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Analysis of brain tumour MRI with stress level using frequency analysis. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns3.6197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The Computing science applied to determine the solutions for medical, science and business domain. The Data mining techniques used to identify the features and applied to solve the challenging issues in the domains. This work attempted to fetch the draw brain MRI and converted to computable format. The converted images are used form the frequent wave and classified based on the mode. The relationship between the stress level and affected brain neuron activeness relationship identified and presented as part of the paper . The result shows that the highly affected neurons stress levels are high.
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Riganello F, Soddu A, Tonin P. Addressing Pain for a Proper Rehabilitation Process in Patients With Severe Disorders of Consciousness. Front Pharmacol 2021; 12:628980. [PMID: 33679413 PMCID: PMC7926206 DOI: 10.3389/fphar.2021.628980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/08/2021] [Indexed: 01/18/2023] Open
Abstract
Consciousness constitutes a fundamental prerequisite in the individual appraisal and experience of pain. In the same way, a person needs to be able to report on pain perception. Patients who suffered a severe brain injury with disorders of consciousness (DOC) represent a spectrum of pathologies affecting patients' capacity to interact with the external world. In these patients, the most relevant aspects in response to pain are physiologic and behavioral. The treatments and management of pain are challenging issues in these patients, arising serious ethical concerns and bringing emotional load among medical staff, caregivers, and relatives. In this review, we report the importance of having a correct pain management in DOC patients, to individuate the best pharmacological treatment that can make the difference in detecting a behavioral response, indicative of a change in the level of consciousness, and in planning a more effective rehabilitative approach.
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Affiliation(s)
- F. Riganello
- Research in Advanced NeuroRehabilitation, Istituto Sant’Anna, Crotone, Italy
| | - A. Soddu
- Department of Physics and Astronomy, Brain and Mind Institute, Western University, London, ON, Canada
| | - P. Tonin
- Research in Advanced NeuroRehabilitation, Istituto Sant’Anna, Crotone, Italy
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3
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Moore BA, Brock MS, Brager A, Collen J, LoPresti M, Mysliwiec V. Posttraumatic Stress Disorder, Traumatic Brain Injury, Sleep, and Performance in Military Personnel. Sleep Med Clin 2020; 15:87-100. [DOI: 10.1016/j.jsmc.2019.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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4
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Alves DE, Nilsen W, Fure SCR, Enehaug H, Howe EI, Løvstad M, Fink L, Andelic N, Spjelkavik Ø. What characterises work and workplaces that retain their employees following acquired brain injury? Systematic review. Occup Environ Med 2020; 77:122-130. [PMID: 31907293 PMCID: PMC7029230 DOI: 10.1136/oemed-2019-106102] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 12/11/2019] [Accepted: 12/14/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The objective of this study was to conduct a systematic review assessing workplace factors related to work retention (or return to work) in employees with acquired brain injury (ABI). Additionally, we aimed to synthesise the evidence and state of knowledge on this subject. METHODS A database search was performed in nine relevant electronic databases. Inclusion criteria were quantitative peer-reviewed publications empirically investigating the relationship between work/workplace factors and work retention in employees following ABI. The methodological quality was determined by Effective Public Health Practice Project scoring, and evidence was synthesised narratively. RESULTS Thirteen studies were included. We found moderate evidence for a negative relationship between manual work and work retention. We also found limited evidence for a U-shaped relationship between workload and complete work retention at 6 months and no relationship at 12 months; a positive relationship between managers, compared with non-managers, and faster work retention; a positive relationship between large enterprise size defined as ≥250 employees, and no relationship between large enterprise size, defined as ≥1000 employees, and work retention. CONCLUSION Relative to individual factors, there is little evidence on specific workplace factors' relationship to work retention among employees with ABI. For most workplace factors, there were too few high-quality studies to designate evidence as more than limited or insufficient. Future studies should replicate rigorous studies of well-defined modifiable workplace factors related to work retention. PROSPERO REGISTRATION NUMBER CRD42018082201.
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Affiliation(s)
| | - Wendy Nilsen
- Work Research Institute, OsloMet- Oslo Metropolitan University, Oslo, Norway
| | - Silje Christine Reistad Fure
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Heidi Enehaug
- Work Research Institute, OsloMet- Oslo Metropolitan University, Oslo, Norway
| | - Emilie Isager Howe
- Department of Physical medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Louisa Fink
- Institute of Social Psychology, Goethe University Frankfurt, Frankfurt, Hessen, Germany
| | - Nada Andelic
- Department of Physical medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øystein Spjelkavik
- Work Research Institute, OsloMet- Oslo Metropolitan University, Oslo, Norway
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5
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Astafiev SV, Wen J, Brody DL, Cross AH, Anokhin AP, Zinn KL, Corbetta M, Yablonskiy DA. A Novel Gradient Echo Plural Contrast Imaging Method Detects Brain Tissue Abnormalities in Patients With TBI Without Evident Anatomical Changes on Clinical MRI: A Pilot Study. Mil Med 2019; 184:218-227. [PMID: 30901451 DOI: 10.1093/milmed/usy394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/10/2018] [Accepted: 11/21/2018] [Indexed: 01/06/2023] Open
Abstract
RESEARCH OBJECTIVES It is widely accepted that mild traumatic brain injury (mTBI) causes injury to the white matter, but the extent of gray matter (GM) damage in mTBI is less clear. METHODS We tested 26 civilian healthy controls and 14 civilian adult subacute-chronic mTBI patients using quantitative features of MRI-based Gradient Echo Plural Contrast Imaging (GEPCI) technique. GEPCI data were reconstructed using previously developed algorithms allowing the separation of R2t*, a cellular-specific part of gradient echo MRI relaxation rate constant, from global R2* affected by BOLD effect and background gradients. RESULTS Single-subject voxel-wise analysis (comparing each mTBI patient to the sample of 26 control subjects) revealed GM abnormalities that were not visible on standard MRI images (T1w and T2w). Analysis of spatial overlap for voxels with low R2t* revealed tissue abnormalities in multiple GM regions, especially in the frontal and temporal regions, that are frequently damaged after mTBI. The left posterior insula was the region with abnormalities found in the highest proportion (50%) of mTBI patients. CONCLUSIONS Our data suggest that GEPCI quantitative R2t* metric has potential to detect abnormalities in GM cellular integrity in individual TBI patients, including abnormalities that are not detectable by a standard clinical MRI.
