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Ladowsky-Brooks RL. Recall and recognition of similarities items in neuropsychological assessment: Memory, validity, and meaning. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-8. [PMID: 38557276 DOI: 10.1080/23279095.2024.2334344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The current study examined whether the Memory Similarities Extended Test (M-SET), a memory test based on the Similarities subtest of the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II), has value in neuropsychological testing. The relationship of M-SET measures of cued recall (CR) and recognition memory (REC) to brain injury severity and memory scores from the Wechsler Memory Scale, Fourth Edition (WMS-IV) was analyzed in examinees with traumatic brain injuries ranging from mild to severe. Examinees who passed standard validity tests were divided into groups with intracranial injury (CT + ve, n = 18) and without intracranial injury (CT-ve, n = 50). In CT + ve only, CR was significantly correlated with Logical Memory I (LMI: rs = .62) and Logical Memory II (LMII: rs = .65). In both groups, there were smaller correlations with delayed visual memory (VRII: rs = .38; rs = .44) and psychomotor speed (Coding: rs = .29; rs = .29). The REC score was neither an indicator of memory ability nor an internal indicator of performance validity. There were no differences in M-SET or WMS-IV scores for CT-ve and CT + ve, and reasons for this are discussed. It is concluded that M-SET has utility as an incidental cued recall measure.
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Halalmeh DR, Salama HZ, LeUnes E, Feitosa D, Ansari Y, Sachwani-Daswani GR, Moisi MD. The Role of Neuropsychology in Traumatic Brain Injury: Comprehensive Literature Review. World Neurosurg 2024; 183:128-143. [PMID: 38104936 DOI: 10.1016/j.wneu.2023.12.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Traumatic brain injury (TBI) is a major public health concern, often leading to significant behavioral and cognitive changes with subsequent impairment in daily functioning and personal interactions. The management of TBI involves a multidisciplinary approach. Neuropsychology has emerged as a critical discipline in assessing, diagnosing, treating, and rehabilitating individuals with TBI. Successful management also requires careful consideration of the patient's cognitive status. Therefore, clinicians must have a comprehensive understanding of the overall clinical picture of the patient at the cognitive and physical level. The primary aim of this research is to explore the role of neuropsychology in TBI management and rehabilitation thoroughly while providing an updated review of the literature. Various neuropsychological assessment tools used to evaluate cognitive functioning in individuals with TBI will be discussed in addition to their validity, reliability, and usefulness in identifying cognitive deficits and developing individualized treatment plans. The findings in this article will have significant implications on the clinical practice of neuropsychology in TBI patients, highlighting the importance of neuropsychological assessment in optimizing the management of this population. The need for increased awareness of neuropsychology among health care professionals, especially in the acute hospital setting, is growing along with the increase in diagnosis of TBI and its complications. Adequate understanding of the complex interplay between cognitive, emotional, and behavioral factors in TBI can inform the development of new interventions and treatment strategies, making it equally as important for patients and their families.
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Affiliation(s)
- Dia R Halalmeh
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA.
| | | | - Emma LeUnes
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - David Feitosa
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - Yusuf Ansari
- Temple University, Philadelphia, Pennsylvania, USA
| | - Gul R Sachwani-Daswani
- Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
| | - Marc D Moisi
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
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Jaywant A, Blunt E, Jamison K, Kim N, RoyChoudhury A, Schiff ND, Kuceyeski A, Dams-O'Connor K, Shah S. Association Between the Attention Network Test, Neuropsychological Measures, and Disability in Post-Acute Traumatic Brain Injury. Neurotrauma Rep 2023; 4:318-329. [PMID: 37771426 PMCID: PMC10523404 DOI: 10.1089/neur.2022.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Cognitive impairment after traumatic brain injury (TBI) is persistent and disabling. Assessing cognitive function in a reliable and valid manner, using measures that are sensitive to the integrity of underlying neural substrates, is crucial in clinical research. The Attention Network Test (ANT) is one such assessment measure that has demonstrated associations with neural regions involved in attention; however, clinical utility of the ANT is limited because its relationship with neuropsychological measures of cognitive function (i.e., its construct validity) has not yet been established in TBI. We evaluated the association between the ANT and 1) a neuropsychological battery assessing executive function and memory and 2) global function assessed by the Glasgow Outcome Scale-Extended (GOSE). Forty-eight adults with complicated mild-severe TBI were evaluated ∼5 months post-injury. Using principal component analysis and multi-variate linear regression adjusted for age, gender, education, and cause of injury, we found that ANT reaction time and executive network scores predicted a principal component assessing processing speed and executive function. Conversely, the ANT did not predict a principal component assessing memory. The ANT was weakly associated with the GOSE. Among persons with TBI during the post-acute phase of recovery, the ANT has good construct validity as evidenced by its associations with neuropsychological measures of processing speed and executive function, but not memory. Given that ANT networks are known to relate to specific neuroanatomical regions, the ANT may be a useful outcome measure for evaluating novel therapeutics targeting attention and executive functions after TBI.
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Affiliation(s)
- Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, New York, USA
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
| | - Emily Blunt
- Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Nayoung Kim
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Arindam RoyChoudhury
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Nicholas D. Schiff
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
| | - Kristen Dams-O'Connor
- Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sudhin Shah
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
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Fusi G, Crepaldi M, Palena N, Segatta C, Bariselli M, Cerrano C, Rusconi ML, Vascello MGF. Decision-making abilities under risk and ambiguity in adults with traumatic brain injury: what do we know so far? A systematic review and meta-analysis. J Clin Exp Neuropsychol 2023; 45:389-410. [PMID: 37585702 DOI: 10.1080/13803395.2023.2245107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/21/2023] [Indexed: 08/18/2023]
Abstract
Traumatic brain injury (TBI) is a major health and socio-economic problem since it is one of the major sources of death and disability worldwide. TBI patients usually show high heterogeneity in their clinical features, including both cognitive and emotional/behavioral alterations. As it specifically concerns cognitive functioning, these patients usually show decision-making (DM) deficits. DM is commonly considered a complex and multistep process that is strictly linked to both hot and cold executive functioning and is pivotal for daily life functioning and patients' autonomy. However, the results are not always in agreement, with some studies that report huge alterations in the DM processes, while others do not. The present systematic review and meta-analysis aims to integrate past literature on this topic, providing a clear and handy picture both for researchers and clinicians. Thirteen studies addressing domain-general DM abilities were included from an initial N = 968 (from three databases). Results showed low heterogeneity between the studies (I2 = 7.90, Q (12) = 13.03, p = .37) supporting the fact that, overall, TBI patients showed lower performance in DM tasks as compared to healthy controls (k = 899, g = .48, 95% CI [0.33; 0.62]) both in tasks under ambiguity and under risk. The evidence that emerged from this meta-analysis denotes a clear deficit of DM abilities in TBI patients. However, DM tasks seemed to have good sensitivity but low specificity. A detailed description of patients' performances and the role of both bottom-up, hot executive functions and top-down control functions have been further discussed. Finally, future directions and practical implications for both researchers and clinicians have been put forward.
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Affiliation(s)
- Giulia Fusi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Maura Crepaldi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Nicola Palena
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Cecilia Segatta
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Martina Bariselli
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Costanza Cerrano
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Maria Luisa Rusconi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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Prakash SK, Reddy RP, Mathulla AR, Rajeswaran J, Shukla DP. Neuropsychological Profile of Traumatic Brain Injury Patients with Medicolegal Cases: A Pilot Study. INDIAN JOURNAL OF NEUROTRAUMA 2022. [DOI: 10.1055/s-0041-1740943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Introduction Traumatic brain injury (TBI) is a global health problem and is a silent epidemic of the modern times. Studies indicate litigation is a prominent factor that accounts for poor outcome and prolonged recovery from mild TBI. Depression is the most frequently diagnosed psychiatric disorder after TBI. Postconcussion symptoms, litigation, and suboptimal effort could contribute to the neuropsychological functioning of TBI patients medicolegal cases (MLCs). With increase in TBI and medicolegal cases, there is a requirement for comprehensive neuropsychological assessment.
