, CH-5001 Aarau, Switzerland
| | - Markus Schwendinger
- Interdisciplinary Emergency Centre, Baden Cantonal Hospital, CH-5404 Baden, Switzerland
| | - Christoph Meier
- Department of Surgery, Waid City Hospital, CH-8037 Zurich, Switzerland
| | - Erika Jasmin Ulbrich
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Sönke Johannes
- Bellikon Rehabilitation Clinic, CH-5454 Bellikon, Switzerland
| |
Collapse
|
25
|
Galetto V, Sacco K. Neuroplastic Changes Induced by Cognitive Rehabilitation in Traumatic Brain Injury: A Review. Neurorehabil Neural Repair 2017; 31:800-813. [DOI: 10.1177/1545968317723748] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background. Cognitive deficits are among the most disabling consequences of traumatic brain injury (TBI), leading to long-term outcomes and interfering with the individual’s recovery. One of the most effective ways to reduce the impact of cognitive disturbance in everyday life is cognitive rehabilitation, which is based on the principles of brain neuroplasticity and restoration. Although there are many studies in the literature focusing on the effectiveness of cognitive interventions in reducing cognitive deficits following TBI, only a few of them focus on neural modifications induced by cognitive treatment. The use of neuroimaging or neurophysiological measures to evaluate brain changes induced by cognitive rehabilitation may have relevant clinical implications, since they could add individualized elements to cognitive assessment. Nevertheless, there are no review studies in the literature investigating neuroplastic changes induced by cognitive training in TBI individuals. Objective. Due to lack of data, the goal of this article is to review what is currently known on the cerebral modifications following rehabilitation programs in chronic TBI. Methods. Studies investigating both the functional and structural neural modifications induced by cognitive training in TBI subjects were identified from the results of database searches. Forty-five published articles were initially selected. Of these, 34 were excluded because they did not meet the inclusion criteria. Results. Eleven studies were found that focused solely on the functional and neurophysiological changes induced by cognitive rehabilitation. Conclusions. Outcomes showed that cerebral activation may be significantly modified by cognitive rehabilitation, in spite of the severity of the injury.
Collapse
Affiliation(s)
- Valentina Galetto
- Imaging and Cerebral Plasticity Research Group, Department of Psychology, University of Turin, Turin, Italy
- Centro Puzzle, Turin, Italy
| | - Katiuscia Sacco
- Imaging and Cerebral Plasticity Research Group, Department of Psychology, University of Turin, Turin, Italy
- Neuroscience Institute of Turin, University of Turin, Turin, Italy
| |
Collapse
|
26
|
Executive attention deficits after traumatic brain injury reflect impaired recruitment of resources. NEUROIMAGE-CLINICAL 2017; 14:233-241. [PMID: 28180082 PMCID: PMC5288490 DOI: 10.1016/j.nicl.2017.01.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 12/13/2016] [Accepted: 01/11/2017] [Indexed: 11/24/2022]
Abstract
Deficits in attention are a common and devastating consequence of traumatic brain injury (TBI), leading to functional impairments, rehabilitation barriers, and long-term disability. While such deficits are well documented, little is known about their underlying pathophysiology hindering development of effective and targeted interventions. Here we evaluate the integrity of brain systems specific to attentional functions using quantitative assessments of electroencephalography recorded during performance of the Attention Network Test (ANT), a behavioral paradigm that separates alerting, orienting, and executive components of attention. We studied 13 patients, at least 6 months post-TBI with cognitive impairments, and 24 control subjects. Based on performance on the ANT, TBI subjects showed selective impairment in executive attention. In TBI subjects, principal component analysis combined with spectral analysis of the EEG after target appearance extracted a pattern of increased frontal midline theta power (2.5–7.5 Hz) and suppression of frontal beta power (12.5–22.5 Hz). Individual expression of this pattern correlated (r = − 0.67, p < 0.001) with executive attention impairment. The grading of this pattern of spatiotemporal dynamics with executive attention deficits reflects impaired recruitment of anterior forebrain resources following TBI; specifically, deafferentation and variable disfacilitation of medial frontal neuronal populations is proposed as the basis of our findings. Electrophysiological correlate of impaired executive attention after Traumatic Brain Injury is derived. Theta increases in medial frontal and beta suppression in frontal regions is linked to behavioral performance. Individual-specific pathophysiology allows for tracking of recovery/interventions and studies of function-structure.
