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Sabiniewicz A, Lindner KK, Haehner A, Hummel T. Depression Severity Is Different in Dysosmic Patients Who Have Experienced Traumatic Brain Injury Compared with Those Who Have Not. Neurol Int 2023; 15:638-648. [PMID: 37218979 DOI: 10.3390/neurolint15020040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
Traumatic brain injury (TBI) in humans can result in olfactory, cognitive, and affective changes. Surprisingly, research on the consequences of TBI often did not control for olfactory function in the investigated groups. Consequently, the affective or cognitive differences might be misleading as related rather to different olfactory performance than to a TBI experience. Hence, our study aimed to investigate whether TBI occurrence would lead to altered affective and cognitive functioning in two groups of dysosmic patients, one with TBI experience and one without. In total, 51 patients with TBI experience and 50 controls with varied causes of olfactory loss were thoroughly examined in terms of olfactory, cognitive, and affective performance. Student t-tests demonstrated that the only significant difference between the groups appeared in the depression severity, with TBI patients being more depressed (t = 2.3, p = 0.011, Cohen's d = -0.47). Regression analyses further showed that TBI experience was significantly associated with depression severity (R2 = 0.05, F [1, 96] = 5.5, p = 0.021, beta = 1.4). In conclusion, the present study showed that TBI experience is linked to depression, which is more pronounced compared to individuals with olfactory loss without TBI.
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Affiliation(s)
- Agnieszka Sabiniewicz
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Institute of Psychology, University of Wrocław, 50-527 Wrocław, Poland
| | - Kyri-Kristin Lindner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Antje Haehner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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2
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Abstract
OBJECTIVE Disorders of social cognition, such as difficulties with emotion perception, alexithymia, Theory of Mind (ToM), empathy and disorders of emotion regulation, are prevalent and pervasive problems across many neurological, neurodevelopmental and neuropsychiatric conditions. Clinicians are familiar with how these difficulties present but assessment and treatment has lagged behind other traditional cognitive domains, such as memory, language and executive functioning. METHOD In this paper, we review the prevalence and degree of impairment associated with disorders of social cognition and emotion regulation across a range of clinical conditions, with particular emphasis on their relationship to cognitive deficits and also real-world functioning. We reported effects sizes from published meta-analyses for a range of clinical disorders and also review test usage and available tests. RESULTS In general, many clinical conditions are associated with impairments in social cognition and emotion regulation. Effect sizes range from small to very large and are comparable to effect sizes for impairments in nonsocial cognition. Socio-emotional impairments are also associated with social and adaptive functioning. In reviewing prior research, it is apparent that the standardized assessment of social cognition, in particular, is not routine in clinical practice. This is despite the fact that there are a range of tools available and accruing evidence for the efficacy of interventions for social cognitive impairments. CONCLUSION We are using this information to urge and call for clinicians to factor social cognition into their clinical assessments and treatment planning, as to provide rigorous, holistic and comprehensive person-centred care.
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Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Travis Wearne
- School of Psychology, University of Western Sydney, Penrith South, Australia
| | - Michelle Kelly
- School of Psychological Sciences, University of Newcastle, Callaghan, Australia
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3
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Green SL, Gignac GE, Watson PA, Brosnan N, Becerra R, Pestell C, Weinborn M. Apathy and Depression as Predictors of Activities of Daily Living Following Stroke and Traumatic Brain Injuries in Adults: A Meta-Analysis. Neuropsychol Rev 2021; 32:51-69. [PMID: 33759039 DOI: 10.1007/s11065-021-09501-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
Apathy and depression are common sequelae of acquired brain injury (ABI). Apathy is a syndrome characterized by diminished motivation and purposeful behaviours. Depression is a mood disorder featuring sadness, worthlessness, anhedonia and suicidal ideation. Both are associated negatively with activities of daily living (ADL), the skills required to fulfil basic and complex physical needs. However, the current literature's results are inconsistent and based on relatively small sample sizes. Furthermore, the unique and combined effects of apathy and depression as predictors of ADL have not yet been estimated. This is important, as both may have implications for planning rehabilitation after an ABI. Consequently, we aimed to estimate the association between apathy, depression and ADL in the stroke and traumatic brain injured population via meta-analysis and meta-analytic path-analysis. Based on the meta-analyses (N = 1,166 to N = 1,389), we estimated the following statistically significant bivariate effects: depression and apathy (r = .53, 95% CI: .42/.63), depression and ADL (r = -.27, 95% CI: -.43/-.11), apathy and ADL (r = -.41, 95% CI: -.51/-.31). A meta-analytic mediation model found that depression had a significant indirect effect onto ADL (β = -.17, 95% CI: -.26/-.09), while apathy had a significant direct effect (β = -.34, 95% CI: -.48/-.19) onto ADL (model R2 = .16). We interpreted the results to suggest that apathy and depression may impact adversely on engagement with ADL in people with ABI, although the potential influence of depression on ADL may occur primarily through its influence on apathy. Thus, greater focus on apathy by practitioners may be merited in cases with ABI.
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Affiliation(s)
- Sarah L Green
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Gilles E Gignac
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.
| | - Prue A Watson
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Nicky Brosnan
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Rodrigo Becerra
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Carmela Pestell
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Michael Weinborn
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
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4
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Neumann D, Sander AM, Perkins SM, Bhamidipalli SS, Hammond FM. Negative Attribution Bias and Related Risk Factors After Brain Injury. J Head Trauma Rehabil 2021; 36:E61-E70. [PMID: 32769831 PMCID: PMC7769858 DOI: 10.1097/htr.0000000000000600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE In participants with traumatic brain injury (TBI) and peer controls, examine (1) differences in negative attributions (interpret ambiguous behaviors negatively); (2) cognitive and emotional factors associated with negative attributions; and (3) negative attribution associations with anger responses, life satisfaction, and participation. SETTING Two TBI outpatient rehabilitation centers. PARTICIPANTS Participants with complicated mild to severe TBI (n = 105) and peer controls (n = 105). DESIGN Cross-sectional survey study. MAIN MEASURES Hypothetical scenarios describing ambiguous behaviors were used to assess situational anger and attributions of intent, hostility, and blame. Executive functioning, perspective taking, emotion perception and social inference, alexithymia, aggression, anxiety, depression, participation, and life satisfaction were also assessed. RESULTS Compared with peer controls, participants with TBI rated behaviors significantly more intentional, hostile, and blameworthy. Regression models explained a significant amount of attribution variance (25%-43%). Aggression was a significant predictor in all models; social inference was also a significant predictor of intent and hostility attributions. Negative attributions were associated with anger responses and lower life satisfaction. CONCLUSION People with TBI who have higher trait aggression and poor social inferencing skills may be prone to negative interpretations of people's ambiguous actions. Negative attributions and social inferencing skills should be considered when treating anger problems after TBI.