Method The aim of the study was to evaluate the cognitive functions, postconcussion, and depressive symptoms in TBI patients with MLC and without MLCs (non-MLC). Patients were also assessed on electrophysiological parameters. An observational cross-sectional design was adopted, the sample size was 30 TBI patients in total, 15 (MLC) and 15 (non-MLC), and 11 patients from each group for electrophysiological assessment. The patients were in the age range of 18 to 50 years.
Results The MLC group had poor performance compared with the non-MLC group on both neuropsychological and electrophysiological measures. There was evidence of significant difference in verbal working memory, verbal learning, and memory and visuoconstructive ability. In the MLC group, postconcussion and depressive scores were negatively correlated with visuospatial span.
Conclusion Findings from this study indicate differences in the neuropsychological performance and electroencephalographic measures in between MLC and non-MLC groups. The results could be indicative of persistent cognitive problems associated with TBI for patients pursuing litigation. Poor performance could also be attributed to suboptimal level of effort. However, being a preliminary study with a small sample size, the findings need to be treated with caution.
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Affiliation(s)
- Simi K. Prakash
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rajakumari P. Reddy
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anna R. Mathulla
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jamuna Rajeswaran
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dhaval P. Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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6
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Donders J, Forness K, Anderson LB, Gillis J, Benedict RHB. Performance on, and correlates of, the Brief Visuospatial Memory Test—Revised after traumatic brain injury. J Clin Exp Neuropsychol 2022; 44:42-49. [PMID: 35466856 DOI: 10.1080/13803395.2022.2069231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jacobus Donders
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Kip Forness
- Department of Psychology, University of Hartford, West Hartford, CT, USA
| | | | - John Gillis
- Jacobs School of Medicine and Behavioral Sciences, SUNY Buffalo, NY, USA
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Dinnes CR, Hux K. Informal Written Language Analysis Methods: Case Examples of Adults With Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:203-220. [PMID: 34962829 DOI: 10.1044/2021_ajslp-21-00196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Written expression challenges following traumatic brain injury (TBI) in adults have received little clinical attention but can substantially affect quality of life and the success of reintegration efforts. Assessment tools and procedures are lacking despite the likelihood of post-TBI problems with microstructure (e.g., productivity, spelling accuracy) and macrostructure (e.g., topic adherence, organization) aspects of written language. The lack of standardized procedures forces reliance on informal methods to determine writing strengths and challenges. METHOD A combination of assessment procedures allowed for evaluation of the productivity and efficiency, adherence to writing conventions (e.g., spelling, sentence structure, punctuation), and macrostructure organization (e.g., story grammar, topic adherence) of written narratives collected from five adults with TBI. RESULTS Use of multiple assessment methods revealed disparate writing challenges across the five case examples. The differing writing profiles underscore the necessity of evaluating multiple aspects of written narratives. CONCLUSIONS The described analysis methods can help clinicians determine areas of strength and challenge in written work generated by adults with TBI. Examination of multiple aspects of writing is key to garnering a comprehensive appraisal of post-TBI writing.
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Affiliation(s)
- Carly R Dinnes
- Department of Communication Sciences and Disorders, Bowling Green University, OH
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Pizzi M, Borella E, Piras F. Performance-Based Everyday Problem-Solving in Patients With TBI. Arch Clin Neuropsychol 2021; 36:1393–1403. [PMID: 33834212 DOI: 10.1093/arclin/acab015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The present study examined whether the everyday problems test (EPT), a performance-based measure of everyday problem-solving, can be considered a useful test in assessing functional independence in patients with traumatic brain injury (TBI). The relationship between EPT, cognitive abilities (i.e., selective attention, set switching, and working memory) and self-rated measures of everyday functioning and disability in these patients was also assessed. METHOD In this case-control study 25 postcomatose outpatients with TBI (age M = 35.9, SD = 14.21) from a neurorehabilitation unit and 25 matched controls were enrolled. Participants were administered the EPT along with neuropsychological tests of selective attention, set switching and working memory, and self-rated measures of everyday functioning and disability. RESULTS Patients with TBI were less accurate and slower than controls in the EPT; the two groups were accurately classified based on EPT completion time (likelihood ratio test χ2 = 28.67, R2 = 0.72, p < .001). In the patient group education and selective attention explained a large portion of variance in EPT accuracy (R2 = 0.53, p = .001), while only selective attention explained a significant portion of variance in EPT time (R2 = 0.24, p < .01). Self-rated measures of everyday functioning and disability did not significantly contribute to EPT performance variance. CONCLUSION Including performance-based measures as the EPT in a multifactorial approach to assessment can be useful for unraveling cognitive factors contributing to TBI's impact on everyday functioning. Since attentional processes seem to play a significant role in determining EPT performance, rehabilitation of functional independence should target this ability first.
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Affiliation(s)
- Marcella Pizzi
- IRCCS Santa Lucia Foundation, Speech Therapy School, Rome, Italy
| | - Erika Borella
- Department of General Psychology, University of Padova, Padua, Italy
| | - Federica Piras
- Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
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Valentini F, Fabio V, Boccia M, Tanzilli A, Iannetti M, Cinelli MC, De Angelis C, Fasotti L, Formisano R, Guariglia C, Ciurli MP. Two Ecological Tools for Testing Slowness of Information Processing in Italian Patients with Moderate-to-Severe Traumatic Brain Injury. Arch Clin Neuropsychol 2021; 37:677-691. [PMID: 34718376 DOI: 10.1093/arclin/acab085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/12/2021] [Accepted: 09/24/2021] [Indexed: 11/12/2022] Open
Abstract
Slowness of Information Processing (SIP) is frequently experienced after traumatic brain injury (TBI); however, the impact of SIP on everyday functioning may be underestimated by standard neuropsychological tests. OBJECTIVE we aimed to adapt two ecological instruments assessing SIP in Italian patients with moderate-to-severe TBI, as formerly proposed by Winkens and colleagues for persons with stroke, testing also its possible relation with other neuropsychological processes and functional outcomes. METHOD we performed an observational study on 37 patients with moderate-to-severe TBI and 35 demographically matched healthy controls, who underwent the Mental Slowness Observation Test (MSOT) and the Mental Slowness Questionnaire (MSQ), which had been adapted through a pilot study on independent sample of participants; extensive neuropsychological and functional evaluations were performed as well. RESULTS We found good clinical and psychometric properties of the Italian adaptation of the MSOT and MSQ; also, performance on MSOT significantly correlated with executive functions. Moreover, patients with TBI are significantly slower and less accurate than healthy controls on the MSOT, in particular in tasks with time limits. Even if the subjective feeling of SIP does not differ between patients and controls, we found a significant correlation between MSQ and MSOT. Finally, the performances on the MSOT correlated with measures of functional outcome and community integration. CONCLUSIONS the results support the use of the MSOT and the MSQ to measure SIP in an ecological fashion in patients with TBI, so that specific treatments for persons with acquired brain injury can be prescribed.
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Affiliation(s)
- Federica Valentini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Valentina Fabio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Antonio Tanzilli
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy.,Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Manuela Iannetti
- Neurorehabilitation 2 and Post-coma Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Maria Cristina Cinelli
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Carmela De Angelis
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Luciano Fasotti
- Rehabilitation Medical Centre Groot Klimmendaal, 6813 Arnhem, The Netherlands.,Donders Institute for Brain, Cognition, and Behaviour, Radboud University, 6525 Nijmegen, The Netherlands
| | - Rita Formisano
- Neurorehabilitation 2 and Post-coma Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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Lee P, Li PC, Liu CH, Lin HY, Huang CY, Hsieh CL. Practice Effects, Test-Retest Reliability, and Minimal Detectable Change of the Ruff 2 and 7 Selective Attention Test in Patients with Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9440. [PMID: 34574365 PMCID: PMC8471144 DOI: 10.3390/ijerph18189440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Ruff 2 and 7 Selective Attention Test (RSAT) is designed to measure selective attention. It tests automatic detection speed (ADS), automatic detection errors (ADE), automatic detection accuracy (ADA), controlled search speed (CSS), controlled search errors (CSE), and controlled search accuracy (CSA). The purpose of this study was to examine the test-retest reliability, practice effect, and minimum detectable change (MDC) of the RSAT in patients with schizophrenia. METHODS A total of 101 patients with schizophrenia completed the RSAT twice at a 4-week interval. The intra-class correlation coefficient (ICC), paired t test, and effect size were used to examine the test-retest reliability and practice effect. The standard error of measurement (SEM) and MDC were calculated. RESULTS The difference scores between the two assessments were significant in all the indexes. The absolute effect sizes were 0.14 to 0.30. The ICCs of the RSAT ranged from 0.69 to 0.91. The MDC% in the indexes of ADS, ADA, and CSA of the RSAT were <30%. CONCLUSIONS The RSAT is reliable for assessing selective attention in patients with schizophrenia. The RSAT has good to excellent test-retest reliability, a trivial to small practice effect, and indexes of ADS, ADA, and CSA, representing acceptable random measurement error.
