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Aliaga Á, Bracho MJ, Romero M, Saldías MJ, Jofré X, Salas C. The contribution of executive functions to the process of return to work after brain injury: A systematic review. Neuropsychol Rehabil 2024; 34:619-648. [PMID: 37427841 DOI: 10.1080/09602011.2023.2224031] [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: 08/12/2022] [Accepted: 06/02/2023] [Indexed: 07/11/2023]
Abstract
Acquired brain injury (ABI) is a worldwide public health issue for its high prevalence rate and the disability it produces. The consequences of ABI, including cognitive deficits, may impact return to work. This review focuses on the association between executive functions (EFs) and return to work after ABI. A systematic review of the literature between 1998 and 2023 was conducted following PRISMA guidelines. The articles were retrieved from the Pubmed, Medline and Web of Science databases. A total of 49 studies were finally selected. Impairments of EF were consistently shown to have a negative impact on return to work after an ABI. There is evidence that specific executive functions and neurobehavioral variables may affect return to work Studies showed a significant theoretical and methodological heterogeneity, representing an important limitation to understand the relation between EFs and work. There is a robust association between EFs and return to work after brain injury. Findings in this systematic review raise the need for further research on the role of specific EF profiles in the process of returning to work after brain damage.
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Affiliation(s)
- Álvaro Aliaga
- Unidad de Neuropsicología Clínica, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | | | - Matías Romero
- Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | | | - Ximena Jofré
- Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Christian Salas
- Unidad de Neuropsicología Clínica, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Centro de Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
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de Macêdo LP, de Castro Tavares R, Torres Braga M, Dos Santos LM, Donato G, Lima Júnior FASD, de Macêdo RP, Ugulino Netto A, Franke K, Vansant Oliveira Eugênio P, Batista Cezar-Junior A, Vilela Faquini I, Júnior Silva JL, de Carvalho Júnior EV, Almeida NS, Bandeira E Farias FA, Moraes Valença M, Rocha Cirne Azevedo-Filho H. The relationship between the level of vitamin D and ruptured intracranial aneurysms among patients with high sun exposure. Sci Rep 2024; 14:3555. [PMID: 38347057 PMCID: PMC10861505 DOI: 10.1038/s41598-024-53676-y] [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: 09/11/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024] Open
Abstract
Non-traumatic subarachnoid hemorrhage (SAH) accounts for 3-5% of acute strokes. Intracranial aneurysm is the most common cause of non-traumatic SAH. Vitamin D influences the cardiovascular system, including the formation and rupture of cerebral aneurysms. To evaluate the serum vitamin D level in patients living in the tropical zone who suffered aneurysmal subarachnoid hemorrhage and its correlation with demographic and neurological characteristics. This is an analytical cross-sectional study to assess the serum level of vitamin D in a study population of 99 patients treated and diagnosed with aSAH in a public hospital in Recife-PE over a period of 12 months. In the study sample, composed of individuals with high sun exposure due to the lifestyle they lead in a tropical region, we observed hypovitaminosis D (85.9%), with a median of 19.9 ng/ml, although the majority of individuals are skin with high concentration of melanin (Fitzpatrick skin type IV and V). In addition, rates of sun exposure are high to all patients (Solar Index 9.03 P50). Most individuals were female (79.8%); there was no statistical difference in solar exposure/solar index between genders. As for the neurological repercussions, there was no statistical relevance in the clinical prognostic scales evaluated. As the sample was composed mainly of individuals whose economic activity is agriculture, the values of solar index found are vastly higher than those of other studies conducted in high latitude regions. In line with the literature review, some aspects were raised with the objective of justifying such findings that go from the base of the poor diet of these individuals, the increase of melanin in the skin and genetic alterations that directs us to possible mechanisms of natural photoprotection to high sun exposure. Thus, we had a vast majority (85%) of hypovitaminosis D, which in fact makes us wonder if there is any influence of calcitriol on vitamin D receptors in vascular walls and in the cardiovascular system as a whole, which influence bleeding events of this nature. As for the neurological repercussions, measured using assessment scales (Glasgow coma scale, WFNS scale, Hunt-Hess and Fisher's tomographic scale) there was no significant difference in the results. As it is only a descriptive study, the causal relationship of the facts cannot be established. However, in a population exposed to high sun exposure and affected by aneurysmal SAH, there is a significant rate of hypovitaminosis D, which supports the hypothesis that vitamin D plays a role in vascular pathologies, such as cerebral aneurysms and SAH.