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Affiliation(s)
- Dawn Neumann
- Departments of Physical Medicine and Rehabilitation (Drs Neumann and Hammond) and Biostatistics (Dr Perkins and Ms Bhamidipalli), Indiana University School of Medicine, Indianapolis; Rehabilitation Hospital of Indiana, Indianapolis (Drs Neumann and Hammond); Division of Clinical Neuropsychology and Rehabilitation Psychology, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, Texas (Dr Sander); and Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Dr Sander)
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5
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McDonald S, Genova H. The effect of severe traumatic brain injury on social cognition, emotion regulation, and mood. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:235-260. [PMID: 34389120 DOI: 10.1016/b978-0-12-822290-4.00011-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This chapter provides a review of the emotional and psychosocial consequences of moderate to severe traumatic brain injury (TBI). Many of the disorders affecting socioemotional function arise from damage to frontotemporal systems, exacerbated by white matter injury. They include disorders of social cognition, such as the ability to recognize emotions in others, the ability to attribute mental states to others, and the ability to experience empathy. Patients with TBI also often have disorders of emotion regulation. Disorders of drive or apathy can manifest across cognitive, emotional, and behavioral domains. Likewise, disorders of control can lead to dysregulated emotions and behavior. Other disorders, such as loss of self-awareness, are also implicated in poor psychosocial recovery. Finally, this chapter overviews psychiatric disorders associated with TBI, especially anxiety and depression. For each kind of disorder, the nature of the disorder and its prevalence, as well as theoretical considerations and impact on every day functions, are reviewed.
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Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.
| | - Helen Genova
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
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6
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Yeshokumar AK, Blum RA, Randell T, Jetté N, Easton A. Exploration of patient- and relative-reported outcomes of cognitive, emotional, and social function after encephalitis. Brain Inj 2020; 35:255-263. [PMID: 33356613 DOI: 10.1080/02699052.2020.1865567] [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: 02/02/2023]
Abstract
Objective: We evaluated cognitive, emotional, and social function after encephalitis, as perceived and reported by individuals post-encephalitis and their relatives.Hypothesis: There will be differential effects on various domains as self-reported by individuals post-encephalitis. Outcomes will be worse than in prior studies of other forms of acute brain injury. Post-encephalitis relative-report will demonstrate worse outcomes than self-report.Methods and Procedures: Members of The Encephalitis Society residing in the United Kingdom and Ireland were recruited to complete a demographic questionnaire and the European Brain Injury Questionnaire (EBIQ).Results: 266 individuals affected by encephalitis and 140 relatives participated in this study. The three domains with the highest (worst) mean scores were somatic, cognitive, and communication (p < .001). Individuals post-encephalitis self-reported worse outcomes than individuals post-stroke in seven of nine domains (p < .005), but there were no differences compared to individuals post-traumatic brain injury (TBI). Relatives reported worse encephalitis outcomes in seven of nine domains than did individuals directly affected by encephalitis (p < .005).Conclusions: Individuals affected by encephalitis experience the most significant symptoms in the somatic, cognitive, and communication domains. Outcomes as assessed by relatives were notably worse than those assessed by individuals themselves in nearly all domains.
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Affiliation(s)
- Anusha K Yeshokumar
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Raia A Blum
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Taylor Randell
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nathalie Jetté
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ava Easton
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.,The Encephalitis Society, Malton, UK
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7
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Jung T, Katase A, Wagatsuma M, Fujii T, Jung Y, Jeng B, Chaparro G. The influence of concurrent cognitive tasks on motor performance in people with traumatic brain injury: a pilot study. Physiother Theory Pract 2020; 38:1358-1365. [PMID: 33164609 DOI: 10.1080/09593985.2020.1840681] [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: 10/23/2022]
Abstract
Background: Performing dual-tasks is often required for completing activities of daily living. Limited research investigated the effects of dual-tasking on gait in people with Traumatic Brain Injury (TBI).Purpose: To investigate the effects of cognitive tasks on gait in people with TBI Methods: Seven individuals with TBI and nine controls completed walking under three conditions; usual walking, walking with questions and answers, and walking with word generation while 3D motion analysis system captured gait.Results: Significant group x condition interactions were found in which TBI group showed greater changes in speed (p < .01), cadence (p = .07), and ankle kinematics (p = .03) as cognitive task became more complex from usual walking to walking with word generation. TBI group decreased speed (p = .02), stride length (p = .01), and hip kinematics (p = .03) as concurrent task became more complex. The control showed decreases in speed (p = .01), stride length (p = .01), and joint kinematics in the hip (p = .03) and knee (p = .01) as the complexity of concurrent cognitive task increased.Conclusion: People with TBI have greater difficulty walking with a cognitive task and show greater compromises in gait performance as the task complexity increases when compared to those without TBI. Clinicians should consider the use of progression in cognitive tasks for dual-task gait training.
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Affiliation(s)
- Taeyou Jung
- Center of Achievement, Department of Kinesiology, California State University, Northridge, CA, USA
| | - Ai Katase
- Center of Achievement, Department of Kinesiology, California State University, Northridge, CA, USA
| | - Mayumi Wagatsuma
- Center of Achievement, Department of Kinesiology, California State University, Northridge, CA, USA
| | - Takuto Fujii
- Center of Achievement, Department of Kinesiology, California State University, Northridge, CA, USA
| | - Youngok Jung
- Department of Family and Consumer Sciences, College of Health and Human Services, California State University, Long Beach, Long Beach, CA, USA
| | - Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gioella Chaparro
- Department of Kinesiology, California State University, Dominguez Hills, Carson, CA, USA
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8
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Prigatano GP, Sherer M. Impaired Self-Awareness and Denial During the Postacute Phases After Moderate to Severe Traumatic Brain Injury. Front Psychol 2020; 11:1569. [PMID: 32765359 PMCID: PMC7378811 DOI: 10.3389/fpsyg.2020.01569] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/11/2020] [Indexed: 12/02/2022] Open
Abstract
While a number of empirical studies have appeared on impaired self-awareness (ISA) after traumatic brain injury (TBI) over the last 20 years, the relative role of denial (as a psychological method of coping) has typically not been addressed in these studies. We propose that this failure has limited our understanding of how ISA and denial differentially affect efforts to rehabilitate persons with TBI. In this selective review paper, we summarize early findings in the field and integrate those findings with more recent observations (i.e., 1999–2019). We believe that this synthesis of information and expert clinical opinion will inform future research on ISA and denial as well as approaches to rehabilitation for persons with TBI.
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Affiliation(s)
- George P Prigatano
- Department of Clinical Neuropsychology, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Mark Sherer
- TIRR Memorial Hermann, Houston, TX, United States
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9
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Howell S, Beeke S, Pring T, Varley R. Measuring outcomes of a peer-led social communication skills intervention for adults with acquired brain injury: A pilot investigation. Neuropsychol Rehabil 2020; 31:1069-1090. [PMID: 32408795 DOI: 10.1080/09602011.2020.1760892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Reduced social competence following severe acquired brain injury (ABI) is well-documented. This pilot study investigated a peer-led group intervention based on the claim that peer models may be a more effective mechanism for behaviour change than clinician-led approaches. Twelve participants with severe ABI were recruited from a post-acute neurorehabilitation setting and randomly assigned to either a peer-led intervention or a staff-led activity group (usual care) (Clinicaltrials.gov: NCT02211339). The groups met twice a week for 8 weeks. A peer was trained separately to facilitate interaction in the intervention group. Training comprised 16 individual sessions over 4 weeks. Group behaviour was measured twice at baseline, after intervention and at maintenance (4 weeks), using the Adapted Measure of Participation in Conversation (MPC) and the Interactional Network Tool (INT), a newly devised measure of group conversational interaction. Outcome measures showed differential sensitivity. The groups did not differ in baseline behaviour. Findings showed a significant improvement in the treated group on the MPC transaction scale post-intervention (p = .02). The intervention group showed more balanced interaction post-intervention on the INT and at follow-up. Findings show preliminary evidence of the advantage for peer-led groups. The INT shows promise as a method to detect a change in group communication behaviour.Trial registration: ClinicalTrials.gov identifier: NCT02211339.