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Affiliation(s)
- Posen Lee
- Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Ping-Chia Li
- Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chin-Hsuan Liu
- Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Occupational Therapy, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan
| | - Hung-Yu Lin
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Chien-Yu Huang
- Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 10051, Taiwan
| | - Ching-Lin Hsieh
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 10051, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei 10002, Taiwan
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11
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Walz JA, Mani R, Alnawmasi MM, Khuu SK. Visuospatial Attention Allocation as an Indicator of Cognitive Deficit in Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2021; 15:675376. [PMID: 34354575 PMCID: PMC8329082 DOI: 10.3389/fnhum.2021.675376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/23/2021] [Indexed: 01/02/2023] Open
Abstract
Traumatic Brain Injury (TBI) is defined by changes in brain function resulting from external forces acting on the brain and is typically characterized by a host of physiological and functional changes such as cognitive deficits including attention problems. In the present study, we focused on the effect of TBI on the ability to allocate attention in vision (i.e., the use of endogenous and exogenous visual cues) by systematically reviewing previous literature on the topic. We conducted quantitative synthesis of 16 selected studies of visual attention following TBI, calculating 80 effect size estimates. The combined effect size was large (g = 0.79, p < 0.0001) with medium heterogeneity (I2 = 68.39%). Subgroup analyses revealed an increase in deficit with moderate-to-severe and severe TBI as compared to mild TBI [F(2, 76) = 24.14, p < 0.0001]. Task type was another key source of variability and subgroup analyses indicated that higher order attention processes were severely affected by TBI [F(2, 77) = 5.66, p = 0.0051). Meta-regression analyses revealed significant improvement in visual attention deficit with time [p(mild) = 0.031, p(moderate-to-severe) = 0.002, p(severe) < 0.0001]. Taken together, these results demonstrate that visual attention is affected by TBI and that regular assessment of visual attention, using a systematic attention allocation task, may provide a useful clinical measure of cognitive impairment and change after TBI.
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Affiliation(s)
- Jacinta A Walz
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Revathy Mani
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Mohammed M Alnawmasi
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
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12
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Eilam-Stock T, George A, Charvet LE. Cognitive Telerehabilitation with Transcranial Direct Current Stimulation Improves Cognitive and Emotional Functioning Following a Traumatic Brain Injury: A Case Study. Arch Clin Neuropsychol 2021; 36:442-453. [PMID: 33885138 DOI: 10.1093/arclin/acaa059] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Cognitive deficits following a traumatic brain injury (TBI) are a leading cause of disability in young adults and there is a critical need for novel approaches to improve cognitive outcomes in TBI survivors. Transcranial direct current stimulation (tDCS) paired with cognitive remediation has emerged as a viable, cost-effective, noninvasive approach for treating cognitive impairments in a wide variety of neurological conditions. Here, we report the first case study utilizing remotely supervised tDCS (RS-tDCS) protocol paired with cognitive remediation in a 29-year-old man with persisting cognitive and emotional sequelae following TBI. METHOD Neuropsychological measures were administered before and after the patient completed 20 daily sessions of RS-tDCS (2.0 mA × 20 minutes, left anodal dorsolateral prefrontal cortex montage). During the daily stimulation period, he completed adaptive cognitive training. All treatment procedures were delivered at home and monitored in real time via videoconference with a study technician. RESULTS Following 20 RS-tDCS and cognitive training sessions, he had significant improvements (>1 SD) on tests of attention and working memory, semantic fluency, and information processing speed. Mood was also improved. CONCLUSIONS This is the first demonstration of at-home telerehabilitation with RS-tDCS and cognitive training to improve cognitive outcomes following TBI.
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Affiliation(s)
- Tehila Eilam-Stock
- Department of Neurology, NYU Grossman School of Medicine, New York 10017, USA
| | - Allan George
- Department of Neurology, NYU Grossman School of Medicine, New York 10017, USA
| | - Leigh E Charvet
- Department of Neurology, NYU Grossman School of Medicine, New York 10017, USA
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13
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Braw Y. Response Time Measures as Supplementary Validity Indicators in Forced-Choice Recognition Memory Performance Validity Tests: A Systematic Review. Neuropsychol Rev 2021; 32:71-98. [PMID: 33821424 DOI: 10.1007/s11065-021-09499-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 03/05/2021] [Indexed: 01/17/2023]
Abstract
Performance validity tests (PVTs) based on the forced-choice recognition memory (FCRM) paradigm are commonly used for the detection of noncredible performance. Examinees' response times (RTs) are affected by cognitive processes associated with deception and can also be gathered without lengthening the duration of the assessment. Consequently, interest in the utility of these measures as supplementary validity indicators in FCRM-PVTs has grown over the years. The current systematic review summarizes both clinical and simulation (i.e., healthy participants simulating cognitive impairment) studies of RTs in FCRM-PVTs. The findings of 25 peer-reviewed articles (n = 26 empirical studies) indicate that noncredible performance in FCRM-PVTs is associated with longer RTs. Additionally, there are indications that noncredible performance is associated with larger variability in RTs. RT measures, however, have lower discrimination capacity than conventional accuracy measures. Their utility may therefore lie in reaching decisions regarding cases with border zone accuracy scores, as well as aiding in the detection of more sophisticated examinees who are aware of the use of accuracy-based validity indicators in FCRM-PVTs. More research, however, is required before these measures are incorporated in daily practice and clinical decision-making processes.
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Affiliation(s)
- Yoram Braw
- Department of Psychology, Ariel University, Ariel, Israel.
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14
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León-Domínguez U, Solís-Marcos I, López-Delgado CA, Martín JMBY, León-Carrión J. A Frontal Neuropsychological Profile in Fitness to Drive. ACCIDENT; ANALYSIS AND PREVENTION 2020; 148:105807. [PMID: 33069156 DOI: 10.1016/j.aap.2020.105807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/24/2020] [Accepted: 09/27/2020] [Indexed: 06/11/2023]
Abstract
Traffic accidents are a global concern due to the elevated mortality rates of both drivers and pedestrians. The World Health Organization declared 2011-2020 as the Decade of Action for Road Safety, endorsing initiatives to reduce traffic-related deaths. Yet, despite these incentives, fatal accidents still occur. Different studies have linked deficits in executive functions to risky driving attitudes and crashes. The present study focuses on demographic, cognitive and personality factors, related to the prefrontal cortex, that are characteristic of drivers prone to risky behavior behind the wheel. The penalty Points System was used to classify drivers as "safe", with no point loss over a two-year period, or "risky", with full point loss during the same interval. A neuropsychological assessment of prefrontal cognitive functions was carried out on each group to identify variables associated with safe and risky behavior. Neuropsychological indexes were obtained from a continuous performance task without cue (Simple Attention), a continuous performance task with cue (Conditioned Attention), the Tower of Hanoi test and the Neurologically-related Changes in Personality Inventory (NECHAPI). A Discriminant Analysis (DA) found that education level, reaction times in Simple and Conditioned Attention, learning errors in the Tower of Hanoi and vulnerability in the personality test, best predicted whether drivers were likely to be in the safe or risky group. Finally, a cross-validation analysis performed on the same sample correctly classified 87.5% of the drivers. These data suggest that prefrontal dysfunction contributes to risky behavior behind the wheel. The inclusion of cognitive programs to identify and train drivers with this propensity could reduce risky driving, and consequently, save lives on the road.