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Affiliation(s)
- Lívio Pereira de Macêdo
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil.
- Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
- , Recife, Brasil.
| | | | | | | | - Glaudir Donato
- Medical Student, Centro de Ciências Médicas, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | | | | | | | - Kauê Franke
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
| | | | | | - Igor Vilela Faquini
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
| | | | | | - Nivaldo S Almeida
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
| | | | | | - Hildo Rocha Cirne Azevedo-Filho
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
- Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Gao P, Jin Z, Wang P, Zhang X. OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:1688-1698. [PMID: 35596958 DOI: 10.1093/arclin/acac030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ping Gao
- Department 5 of Neurosurgery, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Zhibin Jin
- Department 5 of Neurosurgery, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Peng Wang
- Department 5 of Neurosurgery, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Xiang Zhang
- Department 5 of Neurosurgery, Cangzhou Central Hospital, Cangzhou, Hebei, China
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Abstract
Aneurysmal subarachnoid hemorrhage (aSAH) results from the rupture of an intracranial aneurysm and represents a highly debilitating and devastating disorder. The prevalence rate of neuroendocrine impairment in the acute phase is extremely variable, ranging from 3.8% to 92.3%, depending on the time point considered, the method/test utilized, the clinical severity at admission, and probably also ethnicity. Further studies are needed to clarify such a wide range in neuroendocrine dysfunction in patients with aSAH. The overall neuroendocrine impairment rate in chronic aSAH is in the range 47%-83.3% with specific neuroendocrine impairment varying from 2.5% to 83.3%. The overall pituitary deficiency rate tends to decrease over time after SAH, with recovery of most endocrine and some de novo dysfunctions being reported. Only one study has reported an increase of overall endocrine impairment in the chronic follow-up. Neuroendocrine dysfunction seems to have a high prevalence in aSAH patients, even though its exact impact is not precisely known and is based on contrasting findings. More high-quality studies and trials are necessary before informing guidelines and protocols recommending preventive endocrine screening and related treatment (hormone replacement therapy) on a routine basis. The usage of standardized testing and reporting procedures could significantly move the field forward.
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Nanegrungsunk D, Ragozzino ME, Xu HL, Haselton KJ, Paisansathan C. Subarachnoid hemorrhage in C57BL/6J mice increases motor stereotypies and compulsive-like behaviors. Neurol Res 2020; 43:239-251. [PMID: 33135605 DOI: 10.1080/01616412.2020.1841481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Long-term behavioral, mood, and cognitive deficits affect over 30% of patients with subarachnoid hemorrhage (SAH). The aim of the present study was to examine the neurobehavioral outcomes following endovascular perforation induced SAH in mice. METHODS C57BL/6 J (B6) mice were exposed to endovascular perforation induced SAH or control surgery. Three weeks later, mice received a series of behavioral tests, e.g. motor function, stereotypy, learning, memory, behavioral flexibility, depression and anxiety. The immunohistologic experiment examined neuronalloss in the cortex following SAH. RESULTS SAH mice exhibited increased marble burying and nestlet shredding compared to that of control mice. Although SAH did not affect memory, learning or reversal learning,mice displayed greater overall object exploration in the novel object recognition test, as well as elevated perseveration during probabilistic reversal learning.In the forced swim and open field tests, SAH mice performed comparably to that of control mice. However, SAH mice exhibited an increased frequency in 'jumping' behavior in the open field test. Histological analyses revealed reduced neuron density in the parietal-entorhinal cortices of SAH mice on the injured side compared to that of control mice. DISCUSSION The findings suggest that parietal-entorhinal damage from SAH increases stereotyped motor behaviors and 'compulsive-like' behaviors without affecting cognition (learning and memory) or mood (anxiety and depression). This model can be used to better understand the neuropathophysiology following SAH that contributes to behavioral impairments in survivors with no gross sensory-motor deficits.
