1
|
Chuang LL, Hsu AL, Lin YH, Yu MH, Hu GC, Ou YC, Wong AMK. Multimodal training with dual-task enhances immediate and retained effects on dual-task effects of gait speed not by cognitive-motor trade-offs in stroke survivors: a randomized controlled trial. Disabil Rehabil 2024:1-10. [PMID: 38885066 DOI: 10.1080/09638288.2024.2365986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Individuals who have experienced stroke may benefit from dual-task related training to improve gait speed performance. Whether noted improvements reflect true effects on gait or cognitive-motor trade-offs still remains unclear. Therefore, this study aimed to investigate the effects of dual-task training on dual-task effects of both walking and cognitive domains in stroke survivors. MATERIALS AND METHODS Forty-four individuals with stroke were randomized to dual-task or single-task training groups. Both groups exercised three 60-minute sessions per week for 4 weeks. The primary outcomes were dual-task effects on gait speed and cognitive score. Outcomes were assessed before and after the intervention and 1-month follow-up. RESULTS While both groups exhibited improvement in absolute gait speed under dual-task conditions, the dual-task training group demonstrated superior results by providing an additional gain on dual-task effects of gait speed. Compared to single-task training, dual-task training exhibited a significant improvement in dual-task effects of gait speed at post-treatment and follow-up. Regarding the dual-task effects on cognitive scores, no significant differences within and between groups after training were observed. CONCLUSION Dual-task training enhances immediate and retained effects on the dual-task effects of gait speed in individuals with stroke, not by cognitive-motor trade-offs. TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. CLINICALTRIALS.GOV IDENTIFIER NCT02686515.
Collapse
Affiliation(s)
- Li-Ling Chuang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - An-Lun Hsu
- Department of Physical Therapy, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yun-Hsuan Lin
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Meng-Hua Yu
- Department of Physical Therapy, Mackay Memorial Hospital, Taipei, Taiwan
| | - Gwo-Chi Hu
- Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Yu-Chih Ou
- Department of Physical Therapy, Mackay Memorial Hospital, Taipei, Taiwan
| | - Alice May-Kuen Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
| |
Collapse
|
2
|
Pavel DG, Henderson TA, DeBruin S. The Legacy of the TTASAAN Report-Premature Conclusions and Forgotten Promises: A Review of Policy and Practice Part I. Front Neurol 2022; 12:749579. [PMID: 35450131 PMCID: PMC9017602 DOI: 10.3389/fneur.2021.749579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022] Open
Abstract
Brain perfusion single photon emission computed tomography (SPECT) scans were initially developed in 1970's. A key radiopharmaceutical, hexamethylpropyleneamine oxime (HMPAO), was originally approved in 1988, but was unstable. As a result, the quality of SPECT images varied greatly based on technique until 1993, when a method of stabilizing HMPAO was developed. In addition, most SPECT perfusion studies pre-1996 were performed on single-head gamma cameras. In 1996, the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology (TTASAAN) issued a report regarding the use of SPECT in the evaluation of neurological disorders. Although the TTASAAN report was published in January 1996, it was approved for publication in October 1994. Consequently, the reported brain SPECT studies relied upon to derive the conclusions of the TTASAAN report largely pre-date the introduction of stabilized HMPAO. While only 12% of the studies on traumatic brain injury (TBI) in the TTASAAN report utilized stable tracers and multi-head cameras, 69 subsequent studies with more than 23,000 subjects describe the utility of perfusion SPECT scans in the evaluation of TBI. Similarly, dementia SPECT imaging has improved. Modern SPECT utilizing multi-headed gamma cameras and quantitative analysis has a sensitivity of 86% and a specificity of 89% for the diagnosis of mild to moderate Alzheimer's disease-comparable to fluorodeoxyglucose positron emission tomography. Advances also have occurred in seizure neuroimaging. Lastly, developments in SPECT imaging of neurotoxicity and neuropsychiatric disorders have been striking. At the 25-year anniversary of the publication of the TTASAAN report, it is time to re-examine the utility of perfusion SPECT brain imaging. Herein, we review studies cited by the TTASAAN report vs. current brain SPECT imaging research literature for the major indications addressed in the report, as well as for emerging indications. In Part II, we elaborate technical aspects of SPECT neuroimaging and discuss scan interpretation for the clinician.
