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Milillo MM, Neumann CS, Maurer JM, Jin C, Commerce E, Reynolds BL, Harenski CL, Kiehl KA. Association Between Traumatic Brain Injury and Psychopathic Traits Among Justice-Involved Adolescents. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01212-x. [PMID: 38922463 DOI: 10.1007/s10802-024-01212-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/27/2024]
Abstract
Traumatic brain injury (TBI) is a global public health problem and is highly prevalent among justice-involved populations. Pediatric TBI is linked with long-term negative outcomes and is correlated with substance use, criminal behavior, psychiatric disorders, and disruptions in neurocognition. These same TBI correlates are evident among youth with psychopathic traits. Given ongoing neurobiological and social development in adolescence, understanding the link between psychopathic traits and TBI in justice-involved youth is critical. A sample of 263 male adolescents were recruited from a maximum-security juvenile justice facility. Using a structural equation modeling (SEM) framework, measurement invariance of psychopathic traits (TBI ±) was tested, and psychopathy scores were accounted for in terms of TBI variables (severity, age of first TBI, total number), participant's age, IQ, substance use, and internalizing psychopathology. There was evidence of strong invariance across TBI status and those with TBI had higher affective and impulsive lifestyle psychopathic traits than adolescents without TBI. The SEM indicated that TBI severity was associated with lower IQ scores, which in turn were associated with increased lifestyle/antisocial (Factor 2) psychopathic traits. Total number of TBIs was associated with higher substance use, which was associated with both increased interpersonal/affective (Factor 1) and Factor 2 psychopathic traits. These TBI variables also had indirect associations with psychopathic traits through IQ and substance use. The findings indicate that TBI is associated with psychopathic traits and suggest that disturbances in cognition and substance use may be treatment targets for youth with TBI and psychopathic traits.
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Affiliation(s)
- Michaela M Milillo
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA.
- Department of Psychology, University of New Mexico, Albuquerque, NM, 87106, USA.
| | - Craig S Neumann
- Department of Psychology, University of North Texas, Denton, TX, 76201, USA
| | - J Michael Maurer
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA
| | - Christine Jin
- Department of Psychology, University of North Texas, Denton, TX, 76201, USA
| | - Ella Commerce
- Department of Psychology, University of North Texas, Denton, TX, 76201, USA
| | - Brooke L Reynolds
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA
| | - Carla L Harenski
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA
| | - Kent A Kiehl
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA.
- Department of Psychology, University of New Mexico, Albuquerque, NM, 87106, USA.
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Kaurani P, Moreira de Marchi Apolaro AV, Kunchala K, Maini S, Rges HAF, Isaac A, Lakkimsetti M, Raake M, Nazir Z. Advances in Neurorehabilitation: Strategies and Outcomes for Traumatic Brain Injury Recovery. Cureus 2024; 16:e62242. [PMID: 39006616 PMCID: PMC11244718 DOI: 10.7759/cureus.62242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Traumatic brain injury (TBI) consists of an external physical force that causes brain function impairment or pathology and globally affects 50 million people each year, with a cost of 400 billion US dollars. Clinical presentation of TBI can occur in many forms, and patients usually require prolonged hospital care and lifelong rehabilitation, which leads to an impact on the quality of life. For this narrative review, no particular method was used to extract data. With the aid of health descriptors and Medical Subject Heading (MeSH) terms, a search was thoroughly conducted in databases such as PubMed and Google Scholar. After the application of exclusion and inclusion criteria, a total of 146 articles were effectively used for this review. Results indicate that rehabilitation after TBI happens through neuroplasticity, which combines neural regeneration and functional reorganization. The role of technology, including artificial intelligence, virtual reality, robotics, computer interface, and neuromodulation, is to impact rehabilitation and life quality improvement significantly. Pharmacological intervention, however, did not result in any benefit when compared to standard care and still needs further research. It is possible to conclude that, given the high and diverse degree of disability associated with TBI, rehabilitation interventions should be precocious and tailored according to the individual's needs in order to achieve the best possible results. An interdisciplinary patient-centered care health team and well-oriented family members should be involved in every stage. Lastly, strategies must be adequate, well-planned, and communicated to patients and caregivers to attain higher functional outcomes.