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Affiliation(s)
- Susan Howell
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Suzanne Beeke
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Tim Pring
- Division of Language and Communication Science, City, University of London, London, UK
| | - Rosemary Varley
- Division of Psychology and Language Sciences, University College London, London, UK
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10
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Williams C, Wood RL, Alderman N, Worthington A. The Psychosocial Impact of Neurobehavioral Disability. Front Neurol 2020; 11:119. [PMID: 32153495 PMCID: PMC7047747 DOI: 10.3389/fneur.2020.00119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 02/03/2020] [Indexed: 11/24/2022] Open
Abstract
Neurobehavioral disability (NBD) comprises elements of executive and attentional dysfunction, poor insight, problems of awareness and social judgement, labile mood, altered emotional expression, and poor impulse control, any or all of which can have a serious impact upon a person's decision-making and capacity for social independence. The aim of this narrative review is to explore some of the more intrusive forms of NBD that act as obstacles to psychosocial outcome to act as a frame of reference for developing effective rehabilitation interventions. Special consideration is given to the psychosocial impact of three core forms of NBD: a failure of social cognition, aggressive behavior, and problems of drive/motivation. Consideration is also given to the developmental implications of sustaining a brain injury in childhood or adolescence, including its impact on maturational and social development and subsequent effects on long-term psychosocial behavior.
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Affiliation(s)
- Claire Williams
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom
| | | | - Nick Alderman
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom.,Elysium Neurological Services, Elysium Healthcare, Badby Park, Daventry, United Kingdom
| | - Andrew Worthington
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom.,Swansea University Medical School, Swansea University, Swansea, United Kingdom.,Headwise Limited, Birmingham, United Kingdom
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11
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Costa SL, Dapor C, Weber E, DeLuca J, Chiaravalloti ND. Comparing learning performance on the open trial selective reminding test with the California verbal learning test II in traumatic brain injury. Brain Inj 2019; 34:245-252. [PMID: 31680557 DOI: 10.1080/02699052.2019.1686772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Learning and memory deficits are prevalent following moderate to severe traumatic brain injury (TBI), affecting between 54% and 84% of impacted individuals.Objective: The current study examined learning performance on two tests of verbal memory: the OT-SRT and the CVLT-II.Methods: Sixty-eight participants with TBI performed the OT-SRT and the CVLT-II on two different days. Additionally, all participants completed cognitive tests assessing processing speed, working memory and executive functions. By definition, all participants with TBI were identified as having impaired learning on the OT-SRT, however only 38 were also identified as impaired on the CVLT-II. The sample was thus divided into two groups, those who failed both tests (Fail-2) and those who failed only the OT-SRT (Fail-1).Results: The Failed-1 group showed significantly better performance in processing speed, working memory and executive functions compared to the Fail-2 group. On the CVLT-II, the Fail-1 group performed significantly better on the number of words recalled on trials 1 and 5 compared to the Fail-2 group. Both groups performed similarly the OT-SRT.Discussion: The CVLT-II and the OT-SRT are not equivalent tests and should not be used interchangeably.
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Affiliation(s)
- Silvana L Costa
- Neuropsychology and Neuroscience Lab, Kessler Foundation, East Hanover, NJ, USA.,Department of Physical Medicine & Rehabilitation, Rutgers the State University, Newark, NJ, USA
| | - Caterina Dapor
- Neurology Section, Department of Neuroscience, Biomedicine and Movements Sciences, University of Verona, Verona, Italy
| | - Erica Weber
- Neuropsychology and Neuroscience Lab, Kessler Foundation, East Hanover, NJ, USA.,Department of Physical Medicine & Rehabilitation, Rutgers the State University, Newark, NJ, USA
| | - John DeLuca
- Neuropsychology and Neuroscience Lab, Kessler Foundation, East Hanover, NJ, USA.,Department of Physical Medicine & Rehabilitation, Rutgers the State University, Newark, NJ, USA
| | - Nancy D Chiaravalloti
- Neuropsychology and Neuroscience Lab, Kessler Foundation, East Hanover, NJ, USA.,Department of Physical Medicine & Rehabilitation, Rutgers the State University, Newark, NJ, USA
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12
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Soendergaard PL, Siert L, Poulsen I, Wood RL, Norup A. Measuring Neurobehavioral Disabilities Among Severe Brain Injury Survivors: Reports of Survivors and Proxies in the Chronic Phase. Front Neurol 2019; 10:51. [PMID: 30804873 PMCID: PMC6370614 DOI: 10.3389/fneur.2019.00051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/15/2019] [Indexed: 11/28/2022] Open
Abstract
Background: Neurobehavioral disability (NBD) has a major influence on long-term psychosocial outcome following acquired brain injury, as it affects not only the survivor of the brain injury, but the whole family. Objectives: To investigate (1) the frequency of NBD among survivors of severe brain injury measured by the Danish version of the St Andrew's-Swansea Neurobehavioural Outcome Scale (SASNOS) rated by patients and proxies, (2) factors associated with NBD, and (3) concordance between reports of NBD completed by patients and proxies. Methods: SASNOS was administered at an outpatient unit as a part of a follow-up assessment after discharge from intensive neurorehabilitation. SASNOS consists of five factors describing the following domains: Interpersonal Behavior, Cognition, Aggression, Inhibition and Communication, and both the patient and a proxy were asked to complete the questionnaire. Data collection was conducted over a period of 2 years, and 32 patients and 31 proxies completed the questionnaire. Mean time since injury was 19.4 months (10.0 SD). Most patients were male (68.8%), and most proxies were female (58.1%). Most of the patients had suffered a traumatic brain injury (68.8%). Results: A fourth of this patient group reported themselves below the normal range on the major domains of Interpersonal Behavior and Cognition. Significant associations between proxies' reports and time since injury, cohabitant status, and the patient's score on the Extended Glasgow Outcome Scale were found. Furthermore, significant differences were found between patient and proxy ratings. Proxies rated patients as having fewer problems on the Interpersonal Behavior domain, and more problems in relation to Cognition. Cognition was the only domain, where patients rated themselves higher indicating fewer problems, compared with their proxies. On both the Aggression and Communication domains, proxies rated patients higher indicating fewer problems than the patients themselves. Conclusion: Danish brain injury survivors experienced NBD as measured by SASNOS. Differences were found between patient and proxy ratings in relation to Cognition and Interpersonal Behavior. The NBDs identified can affect the survivor's ability to reintegrate and participate in activities of daily living, emphasizing how a systematic assessment is required.