Collapse
Affiliation(s)
- Dan G Pavel
- Pathfinder Brain SPECT Imaging, Deerfield, IL, United States.,The International Society of Applied Neuroimaging (ISAN), Denver, CO, United States
| | - Theodore A Henderson
- The International Society of Applied Neuroimaging (ISAN), Denver, CO, United States.,The Synaptic Space, Inc., Denver, CO, United States.,Neuro-Luminance, Inc., Denver, CO, United States.,Dr. Theodore Henderson, Inc., Denver, CO, United States
| | - Simon DeBruin
- The International Society of Applied Neuroimaging (ISAN), Denver, CO, United States.,Good Lion Imaging, Columbia, SC, United States
| |
Collapse
|
3
|
Nakajima R, Kinoshita M, Nakada M. Simultaneous Damage of the Cingulate Cortex Zone II and Fronto-Striatal Circuit Causes Prolonged Selective Attentional Deficits. Front Hum Neurosci 2022; 15:762578. [PMID: 35002655 PMCID: PMC8740164 DOI: 10.3389/fnhum.2021.762578] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/06/2021] [Indexed: 11/15/2022] Open
Abstract
Selective attention is essential for successful cognitive performance. Although several brain areas are known to be involved in selective attention, damage to some of these areas does not necessarily cause attentional deficits. In the current study, we hypothesized that damage to specific parts of the right cerebral hemisphere, especially the cingulate cortex (CC), causes prolonged selective attentional deficits, and examined the influence of focal brain damage on selective attention. We recruited 36 patients with right cerebral hemispheric WHO grade 2 and 3 brain tumors who underwent surgery. We assessed selective attention over time from pre-operation to 3 months postoperatively using the cancelation test and color Stroop test, and calculated the percentage of deficit. Additionally, two types of imaging analyses were performed: voxel-based lesion symptom mapping (VLSM) and multiple logistic regression analysis, to reveal related brain regions for selective attention. Consequently, we found that the CC and deep part of the middle frontal gyrus were associated with deficits in selective attention via VLSM. Using multiple logistic regression analysis, the CC zone II at the cortical level (p < 0.0001) and the fronto-striatal tract (FST) at the subcortical level (p = 0.0079) were associated with attentional deficit among several regions identified in the VLSM. At 3 months postoperatively, selective attention was impaired in patients who underwent resection of these regions. Moreover, only patients with simultaneous damage of the CC zone II and FST had prolonged attentional deficits until the chronic phase. Our results suggest that the right CC zone II and FST are critical areas for the selective attentional networks.
Collapse
Affiliation(s)
- Riho Nakajima
- Department of Occupational Therapy, Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Masashi Kinoshita
- Department of Neurosurgery, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| |
Collapse
|
4
|
Cremers LGM, Huizinga W, Niessen WJ, Krestin GP, Poot DHJ, Ikram MA, Lötjönen J, Klein S, Vernooij MW. Predicting Global Cognitive Decline in the General Population Using the Disease State Index. Front Aging Neurosci 2020; 11:379. [PMID: 32038225 PMCID: PMC6989484 DOI: 10.3389/fnagi.2019.00379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background Identifying persons at risk for cognitive decline may aid in early detection of persons at risk of dementia and to select those that would benefit most from therapeutic or preventive measures for dementia. Objective In this study we aimed to validate whether cognitive decline in the general population can be predicted with multivariate data using a previously proposed supervised classification method: Disease State Index (DSI). Methods We included 2,542 participants, non-demented and without mild cognitive impairment at baseline, from the population-based Rotterdam Study (mean age 60.9 ± 9.1 years). Participants with significant global cognitive decline were defined as the 5% of participants with the largest cognitive decline per year. We trained DSI to predict occurrence of significant global cognitive decline using a large variety of baseline features, including magnetic resonance imaging (MRI) features, cardiovascular risk factors, APOE-ε4 allele carriership, gait features, education, and baseline cognitive function as predictors. The prediction performance was assessed as area under the receiver operating characteristic curve (AUC), using 500 repetitions of 2-fold cross-validation experiments, in which (a randomly selected) half of the data was used for training and the other half for testing. Results A mean AUC (95% confidence interval) for DSI prediction was 0.78 (0.77–0.79) using only age as input feature. When using all available features, a mean AUC of 0.77 (0.75–0.78) was obtained. Without age, and with age-corrected features and feature selection on MRI features, a mean AUC of 0.70 (0.63–0.76) was obtained, showing the potential of other features besides age. Conclusion The best performance in the prediction of global cognitive decline in the general population by DSI was obtained using only age as input feature. Other features showed potential, but did not improve prediction. Future studies should evaluate whether the performance could be improved by new features, e.g., longitudinal features, and other prediction methods.
