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Kim N, Watson W, Caliendo E, Nowak S, Schiff ND, Shah SA, Hill NJ. Objective Neurophysiologic Markers of Cognition After Pediatric Brain Injury. Neurol Clin Pract 2022; 12:352-364. [PMID: 36380885 PMCID: PMC9647802 DOI: 10.1212/cpj.0000000000200066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 06/22/2022] [Indexed: 01/27/2023]
Abstract
Background and Objectives Following brain injury, clinical assessments of residual and emerging cognitive function are difficult and fraught with errors. In adults, recent American Academy of Neurology (AAN) practice guidelines recommend objective neuroimaging and neurophysiologic measures to support diagnosis. Equivalent measures are lacking in pediatrics-an especially great challenge due to the combined heterogeneity of both brain injury and pediatric development. Therefore, we aim to establish quantitative, clinically practicable measures of cognitive function following pediatric brain injury. Methods Participants with and without brain injury were aged 8-18 years, clinically classified according to cognitive recovery state: N = 8 in disorders of consciousness (DoC), N = 7 in confusional state, N = 19 cognitively impaired, and N = 13 typically developing uninjured controls. We prospectively measured electroencephalographic markers of sensory processing and attention in an auditory oddball paradigm, and of covert movement attempts in a command-following paradigm. Results In 3 participants with DoC, EEG markers of active attempted command following revealed cognitive function that clinical assessment had failed to detect. These same 3 individuals could also be distinguished from the rest of their group by 2 event-related potentials that correlate with sensory processing and orienting attention in the oddball paradigm. Considered across the whole participant group, magnitudes of these 2 ERP markers significantly increased as cognitive recovery progressed (ANOVA: each p < 0.001); viewed jointly, the 2 ERP markers cleanly delineated the 4 cognitive states. Discussion Despite heterogeneity of brain injuries and brain development, our objective EEG markers reflected cognitive recovery independent of motor function. Two of these markers required no active participation. Together, they allowed us to identify 3 individuals who meet the criteria for cognitive-motor dissociation. To diagnose, prognose, and track cognitive recovery accurately, such markers should be used in pediatrics.
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Affiliation(s)
- Nayoung Kim
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - William Watson
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Eric Caliendo
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Sophie Nowak
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Nicholas D Schiff
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Sudhin A Shah
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - N Jeremy Hill
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
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2
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Motanis H, Khorasani LN, Giza CC, Harris NG. Peering into the Brain through the Retrosplenial Cortex to Assess Cognitive Function of the Injured Brain. Neurotrauma Rep 2021; 2:564-580. [PMID: 34901949 PMCID: PMC8655812 DOI: 10.1089/neur.2021.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The retrosplenial cortex (RSC) is a posterior cortical area that has been drawing increasing interest in recent years, with a growing number of studies studying its contribution to cognitive and sensory functions. From an anatomical perspective, it has been established that the RSC is extensively and often reciprocally connected with the hippocampus, neocortex, and many midbrain regions. Functionally, the RSC is an important hub of the default-mode network. This endowment, with vast anatomical and functional connections, positions the RSC to play an important role in episodic memory, spatial and contextual learning, sensory-cognitive activities, and multi-modal sensory information processing and integration. Additionally, RSC dysfunction has been reported in cases of cognitive decline, particularly in Alzheimer's disease and stroke. We review the literature to examine whether the RSC can act as a cortical marker of persistent cognitive dysfunction after traumatic brain injury (TBI). Because the RSC is easily accessible at the brain's surface using in vivo techniques, we argue that studying RSC network activity post-TBI can shed light into the mechanisms of less-accessible brain regions, such as the hippocampus. There is a fundamental gap in the TBI field about the microscale alterations occurring post-trauma, and by studying the RSC's neuronal activity at the cellular level we will be able to design better therapeutic tools. Understanding how neuronal activity and interactions produce normal and abnormal activity in the injured brain is crucial to understanding cognitive dysfunction. By using this approach, we expect to gain valuable insights to better understand brain disorders like TBI.
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Affiliation(s)
- Helen Motanis
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Laila N. Khorasani
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Christopher C. Giza
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Neil G. Harris
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- Intellectual Development and Disabilities Research Center, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- *Address correspondence to: Neil G. Harris, PhD, Department of Neurosurgery, University of California at Los Angeles, Wasserman Building, 300 Stein Plaza, Room 551, Los Angeles, CA 90095, USA;
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3
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Romeas T, Greffou S, Allard R, Forget R, McKerral M, Faubert J, Gagnon I. Dynamic Visual Stimulations Produced in a Controlled Virtual Reality Environment Reveals Long-Lasting Postural Deficits in Children With Mild Traumatic Brain Injury. Front Neurol 2021; 12:596615. [PMID: 34899549 PMCID: PMC8654728 DOI: 10.3389/fneur.2021.596615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/27/2021] [Indexed: 11/27/2022] Open
Abstract
Motor control deficits outlasting self-reported symptoms are often reported following mild traumatic brain injury (mTBI). The exact duration and nature of these deficits remains unknown. The current study aimed to compare postural responses to static or dynamic virtual visual inputs and during standard clinical tests of balance in 38 children between 9 and 18 years-of-age, at 2 weeks, 3 and 12 months post-concussion. Body sway amplitude (BSA) and postural instability (vRMS) were measured in a 3D virtual reality (VR) tunnel (i.e., optic flow) moving in the antero-posterior direction in different conditions. Measures derived from standard clinical balance evaluations (BOT-2, Timed tasks) and post-concussion symptoms (PCSS-R) were also assessed. Results were compared to those of 38 healthy non-injured children following a similar testing schedule and matched according to age, gender, and premorbid level of physical activity. Results highlighted greater postural response with BSA and vRMS measures at 3 months post-mTBI, but not at 12 months when compared to controls, whereas no differences were observed in post-concussion symptoms between mTBI and controls at 3 and 12 months. These deficits were specifically identified using measures of postural response in reaction to 3D dynamic visual inputs in the VR paradigm, while items from the BOT-2 and the 3 timed tasks did not reveal deficits at any of the test sessions. PCSS-R scores correlated between sessions and with the most challenging condition of the BOT-2 and as well as with the timed tasks, but not with BSA and vRMS. Scores obtained in the most challenging conditions of clinical balance tests also correlated weakly with BSA and vRMS measures in the dynamic conditions. These preliminary findings suggest that using 3D dynamic visual inputs such as optic flow in a controlled VR environment could help detect subtle postural impairments and inspire the development of clinical tools to guide rehabilitation and return to play recommendations.
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Affiliation(s)
- Thomas Romeas
- Faubert Laboratory, École d'Optométrie, Université de Montréal, Montréal, QC, Canada.,Institut National du Sport du Québec, Montréal, QC, Canada
| | - Selma Greffou
- Faubert Laboratory, École d'Optométrie, Université de Montréal, Montréal, QC, Canada
| | - Remy Allard
- Faubert Laboratory, École d'Optométrie, Université de Montréal, Montréal, QC, Canada
| | - Robert Forget
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal - IURDPM, Montréal, QC, Canada
| | - Michelle McKerral
- Department of Psychology, Université de Montréal and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal - IURDPM, Montréal, QC, Canada
| | - Jocelyn Faubert
- Faubert Laboratory, École d'Optométrie, Université de Montréal, Montréal, QC, Canada
| | - Isabelle Gagnon
- Montreal Children's Hospital, McGill University Health Center, McGill University, Montréal, QC, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
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4
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Quantitative multimodal imaging in traumatic brain injuries producing impaired cognition. Curr Opin Neurol 2021; 33:691-698. [PMID: 33027143 DOI: 10.1097/wco.0000000000000872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Cognitive impairments are a devastating long-term consequence following traumatic brain injury (TBI). This review provides an update on the quantitative mutimodal neuroimaging studies that attempt to elucidate the mechanism(s) underlying cognitive impairments and their recovery following TBI. RECENT FINDINGS Recent studies have linked individual specific behavioural impairments and their changes over time to physiological activity and structural changes using EEG, PET and MRI. Multimodal studies that combine measures of physiological activity with knowledge of neuroanatomical and connectivity damage have also illuminated the multifactorial function-structure relationships that underlie impairment and recovery following TBI. SUMMARY The combined use of multiple neuroimaging modalities, with focus on individual longitudinal studies, has the potential to accurately classify impairments, enhance sensitivity of prognoses, inform targets for interventions and precisely track spontaneous and intervention-driven recovery.