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Affiliation(s)
- Pernille Langer Soendergaard
- Department of Neurology, Rigshospitalet, Glostrup, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Lars Siert
- RUBRIC (Research Unit on Brain Injury Rehabilitation Copenhagen), Department of Neurorehabilitation, TBI Unit, Copenhagen University Hospital, Rigshospitalet, Hvidovre, Denmark
| | - Ingrid Poulsen
- RUBRIC (Research Unit on Brain Injury Rehabilitation Copenhagen), Department of Neurorehabilitation, TBI Unit, Copenhagen University Hospital, Rigshospitalet, Hvidovre, Denmark.,Health, Section of Nursing Science, Aarhus University, Aarhus, Denmark
| | - Rodger Ll Wood
- Swansea University, Institute of Life Sciences, College of Medicine, Swansea, United Kingdom
| | - Anne Norup
- Department of Neurology, Rigshospitalet, Glostrup, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
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13
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Konstantinou N, Pettemeridou E, Stamatakis EA, Seimenis I, Constantinidou F. Altered Resting Functional Connectivity Is Related to Cognitive Outcome in Males With Moderate-Severe Traumatic Brain Injury. Front Neurol 2019; 9:1163. [PMID: 30687219 PMCID: PMC6335280 DOI: 10.3389/fneur.2018.01163] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 12/17/2018] [Indexed: 12/30/2022] Open
Abstract
TBI results in significant cognitive impairments and in altered brain functional connectivity. However, no studies explored so far, the relationship between global functional connectivity and cognitive outcome in chronic moderate-severe TBI. This proof of principle study employed the intrinsic connectivity contrast, an objective voxel-based metric of global functional connectivity, in a small sample of chronic moderate-severe TBI participants and a group of healthy controls matched on gender (males), age, and education. Cognitive tests assessing executive functions, verbal memory, visual memory, attention/organization, and cognitive reserve were administered. Group differences in terms of global functional connectivity maps were assessed and the association between performance on the cognitive measures and global functional connectivity was examined. Next, we investigated the spatial extent of functional connectivity in the brain regions found to be associated with cognitive performance, using traditional seed-based analyses. Global functional connectivity of the TBI group was altered, compared to the controls. Moreover, the strength of global functional connectivity in affected brain areas was associated with cognitive outcome. These findings indicate that impaired global functional connectivity is a significant consequence of TBI suggesting that cognitive impairments following TBI may be partly attributed to altered functional connectivity between brain areas involved in the specific cognitive functions.
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Affiliation(s)
- Nikos Konstantinou
- Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Eva Pettemeridou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus.,Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | | | - Ioannis Seimenis
- Medical Physics Laboratory, Medical School, Democritus University of Thrace, Alexandroupoli, Greece
| | - Fofi Constantinidou
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus.,Department of Psychology, University of Cyprus, Nicosia, Cyprus
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14
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Byom L, Duff M, Mutlu B, Turkstra LS. Facial emotion recognition of older adults with traumatic brain injury. Brain Inj 2018; 33:322-332. [PMID: 30526138 PMCID: PMC8351800 DOI: 10.1080/02699052.2018.1553066] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 08/29/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The objective of this study was to examine the effects of traumatic brain injury (TBI) and age on facial emotion recognition abilities in adults. Age and TBI were expected to have negative effects on emotion recognition and a TBI by age interaction was hypothesized such that older adults with TBI would have the lowest emotion recognition scores. METHODS A prospective cohort study was conducted. Participants were 26 adults with moderate-severe TBI (13 older and 13 younger) and 26 uninjured peers matched for age, sex, and education. Emotion recognition was measured using the Emotion Recognition Task, which is comprised of dynamically morphed facial expressions of the six basic emotions, presented at different intensity levels. RESULTS TBI and older age were associated with poorer recognition of both subtle and intense expressions, but only for expressions of anger and sadness. There was no interaction of age and TBI. CONCLUSIONS Results add to the growing evidence of emotion recognition impairments after TBI, particularly for select negative emotions, and extend this finding to adults over the age of 60. Further research is needed to better understand social cognitive effects of TBI across the adult lifespan.
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Affiliation(s)
- Lindsey Byom
- University of North Carolina at Chapel Hill School of Medicine, Division of Speech and Hearing Sciences, Department of Allied Health Sciences
- University of Wisconsin-Madison, Department of Communication Sciences and Disorders
| | - Melissa Duff
- Vanderbilt University, Department of Hearing and Speech Sciences
| | - Bilge Mutlu
- University of Wisconsin-Madison, Department of Computer Sciences
| | - Lyn S. Turkstra
- University of Wisconsin-Madison, Department of Communication Sciences and Disorders
- McMaster University, School of Rehabilitation Science
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15
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Bell C, Hackett J, Hall B, Pülhorn H, McMahon C, Bavikatte G. Symptomatology following traumatic brain injury in a multidisciplinary clinic: experiences from a tertiary centre. Br J Neurosurg 2018; 32:495-500. [DOI: 10.1080/02688697.2018.1490945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Chris Bell
- School of Medicine, University of Liverpool, Liverpool, UK
| | - James Hackett
- School of Medicine, University of Liverpool, Liverpool, UK
| | - Benjamin Hall
- School of Medicine, University of Liverpool, Liverpool, UK
| | - Heinke Pülhorn
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Catherine McMahon
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Ganesh Bavikatte
- Neurorehabilitation Unit, The Walton Centre NHS Foundation Trust, Liverpool, UK
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Late Functional Changes Post-Severe Traumatic Brain Injury Are Related to Community Reentry Support: Results From the PariS-TBI Cohort. J Head Trauma Rehabil 2018; 32:E26-E34. [PMID: 28060204 DOI: 10.1097/htr.0000000000000276] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To explore late functional changes after a traumatic brain injury and their relation to patients' characteristics and reentry support. DESIGN Prospective follow-up of an inception cohort of adults with severe traumatic brain injury recruited in 2005-2007 in the Parisian area, France. One and 4-year assessments were performed by trained neuropsychologists. One-to-4-year change in the Glasgow Outcome Scale-Extended defined 3 groups: "improvement," "stability," and "worsening." Relationships between these groups and patients' characteristics were analyzed. RESULTS Among 504 recruited patients and 245 four-year survivors, 93 participated in both evaluations. Overall Glasgow Outcome Scale-Extended improved by 0.4. Forty percent of the sample improved, 44% were stable, and 16% worsened. Being in a more unfavorable group was related to preinjury alcohol abuse and to higher anxiety and depression at 4 years. Attendance to a specialized community reentry unit was related to higher chances of being in the "improvement" group in univariate analyses and after adjustment for age, time to follow command, preinjury alcohol and occupation, and mood disorders (adjusted odds ratio [OR] = 4.6 [1.1-20]). CONCLUSION Late functional changes were related to psychosocial variables and to reentry support. The effect of reentry support on late recovery needs to be confirmed by further investigations.
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Rasch Analysis, Dimensionality, and Scoring of the Neuropsychiatric Inventory Irritability and Aggression Subscales in Individuals With Traumatic Brain Injury. Arch Phys Med Rehabil 2018; 99:281-288.e2. [DOI: 10.1016/j.apmr.2017.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/22/2017] [Accepted: 07/31/2017] [Indexed: 11/18/2022]
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18
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Weil ZM, Corrigan JD, Karelina K. Alcohol Use Disorder and Traumatic Brain Injury. Alcohol Res 2018; 39:171-180. [PMID: 31198656 PMCID: PMC6561403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Alcohol use and traumatic brain injury (TBI) are inextricably and bidirectionally linked. Alcohol intoxication is one of the strongest predictors of TBI, and a substantial proportion of TBIs occur in intoxicated individuals. An inverse relationship is also emerging, such that TBI can serve as a risk factor for, or modulate the course of, alcohol use disorder (AUD). Critically, alcohol use after TBI is a key predictor of rehabilitation outcomes, prognosis, and additional head injuries. This review provides a general overview of the bidirectional relationship between TBI and AUD and a discussion of potential neuropsychological and neurobiological mechanisms that might underlie the relationship.