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Affiliation(s)
- Purvi Kaurani
- Neurology, DY Patil University School of Medicine, Navi Mumbai , IND
| | | | - Keerthi Kunchala
- Internal Medicine, Sri Venkateswara Medical College, Tirupati, IND
| | - Shriya Maini
- Medicine and Surgery, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Huda A F Rges
- Mental Health, National Authority for Mental Health and Psychosocial Support, Benghazi, LBY
| | - Ashley Isaac
- General Medicine, Isra University Hospital, Hyderabad, PAK
| | | | | | - Zahra Nazir
- Internal Medicine, Combined Military Hospital, Quetta, PAK
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Troeung L, Sarunga Raja TL, Mann G, Wagland J, MacLeod C, Martini A. IMproving psYchosocial adjustment to Traumatic Brain Injury from acute to chronic injury through development and evaluation of the myTBI online psychoeducation platform: protocol for a mixed-methods study. BMJ Open 2024; 14:e080030. [PMID: 38508623 PMCID: PMC10953309 DOI: 10.1136/bmjopen-2023-080030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION This protocol describes the myTBI study which aims to: (1) develop an online psychoeducation platform for people with traumatic brain injury (TBI), their family members/caregivers, and healthcare staff to improve psychosocial adjustment to TBI across different phases of injury (acute, postacute, and chronic), and (2) undertake an evaluation of efficacy, acceptability, and feasibility. METHODS AND ANALYSIS A three-stage mixed-methods research design will be used. The study will be undertaken across four postacute community-based neurorehabilitation and disability support services in Western Australia. Stage 1 (interviews and surveys) will use consumer-driven qualitative methodology to: (1) understand the recovery experiences and psychosocial challenges of people with TBI over key stages (acute, postacute, and chronic), and (2) identify required areas of psychosocial support to inform the psychoeducation platform development. Stage 2 (development) will use a Delphi expert consensus method to: (1) determine the final psychoeducation modules, and (2) perform acceptance testing of the myTBI platform. Finally, stage 3 (evaluation) will be a randomised stepped-wedge trial to evaluate efficacy, acceptability, and feasibility. Outcomes will be measured at baseline, postintervention, follow-up, and at final discharge from services. Change in outcomes will be analysed using multilevel mixed-effects modelling. Follow-up surveys will be conducted to evaluate acceptability and feasibility. ETHICS AND DISSEMINATION Ethics approval was granted by North Metropolitan Health Service Mental Health Research Ethics and Governance Office (RGS0000005877). Study findings will be relevant to clinicians, researchers, and organisations who are seeking a cost-effective solution to deliver ongoing psychoeducation and support to individuals with TBI across the recovery journey. TRIAL REGISTRATION NUMBER ACTRN12623000990628.
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Affiliation(s)
- Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Thilaga L Sarunga Raja
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- Oats Street Rehabilitation Centre, Brightwater Care Group, East Victoria Park, Western Australia, Australia
| | - Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Janet Wagland
- Disability Services, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Colin MacLeod
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- The University of Western Australia, Crawley, Western Australia, Australia
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Liu T, Yu S, Liu M, Zhao Z, Yuan J, Sha Z, Liu X, Qian Y, Nie M, Jiang R. Cognitive impairment in Chinese traumatic brain injury patients: from challenge to future perspectives. Front Neurosci 2024; 18:1361832. [PMID: 38529265 PMCID: PMC10961372 DOI: 10.3389/fnins.2024.1361832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/27/2024] [Indexed: 03/27/2024] Open
Abstract
Traumatic Brain Injury (TBI) is a prevalent form of neurological damage that may induce varying degrees of cognitive dysfunction in patients, consequently impacting their quality of life and social functioning. This article provides a mini review of the epidemiology in Chinese TBI patients and etiology of cognitive impairment. It analyzes the risk factors of cognitive impairment, discusses current management strategies for cognitive dysfunction in Chinese TBI patients, and summarizes the strengths and limitations of primary testing tools for TBI-related cognitive functions. Furthermore, the article offers a prospective analysis of future challenges and opportunities. Its objective is to contribute as a reference for the prevention and management of cognitive dysfunction in Chinese TBI patients.