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Hershaw J, Hill-Pearson CA, Arango JI, Souvignier AR, Pazdan RM. Changes in attentional processing following neurofeedback in patients with persistent post-concussive symptoms: a pilot study. Brain Inj 2020; 34:1723-1731. [PMID: 33196305 DOI: 10.1080/02699052.2020.1812720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Persistent post-concussive symptoms (PPCS) often include attention deficits, particularly orienting and executive attention. Research in other clinical populations has demonstrated that neurofeedback therapy (NFT) is effective at improving orienting and executive attention, although its effects on attentional networks in patients with PPCS are unknown. METHOD In this single-group pilot study, we examined attention-related event-related potentials (ERPs) - N1 and P3 - and cognitive outcomes following Live Z-score training (LZT), a variant of NFT. RESULTS No changes in early selective attention, as indexed by N1 amplitude, were observed; however, P3 amplitude, which indexes neural resource allocation, increased following LZT and returned to baseline by 3 months. Cognitive performance improved following treatment, which was sustained at 3 months. The magnitude of change in P3 and ANT performance did not differ between orienting or executive attention, suggesting LZT improved general attentional processing efficiency. CONCLUSION Our results suggest that LZT may positively affect attention globally, but does not target specific attention networks. These pilot data warrant the initiation of a clinical trial evaluating the effectiveness of LZT for treating attention deficits in patients with PPCS.
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Affiliation(s)
- Jamie Hershaw
- Defense and Veterans Brain Injury Center , Fort Carson, CO, USA.,General Dynamics Information Technology , Falls Church, VA, USA
| | - Candace A Hill-Pearson
- Defense and Veterans Brain Injury Center , Fort Carson, CO, USA.,General Dynamics Information Technology , Falls Church, VA, USA
| | - Jorge I Arango
- Defense and Veterans Brain Injury Center , Fort Carson, CO, USA.,General Dynamics Information Technology , Falls Church, VA, USA
| | - Alicia R Souvignier
- Defense and Veterans Brain Injury Center , Fort Carson, CO, USA.,Warrior Recovery Center, Evans Army Community Hospital , Fort Carson, CO, USA
| | - Renee M Pazdan
- Defense and Veterans Brain Injury Center , Fort Carson, CO, USA.,Warrior Recovery Center, Evans Army Community Hospital , Fort Carson, CO, USA
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Piantella S, McDonald SJ, Maruff P, Wright BJ. Assessing the Long-Term Impact of Concussion upon Cognition: A 5-Year Prospective Investigation. Arch Clin Neuropsychol 2020; 35:482-490. [PMID: 32161939 DOI: 10.1093/arclin/acaa012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Jockeys have high rates of concussion, with 5% of jockeys receiving at least one concussion annually. The impact of acute concussion upon cognition is well understood, but less is known about the long-term effects of concussion upon cognition. Our aim was to assess the impact of concussion upon jockeys who had provided pre-concussion assessments of cognition using a prospective design. METHOD In this study, over a 5-year period, we assessed the cognitive performance of jockeys with ≥1 medically diagnosed concussion (MDC; n = 17, months since concussion, M = 29.18), against those who had not been concussed (NC; n = 41). Jockeys who had not been concussed in the preceding 6 months completed four computer-based cognitive assessments from the CogSport battery. RESULTS Unlike the majority of the small existing literature, there was no difference (p ≥ .05) between the MDC and NC groups after controlling for age and baseline performance. Additionally, we used a measure of reliable change to assess for clinically meaningful decrements from baseline in each test and composite score 5 years later. None of the jockeys in the MDC group recorded significant decrements on any CogSport measure from baseline (z > -1.65). CONCLUSIONS The findings suggest that the presence of concussion does not result in persistent decrements in cognitive performance and that when findings are considered collectively, assessing factors beyond medically diagnosed concussion (e.g., chronic stress, undiagnosed concussion) may improve the interpretation of our current findings.
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Affiliation(s)
- Stefan Piantella
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | - Stuart J McDonald
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Paul Maruff
- The Florey Institute, The University of Melbourne, Parkville, VIC, Australia
| | - Bradley J Wright
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
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7
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Electrophysiological Markers of Visuospatial Attention Recovery after Mild Traumatic Brain Injury. Brain Sci 2019; 9:brainsci9120343. [PMID: 31783501 PMCID: PMC6956036 DOI: 10.3390/brainsci9120343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 11/17/2022] Open
Abstract
Objective: Attentional problems are amongst the most commonly reported complaints following mild traumatic brain injury (mTBI), including difficulties orienting and disengaging attention, sustaining it over time, and dividing attentional resources across multiple simultaneous demands. The objective of this study was to track, using a single novel electrophysiological task, various components associated with the deployment of visuospatial selective attention. Methods: A paradigm was designed to evoke earlier visual evoked potentials (VEPs), as well as attention-related and visuocognitive ERPs. Data from 36 individuals with mTBI (19 subacute, 17 chronic) and 22 uninjured controls are presented. Postconcussion symptoms (PCS), anxiety (BAI), depression (BDI-II) and visual attention (TEA Map Search, DKEFS Trail Making Test) were also assessed. Results: Earlier VEPs (P1, N1), as well as processes related to visuospatial orientation (N2pc) and encoding in visual short-term memory (SPCN), appear comparable in mTBI and control participants. However, there appears to be a disruption in the spatiotemporal dynamics of attention (N2pc-Ptc, P2) in subacute mTBI, which recovers within six months. This is also reflected in altered neuropsychological performance (information processing speed, attentional shifting). Furthermore, orientation of attention (P3a) and working memory processes (P3b) are also affected and remain as such in the chronic post-mTBI period, in co-occurrence with persisting postconcussion symptomatology. Conclusions: This study adds original findings indicating that such a sensitive and rigorous ERP task implemented at diagnostic and follow-up levels could allow for the identification of subtle but complex brain activation and connectivity deficits that can occur following mTBI.
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8
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Shen IH, Lin YJ, Chen CL, Liao CC. Neural Correlates of Response Inhibition and Error Processing in Individuals with Mild Traumatic Brain Injury: An Event-Related Potential Study. J Neurotrauma 2019; 37:115-124. [PMID: 31317830 DOI: 10.1089/neu.2018.6122] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Individuals with a mild traumatic brain injury (mTBI) often have executive control deficits; however, the underlying neural mechanisms of such deficits are yet to be clarified. Inhibitory control and cognitive monitoring are two fundamental aspects of executive control processes. This study investigated the executive control of mTBI by using the Stop-signal task. Eighteen adults with mTBI and 18 age-, sex-, and education level-matched controls were recruited. Behavioral performance and event-related potential correlates of response inhibition and error processing were compared between groups. The mTBI group tended to have a lower probability of inhibition and a longer stop signal reaction time. N1 amplitude was greater on successful trials. Also on successful trials, N2 and P3 peaked earlier than on failed trials. The N2 amplitude of the mTBI group tended to be smaller than that of the controls. The control group had larger P3 amplitude on successful trials than on failed trials, whereas the mTBI group exhibited no P3 amplitudes difference between the two trial types. In addition, the mTBI group showed significantly longer error positivity latency than did the controls. These results suggest that inhibitory control and error processing were inefficient in the mTB group even more than three months after injury. Electrophysiological markers of cognitive dysfunction can be used as a sensitive tool for determining executive control after mTBI.