Collapse
Affiliation(s)
- Lotte G M Cremers
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Wyke Huizinga
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Wiro J Niessen
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, Netherlands.,Department of Imaging Science and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, Netherlands
| | - Gabriel P Krestin
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Dirk H J Poot
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - M Arfan Ikram
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Neurology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jyrki Lötjönen
- VTT Technical Research Centre of Finland, Tampere, Finland.,Combinostics, Tampere, Finland
| | - Stefan Klein
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
5
|
Kim DH, Kim KH, Lee SM. The effects of Virtual Reality Training with Upper Limb Sensory
Exercise Stimulation on the AROM of Upper Limb Joints, Function, and
Concentration in Chronic Stroke Patients. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2019. [DOI: 10.1055/a-0917-4604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Abstract
Objective We investigated the effect of upper limb sensory stimulation
and virtual reality rehabilitation (SMVR) on upper extremity active joint angle,
function and cognitive ability in chronic stroke patients.
Methods A total of 30 patients were randomly divided into SMVR group and
CON group. SMVR group was performed 60 min three times a week for 8
weeks in upper limb sensory stimulation and robot virtual reality
rehabilitation. CON group performed conservative treatment and peripheral joint
movement for 60 min. The upper limb function was measured by the
Jebsen-Taylor hand function test (JTT) and the cognitive ability test was
performed by the Stroop test (ST) and Trail making test (TMT).
Results There was a significant difference (P<0.05) between
before and after training in both groups, and SMVR group showed significant
improvement in both groups.
Conclusions In this study, we confirmed that robot virtual reality
training in combination with limb motion stimulation for stroke patients
positively affects the angle, function, and concentration of upper extremity
active joints in chronic stroke patients.
Collapse
Affiliation(s)
- Dong Hoon Kim
- Bundang Jesaeng Hospital, RM, Seongnam, Korea (the Republic
of)
| | - Kyung-Hun Kim
- Physical Therapy, Gimcheon University, Gimcheon, Korea (the Republic
of)
| | - Suk-Min Lee
- Physical Therapy, Sahmyook University, Nowon-gu, Korea (the Republic
of)
| |
Collapse
|
6
|
Park MO, Lee SH. Effect of a dual-task program with different cognitive tasks applied to stroke patients: A pilot randomized controlled trial. NeuroRehabilitation 2019; 44:239-249. [PMID: 31006694 DOI: 10.3233/nre-182563] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dual-task training using one walking and one cognitive task is effective in improving post-stroke motor functions. OBJECTIVE We aimed to investigate the effectiveness of dual-task training using various cognitive tasks for the assessment of attention, executive function, and motor function in stroke patients. METHODS This was a single-center, randomized trial involving 30 stroke patients who were divided into a dual-task (test) group (n = 15) using different cognitive tests, and a conventional occupational therapy (control) group (n = 15). In both groups, interventions were conducted 18 times, at 30 minutes per session, 3 sessions per week, for 6 weeks. Primary outcome measures were the Trail Making Test A&B, the Digit Span Test (DST) Forward and Backward, and the Stroop (ST) Color and Word test. Secondary outcome measures were the Fugl-Meyer Assessment, the Modified Functional Reach Test, and the Berg Balance Scale. Each test was applied pre-and post- intervention. RESULTS Post-intervention, the dual-task group showed a significantly stronger effect than the occupational therapy group in the DST-Forward (p = 0.04), DST-Backward (p = 0.001), ST-Color (p = 0.023), and Berg Balance Scale (p = 0.009) assessments. CONCLUSIONS Dual-task training using various cognitive tasks had a greater positive effect than conventional occupational therapy on auditory attention, memory span, executive function, and balance.