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Affiliation(s)
- Tao Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Shaohui Yu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mingqi Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhihao Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiangyuan Yuan
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhuang Sha
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuanhui Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yu Qian
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Meng Nie
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Rongcai Jiang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
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Aaronson AL, Smith B, Krese K, Barnhart M, Adamson M, de Wit H, Philip NS, Brenner LA, Bender-Pape T, Herrold AA. Impulsivity and Psychiatric Diagnoses as Mediators of Suicidal Ideation and Suicide Attempts Among Veterans With Traumatic Brain Injury. J Neuropsychiatry Clin Neurosci 2024; 36:125-133. [PMID: 38192217 PMCID: PMC11018458 DOI: 10.1176/appi.neuropsych.20230044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Traumatic brain injury (TBI) is a risk factor for suicide, but questions related to mechanisms remain unanswered. Impulsivity is a risk factor for suicide and is a common sequela of TBI. The authors explored the relationships between TBI and both suicidal ideation and suicide attempts and explored whether impulsivity and comorbid psychiatric diagnoses mediate these relationships. METHODS This cross-sectional retrospective chart review study included 164 veterans enrolled in a previous study. Sixty-nine veterans had no TBI history, and 95 had a TBI history (mild, N=44; moderate, N=13; severe, N=12; and unclear severity, N=26). To examine the associations between TBI and suicidal ideation or suicide attempts, as well as potential mediators of these relationships, chi-square tests, t tests, and logistic regression models were used. RESULTS Unadjusted analyses indicated that veterans with TBI were more likely to report suicidal ideation; however, in analyses controlling for mediators, this relationship was no longer significant. Among veterans with TBI, suicidal ideation was related most strongly to high impulsivity (odds ratio=15.35, 95% CI=2.43-96.79), followed by depression (odds ratio=5.73, 95% CI=2.53-12.99) and posttraumatic stress disorder (odds ratio=2.57, 95% CI=1.03-6.42). TBI was not related to suicide attempts, yet suicide attempts were related to high impulsivity (odds ratio=6.95, 95% CI=1.24-38.75) and depression (odds ratio=3.89, 95% CI=1.56-9.40). CONCLUSIONS These findings suggest that impulsivity, followed by psychiatric diagnoses, most strongly mediate the relationships between TBI and both suicidal ideation and suicide attempts. Impulsivity may be mechanistically related to, and serve as a future treatment target for, suicidality among veterans with TBI.
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Affiliation(s)
- Alexandra L Aaronson
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Bridget Smith
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Kelly Krese
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Meghan Barnhart
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Maheen Adamson
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Harriet de Wit
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Noah S Philip
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Lisa A Brenner
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Theresa Bender-Pape
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
| | - Amy A Herrold
- Mental Health Service Line (Aaronson) and Research Service Line (Smith, Bender-Pape, Herrold), Edward J. Hines Veterans Administration Hospital, Hines, Ill.; Department of Psychiatry, University of Illinois, Chicago (Aaronson); Brain Innovation Center, Shirley Ryan AbilityLab, Chicago (Krese); Chicago Association for Research and Education in Science, Hines, Ill. (Krese); Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Barnhart, Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora (Barnhart, Brenner); Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Adamson); Department of Neurosurgery, Stanford University, Stanford, Calif. (Adamson); Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago (de Wit); Center for Neurorestoration and Neurotechnology, Veterans Affairs Providence Health Care System, Providence, R.I. (Philip); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Philip); Departments of Physical Medicine and Rehabilitation (Bender-Pape) and Psychiatry and Behavioral Sciences (Herrold), Northwestern University, Chicago
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Liu Y, Yao X, Qian J. Thirty years of research on traumatic brain injury rehabilitation: a bibliometric study. Front Neurol 2023; 14:1170731. [PMID: 37255720 PMCID: PMC10225562 DOI: 10.3389/fneur.2023.1170731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/26/2023] [Indexed: 06/01/2023] Open
Abstract
Background Traumatic brain injury (TBI) is a major public health concern with far-reaching consequences on individuals' lives. Despite the abundance of works published on TBI rehabilitation, few studies have bibliometrically analyzed the published TBI rehabilitation research. This study aims to characterize current international trends and global productivity by analyzing articles on TBI rehabilitation using bibliometric approaches and visualization methods. Methods We conducted a bibliometric analysis of data retrieved and extracted from the Web of Science Core Collection database to examine the evolution and thematic trends in TBI rehabilitation research up until December 31, 2022. The specific characteristics of the research articles on TBI rehabilitation were evaluated, such as publication year, countries/regions, institutions, authors, journals, research fields, references, and keywords. Results Our analysis identified 5,541 research articles on TBI rehabilitation and observed a progressive increase in publications and citations over the years. The United States (US, 2,833, 51.13%), Australia (727, 13.12%), and Canada (525, 9.47%) were the most prolific countries/regions. The University of Washington (226, 4.08%) and Hammond FM (114, 2.06%) were the most productive institution and author, respectively. The top three productive journals were Brain Injury (862; 15.56%), Archives of Physical Medicine and Rehabilitation (630; 11.37%), and Journal of Head Trauma Rehabilitation (405, 7.31%). The most frequent research fields were Rehabilitation, Neurosciences, and Clinical Neurology. Co-citation references primarily addressed "outcome assessment," "community integration" and "TBI management," and "injury chronicity" and "sequelae" have gained more attention in recent years. "Mild TBI," "outcome," "stroke" and "children" were the commonly used keywords. Additionally, the analysis unveiled emerging research frontiers, including "return to work," "disorder of consciousness," "veterans," "mild TBI," "pediatric," "executive function" and "acquired brain injury." Conclusion This study provides valuable insights into the current state of TBI rehabilitation research, which has experienced a rapid increase in attention and exponential growth in publications and citations in the last three decades. TBI rehabilitation research is characterized by its multi-disciplinary approach, involving fields such as Rehabilitation, Neurosciences, and Clinical Neurology. The analysis revealed emerging research subjects that could inform future research directions.
