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Di Somma R, Fleming P. A systematic literature review of the impact of impaired self-awareness on the process of rehabilitation in acquired brain injury. Brain Inj 2024:1-12. [PMID: 39159384 DOI: 10.1080/02699052.2024.2392161] [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: 04/24/2023] [Revised: 06/27/2024] [Accepted: 08/09/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Impaired self-awareness (ISA) is common in individuals with an acquired brain injury (ABI) and can lead to reduced awareness of one's difficulties. Previous reviews have found that ISA impacts on functional outcomes in rehabilitation. However, to date there has not been a systematic literature review which examines how ISA impacts on the process of rehabilitation in ABI populations. METHOD A literature search was conducted using several databases in May 2024, including Academic Search Premier, CINAHL, MEDLINE, APA PsycARTICLES and APA PsycINFO. Seventeen articles were selected for the review and were analyzed using Narrative Synthesis. RESULTS Four themes arose from the findings, including goal setting, treatment adherence, engagement and willingness to change and time spent in hospital. ISA was found to impact on the value adult ABI participants placed in rehabilitation, which decreased treatment compliance, motivation, and engagement. ISA also impacted on goal setting and behavior and resulted in a longer length of time spent in hospital. CONCLUSION This review emphasizes the impact of ISA on various aspects/processes of rehabilitation in ABI and provides considerations of how clinicians might adapt interventions to manage these difficulties.
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Affiliation(s)
- Rebecca Di Somma
- Department of Clinical Psychology, Faculty of Psychological Health, Wellbeing and Social Work, Aire Building, University of Hull, Hull, UK
| | - Peter Fleming
- Department of Clinical Psychology, Faculty of Psychological Health, Wellbeing and Social Work, Aire Building, University of Hull, Hull, UK
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2
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Câmara-Costa H, Dellatolas G, Jourdan C, Ruet A, Bayen E, Vallat-Azouvi C, Allain P, Chevignard M, Azouvi P. The 20-item dysexecutive questionnaire after severe traumatic brain injury: Distribution of the total score and its significance. Neuropsychol Rehabil 2024:1-22. [PMID: 39106184 DOI: 10.1080/09602011.2024.2387065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 07/26/2024] [Indexed: 08/09/2024]
Abstract
TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01437683..
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Affiliation(s)
- Hugo Câmara-Costa
- Rehabilitation Department for Children with Acquired Brain Injury; Saint Maurice Hospitals, Saint Maurice, France
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB), F-75006, Paris, France
- Sorbonne Université, GRC 24 Handicap Moteur Cognitif et Réadaptation (HaMCRe), AP-HP, F-75013, Paris, France
| | - Georges Dellatolas
- Sorbonne Université, GRC 24 Handicap Moteur Cognitif et Réadaptation (HaMCRe), AP-HP, F-75013, Paris, France
| | - Claire Jourdan
- Physical Medicine and Rehabilitation Department, Lapeyronie Hospital, CHRU, Montpellier, France
| | - Alexis Ruet
- Physical Medicine and Rehabilitation Department, CHU Caen, INSERM U1077, Caen, France
| | - Eléonore Bayen
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB), F-75006, Paris, France
- Sorbonne Université, GRC 24 Handicap Moteur Cognitif et Réadaptation (HaMCRe), AP-HP, F-75013, Paris, France
- Assistance Publique-Hôpitaux de Paris (APHP), Groupe Hospitalier Pitié-Salpêtrière, Service De Médecine Physique et Réadaptation, Paris, France
| | | | - Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, Nantes Université, Maison de la recherche Germaine Tillion, Angers, France
- Département de Neurologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Brain Injury; Saint Maurice Hospitals, Saint Maurice, France
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB), F-75006, Paris, France
- Sorbonne Université, GRC 24 Handicap Moteur Cognitif et Réadaptation (HaMCRe), AP-HP, F-75013, Paris, France
| | - Philippe Azouvi
- AP-HP, GH Paris Saclay, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807, Villejuif, France
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3
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Herbet G, Duffau H, Mandonnet E. Predictors of cognition after glioma surgery: connectotomy, structure-function phenotype, plasticity. Brain 2024; 147:2621-2635. [PMID: 38573324 DOI: 10.1093/brain/awae093] [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] [Received: 12/02/2023] [Revised: 02/19/2024] [Accepted: 03/09/2024] [Indexed: 04/05/2024] Open