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Affiliation(s)
- Umberto León-Domínguez
- Human Cognition and Brain Research lab, School of Psychology, University of Monterrey, San Pedro Garza, García, Mexico.
| | - Ignacio Solís-Marcos
- The Swedish National Road and Transport Research Institute (VTI) Linköping, Sweden
| | | | | | - José León-Carrión
- Department of Experimental Psychology, University of Seville, Seville, Spain; Center for Brain Injury Rehabilitation (CRECER), Seville, Spain
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15
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Omer E, Elbaum T, Braw Y. Identifying Feigned Cognitive Impairment: Investigating the Utility of Diffusion Model Analyses. Assessment 2020; 29:198-208. [PMID: 32988242 DOI: 10.1177/1073191120962317] [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: 11/17/2022]
Abstract
Forced-choice performance validity tests are routinely used for the detection of feigned cognitive impairment. The drift diffusion model deconstructs performance into distinct cognitive processes using accuracy and response time measures. It thereby offers a unique approach for gaining insight into examinees' speed-accuracy trade-offs and the cognitive processes that underlie their performance. The current study is the first to perform such analyses using a well-established forced-choice performance validity test. To achieve this aim, archival data of healthy participants, either simulating cognitive impairment in the Word Memory Test or performing it to the best of their ability, were analyzed using the EZ-diffusion model (N = 198). The groups differed in the three model parameters, with drift rate emerging as the best predictor of group membership. These findings provide initial evidence for the usefulness of the drift diffusion model in clarifying the cognitive processes underlying feigned cognitive impairment and encourage further research.
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16
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Ryan J, Woods RL, Britt CJ, Murray AM, Shah RC, Reid CM, Wolfe R, Nelson MR, Orchard SG, Lockery JE, Trevaks RE, Storey E. Normative Data for the Symbol Digit Modalities Test in Older White Australians and Americans, African-Americans, and Hispanic/Latinos. J Alzheimers Dis Rep 2020; 4:313-323. [PMID: 33024939 PMCID: PMC7504980 DOI: 10.3233/adr-200194] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Processing speed, which can be assessed using the Symbol Digit Modalities Test (SDMT), is central to many brain functions. Processing speed declines with advanced age but substantial impairments are indicative of brain injury or disease. Objective The purpose of this study was to provide SDMT normative data for older community-dwelling individuals in the U.S. and Australia. Methods The ASPREE trial recruited 19,114 relatively healthy older men and women in Australia and the U.S. from the general community. All participants were without a diagnosis of dementia and with a Modified Mini-Mental State examination score of 78 or more at enrolment. The SDMT was administered at baseline as part of a neuropsychological test battery. Results The median age of participants was 74 years (range 65-99), and 56% were women. The median years of education was 12. Ethno-racial differences in SDMT performance were observed and normative data were thus presented separately for 16,289 white Australians, 1,082 white Americans, 891 African-Americans, and 316 Hispanic/Latinos. There were consistent positive associations found between SDMT and education level, and negative associations between SDMT and age. Mean scores for women were consistently higher than men with the exception of Hispanic/Latinos aged ≥70 years. Conclusion This study provides comprehensive SDMT normative data for whites (Australian and U.S.), Hispanic/Latinos, and African-Americans, according to gender, age, and education level. These norms can be used clinically as reference standards to screen for cognitive impairments in older individuals.
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Affiliation(s)
- Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Carlene J Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Health Research Institute and Division of Geriatrics, Department of Medicine, Hennepin HealthCare and University of Minnesota, MN, USA
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jessica E Lockery
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ruth E Trevaks
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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17
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Abeare CA, Hurtubise JL, Cutler L, Sirianni C, Brantuo M, Makhzoum N, Erdodi LA. Introducing a forced choice recognition trial to the Hopkins Verbal Learning Test – Revised. Clin Neuropsychol 2020; 35:1442-1470. [DOI: 10.1080/13854046.2020.1779348] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | - Laura Cutler
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | | | - Maame Brantuo
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Nadeen Makhzoum
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Laszlo A. Erdodi
- Department of Psychology, University of Windsor, Windsor, ON, Canada
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18
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Lacking Pace but Not Precision: Age-Related Information Processing Changes in Response to a Dynamic Attentional Control Task. Brain Sci 2020; 10:brainsci10060390. [PMID: 32575518 PMCID: PMC7349744 DOI: 10.3390/brainsci10060390] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/01/2020] [Accepted: 06/14/2020] [Indexed: 11/17/2022] Open
Abstract
Age-related decline in information processing can have a substantial impact on activities such as driving. However, the assessment of these changes is often carried out using cognitive tasks that do not adequately represent the dynamic process of updating environmental stimuli. Equally, traditional tests are often static in their approach to task complexity, and do not assess difficulty within the bounds of an individual’s capability. To address these limitations, we used a more ecologically valid measure, the Swansea Test of Attentional Control (STAC), in which a threshold for information processing speed is established at a given level of accuracy. We aimed to delineate how older, compared to younger, adults varied in their performance of the task, while also assessing relationships between the task outcome and gender, general cognition (MoCA), perceived memory function (MFQ), cognitive reserve (NART), and aspects of mood (PHQ-9, GAD-7). The results indicate that older adults were significantly slower than younger adults but no less precise, irrespective of gender. Age was negatively correlated with the speed of task performance. Our measure of general cognition was positively correlated with the task speed threshold but not with age per se. Perceived memory function, cognitive reserve, and mood were not related to task performance. The findings indicate that while attentional control is less efficient in older adulthood, age alone is not a defining factor in relation to accuracy. In a real-life context, general cognitive function, in conjunction with dynamic measures such as STAC, may represent a far more effective strategy for assessing the complex executive functions underlying driving ability.
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19
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Hinault T, Kraut M, Bakker A, Dagher A, Courtney SM. Disrupted Neural Synchrony Mediates the Relationship between White Matter Integrity and Cognitive Performance in Older Adults. Cereb Cortex 2020; 30:5570-5582. [DOI: 10.1093/cercor/bhaa141] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/14/2020] [Accepted: 05/06/2020] [Indexed: 12/16/2022] Open
Abstract
Abstract
Our main goal was to determine the influence of white matter integrity on the dynamic coupling between brain regions and the individual variability of cognitive performance in older adults. Electroencephalography was recorded while participants performed a task specifically designed to engage working memory and inhibitory processes, and the associations among functional activity, structural integrity, and cognitive performance were assessed. We found that the association between white matter microstructural integrity and cognitive functioning with aging is mediated by time-varying alpha and gamma phase-locking value. Specifically, better preservation of the inferior fronto-occipital fasciculus in older individuals drives faster task-related modulations of alpha and gamma long-range phase-locking value between the inferior frontal gyrus and occipital lobe and lower local phase-amplitude coupling in occipital lobes, which in turn drives better cognitive control performance. Our results help delineate the role of individual variability of white matter microstructure in dynamic synchrony and cognitive performance during normal aging.
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Affiliation(s)
- T Hinault
- U1077 INSERM-EPHE-UNICAEN, Caen, 14000, France
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - M Kraut
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - A Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- F.M. Kirby Research Center, Kennedy Krieger Institute, Baltimore, MD 21205, USA
| | - A Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montréal QC, H3A 2B4, Canada
| | - S M Courtney
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
- F.M. Kirby Research Center, Kennedy Krieger Institute, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins University, Baltimore, MD 21205, USA
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20
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Mao X, Terpolilli NA, Wehn A, Cheng S, Hellal F, Liu B, Seker B, Plesnila N. Progressive Histopathological Damage Occurring Up to One Year after Experimental Traumatic Brain Injury Is Associated with Cognitive Decline and Depression-Like Behavior. J Neurotrauma 2020; 37:1331-1341. [DOI: 10.1089/neu.2019.6510] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Xiang Mao
- Institute for Stroke and Dementia Research, Munich University Hospital, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Nicole A. Terpolilli
- Institute for Stroke and Dementia Research, Munich University Hospital, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurosurgery, Munich University Hospital, Munich, Germany
| | - Antonia Wehn
- Institute for Stroke and Dementia Research, Munich University Hospital, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Shiqi Cheng
- Institute for Stroke and Dementia Research, Munich University Hospital, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Farida Hellal
- Institute for Stroke and Dementia Research, Munich University Hospital, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Baiyun Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University and China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Burcu Seker
- Institute for Stroke and Dementia Research, Munich University Hospital, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Nikolaus Plesnila
- Institute for Stroke and Dementia Research, Munich University Hospital, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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21
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Pundole A, Varley R, Beeke S. Assessing emergence from a prolonged disorder of consciousness: Current opinion and practice in the UK. Neuropsychol Rehabil 2020; 31:1003-1027. [PMID: 32404044 DOI: 10.1080/09602011.2020.1758160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND A patient in PDOC must demonstrate functional object use or functional communication to confirm they have emerged from this state. A range of tasks and stimuli are used and patients must achieve 100% accuracy. As consciousness occurs along a continuum, determining emergence is not straightforward. OBJECTIVE To establish the opinions of expert clinicians on how emergence is determined in practice. METHODS An online survey was completed by clinicians working in specialist rehabilitation settings across the UK. Questions were asked about diagnosis and confidence, informal assessment, formal assessment, and family involvement. Descriptive statistics were used to analyse responses to closed questions. Responses to open questions were analysed using thematic analysis. RESULTS Seventy-five surveys were analysed. Approximately a third (30.4 %) used tasks other than those recommended to determine emergence. A lack of confidence in tasks to detect the return of functional communication was reported by 46.4%. The majority (78.6%) reported they worked with patients who they felt had emerged, but could not demonstrate it based on the current criteria. A range of stimuli were employed, but 30.6% of respondents were not confident they could choose stimuli appropriately. Respondents reported a range of benefits and challenges when involving family in assessment.