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Affiliation(s)
- Yang Liu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Xiaomeng Yao
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Jinghua Qian
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Mitophagy and Traumatic Brain Injury: Regulatory Mechanisms and Therapeutic Potentials. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:1649842. [PMID: 36846712 PMCID: PMC9957633 DOI: 10.1155/2023/1649842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/25/2022] [Accepted: 01/21/2023] [Indexed: 02/19/2023]
Abstract
Traumatic brain injury (TBI), a kind of external trauma-induced brain function alteration, has posed a financial burden on the public health system. TBI pathogenesis involves a complicated set of events, including primary and secondary injuries that can cause mitochondrial damage. Mitophagy, a process in which defective mitochondria are specifically degraded, segregates and degrades defective mitochondria allowing a healthier mitochondrial network. Mitophagy ensures that mitochondria remain healthy during TBI, determining whether neurons live or die. Mitophagy acts as a critical regulator in maintaining neuronal survival and healthy. This review will discuss the TBI pathophysiology and the consequences of the damage it causes to mitochondria. This review article will explore the mitophagy process, its key factors, and pathways and reveal the role of mitophagy in TBI. Mitophagy will be further recognized as a therapeutic approach in TBI. This review will offer new insights into mitophagy's role in TBI progression.
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8
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Temkin N, Machamer J, Dikmen S, Nelson LD, Barber J, Hwang PH, Boase K, Stein MB, Sun X, Giacino J, McCrea MA, Taylor SR, Jain S, Manley G. Risk Factors for High Symptom Burden Three Months after Traumatic Brain Injury and Implications for Clinical Trial Design: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study. J Neurotrauma 2022; 39:1524-1532. [PMID: 35754333 PMCID: PMC9689769 DOI: 10.1089/neu.2022.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
More than 75% of patients presenting to level I trauma centers in the United States with suspicion of TBI sufficient to require a clinical computed tomography scan report injury-related symptoms 3 months later. There are currently no approved treatments, and few clinical trials have evaluated possible treatments. Efficient trials will require subject inclusion and exclusion criteria that balance cost-effective recruitment with enrolling individuals with a higher chance of benefiting from the interventions. Using data from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, we examined the relationship of 3-month symptoms to pre-injury, demographic, and acute characteristics as well as 2-week symptoms and blood-based biomarkers to identify and evaluate factors that may be used for sample enrichment for clinical trials. Many of the risk factors for TBI symptoms reported in the literature were supported, but the effect sizes of each were small or moderate (< 0.5). The only factors with large effect sizes when predicting 3-month symptom burden were TBI-related (i.e., post-concussive) and post-traumatic stress symptom levels at 2 weeks (respective effect sizes 1.13 and 1.34). TBI severity was not significantly associated with 3-month symptom burden (p = 0.37). Using simulated data to evaluate the effect of enrichment, we showed that including only people with high symptom burden at 2 weeks would permit trials to reduce the sample size by half, with minimal increase in screening, as compared with enrolling an unenriched sample. Clinical trials aimed at reducing symptoms after TBI can be efficiently conducted by enriching the included sample with people reporting a high early symptom burden.