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19
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Internet and Social Media Use After Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study. J Head Trauma Rehabil 2018; 33:E9-E17. [DOI: 10.1097/htr.0000000000000305] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Batchos E, Easton A, Haak C, Ditchman N. Social factors predictive of social integration for adults with brain injury. Disabil Rehabil 2017; 40:2062-2069. [PMID: 28521554 DOI: 10.1080/09638288.2017.1326175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Individuals with acquired brain injury (ABI) may not only struggle with physical and cognitive impairments, but may also face challenges reintegrating into the community socially. Research has demonstrated that following ABI, individuals' social networks tend to dwindle, support may decline, and isolation increases. This study examined factors impacting social integration in a community-based sample of 102 individuals with ABI. METHODS Potential predictors included emotional support, instrumental support, problem solving confidence, and approach-avoidance style (AAS) of problem solving, while controlling for age, gender, education, and time since injury. Hierarchical regression was used to analyze whether these factors were predictive of social integration. RESULTS The final model accounted for 33% of the variance in social integration outcomes. Results demonstrated that emotional support was initially a significant predictor; however, when controlling for emotional support the variance in social integration was better accounted for by social problem solving - specifically, AAS. A follow-up mediation analysis indicated that the relationship between social problem solving (specifically, AAS) and social integration was partially mediated by emotional support. CONCLUSIONS This suggests that for individuals with ABI, a tendency to approach rather than avoid social problem solving issues is a significant predictor for social integration both directly and indirectly through its association with emotional social support. Implications for Rehabilitation Both instrumental and emotional social support should be assessed in patients with acquired brain injury (ABI), ensuring that emotional needs are met in addition to the more obvious instrumental needs. Barriers to problem solving for people with ABI may limit optimal social integration; thus, assessment and intervention aimed at increasing AAS are recommended. To enhance the social integration outcomes of people with brain injury, strength-based psychosocial rehabilitation should optimally balance an individual's abilities with areas requiring compensation, focusing on how to approach rather than avoid problems as well as strategies to cultivate emotional social support.
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Affiliation(s)
- Elisabeth Batchos
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | - Amanda Easton
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | - Christopher Haak
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | - Nicole Ditchman
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
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21
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The Relations of Self-Reported Aggression to Alexithymia, Depression, and Anxiety After Traumatic Brain Injury. J Head Trauma Rehabil 2017; 32:205-213. [DOI: 10.1097/htr.0000000000000261] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Abstract
OBJECTIVES The negative effect of changes in social behavior following traumatic brain injury (TBI) are known, but much less is known about the neuropsychological impairments that may underlie and predict these changes. The current study investigated possible associations between post-injury behavior and neuropsychological competencies of emotion recognition, understanding intentions, and response selection, that have been proposed as important for social functioning. METHODS Forty participants with TBI and 32 matched healthy participants completed a battery of tests assessing the three functions of interest. In addition, self- and proxy reports of pre- and post-injury behavior, mood, and community integration were collected. RESULTS The TBI group performed significantly poorer than the comparison group on all tasks of emotion recognition, understanding intention, and on one task of response selection. Ratings of current behavior suggested significant changes in the TBI group relative to before the injury and showed significantly poorer community integration and interpersonal behavior than the comparison group. Of the three functions considered, emotion recognition was associated with both post-injury behavior and community integration and this association could not be fully explained by injury severity, time since injury, or education. CONCLUSIONS The current study confirmed earlier findings of associations between emotion recognition and post-TBI behavior, providing partial evidence for models proposing emotion recognition as one of the pre-requisites for adequate social functioning. (JINS, 2017, 23, 400-411).
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23
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Manskow US, Friborg O, Røe C, Braine M, Damsgard E, Anke A. Patterns of change and stability in caregiver burden and life satisfaction from 1 to 2 years after severe traumatic brain injury: A Norwegian longitudinal study. NeuroRehabilitation 2017; 40:211-222. [DOI: 10.3233/nre-161406] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Unn Sollid Manskow
- Department of Rehabilitation, University Hospital of North Norway, Tromso, Norway
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Faculty of Health Sciences, Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mary Braine
- School of Nursing and Midwifery, Faculty of Health and Social Care, University of Salford, Salford, UK
| | - Elin Damsgard
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromso, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
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Cassel A, McDonald S, Kelly M, Togher L. Learning from the minds of others: A review of social cognition treatments and their relevance to traumatic brain injury. Neuropsychol Rehabil 2016; 29:22-55. [DOI: 10.1080/09602011.2016.1257435] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Anneli Cassel
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Skye McDonald
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Michelle Kelly
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of Newcastle, Newcastle, Australia
| | - Leanne Togher
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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25
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Abstract
The aim of this qualitative study was to examine the issues involved in social integration for those affected by traumatic brain injury, following a period of rehabilitation. Eighteen patients, their significant other* and members of the rehabilitation team involved in their care were interviewed when the patient was discharged from the ward of a neurological rehabilitation hospital, 6 months later and, again, at one year following discharge from the ward. When the data were analysed at the time of the final interview, two respondents reported social isolation. Although many others felt that the level of social contact was that of their choice, several issues were discussed that affected social relationships. These included the impact of impairments, the social response of others and the fact that social networks change naturally over time irrespective of injury or disability. When the data were considered from a sociological perspective, the themes of self-identity, master status and stranger status emerged. This gave a different insight into issues that could be relevant but had not been discussed widely within the head injury literature. Further consideration of the individual in the context of personhood as well as head injury is recommended as a means to develop understanding.
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26
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Osborne-Crowley K, McDonald S. A review of social disinhibition after traumatic brain injury. J Neuropsychol 2016; 12:176-199. [DOI: 10.1111/jnp.12113] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/05/2016] [Indexed: 11/25/2022]
Affiliation(s)
| | - Skye McDonald
- School of Psychology; The University of New South Wales; Sydney New South Wales Australia
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27
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Downing M, Ponsford J. Sexuality in individuals with traumatic brain injury and their partners. Neuropsychol Rehabil 2016; 28:1028-1037. [DOI: 10.1080/09602011.2016.1236732] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Marina Downing
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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28
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Assessment of Executive Function in Patients With Substance Use Disorder: A Comparison of Inventory- and Performance-Based Assessment. J Subst Abuse Treat 2016; 66:1-8. [DOI: 10.1016/j.jsat.2016.02.010] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 02/15/2016] [Accepted: 02/28/2016] [Indexed: 11/23/2022]
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29
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McGuire BE, Greenwood RJ. Effects of an intervention aimed at memory on perceived burden and self-esteem after traumatic head injury. Clin Rehabil 2016. [DOI: 10.1177/026921559000400412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper investigates the effects of a six-week memory rehabilitation programme on the self-esteem of 18 patients with traumatic head injury, and the effects of the intervention on the level of subjective burden experienced by 18 relatives or primary carers of the head-injured patients, regardless of the efficacy of the programme itself. The study found a significant improvement in the head-injured patients' self-esteem and a significant decrease in the perceived burden of the relatives at the end of the six-week intervention. Possible explanations for these findings are suggested, and the practical implications for rehabilitation are discussed
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Affiliation(s)
- Brian E McGuire
- Disability Services, PO Box 2496, North Parramatta, NSW 2151, Australia
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30
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Negative symptoms in the traumatically brain-injured during the first year postdischarge, and their effect on rehabilitation status, work status and family burden. Clin Rehabil 2016. [DOI: 10.1177/026921559400800302] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Approximately one year after discharge from postacute rehabilitation, 47 severely head-injured patients showed physical, cognitive, subjective, emotional and behavioural changes from their preinjury status, according to relatives/carers. Negative symptoms were prominent, and were related to employment status, overall rehabilitation status and relatives'/carers' levels of stress and psychological morbidity.