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Affiliation(s)
- Serguei V Astafiev
- Department of Radiology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO.,Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8134, St. Louis, MO
| | - Jie Wen
- Department of Radiology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO
| | - David L Brody
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8111, St. Louis, MO.,Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD
| | - Anne H Cross
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8111, St. Louis, MO
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8134, St. Louis, MO
| | - Kristina L Zinn
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8111, St. Louis, MO
| | - Maurizio Corbetta
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8111, St. Louis, MO.,Department of Neuroscience and Padova Neuroscience Center (PNC), University of Padova, Palazzina Neuroscienze, Via Giustiniani, 2, Padova, Italy
| | - Dmitriy A Yablonskiy
- Department of Radiology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO
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6
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He XY, Dan QQ, Wang F, Li YK, Fu SJ, Zhao N, Wang TH. Protein Network Analysis of the Serum and Their Functional Implication in Patients Subjected to Traumatic Brain Injury. Front Neurosci 2019; 12:1049. [PMID: 30766469 PMCID: PMC6365836 DOI: 10.3389/fnins.2018.01049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/24/2018] [Indexed: 02/05/2023] Open
Abstract
Traumatic brain injury (TBI) often leads to severe neurobehavioral impairment, but the underlying molecular mechanism remains to be elucidated. Here, we collected the sera from 23 patients (aged from 19 to 81 years old, third day after TBI as TBI-third group) subjected to TBI from The First Hospital of Kunming City, and the sera from 22 healthy donors (aged from 18 to 81 years old and as control group). Then, three samples from TBI-third group and three samples from control group were subjected to the protein microarray detection, and bioinformatics analysis. Then, enzyme-linked immunosorbent assay (ELISA) was used to verify significantly altered protein levels. Results showed that, when compared with the control group, all significantly differentially expressed proteins [DEPs, P < 0.05, FDR < 0.05, fold change (FC) > 2] contained 172 molecules in the TBI-third group, in which 65 proteins were upregulated, while 107 proteins were downregulated. The biological processes of these DEPs, mostly happened in the extracellular region and the extracellular region parts, are mainly involved in the regulation of cellular process, signaling and signal transduction, cell communication, response to stimuli, the immune system process and multicellular organismal development. Moreover, the essential molecular functions of them are cytokine activity, growth factor activity and morphogen activity. Additionally, the most significant pathways are enriched in cytokine–cytokine receptor interaction and PI3K-Akt signaling pathways among downregulated proteins, and pathways in cancer and cytokine–cytokine receptor interaction among upregulated proteins. Of these, we focused on the NGF, NT-3, IGF-2, HGF, NPY, CRP, MMP-9, and ICAM-2 with a high number of interactors in Protein–Protein Interaction (PPI) Network indicated by bioinformatics report. Furthermore, using ELISA test, we confirmed that all increase in the levels of NGF, NT-3, IGF-2, HGF, NPY, CRP, MMP-9, and ICAM-2 in the serum from TBI patients. Together, we determined the screened protein expressional profiles in serum for TBI patients, in which the cross-network between inflammatory factors and growth factors may play a crucial role in TBI damage and repair. Our findings could contribute to indication for the diagnosis and treatment of TBI in future translational medicine and clinical practice.
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Affiliation(s)
- Xiu-Ying He
- Department of Anesthesiology, Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qi-Qin Dan
- Department of Anesthesiology, Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Fang Wang
- Institute of Neuroscience, Laboratory Zoology Department, Kunming Medical University, Kunming, China
| | - Yu-Kai Li
- Institute of Neuroscience, Laboratory Zoology Department, Kunming Medical University, Kunming, China
| | - Song-Jun Fu
- Institute of Neuroscience, Laboratory Zoology Department, Kunming Medical University, Kunming, China
| | - Nan Zhao
- Department of Neurosurgery, The First Hospital of Kunming, Kunming, China
| | - Ting-Hua Wang
- Department of Anesthesiology, Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Institute of Neuroscience, Laboratory Zoology Department, Kunming Medical University, Kunming, China
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7
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Hardcastle VG. Why "Moral Enhancement" Isn't Always Moral Enhancement: The Case of Traumatic Brain Injury in American Vets. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2018; 43:527-546. [PMID: 30189040 DOI: 10.1093/jmp/jhy022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this article, I argue that as we learn more about how we might intervene in the brain in ways that impact human behavior, the scope of what counts as "moral behavior" becomes smaller and smaller because things we successfully manipulate using evidence-based science are often things that fall outside the sphere of morality. Consequently, the argument that we are morally obligated to morally enhance our neighbors starts to fall apart, not because humans should be free to make terrible choices, but because morality is not something subject to such manipulation. To illustrate my argument, I shall use the rise of veteran diversion courts in the United States as a putative instance of an intervention designed to change human behavior for the better. Part of my purpose in working my way through this case study is to demonstrate that many philosophers have the psychology of immoral action wrong.
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Taghdiri F, Varriano B, Tartaglia MC. Assessment of Oculomotor Function in Patients With Postconcussion Syndrome: A Systematic Review. J Head Trauma Rehabil 2018; 32:E55-E67. [PMID: 28195951 DOI: 10.1097/htr.0000000000000286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Concussion and its associated sequel, postconcussion syndrome (PCS), have a debilitating impact on the lives of concussed patients. However, a diagnostic biomarker for this condition is lacking. Recently, there has been a surge of interest in using oculomotor function testing as an objective assessment of patients with PCS. OBJECTIVES To systematically synthesize, appraise, and summarize all published empirical studies that have assessed alteration of oculomotor functions in patients with PCS. METHODS Medline, Embase, PsychINFO, and CINAHL databases searched up to July 2016 for studies that used oculomotor function assessment in patients with postconcussion symptoms. RESULTS The search identified 1637 citations, and finally 8 case-control studies were included. Of these, 5 studies used a similar task with a target moving in a circular trajectory. Three other studies measured conventional oculomotor tasks such as saccade, vergence, and smooth pursuit eye movements. CONCLUSIONS Currently, there is limited support for the recommendation of oculomotor function assessments for diagnosis and identification of patients with PCS following head trauma. Therefore, more rigorous studies assessing oculomotor function changes in patients with PCS are warranted.