Collapse
Affiliation(s)
- Myoung-Ok Park
- Department of Occupational Therapy, Division of Health Science, Baekseok University, Cheonan-si, Chungcheongnam-do, Republic of Korea
| | - Sang-Heon Lee
- Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Asan-si, Chungcheongnam-do, Republic of Korea
| |
Collapse
|
7
|
Langen CD, Cremers LGM, de Groot M, White T, Ikram MA, Niessen WJ, Vernooij MW. Disconnection due to white matter hyperintensities is associated with lower cognitive scores. Neuroimage 2018; 183:745-756. [PMID: 30144572 DOI: 10.1016/j.neuroimage.2018.08.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/27/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022] Open
Abstract
Previous studies have linked global burden of age-related white matter hyperintensities (WMHs) to cognitive impairment. We aimed to determine how WMHs in individual white matter connections relate to measures of cognitive function relative to measures of connectivity which do not take WMHs into account. Brain connectivity and WMH-related disconnectivity were derived from 3714 participants of the population-based Rotterdam Study. Connectivity was represented by the structural connectome, which was defined using diffusion tensor data, whereas the disconnectome represented disconnectivity due to WMH. The relationship between (dis)connectivity and cognitive measures was estimated using linear regression. We found that lower disconnectivity and higher connectivity corresponded to better cognitive function. There were many more significant associations with cognitive function in the disconnectome than in the connectome. Most connectome associations attenuated when disconnection was included in the model. WMH-related disconnectivity was especially related to worse executive functioning. Better cognitive speed corresponded to higher connectivity in specific connections independent of WMH presence. We conclude that WMH-related disconnectivity explains more variation in cognitive function than does connectivity. Efficient wiring in specific connections is important to information processing speed independent of WMH presence.
Collapse
Affiliation(s)
- Carolyn D Langen
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Medical Informatics, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Lotte G M Cremers
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Marius de Groot
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Medical Informatics, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Tonya White
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - M Arfan Ikram
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Wiro J Niessen
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Medical Informatics, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Imaging Physics, Faculty of Applied Sciences, PO Box 5046, 2600GA, Delft University of Technology, Delft, the Netherlands.
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| |
Collapse
|
8
|
Raji CA, Henderson TA. PET and Single-Photon Emission Computed Tomography in Brain Concussion. Neuroimaging Clin N Am 2018; 28:67-82. [PMID: 29157854 DOI: 10.1016/j.nic.2017.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This article offers an overview of the application of PET and single photon emission computed tomography brain imaging to concussion, a type of mild traumatic brain injury and traumatic brain injury, in general. The article reviews the application of these neuronuclear imaging modalities in cross-sectional and longitudinal studies. Additionally, this article frames the current literature with an overview of the basic physics and radiation exposure risks of each modality.
Collapse
Affiliation(s)
- Cyrus A Raji
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, UCSF China Basin, 185 Berry Street, Suite 350, San Francisco, CA 94158, USA
| | - Theodore A Henderson
- The Synaptic Space Inc, Neuro-Laser Foundation, Neuro-Luminance Brain Health Centers Inc, Dr. Theodore Henderson Inc, 3979 East Arapahoe Road, Suite 200, Centennial, CO 80122, USA.
| |
Collapse
|
9
|
Evans TE, Adams HHH, Licher S, Wolters FJ, van der Lugt A, Ikram MK, O'Sullivan MJ, Vernooij MW, Ikram MA. Subregional volumes of the hippocampus in relation to cognitive function and risk of dementia. Neuroimage 2018; 178:129-135. [PMID: 29778641 DOI: 10.1016/j.neuroimage.2018.05.041] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Total hippocampal volume has been consistently linked to cognitive function and dementia. Yet, given its complex and parcellated internal structure, the role of subregions of the hippocampus in cognition and risk of dementia remains relatively underexplored. We studied subregions of the hippocampus in a large population-based cohort to further understand their role in cognitive impairment and dementia risk. METHODS We studied 5035 dementia- and stroke-free persons from the Rotterdam Study, aged over 45 years. All participants underwent magnetic resonance imaging (1.5 T) between 2005 and 2015. Automatic segmentation of the hippocampus and 12 of its subregions was performed using the FreeSurfer software (version 6.0). A cognitive test battery was performed, and participants were followed up for the development of dementia until 2015. Associations of hippocampal subregion volumes with cognition and incident dementia were examined using linear and Cox regression models, respectively. All analyses were adjusted for age, sex, education, and total hippocampal volume. RESULTS Mean age was 64.3 years (SD 10.6) with 56% women. Smaller volumes of the hippocampal fimbria, presubiculum and subiculum showed the strongest associations with poor performance on several cognitive domains, including executive function but not memory. During a mean follow-up of 5.5 years, 76 persons developed dementia. Smaller subiculum volume was associated with risk of dementia adjusted for total volume (hazard ratio per SD decrease in volume: 1.75, 95% confidence interval 1.35; 2.26). CONCLUSIONS In a community-dwelling non-demented population, we describe patterns of association between hippocampal subregions with cognition and risk of dementia. Specifically, the subiculum was associated with both poorer cognition and higher risk of dementia.