Abstract
Determining preoperatively the maximal extent of resection that would preserve cognitive functions is the core challenge of brain tumour surgery. Over the past decade, the methodological framework to achieve this goal has been thoroughly renewed: the population-level topographically-focused voxel-based lesion-symptom mapping has been progressively overshadowed by machine learning (ML) algorithmics, in which the problem is framed as predicting cognitive outcomes in a patient-specific manner from a typically large set of variables. However, the choice of these predictors is of utmost importance, as they should be both informative and parsimonious. In this perspective, we first introduce the concept of connectotomy: instead of parameterizing resection topography through the status (intact/resected) of a huge number of voxels (or parcels) paving the whole brain in the Cartesian 3D-space, the connectotomy models the resection in the connectivity space, by computing a handful number of networks disconnection indices, measuring how the structural connectivity sustaining each network of interest was hit by the resection. This connectivity-informed reduction of dimensionality is a necessary step for efficiently implementing ML tools, given the relatively small number of patient-examples in available training datasets. We further argue that two other major sources of interindividual variability must be considered to improve the accuracy with which outcomes are predicted: the underlying structure-function phenotype and neuroplasticity, for which we provide an in-depth review and propose new ways of determining relevant predictors. We finally discuss the benefits of our approach for precision surgery of glioma.
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Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier 34090, France
- Praxiling lab, UMR5267 CNRS & Paul Valéry University, Montpellier 34090, France
- Department of Medicine, University of Montpellier, Montpellier 34090, France
- Institut Universitaire de France, Paris 75000, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier 34090, France
- Department of Medicine, University of Montpellier, Montpellier 34090, France
- Team 'Plasticity of Central Nervous System, Stem Cells and Glial Tumors', U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, Montpellier 34000, France
| | - Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisière Hospital, AP-HP, Paris 75010, France
- Frontlab, CNRS UMR 7225, INSERM U1127, Paris Brain Institute (ICM), Paris 75013, France
- Université de Paris Cité, UFR de médecine, Paris 75005, France
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4
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Rodríguez-Rajo P, García-Rudolph A, Sánchez-Carrión R, Aparicio-López C, Enseñat-Cantallops A, García-Molina A. Computerized social cognitive training in the subacute phase after traumatic brain injury: A quasi-randomized controlled trial. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:540-553. [PMID: 35196474 DOI: 10.1080/23279095.2022.2042693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To assess the usefulness of a computerized tasks module designed for the rehabilitation of social cognition (SC) in acquired brain injury. METHODS Quasi-randomized controlled trial (ClinicalTrials.gov:NCT03479970) involving 45 patients with moderate-severe traumatic brain injury (TBI) in a subacute inpatient rehabilitation hospital. The experimental group (n = 28) received treatment with a computerized SC module in combination with a non-SC module. The control group (n = 26) only received a treatment with non-SC module. RESULTS Intragroup comparisons showed that the experimental group had better results for all SC measures, except for International Affective Picture System (IAPS). The control group improved for Facial Expressions of cEmotion-Stimuli and Tests (FEEST) and Moving Shapes Paradigm (MSP), showing no changes with respect to pretreatment in IAPS, MSP and Reading the Mind in the Eyes Test (RMET). Intergroup comparisons did not present differences between the two groups for pretreatment measures. Post-treatment comparison showed that the experimental group obtained better results for RMET than the control group. CONCLUSION The computerized SC module was useful for the rehabilitation of SC in patients with moderate-severe TBI in the subacute phase. The group that received combined rehabilitative treatment (SC + non-SC) obtained better results for SC than the group that received treatment intended only for non-SC.
