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Estelle MCP, Voelbel GT. The effect of processing speed on verbal and visual memory of adults with a chronic acquired brain injury. Brain Inj 2024; 38:170-176. [PMID: 38287215 DOI: 10.1080/02699052.2024.2309250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE Memory problems are among the most frequently reported cognitive complaints by individuals with an acquired brain injury (ABI). Processing speed and working memory deficits are often the result of ABI. These cognitive deficits significantly impact the acquisition and retention of information necessary for memory formation. This study investigated the influence of processing speed and working memory on immediate and delayed recall for verbal and visual memory, as well as overall memory recall in adults living with a chronic ABI. METHODS Sixty-three participants living with a chronic ABI, who were at least one-year post-injury, were cognitively assessed with the CNS-Vital Signs (CNS-VS) computerized cognitive battery and Wechsler Test of Adult Reading. RESULTS The CNS-VS Processing Speed significantly predicted delayed recall for verbal memory and overall memory performance. The CNS-VS Working Memory was not a significant predictor of memory recall. CONCLUSIONS Processing speed deficits negatively impact memory in individuals with a chronic ABI. These findings suggest the memory recall of adults with a chronic ABI is associated with poor processing speed and poor acquisition of information. Therefore, cognitive rehabilitation that improves processing speed should be the focus for individuals with ABI to improve memory performance as well as impaired processing speed.
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Affiliation(s)
| | - Gerald T Voelbel
- Department of Occupational Therapy, New York University, New York, New York, USA
- Center of Health and Rehabilitation Research, New York University, New York, New York, USA
- Department of Rehabilitation Medicine, New York University Langone Health, New York, New York, USA
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LaCroix AN, Greene-Winek A, Simon S, Groth H, Ratiu I. A Verbal Card Sorting Task to Measure Executive Functions. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1698-1704. [PMID: 37276448 DOI: 10.1044/2023_ajslp-23-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE The Wisconsin Card Sorting Test (WCST) is commonly used to measure nonverbal executive functions (EFs) in a variety of clinical populations. However, in some clinical populations (e.g., people with aphasia), deficits may be present in more linguistic (or verbal) domains and less pronounced in nonverbal domains. Thus, when determining possible deficits in these individuals, it is critical to assess both verbal and nonverbal cognitive abilities. The purpose of this study was to create a verbal card sorting task (VCST) to complement the WCST. METHOD We created the VCST by modifying a computerized version of the WCST, the Berg Card Sorting Task (BCST). We then compared 35 individuals with mild traumatic brain injury (mTBI) and 33 matched controls' performance on each task. We tested the VCST in individuals with mTBI first because they demonstrate impaired EFs but unimpaired language. We therefore expected the mTBI group to perform similarly on the VCST and BCST, suggesting that the two tasks measure EFs similarly. RESULTS In line with our hypothesis, the mTBI group had unimpaired inhibition and sustained attention but impaired shifting on each task. Component loadings for both tasks were also similar, and participants' inhibition and shifting scores positively correlated across the two tasks. CONCLUSIONS Together, these findings suggest that the VCST is a potentially useful tool for measuring verbal EF deficits. Our results also provide important insights into the EF impairments experienced by individuals with mTBI. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23230475.