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Affiliation(s)
- I-Hsuan Shen
- Department of Occupational Therapy, Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan
| | - Ying-Ju Lin
- Department of Occupational Therapy, Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Northern Service Center, Sunshine Social Welfare Foundation, Taipei, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan.,Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Chih Liao
- Department of Neurosurgery, Division of Neurospine, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan.,Department of Neurospinal Surgery, Mennonite Christian Hospital, Hualien, Taiwan
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9
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Alnawmasi MM, Chakraborty A, Dalton K, Quaid P, Dunkley BT, Thompson B. The effect of mild traumatic brain injury on the visual processing of global form and motion. Brain Inj 2019; 33:1354-1363. [PMID: 31317788 DOI: 10.1080/02699052.2019.1641842] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Cortical visual processing involves the ventral stream (form perception) and the dorsal stream (motion perception). We assessed whether mild traumatic brain injury (TBI) differentially affects these two streams. Eleven adults with mild TBI (28 ± 9 yrs, 17 ± 5 months post injury) and 25 controls (25 ± 5 yrs) participated. Participants completed tests of global processing involving Glass patterns (form) and random dot kinematograms (motion), measurement of contrast thresholds for motion direction discrimination, a comprehensive vision screening and the Post-Concussion Symptom Inventory (PCSI). Our results showed that the mild TBI group had significantly higher (worse) global form (mean ± SD: TBI 25 ± 6%, control 21 ± 5%) and motion (TBI 14 ± 7%, control 11 ± 3%) coherence thresholds than controls. The magnitude of the mild TBI group deficit did not differ between the two tasks. Contrast thresholds for motion direction discrimination did not differ between the groups, but were positively correlated with PCSI score (r2 = 0.51. p = 0.01) in the mild TBI group. The mild TBI group had worse outcomes than controls for all clinical measurements of vision except distance visual acuity. In conclusion, mild TBI affects processing in both the dorsal and ventral cortical processing streams equally. In addition, spatiotemporal contrast sensitivity may be related to the symptoms of mild TBI.
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Affiliation(s)
- Mohammed M Alnawmasi
- a School of Optometry and Vision Science, University of Waterloo , Waterloo , Canada.,b College of Applied Medical Sciences, Department of Optometry, Qassim University , Buraidah , Saudi Arabia
| | - Arijit Chakraborty
- a School of Optometry and Vision Science, University of Waterloo , Waterloo , Canada
| | - Kristine Dalton
- a School of Optometry and Vision Science, University of Waterloo , Waterloo , Canada
| | - Patrick Quaid
- a School of Optometry and Vision Science, University of Waterloo , Waterloo , Canada.,c VUE Cubed Vision Rehabilitation Clinics, The Guelph Vision Therapy Centre , Guelph , ON , Canada
| | - Benjamin T Dunkley
- a School of Optometry and Vision Science, University of Waterloo , Waterloo , Canada.,d Diagnostic Imaging, Hospital for Sick Children; Neurosciences & Mental Health, Hospital for Sick Children Research Institute; Medical Imaging, University of Toronto , Toronto , Canada
| | - Benjamin Thompson
- a School of Optometry and Vision Science, University of Waterloo , Waterloo , Canada
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Drapeau J, Gosselin N, Peretz I, McKerral M. Electrophysiological Responses to Emotional Facial Expressions Following a Mild Traumatic Brain Injury. Brain Sci 2019; 9:E142. [PMID: 31216634 PMCID: PMC6627801 DOI: 10.3390/brainsci9060142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to measure neural information processing underlying emotional recognition from facial expressions in adults having sustained a mild traumatic brain injury (mTBI) as compared to healthy individuals. We thus measured early (N1, N170) and later (N2) event-related potential (ERP) components during presentation of fearful, neutral, and happy facial expressions in 10 adults with mTBI and 11 control participants. Findings indicated significant differences between groups, irrespective of emotional expression, in the early attentional stage (N1), which was altered in mTBI. The two groups showed similar perceptual integration of facial features (N170), with greater amplitude for fearful facial expressions in the right hemisphere. At a higher-level emotional discrimination stage (N2), both groups demonstrated preferential processing for fear as compared to happiness and neutrality. These findings suggest a reduced early selective attentional processing following mTBI, but no impact on the perceptual and higher-level cognitive processes stages. This study contributes to further improving our comprehension of attentional versus emotional recognition following a mild TBI.
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Affiliation(s)
- Joanie Drapeau
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Nathalie Gosselin
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Isabelle Peretz
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Michelle McKerral
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
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Papathanasiou ES, Cronin T, Seemungal B, Sandhu J. Electrophysiological testing in concussion: A guide to clinical applications. JOURNAL OF CONCUSSION 2018. [DOI: 10.1177/2059700218812634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The diagnosis of mild traumatic brain injury in concussion is difficult since it is often unwitnessed, the patient’s recall is unreliable and initial clinical examination is often unrevealing, correlating poorly with the extent of brain injury. At present, there are no objective biomarkers of mild traumatic brain injury in concussion. Thus, a sensitive gold standard test is required to enable the effective and safe triage of patients who present to the acute services. As well as triage, objective monitoring of patients’ recovery over time and separate from clinical features that patients may develop following the injury (e.g. depression and migraine) is also needed. In contrast to neuroimaging, which is widely used to investigate traumatic brain injury patients, electrophysiology is readily available, is cheap and there are internationally recognized standardised methodologies. Herein, we review the existing literature on electrophysiological testing in concussion and mild traumatic brain injury; specifically, electroencephalogram, polysomnography, brainstem auditory evoked potentials, electro- and videonystagmography, vestibular evoked myogenic potentials, visually evoked potentials, somatosensory evoked potentials and transcranial magnetic stimulation.
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Affiliation(s)
- Eleftherios S Papathanasiou
- Clinical Neurophysiology Laboratory, Clinic B, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Thomas Cronin
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Barry Seemungal
- Division of Brain Sciences, St Mary’s and Charing Cross Hospitals, Imperial College London, London, UK
| | - Jaswinder Sandhu
- Sheffield Institute of Translational Neuroscience, University of Sheffield, Sheffield, UK
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12
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Armstrong RA. Visual problems associated with traumatic brain injury. Clin Exp Optom 2018; 101:716-726. [PMID: 29488253 DOI: 10.1111/cxo.12670] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/12/2018] [Accepted: 01/17/2018] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) and its associated concussion are major causes of disability and death. All ages can be affected but children, young adults and the elderly are particularly susceptible. A decline in mortality has resulted in many more individuals living with a disability caused by TBI including those affecting vision. This review describes: (1) the major clinical and pathological features of TBI; (2) the visual signs and symptoms associated with the disorder; and (3) discusses the assessment of quality of life and visual rehabilitation of the patient. Defects in primary vision such as visual acuity and visual fields, eye movement including vergence, saccadic and smooth pursuit movements, and in more complex aspects of vision involving visual perception, motion vision ('akinopsia'), and visuo-spatial function have all been reported in TBI. Eye movement dysfunction may be an early sign of TBI. Hence, TBI can result in a variety of visual problems, many patients exhibiting multiple visual defects in combination with a decline in overall health. Patients with chronic dysfunction following TBI may require occupational, vestibular, cognitive and other forms of physical therapy. Such patients may also benefit from visual rehabilitation, including reading-related oculomotor training and the prescribing of spectacles with a variety of tints and prism combinations.