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Affiliation(s)
- Nancy Temkin
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Joan Machamer
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Sureyya Dikmen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Lindsay D. Nelson
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jason Barber
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Phillip H. Hwang
- Department of Anatomy and Neurobiology, Boston University, Boston Massachusetts, USA
| | - Kim Boase
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Murray B. Stein
- Department of Psychiatry and Herbert Wertheim School of Public Health, University of California, San Diego, California, USA
| | - Xiaoying Sun
- Biostatistics Research Center Herbert Wertheim School of Public Health, University of California, San Diego, California, USA
| | - Joseph Giacino
- Department of Rehabilitation Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Michael A. McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sabrina R. Taylor
- Brain and Spinal Injury Center, San Francisco California, USA
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Sonia Jain
- Biostatistics Research Center Herbert Wertheim School of Public Health, University of California, San Diego, California, USA
| | - Geoff Manley
- Brain and Spinal Injury Center, San Francisco California, USA
- Department of Neurological Surgery, University of California, San Francisco, California, USA
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9
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Findlay MC, Bauer SZ, Gautam D, Lucke-Wold B. Rehabilitation After Neurotrauma: A Commentary. JOURNAL OF SURGERY CARE 2022; 1:19-26. [PMID: 36321858 PMCID: PMC9620735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Rehabilitation following neurotrauma is an important component of recovery. The best outcomes involve multidisciplinary management. This involves medical therapies, functional therapies, and physical therapies. Speech therapy, physical therapy, and occupational therapy are crucial components. Emerging evidence has implicated the need for vision therapies and a focus on mental health. A seamless integration from inpatient to outpatient is validated. This can be at outpatient facilities or home care. The importance is a key point person for the patient.
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Affiliation(s)
| | - Sawyer Z Bauer
- Reno School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Diwas Gautam
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida USA
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10
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Richmond-Hacham B, Izchak H, Elbaum T, Qubty D, Bader M, Rubovitch V, Pick CCG. Sex-specific cognitive effects of mild traumatic brain injury to the frontal and temporal lobes. Exp Neurol 2022; 352:114022. [PMID: 35202640 DOI: 10.1016/j.expneurol.2022.114022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/18/2022] [Accepted: 02/16/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cognitive deficits are the most enduring and debilitating sequelae of mild traumatic brain injury (mTBI). However, relatively little is known about whether the cognitive effects of mTBI vary with respect to time post-injury, biological sex, and injury location. OBJECTIVES The aim of this study was to assess the effect of the side and site of mTBI and to determine whether these effects are sexually dimorphic. METHODS Male and female ICR mice were subjected to either a sham procedure or mTBI to the temporal lobes (right-sided or left-sided) or to the frontal lobes (bilateral) using a weight-drop model. After recovery, mice underwent a battery of behavioral tests at two post-injury time points. RESULTS Different mTBI impact locations produced dissociable patterns of memory deficits; the extent of these deficits varied across sexes, time points, and memory domains. In both sexes, frontal mTBI mice exhibited a delayed onset of spatial memory deficits. Additionally, the performance of the frontal and left temporal injured males and females was more variable than that of controls. Interestingly, only in females does the effect of mTBI on visual recognition memory depend on the time post-injury. Moreover, only in females does spatial recognition memory remain relatively intact after mTBI to the left temporal lobe. CONCLUSION This study showed that different mTBI impact sites produce dissociable and sex-specific patterns of cognitive deficits in mice. The results emphasize the importance of considering the injury site/side and biological sex when evaluating the cognitive sequelae of mTBI.
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Affiliation(s)
- Bar Richmond-Hacham
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Haim Izchak
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Elbaum
- Department of Industrial Engineering and Management, Ariel University, Ariel, Israel
| | - Doaa Qubty
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Miaad Bader
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Vardit Rubovitch
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Chaim C G Pick
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Center for the Biology of Addictive Diseases, Tel Aviv University, Tel Aviv, Israel.
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11
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Thøgersen CMS, Glintborg C, Hansen TGB, Trettvik J. Psychotherapeutic Intervention for Adults With Acquired Brain Injury: A Case Study Using BackUp. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:771416. [PMID: 36188993 PMCID: PMC9397759 DOI: 10.3389/fresc.2022.771416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022]
Abstract
A moderate-to-severe acquired brain injury (ABI) can have tremendous lifelong consequences for ABI-survivors and their families. Despite rehabilitation practice since the 1980s aspiring to a dynamic, coherent and holistic approach, the psychological dimension still seems to be a challenge and research has revealed persisting psychosocial impairments after ABI. Therefore, we developed BackUp©, a manual based short term psychological intervention for adults with ABI. This study explores the effect of the intervention though a small feasibility study, employing a single case design. One client received the intervention. Self-report measures were collected, and a semi structured interview was conducted. While results from pre, post and follow-up measures do not show clear positive results, the interview reveals positive experiences and the participant reported achieving his therapy goal. This case study provides support for a psychological intervention to support the psychological rehabilitation after an ABI.