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Affiliation(s)
- Arianna N LaCroix
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | | | - Sandy Simon
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale
| | - Hannah Groth
- College of Health Sciences, Midwestern University, Glendale, AZ
| | - Ileana Ratiu
- College of Health Solutions, Arizona State University, Tempe
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Norman R, Flaugher T, Chang S, Power E. Self-Perception of Cognitive-Communication Functions After Mild Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:883-906. [PMID: 36645876 PMCID: PMC10166193 DOI: 10.1044/2022_ajslp-22-00101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/01/2022] [Accepted: 10/19/2022] [Indexed: 05/10/2023]
Abstract
PURPOSE A mixed-method approach was used to investigate the lived experiences of adults with mild traumatic brain injury (mTBI). The study aimed to understand the perceived relationship between cognitive-communication problems, thinking and communication concerns, and neurobehavioral symptoms. We hypothesized that individuals with cognitive-communication problems would attribute their problems with communication to their mTBI history and their self-perceived problems would be correlated with symptomatology. METHOD The Neurobehavioral Symptom Inventory (NSI) and an online cognitive-communication survey was used to conduct a study of 30 adults with mTBI history. Quantitative survey and NSI scores were analyzed with content analysis and correlational statistics. RESULTS The average NSI Total score was 17 with the following subscale scores: somatic (5), affective (8), and cognitive (3.9). Participants reported problems with expressive communication (56%), comprehension (80%), thinking (63%), and social skills (60%). Content analysis revealed problems in the following areas: expression (e.g., verbal, and written language), comprehension (reading and verbal comprehension), cognition (e.g., attention, memory and speed of processing, error regulation), and functional consequences (e.g., academic work, social problems, and anxiety and stress). A Pearson correlation indicated a statistically significant relationship (p < .01) between the Communication Survey Total and the Total, Somatic, Affective, and Cognitive subscales. CONCLUSIONS This study highlights a multifactorial basis of cognitive-communication impairment in adults with mTBI. We show that those with mTBI history perceive difficulties with cognitive-communication skills: conversations, writing, and short-term memory/attention. Furthermore, those with mTBI perceive their cognitive-communication problems after injury have impacted their vocational, social, and academic success.
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Affiliation(s)
- Rocio Norman
- Department of Communication Sciences and Disorders, University of Texas Health Science Center at San Antonio
| | - Tara Flaugher
- Department of Neuroscience, Developmental and Regenerative Biology, University of Texas at San Antonio
| | - Sharon Chang
- Department of Otolaryngology—Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Emma Power
- University of Technology Sydney, Speech Pathology, New South Wales, Australia
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O'Brien KH, Wallace T, Kemp AM, Pei Y. Cognitive-Communication Complaints and Referrals for Speech-Language Pathology Services Following Concussion. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:790-807. [PMID: 35041792 DOI: 10.1044/2021_ajslp-21-00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Speech-language pathologists are increasingly being recognized as key members of concussion management teams. This study investigates whether self-report of communication problems postconcussion may be useful in identifying clients who could benefit from speech-language pathology services. METHOD Participants included 41 adolescents and adults from an outpatient specialty concussion clinic. All completed the La Trobe Communication Questionnaire (LCQ) at admission, and 23 repeated this measure at discharge. Participants were prospectively enrolled, with chart reviews providing demographic, injury, and medical factors. The analysis considered (a) communication complaints and resolution over time, including comparison to two previously published LCQ studies of typical adults and adults with and without traumatic brain injury (TBI); (b) the relationship between communication complaints, participant factors, and common concussion assessments; and (c) factors related to speech-language pathology service referral for rehabilitation. RESULTS At first visit, 12 of 41 participants (29%) reported communication problems, although 19 (46%) reported difficulty with greater than half of LCQ items. At a group level, compared to published reference data of both people with chronic mixed severity TBI and controls, participants in this study reported more problems at first visit with communication overall, as well as greater difficulty with the LCQ Initiation/Conversation Flow subscale. Partner Sensitivity subscale scores at first visit were also greater than published control data. LCQ subscale scores of Initiation/Conversation Flow and Partner Sensitivity decreased from first visit to last visit, demonstrating resolution over time. Only concussion symptom scales and not demographic, injury, or cognitive screenings were related to LCQ scores. The same two LCQ subscales, Initiation/Conversation Flow and Partner Sensitivity, predicted referral for speech-language pathology services, along with symptom scales and being injured due to motor vehicle crash. DISCUSSION A subset of people recovering from concussion report experiencing communication problems. Reporting of particular communication problems was related to referral for speech-language pathology rehabilitation services and may be useful in directing care after concussion.