Collapse
Affiliation(s)
- Tavia E Evans
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Division of Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, Maurice Wohl Clinical Neuroscience Institute, 5 Cutcombe Road, London, SE5 9RX, UK.
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Silvan Licher
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Michael J O'Sullivan
- Division of Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, Maurice Wohl Clinical Neuroscience Institute, 5 Cutcombe Road, London, SE5 9RX, UK; Mater Centre for Neuroscience and Queensland Brain Institute, 79, University of Queensland, St Lucia, QLD, 4072, Australia.
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| |
Collapse
|
10
|
Altered tract-specific white matter microstructure is related to poorer cognitive performance: The Rotterdam Study. Neurobiol Aging 2016; 39:108-17. [PMID: 26923407 DOI: 10.1016/j.neurobiolaging.2015.11.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 11/24/2015] [Accepted: 11/26/2015] [Indexed: 01/23/2023]
|
11
|
Romero K, Lobaugh NJ, Black SE, Ehrlich L, Feinstein A. Old wine in new bottles: validating the clinical utility of SPECT in predicting cognitive performance in mild traumatic brain injury. Psychiatry Res 2015; 231:15-24. [PMID: 25466236 DOI: 10.1016/j.pscychresns.2014.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 10/21/2014] [Accepted: 11/06/2014] [Indexed: 11/16/2022]
Abstract
The neural underpinnings of cognitive dysfunction in mild traumatic brain injury (TBI) are not fully understood. Consequently, patient prognosis using existing clinical imaging is somewhat imprecise. Single photon emission computed tomography (SPECT) is a frequently employed investigation in this population, notwithstanding uncertainty over the clinical utility of the data obtained. In this study, subjects with mild TBI underwent (99m)Tc-ECD SPECT scanning, and were administered a brief battery of cognitive tests and self-report symptom scales of concussion and emotional distress. Testing took place 2 weeks (n=84) and 1 year (n=49) post-injury. Multivariate analysis (i.e., partial least squares analysis) revealed that frontal perfusion in right superior frontal and middle frontal gyri predicted poorer performance on the Stroop test, an index of executive function, both at initial and follow-up testing. Conversely, SPECT scans categorized as normal or abnormal by radiologists did not differentiate cognitively impaired from intact subjects. These results demonstrate the clinical utility of SPECT in mild TBI, but only when data are subjected to blood flow quantification analysis.
Collapse
Affiliation(s)
- Kristoffer Romero
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5.
| | - Nancy J Lobaugh
- Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, Canada M5T 1R8
| | - Sandra E Black
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5; L.C. Campbell Cognitive Neurology Research Unit, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5; Heart and Stroke Foundation Centre for Stroke Recovery, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5
| | - Lisa Ehrlich
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5
| | - Anthony Feinstein
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5
| |
Collapse
|
12
|
Raji CA, Tarzwell R, Pavel D, Schneider H, Uszler M, Thornton J, van Lierop M, Cohen P, Amen DG, Henderson T. Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review. PLoS One 2014; 9:e91088. [PMID: 24646878 PMCID: PMC3960124 DOI: 10.1371/journal.pone.0091088] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 02/10/2014] [Indexed: 12/14/2022] Open
Abstract
Purpose This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI). Methods After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review. Results We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94%) and temporal (77%) lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value. Conclusions This review demonstrates Level IIA evidence (at least one non-randomized controlled trial) for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post-injury neurological or psychiatric symptoms.