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Affiliation(s)
- Foad Taghdiri
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Canada (Mr Taghdiri, Ms Varriano, and Dr Tartaglia); and Division of Neurology, University Health Network, Toronto Western Hospital, Canada (Dr Tartaglia)
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9
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Kaya H, Sogüt O, Gokdemir MT, Albayrak L, Taskιn A. The Role of Oxidative Status in Initial Evaluation of Paediatric Patients with Graded Traumatic Brain Injury. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791302000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction The purposes of this study were (a) to investigate the oxidative and antioxidative status in paediatric patients with varying severity of traumatic brain injury (TBI) during the early post-traumatic period; (b) to correlate injury severity with the oxidative and antioxidative status of patients; and (c) to identify early predictors of outcome in patients with TBI. Methods Fifty-two consecutive paediatric patients with isolated TBI and 31 age- and sex-matched healthy controls were enrolled. Patients were divided into two groups based on their Glasgow Coma Scale (GCS) scores recorded upon admission to the emergency department within the first 24 hours after injury. Twenty-three patients with moderate to severe TBI and 29 patients with mild TBI (GCS scores of >13) were included. The primary outcome variable was hospital mortality. Plasma total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) were assessed as predictors of early oxidative changes in serum using a novel automated measurement method. Results Compared to patients with mild TBI, TOS and OSI values were markedly elevated in patients with moderate to severe TBI. However, TAS levels did not show significant changes in either group of patients. Both GCS scores and Revised Trauma Scores were negatively correlated with the TOS and OSI, but neither was significantly correlated with the TAS. The TOS and OSI were significantly higher in non-survivors than in survivors. However, there was no significant difference in TAS levels between survivors and non-survivors. Conclusion Paediatric patients with isolated TBI are exposed to extensive oxidative stress, which varies with injury severity.
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Affiliation(s)
- H Kaya
- Harran University, Faculty of Medicine, Department of Emergency Medicine, Sanliurfa, Turkey
| | | | - MT Gokdemir
- Harran University, Faculty of Medicine, Department of Emergency Medicine, Sanliurfa, Turkey
| | - L Albayrak
- Harran University, Faculty of Medicine, Department of Emergency Medicine, Sanliurfa, Turkey
| | - A Taskιn
- Harran University, Faculty of Medicine, Department of Biochemistry, Sanliurfa, Turkey
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10
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Postural Stability Assessment in Patients with Mild Traumatic Brain Injury Complaining of Dizziness. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0285-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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11
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Lindsay S, Stoica A. A systematic review of factors affecting driving and public transportation among youth and young adults with acquired brain injury. Brain Inj 2017. [DOI: 10.1080/02699052.2017.1321140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sally Lindsay
- Department of Occupational Science and Occupational Therapy, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON, Canada
| | - Andrei Stoica
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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12
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Lavoie S, Sechrist S, Quach N, Ehsanian R, Duong T, Gotlib IH, Isaac L. Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study. Front Psychol 2017; 8:634. [PMID: 28529492 PMCID: PMC5418333 DOI: 10.3389/fpsyg.2017.00634] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/09/2017] [Indexed: 11/30/2022] Open
Abstract
In the general population, females experience depression at significantly higher rates than males. Individuals with traumatic brain injury (TBI) are at substantially greater risk for depression compared to the overall population. Treatment of, and recovery from, TBI can be hindered by depression; comorbid TBI and depression can lead to adverse outcomes and negatively affect multiple aspects of individuals’ lives. Gender differences in depression following TBI are not well understood, and relevant empirical findings have been mixed. Utilizing the Patient Health Questionnaire-9 (PHQ-9) 1 year after TBI, we examined whether women would experience more severe depressive symptoms, and would endorse higher levels of depression within each category of depression severity, than would men. Interestingly, and contrary to our hypothesis, men and women reported mild depression at equal rates; PHQ-9 total scores were slightly lower in women than in men. Men and women did not differ significantly in any PHQ-9 depression severity category. Item analyses, yielded significant gender differences on the following items: greater concentration difficulties (cognitive problems) in men and more sleep disturbances (psychosomatic issues) in women per uncorrected two-sample Z-test for proportions analyses; however, these results were not significant after the family-wise Bonferroni correction. Our results indicate that, in contrast to the general population, mild depression in persons with moderate to severe TBI may not be gender-specific. These findings underscore the need for early identification, active screening, and depression treatment equally for men and women to improve emotional well-being, promote recovery, and enhance quality of life following TBI.
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Affiliation(s)
- Sarah Lavoie
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA
| | - Samantha Sechrist
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA
| | - Nhung Quach
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA
| | - Reza Ehsanian
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA.,Department of Neurosurgery, Stanford University, StanfordCA, USA
| | - Thao Duong
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA.,Department of Physical Medicine and Rehabilitation, Stanford University, StanfordCA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, StanfordCA, USA
| | - Linda Isaac
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San JoseCA, USA.,Department of Physical Medicine and Rehabilitation, Stanford University, StanfordCA, USA
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13
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Lin LF, Liou TH, Hu CJ, Ma HP, Ou JC, Chiang YH, Chiu WT, Tsai SH, Chu WC. Balance function and sensory integration after mild traumatic brain injury. Brain Inj 2016; 29:41-6. [PMID: 25265292 DOI: 10.3109/02699052.2014.955881] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study examined the disparities in balance functions and sensory integration in patients with mild traumatic brain injuries (mTBIs) and healthy controls. PARTICIPANTS One hundred and seven patients with mTBI and 107 age- and sex-matched controls were recruaited for this study. PRIMARY MEASURES Symptoms of dizziness, balance functions and the ability to perform daily activities were assessed using the dizziness handicap inventory (DHI). This study also performed the postural-stability test and a modified clinical test of sensory integration by using the Biodex Stability System (BBS). RESULTS DHI scores (functional, emotional, physical and total self-reported scores) were substantially increased in patients following an mTBI compared with the scores of the controls (p < 0.000). The postural-stability test indices (anterior-posterior) (p = 0.045) and the sensory-integration test index (eyes-open-firm-surface index) (p = 0.006) were substantially lower in patients with mTBI than in the controls. However, indices of two other postural-stability test indices (overall and medial-lateral) and three other sensory-integration tests indices (eyes-closed-firm-surface, eyes-open-foam-surface and eyes-closed-foam-surface) measured for the mTBI group did not differ from those of the control group. CONCLUSION Activities of daily living, balance in postural stability and sensory integration were strongly impaired in patients with mTBI.