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31
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Oddy M, Bonham E, McMillan T, Stroud A, Rickard S. A comprehensive service for the rehabilitation and long-term care of head injury survivors. Clin Rehabil 2016. [DOI: 10.1177/026921558900300314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M. Oddy
- Tunbridge Wells Health Authority
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32
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Abstract
The aim of this study was to identify the incidence and nature of behaviour problems following severe head injury. All severe head injuries in a known population were identified from a three-year period. Sixteen patients were assessed for behavioural problems shortly after injury, while still in hospital. The relatives' judgements of behavioural change observed at home, for a total of 33 patients from three consecutive years, was collected to compare the extent of behavioural problems during the years following injury. More behavioural problems were reported at home, by families, than by nursing and therapy staff in hospital. Relatives identified behaviour change in about 80% of the patients and significant practical problems were reported at home in about half of all severely head-injured people. Symptoms appeared to be persistent and tended to worsen over a three-year period following the injury. In particular, aggressive behaviour increased. Behaviour change did not correlate with either age or the severity of the injury as measured by post-traumatic amnesia. The results of this study draw attention to the need for treatment and support for the families of brain-injured patients showing behavioural disturbance, at home, after they have been discharged from hospital.
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Affiliation(s)
- Roger Johnson
- Lewin Rehabilitation Unit, Addenbrooke's Hospital, Cambridge
| | - Heather Balleny
- Lewin Rehabilitation Unit, Addenbrooke's Hospital, Cambridge
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33
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Bivona U, Antonucci G, Contrada M, Rizza F, Leoni F, Zasler ND, Formisano R. A biopsychosocial analysis of sexuality in adult males and their partners after severe traumatic brain injury. Brain Inj 2016; 30:1082-95. [PMID: 27260951 DOI: 10.3109/02699052.2016.1165867] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The primary aim of this study was to investigate changes in sexual function in males and their partners following severe TBI. Secondary aims of the study were to explore the relationship between selected sociodemographic, emotional/behavioural and sexual function variables. METHODS Twenty males with a history of severe TBI and 20 healthy controls (HC) and their respective partners were recruited. Sexual life was assessed with the Sexuality Evaluation Schedule Assessment Monitoring (SESAMO). Study participant level of self-awareness was evaluated by the Awareness Questionnaire, whereas their neuropsychiatric and psychopathological statuses were assessed by the NPI, the HAM-D and STAI. RESULTS A reduction in desire and frequency of sexual intercourse was found in all survivors and their partners. Moreover, higher levels of survivor depression correlated with lower partner harmony. Survivor feelings toward their partners gradually decreased over time, as did the ability to make decisions as a couple. The comparison with HC couples revealed that both survivors' and their partners' exaggerated the extent of disease. CONCLUSIONS After male severe TBI, men appear to have a reduced quality of their sexual life, which may be more a result of relationship dysfunction than a sexual performance deficit related to their brain injury history.
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Affiliation(s)
| | - Gabriella Antonucci
- a IRCCS Fondazione Santa Lucia , Rome , Italy.,b Department of Psychology , 'Sapienza' Università , Rome , Italy
| | - Marianna Contrada
- a IRCCS Fondazione Santa Lucia , Rome , Italy.,b Department of Psychology , 'Sapienza' Università , Rome , Italy
| | - Federica Rizza
- b Department of Psychology , 'Sapienza' Università , Rome , Italy
| | | | - Nathan D Zasler
- c Concussion Care Centre of Virginia, LTD.,d Tree of Life Services, Inc. , Richmond , VA , USA
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Yu YW, Hsieh TH, Chen KY, Wu JCC, Hoffer BJ, Greig NH, Li Y, Lai JH, Chang CF, Lin JW, Chen YH, Yang LY, Chiang YH. Glucose-Dependent Insulinotropic Polypeptide Ameliorates Mild Traumatic Brain Injury-Induced Cognitive and Sensorimotor Deficits and Neuroinflammation in Rats. J Neurotrauma 2016; 33:2044-2054. [PMID: 26972789 PMCID: PMC5116684 DOI: 10.1089/neu.2015.4229] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is a major public health issue, representing 75-90% of all cases of TBI. In clinical settings, mTBI, which is defined as a Glascow Coma Scale (GCS) score of 13-15, can lead to various physical, cognitive, emotional, and psychological-related symptoms. To date, there are no pharmaceutical-based therapies to manage the development of the pathological deficits associated with mTBI. In this study, the neurotrophic and neuroprotective properties of glucose-dependent insulinotropic polypeptide (GIP), an incretin similar to glucagon-like peptide-1 (GLP-1), was investigated after its steady-state subcutaneous administration, focusing on behavior after mTBI in an in vivo animal model. The mTBI rat model was generated by a mild controlled cortical impact (mCCI) and used to evaluate the therapeutic potential of GIP. We used the Morris water maze and novel object recognition tests, which are tasks for spatial and recognition memory, respectively, to identify the putative therapeutic effects of GIP on cognitive function. Further, beam walking and the adhesive removal tests were used to evaluate locomotor activity and somatosensory functions in rats with and without GIP administration after mCCI lesion. Lastly, we used immunohistochemical (IHC) staining and Western blot analyses to evaluate the inflammatory markers, glial fibrillary acidic protein (GFAP), amyloid-β precursor protein (APP), and bone marrow tyrosine kinase gene in chromosome X (BMX) in animals with mTBI. GIP was well tolerated and ameliorated mTBI-induced memory impairments, poor balance, and sensorimotor deficits after initiation in the post-injury period. In addition, GIP mitigated mTBI-induced neuroinflammatory changes on GFAP, APP, and BMX protein levels. These findings suggest GIP has significant benefits in managing mTBI-related symptoms and represents a novel strategy for mTBI treatment.