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Affiliation(s)
- P Rodríguez-Rajo
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A García-Rudolph
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - R Sánchez-Carrión
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - C Aparicio-López
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - A Enseñat-Cantallops
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - A García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Facultad de Psicología, Centro de Estudios en Neurociencia Humana y Neuropsicología, Universidad Diego Portales, Santiago de Chile, Chile
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Slomp AC, van der Zee S, Boertien JM, Gerritsen MJJ, van Laar T, Spikman JM. Impaired facial emotion recognition in relation to social behaviours in de novo Parkinson's disease. J Neuropsychol 2024; 18:205-216. [PMID: 37488778 DOI: 10.1111/jnp.12341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 06/17/2023] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Abstract
Facial emotion recognition (FER) is a crucial component of social cognition and is essential in social-interpersonal behaviour regulation. Although FER impairment is well-established in advanced PD, data about FER at the time of diagnosis and its relationship with social behavioural problems in daily life are lacking. The aim was to examine FER at the time of PD diagnosis compared to a matched healthy control (HC) group and to associate FER with indices of social behavioural problems. In total, 142 de novo, treatment-naïve PD patients and 142 HC were included. FER was assessed by the Ekman 60 faces test (EFT). Behavioural problems in PD patients were assessed using the Dysexecutive Questionnaire (DEX-self and DEX-proxy) and the Apathy Evaluation Scale (AES-self). PD patients had significantly lower EFT-total scores (p = .001) compared to HC, with worse recognition of Disgust (p = .001) and Sadness (p = .016). Correlational analyses yielded significant correlations between AES-self and both EFT-total (rs = .28) and Fear (rs = .22). Significant negative correlations were found between DEX-proxy and both EFT-total (rs = -.28) and Anger (rs = -.26). Analyses of DEX-subscales showed that proxy ratings were significantly higher than patient-ratings for the Social Conventions subscale (p = .047). This DEX-proxy subscale had the strongest correlation with EFT-total (rs = -.29). Results show that de novo PD patients already show impaired FER compared to HC. In addition, lower FER is linked to self-reported apathy and proxy-reported social-behavioural problems, especially concerning social conventions. These findings validate the importance of the inclusion of social cognition measures in the neuropsychological assessment even in early PD.
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Affiliation(s)
- Anne Carien Slomp
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, Subdepartment of Clinical Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Sygrid van der Zee
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, Subdepartment of Clinical Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeffrey M Boertien
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marleen J J Gerritsen
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, Subdepartment of Clinical Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Medical Psychology, Deventer Hospital, Deventer, The Netherlands
| | - Teus van Laar
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jacoba M Spikman
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, Subdepartment of Clinical Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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6
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Siebenga FF, van der Weide HL, Gelmers F, Rakers SE, Kramer MCA, van der Hoorn A, Enting RH, Bosma I, Groen RJM, Jeltema HR, Wagemakers M, Spikman JM, Buunk AM. Emotion recognition in relation to tumor characteristics in patients with low-grade glioma. Neuro Oncol 2024; 26:528-537. [PMID: 37904541 PMCID: PMC10912004 DOI: 10.1093/neuonc/noad209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Patients with low-grade gliomas (LGG) treated with surgery, generally function well and have a favorable prognosis. However, LGG can affect neurocognitive functioning. To date, little is known about social cognition (SC) in these patients, although impaired SC is related to social-behavioral problems and poor societal participation. Frontal brain areas are important for SC and LGG frequently have a frontal location. Therefore, the aim of the present study was to investigate whether emotion recognition, a key component of SC, was impaired, and related to general cognition, tumor location, laterality, tumor volume, and histopathological characteristics in patients with LGG, postsurgery, and before start of adjuvant therapy. METHODS A total of 121 patients with LGG were matched with 169 healthy controls (HC). Tumor location [including (frontal) subregions; insula, anterior cingulate cortex, lateral prefrontal cortex (LPFC), orbitofrontal-ventromedial PFC] and tumor volume were determined on MRI scans. Emotion recognition was measured with the Ekman 60 faces test of the Facial Expressions of Emotion-Stimuli and Tests (FEEST). RESULTS Patients with LGG performed significantly lower on the FEEST than HC, with 33.1% showing impairment compared to norm data. Emotion recognition was not significantly correlated to frontal tumor location, laterality, and histopathological characteristics, and significantly but weakly with general cognition and tumor volume. CONCLUSIONS Emotion recognition is impaired in patients with LGG but not (strongly) related to specific tumor characteristics or general cognition. Hence, measuring SC with individual neuropsychological assessment of these patients is crucial, irrespective of tumor characteristics, to inform clinicians about possible impairments, and consequently offer appropriate care.