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Affiliation(s)
- Li-Fong Lin
- a Graduate Institute of Biomedical Engineering, National Yang-Ming University , Taiwan ROC
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14
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Astafiev SV, Zinn KL, Shulman GL, Corbetta M. Exploring the physiological correlates of chronic mild traumatic brain injury symptoms. NEUROIMAGE-CLINICAL 2016; 11:10-19. [PMID: 26909324 PMCID: PMC4732189 DOI: 10.1016/j.nicl.2016.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 12/31/2015] [Accepted: 01/04/2016] [Indexed: 12/14/2022]
Abstract
We report on the results of a multimodal imaging study involving behavioral assessments, evoked and resting-state BOLD fMRI, and DTI in chronic mTBI subjects. We found that larger task-evoked BOLD activity in the MT+/LO region in extra-striate visual cortex correlated with mTBI and PTSD symptoms, especially light sensitivity. Moreover, higher FA values near the left optic radiation (OR) were associated with both light sensitivity and higher BOLD activity in the MT+/LO region. The MT+/LO region was localized as a region of abnormal functional connectivity with central white matter regions previously found to have abnormal physiological signals during visual eye movement tracking (Astafiev et al., 2015). We conclude that mTBI symptoms and light sensitivity may be related to excessive responsiveness of visual cortex to sensory stimuli. This abnormal sensitivity may be related to chronic remodeling of white matter visual pathways acutely injured. We report a multimodal imaging study of symptoms in chronic mTBI. Higher BOLD activity in the MT +/LO region correlated with mTBI symptoms. Higher FA near the left optic radiation was associated with light sensitivity.
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Affiliation(s)
- Serguei V Astafiev
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO 63110, USA.
| | - Kristina L Zinn
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO 63110, USA.
| | - Gordon L Shulman
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO 63110, USA.
| | - Maurizio Corbetta
- Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO 63110, USA.
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15
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Astafiev SV, Shulman GL, Metcalf NV, Rengachary J, MacDonald CL, Harrington DL, Maruta J, Shimony JS, Ghajar J, Diwakar M, Huang MX, Lee RR, Corbetta M. Abnormal White Matter Blood-Oxygen-Level-Dependent Signals in Chronic Mild Traumatic Brain Injury. J Neurotrauma 2015; 32:1254-71. [PMID: 25758167 DOI: 10.1089/neu.2014.3547] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Concussion, or mild traumatic brain injury (mTBI), can cause persistent behavioral symptoms and cognitive impairment, but it is unclear if this condition is associated with detectable structural or functional brain changes. At two sites, chronic mTBI human subjects with persistent post-concussive symptoms (three months to five years after injury) and age- and education-matched healthy human control subjects underwent extensive neuropsychological and visual tracking eye movement tests. At one site, patients and controls also performed the visual tracking tasks while blood-oxygen-level-dependent (BOLD) signals were measured with functional magnetic resonance imaging. Although neither neuropsychological nor visual tracking measures distinguished patients from controls at the level of individual subjects, abnormal BOLD signals were reliably detected in patients. The most consistent changes were localized in white matter regions: anterior internal capsule and superior longitudinal fasciculus. In contrast, BOLD signals were normal in cortical regions, such as the frontal eye field and intraparietal sulcus, that mediate oculomotor and attention functions necessary for visual tracking. The abnormal BOLD signals accurately differentiated chronic mTBI patients from healthy controls at the single-subject level, although they did not correlate with symptoms or neuropsychological performance. We conclude that subjects with persistent post-concussive symptoms can be identified years after their TBI using fMRI and an eye movement task despite showing normal structural MRI and DTI.
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Affiliation(s)
- Serguei V Astafiev
- 1 Department of Neurology, Washington University in St. Louis , St. Louis, Missouri
| | - Gordon L Shulman
- 1 Department of Neurology, Washington University in St. Louis , St. Louis, Missouri
| | - Nicholas V Metcalf
- 1 Department of Neurology, Washington University in St. Louis , St. Louis, Missouri
| | - Jennifer Rengachary
- 1 Department of Neurology, Washington University in St. Louis , St. Louis, Missouri
| | | | - Deborah L Harrington
- 2 Department of Radiology, University of California , San Diego, San Diego, California
| | - Jun Maruta
- 3 Brain Trauma Foundation , New York, New York
| | | | - Jamshid Ghajar
- 3 Brain Trauma Foundation , New York, New York.,4 Department of Neurological Surgery, Weill Cornell Medical College , New York, New York
| | - Mithun Diwakar
- 2 Department of Radiology, University of California , San Diego, San Diego, California
| | - Ming-Xiong Huang
- 2 Department of Radiology, University of California , San Diego, San Diego, California
| | - Roland R Lee
- 2 Department of Radiology, University of California , San Diego, San Diego, California
| | - Maurizio Corbetta
- 1 Department of Neurology, Washington University in St. Louis , St. Louis, Missouri
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Ramesh D, Keyser-Marcus LA, Ma L, Schmitz JM, Lane SD, Marwitz JH, Kreutzer JS, Moeller FG. Prevalence of traumatic brain injury in cocaine-dependent research volunteers. Am J Addict 2015; 24:341-7. [PMID: 25662909 DOI: 10.1111/ajad.12192] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 12/05/2014] [Accepted: 12/09/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is a high prevalence of traumatic brain injury (TBI) among those with substance dependence. However, TBI often remains undiagnosed in these individuals, due to lack of routine screening in substance use treatment settings or due to overlap in some of the cognitive sequelae (eg impulsivity, disinhibition) of TBI and cocaine dependence. METHODS The prevalence of self-reported mild to moderate TBI in a group of cocaine-dependent (n = 95) and a group of healthy volunteers (n = 75) enrolled at the same facility was assessed. Additionally, the relationship between TBI and clinically relevant correlates, including impulsivity, cocaine use history, and treatment outcome in the cocaine-dependent group was also examined. RESULTS A higher proportion of individuals with cocaine dependence (29.5%) reported having suffered a TBI in their lifetime compared to controls (8%) on a Closed Head Injury scale. Among cocaine users, the average age of sustaining TBI was significantly lower than the age of initiating cocaine use. Presence of TBI was not associated with higher impulsivity on the Barratt Impulsiveness Scale-11 or self-reported years of cocaine use. No differences were noted on treatment outcome for cocaine dependence as measured by treatment effectiveness scores (TES) between cocaine users with TBI and their non-TBI counterparts. CONCLUSIONS These results are the first to highlight the high prevalence of TBI among individuals with cocaine dependence. This study underscores the possible role of TBI history as a risk factor for onset of cocaine use, however, more research is needed to determine the impact of co-morbid TBI as a complicating factor in the substance abuse treatment setting.