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Petley L, Bardouille T, Chiasson D, Froese P, Patterson S, Newman A, Omisade A, Beyea S. Attentional dysfunction and recovery in concussion: effects on the P300m and contingent magnetic variation. Brain Inj 2018; 32:464-473. [DOI: 10.1080/02699052.2018.1429022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Lauren Petley
- Biomedical Translational Imaging Centre (BIOTIC), IWK Health Centre, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Tim Bardouille
- Biomedical Translational Imaging Centre (BIOTIC), IWK Health Centre, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Darrell Chiasson
- Nova Scotia Health Authority, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Patrick Froese
- Nova Scotia Health Authority, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | | | - Aaron Newman
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Antonina Omisade
- Nova Scotia Health Authority, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Steven Beyea
- Biomedical Translational Imaging Centre (BIOTIC), IWK Health Centre, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
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14
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Shah-Basak PP, Urbain C, Wong S, da Costa L, Pang EW, Dunkley BT, Taylor MJ. Concussion Alters the Functional Brain Processes of Visual Attention and Working Memory. J Neurotrauma 2017; 35:267-277. [PMID: 29020848 DOI: 10.1089/neu.2017.5117] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Millions of North Americans sustain a concussion or a mild traumatic brain injury annually, and are at risk of cognitive, emotional, and physical sequelae. Although functional MRI (fMRI) studies have provided an initial framework for examining functional deficits induced by concussion, particularly working memory and attention, the temporal dynamics underlying these deficits are not well understood. We used magnetoencephalography (MEG), a modality with millisecond temporal resolution, in conjunction with a 1-back visual working memory (VWM) paradigm using scenes from everyday life to characterize spatiotemporal functional differences at specific VWM stages, in adults had had or had not had a recent concussion. MEG source-level differences between groups were determined by whole-brain analyses during encoding and recognition phases. Despite comparable behavioral performance, abnormal hypo- and hyperactivation patterns were found in brain areas involving frontoparietal, ventral occipitotemporal, temporal, and subcortical areas in concussed patients. These patterns and their timing varied as a function of VWM stagewise processing, linked to early attentional control, visuoperceptual scene processing, and VWM maintenance and retrieval processes. Parietal hypoactivation, starting at 60 ms during encoding, was correlated with symptom severity, possibly linked to impaired top-down attentional processing. Hyperactivation in the scene-selective occipitotemporal areas, the medial temporal complex, specifically the right hippocampus and orbitofrontal areas during encoding and/or recognition, lead us to posit inefficient but compensatory visuoperceptual, relational, and retrieval processing. Although injuries sustained after the concussion were considered "mild," these data suggest that they can have prolonged effects on early attentional and VWM processes.
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Affiliation(s)
- Priyanka P Shah-Basak
- 1 Diagnostic Imaging, The Hospital for Sick Children , Toronto, Ontario, Canada
- 2 Rotman Research Institute , Baycrest Centre, Toronto, Ontario, Canada
| | - Charline Urbain
- 1 Diagnostic Imaging, The Hospital for Sick Children , Toronto, Ontario, Canada
- 3 Laboratoire de Cartographie Fonctionnelle du Cerveau, Erasme Hospital , ULB Bruxelles, Belgium
| | - Simeon Wong
- 1 Diagnostic Imaging, The Hospital for Sick Children , Toronto, Ontario, Canada
| | - Leodante da Costa
- 4 Department of Surgery, Division of Neurosurgery, Sunnybrook Hospital, University of Toronto , Toronto, Ontario, Canada
| | - Elizabeth W Pang
- 5 Division of Neurology, The Hospital for Sick Children , Toronto, Ontario, Canada
- 6 Program in Neuroscience and Mental Health, SickKids Research Institute , Toronto, Ontario, Canada
| | - Benjamin T Dunkley
- 1 Diagnostic Imaging, The Hospital for Sick Children , Toronto, Ontario, Canada
- 6 Program in Neuroscience and Mental Health, SickKids Research Institute , Toronto, Ontario, Canada
- 7 Department of Medical Imaging, Sunnybrook Hospital, University of Toronto , Toronto, Ontario, Canada
| | - Margot J Taylor
- 1 Diagnostic Imaging, The Hospital for Sick Children , Toronto, Ontario, Canada
- 7 Department of Medical Imaging, Sunnybrook Hospital, University of Toronto , Toronto, Ontario, Canada
- 8 Department of Psychology, Sunnybrook Hospital, University of Toronto , Toronto, Ontario, Canada
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15
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Sun H, Luo C, Chen X, Tao L. Assessment of cognitive dysfunction in traumatic brain injury patients: a review. Forensic Sci Res 2017; 2:174-179. [PMID: 30483638 PMCID: PMC6197081 DOI: 10.1080/20961790.2017.1390836] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the major causes of human mortality and morbidity in the world. Brain injury could affect the core of a person's being - their thinking, memory, personality and behaviour. Electrophysiological markers from the human electroencephalogram and brain imaging provide a rich source of data which helps to elucidate specific processing impairments in TBI patients. To assess the cognitive and social function in traumatic brain injury patients, this review will focus on some of methods for assessing the disabling cognitive and social function deficits induced by TBI. There are many new technologies available to address TBI and recognition related questions. Integration of the various techniques will help to facilitate our comprehending of TBI, cognitive function and social function, and improve treatment and rehabilitation.
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Affiliation(s)
- Huiyan Sun
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China.,Affiliated Hospital, Chifeng University, Inner Mongolia, China
| | - Chengliang Luo
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
| | - Xiping Chen
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
| | - Luyang Tao
- School of Biology & Basic Medical Science, Soochow University, Suzhou, China
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Heuer S, Ivanova MV, Hallowell B. More Than the Verbal Stimulus Matters: Visual Attention in Language Assessment for People With Aphasia Using Multiple-Choice Image Displays. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1348-1361. [PMID: 28520866 PMCID: PMC5755551 DOI: 10.1044/2017_jslhr-l-16-0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/02/2016] [Accepted: 01/11/2017] [Indexed: 05/27/2023]
Abstract
PURPOSE Language comprehension in people with aphasia (PWA) is frequently evaluated using multiple-choice displays: PWA are asked to choose the image that best corresponds to the verbal stimulus in a display. When a nontarget image is selected, comprehension failure is assumed. However, stimulus-driven factors unrelated to linguistic comprehension may influence performance. In this study we explore the influence of physical image characteristics of multiple-choice image displays on visual attention allocation by PWA. METHOD Eye fixations of 41 PWA were recorded while they viewed 40 multiple-choice image sets presented with and without verbal stimuli. Within each display, 3 images (majority images) were the same and 1 (singleton image) differed in terms of 1 image characteristic. The mean proportion of fixation duration (PFD) allocated across majority images was compared against the PFD allocated to singleton images. RESULTS PWA allocated significantly greater PFD to the singleton than to the majority images in both nonverbal and verbal conditions. Those with greater severity of comprehension deficits allocated greater PFD to nontarget singleton images in the verbal condition. CONCLUSION When using tasks that rely on multiple-choice displays and verbal stimuli, one cannot assume that verbal stimuli will override the effect of visual-stimulus characteristics.
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Affiliation(s)
- Sabine Heuer
- Department of Communication Sciences and Disorders, University of Wisconsin–Milwaukee
| | - Maria V. Ivanova
- National Research University Higher School of Economics, Moscow, Russia
| | - Brooke Hallowell
- School of Rehabilitation and Communication Sciences, Ohio University, Athens
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17
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Patel VC, Jurgens CWD, Krahe TE, Povlishock JT. Adaptive reorganization of retinogeniculate axon terminals in dorsal lateral geniculate nucleus following experimental mild traumatic brain injury. Exp Neurol 2016; 289:85-95. [PMID: 28038987 DOI: 10.1016/j.expneurol.2016.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/08/2016] [Accepted: 12/23/2016] [Indexed: 11/17/2022]
Abstract
The pathologic process in traumatic brain injury marked by delayed axonal loss, known as diffuse axonal injury (DAI), leads to partial deafferentation of neurons downstream of injured axons. This process is linked to persistent visual dysfunction following mild traumatic brain injury (mTBI), however, examination of deafferentation in humans is impossible with current technology. To investigate potential reorganization in the visual system following mTBI, we utilized the central fluid percussion injury (cFPI) mouse model of mTBI. We report that in the optic nerve of adult male C57BL/6J mice, axonal projections of retinal ganglion cells (RGCs) to their downstream thalamic target, dorsal lateral geniculate nucleus (dLGN), undergo DAI followed by scattered, widespread axon terminals loss within the dLGN at 4days post-injury. However, at 10days post-injury, significant reorganization of RGC axon terminals was found, suggestive of an adaptive neuroplastic response. While these changes persisted at 20days post-injury, the RGC axon terminal distribution did not recovery fully to sham-injury levels. Our studies also revealed that following DAI, the segregation of axon terminals from ipsilateral and contralateral eye projections remained consistent with normal adult mouse distribution. Lastly, our examination of the shell and core of dLGN suggested that different RGC subpopulations may vary in their susceptibility to injury or in their contribution to reorganization following injury. Collectively, these findings support the premise that subcortical axon terminal reorganization may contribute to recovery following mTBI, and that different neural phenotypes may vary in their contribution to this reorganization despite exposure to the same injury.