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12
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Pedrotty M, Wong TS, Wilde EA, Bigler ED, Laatsch LK. Application of neuropsychology and imaging to brain injury and use of the integrative cognitive rehabilitation psychotherapy model. NeuroRehabilitation 2021; 49:307-327. [PMID: 34420990 DOI: 10.3233/nre-218028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An early approach to cognitive rehabilitation therapy (CRT) was developed based on A. R. Luria's theory of brain function. Expanding upon this approach, the Integrative Cognitive Rehabilitation Psychotherapy model (ICRP) was advanced. OBJECTIVE To describe the ICRP approach to treatment of clients post brain injury and provide a comprehensive list of evaluation tools to determine the client's abilities and needs. Finally, to provide a link between CRT and functional imaging studies designed to improve rehabilitation efforts. METHODS History of cognitive rehabilitation and neuropsychological testing is reviewed and description of cognitive, academic, psychiatric, and substance abuse tools are provided. Cognitive and emotional treatment techniques are fully described. Additionally, a method of determining the client's stage of recovery and pertinent functional imaging studies is detailed. RESULTS Authors have been able to provide a set of tools and techniques to use in comprehensive treatment of clients with brain injury. CONCLUSIONS Inclusive treatment which is outlined in the ICRP model is optimal for the client's recovery and return to a full and satisfying life post brain injury. The model provides a framework for neuropsychologists to integrate issues that tend to co-occur in clients living with brain injury into a unified treatment plan.
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Affiliation(s)
- Mark Pedrotty
- Tingley Hospital Outpatient -UNM, Albuquerque, NM, USA
| | - Tiffanie S Wong
- Polytrauma Rehabilitation Center, Comprehensive Rehabilitation Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Stem Cognitive and Psychological Rehabilitation, Inc., Palo Alto, CA, USA
| | - Elisabeth A Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,George E. Wahlen Veterans' Affairs Medical Center, Salt Lake City, UT, USA
| | - Erin D Bigler
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Linda K Laatsch
- Department of Neurology, University of Illinois, Chicago, IL, USA
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13
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Mitchell T, du Preez E, Theadom A. An intervention to improve coping strategies in adult male prisoners with a history of traumatic brain injury: A pilot randomised clinical trial. Clin Rehabil 2021; 35:1185-1195. [PMID: 33706573 DOI: 10.1177/0269215521998535] [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: 11/17/2022]
Abstract
OBJECTIVE To determine whether a psychological intervention improves coping, post-concussion symptoms and decreases in-prison infractions in adult males with a history of traumatic brain injury. DESIGN A single centre, randomised, wait-list, pilot study. SETTING A high security prison in New Zealand. SUBJECTS Fifty-five adult male participants who had experienced at least one traumatic brain injury in their lifetime (mean age 37.29 +/-9.81 years). INTERVENTION A manualised ten session, in-person, group based combined Cognitive Behavioural Therapy /Mindfulness Based Stress Reduction intervention versus wait list control. MAIN MEASURES The Negative Affect Repair Questionnaire and Rivermead Post-concussion Symptom Questionnaire were completed at baseline, post-intervention (five weeks) and at 12 week follow up. In-prison misconduct charges and negative file notes were reviewed for the previous five weeks at each assessment time point. RESULTS There was an improvement in the use of calming and distraction strategies in the intervention group from baseline (x̄ = 17.38, SD = 3.57) to post-intervention (x̄ = 18.67, SD = 3.84) and 12-week follow up (x̄ = 18.13, SD = 2.63). Participants in the intervention group had significantly higher negative affect repair on the calming and distractive strategies subscale following completion of the intervention, compared to wait-list controls (F = 4.69, P = 0.04) with a moderate effect size (ηp2 = 0.11). Improvements in use of calming and distractive strategies was not sustained at the twelve-week follow-up (F = 0.87, P = 0.36). There was no-significant improvement on other negative affect subscales or for post-concussion symptoms or decrease in-prison infractions. CONCLUSION A manualised psychological intervention may have the potential to facilitate the development of positive coping strategies in prisoners with a history of traumatic brain injury.