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Affiliation(s)
- Divya Ramesh
- Department of Pharmacology Toxicology, Virginia Commonwealth University, Richmond, Virginia; Institute for Drug & Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
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Development and Preliminary Validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA). BRAIN IMPAIR 2014. [DOI: 10.1017/brimp.2014.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background and aims: For patients with a severe brain injury there is no objective physiotherapy assessment tool that is responsive to the incremental changes in motor recovery in the acute stage. The aims of this study were to identify the items of neuro-motor recovery and scoring criteria for the Acute Brain Injury Physiotherapy Assessment (ABIPA) and determine responsiveness to change and concurrent validity against accepted standard measures of consciousness and physical function in the severe brain injury population.Method: The literature was searched and an expert consensus panel of experienced clinical physiotherapists informed item selection and developed practical assessment guidelines. The ABIPA was investigated for responsiveness to change and concurrent validity against the Glasgow Coma Scale (GCS), Clinical Outcome Variable Scale (COVS) and Motor Assessment Scale (MAS). Eleven patients (9 males; cohort 41 ± 18 years) with moderate/severe brain injury were recruited, and assessed on days 1, 3, 7 and then weekly until discharge.Results: The ABIPA demonstrated good to excellent correlations overall with the GCS (rho > .76, p ≤ .001), COVS (rho > .82, p ≤ .001) and MAS (rho > 0.66, p ≤ .001). On day 3, the ABIPA showed the greatest responsiveness to change (standardised response means (SRM) > .83) compared to other measures (SRMs < .77). At discharge all tools demonstrated change in neuro-motor recovery.Conclusions: The ABIPA is a promising tool for detecting incremental changes in neuro-motor recovery early after severe brain injury.
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Prieto DA, Ye X, Veenstra TD. Proteomic analysis of traumatic brain injury: the search for biomarkers. Expert Rev Proteomics 2014; 5:283-91. [DOI: 10.1586/14789450.5.2.283] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Logan BW, Goldman S, Zola M, Mackey A. Concussive brain injury in the military: September 2001 to the present. BEHAVIORAL SCIENCES & THE LAW 2013; 31:803-813. [PMID: 24130079 DOI: 10.1002/bsl.2092] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Since the terrorist attacks of September 11, 2001, 1,348,405 citizens have been deployed to combat in Operation Iraqi Freedom (OIF), Operation New Dawn in Iraq, and Operation Enduring Freedom in Afghanistan (OEF). During this same period 266,810 (20%) of these individuals have been diagnosed with a traumatic brain injury (TBI). The majority of these were Army soldiers, with 155,282 (58%) receiving the diagnosis. Mild TBI comprised 82% of the total, with the remainder being moderate to severe. Over this same period the Department of Defense (DoD) has invested $374.9 million to enhance access and quality of care services, including 57 TBI treatment centers in the combat theater and throughout the U.S. The Army's medical research division, the Medical Research and Material Command (MRMC), has invested an additional $700 million to TBI research during this time. The effort has faced a number of challenges, including limited human subject basic and translational research, limited epidemiological data on combat-related injuries, limited capacity and standards for data acquisition, and a lack of standardized evidenced-based protocols for treatment. All these areas have undergone significant growth and development, leading to the comprehensive system of care present today. A further challenge in this patient population has been the clinical co-morbidity of TBI, post-traumatic stress disorder, and chronic pain syndrome. The Army and the DoD have created treatment programs that are interdisciplinary in clinical approach, targeting particular neuropsychological domains of dysfunction rather than diagnostic category or etiology of injury. This article presents the history of this effort, the challenges to accurate and adequate diagnosis and care that remain, and the future of brain injury clinical and research efforts in the military.
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Affiliation(s)
- Bret W Logan
- Executive Director, Intrepid Spirit III NICOE Satellite at Ft Campbell, 650 Joel Drive, BLDG 2543, Ft Campbell, KY, 42223
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Tate CM, Wang KK, Eonta S, Zhang Y, Carr W, Tortella FC, Hayes RL, Kamimori GH. Serum Brain Biomarker Level, Neurocognitive Performance, and Self-Reported Symptom Changes in Soldiers Repeatedly Exposed to Low-Level Blast: A Breacher Pilot Study. J Neurotrauma 2013; 30:1620-30. [DOI: 10.1089/neu.2012.2683] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
| | - Kevin K.W. Wang
- Banyan Laboratories, Banyan Biomarkers, Inc., Alachua, Florida
- Center for Neuroproteomics and Biomarker Research, Department of Psychiatry, University of Florida, Gainesville, Florida
| | | | - Yang Zhang
- Department of Behavioral Biology, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Walter Carr
- Naval Medical Research Center, Silver Spring, Maryland
| | - Frank C. Tortella
- Brain Trauma Neuroprotection Neurorestoration Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Ronald L. Hayes
- Banyan Laboratories, Banyan Biomarkers, Inc., Alachua, Florida
| | - Gary H. Kamimori
- Department of Behavioral Biology, Walter Reed Army Institute of Research, Silver Spring, Maryland
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Maksimovskiy AL, McGlinchey RE, Fortier CB, Salat DH, Milberg WP, Oscar-Berman M. White Matter and Cognitive Changes in Veterans Diagnosed with Alcoholism and PTSD. ACTA ACUST UNITED AC 2013; 2:144. [PMID: 24855633 DOI: 10.4172/2329-6488.1000144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Alcoholism frequently occurs in returning U.S. Veterans, and is often comorbid with Post Traumatic Stress Disorder (PTSD). The goal of this study was to investigate the relationship between white matter changes and neuropsychological alterations in Operation Enduring Freedom, and/or Operation Iraqi Freedom (OEF/OIF) alcoholic Veterans with two primary aims: (1) to examine the relationship of alcoholism to brain structure and function while controlling for the potential effects of comorbid PTSD, and (2) to examine whether the effects of alcoholism are moderated by the quantity of lifetime alcohol consumption. Our sample consisted of 71 deployed OEF/OIF Veterans stratified into four groups: alcoholics without PTSD, alcoholics with PTSD, participants with PTSD without comorbid alcoholism, and control participants without alcoholism or PTSD. Participants were given an extensive neuropsychological and psychiatric assessment battery, as well as Magnetic Resonance Diffusion Tensor Imaging (DT-MRI) scans. Results showed that disruption of executive functioning, and abnormal fractional anisotropy (FA; a measure of axonal integrity) within the frontal subcortical and dorsolateral frontal-parietal regions, occurred independently of the effects of PTSD. Furthermore, these cognitive and neuronal alterations were unique to the most severe subgroup of alcoholics who consumed the greatest amount of alcohol over the course of their lifetime, as compared to the rest of the sample. Axonal integrity within this subgroup, in regions underlying the frontal subcortical area, was shown to be decreased independently of cognitive changes. Integrity of axons underlying the dorsolateral frontal-parietal region, however, was increased. We hypothesized that this is a compensatory mechanism for executive dysfunction.