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Affiliation(s)
- Amy Pundole
- Division of Psychology and Language Sciences, University College London, London, UK.,Clinical Lead Speech and Language Therapist, Royal Hospital for Neurodisability, London, UK
| | - Rosemary Varley
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Suzanne Beeke
- Division of Psychology and Language Sciences, University College London, London, UK
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22
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Norman RS, Shah MN, Turkstra LS. Language Comprehension After Mild Traumatic Brain Injury: The Role of Speed. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1479-1490. [PMID: 31454258 PMCID: PMC7251601 DOI: 10.1044/2019_ajslp-18-0203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Purpose The aim of this study was to characterize language comprehension in mild traumatic brain injury (mTBI) by testing a speed-based hypothesis. We hypothesized that adults with mTBI would perform worse than a group of adults with orthopedic injuries (OIs) on an experimental language comprehension task. Method The study employed a prospective experimental design. Participants were 19 adults with mTBI and 19 adults with OI ages 18-55 years. Participants completed the Whatdunit task, a sentence agent selection task in speeded and unspeeded conditions. Results In the unspeeded condition, the mTBI group performed with a marginally significant higher accuracy than the OI group. In the speeded condition, the mTBI group performed with lower accuracy than the OI group; however, this difference did not reach statistical significance. There was a marginally significant interaction of Sentence Type × Group for reaction time in the speeded condition. Conclusions While our task might have been sensitive to cognitive processing abilities in both groups (as evidenced by the main effects of condition and sentence type), the task was not specific enough to capture mTBI-related deficits. The similarities in performance between both groups have clinical implications for the treatment of not just brain-related trauma but also trauma in general.
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Affiliation(s)
- Rocío S. Norman
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | - Manish N. Shah
- Berbee Walsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin–Madison
| | - Lyn S. Turkstra
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
- Neuroscience Training Program and Department of Surgery, University of Wisconsin–Madison
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23
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Norman RS, Shah MN, Turkstra LS. Reaction time and cognitive-linguistic performance in adults with mild traumatic brain injury. Brain Inj 2019; 33:1173-1183. [PMID: 31291747 DOI: 10.1080/02699052.2019.1632487] [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: 10/26/2022]
Abstract
Objective: The purpose of this study was to characterize cognitive-linguistic performance in adults with mild traumatic brain injury (mTBI) to advance assessment and treatment practices. We hypothesized that individuals with mTBI would demonstrate longer reaction times (RTs) and greater error rates when compared to an orthopedic injury (OI) group on a category-naming task. Method: Participants were age and education-matched adults with mTBI (n = 20; 12 females) and adults with OI (n = 21; 5 females) who were discharged to home after an Emergency Department visit. Our primary task was a category-naming task shown to be sensitive to language deficits after mTBI. The task was adapted and administered under speeded and unspeeded conditions. Results: There was a significant main effect of condition on RT (speeded faster than unspeeded) and accuracy (more errors in the speeded condition). There was a marginally significant effect of group on errors, with more errors in the mTBI group than the OI group. Naming RT and accuracy in both conditions were moderately correlated with injury variables and symptom burden. Conclusions: Our data showed a marginal effect of group on accuracy of performance. Correlations found between naming and neurobehavioural symptoms, including sleep quality, suggest that the latter should be considered in future research.
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Affiliation(s)
- Rocío S Norman
- a Department of Communication Sciences and Disorders, University of Wisconsin-Madison , Madison , WI , USA
| | - Manish N Shah
- b BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, School of Medicine and Public Health , Madison , WI , USA
| | - Lyn S Turkstra
- a Department of Communication Sciences and Disorders, University of Wisconsin-Madison , Madison , WI , USA.,c Neuroscience Training Program and Department of Surgery, University of Wisconsin-Madison , Madison , WI , USA
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24
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McGuire JL, Ngwenya LB, McCullumsmith RE. Neurotransmitter changes after traumatic brain injury: an update for new treatment strategies. Mol Psychiatry 2019; 24:995-1012. [PMID: 30214042 DOI: 10.1038/s41380-018-0239-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 12/12/2022]
Abstract
Traumatic brain injury (TBI) is a pervasive problem in the United States and worldwide, as the number of diagnosed individuals is increasing yearly and there are no efficacious therapeutic interventions. A large number of patients suffer with cognitive disabilities and psychiatric conditions after TBI, especially anxiety and depression. The constellation of post-injury cognitive and behavioral symptoms suggest permanent effects of injury on neurotransmission. Guided in part by preclinical studies, clinical trials have focused on high-yield pathophysiologic mechanisms, including protein aggregation, inflammation, metabolic disruption, cell generation, physiology, and alterations in neurotransmitter signaling. Despite successful treatment of experimental TBI in animal models, clinical studies based on these findings have failed to translate to humans. The current international effort to reshape TBI research is focusing on redefining the taxonomy and characterization of TBI. In addition, as the next round of clinical trials is pending, there is a pressing need to consider what the field has learned over the past two decades of research, and how we can best capitalize on this knowledge to inform the hypotheses for future innovations. Thus, it is critically important to extend our understanding of the pathophysiology of TBI, particularly to mechanisms that are associated with recovery versus development of chronic symptoms. In this review, we focus on the pathology of neurotransmission after TBI, reflecting on what has been learned from both the preclinical and clinical studies, and we discuss new directions and opportunities for future work.
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Affiliation(s)
- Jennifer L McGuire
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH, USA.
| | - Laura B Ngwenya
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH, USA.,Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA.,Neurotrauma Center, University of Cincinnati Gardner Neuroscience Institute, Cincinnati, OH, 45219, USA
| | - Robert E McCullumsmith
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA.,Department of Psychiatry, Cincinnati Veterans Administration Medical Center, Cincinnati, OH, USA
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25
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Polich G, Iaccarino MA, Zafonte R. Psychopharmacology of traumatic brain injury. HANDBOOK OF CLINICAL NEUROLOGY 2019; 165:253-267. [PMID: 31727216 DOI: 10.1016/b978-0-444-64012-3.00015-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The pathophysiology of traumatic brain injury (TBI) can be highly variable, involving functional and/or structural damage to multiple neuroanatomical networks and neurotransmitter systems. This wide-ranging potential for physiologic injury is reflected in the diversity of neurobehavioral and neurocognitive symptoms following TBI. Here, we aim to provide a succinct, clinically relevant, up-to-date review on psychopharmacology for the most common sequelae of TBI in the postacute to chronic period. Specifically, treatment for neurobehavioral symptoms (depression, mania, anxiety, agitation/irritability, psychosis, pseudobulbar affect, and apathy) and neurocognitive symptoms (processing speed, attention, memory, executive dysfunction) will be discussed. Treatment recommendations will reflect general clinical practice patterns and the research literature.
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Affiliation(s)
- Ginger Polich
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Mary Alexis Iaccarino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States.