Collapse
Affiliation(s)
- Cyrus A. Raji
- UCLA Medical Center, Los Angeles, California, United States of America
| | - Robert Tarzwell
- University of British Columbia School of Medicine, Vancouver, British Columbia, Canada
| | - Dan Pavel
- PathFinder Brain SPECT, Deerfield, Illinois, United States of America
| | | | - Michael Uszler
- St. Johns Health Center, Santa Monica, California, United States of America
| | - John Thornton
- Rossiter-Thornton Associates, Toronto, Ontario, Canada
| | | | - Phil Cohen
- Lions Gate Hospital, Vancouver, British Columbia, Canada
| | - Daniel G. Amen
- Amen Clinics, Inc., Newport Beach, California, United States of America
| | | |
Collapse
|
13
|
Kim GY, Han MR, Lee HG. Effect of Dual-task Rehabilitative Training on Cognitive and Motor Function of Stroke Patients. J Phys Ther Sci 2014; 26:1-6. [PMID: 24567664 PMCID: PMC3927016 DOI: 10.1589/jpts.26.1] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 07/22/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To determine the effect of dual-task training with cognitive tasks on
cognitive and walking ability after stroke. [Subjects and Methods] Twenty patients
diagnosed with stroke participated in this study. All participants were receiving a
traditional rehabilitation program 5 days a week. Dual-task and single-task training were
additionally performed for 4 weeks, 3 days a week. The Stroop test, Timed Up and Go (TUG)
test, 10-Meter Walk Test (10MWT), and Figure-of-8 Walk Test (F8WT) were used to measure
cognitive and walking abilities and were evaluated 3 times (before and after training and
at the 2-week follow-up). [Results] Dual-task training improved cognitive and walking
abilities, and dual-task training subjects’ performance was better than single-task
training subjects’ performance. In addition, these training benefits were maintained for 2
weeks. [Conclusion] Dual-task training improves cognitive and walking abilities of
patients with stroke.
Collapse
Affiliation(s)
- Gye Yeop Kim
- Department of Physical Therapy, College of Health and Welfare, Dongshin University, Republic of Korea
| | - Mi Ran Han
- Department of Physical Therapy, Suncheon Medical Center, Republic of Korea
| | - Hong Gyun Lee
- Department of Physical Therapy, College of Health and Welfare, Dongshin University, Republic of Korea
| |
Collapse
|
14
|
Esbjörnsson E, Skoglund T, Mitsis M, Hofgren C, Larsson J, Sunnerhagen KS. Cognitive impact of traumatic axonal injury (TAI) and return to work. Brain Inj 2013; 27:521-8. [DOI: 10.3109/02699052.2012.743179] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
15
|
Ohnuma T, Sakai Y, Maeshima H, Higa M, Hanzawa R, Kitazawa M, Hotta Y, Katsuta N, Takebayashi Y, Shibata N, Arai H. No correlation between plasma NMDA-related glutamatergic amino acid levels and cognitive function in medicated patients with schizophrenia. Int J Psychiatry Med 2013; 44:17-27. [PMID: 23356091 DOI: 10.2190/pm.44.1.b] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Disrupted glutamatergic neurotransmission and cognitive functions are key components in the pathophysiology of schizophrenia. Changes in levels of serum/plasma glutamatergic amino acids, such as glutamate, glycine, and L- and D-serine may be possible clinical markers. Following our recent findings that peripheral blood levels of endogenous glycine, alanine, and especially D-serine may reflect the degree/change in symptoms in schizophrenia, here we investigated whether these plasma amino acid levels may also reflect the status of cognitive functions in schizophrenia. METHODS One hundred eight Japanese patients with schizophrenia were evaluated with cognitive assessment batteries at the time that plasma glutamatergic amino acid levels were measured using high-performance liquid chromatography. For analyzing cognitive functions, batteries for reflection prefrontal cortex cognitive functions, verbal fluency tests, the Stroop test, and the digit span forward and backward tests were administered. RESULTS Results failed to show a relationship between any plasma glutamatergic amino acid level and cognitive batteries. CONCLUSIONS Our results suggest that plasma glutamatergic amino acid levels may be significant biological markers that reflect the condition or a dramatic change at the time of testing, especially in severely affected patients, but they do not reflect cognitive function.