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Affiliation(s)
| | - Elizabeth du Preez
- Department of Psychology, School of Clinical Sciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand
| | - Alice Theadom
- Department of Psychology, School of Clinical Sciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand.,TBI Network, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand
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14
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Heslot C, Cogné M, Guillouët E, Perdrieau V, Lefevre-Dognin C, Glize B, Bonan I, Azouvi P. Management of unfavorable outcome after mild traumatic brain injury: Review of physical and cognitive rehabilitation and of psychological care in post-concussive syndrome. Neurochirurgie 2020; 67:283-289. [PMID: 33049290 DOI: 10.1016/j.neuchi.2020.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 08/26/2020] [Accepted: 09/13/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Mild Traumatic Brain Injury (mTBI) is a public health issue with approximately 42 million people worldwide affected yearly. Most patients have a favorable short-term recovery but 10-20% are likely to develop post-concussive syndrome (association of physical, cognitive, and psychological difficulties after injury). Post-concussive syndrome can be associated with Post-Traumatic Stress Disorder (PTSD). There is to date no recommendation on the interventions that could be done to reduce post-concussive syndrome. The present review aims at summarizing the effect of therapeutic education, physical and cognitive rehabilitation and of psychological care in mTBI patients with post-concussive syndrome. METHODS In the current international literature, we investigated the effects of therapeutic education, physical and cognitive rehabilitation and of psychological care in this population using the Medline database and we discussed the results of these studies. RESULTS The application of a therapeutic education intervention within 3 months after mTBI has been found appropriate and effective to prevent post-concussion syndrome in several studies but the timeline of this intervention differs among the existing studies. Concerning physical disabilities, several pharmacological, rehabilitative and non-pharmacological techniques have shown some efficacy in reducing headache and vertigo; rTMS seems also promising in this context. The management of fatigue is also crucial and requires a multidisciplinary approach. We did not find any intervention in mTBI patients with post-concussive syndrome suffering from dysosmia and/or dysgueusia. No pharmacological treatment is currently recommended to reduce the cognitive symptoms of post-concussive syndrome after mTBI. Rehabilitation and brain-stimulation techniques have already proven their efficacy to reduce the cognitive impairment in this population. Even if the use of Virtual Reality software seems well tolerated in this population, its efficacy and additional value needs to be demonstrated in larger studies. Concerning the psychological care after mTBI, Cognitive and Behavioral Therapy interventions are the most frequently reported in this population, followed by psychoeducational interventions. PTSD management seems crucial in overall recovery of patients with post-concussive syndrome. CONCLUSION Many studies have sought to demonstrate the effectiveness of various rehabilitation techniques, including different cognitive rehabilitation programs, technology-assisted rehabilitation, different types of brain stimulation and some pharmacological treatments. However, most of these studies are of a low level of scientific evidence and it would be necessary to carry out well-conducted prospective randomized trials in order to offer an appropriate and effective multidisciplinary management for patients with post-concussive syndrome after mTBI.
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Affiliation(s)
- C Heslot
- Rehabilitation Medicine Unit, Rennes University Hospital, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - M Cogné
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
| | - E Guillouët
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - V Perdrieau
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - C Lefevre-Dognin
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - B Glize
- Rehabilitation Medicine Unit, Bordeaux University Hospital, place Amélie-Raba-Léon, 33000 Bordeaux, France; EA4136, Bordeaux University, 146, rue Léo-Saignat, 33000 Bordeaux, France
| | - I Bonan
- Rehabilitation Medicine Unit, Rennes University Hospital, 2, rue Henri-le-Guilloux, 35000 Rennes, France; Unit Empenn-U1228, INSERM, INRIA, University of Rennes 1, Rennes, France
| | - P Azouvi
- Rehabilitation Medicine Unit, Raymond Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; EA 4047 HANDIReSP, Versailles-Saint Quentin University, France
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15
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Chen CL, Lin MY, Huda MH, Tsai PS. Effects of cognitive behavioral therapy for adults with post-concussion syndrome: A systematic review and meta-analysis of randomized controlled trials. J Psychosom Res 2020; 136:110190. [PMID: 32712533 DOI: 10.1016/j.jpsychores.2020.110190] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/22/2020] [Accepted: 07/03/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although the mechanism of post-concussion syndrome remains unclear, psychological factors are thought to be associated with its development. Cognitive behavioral therapy is the gold standard for psychological disorders; however, its effects on post-concussion syndrome remain unclear. Through this meta-analysis, we assessed the effects of cognitive behavioral therapy on post-concussion syndrome following traumatic brain injury. METHODS Six electronic databases were searched from inception to September 15, 2019, for randomized controlled trials evaluating the effects of cognitive behavioral therapy for adults with post-concussion syndrome. Primary outcomes included the severity of symptoms of post-concussion syndrome, depression, anxiety, and social integration. Secondary outcomes were fatigue, cognitive function, and quality of life. Effects were estimated through the calculation of Hedge's g and 95% confidence interval using a random effects model. Sensitivity analyses were conducted by excluding studies in which an intention-to-treat analysis was not employed. RESULTS In total, 24 studies were included. Most studies had risk of bias. Significant effects were found for most outcomes, except for severity of symptoms of post-concussion syndrome, fatigue, executive function, and problem solving. After sensitivity analyses, the effects of cognitive behavioral therapy remained significant for immediate and mid-term effects on depression, anxiety, and social integration. CONCLUSIONS This study does not support the effectiveness of cognitive behavioral therapy for severity of symptoms of post-concussion syndrome; however, it might be an effective treatment option for improving depression, anxiety, and social integration in individuals with traumatic brain injury.