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26
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Tomer E, Lupu T, Golan L, Wagner M, Braw Y. Eye tracking as a mean to detect feigned cognitive impairment in the word memory test. APPLIED NEUROPSYCHOLOGY-ADULT 2018; 27:49-61. [PMID: 30183408 DOI: 10.1080/23279095.2018.1480483] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Eye movements showed initial promise for the detection of deception and may be harder to consciously manipulate than conventional accuracy measures. Therefore, we integrated an eye-tracker with the Word Memory Test (WMT) and tested its usefulness for the detection of feigned cognitive impairment. As part of the study, simulators (n = 44) and honest controls (n = 41) performed WMT's immediate-recognition (IR) subtest while their eye movements were recorded. In comparison to the control group, simulators spent less time gazing at relevant stimuli, spent more time gazing at irrelevant stimuli, and had a lower saccade rate. Group classification using a scale that combined the eye movement measures and the WMT's accuracy measure showed tentative promise (i.e., it enhanced classification compared to the use of the accuracy measure as the sole predictor of group membership). Overall, integration of an eye-tracker with the WMT was found to be feasible and the eye movement measures showed initial promise for the detection of feigned cognitive impairment. Moreover, eye movement measures proved useful in enhancing our understanding of strategies utilized by the simulators and the cognitive processes that affect their behavior. While the findings are clearly preliminary, we hope that they will encourage further research of these promising psychophysiological measures.
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Affiliation(s)
- Elbaum Tomer
- Department of Psychology, Ariel University, Ariel, Israel
| | - Tamar Lupu
- Department of Psychology, Ariel University, Ariel, Israel
| | - Lior Golan
- Department of Psychology, Ariel University, Ariel, Israel
| | - Michael Wagner
- Department of Psychology, Ariel University, Ariel, Israel
| | - Yoram Braw
- Department of Psychology, Ariel University, Ariel, Israel.,Emotion and Cognition Research Center, Shalvata Mental Health Center, Hod HaSharon, Israel
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27
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Experimental Traumatic Brain Injury Identifies Distinct Early and Late Phase Axonal Conduction Deficits of White Matter Pathophysiology, and Reveals Intervening Recovery. J Neurosci 2018; 38:8723-8736. [PMID: 30143572 PMCID: PMC6181309 DOI: 10.1523/jneurosci.0819-18.2018] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/15/2018] [Accepted: 07/10/2018] [Indexed: 01/26/2023] Open
Abstract
Traumatic brain injury (TBI) patients often exhibit slowed information processing speed that can underlie diverse symptoms. Processing speed depends on neural circuit function at synapses, in the soma, and along axons. Long axons in white matter (WM) tracts are particularly vulnerable to TBI. We hypothesized that disrupted axon–myelin interactions that slow or block action potential conduction in WM tracts may contribute to slowed processing speed after TBI. Concussive TBI in male/female mice was used to produce traumatic axonal injury in the corpus callosum (CC), similar to WM pathology in human TBI cases. Compound action potential velocity was slowed along myelinated axons at 3 d after TBI with partial recovery by 2 weeks, suggesting early demyelination followed by remyelination. Ultrastructurally, dispersed demyelinated axons and disorganized myelin attachment to axons at paranodes were apparent within CC regions exhibiting traumatic axonal injury. Action potential conduction is exquisitely sensitive to paranode abnormalities. Molecular identification of paranodes and nodes of Ranvier detected asymmetrical paranode pairs and abnormal heminodes after TBI. Fluorescent labeling of oligodendrocyte progenitors in NG2CreER;mTmG mice showed increased synthesis of new membranes extended along axons to paranodes, indicating remyelination after TBI. At later times after TBI, an overall loss of conducting axons was observed at 6 weeks followed by CC atrophy at 8 weeks. These studies identify a progression of both myelinated axon conduction deficits and axon–myelin pathology in the CC, implicating WM injury in impaired information processing at early and late phases after TBI. Furthermore, the intervening recovery reveals a potential therapeutic window. SIGNIFICANCE STATEMENT Traumatic brain injury (TBI) is a major global health concern. Across the spectrum of TBI severities, impaired information processing can contribute to diverse functional deficits that underlie persistent symptoms. We used experimental TBI to exploit technical advantages in mice while modeling traumatic axonal injury in white matter tracts, which is a key pathological feature of human TBI. A combination of approaches revealed slowed and failed signal conduction along with damage to the structure and molecular composition of myelinated axons in the white matter after TBI. An early regenerative response was not sustained yet reveals a potential time window for intervention. These insights into white matter abnormalities underlying axon conduction deficits can inform strategies to improve treatment options for TBI patients.
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Bayard S, Gély-Nargeot MC, Raffard S, Guerdoux-Ninot E, Kamara E, Gros-Balthazard F, Jacus JP, Moroni C. French Version of the Hayling Sentence Completion Test, Part I: Normative Data and Guidelines for Error Scoring. Arch Clin Neuropsychol 2018; 32:585-591. [PMID: 28168283 DOI: 10.1093/arclin/acx010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 01/17/2017] [Indexed: 11/14/2022] Open
Abstract
Objective The Hayling Sentence Completion Test (HSCT) measures prepotent response inhibition, useful to assess inhibition deficit in a variety of clinical conditions. Despite its extensive use by numerous clinical and research groups in France, normative data for the HSCT are not yet available for French speakers. Method A French version of the HCST was administered to a sample of 426 healthy community-dwelling French speaking adults (20-87 years of age). Normative data were calculated using a regression-based approach. Results Regression analyses indicated that both age and education were associated with response latency and number of errors in the inhibition condition. Equations to calculate Z scores are provided for clinical use. In addition, we provided a clear guideline for the error scoring of the inhibition condition by establishing a corpus of errors adjusted for the linguistic and cultural realities of the French population. Using this guideline, a good inter-rater reliability was observed. Because of the restricted ranges of response latency and number of errors in the automatic condition, the relationship between these scores and demographic factors was not explored. By consequence, no norms were proposed for this condition. Conclusions We provide normative data of a French version of the HSCT for adults and elderly patients. These normative data obtained will be extremely useful for clinical practice and research purposes.
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Affiliation(s)
- Sophie Bayard
- Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier , France
| | | | - Stéphane Raffard
- Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier, France.,Service Universitaire de Psychiatrie Adulte, CHRU Montpellier, Montpellier, France
| | - Estelle Guerdoux-Ninot
- Clinique du Millénaire de Montpellier, Service de Neuro-Gériatrie, Montpellier cedex 02, France.,SIRIC, Institut régional du Cancer de Montpellier (ICM-Val d'Aurelle), Montpellier cedex 05, France
| | | | | | | | - Christine Moroni
- Équipe "Neuropsychologie, Audition, Cognition, Action" (NACA), Laboratoire "Psychologie: Interactions, Temps, Emotions, Cognition" (PSITEC) EA 4072, Université Lille Nord de France, France
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Owens JA, Spitz G, Ponsford JL, Dymowski AR, Willmott C. An investigation of white matter integrity and attention deficits following traumatic brain injury. Brain Inj 2018; 32:776-783. [PMID: 29565696 DOI: 10.1080/02699052.2018.1451656] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between white matter tracts and multiple aspects of attention and working memory deficits in a relatively acute traumatic brain injury (TBI) sample. METHOD Neuropsychological measures of attention and working memory were administered to 20 participants with complicated mild-to-very severe TBI and 20 control participants. Tract-based spatial statistics was used to assess fractional anisotropy (FA) and mean diffusivity (MD) of white matter tracts for 15 TBI participants and 20 controls. RESULTS When compared to controls, participants with TBI were found to have lower FA (p < 0.001) and higher MD (p < 0.001) values in the majority of white matter tracts. TBI participants were also slower to complete tasks including Trail Making Test, Hayling, computerized Selective Attention Task, n-back and Symbol Digit Modalities Test (p < 0.001), when compared to controls. When controlling for age and estimated premorbid intelligence, slowed information processing speed following TBI was found to be associated with FA values in the corpus callosum, superior longitudinal fasciculus, cingulum, inferior fronto-occipital fasciculi, corona radiata and cerebral white matter. CONCLUSION The results highlight the widespread damage associated with TBI, as well as the impact of these alterations on information processing speed.