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Affiliation(s)
- Yu-Wen Yu
- 1 PhD Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes , Taipei, Taiwan
| | - Tsung-Hsun Hsieh
- 1 PhD Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes , Taipei, Taiwan .,2 Center for Neurotrauma and Neuroregeneration, Taipei Medical University , Taipei, Taiwan .,3 Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University , Taoyuan, Taiwan
| | - Kai-Yun Chen
- 1 PhD Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes , Taipei, Taiwan .,2 Center for Neurotrauma and Neuroregeneration, Taipei Medical University , Taipei, Taiwan
| | - John Chung-Che Wu
- 4 Department of Surgery, College of Medicine, Taipei Medical University , Taipei, Taiwan
| | - Barry J Hoffer
- 1 PhD Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes , Taipei, Taiwan .,5 Department of Neurosurgery, Case Western Reserve University , School of Medicine, Cleveland, Ohio
| | - Nigel H Greig
- 6 Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health , Baltimore, Maryland
| | - Yazhou Li
- 6 Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health , Baltimore, Maryland
| | - Jing-Huei Lai
- 2 Center for Neurotrauma and Neuroregeneration, Taipei Medical University , Taipei, Taiwan .,4 Department of Surgery, College of Medicine, Taipei Medical University , Taipei, Taiwan
| | - Cheng-Fu Chang
- 4 Department of Surgery, College of Medicine, Taipei Medical University , Taipei, Taiwan
| | - Jia-Wei Lin
- 4 Department of Surgery, College of Medicine, Taipei Medical University , Taipei, Taiwan
| | - Yu-Hsin Chen
- 7 Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan .,8 Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University , Taipei, Taiwan
| | - Liang-Yo Yang
- 7 Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan .,9 Research Center for Biomedical Devices and Prototyping Production, Taipei Medical University , Taipei, Taiwan .,11 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yung-Hsiao Chiang
- 1 PhD Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes , Taipei, Taiwan .,2 Center for Neurotrauma and Neuroregeneration, Taipei Medical University , Taipei, Taiwan .,4 Department of Surgery, College of Medicine, Taipei Medical University , Taipei, Taiwan .,10 Translational Laboratory, Department of Medical Research, Taipei Medical University Hospital, Taipei, Taiwan
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Palmer S, Herbert C. Friendships and intimacy: Promoting the maintenance and development of relationships in residential neurorehabilitation. NeuroRehabilitation 2016; 38:291-8. [DOI: 10.3233/nre-161320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Batty RA, Francis A, Thomas N, Hopwood M, Ponsford J, Rossell SL. A brief neurocognitive assessment of patients with psychosis following traumatic brain injury (PFTBI): Use of the Repeatable battery for the Assessment of Neuropsychological Status (RBANS). Psychiatry Res 2016; 237:27-36. [PMID: 26921048 DOI: 10.1016/j.psychres.2016.01.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 11/02/2015] [Accepted: 01/27/2016] [Indexed: 11/25/2022]
Abstract
Patients who develop psychosis following a traumatic brain injury (PFTBI) show impaired neurocognition; however, the degree of impairment has not been empirically investigated using a standardised battery. We administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to patients with PFTBI (n=10), and to three groups of controls: traumatic brain injury (TBI) (n=10), schizophrenia (n=23), and nonclinical controls (n=23). The results confirmed that the cognitive neuropsychological profile of dually-diagnosed patients with PFTBI is significantly and substantially impaired. Seventy per cent of patients with PFTBI received a neuropsychological classification between the "extremely low" and "low average" ranges. Group-wise analyses on the RBANS indices indicated that patients with PFTBI had the lowest (Immediate Memory, Attention, Delayed Memory, Total Score), or equal lowest (visuospatial, equivalent with schizophrenia patients) scores, with the exception of the Language Index where no group differences were shown (however, the mean PFTBI score on the Language Index was two standard deviations below the RBANS normative score). These findings provide novel evidence of impaired cognitive neuropsychological processing in patients with PFTBI using a standardised and replicable battery.
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Affiliation(s)
- Rachel A Batty
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia; RMIT University, Bundoora, Victoria, Australia.
| | | | - Neil Thomas
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia
| | - Malcolm Hopwood
- University of Melbourne, Department of Psychiatry, Albert Road Clinic, Melbourne, Victoria, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia
| | - Susan L Rossell
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, Victoria, Australia; Monash-Alfred Psychiatry Research Centre (MAPrc), Melbourne, Victoria, Australia
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Weil ZM, Corrigan JD, Karelina K. Alcohol abuse after traumatic brain injury: Experimental and clinical evidence. Neurosci Biobehav Rev 2016; 62:89-99. [DOI: 10.1016/j.neubiorev.2016.01.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/16/2015] [Accepted: 01/21/2016] [Indexed: 01/06/2023]
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Swaine B, Dassa C, Koné A, Dutil É, Demers L, Trempe C. The PQRS-Montreal: a measure of patients’ perceptions of the quality of rehabilitation services for persons with a traumatic brain injury. Disabil Rehabil 2016; 39:59-72. [DOI: 10.3109/09638288.2016.1140828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Bonnie Swaine
- École de Réadaptation, Université de Montréal, Montréal, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Québec, Canada
| | - Clément Dassa
- École de Santé Publique, Université de Montréal, Montréal, Québec, Canada
| | - Anna Koné
- Groupe de Recherche Interdisciplinaire en Santé (GRIS), Université de Montréal, Montréal, Québec, Canada
| | - Élisabeth Dutil
- École de Réadaptation, Université de Montréal, Montréal, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Québec, Canada
| | - Louise Demers
- École de Réadaptation, Université de Montréal, Montréal, Québec, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Claire Trempe
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille, Université de Montréal, Montréal, Québec, Canada
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Osier ND, Dixon CE. Catecholaminergic based therapies for functional recovery after TBI. Brain Res 2015; 1640:15-35. [PMID: 26711850 DOI: 10.1016/j.brainres.2015.12.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 11/15/2022]
Abstract
Among the many pathophysiologic consequences of traumatic brain injury are changes in catecholamines, including dopamine, epinephrine, and norepinephrine. In the context of TBI, dopamine is the one most extensively studied, though some research exploring epinephrine and norepinephrine have also been published. The purpose of this review is to summarize the evidence surrounding use of drugs that target the catecholaminergic system on pathophysiological and functional outcomes of TBI using published evidence from pre-clinical and clinical brain injury studies. Evidence of the effects of specific drugs that target catecholamines as agonists or antagonists will be discussed. Taken together, available evidence suggests that therapies targeting the catecholaminergic system may attenuate functional deficits after TBI. Notably, it is fairly common for TBI patients to be treated with catecholamine agonists for either physiological symptoms of TBI (e.g. altered cerebral perfusion pressures) or a co-occuring condition (e.g. shock), or cognitive symptoms (e.g. attentional and arousal deficits). Previous clinical trials are limited by methodological limitations, failure to replicate findings, challenges translating therapies to clinical practice, the complexity or lack of specificity of catecholamine receptors, as well as potentially counfounding effects of personal and genetic factors. Overall, there is a need for additional research evidence, along with a need for systematic dissemination of important study details and results as outlined in the common data elements published by the National Institute of Neurological Diseases and Stroke. Ultimately, a better understanding of catecholamines in the context of TBI may lead to therapeutic advancements. This article is part of a Special Issue entitled SI:Brain injury and recovery.
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Affiliation(s)
- Nicole D Osier
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, USA; School of Nursing, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - C Edward Dixon
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15260, USA; V.A. Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA.
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Osborne-Crowley K, McDonald S, Francis H. Development of an observational measure of social disinhibition after traumatic brain injury. J Clin Exp Neuropsychol 2015; 38:341-53. [DOI: 10.1080/13803395.2015.1115824] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Osier ND, Carlson SW, DeSana A, Dixon CE. Chronic Histopathological and Behavioral Outcomes of Experimental Traumatic Brain Injury in Adult Male Animals. J Neurotrauma 2015; 32:1861-82. [PMID: 25490251 PMCID: PMC4677114 DOI: 10.1089/neu.2014.3680] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The purpose of this review is to survey the use of experimental animal models for studying the chronic histopathological and behavioral consequences of traumatic brain injury (TBI). The strategies employed to study the long-term consequences of TBI are described, along with a summary of the evidence available to date from common experimental TBI models: fluid percussion injury; controlled cortical impact; blast TBI; and closed-head injury. For each model, evidence is organized according to outcome. Histopathological outcomes included are gross changes in morphology/histology, ventricular enlargement, gray/white matter shrinkage, axonal injury, cerebrovascular histopathology, inflammation, and neurogenesis. Behavioral outcomes included are overall neurological function, motor function, cognitive function, frontal lobe function, and stress-related outcomes. A brief discussion is provided comparing the most common experimental models of TBI and highlighting the utility of each model in understanding specific aspects of TBI pathology. The majority of experimental TBI studies collect data in the acute postinjury period, but few continue into the chronic period. Available evidence from long-term studies suggests that many of the experimental TBI models can lead to progressive changes in histopathology and behavior. The studies described in this review contribute to our understanding of chronic TBI pathology.