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Affiliation(s)
- Katy H O'Brien
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Tracey Wallace
- Complex Concussion Clinic, Shepherd Center, Atlanta, GA
- SHARE Military Initiative, Shepherd Center, Atlanta, GA
| | - Amy M Kemp
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Yalian Pei
- Department of Communication Sciences and Special Education, University of Georgia, Athens
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Ratiu I, Fissel-Brannick S, Whiting M, Murnion L, Azuma T. The impact of mild traumatic brain injury on reading comprehension and eye movements: preliminary results. JOURNAL OF COMMUNICATION DISORDERS 2022; 96:106197. [PMID: 35151226 DOI: 10.1016/j.jcomdis.2022.106197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 12/21/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Individuals who sustain a mild traumatic brain injury (mTBI) can suffer from executive function, working memory, and attention deficits, which can impact functional task performance, including reading comprehension. Individuals with mTBI commonly report reading difficulties, but such difficulties have been historically difficult to capture using behavioral measures. The current study examined reading performance in those with and without mTBI using eye-tracking measures, which may be more sensitive to reading impairment in mTBI. METHOD/RESULTS In Experiment 1, 26 participants with a history of mTBI and 26 healthy control participants completed working memory (WM) and reading comprehension tasks. We found no differences in behavioral measures but found that spontaneous eye-blinking frequency was lower during the reading task in the mTBI group. In Experiment 2, we explored the impact of auditory distraction (e.g., multi-talker babble) on reading and memory performance. Twenty-three new participants with a history of mTBI and 26 healthy control participants completed a short-term memory (STM) task, a WM task, and a reading comprehension task under two distraction conditions. As in Experiment 1, we found no differences on behavioral measures, but observed significant differences on spontaneous eye-blinking frequency between those with and without mTBI. Group differences in distraction effects were also observed and performance on the WM task predicted reading comprehension performance. CONCLUSIONS The lack of differences on behavioral measures between groups, but lower frequencies of spontaneous eye blinking in the mTBI group suggests that while these individuals successfully completed the reading comprehension task, they may require more cognitive resources to do so.
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Affiliation(s)
- Ileana Ratiu
- Midwestern University, USA; Arizona State University, USA.
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Norman RS, Mueller KD, Huerta P, Shah MN, Turkstra LS, Power E. Discourse Performance in Adults With Mild Traumatic Brain Injury, Orthopedic Injuries, and Moderate to Severe Traumatic Brain Injury, and Healthy Controls. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:67-83. [PMID: 34694868 PMCID: PMC9135020 DOI: 10.1044/2021_ajslp-20-00299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/22/2021] [Accepted: 04/19/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Adults with mild traumatic brain injury (mTBI) are at risk for communication disorders, yet studies exploring cognitive-communication performance are currently lacking. AIMS This aim of this study was to characterize discourse-level performance by adults with mTBI on a standardized elicitation task and compare it to (a) healthy adults, (b) adults with orthopedic injuries (OIs), and (c) adults with moderate to severe TBI. METHOD This study used a cross-sectional design. The participants included mTBI and OI groups recruited prospectively from an emergency medicine department. Moderate to severe TBI and healthy data were acquired from TalkBank. One-way analyses of variance were used to compare mean linguistic scores. RESULTS Seventy participants across all groups were recruited. Groups did not differ on demographic variables. The study found significant differences in both content and productivity measures among the groups. Variables did not appear sensitive to differentiate between mTBI and OI groups. DISCUSSION Cognitive and language performance of adults with mTBI is a pressing clinical issue. Studies exploring language with carefully selected control groups can influence the development of sensitive measures to identify individuals with cognitive-communication deficits.