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Affiliation(s)
- Danop Nanegrungsunk
- Department of Anesthesiology, University of Illinois College of Medicine at Chicago , Chicago, IL, USA.,Neuroanesthesia Research Laboratory, University of Illinois College of Medicine , Chicago, IL, USA
| | - Michael E Ragozzino
- Department of Psychologyat the University of Illinois at Chicago , Chicago, IL, USA
| | - Hao-Liang Xu
- Neuroanesthesia Research Laboratory, University of Illinois College of Medicine , Chicago, IL, USA
| | - Kyle J Haselton
- Neuroanesthesia Research Laboratory, University of Illinois College of Medicine , Chicago, IL, USA
| | - Chanannait Paisansathan
- Department of Anesthesiology, University of Illinois College of Medicine at Chicago , Chicago, IL, USA.,Neuroanesthesia Research Laboratory, University of Illinois College of Medicine , Chicago, IL, USA
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Watson PA, Gignac GE, Weinborn M, Green S, Pestell C. A Meta-Analysis of Neuropsychological Predictors of Outcome Following Stroke and Other Non-Traumatic Acquired Brain Injuries in Adults. Neuropsychol Rev 2020; 30:194-223. [PMID: 32198606 DOI: 10.1007/s11065-020-09433-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/23/2020] [Indexed: 11/25/2022]
Abstract
A number of cognitive abilities have been reported to predict outcome following a non-traumatic acquired brain injury (ABI) in adults. However, the results are inconsistent. Furthermore, the unique and combined capacity of these cognitive abilities to predict ABI outcome has not been evaluated. Consequently, we employed meta-analysis and multiple regression to evaluate the capacity of various neuropsychological domains to predict two separate outcome variables in adults: (1) activities of daily living; and (2) quality of life. Based on the activities of daily living meta-analysis (N = 2384), we estimated the following significant bivariate effects: memory (r = .31, 95% CI: .20/.41]), language (r = .33, 95% CI:.26/.40), attention (r = .38, 95% CI: .30/.46]), executive functions (r = .29, 95% CI: .19/.39]), and visuospatial abilities (r = .41, 95% CI: .34/ .48). Based on the quality of life meta-analysis (N = 1037), we estimated the following significant bivariate effects: memory (r = .12, 95% CI: .03/.20]), language (r = .19, 95% CI: .06/ .32), attention (r = .30, 95% CI: .16/.44]), executive functions (r = .24, 95% CI: .12/.37) and visuospatial/constructional abilities (r = .30, 95% CI: .14/.46). Meta-analytic structural equation modelling (metaSEM) identified two significant, unique predictors of activities of daily living, attention and visuospatial abilities, and the model accounted for 21% of the variance (multiple R2 = .21, 95%CI: .16/.26). For the corresponding quality of life metaSEM, no statistically significant unique predictors were identified, however, a significant multiple correlation was observed, multiple R2 = .11 (95%CI: 04/.18). We conclude that practitioners may be able to predict, with some degree of accuracy, functional outcome following a stroke and other non-traumatic ABI in adults. We also provide some critical commentary on the nature and quality of the measures used in this area of research to represent the cognitive dimensions of interest.
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Affiliation(s)
- Prue A Watson
- School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009
| | - Gilles E Gignac
- School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009.