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Affiliation(s)
- Vishal C Patel
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, USA.
| | - Christopher W D Jurgens
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, USA.
| | - Thomas E Krahe
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, USA.
| | - John T Povlishock
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, USA.
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18
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Drapeau J, Gosselin N, Peretz I, McKerral M. Emotional recognition from dynamic facial, vocal and musical expressions following traumatic brain injury. Brain Inj 2016; 31:221-229. [DOI: 10.1080/02699052.2016.1208846] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Joanie Drapeau
- Centre de recherche interdisciplinaire en réadaptation (CRIR) – Centre de réadaptation Lucie-Bruneau (CRLB)
- Centre de recherche en neuropsychologie et cognition (CERNEC)
- Centre for Research on Brain, Language and Music (CRBLM) and International Laboratory for Brain, Music and Sound Research (BRAMS)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Nathalie Gosselin
- Centre de recherche en neuropsychologie et cognition (CERNEC)
- Centre for Research on Brain, Language and Music (CRBLM) and International Laboratory for Brain, Music and Sound Research (BRAMS)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Isabelle Peretz
- Centre for Research on Brain, Language and Music (CRBLM) and International Laboratory for Brain, Music and Sound Research (BRAMS)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Michelle McKerral
- Centre de recherche interdisciplinaire en réadaptation (CRIR) – Centre de réadaptation Lucie-Bruneau (CRLB)
- Centre de recherche en neuropsychologie et cognition (CERNEC)
- Département de psychologie, Université de Montréal, Montréal, Québec, Canada
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Fratantoni JM, DeLaRosa BL, Didehbani N, Hart J, Kraut MA. Electrophysiological Correlates of Word Retrieval in Traumatic Brain Injury. J Neurotrauma 2016; 34:1017-1021. [PMID: 27596052 PMCID: PMC5333558 DOI: 10.1089/neu.2016.4651] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Persons who have had a traumatic brain injury (TBI) often have word retrieval deficits; however, the underlying neural mechanisms of such deficits are yet to be clarified. Previous studies in normal subjects have shown that during a word retrieval task, there is a 750 msec event-related potential (ERP) divergence detected at the left fronto-temporal region when subjects evaluate word pairs that facilitate retrieval compared with responses elicited by word pairs that do not facilitate retrieval. In this study, we investigated the neurophysiological correlates of word retrieval networks in 19 retired professional athletes with TBI and 19 healthy control (HC) subjects. We recorded electroencephalography (EEG) in the participants during a semantic object retrieval task. In this task, participants indicated whether presented word pairs did (retrieval) or did not (non-retrieval) facilitate the retrieval of an object name. There were no significant differences in accuracy or reaction time between the two groups. The EEG showed a significant group by condition interaction over the left fronto-temporal region. The HC group mean amplitudes were significantly different between conditions, but the TBI group data did not show this difference, suggesting neurophysiological effects of injury. These findings provide evidence that ERP amplitudes may be used as a marker of disrupted semantic retrieval circuits in persons with TBI even when those persons perform normally.
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Affiliation(s)
- Julie M Fratantoni
- 1 Center for BrainHealth, The University of Texas at Dallas , Dallas, Texas
| | - Bambi L DeLaRosa
- 1 Center for BrainHealth, The University of Texas at Dallas , Dallas, Texas
| | - Nyaz Didehbani
- 1 Center for BrainHealth, The University of Texas at Dallas , Dallas, Texas.,2 Department of Psychiatry, The University of Texas Southwestern Medical Center , Dallas, Texas
| | - John Hart
- 1 Center for BrainHealth, The University of Texas at Dallas , Dallas, Texas.,3 Department of Neurology and Neurotherapeutics, The University of Texas Southwestern Medical Center , Dallas, Texas
| | - Michael A Kraut
- 4 Department of Radiology, The Johns Hopkins University School of Medicine , Baltimore, Maryland
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20
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First- and second-order contrast sensitivity functions reveal disrupted visual processing following mild traumatic brain injury. Vision Res 2016; 122:43-50. [DOI: 10.1016/j.visres.2016.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/16/2016] [Accepted: 03/18/2016] [Indexed: 11/17/2022]
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21
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Rosner MS, Feinberg DL, Doble JE, Rosner AJ. Treatment of vertical heterophoria ameliorates persistent post-concussive symptoms: A retrospective analysis utilizing a multi-faceted assessment battery. Brain Inj 2016; 30:311-7. [DOI: 10.3109/02699052.2015.1113564] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Bottari C, Gosselin N, Chen JK, Ptito A. The impact of symptomatic mild traumatic brain injury on complex everyday activities and the link with alterations in cerebral functioning: Exploratory case studies. Neuropsychol Rehabil 2015; 27:871-890. [DOI: 10.1080/09602011.2015.1110528] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Nadia Gosselin
- Montreal Sacred Heart Hospital Research Center, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Jen-Kai Chen
- Cognitive Neuroscience Unit, Montreal Neurological Institute, Montreal, Canada
- Department of Psychology, McGill University Health Centre, Montreal, Canada
| | - Alain Ptito
- Cognitive Neuroscience Unit, Montreal Neurological Institute, Montreal, Canada
- Department of Psychology, McGill University Health Centre, Montreal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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24
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Costa TL, Zaninotto ALC, Benute GG, De Lúcia MCS, Paiva WS, Wagemans J, Boggio PS. Perceptual organization deficits in traumatic brain injury patients. Neuropsychologia 2015; 78:142-52. [PMID: 26455804 DOI: 10.1016/j.neuropsychologia.2015.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/26/2015] [Accepted: 10/04/2015] [Indexed: 10/22/2022]
Abstract
Traumatic brain injury (TBI) is a prevalent condition and there is limited visual perception research with this population. Here, we investigated perceptual organization changes in a rather homogeneous sample of closed head TBI outpatients with diffuse axonal injury only and no other known comorbidities. Patients had normal or corrected visual acuity. Perceptual organization was measured with the Leuven Perceptual Organization Screening Test (L-POST), a coherent motion task (CM) and the Leuven Embedded Figures Test (L-EFT). These tests were chosen to screen for deficits in different aspects of perceptual organization (L-POST), to evaluate local and global processing (L-EFT) and grouping in a dynamic set of stimuli (CM). TBI patients were significantly impaired compared to controls in all measures for both response time and accuracy, except for CM thresholds and object recognition subtests. The TBI group was similarly affected in all aspects of the L-EFT. TBI was also similarly affected in all perceptual factors of the L-POST. No significant correlations were found between scores and time post-injury, except for CM thresholds (rs=-0.74), which might explain the lack of group-level differences. The only score significantly correlated to IQ was L-EFT response time (rs=-0.67). These findings demonstrate that perceptual organization is diffusely affected in TBI and this effect has no substantial correlations with IQ. As many of the neuropsychological tests used to measure different cognitive functions involve some level of visual discrimination and perceptual organization demands, these results must be taken into account in the general neuropsychological evaluation of TBI patients.
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Affiliation(s)
- Thiago L Costa
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Mackenzie Presbyterian University, São Paulo, Brazil; Division of Psychology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
| | - Ana Luiza C Zaninotto
- Division of Psychology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Gláucia G Benute
- Division of Psychology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Mara C S De Lúcia
- Division of Psychology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Wellingson S Paiva
- Division of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Johan Wagemans
- Department of Brain and Cognition, Laboratory of Experimental Psychology, University of Leuven, Belgium
| | - Paulo S Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Mackenzie Presbyterian University, São Paulo, Brazil
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Fimreite V, Ciuffreda KJ, Yadav NK. Effect of luminance on the visually-evoked potential in visually-normal individuals and in mTBI/concussion. Brain Inj 2015; 29:1199-1210. [PMID: 26083046 PMCID: PMC7197393 DOI: 10.3109/02699052.2015.1035329] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess quantitatively the effect of luminance on VEP amplitude and latency in visually-normals (VN) and patients with mild traumatic brain injury (mTBI). METHODS VN individuals (n = 20) and those with mTBI (n = 19) participated. Those with mTBI were assessed 1-10 years post-injury (mean = 4.97 years), with the exception of one subject. Pattern VEP testing was employed using the DIOPSYS™ NOVA-TR system, with a 74 cd m-2 baseline luminance. Luminance levels were reduced with five different neutral density (ND) filters (0.5, 1.0, 1.5, 2.0 and 2.5) and compared to the baseline response. All testing was performed under binocular-viewing conditions with full refractive correction in place. RESULTS In both groups, mean VEP amplitude reduced with decrease in luminance (p < 0.05). At each luminance level, the mean VEP amplitude was significantly lower in mTBI than in the VN population (p < 0.05). In both groups, the mean VEP latency increased progressively with reduction in luminance (p < 0.05), with it being significantly higher in mTBI than in the VN population (p < 0.05). CONCLUSIONS High luminance levels produced an optimal VEP response in both populations. VEP amplitude was robust, whereas latency progressively increased in both groups as luminance decreased. The latency increase with decreased luminance was significantly larger in those with mTBI, thus suggesting that latency can be used to differentiate reliably between VN individuals and those with mTBI.