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Affiliation(s)
- Jacqueline Anne Owens
- a School of Psychological Sciences , Monash University , Melbourne , Australia.,b Monash-Epworth Rehabilitation Research Centre , Epworth HealthCare , Melbourne , Australia.,c Monash Institute of Cognitive and Clinical Neurosciences , Monash University , Melbourne , Australia
| | - Gershon Spitz
- a School of Psychological Sciences , Monash University , Melbourne , Australia.,b Monash-Epworth Rehabilitation Research Centre , Epworth HealthCare , Melbourne , Australia.,c Monash Institute of Cognitive and Clinical Neurosciences , Monash University , Melbourne , Australia
| | - Jennie Louise Ponsford
- a School of Psychological Sciences , Monash University , Melbourne , Australia.,b Monash-Epworth Rehabilitation Research Centre , Epworth HealthCare , Melbourne , Australia.,c Monash Institute of Cognitive and Clinical Neurosciences , Monash University , Melbourne , Australia
| | - Alicia Rhian Dymowski
- a School of Psychological Sciences , Monash University , Melbourne , Australia.,b Monash-Epworth Rehabilitation Research Centre , Epworth HealthCare , Melbourne , Australia.,c Monash Institute of Cognitive and Clinical Neurosciences , Monash University , Melbourne , Australia
| | - Catherine Willmott
- a School of Psychological Sciences , Monash University , Melbourne , Australia.,b Monash-Epworth Rehabilitation Research Centre , Epworth HealthCare , Melbourne , Australia.,c Monash Institute of Cognitive and Clinical Neurosciences , Monash University , Melbourne , Australia
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Zhang BL, Fan YS, Wang JW, Zhou ZW, Wu YG, Yang MC, Sun DD, Zhang JN. Cognitive impairment after traumatic brain injury is associated with reduced long-term depression of excitatory postsynaptic potential in the rat hippocampal dentate gyrus. Neural Regen Res 2018; 13:1753-1758. [PMID: 30136690 PMCID: PMC6128047 DOI: 10.4103/1673-5374.238618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Traumatic brain injury can cause loss of neuronal tissue, remote symptomatic epilepsy, and cognitive deficits. However, the mechanisms underlying the effects of traumatic brain injury are not yet clear. Hippocampal excitability is strongly correlated with cognitive dysfunction and remote symptomatic epilepsy. In this study, we examined the relationship between traumatic brain injury-induced neuronal loss and subsequent hippocampal regional excitability. We used hydraulic percussion to generate a rat model of traumatic brain injury. At 7 days after injury, the mean modified neurological severity score was 9.5, suggesting that the neurological function of the rats was remarkably impaired. Electrophysiology and immunocytochemical staining revealed increases in the slope of excitatory postsynaptic potentials and long-term depression (indicating weakened long-term inhibition), and the numbers of cholecystokinin and parvalbumin immunoreactive cells were clearly reduced in the rat hippocampal dentate gyrus. These results indicate that interneuronal loss and changes in excitability occurred in the hippocampal dentate gyrus. Thus, traumatic brain injury-induced loss of interneurons appears to be associated with reduced long-term depression in the hippocampal dentate gyrus.
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Affiliation(s)
- Bao-Liang Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Yue-Shan Fan
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Ji-Wei Wang
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Zi-Wei Zhou
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Yin-Gang Wu
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Meng-Chen Yang
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Dong-Dong Sun
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Jian-Ning Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
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The Box Task: A tool to design experiments for assessing visuospatial working memory. Behav Res Methods 2017; 50:1981-1987. [DOI: 10.3758/s13428-017-0966-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Azouvi P, Arnould A, Dromer E, Vallat-Azouvi C. Neuropsychology of traumatic brain injury: An expert overview. Rev Neurol (Paris) 2017; 173:461-472. [PMID: 28847474 DOI: 10.1016/j.neurol.2017.07.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/13/2017] [Indexed: 01/12/2023]
Abstract
Traumatic brain injury (TBI) is a serious healthcare problem, and this report is a selective review of recent findings on the epidemiology, pathophysiology and neuropsychological impairments following TBI. Patients who survive moderate-to-severe TBI frequently suffer from a wide range of cognitive deficits and behavioral changes due to diffuse axonal injury. These deficits include slowed information-processing and impaired long-term memory, attention, working memory, executive function, social cognition and self-awareness. Mental fatigue is frequently also associated and can exacerbate the consequences of neuropsychological deficits. Personality and behavioral changes can include combinations of impulsivity and apathy. Even mild TBI raises specific problems: while most patients recover within a few weeks or months, a minority of patients may suffer from long-lasting symptoms (post-concussion syndrome). The pathophysiology of such persistent problems remains a subject of debate, but seems to be due to both injury-related and non-injury-related factors.
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Affiliation(s)
- P Azouvi
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France.
| | - A Arnould
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France
| | - E Dromer
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France
| | - C Vallat-Azouvi
- HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France; Laboratoire de psychopathologie et neuropsychologie, EA 2027, université Paris-8-Saint-Denis, 2, rue de la Liberté, 93526 Saint-Denis, France; Antenne UEROS- UGECAMIDF, hôpital Raymond-Poincaré, 104, boulevard Raymond-Poincaré, 92380 Garches, France
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Spitoni GF, Bevacqua S, Cerini C, Ciurli P, Piccardi L, Guariglia P, Pezzuti L, Antonucci G. Normative Data for the Hayling and Brixton Tests in an Italian Population. Arch Clin Neuropsychol 2017; 33:466-476. [DOI: 10.1093/arclin/acx072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/26/2017] [Indexed: 01/10/2023] Open
Affiliation(s)
- Grazia Fernanda Spitoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Neuropsychology Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sara Bevacqua
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Claudia Cerini
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Paola Ciurli
- Neuropsychology Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Laura Piccardi
- Neuropsychology Unit, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Life, Health and Environmental Sciences, L’Aquila University, L’Aquila, Italy
| | - Paola Guariglia
- Department of Human Science and Society, University of Enna “Kore”, Enna, Italy
| | - Lina Pezzuti
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Gabriella Antonucci
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Neuropsychology Unit, IRCCS Santa Lucia Foundation, Rome, Italy
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Bayard S, Moroni C, Gély-Nargeot MC, Rossignol-Arifi A, Kamara E, Raffard S. French Version of the Hayling Sentence Completion Test, Part II: Clinical Utility in Schizophrenia and Parkinson's Disease. Arch Clin Neuropsychol 2017; 32:592-597. [PMID: 28174827 DOI: 10.1093/arclin/acx011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 01/17/2017] [Indexed: 11/13/2022] Open
Abstract
Objective We previously developed normative data for a French version of the Hayling Sentence Completion Test (f-HSCT) for adults and elderly people. The present study aimed to evaluate the clinical utility of the f-HSCT norms in two clinical populations in which inhibition dysfunction has been largely documented, i.e., Parkinson's disease (PD) and schizophrenia. Method Eighty-five non-demented patients with idiopathic PD and 64 out-patients with schizophrenia completed the automatic and inhibition conditions of the f-HSCT. Time latencies and errors raw data of each patient were compared to the norms previously developed by the authors. Results In the automatic condition, errors were rare in both clinical groups and time latencies on this condition felt within the normative data range. Compared with the standardized norms, 46% of patients with PD and 61% of patients with schizophrenia had a deviant performance (i.e., borderline or deficit) for the inhibition error score. The proportion of patients with a deviant performance on the inhibition response time score was similar in both clinical samples (respectively, 25% and 23%). Finally, slightly more than half of patients with PD and more than two-thirds of patients with schizophrenia had a deviant performance on at least one of the f-HSCT inhibition measures. Conclusions Our results suggest that the f-HSCT has a strong potential for characterizing inhibition of prepotent responses in PD and schizophrenia. Furthermore, it requires only a short administration time so it may be ideal to detect response inhibition in clinical populations with cognitive fatigue.