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Affiliation(s)
- Chiao-Ling Chen
- School of Nursing, College of Nursing, Taipei Medical University, No. 250 Wuxing St, Xinyi District, Taipei, Taiwan, ROC; Taipei Neuroscience Institute, Taipei Medical University, No.291, Zhongzheng Rd., Zhonghe District, Taipei, Taiwan, ROC; Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, Taipei, Taiwan, ROC.
| | - Mei-Yu Lin
- School of Nursing, College of Nursing, Taipei Medical University, No. 250 Wuxing St, Xinyi District, Taipei, Taiwan, ROC
| | - Mega Hasanul Huda
- School of Nursing, College of Nursing, Taipei Medical University, No. 250 Wuxing St, Xinyi District, Taipei, Taiwan, ROC
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, No. 250 Wuxing St, Xinyi District, Taipei, Taiwan, ROC; Department of Nursing and Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, No. 111, Sec 3, Xinglong Rd, Wenshan District, Taipei, Taiwan, ROC; Sleep Research Center, Taipei Medical University Hospital, No. 252 Wuxing St, Xinyi District, Taipei, Taiwan, ROC.
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16
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Sander AM, Clark AN, Arciniegas DB, Tran K, Leon-Novelo L, Ngan E, Bogaards J, Sherer M, Walser R. A randomized controlled trial of acceptance and commitment therapy for psychological distress among persons with traumatic brain injury. Neuropsychol Rehabil 2020; 31:1105-1129. [PMID: 32408846 DOI: 10.1080/09602011.2020.1762670] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psychological distress is common in persons with traumatic brain injury (TBI) but treatments remain underdeveloped. This randomized controlled trial of Acceptance and Commitment Therapy (ACT) was designed to address this gap. Ninety-three persons with medically-documented complicated mild to severe TBI, normal-to-mildly impaired memory, and clinically significant psychological distress in the chronic phase of recovery were randomized to receive eight weeks of ACT (manualized with adaptations to address TBI-related cognitive impairments) or a single session of needs assessment, brief counseling/education, and referral. The ACT group showed significantly greater reduction of psychological distress (Brief Symptom Inventory 18) and demonstrated improvements in psychological flexibility and commitment to action (Acceptance and Action Questionnaire-II (AAQ-II) scores). The number of treatment responders (post-treatment BSI 18 GSI T scores <63) was larger in the ACT group than in the control group. Entry of AAQ-II scores into the model of between-group differences in BSI 18 GSI T scores indicated that core ACT processes explained the variance in treatment group outcomes. Provision of ACT reduces psychological distress in persons with TBI in the chronic phase of recovery when adaptations are made to accommodate TBI-related cognitive impairments. Additional clinical trials with a structurally equivalent control group are needed.
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Affiliation(s)
- Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.,Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA.,Department of Physical Medicine and Rehabilitation, Harris Health System, Houston, TX, USA
| | - Allison N Clark
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.,Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA.,Department of Physical Medicine and Rehabilitation, Harris Health System, Houston, TX, USA
| | - David B Arciniegas
- Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA.,Marcus Institute for Brain Health, University of Colorado, Denver, CO, USA
| | - Kim Tran
- Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - Luis Leon-Novelo
- Department of Biostatistics and Data Science, School of Public Health , University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Esther Ngan
- Department of Biostatistics and Data Science, School of Public Health , University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jay Bogaards
- Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - Mark Sherer
- Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - Robyn Walser
- National Center for Posttraumatic Stress Disorder, Palo Alto, CA, USA
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