Collapse
Affiliation(s)
- Tohru Ohnuma
- Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Stroop effects in persons with traumatic brain injury: selective attention, speed of processing, or color-naming? A meta-analysis. J Int Neuropsychol Soc 2011; 17:354-63. [PMID: 21320377 DOI: 10.1017/s135561771000175x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The color word Stroop test is the most common tool used to assess selective attention in persons with traumatic brain injury (TBI). A larger Stroop effect for TBI patients, as compared to controls, is generally interpreted as reflecting a decrease in selective attention. Alternatively, it has been suggested that this increase in Stroop effects is influenced by group differences in generalized speed of processing (SOP). The current study describes an overview and meta-analysis of 10 studies, where persons with TBI (N = 324) were compared to matched controls (N = 501) on the Stroop task. The findings confirmed that Stroop interference was significantly larger for TBI groups (p = .008). However, these differences may be strongly biased by TBI-related slowdown in generalized SOP (r² = .81 in a Brinley analysis). We also found that TBI-related changes in sensory processing may affect group differences. Mainly, a TBI-related increase in the latency difference between reading and naming the font color of a color-neutral word (r² = .96) was linked to Stroop effects. Our results suggest that, in using Stroop, it seems prudent to control for both sensory factors and SOP to differentiate potential changes in selective attention from other changes following TBI.
Collapse
|
17
|
Molina V, Tamayo P, Montes C, De Luxán A, Martin C, Rivas N, Sancho C, Domínguez-Gil A. Clozapine may partially compensate for task-related brain perfusion abnormalities in risperidone-resistant schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:948-54. [PMID: 18262704 DOI: 10.1016/j.pnpbp.2007.12.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Revised: 12/20/2007] [Accepted: 12/22/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Previous reports show different cerebral activity patterns during treatment with clozapine and typical neuroleptics. However, to date no study has directly compared the brain activity patterns while subjects are undergoing treatment with clozapine and other atypical antipsychotics. This comparison is of interest, given the probably different mechanism of action of clozapine in comparison with other atypicals. OBJECTIVE To assess the effect of clozapine on perfusion deviations still evident during treatment with risperidone. METHODS Here we used hexamethylene-propylenaminoxime single photon emission computed tomography to compare the perfusion patterns observed during the performance of a Stroop test in 10 patients sequentially treated with risperidone and clozapine, owing to a lack of response to the former, and in 10 healthy controls. RESULTS Patients on risperidone showed decreased perfusion as compared to controls in the medial prefrontal, middle cingulate and insular regions, as well as increased activities in brain stem and the posterior hippocampus. After receiving clozapine, the same patients showed an even wider prefrontal perfusion deficit and the brain stem was still hyperactive, but the abnormalities in the cingulate cortex, insula and hippocampus had disappeared. Clinical improvement was directly related to an increase in thalamic perfusion. CONCLUSION Clozapine may alleviate hyperactivity in the limbic system in schizophrenia and may facilitate activation of the regions involved in cognitive tasks to a greater degree than risperidone, as well as eliciting greater inhibition of the PF region.
Collapse
Affiliation(s)
- V Molina
- Department of Psychiatry, Hospital Clínico Universitario, Salamanca, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Schroeter ML, Ettrich B, Schwier C, Scheid R, Guthke T, von Cramon DY. Diffuse axonal injury due to traumatic brain injury alters inhibition of imitative response tendencies. Neuropsychologia 2007; 45:3149-56. [PMID: 17727901 DOI: 10.1016/j.neuropsychologia.2007.07.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Revised: 06/27/2007] [Accepted: 07/09/2007] [Indexed: 11/19/2022]
Abstract
It is well known that traumatic brain injury particularly affects the frontal lobes. Consequently, patients often suffer from executive dysfunction and behavioral disturbances. Accordingly, our study aimed at investigating patients after traumatic brain injury with two tasks involving different functional processes and structural networks supported by the frontal lobes. Two paradigms were applied: the Stroop color-word task and a task in which subjects had to inhibit imitative response tendencies. We selected a patient group solely with diffuse axonal injury, as this type of injury is homogenous and is correlated with cognitive dysfunction more than focal contusions. To evaluate long-term effects most relevant for rehabilitation, we selected a patient group whose brain injuries dated back several years. Our results show that patients with diffuse axonal injury inhibited imitative responses more successfully than control subjects, whereas executive processes examined with the Stroop task were unaltered. Interestingly, impairments were tightly correlated both with the length of the post-traumatic amnesia predicting outcome in traumatic brain injury and with behavioral disturbances. Impairments in the imitation-inhibition task may indicate alterations in an anterior frontomedian neural network even years after traumatic brain injury.