Collapse
|
27
|
A psychoengineering paradigm for the neurocognitive mechanisms of biofeedback and neurofeedback. Neurosci Biobehav Rev 2016; 68:891-910. [DOI: 10.1016/j.neubiorev.2016.06.012] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/03/2016] [Accepted: 06/14/2016] [Indexed: 01/02/2023]
|
28
|
Bigler ED. Systems Biology, Neuroimaging, Neuropsychology, Neuroconnectivity and Traumatic Brain Injury. Front Syst Neurosci 2016; 10:55. [PMID: 27555810 PMCID: PMC4977319 DOI: 10.3389/fnsys.2016.00055] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/08/2016] [Indexed: 01/03/2023] Open
Abstract
The patient who sustains a traumatic brain injury (TBI) typically undergoes neuroimaging studies, usually in the form of computed tomography (CT) and magnetic resonance imaging (MRI). In most cases the neuroimaging findings are clinically assessed with descriptive statements that provide qualitative information about the presence/absence of visually identifiable abnormalities; though little if any of the potential information in a scan is analyzed in any quantitative manner, except in research settings. Fortunately, major advances have been made, especially during the last decade, in regards to image quantification techniques, especially those that involve automated image analysis methods. This review argues that a systems biology approach to understanding quantitative neuroimaging findings in TBI provides an appropriate framework for better utilizing the information derived from quantitative neuroimaging and its relation with neuropsychological outcome. Different image analysis methods are reviewed in an attempt to integrate quantitative neuroimaging methods with neuropsychological outcome measures and to illustrate how different neuroimaging techniques tap different aspects of TBI-related neuropathology. Likewise, how different neuropathologies may relate to neuropsychological outcome is explored by examining how damage influences brain connectivity and neural networks. Emphasis is placed on the dynamic changes that occur following TBI and how best to capture those pathologies via different neuroimaging methods. However, traditional clinical neuropsychological techniques are not well suited for interpretation based on contemporary and advanced neuroimaging methods and network analyses. Significant improvements need to be made in the cognitive and behavioral assessment of the brain injured individual to better interface with advances in neuroimaging-based network analyses. By viewing both neuroimaging and neuropsychological processes within a systems biology perspective could represent a significant advancement for the field.
Collapse
Affiliation(s)
- Erin D. Bigler
- Department of Psychology, Neuroscience Center, Brigham Young UniversityProvo, UT, USA
| |
Collapse
|
29
|
Logan DM, Hill KR, Larson MJ. Cognitive control of conscious error awareness: error awareness and error positivity (Pe) amplitude in moderate-to-severe traumatic brain injury (TBI). Front Hum Neurosci 2015. [PMID: 26217212 PMCID: PMC4493384 DOI: 10.3389/fnhum.2015.00397] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Poor awareness has been linked to worse recovery and rehabilitation outcomes following moderate-to-severe traumatic brain injury (M/S TBI). The error positivity (Pe) component of the event-related potential (ERP) is linked to error awareness and cognitive control. Participants included 37 neurologically healthy controls and 24 individuals with M/S TBI who completed a brief neuropsychological battery and the error awareness task (EAT), a modified Stroop go/no-go task that elicits aware and unaware errors. Analyses compared between-group no-go accuracy (including accuracy between the first and second halves of the task to measure attention and fatigue), error awareness performance, and Pe amplitude by level of awareness. The M/S TBI group decreased in accuracy and maintained error awareness over time; control participants improved both accuracy and error awareness during the course of the task. Pe amplitude was larger for aware than unaware errors for both groups; however, consistent with previous research on the Pe and TBI, there were no significant between-group differences for Pe amplitudes. Findings suggest possible attention difficulties and low improvement of performance over time may influence specific aspects of error awareness in M/S TBI.