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Affiliation(s)
- Femke F Siebenga
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hiska L van der Weide
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Floor Gelmers
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra E Rakers
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Miranda C A Kramer
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anouk van der Hoorn
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roelien H Enting
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ingeborg Bosma
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rob J M Groen
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen
| | - Jacoba M Spikman
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne M Buunk
- Department of Neurology, Unit of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Halalmeh DR, Salama HZ, LeUnes E, Feitosa D, Ansari Y, Sachwani-Daswani GR, Moisi MD. The Role of Neuropsychology in Traumatic Brain Injury: Comprehensive Literature Review. World Neurosurg 2024; 183:128-143. [PMID: 38104936 DOI: 10.1016/j.wneu.2023.12.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Traumatic brain injury (TBI) is a major public health concern, often leading to significant behavioral and cognitive changes with subsequent impairment in daily functioning and personal interactions. The management of TBI involves a multidisciplinary approach. Neuropsychology has emerged as a critical discipline in assessing, diagnosing, treating, and rehabilitating individuals with TBI. Successful management also requires careful consideration of the patient's cognitive status. Therefore, clinicians must have a comprehensive understanding of the overall clinical picture of the patient at the cognitive and physical level. The primary aim of this research is to explore the role of neuropsychology in TBI management and rehabilitation thoroughly while providing an updated review of the literature. Various neuropsychological assessment tools used to evaluate cognitive functioning in individuals with TBI will be discussed in addition to their validity, reliability, and usefulness in identifying cognitive deficits and developing individualized treatment plans. The findings in this article will have significant implications on the clinical practice of neuropsychology in TBI patients, highlighting the importance of neuropsychological assessment in optimizing the management of this population. The need for increased awareness of neuropsychology among health care professionals, especially in the acute hospital setting, is growing along with the increase in diagnosis of TBI and its complications. Adequate understanding of the complex interplay between cognitive, emotional, and behavioral factors in TBI can inform the development of new interventions and treatment strategies, making it equally as important for patients and their families.
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Affiliation(s)
- Dia R Halalmeh
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA.
| | | | - Emma LeUnes
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - David Feitosa
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - Yusuf Ansari
- Temple University, Philadelphia, Pennsylvania, USA
| | - Gul R Sachwani-Daswani
- Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
| | - Marc D Moisi
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
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8
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Buunk AM, Spikman JM, Wagemakers M, Jeltema JR, de Vries J, Mazuri A, Uyttenboogaart M, Groen RJM. The vanishing of the ACoA syndrome after aneurysmal subarachnoid haemorrhage: New era, different management, fewer problems? J Neuropsychol 2024; 18 Suppl 1:142-157. [PMID: 37902411 DOI: 10.1111/jnp.12352] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023]
Abstract
Historically, a specific set of symptoms has been related to the rupture and repair of anterior communicating artery (ACoA) aneurysms. These consequences were defined as the 'ACoA syndrome' and included observations of severe memory loss, confabulation and personality or behavioural changes. These observations correspond to neuropsychological impairments in memory, executive functions and social cognition. However, in more recent studies, the existence of such a distinct syndrome has been called into question. We aimed to investigate the existence of the ACoA syndrome, by combining analysis of our own data with a systematic review of the literature. Memory, executive functions and social cognition of subarachnoid haemorrhage patients with ACoA aneurysms (N = 28) were compared to patients with aneurysms in other locations (N = 66). Results showed no significant differences. Subsequently, a systematic review of the existing literature on the ACoA syndrome was performed using Embase and PubMed until October 2022. Studies that investigated cognitive functions after rupture and repair of ACoA aneurysms were included. The search yielded 847 unique entries and after screening titles and abstracts, 648 records were excluded. 199 full-text articles were assessed for eligibility and 55 articles were included. Evidence was found for the ACoA syndrome in studies between 1960 and 2000, with impairments in memory and executive problems in the majority of studies. However, the majority of studies from 2000 did not demonstrate a distinct ACoA syndrome, although neuropsychological measurements improved. This coincides with the changes in the management of ACoA aneurysms over the past decades, such as the emergence of endovascular treatment and improvement of neurointensive care. Therefore, we hypothesize that the management techniques of ACoA aneurysms until around 2000, i.e. mainly conventional clipping, could be related to the presence of symptoms of the ACoA syndrome.