Collapse
Affiliation(s)
- Matthias L Schroeter
- Max-Planck-Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103 Leipzig, Germany.
| | | | | | | | | | | |
Collapse
|
19
|
Grapperon J, Niel-Ulmann L, Pignol AC, Bruschera D, Costes O, Delate J, Vidal F. [Exploration of traumatic brain-injury attention difficulty by event-related potentials]. ANNALES DE READAPTATION ET DE MEDECINE PHYSIQUE : REVUE SCIENTIFIQUE DE LA SOCIETE FRANCAISE DE REEDUCATION FONCTIONNELLE DE READAPTATION ET DE MEDECINE PHYSIQUE 2006; 49:23-31. [PMID: 16146662 DOI: 10.1016/j.annrmp.2005.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Accepted: 08/01/2005] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To specify, in cognitive processing leading to an action, the localization of difficulties in attention following severe, traumatic brain injury. METHOD Stimulus-locked and response-locked event-related potentials were recorded during a Stroop task in 25 patients with traumatic brain injury and 25 control subjects approximately 4 months after the accident. The latency and amplitude of the waves were compared between the two groups and correlated with clinical data. RESULTS The reaction times of brain-injured patients were significantly longer than those of the control group, but neither the number of errors nor the interference differed between the groups. Electrophysiological recordings showed early abnormalities between 100 and 200 ms after stimulus onset. The key area could be the medial occipitotemporal side connected with frontal regions. Recordings also showed disruptions in motor program monitoring, which implied frontomedial areas. CONCLUSION This protocol allows for precisely dating cognitive abnormalities. Future studies should relate cognitive with neuropsychological abnormalities and examine the possibilities of later regression.
Collapse
Affiliation(s)
- J Grapperon
- Laboratoire de neurophysiologie clinique, hôpital d'instruction des armées Sainte-Anne, 83800 Toulon Naval, France.
| | | | | | | | | | | | | |
Collapse
|
20
|
Babikian T, Freier MC, Tong KA, Nickerson JP, Wall CJ, Holshouser BA, Burley T, Riggs ML, Ashwal S. Susceptibility weighted imaging: neuropsychologic outcome and pediatric head injury. Pediatr Neurol 2005; 33:184-94. [PMID: 16139733 DOI: 10.1016/j.pediatrneurol.2005.03.015] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Revised: 02/17/2005] [Accepted: 03/28/2005] [Indexed: 02/08/2023]
Abstract
Traumatic brain injury is among the most frequent pediatric neurologic disorders in the United States, affecting multiple aspects of neuropsychologic functioning. This study assessed the efficacy of susceptibility weighted imaging as a predictor of long-term neuropsychologic functioning after pediatric brain injury compared with magnetic resonance spectroscopic imaging. Susceptibility weighted imaging is a relatively new method that is considered superior to traditional magnetic resonance imaging sequences for detecting hemorrhagic diffuse axonal injury. In this study, imaging and spectroscopy were acquired 6 +/- 4 days after injury. Measures of neuropsychologic functioning were administered to 18 children and adolescents 1-4 years post injury. Negative correlations between lesion number and volume with neuropsychologic functioning were demonstrated. Lesion volume explained over 32% of the variance in cognitive performance, explaining at least an additional 20% beyond injury severity and age at injury alone and 19% beyond magnetic resonance spectroscopic metabolite variables. Exploratory analyses resulted in notable trends, with lesions in deeper brain regions more strongly associated with poorer neuropsychologic performance. Improved detection of the extent of diffuse axonal injury following a brain injury will allow for a better understanding of its association with long-term outcome, which in turn can improve prognostic efficacy for effective treatment planning.
Collapse
Affiliation(s)
- Talin Babikian
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | | | | | | | | | | | | | | | | |
Collapse
|