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Affiliation(s)
- Arkadiy L Maksimovskiy
- Geriatric Research Education and Clinical Center (GRECC) and the Translational Research Center for TBI and Stress-Related Disorders (TRACTS), VA Boston Healthcare System Boston, MA, USA
| | | | | | - David H Salat
- Behavioral Neuroscience Ph.D. Program and Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and VA Boston Healthcare System, Boston, MA, USA
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Green L, Godfrey C, Soo C, Anderson V, Catroppa C. Agreement between parent-adolescent ratings on psychosocial outcome and quality-of-life following childhood traumatic brain injury. Dev Neurorehabil 2012; 15:105-13. [PMID: 22432599 DOI: 10.3109/17518423.2011.638331] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study investigated parent-adolescent agreement in long-term psychosocial and quality-of-life (QoL) outcomes. The sample comprised adolescents aged 15-18 years, who sustained childhood traumatic brain injury (TBI) between birth and 5 years of age. METHODS Thirty-three participants (17 adolescents with TBI and 16 TBI parent-proxies) were involved in the study which compared parent and adolescent ratings on the Sydney Psychosocial Reintegration Scale-Child form (SPRS-C) and the Pediatric Quality-of-Life Inventory (PedsQL). The questionnaires were administered through phone interviews. RESULTS As hypothesized, parent-adolescent agreement was acceptable for psychosocial outcome (intra-class coefficient [ICC] of 0.844, p < 0.001), whereas discrepancies were found for ratings of QoL (ICC of 0.506, p = 0.092). CONCLUSION The finding that parents and adolescents agree on psychosocial outcome is promising for those instances when the patient is unable to report; however, discrepancies regarding QoL suggest caution needs to be taken when interpreting parent-rated QoL data.
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Affiliation(s)
- Laura Green
- Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Australia
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Laxe S, Tschiesner U, Zasler N, López-Blazquez R, Tormos JM, Bernabeu M. What domains of the International Classification of Functioning, Disability and Health are covered by the most commonly used measurement instruments in traumatic brain injury research? Clin Neurol Neurosurg 2012; 114:645-50. [DOI: 10.1016/j.clineuro.2011.12.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 12/10/2011] [Accepted: 12/24/2011] [Indexed: 10/14/2022]
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Huang LC, Wu MN, Chen CH, Huang P. Susceptibility-weighted imaging in patient with consciousness disturbance after traffic accident. Am J Emerg Med 2012; 31:261.e1-3. [PMID: 22560099 DOI: 10.1016/j.ajem.2012.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 03/19/2012] [Indexed: 10/28/2022] Open
Abstract
Both diffuse axonal injury (DAI) and fat embolism syndrome could be the cause of altered consciousness in patients who suffered from traffic accident. In some situations, distinguishing DAI from fat embolism syndrome may be difficult because routine brain imaging could not detect the lesions. Susceptibility weighted imaging is sensitive to detect petechial hemorrhages in cerebral fat embolism and DAI. The areas most vulnerable to DAI are the cerebral gray-white matter junction, splenium of the corpus callosum, and dorsolateral brainstem. However, cerebral and cerebellar white matter and splenium of corpus callosum are the areas most vulnerable to cerebral fat embolism. In additional to history, clinical manifestation, and prognosis, evaluating the distribution of hypointense lesions in susceptibility-weighted imaging could be useful to differentiate these 2 conditions.
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Affiliation(s)
- Ling-Chun Huang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Srinivasan R. Patient safety in the rehabilitation of children with traumatic brain injury and cerebral palsy. Phys Med Rehabil Clin N Am 2012; 23:393-400. [PMID: 22537701 DOI: 10.1016/j.pmr.2012.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With the advent of newer and better therapies available, patient safety is emerging as a new topic. Pediatric patient safety is relatively new, in that there are few guidelines available. Safety in children with traumatic brain injury (TBI) given the incidence of TBI is very vital. This is an attempt to identify the key points in TBI.
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Affiliation(s)
- Rajashree Srinivasan
- Department of Rehabilitation Medicine, Baylor University Medical Center, 3301 Swiss Avenue, Dallas, TX 75204, USA.
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Kleffelgaard I, Roe C, Soberg HL, Bergland A. Associations among self-reported balance problems, post-concussion symptoms and performance-based tests: a longitudinal follow-up study. Disabil Rehabil 2011; 34:788-94. [PMID: 22149161 DOI: 10.3109/09638288.2011.619624] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The main objectives of this study were to describe long-term self-reported balance problems and to explore their associations with post-concussion symptoms and performance-based tests. METHOD Prospective study of patients with mild traumatic brain injury (MTBI). Self-reported balance problems and post-concussion symptoms were measured with the Rivermead Post-concussion Symptoms Questionnaire at 1 and 4 years after injury. Performance-based tests were performed 4 years after injury and included posturography, the Dynamic Gait Index (DGI), walking speed tests, and the six-minute walk test. RESULTS Self-reported balance problems were reported in 31% of patients 4 years after injury and correlated significantly with post-concussion symptoms. The correlations with performance-based tests varied from ρ = 0.18 to ρ = 0.70 and were strongest for the maximum walking speed test (ρ = 0.70) and a dual-task test (ρ = 0.43). The DGI had a considerable ceiling effect. CONCLUSIONS Balance problems were long-term consequences of MTBI in one third of this study sample. Self-reported balance problems correlated with post-concussion symptoms and some of the performance-based tests. Future research needs to develop and evaluate appropriate rehabilitation strategies that also address the balance problems.