Collapse
Affiliation(s)
- Dustin M Logan
- Department of Psychology, Brigham Young University Provo, UT, USA
| | - Kyle R Hill
- Department of Psychology, Brigham Young University Provo, UT, USA
| | - Michael J Larson
- Department of Psychology, Brigham Young University Provo, UT, USA ; Neuroscience Center, Brigham Young University Provo, UT, USA
| |
Collapse
|
30
|
Bailey N, Hoy K, Maller J, Upton D, Segrave R, Fitzgibbon B, Fitzgerald P. Neural evidence that conscious awareness of errors is reduced in depression following a traumatic brain injury. Biol Psychol 2015; 106:1-10. [DOI: 10.1016/j.biopsycho.2015.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/20/2015] [Accepted: 01/20/2015] [Indexed: 01/02/2023]
|
31
|
Ulam F, Shelton C, Richards L, Davis L, Hunter B, Fregni F, Higgins K. Cumulative effects of transcranial direct current stimulation on EEG oscillations and attention/working memory during subacute neurorehabilitation of traumatic brain injury. Clin Neurophysiol 2015; 126:486-96. [DOI: 10.1016/j.clinph.2014.05.015] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 04/25/2014] [Accepted: 05/22/2014] [Indexed: 11/30/2022]
|
32
|
Gamma deficits as a neural signature of cognitive impairment in children treated for brain tumors. J Neurosci 2014; 34:8813-24. [PMID: 24966381 DOI: 10.1523/jneurosci.5220-13.2014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cognitive impairment is consistently reported in children treated for brain tumors, particularly in the categories of processing speed, memory, and attention. Although tumor site, hydrocephalus, chemotherapy, and cranial radiation therapy (CRT) are all associated with poorer function, CRT predicts the greatest deficits. There is a particularly high correlation between CRT and slowed information-processing speed. Cortical gamma-band oscillations have been associated with processing behaviorally relevant information; however, their role in the maintenance of cognition in individuals with processing deficits is unclear. We examined gamma oscillations using magnetoencephalography (MEG) in children undergoing CRT to test whether gamma characteristics can be a signature of cognitive impairment in this population. We collected resting-state data as well as data from baseline and active periods during two visual-motor reaction time tasks of varying cognitive loads from 18 healthy children and 20 patients. We found that only high-gamma oscillations (60-100 Hz), and not low-gamma oscillations (30-59 Hz), showed significant group differences in absolute power levels. Overall, compared with healthy children, patients showed the following: (1) lower total high-gamma (60-100 Hz) power during the resting state, as well as during task-related baseline and performance measures; (2) no change in gamma reactivity to increases in cognitive load; and (3) slower processing speeds both inside and outside MEG. Our findings show that high-gamma oscillations are disrupted in children after treatment for a brain tumor. The temporal dynamic of the high-gamma response during information processing may index cognitive impairment in humans with neurological injury.
Collapse
|
33
|
Solbakk AK, Løvstad M. Effects of focal prefrontal cortex lesions on electrophysiological indices of executive attention and action control. Scand J Psychol 2014; 55:233-43. [DOI: 10.1111/sjop.12106] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 01/05/2014] [Indexed: 01/06/2023]
Affiliation(s)
- Anne-Kristin Solbakk
- Department of Neurosurgery; Division of Surgery and Clinical Neuroscience; Oslo University Hospital-Rikshospitalet; Norway
- Department of Psychosomatic Medicine; Division of Surgery and Clinical Neuroscience; Oslo University Hospital-Rikshospitalet; Norway
| | - Marianne Løvstad
- Sunnaas Rehabilitation Hospital; Research Department; Nesodden Norway
- Department of Psychology; University of Oslo; Oslo Norway
| |
Collapse
|
34
|
Abstract
CONTEXT The long-term implications of concussive injuries for brain and cognitive health represent a growing concern in the public consciousness. As such, identifying measures sensitive to the subtle yet persistent effects of concussive injuries is warranted. OBJECTIVE To investigate how concussion sustained early in life influences visual processing in young adults. We predicted that young adults with a history of concussion would show decreased sensory processing, as noted by a reduction in P1 event-related potential component amplitude. DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty-six adults (18 with a history of concussion, 18 controls) between the ages of 20 and 28 years completed a pattern-reversal visual evoked potential task while event-related potentials were recorded. MAIN OUTCOME MEASURE(S) The groups did not differ in any demographic variables (all P values > .05), yet those with a concussive history exhibited reduced P1 amplitude compared with the control participants (P = .05). CONCLUSIONS These results suggest that concussion history has a negative effect on visual processing in young adults. Further, upper-level neurocognitive deficits associated with concussion may, in part, result from less efficient downstream sensory capture.