| | - Michael Weinborn
- School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia
| | - Sarah Green
- School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009
| | - Carmela Pestell
- School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009
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Vetkas A, Prans E, Kõks S, Rätsep T, Asser T. Aneurysmal subarachnoid haemorrhage: Effect of CRHR1 genotype on mental health-related quality of life. Sci Rep 2020; 10:724. [PMID: 31959877 PMCID: PMC6971041 DOI: 10.1038/s41598-020-57527-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/31/2019] [Indexed: 11/09/2022] Open
Abstract
Quality of life (QoL) disturbances are common after aneurysmal subarachnoid hemorrhage (aSAH) both in physical and mental health domains and their causes are not clearly understood. Corticotropin-releasing hormone receptor 1 (CRHR1) is involved in stress reactivity and development of mental health disturbances after negative life-events. We performed a retrospective cohort study of long-term QoL outcomes among 125 surgically treated aSAH patients (2001-2013). QoL was assessed with Short Form Health Survey (SF-36) and compared to an age and gender matched general population. Genotyping of CRHR1 single nucleotide polymorphisms was performed (Rs7209436, Rs110402, Rs242924) and their effect on QoL scores was explored. aSAH patients experienced a reduced quality of life in all domains. CRHR1 minor genotype was associated with higher SF-36 mental health (OR = 1.31-1.6, p < 0.05), role-emotional (OR = 1.57, p = 0.04) and vitality scores (OR = 1.31-1.38, p < 0.05). Association of all studied SNP's with vitality and Rs242924 with mental health scores remained statistically significant after Bonferroni correction. Mental quality of life scores were associated with physical state of patients, antidepressant history and CRHR1 genotype. Predisposition to mental health disturbances after stressful life-events might be associated with reduced mental QoL after aSAH and selected patients could be provided advanced counselling in the recovery phase.
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Affiliation(s)
| | | | - Sulev Kõks
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
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Duong P, Sauvé-Schenk K, Egan MY, Meyer MJ, Morrison T. Operational Definitions and Estimates of Return to Work Poststroke: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2019; 100:1140-1152. [DOI: 10.1016/j.apmr.2018.09.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 11/29/2022]
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Shah-Basak PP, Dunkley BT, Ye AX, Wong S, da Costa L, Pang EW. Altered beta-band functional connectivity may be related to 'performance slowing' in good outcome aneurysmal subarachnoid patients. Neurosci Lett 2019; 699:64-70. [PMID: 30711525 DOI: 10.1016/j.neulet.2019.01.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 10/27/2022]
Abstract
Recent evidence suggests that good neurological outcome in subarachnoid hemorrhage (SAH) does not equate to good neuropsychological and cognitive outcome. These individuals continue to face cognitive difficulties in tasks involving mental flexibility, short-term memory and attention, resulting in decreased independence in daily living and reduced ability to return to work. In the current study, we examined the functional connectivity profiles using magnetoencephalography (MEG) in SAH patients, versus controls, during a visual short-term memory, 1-back, task. Our results found that a global measure of MEG-based phase synchrony in the beta band (15-30 Hz), derived from a time window during correct recognition, significantly differentiated the controls from the patients. During correct recognition, the connectivity patterns in the controls were characterized by inter-hemispheric parieto-frontal connections, involving the posterior parietal cortex, while patients appeared to recruit an entirely different network of regions, involving the anterior frontal and temporal regions. Reduced beta-band synchrony during recognition was associated with overall poorer performance, demonstrated as lower accuracy and slower reaction times in patients, but not in controls. This differentiation between groups suggests an important and distinct role of beta-band phase synchronization, perhaps for memory retrieval, associated with good performance. Performance slowing, short-term memory and attention deficits in these patients may be attributed to the impaired beta-band connectivity among prefrontal regions and the posterior parietal cortex.
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Affiliation(s)
- Priyanka P Shah-Basak
- Department of Diagnostic Imaging, The Hospital for Sick Children, Canada; Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Canada; Canadian Partnership for Stroke Recovery, Ottawa, Canada
| | - Benjamin T Dunkley
- Department of Diagnostic Imaging, The Hospital for Sick Children, Canada; Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada
| | - Annette X Ye
- Department of Diagnostic Imaging, The Hospital for Sick Children, Canada
| | - Simeon Wong
- Department of Diagnostic Imaging, The Hospital for Sick Children, Canada
| | - Leodante da Costa
- Department of Surgery, Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Canada
| | - Elizabeth W Pang
- Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada; Division of Neurology, The Hospital for Sick Children, University of Toronto, Canada.
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