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Affiliation(s)
- Ingerid Kleffelgaard
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway.
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Trauzettel-Klosinski S. Current methods of visual rehabilitation. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:871-8. [PMID: 22259642 PMCID: PMC3258578 DOI: 10.3238/arztebl.2011.0871] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 10/12/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Despite therapeutic progress, many diseases of the eyes and visual pathways still cause persistent visual deficits that make everyday life more difficult in many ways. Rehabilitation aims to compensate for these limitations by optimizing residual vision. The demand for visual rehabilitation will increase markedly in the near future. METHODS We summarize the state of the art in visual rehabilitation on the basis of a selective review of the literature, including randomized, controlled trials (RCTs) in the Cochrane and PubMed databases as well as Cochrane reviews. We also pay particular attention to studies illustrating an important principle or a clinically established method. RESULTS Central visual field defects impair reading. Persons with an absolute central scotoma can regain reading ability by eccentric fixation and text magnification. Many kinds of magnifying visual aids are available. Specific reading training can further improve reading speed. Peripheral field defects impair orientation. Persons with a concentric field defect can be helped by tactile aids, such as a cane, and with orientation and mobility training. Persons with hemianopia can benefit from compensatory saccadic training. CONCLUSION Suitable rehabilitative measures chosen after the thorough diagnostic evaluation of a visual impairment and analysis of its effects can usually restore reading ability, improve orientation, and thereby enhance the patient's independence and quality of life. As the demand for visual rehabilitation is increasing, steps will need to be taken to make it more widely available. Furthermore, as the scientific basis for visual rehabilitation is currently inadequate in some areas, more research in the field will be needed.
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Lee BC, Chen S, Sienko KH. A wearable device for real-time motion error detection and vibrotactile instructional cuing. IEEE Trans Neural Syst Rehabil Eng 2011; 19:374-81. [PMID: 21511568 DOI: 10.1109/tnsre.2011.2140331] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We have developed a mobile instrument for motion instruction and correction (MIMIC) that enables an expert (i.e., physical therapist) to map his/her movements to a trainee (i.e., patient) in a hands-free fashion. MIMIC comprises an expert module (EM) and a trainee module (TM). Both the EM and TM are composed of six-degree-of-freedom inertial measurement units, microcontrollers, and batteries. The TM also has an array of actuators that provide the user with vibrotactile instructional cues. The expert wears the EM, and his/her relevant body position is computed by an algorithm based on an extended Kalman filter that provides asymptotic state estimation. The captured expert body motion information is transmitted wirelessly to the trainee, and based on the computed difference between the expert and trainee motion, directional instructions are displayed via vibrotactile stimulation to the skin. The trainee is instructed to move in the direction of the vibration sensation until the vibration is eliminated. Two proof-of-concept studies involving young, healthy subjects were conducted using a simplified version of the MIMIC system (pre-specified target trajectories representing ideal expert movements and only two actuators) during anterior-posterior trunk movements. The first study was designed to investigate the effects of changing the expert-trainee error thresholds (0.5(°), 1.0(°), and 1.5(°)) and varying the nature of the control signal (proportional, proportional plus derivative). Expert-subject cross-correlation values were maximized (0.99) and average position errors (0.33(°)) and time delays (0.2 s) were minimized when the controller used a 0.5(°) error threshold and proportional plus derivative feedback control signal. The second study used the best performing activation threshold and control signal determined from the first study to investigate subject performance when the motion task complexity and speed were varied. Subject performance decreased as motion speed and complexity increased.
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Affiliation(s)
- Beom-Chan Lee
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA.
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O’Reilly RC, Greywoode J, Morlet T, Miller F, Henley J, Church C, Campbell J, Beaman J, Cox AM, Zwicky E, Bean C, Falcheck S. Comprehensive Vestibular and Balance Testing in the Dizzy Pediatric Population. Otolaryngol Head Neck Surg 2011; 144:142-8. [DOI: 10.1177/0194599810393679] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To describe the spectrum of balance disease in a large population of children presenting to a tertiary care vestibular and balance laboratory. Study Design. Case series with chart review. Setting. Tertiary care pediatric hospital. Main Outcome Measures. Results of audiometric, vestibular, and balance tests and final diagnosis. Subjects and Methods. Retrospective review of audiometric, vestibular, balance testing, and final diagnosis from a patient database. Results. Between September 2003 and September 2007, 132 children were evaluated at the Alfred I. duPont Hospital for Children Vestibular Disorders Program. Sixty-nine of the patients were boys and 63 were girls. The average age was 9.7 ± 5.0 years (range, 1-17 years). Although not all were able to complete the entire test battery (99 children completed at least 50% of the tests in the protocol), a diagnosis was achieved in most cases. The most common diagnoses were peripheral vestibulopathy (29.5%), migraine/benign recurrent vertigo of childhood (24.2%), motor/developmental delay (10.6%), traumatic brain injury (9.8%), and central nervous system structural lesion (9.1%). Conclusions. Peripheral vestibular deficits and migraine disease account for most of the pathology in the pediatric population. With a multidisciplinary approach, diagnosis of the source of vertigo and imbalance is possible in most children.