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Affiliation(s)
- Nicole D. Osier
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Shaun W. Carlson
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Neurological Surgery, Brain Trauma Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anthony DeSana
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania
- Seton Hill University, Greensburg, Pennsylvania
| | - C. Edward Dixon
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Neurological Surgery, Brain Trauma Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
- V.A. Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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Greenwood A, Theadom A, Kersten P, McPherson KM. Exploring researchers' experiences of working with people with acquired brain injury. Brain Inj 2015; 29:592-600. [PMID: 25790259 DOI: 10.3109/02699052.2014.1002422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to investigate the challenges and positive experiences of researchers who work with people who have experienced an acquired brain injury and their families. METHODS People who were currently or had previously worked as a researcher in the field of acquired brain injury (using either quantitative or qualitative methods) were invited to participate in a focus group or individual interview about their experiences. An expert reference group meeting was held to discuss strategies that could be implemented to enhance the researcher experience based on the interview data. RESULTS A total of 19 researchers who worked across four different research teams took part in the study. Six inter-connected themes were identified: researcher motivation, meaning and fulfillment; human connection; knowing and understanding the role; complexity of brain injury in the research context; the research process; and state of the researcher. A number of recommendations for supporting researchers more effectively were identified. DISCUSSION Researchers described a number of positive aspects as well as tensions they encountered in their role. The findings highlight the need to ensure researchers are supported effectively to ensure the quality of research studies in the field of brain injury.
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Affiliation(s)
- Andrea Greenwood
- Person Centred Research Centre, Health and Rehabilitation Institute and
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Gordon WA, Cantor J, Kristen DO, Tsaousides T. Long-term social integration and community support. HANDBOOK OF CLINICAL NEUROLOGY 2015; 127:423-31. [PMID: 25702232 DOI: 10.1016/b978-0-444-52892-6.00027-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
TBI often results in reduced social participation. This decrease in social participation is independent of injury severity and time since injury. Thus, it is one of the many stable hallmarks of TBI. Changes in social participation have been related to many factors, including emotional dysregulation and disturbance and executive dysfunction. While there are evidenced-based treatments available to improve mood and executive functioning, none of the research has examined the impact of the various treatments on social participation or social integration. Therefore, while it is reasonable to expect that individuals who are feeling better about themselves and who improve their approach to day-to-day function will also experience increased social contact, there is no evidence to support this claim. This chapter reviews the literature on post-TBI social integration and its relationship to depression and executive dysfunction. In addition the intervention research in this area is briefly examined.
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Affiliation(s)
- Wayne A Gordon
- Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USA.
| | - Joshua Cantor
- Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USA
| | - Dams-O'Connor Kristen
- Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USA
| | - Theodore Tsaousides
- Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USA
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Abstract
Traumatic brain injury (TBI) is a major cause of death and disability, and therefore an important health and socioeconomic problem for our society. Individuals surviving from a moderate to severe TBI frequently suffer from long-lasting cognitive deficits. Such deficits include different aspects of cognition such as memory, attention, executive functions, and awareness of their deficits. This chapter presents a review of the main neuropsychological and neuroimaging studies of patients with TBI. These studies found that patients evolve differently according to the severity of the injury, the mechanism causing the injury, and the lesion location. Further research is necessary to develop rehabilitation methods that enhance brain plasticity and recovery after TBI. In this chapter, we summarize current knowledge and controversies, focusing on cognitive sequelae after TBI. Recommendations from the Common Data Elements are provided, with an emphasis on diagnosis, outcome measures, and studies organization to make data more comparable across studies. Final considerations on neuroimaging advances, rehabilitation approaches, and genetics are described in the final section of the chapter.
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Affiliation(s)
- Irene Cristofori
- Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Harvey S Levin
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
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Gardizi E, Hanks RA, Millis SR, Figueroa MJ. Comorbidity and Insurance as Predictors of Disability After Traumatic Brain Injury. Arch Phys Med Rehabil 2014; 95:2396-401. [DOI: 10.1016/j.apmr.2014.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/23/2014] [Accepted: 06/06/2014] [Indexed: 11/25/2022]
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Holloway M. How is ABI assessed and responded to in non-specialist settings? Is specialist education required for all social care professionals? ACTA ACUST UNITED AC 2014. [DOI: 10.1108/scn-12-2013-0043] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services.
Design/methodology/approach
– A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs.
Findings
– ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change.
Practical implications
– An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings.
Originality/value
–Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs.
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Validation of the quality of life after brain injury in Chinese persons with traumatic brain injury in Taiwan. J Head Trauma Rehabil 2014; 29:E37-47. [PMID: 23474879 DOI: 10.1097/htr.0b013e3182816363] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the psychometric properties of the Quality of Life After Brain Injury (QOLIBRI) in Chinese persons with traumatic brain injury (TBI) in Taiwan. PARTICIPANTS Three hundred one patients with TBI were interviewed face-to-face at baseline; of these, 132 completed a follow-up assessment 1 year later. SETTINGS Neurosurgery clinics of 6 teaching hospitals in northern Taiwan. MEASURE The 37-item QOLIBRI, including 6 domains of Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, and Physical Problems. RESULTS A small percentage (<1%) of responses were missing, except the Sex Life item under the Social domain (5.9%). The QOLIBRI achieved adequate percentages for the floor value (0%-4%), ceiling value (1%-3.3%), internal consistency (0.79-0.95), and test-retest reliability (0.81-0.89). For construct validity, correlation coefficients (rs) for the QOLIBRI domains and selected clinical measures conceptually related to that domain were all 0.4 or more, except rs for QOLIBRI Cognition and Mini-Mental State Examination scores. A principal components analysis found that one item (Loneliness) of the Emotions domain did not converge with its corresponding domain of the original QOLIBRI (loading score <0.4). Effect sizes of responsiveness to changes in the Glasgow Outcome Scale-Extended over the 1-year period were clinically meaningful for all the QOLIBRI domains except the Emotions domain. CONCLUSION With modifications to the Emotions domain, the QOLIBRI would be suitable for use with Chinese people in Taiwan who have TBI.
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Malouf T, Langdon R, Taylor A. The Insight Interview: A new tool for measuring deficits in awareness after traumatic brain injury. Brain Inj 2014; 28:1523-41. [DOI: 10.3109/02699052.2014.922700] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Tania Malouf
- Queensland Paediatric Rehabilitation Service, Royal Children’s Hospital
BrisbaneAustralia
- Department of Psychology, Mater Children’s Hospital
BrisbaneAustralia
| | | | - Alan Taylor
- Department of Psychology, Macquarie University
SydneyAustralia
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Neumann D, Keiski MA, McDonald BC, Wang Y. Neuroimaging and facial affect processing: implications for traumatic brain injury. Brain Imaging Behav 2013; 8:460-73. [DOI: 10.1007/s11682-013-9285-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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