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Affiliation(s)
- A M Buunk
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J M Spikman
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J R Jeltema
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J de Vries
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Mazuri
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M Uyttenboogaart
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R J M Groen
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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9
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Koob JL, Gorski M, Krick S, Mustin M, Fink GR, Grefkes C, Rehme AK. Behavioral and neuroanatomical correlates of facial emotion processing in post-stroke depression. Neuroimage Clin 2024; 41:103586. [PMID: 38428325 PMCID: PMC10944179 DOI: 10.1016/j.nicl.2024.103586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/24/2024] [Accepted: 02/25/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Emotion processing deficits are known to accompany depressive symptoms and are often seen in stroke patients. Little is known about the influence of post-stroke depressive (PSD) symptoms and specific brain lesions on altered emotion processing abilities and how these phenomena develop over time. This potential relationship may impact post-stroke rehabilitation of neurological and psychosocial function. To address this scientific gap, we investigated the relationship between PSD symptoms and emotion processing abilities in a longitudinal study design from the first days post-stroke into the early chronic phase. METHODS Twenty-six ischemic stroke patients performed an emotion processing task on videos with emotional faces ('happy,' 'sad,' 'anger,' 'fear,' and 'neutral') at different intensity levels (20%, 40%, 60%, 80%, 100%). Recognition accuracies and response times were measured, as well as scores of depressive symptoms (Montgomery-Åsberg Depression Rating Scale). Twenty-eight healthy participants matched in age and sex were included as a control group. Whole-brain support-vector regression lesion-symptom mapping (SVR-LSM) analyses were performed to investigate whether specific lesion locations were associated with the recognition accuracy of specific emotion categories. RESULTS Stroke patients performed worse in overall recognition accuracy compared to controls, specifically in the recognition of happy, sad, and fearful faces. Notably, more depressed stroke patients showed an increased processing towards specific negative emotions, as they responded significantly faster to angry faces and recognized sad faces of low intensities significantly more accurately. These effects obtained for the first days after stroke partly persisted to follow-up assessment several months later. SVR-LSM analyses revealed that inferior and middle frontal regions (IFG/MFG) and insula and putamen were associated with emotion-recognition deficits in stroke. Specifically, recognizing happy facial expressions was influenced by lesions affecting the anterior insula, putamen, IFG, MFG, orbitofrontal cortex, and rolandic operculum. Lesions in the posterior insula, rolandic operculum, and MFG were also related to reduced recognition accuracy of fearful facial expressions, whereas recognition deficits of sad faces were associated with frontal pole, IFG, and MFG damage. CONCLUSION PSD symptoms facilitate processing negative emotional stimuli, specifically angry and sad facial expressions. The recognition accuracy of different emotional categories was linked to brain lesions in emotion-related processing circuits, including insula, basal ganglia, IFG, and MFG. In summary, our study provides support for psychosocial and neural factors underlying emotional processing after stroke, contributing to the pathophysiology of PSD.