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Affiliation(s)
- Robert C. O’Reilly
- Division of Pediatric Otolaryngology, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Jewell Greywoode
- Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Thierry Morlet
- Center for Pediatric Auditory and Speech Sciences, Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Freeman Miller
- Gait Laboratory, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - John Henley
- Gait Laboratory, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Chris Church
- Gait Laboratory, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Jeffrey Campbell
- Division of Pediatric Neurosurgery, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Jason Beaman
- Department of Physical Therapy, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Anne Marie Cox
- Department of Audiology, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Emily Zwicky
- Department of Audiology, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Charles Bean
- Neurology Associates, P.A., Newark, Delaware, USA
| | - Stephen Falcheck
- Department of Neurology, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
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Pangilinan PH, Giacoletti-Argento A, Shellhaas R, Hurvitz EA, Hornyak JE. Neuropharmacology in Pediatric Brain Injury: A Review. PM R 2010; 2:1127-40. [DOI: 10.1016/j.pmrj.2010.07.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 06/16/2010] [Accepted: 07/05/2010] [Indexed: 11/28/2022]
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Abstract
Rehabilitation following traumatic brain injury (TBI) is best provided by an interdisciplinary team of health care providers that takes advantage of the unique skills of multiple specialists, as well as their combined strengths that address problems that cut across disciplines. The setting where rehabilitation is provided is determined by the medical stability of patients, their ability to tolerate intensive therapies, and their likelihood of community reintegration within a reasonable period of time. Successful rehabilitation requires prompt recognition and treatment of TBI-related medical, cognitive, and behavioral problems to promote recovery and enhance community reintegration, using a combination of rehabilitation modalities and medications.
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Affiliation(s)
- Jaime M Levine
- Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA.
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Svestkova O, Angerova Y, Sladkova P, Bickenbach JE, Raggi A. Functioning and disability in traumatic brain injury. Disabil Rehabil 2010; 32 Suppl 1:S68-77. [DOI: 10.3109/09638288.2010.511690] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yang X, Yang S, Wang J, Zhang X, Wang C, Hong G. Expressive proteomics profile changes of injured human brain cortex due to acute brain trauma. Brain Inj 2010; 23:830-40. [PMID: 19697172 DOI: 10.1080/02699050903196670] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To find the expressive proteomics changes in damaged human brain cortex after traumatic brain injury (TBI). METHOD By rapid high-throughput and precise proteomic techniques, the traumatic injured human frontal cortexes were compared with non-trauma controls. RESULTS On 2-DE PAGE, 138 protein spots were found significantly different on expressive level of quantitative mature. Most of these proteins expressed in a fluctuant fashion within 18 hours after trauma, with mean levels lower than control. Eighty-two protein spots were identified by MALDI-MS TOF, which were products of 71 proteins and could be grouped into 10 categories based on possible functions: cytoskeleton (n = 10), metabolism (n = 13), electron transport (n = 8), signalling transduction (n = 4), stress response (n = 6), protein synthesis and turnover (n = 8), transporter (n = 5), cell cycle (n = 1), other (n = 8) and unknown (n = 9). CONCLUSION After traumatic brain injury, there are significant proteins expressing changes in damaged brain tissue. These proteins may play a critical role in TBI. Although some of these proteins functions are not fully understood, they may become novel biomarkers and novel therapy targets in the future.
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Affiliation(s)
- Xinyu Yang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, PR China
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Chevignard M, Toure H, Brugel DG, Poirier J, Laurent-Vannier A. A comprehensive model of care for rehabilitation of children with acquired brain injuries. Child Care Health Dev 2010; 36:31-43. [PMID: 19438875 DOI: 10.1111/j.1365-2214.2009.00949.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acquired brain injury (ABI) is a leading cause of death and lifelong acquired disability in children and remains a significant public health issue. Deficits may only become fully apparent when developmental demands increase and once cognitive processes are expected to be fully developed. It is therefore necessary to provide organized long-term follow-up for children post ABI. Despite these recommendations, it has been shown that only a small proportion of children received specialized rehabilitation and adequate follow-up after ABI. AIMS The aims are: (i) to describe a comprehensive model of care devoted to children with acquired brain injuries; and (ii) to provide descriptive data analysing the characteristics of children followed up, the type/amount of services provided and general outcomes. PROGRAMME DESCRIPTION The programme features an in- and outpatient rehabilitation facility, where multidisciplinary rehabilitation and specialized schooling are provided. The ultimate goal of the programme is to promote each child's successful reintegration in school and in the community. Adequate preparation of discharge is essential, long-term follow-up is organized, and an outreach programme has been developed to deal with the complex delayed psychosocial issues. RESULTS Overall outcome, as measured by the Glasgow Outcome Scale, improved dramatically between admission (3.3; SD = 0.45) and discharge (2.15; SD = 0.74). Most of the children were discharged home with an adequate personalized plan for ongoing rehabilitation and school adaptations. Analysis of the outreach programme underlines the more challenging issues arising in late adolescence-early adulthood. CONCLUSION Given the specificities of childhood ABI, long-term specific care must be organized and co-ordinated, regardless of injury severity.
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Affiliation(s)
- M Chevignard
- Physical Medicine and Rehabilitation Department for children with acquired neurological injuries, Hôpital National de Saint Maurice, 14, rue du Val d'Osne, 94415 Saint Maurice, France.
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Repeated hypoxic episodes induce seizures and alter hippocampal network activities in mice. Neuroscience 2009; 161:599-613. [DOI: 10.1016/j.neuroscience.2009.03.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 02/08/2009] [Accepted: 03/15/2009] [Indexed: 11/23/2022]
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Bernabeu M, Laxe S, Lopez R, Stucki G, Ward A, Barnes M, Kostanjsek N, Reed G, Tate R, Whyte J, Zasler N, Cieza A. Developing core sets for persons with traumatic brain injury based on the international classification of functioning, disability, and health. Neurorehabil Neural Repair 2009; 23:464-7. [PMID: 19221004 DOI: 10.1177/1545968308328725] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors outline the process for developing the International Classification of Functioning, Disability, and Health (ICF) Core Sets for traumatic brain injury (TBI). ICF Core Sets are selections of categories of the ICF that identify relevant categories of patients affected by specific diseases. Comprehensive and brief ICF Core Sets for TBI should become useful for clinical practice and for research. The final definition of the ICF Core Sets for TBI will be determined at an ICF Core Sets Consensus Conference, which will integrate evidence from preliminary studies. The development of ICF Core Sets is an inclusive and open process and rehabilitation professionals are invited to participate.
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Affiliation(s)
- Montserrat Bernabeu
- Brain Injury Unit, Institut Guttmann, Neurorehabilitation Hospital, Barcelona, Spain
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