Collapse
Affiliation(s)
- Robert D. Moore
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign
| | | | - Charles H. Hillman
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign
| |
Collapse
|
35
|
Fischer BL, Parsons M, Durgerian S, Reece C, Mourany L, Lowe MJ, Beall EB, Koenig KA, Jones SE, Newsome MR, Scheibel RS, Wilde EA, Troyanskaya M, Merkley TL, Walker M, Levin HS, Rao SM. Neural activation during response inhibition differentiates blast from mechanical causes of mild to moderate traumatic brain injury. J Neurotrauma 2013; 31:169-79. [PMID: 24020449 DOI: 10.1089/neu.2013.2877] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Military personnel involved in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) commonly experience blast-induced mild to moderate traumatic brain injury (TBI). In this study, we used task-activated functional MRI (fMRI) to determine if blast-related TBI has a differential impact on brain activation in comparison with TBI caused primarily by mechanical forces in civilian settings. Four groups participated: (1) blast-related military TBI (milTBI; n=21); (2) military controls (milCON; n=22); (3) non-blast civilian TBI (civTBI; n=21); and (4) civilian controls (civCON; n=23) with orthopedic injuries. Mild to moderate TBI (MTBI) occurred 1 to 6 years before enrollment. Participants completed the Stop Signal Task (SST), a measure of inhibitory control, while undergoing fMRI. Brain activation was evaluated with 2 (mil, civ)×2 (TBI, CON) analyses of variance, corrected for multiple comparisons. During correct inhibitions, fMRI activation was lower in the TBI than CON subjects in regions commonly associated with inhibitory control and the default mode network. In contrast, inhibitory failures showed significant interaction effects in the bilateral inferior temporal, left superior temporal, caudate, and cerebellar regions. Specifically, the milTBI group demonstrated more activation than the milCON group when failing to inhibit; in contrast, the civTBI group exhibited less activation than the civCON group. Covariance analyses controlling for the effects of education and self-reported psychological symptoms did not alter the brain activation findings. These results indicate that the chronic effects of TBI are associated with abnormal brain activation during successful response inhibition. During failed inhibition, the pattern of activation distinguished military from civilian TBI, suggesting that blast-related TBI has a unique effect on brain function that can be distinguished from TBI resulting from mechanical forces associated with sports or motor vehicle accidents. The implications of these findings for diagnosis and treatment of TBI are discussed.
Collapse
Affiliation(s)
- Barbara L Fischer
- 1 Geriatric Research Education and Clinical Center (GRECC), Wm. S. Middleton Memorial Veterans Affairs Hospital , Madison, Wisconsin
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Long-term test-retest reliability of the P3 NoGo wave and two independent components decomposed from the P3 NoGo wave in a visual Go/NoGo task. Int J Psychophysiol 2013; 89:106-14. [DOI: 10.1016/j.ijpsycho.2013.06.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 05/31/2013] [Accepted: 06/04/2013] [Indexed: 11/21/2022]
|
37
|
Visual event-related potentials as markers of hyperarousal in Gulf War illness: evidence against a stress-related etiology. Psychiatry Res 2013; 211:257-67. [PMID: 23149040 PMCID: PMC3578115 DOI: 10.1016/j.pscychresns.2012.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 08/14/2012] [Accepted: 08/16/2012] [Indexed: 11/20/2022]
Abstract
An exaggerated response to emotional stimuli is among the many symptoms widely reported by veterans of the 1991 Persian Gulf War. These symptomologies have been attributed to damage and dysfunction associated with deployment-related exposures. We collected event-related potential data from 22 veterans meeting Haley criteria for Gulf War (GW) Syndromes 1-3 and from 8 matched GW veteran controls, who were deployed but not symptomatic, while they performed a visual three-condition oddball task where images authenticated to be associated with the 1991 Persian Gulf War were the distractor stimuli. Hyperarousal reported by ill veterans was significantly greater than that by control veterans, but this was not paralleled by higher amplitude P3a in their ERP responses to GW-related distractor stimuli. Whereas previous studies of PTSD patients have shown higher amplitude P3b responses to target stimuli that are placed amid trauma-related nontarget stimuli, ill veterans in this study showed P3b amplitudes to target stimuli - placed amid GW-related nontarget stimuli - that were significantly lower than those of the control group. Hyperarousal scores reliably predicted P3b, but not P3a, amplitudes. Although many factors may contribute to P3b amplitude differences - most notably depression and poor sleep quality, symptoms that are prevalent in the GW syndrome groups - our findings in context of previous studies on this population are consistent with the contention that dysfunction in cholinergic and dopaminergic neurotransmitter systems, and in white matter and basal ganglia may be contributing to impairments in GW veterans.
Collapse
|
38
|
Galvanic vestibular stimulation modulates the electrophysiological response during face processing. Vis Neurosci 2012; 29:255-62. [PMID: 22697300 DOI: 10.1017/s0952523812000235] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although galvanic vestibular stimulation (GVS) is known to affect the speed and accuracy of visual judgments, the underlying electrophysiological response has not been explored. In the present study, we therefore investigated the effect of GVS on the N170 event-related potential, a marker commonly associated with early visual structural encoding. To elicit the waveform, participants distinguished famous from nonfamous faces that were presented in either upright or inverted orientation. Relative to a sham, stimulation increased the amplitude of the N170 and also elevated power spectra within the delta and theta frequency bands, components that have likewise been associated with face processing. This study constitutes the first attempt to model the effects of GVS on the electrophysiological response and, more specifically, indicates that unisensory visual processes linked to object construction are influenced by vestibular information. Given that reductions in the magnitude of both the N170 event-related potential and delta/theta activity accompany certain disease states, GVS may provide hitherto unreported therapeutic benefit.