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Affiliation(s)
- Sophie Bayard
- Laboratoire Epsylon, EA 4556 , Université Paul Valéry Montpellier 3, Montpellier, France
| | - Christine Moroni
- Équipe "Neuropsychologie, Audition, Cognition, Action" (NACA), Laboratoire "Psychologie: Interactions, Temps, Emotions, Cognition" (PSITEC) EA 4072, Université Lille Nord de France, France
| | | | - Alexia Rossignol-Arifi
- Centre Expert Maladie de Parkinson, Service Universitaire de Neurologie, CHRU Montpellier, Montpellier , France
| | | | - Stéphane Raffard
- Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier, France.,Service Universitaire de Psychiatrie Adulte, CHRU Montpellier, Montpellier, France
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Robertson K, Schmitter-Edgecombe M. Focused and divided attention abilities in the acute phase of recovery from moderate to severe traumatic brain injury. Brain Inj 2017; 31:1069-1076. [PMID: 28481625 PMCID: PMC6174004 DOI: 10.1080/02699052.2017.1296192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PRIMARY OBJECTIVE Impairments in attention following traumatic brain injury (TBI) can significantly impact recovery and rehabilitation effectiveness. This study investigated the multi-faceted construct of selective attention following TBI, highlighting the differences on visual nonsearch (focused attention) and search (divided attention) tasks. METHODS AND PROCEDURES Participants were 30 individuals with moderate to severe TBI who were tested acutely (i.e. following emergence from PTA) and 30 age- and education-matched controls. Participants were presented with visual displays that contained either two or eight items. In the focused attention, nonsearch condition, the location of the target (if present) was cued with a peripheral arrow prior to presentation of the visual displays. In the divided attention, search condition, no spatial cue was provided prior to presentation of the visual displays. MAIN OUTCOMES AND RESULTS The results revealed intact focused, nonsearch, attention abilities in the acute phase of TBI recovery. In contrast, when no spatial cue was provided (divided attention condition), participants with TBI demonstrated slower visual search compared to the control group. CONCLUSIONS The results of this study suggest that capitalizing on intact focused attention abilities by allocating attention during cognitively demanding tasks may help to reduce mental workload and improve rehabilitation effectiveness.
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Affiliation(s)
- Kayela Robertson
- a Department of Psychology , Washington State University , Pullman , WA , USA
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36
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Owens JA, Spitz G, Ponsford JL, Dymowski AR, Ferris N, Willmott C. White matter integrity of the medial forebrain bundle and attention and working memory deficits following traumatic brain injury. Brain Behav 2017; 7:e00608. [PMID: 28239519 PMCID: PMC5318362 DOI: 10.1002/brb3.608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 09/10/2016] [Accepted: 10/13/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The medial forebrain bundle (MFB) contains ascending catecholamine fibers that project to the prefrontal cortex (PFC). Damage to these fibers following traumatic brain injury (TBI) may alter extracellular catecholamine levels in the PFC and impede attention and working memory ability. This study investigated white matter microstructure of the medial MFB, specifically the supero-lateral branch (slMFB), following TBI, and its association with performance on attention and working memory tasks. METHOD Neuropsychological measures of attention and working memory were administered to 20 moderate-severe participants with TBI (posttraumatic amnesia M = 40.05 ± 37.10 days, median time since injury 10.48 months, range 3.72-87.49) and 20 healthy controls. Probabilistic tractography was used to obtain fractional anisotropy (FA) and mean diffusivity (MD) values for 17 participants with TBI and 20 healthy controls. RESULTS When compared to controls, participants with TBI were found to have significantly lower FA (p < .001) and higher MD (p < .001) slMFB values, and they were slower to complete tasks including Trail Making Task-A, Hayling, selective attention task, n-back, and Symbol Digit Modalities Test. CONCLUSION This study was the first to demonstrate microstructural white matter damage within the slMFB following TBI. However, no evidence was found for an association of alterations to this tract and performance on attentional tasks.
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Affiliation(s)
- Jacqueline A Owens
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Gershon Spitz
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Jennie L Ponsford
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Alicia R Dymowski
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Nicholas Ferris
- Monash Biomedical Imaging Monash University Melbourne Vic. Australia
| | - Catherine Willmott
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
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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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Donnelly KZ, Linnea K, Grant DA, Lichtenstein J. The feasibility and impact of a yoga pilot programme on the quality-of-life of adults with acquired brain injury. Brain Inj 2016; 31:208-214. [PMID: 27936953 DOI: 10.1080/02699052.2016.1225988] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This pilot study measured the feasibility and impact of an 8-week yoga programme on the quality-of-life of adults with acquired brain injury (ABI). METHODS Thirty-one adults with ABI were allocated to yoga (n = 16) or control (n = 15) groups. Participants completed the Quality of Life After Brain Injury (QOLIBRI) measure pre- and post-intervention; individuals in the yoga group also rated programme satisfaction. Mann-Whitney/Wilcoxon and the Wilcoxon Signed Rank tests were used to evaluate between- and within-group differences for the total and sub-scale QOLIBRI scores, respectively. RESULTS No significant differences emerged between groups on the QOLIBRI pre- or post-intervention. However, there were significant improvements on overall quality-of-life and on Emotions and Feeling sub-scales for the intervention group only. The overall QOLIBRI score improved from 1.93 (SD = 0.27) to 2.15 (SD = 0.34, p = 0.01). The mean Emotions sub-scale increased from 1.69 (SD = 0.40) to 2.01 (SD = 0.52, p = 0.01), and the mean Feeling sub-scale from 2.1 (SD = 0.34) to 2.42 (SD = 0.39, p = 0.01). CONCLUSION Adults with ABI experienced improvements in overall quality-of-life following an 8-week yoga programme. Specific improvements in self-perception and negative emotions also emerged. High attendance and satisfaction ratings support the feasibility of this type of intervention for people with brain injury.
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Affiliation(s)
- Kyla Z Donnelly
- a The Dartmouth Institute for Health Policy and Clinical Practice , Dartmouth College , Lebanon , NH , USA
| | - Kate Linnea
- b Geisel School of Medicine at Dartmouth , Lebanon , NH , USA
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Dymowski AR, Ponsford JL, Owens JA, Olver JH, Ponsford M, Willmott C. The efficacy and safety of extended-release methylphenidate following traumatic brain injury: a randomised controlled pilot study. Clin Rehabil 2016; 31:733-741. [PMID: 27353245 DOI: 10.1177/0269215516655590] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the feasibility, safety and efficacy of extended-release methylphenidate in enhancing processing speed, complex attentional functioning and everyday attentional behaviour after traumatic brain injury. DESIGN Seven week randomised, placebo-controlled, double-blind, parallel pilot study. SETTING Inpatient and outpatient Acquired Brain Injury Rehabilitation Program. PARTICIPANTS Eleven individuals with reduced processing speed and/or attention deficits following complicated mild to severe traumatic brain injury. INTERVENTIONS Participants were allocated using a blocked randomisation schedule to receive daily extended-release methylphenidate (Ritalin® LA at a dose of 0.6 mg/kg) or placebo (lactose) in identical capsules. MAIN OUTCOMES Tests of processing speed and complex attention, and ratings of everyday attentional behaviour were completed at baseline, week 7 (on-drug), week 8 (off-drug) and 9 months follow-up. Vital signs and side effects were monitored from baseline to week 8. RESULTS Three percent ( n = 11) of individuals screened participated (mean post-traumatic amnesia duration = 63.80 days, SD = 45.15). Results were analysed for six and four individuals on methylphenidate and placebo, respectively. Groups did not differ on attentional test performance or relative/therapist ratings of everyday attentional behaviour. One methylphenidate participant withdrew due to difficulty sleeping. Methylphenidate was associated with trends towards increased blood pressure and reported anxiety. CONCLUSION Methylphenidate was not associated with enhanced processing speed, attentional functioning or everyday attentional behaviour after traumatic brain injury. Alternative treatments for attention deficits after traumatic brain injury should be explored given the limited feasibility of methylphenidate in this population.
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Affiliation(s)
- Alicia R Dymowski
- 1 School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia.,2 Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Australia
| | - Jennie L Ponsford
- 1 School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia.,2 Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Australia
| | - Jacqueline A Owens
- 1 School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia.,2 Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Australia
| | - John H Olver
- 3 Epworth-Monash Rehabilitation Medicine Unit, Epworth HealthCare, Australia.,4 Epworth Rehabilitation, Epworth HealthCare, Australia
| | | | - Catherine Willmott
- 1 School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia.,2 Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Australia
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