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Affiliation(s)
- Vanessa Fimreite
- a Department of Biological and Vision Sciences , SUNY/State College of Optometry , New York , NY , USA
| | - Kenneth J Ciuffreda
- a Department of Biological and Vision Sciences , SUNY/State College of Optometry , New York , NY , USA
| | - Naveen K Yadav
- a Department of Biological and Vision Sciences , SUNY/State College of Optometry , New York , NY , USA
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Piponnier JC, Forget R, Gagnon I, McKerral M, Giguère JF, Faubert J. First- and Second-Order Stimuli Reaction Time Measures Are Highly Sensitive to Mild Traumatic Brain Injuries. J Neurotrauma 2015; 33:242-53. [PMID: 25950948 DOI: 10.1089/neu.2014.3832] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mild traumatic brain injury (mTBI) has subtle effects on several brain functions that can be difficult to assess and follow up. We investigated the impact of mTBI on the perception of sine-wave gratings defined by first- and second-order characteristics. Fifteen adults diagnosed with mTBI were assessed at 15 days, 3 months, and 12 months postinjury. Fifteen matched controls followed the same testing schedule. Reaction times (RTs) for flicker detection and motion direction discrimination were measured. Stimulus contrast of first- and second-order patterns was equated to control for visibility, and correct-response RT means, standard deviations (SDs), medians, and interquartile ranges (IQRs) were calculated. The level of symptoms was also evaluated to compare it to RT data. In general in mTBI, RTs were longer, and SDs as well as IQRs larger, than those of controls. In addition, mTBI participants' RTs to first-order stimuli were shorter than those to second-order stimuli, and SDs as well as IQRs larger for first- than for second-order stimuli in the motion condition. All these observations were made over the three sessions. The level of symptoms observed in mTBI was higher than that of control participants, and this difference did also persist up to 1 year after the brain injury, despite an improvement. The combination of RT measures with particular stimulus properties is a highly sensitive method for measuring mTBI-induced visuomotor anomalies and provides a fine probe of the underlying mechanisms when the brain is exposed to mild trauma.
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Affiliation(s)
- Jean-Claude Piponnier
- 1 Visual Psychophysics and Perception Laboratory, École d'Optométrie, Université de Montréal , Montréal, QC, Canada
| | - Robert Forget
- 2 École de réadaptation, Université de Montréal , and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, QC, Canada
| | - Isabelle Gagnon
- 3 Montreal Children's Hospital, McGill University Health Center, and School of Physical and Occupational Therapy, McGill University , Montreal, Montréal, QC, Canada
| | - Michelle McKerral
- 4 Centre de recherche interdisciplinaire en réadaptation-Centre de réadaptation Lucie-Bruneau, and Département de psychologie, Université de Montréal , Montréal, QC, Canada
| | - Jean-François Giguère
- 5 Department of Surgery, Sacré-Coeur Hospital affiliated with Université de Montréal , Montréal, QC, Canada
| | - Jocelyn Faubert
- 1 Visual Psychophysics and Perception Laboratory, École d'Optométrie, Université de Montréal , Montréal, QC, Canada
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27
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Rapp PE, Keyser DO, Albano A, Hernandez R, Gibson DB, Zambon RA, Hairston WD, Hughes JD, Krystal A, Nichols AS. Traumatic brain injury detection using electrophysiological methods. Front Hum Neurosci 2015; 9:11. [PMID: 25698950 PMCID: PMC4316720 DOI: 10.3389/fnhum.2015.00011] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 01/07/2015] [Indexed: 11/20/2022] Open
Abstract
Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI). This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3) The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5) The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system.
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Affiliation(s)
- Paul E. Rapp
- Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD, USA
| | - David O. Keyser
- Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD, USA
| | | | - Rene Hernandez
- US Navy Bureau of Medicine and Surgery, Frederick, MD, USA
| | | | | | - W. David Hairston
- U. S. Army Research Laboratory, Aberdeen Proving Ground, Aberdeen, MD, USA
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Wilson MJ, Harkrider AW, King KA. The Effects of Visual Distracter Complexity on Auditory Evoked P3b in Contact Sports Athletes. Dev Neuropsychol 2014; 39:113-30. [DOI: 10.1080/87565641.2013.870177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Yadav NK, Thiagarajan P, Ciuffreda KJ. Effect of oculomotor vision rehabilitation on the visual-evoked potential and visual attention in mild traumatic brain injury. Brain Inj 2014; 28:922-9. [DOI: 10.3109/02699052.2014.887227] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rabinowitz AR, Li X, Levin HS. Sport and Nonsport Etiologies of Mild Traumatic Brain Injury: Similarities and Differences. Annu Rev Psychol 2014; 65:301-31. [DOI: 10.1146/annurev-psych-010213-115103] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Amanda R. Rabinowitz
- Department of Neurosurgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104;
| | - Xiaoqi Li
- Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine and the University of Texas-Houston Medical School, Houston, Texas 77030
| | - Harvey S. Levin
- Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine and the University of Texas-Houston Medical School, Houston, Texas 77030
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Gosselin N, Bottari C, Chen JK, Huntgeburth SC, De Beaumont L, Petrides M, Cheung B, Ptito A. Evaluating the cognitive consequences of mild traumatic brain injury and concussion by using electrophysiology. Neurosurg Focus 2013. [PMID: 23199430 DOI: 10.3171/2012.10.focus12253] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Mild traumatic brain injury (MTBI), often referred to as concussion when it occurs in sports, produces persistent cognitive problems in at least 15% of patients. Unfortunately, conventional neuropsychological tests usually yield results within normal limits in this population. The main objective of this event-related potential (ERP) study was to understand brain functioning during the performance of a working memory (WM) task in patients who have sustained an MTBI, mostly due to motor vehicle accident or sports concussion. This study also aimed for a better understanding of the association between brain functioning as measured with ERP, behavioral performance on the WM task, postconcussion symptoms, type of injury (that is, sports concussion vs other types), and time since the injury. METHODS Forty-four patients with MTBI (7.6 ± 8.4 months postinjury) were tested on a visual WM task with simultaneous recording of ERP, and were compared with 40 control volunteers who were their equivalent for age and sex. Amplitude and latency of frontal (N200 and N350) and parietal (P200 and P300) ERP waves were measured and were compared between groups. Correlation analyses were also performed between ERP characteristics, clinical variables, and behavioral performance. RESULTS A significant group difference was found for behavioral performance on the WM task, in which the MTBI group had a lower percentage of correct answers than the control group (p < 0.05). The patients with MTBI also had smaller amplitudes of both frontal N350 and parietal P300 ERP components when compared with control volunteers (p < 0.05). No changes were found for latency of ERP components. Smaller ERP amplitudes were associated with slower reaction times and worse accuracy on the WM task among patients with MTBI (p < 0.05). Types of injury (that is, sports concussion vs other mechanisms) were not associated with different ERP characteristics. CONCLUSIONS Abnormal ERP results are observed in patients after MTBI or sports concussion, even for those in the nonacute stage after their injury. Current standard clinical evaluations most often fail to detect cerebral dysfunction after MTBI, even when patients or athletes report symptoms. Clinicians should be aware that patients with MTBI, including sports concussion, probably have underlying mild but persistent cerebral dysfunctions that require further investigation.