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Affiliation(s)
- Rocío S. Norman
- Department of Communication Sciences and Disorders, The University of Texas Health Science Center at San Antonio
| | - Kimberly D. Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | - Paola Huerta
- Department of Communication Sciences and Disorders, The University of Texas Health Science Center at San Antonio
| | - Manish N. Shah
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin–Madison
| | - Lyn S. Turkstra
- Speech-Language Pathology Program, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Emma Power
- Speech Pathology, Graduate School of Health, University of Technology Sydney, New South Wales, Australia
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LeBlanc J, Seresova A, Laberge-Poirier A, Tabet S, Alturki AY, Feyz M, de Guise E. Cognitive-communication performance following mild traumatic brain injury: Influence of sex, age, education, site of lesion and bilingualism. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:130-144. [PMID: 33368845 DOI: 10.1111/1460-6984.12589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/19/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although previous research studies have defined several prognostic factors that affect cognitive-communication performance in patients with all traumatic brain injury (TBI) severity, little is known about what variables are associated with cognitive-communication impairment in complicated mild TBI (mTBI) specifically. AIMS To determine which demographic and trauma-related factors are associated with cognitive-communication performance in the early recovery phase of acute care following a complicated mTBI. METHODS & PROCEDURES Demographic and accident-related data as well as the scores on cognitive-communication skill measures in the areas of auditory comprehension (complex ideational material subtest of the Boston Diagnostic Aphasia Examination), verbal reasoning (verbal absurdities subtest of the Detroit Test of Learning Aptitude), confrontation naming (short form of the Boston Naming Test), verbal fluency (semantic category and letter category naming), and conversational discourse (conversational checklist of the Protocole Montréal d'évaluation de la communication) were retrospectively collected from the medical records of 128 patients with complicated mTBI admitted to a tertiary care trauma hospital. Multiple linear regressions analyses were carried out on the variables sex, age, education level, Glasgow Coma Scale (GCS) score, lesion site and bilingualism. OUTCOMES & RESULTS Females performed better than males on letter-category naming, while those more advanced in age performed worse on most cognitive-communication measures. Patients with higher education achieved better confrontation and letter-category naming, whereas reading comprehension results were worse with a lower GCS score. Bilingual individuals presented more difficulty in conversational discourse skills than those who spoke only one language. In terms of site of lesion, the presence of a right frontal injury was associated with worse auditory and reading comprehension and an occipital lesion was related to worse confrontation naming. CONCLUSIONS & IMPLICATIONS Cognitive-communication skills should be evaluated early in all patients with complicated mTBI, but especially in those who are advanced in age, those with fewer years of education and those who present with lower GCS scores, in order to determine rehabilitation needs. The findings of this study will allow acute care clinicians to better understand how various demographic and injury-related factors affect cognitive-communication skills after complicated mTBI and to better nuance the interpretation of their evaluation results in order to improve clinical care. Further study is required regarding the influence of lesion location, sex and bilingualism following complicated mTBI. What this paper adds What is already known on the subject In early acute recovery studies including all severity of TBI, cognitive-communication performance was poorer in individuals with more advanced age, those with fewer years of education and with more severe TBI. It is not yet known which demographic and injury-related variables predict cognitive-communication performance after a complicated mTBI specifically. What this paper adds to existing knowledge We confirmed that age, level of education and TBI severity, as measured with the GCS score, were associated with some areas of cognitive-communication performance for a group of patients in the acute stage of recovery from a complicated mTBI. We also identified that sex, bilingualism and site of lesion were new variables that show an influence on aspects of cognitive-communication skills in this group of patients. What are the potential or actual clinical implications of this work? The findings of this study on prognostic factors in the case of complicated mTBI will help acute care clinicians to better understand evaluation results knowing the variables that can influence cognitive-communication performance and to nuance the interpretation of these results with the goal of determining rehabilitation needs and enhancing clinical care.
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Affiliation(s)
- Joanne LeBlanc
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, QC, Canada
| | - Alena Seresova
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, QC, Canada
| | | | - Sabrina Tabet
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Abdulrahman Y Alturki
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Adult Neurosurgery Department, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, QC, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, QC, Canada
- Research Institute, McGill University Health Center, Montreal, QC, Canada
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