Collapse
|
39
|
Hudac CM, Kota S, Nedrow JL, Molfese DL. Neural mechanisms underlying neurooptometric rehabilitation following traumatic brain injury. Eye Brain 2012; 4:1-12. [PMID: 28539777 PMCID: PMC5436188 DOI: 10.2147/eb.s27290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Mild to severe traumatic brain injuries have lasting effects on everyday functioning. Issues relating to sensory problems are often overlooked or not addressed until well after the onset of the injury. In particular, vision problems related to ambient vision and the magnocellular pathway often result in posttrauma vision syndrome or visual midline shift syndrome. Symptoms from these syndromes are not restricted to the visual domain. Patients commonly experience proprioceptive, kinesthetic, vestibular, cognitive, and language problems. Neurooptometric rehabilitation often entails the use of corrective lenses, prisms, and binasal occlusion to accommodate the unstable magnocellular system. However, little is known regarding the neural mechanisms engaged during neurooptometric rehabilitation, nor how these mechanisms impact other domains. Event-related potentials from noninvasive electrophysiological recordings can be used to assess rehabilitation progress in patients. In this case report, high-density visual event-related potentials were recorded from one patient with posttrauma vision syndrome and secondary visual midline shift syndrome during a pattern reversal task, both with and without prisms. Results indicate that two factors occurring during the end portion of the P148 component (168–256 milliseconds poststimulus onset) map onto two separate neural systems that were engaged with and without neurooptometric rehabilitation. Without prisms, neural sources within somatosensory, language, and executive brain regions engage inefficient magnocellular system processing. However, when corrective prisms were worn, primary visual areas were appropriately engaged. The impact of using early neurooptometric rehabilitation for posttrauma vision syndrome, visual midline shift syndrome, and other similar subtle vision disorders to support neural reorganization is discussed.
Collapse
Affiliation(s)
| | - Srinivas Kota
- Department of Psychology, University of Nebraska-Lincoln
| | | | - Dennis L Molfese
- Department of Psychology, University of Nebraska-Lincoln.,Center for Brain, Biology, and Behavior, University of Nebraska-Lincoln, Lincoln, NE
| |
Collapse
|
40
|
Folmer RL, Billings CJ, Diedesch-Rouse AC, Gallun FJ, Lew HL. Electrophysiological assessments of cognition and sensory processing in TBI: applications for diagnosis, prognosis and rehabilitation. Int J Psychophysiol 2011; 82:4-15. [PMID: 21419179 DOI: 10.1016/j.ijpsycho.2011.03.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 03/04/2011] [Accepted: 03/08/2011] [Indexed: 12/27/2022]
Abstract
Traumatic brain injuries are often associated with damage to sensory and cognitive processing pathways. Because evoked potentials (EPs) and event-related potentials (ERPs) are generated by neuronal activity, they are useful for assessing the integrity of neural processing capabilities in patients with traumatic brain injury (TBI). This review of somatosensory, auditory and visual ERPs in assessments of TBI patients is provided with the hope that it will be of interest to clinicians and researchers who conduct or interpret electrophysiological evaluations of this population. Because this article reviews ERP studies conducted in three different sensory modalities, involving patients with a wide range of TBI severity ratings and circumstances, it is difficult to provide a coherent summary of findings. However, some general trends emerge that give rise to the following observations and recommendations: 1) bilateral absence of somatosensory evoked potentials (SEPs) is often associated with poor clinical prognosis and outcome; 2) the presence of normal ERPs does not guarantee favorable outcome; 3) ERPs evoked by a variety of sensory stimuli should be used to evaluate TBI patients, especially those with severe injuries; 4) time since onset of injury should be taken into account when conducting ERP evaluations of TBI patients or interpreting results; 5) because sensory deficits (e.g., vision impairment or hearing loss) affect ERP results, tests of peripheral sensory integrity should be conducted in conjunction with ERP recordings; and 6) patients' state of consciousness, physical and cognitive abilities to respond and follow directions should be considered when conducting or interpreting ERP evaluations.
Collapse
Affiliation(s)
- Robert L Folmer
- National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR, USA.
| | | | | | | | | |
Collapse
|