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Affiliation(s)
- Nadia Gosselin
- Research Center, Hôpital du Sacré-Coeur de Montréal, Canada
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32
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Mohan K, Kecova H, Hernandez-Merino E, Kardon RH, Harper MM. Retinal ganglion cell damage in an experimental rodent model of blast-mediated traumatic brain injury. Invest Ophthalmol Vis Sci 2013; 54:3440-50. [PMID: 23620426 DOI: 10.1167/iovs.12-11522] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate retina and optic nerve damage following experimental blast injury. METHODS Healthy adult mice were exposed to an overpressure blast wave using a custom-built blast chamber. The effects of blast exposure on retina and optic nerve function and structure were evaluated using the pattern electroretinogram (pERG), spectral domain optical coherence tomography (OCT), and the chromatic pupil light reflex. RESULTS Assessment of the pupil response to light demonstrated decreased maximum pupil constriction diameter in blast-injured mice using red light or blue light stimuli 24 hours after injury compared with baseline in the eye exposed to direct blast injury. A decrease in the pupil light reflex was not observed chronically following blast exposure. We observed a biphasic pERG decrease with the acute injury recovering by 24 hours postblast and the chronic injury appearing at 4 months postblast injury. Furthermore, at 3 months following injury, a significant decrease in the retinal nerve fiber layer was observed using OCT compared with controls. Histologic analysis of the retina and optic nerve revealed punctate regions of reduced cellularity in the ganglion cell layer and damage to optic nerves. Additionally, a significant upregulation of proteins associated with oxidative stress was observed acutely following blast exposure compared with control mice. CONCLUSIONS Our study demonstrates that decrements in retinal ganglion cell responses can be detected after blast injury using noninvasive functional and structural tests. These objective responses may serve as surrogate tests for higher CNS functions following traumatic brain injury that are difficult to quantify.
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Affiliation(s)
- Kabhilan Mohan
- Iowa City Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA.
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Dean PJA, Sterr A. Long-term effects of mild traumatic brain injury on cognitive performance. Front Hum Neurosci 2013; 7:30. [PMID: 23408228 PMCID: PMC3569844 DOI: 10.3389/fnhum.2013.00030] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 01/23/2013] [Indexed: 11/25/2022] Open
Abstract
Although a proportion of individuals report chronic cognitive difficulties after mild traumatic brain injury (mTBI), results from behavioral testing have been inconsistent. In fact, the variability inherent to the mTBI population may be masking subtle cognitive deficits. We hypothesized that this variability could be reduced by accounting for post-concussion syndrome (PCS) in the sample. Thirty-six participants with mTBI (>1 year post-injury) and 36 non-head injured controls performed information processing speed (Paced Visual Serial Addition Task, PVSAT) and working memory (n-Back) tasks. Both groups were split by PCS diagnosis (4 groups, all n = 18), with categorization of controls based on symptom report. Participants with mTBI and persistent PCS had significantly greater error rates on both the n-Back and PVSAT, at every difficulty level except 0-Back (used as a test of performance validity). There was no difference between any of the other groups. Therefore, a cognitive deficit can be observed in mTBI participants, even 1 year after injury. Correlations between cognitive performance and symptoms were only observed for mTBI participants, with worse performance correlating with lower sleep quality, in addition to a medium effect size association (falling short of statistical significance) with higher PCS symptoms, post-traumatic stress disorder (PTSD), and anxiety. These results suggest that the reduction in cognitive performance is not due to greater symptom report itself, but is associated to some extent with the initial injury. Furthermore, the results validate the utility of our participant grouping, and demonstrate its potential to reduce the variability observed in previous studies.
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Multiple Electrophysiological Markers of Visual-Attentional Processing in a Novel Task Directed toward Clinical Use. J Ophthalmol 2012; 2012:618654. [PMID: 23227309 PMCID: PMC3512316 DOI: 10.1155/2012/618654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 09/16/2012] [Indexed: 11/17/2022] Open
Abstract
Individuals who have sustained a mild brain injury (e.g., mild traumatic brain injury or mild cerebrovascular stroke) are at risk to show persistent cognitive symptoms (attention and memory) after the acute postinjury phase. Although studies have shown that those patients perform normally on neuropsychological tests, cognitive symptoms remain present, and there is a need for more precise diagnostic tools. The aim of this study was to develop precise and sensitive markers for the diagnosis of post brain injury deficits in visual and attentional functions which could be easily translated in a clinical setting. Using electrophysiology, we have developed a task that allows the tracking of the processes involved in the deployment of visual spatial attention from early stages of visual treatment (N1, P1, N2, and P2) to higher levels of cognitive processing (no-go N2, P3a, P3b, N2pc, SPCN). This study presents a description of this protocol and its validation in 19 normal participants. Results indicated the statistically significant presence of all ERPs aimed to be elicited by this novel task. This task could allow clinicians to track the recovery of the mechanisms involved in the deployment of visual-attentional processing, contributing to better diagnosis and treatment management for persons who suffer a brain injury.
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McBride J, Zhao X, Nichols T, Vagnini V, Munro N, Berry D, Jiang Y. Scalp EEG-based discrimination of cognitive deficits after traumatic brain injury using event-related Tsallis entropy analysis. IEEE Trans Biomed Eng 2012; 60:90-6. [PMID: 23070292 DOI: 10.1109/tbme.2012.2223698] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Traumatic brain injury (TBI) is the leading cause of death and disability in children and adolescents in the U.S. This is a pilot study, which explores the discrimination of chronic TBI from normal controls using scalp EEG during a memory task. Tsallis entropies are computed for responses during an old-new memory recognition task. A support vector machine model is constructed to discriminate between normal and moderate/severe TBI individuals using Tsallis entropies as features. Numerical analyses of 30 records (15 normal and 15 TBI) show a maximum discrimination accuracy of 93% (p-value = 7.8557E-5) using four features. These results suggest the potential of scalp EEG as an efficacious method for noninvasive diagnosis of TBI.
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Affiliation(s)
- J McBride
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN 37996, USA.
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36
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Ozen LJ, Fernandes MA. Slowing down after a mild traumatic brain injury: a strategy to improve cognitive task performance? Arch Clin Neuropsychol 2011; 27:85-100. [PMID: 22068441 DOI: 10.1093/arclin/acr087] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Long-term persistent attention and memory difficulties following a mild traumatic brain injury (TBI) often go undetected on standard neuropsychological tests, despite complaints by mild TBI individuals. We conducted a visual Repetition Detection working memory task to digits, in which we manipulated task difficulty by increasing cognitive load, to identify subtle deficits long after a mild TBI. Twenty-six undergraduate students with a self-report of one mild TBI, which occurred at least 6 months prior, and 31 non-head-injured controls took part in the study. Participants were not informed until study completion that the study's purpose was to examine cognitive changes following a mild TBI, to reduce the influence of "diagnosis threat" on performance. Neuropsychological tasks did not differentiate the groups, though mild TBI participants reported higher state anxiety levels. On our working memory task, the mild TBI group took significantly longer to accurately detect repeated targets on our task, suggesting that slowed information processing is a long-term consequence of mild TBI. Accuracy was comparable in the low-load condition and, unexpectedly, mild TBI performance surpassed that of controls in the high-load condition. Temporal analysis of target identification suggested a strategy difference between groups: mild TBI participants made a significantly greater number of accurate responses following the target's offset, and significantly fewer erroneous distracter responses prior to target onset, compared with controls. Results suggest that long after a mild TBI, high-functioning young adults invoke a strategy of delaying their identification of targets in order to maintain, and facilitate, accuracy on cognitively demanding tasks.
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Affiliation(s)
- Lana J Ozen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
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37
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Electrophysiological markers of cognitive deficits in traumatic brain injury: A review. Int J Psychophysiol 2011; 82:53-60. [DOI: 10.1016/j.ijpsycho.2011.01.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 12/22/2010] [Accepted: 01/06/2011] [Indexed: 11/20/2022]
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Duncan CC, Summers AC, Perla EJ, Coburn KL, Mirsky AF. Evaluation of traumatic brain injury: Brain potentials in diagnosis, function, and prognosis. Int J Psychophysiol 2011; 82:24-40. [DOI: 10.1016/j.ijpsycho.2011.02.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/11/2011] [Accepted: 02/17/2011] [Indexed: 11/30/2022]
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Stergiou-Kita M, Dawson DR, Rappolt SG. An integrated review of the processes and factors relevant to vocational evaluation following traumatic brain injury. JOURNAL OF OCCUPATIONAL REHABILITATION 2011; 21:374-394. [PMID: 21258849 DOI: 10.1007/s10926-010-9282-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION In order to develop the evidence base for a clinical practice guideline (CPG) for vocational evaluation following traumatic brain injury (TBI), we undertook a review to identify the key processes evaluators should follow and the key factors they should consider when completing a vocational evaluation. METHODS Processes outlined in the Cochrane Handbook of Systematic Review guided our processes and included: development of review questions, search strategies and selection criteria; quality appraisal; extraction, analysis and data synthesis; drawing conclusions. Four data bases (i.e. Medline; PsychInfo; Embase; The Cochrane Library of Systematic Reviews) were searched for descriptive articles, quantitative and qualitative studies, and nine websites were searched for CPGs (e.g. Scottish Intercollegiate Guideline Network; US National Guideline Clearinghouse; New Zealand Guideline Group). Two reviewers independently appraised methodological quality. Data were extracted into evidence tables which included: study purpose; location; participants; design/method; themes; findings; relevant processes and factors. Directed content analysis was utilized to analyze and synthesize the descriptive process evidence. A constant comparative method was employed to compare study findings in relation to factors associated with successful employment. RESULTS Results from process and factors syntheses are integrated into the Evidence-based Framework for Vocational Evaluation Following TBI. This framework identifies seven key processes in a vocational evaluation, including: (1) identification of the evaluation purpose and rationale; (2) intake process; (3) assessment of the person; (4) assessment of the environment; (5) assessment of the occupation/job requirements; (6) analysis and synthesis of assessment results; (7) development of evaluation recommendations. Relevant factors are integrated into each key process. CONCLUSIONS This framework outlines the key information evaluators should gather, the domains of the person, environment and occupation they should assess, and elements of rigour they should consider when completing a vocational evaluation and making recommendations for work re-entry following a TBI.
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Affiliation(s)
- Mary Stergiou-Kita
- Department of Rehabilitation Science, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada.
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40
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Di Russo F, Bultrini A, Brunelli S, Delussu AS, Polidori L, Taddei F, Traballesi M, Spinelli D. Benefits of sports participation for executive function in disabled athletes. J Neurotrauma 2011; 27:2309-19. [PMID: 20925480 DOI: 10.1089/neu.2010.1501] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated the effect of sports activity on physically-disabled individuals using behavioral and electrophysiological techniques. Visual go/no-go discriminative and simple response tasks were used. Participants included 17 disabled athletes, 9 from open-skill (wheelchair basketball) and eight from closed-skill (swimming) sports, and 18 healthy non-athletes. Reaction times of the disabled athletes were slower than those of healthy non-athletes on both tasks (7% and 13% difference, respectively). Intra-individual variations in reaction times, switch cost, and number of false alarms, were higher in the swimmers, but comparable to healthy non-athletes, in the basketball group. Event-related potentials (ERPs) early components P1, N1, and P2 had longer latencies in the disabled athletes. The late P3 component had longer latency and smaller amplitude in the disabled athletes only in the discriminative response task. The N2 component, which reflected inhibition/execution processing in the discriminative response task, was delayed and reduced in the swimmer group, but was comparable to healthy subjects in the basketball group. Our results show that (1) the ERP components related to perceptual processing, and late components related to executive processing, were impaired in disabled subjects; and (2) open-skill sports such as basketball may partially compensate for executive control impairment by fostering the stability of motor responses and favoring response flexibility.
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Affiliation(s)
- Francesco Di Russo
- Department of Education Sciences for Motor Activity and Sport, University of Rome Foro Italico, Rome, Italy.
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Folmer RL, Billings CJ, Diedesch-Rouse AC, Gallun FJ, Lew HL. Electrophysiological assessments of cognition and sensory processing in TBI: applications for diagnosis, prognosis and rehabilitation. Int J Psychophysiol 2011; 82:4-15. [PMID: 21419179 DOI: 10.1016/j.ijpsycho.2011.03.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 03/04/2011] [Accepted: 03/08/2011] [Indexed: 12/27/2022]
Abstract
Traumatic brain injuries are often associated with damage to sensory and cognitive processing pathways. Because evoked potentials (EPs) and event-related potentials (ERPs) are generated by neuronal activity, they are useful for assessing the integrity of neural processing capabilities in patients with traumatic brain injury (TBI). This review of somatosensory, auditory and visual ERPs in assessments of TBI patients is provided with the hope that it will be of interest to clinicians and researchers who conduct or interpret electrophysiological evaluations of this population. Because this article reviews ERP studies conducted in three different sensory modalities, involving patients with a wide range of TBI severity ratings and circumstances, it is difficult to provide a coherent summary of findings. However, some general trends emerge that give rise to the following observations and recommendations: 1) bilateral absence of somatosensory evoked potentials (SEPs) is often associated with poor clinical prognosis and outcome; 2) the presence of normal ERPs does not guarantee favorable outcome; 3) ERPs evoked by a variety of sensory stimuli should be used to evaluate TBI patients, especially those with severe injuries; 4) time since onset of injury should be taken into account when conducting ERP evaluations of TBI patients or interpreting results; 5) because sensory deficits (e.g., vision impairment or hearing loss) affect ERP results, tests of peripheral sensory integrity should be conducted in conjunction with ERP recordings; and 6) patients' state of consciousness, physical and cognitive abilities to respond and follow directions should be considered when conducting or interpreting ERP evaluations.
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Affiliation(s)
- Robert L Folmer
- National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR, USA.
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42
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Gosselin N, Bottari C, Chen JK, Petrides M, Tinawi S, de Guise É, Ptito A. Electrophysiology and Functional MRI in Post-Acute Mild Traumatic Brain Injury. J Neurotrauma 2011; 28:329-41. [DOI: 10.1089/neu.2010.1493] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nadia Gosselin
- Cognitive Neuroscience Unit, Montreal Neurological Institute and Hospital, Montreal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Carolina Bottari
- Cognitive Neuroscience Unit, Montreal Neurological Institute and Hospital, Montreal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Jen-Kai Chen
- Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Canada
| | - Michael Petrides
- Cognitive Neuroscience Unit, Montreal Neurological Institute and Hospital, Montreal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Simon Tinawi
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada
| | - Élaine de Guise
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada
| | - Alain Ptito
- Cognitive Neuroscience Unit, Montreal Neurological Institute and Hospital, Montreal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada
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Tsirka V, Simos P, Vakis A, Vourkas M, Arzoglou V, Syrmos N, Stavropoulos S, Micheloyannis S. Material-specific difficulties in episodic memory tasks in mild traumatic brain injury. Int J Neurosci 2010; 120:184-91. [PMID: 20374085 DOI: 10.3109/00207450903585308] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study examines acute, material-specific secondary memory performance in 26 patients with mild traumatic brain injury (MTBI) and 26 healthy controls, matched on demographic variables and indexes of crystallized intelligence. Neuropsychological tests were used to evaluate primary and secondary memory, executive functions, and verbal fluency. Participants were also tested on episodic memory tasks involving words, pseudowords, pictures of common objects, and abstract kaleidoscopic images. Patients showed reduced performance on episodic memory measures, and on tasks associated with visuospatial processing and executive function (Trail Making Test part B, semantic fluency). Significant differences between groups were also noted for correct rejections and response bias on the kaleidoscope task. MTBI patients' reduced performance on memory tasks for complex, abstract stimuli can be attributed to a dysfunction in the strategic component of memory process.
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Blanchet S, Paradis-Giroux AA, Pépin M, Mckerral M. Impact of divided attention during verbal learning in young adults following mild traumatic brain injury. Brain Inj 2009; 23:111-22. [DOI: 10.1080/02699050802649688] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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