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Affiliation(s)
- Janusz L Koob
- University Hospital Cologne, Department of Neurology, Cologne 50937, Germany
| | - Maximilian Gorski
- University Hospital Cologne, Department of Neurology, Cologne 50937, Germany
| | - Sebastian Krick
- University Hospital Cologne, Department of Neurology, Cologne 50937, Germany
| | - Maike Mustin
- University Hospital Cologne, Department of Neurology, Cologne 50937, Germany
| | - Gereon R Fink
- University Hospital Cologne, Department of Neurology, Cologne 50937, Germany; Institute of Neuroscience and Medicine, Cognitive Neuroscience (INM-3), Forschungszentrum Jülich, Jülich 52428, Germany
| | - Christian Grefkes
- University Hospital Cologne, Department of Neurology, Cologne 50937, Germany; Institute of Neuroscience and Medicine, Cognitive Neuroscience (INM-3), Forschungszentrum Jülich, Jülich 52428, Germany; Goethe University Frankfurt and University Hospital Frankfurt, Department of Neurology, Frankfurt am Main 60596, Germany.
| | - Anne K Rehme
- University Hospital Cologne, Department of Neurology, Cologne 50937, Germany
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10
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Filipčíková M, Wearne T, McDonald S. Disinhibited and angry: Investigating the relationship between social disinhibition and the components of aggression following severe TBI. Neuropsychol Rehabil 2024; 34:23-44. [PMID: 36445855 DOI: 10.1080/09602011.2022.2149560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022]
Abstract
Social disinhibition and aggression share many similarities. But unlike with aggression, research evidence about social disinhibition following severe traumatic brain injury (TBI) is limited and treatments are missing. Establishing the association between aggression and social disinhibition would facilitate a better conceptualization of these disorders. This study aimed to determine the relationship between social disinhibition and aggression following severe TBI.In this case-control study, 25 individuals with severe TBI and 25 control participants completed the Buss-Perry Aggression Questionnaire (BPAQ), Frontal Systems Behaviour Scale (FrSBe), and Social Disinhibition Interview (SDI).Hierarchical multiple regression analyses revealed that, when controlling for covariates, the inclusion of BPAQ Anger in the model led to a 13% increase in proportion of explained variance of social disinhibition (Adjusted R2 increased from .243 to .363, p < .005). BPAQ Anger was not a significant predictor of SDI scores. Similarly, BPAQ Physical aggression scores did not contribute to the prediction of FrSBe Disinhibition or SDI scores.In conclusion, higher levels of self-reported anger (but no other components of aggression) are associated with higher levels of self-reported social disinhibition. While these findings have potential implications for the treatment of social disinhibition, further research into the possible relationship with aggression should be conducted.
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Affiliation(s)
| | - Travis Wearne
- School of Psychology, University of New South Wales, Sydney, Australia
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
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11
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Strijkert F, Huitema RB, van Munster BC, Spikman JM. Impaired Emotion Recognition: A Potential Marker for Social Behavioral Problems in Patients With Amnestic Mild Cognitive Impairment and Early Alzheimer Disease? Alzheimer Dis Assoc Disord 2023; 37:189-194. [PMID: 37561955 PMCID: PMC10443627 DOI: 10.1097/wad.0000000000000567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Emotion recognition, an important aspect of social cognition, can be impaired already in early Alzheimer disease dementia and amnestic mild cognitive impairment (aMCI) and may underly social behavioral changes, which can increase caregiver burden. However, social behavior is difficult to assess in outpatient settings. We evaluated whether impaired emotion recognition is related to proxy-rated social behavioral problems and thus can serve as a marker of these changes. PATIENTS AND METHOD Emotion recognition was assessed with Ekman 60 Faces Test (EFT-total, 6 separate emotions) in patients (n = 31 AD; n = 37 aMCI) and healthy controls (n = 60 HCs). Social behavioral problems were rated by proxies with the neuropsychiatric inventory (agitation, apathy, irritability, disinhibition, and a sum score). It tested whether EFT scores differed between patients with and without behavioral problems. RESULTS AD had worse EFT-total ( P <0.001), disgust ( P = 0.02), and fear ( P = 0.001) than HC, but not than aMCI, who did not differ from HC. AD displayed more disinhibition ( P < 0.05). EFT and neuropsychiatric inventory sum scores were not significantly correlated. Patients with apathy had lower EFT-total ( P = 0.02). CONCLUSIONS Measuring emotion recognition adds value: it is impaired in early neurodegeneration and associated with apathy but not necessarily related to overall changes in social behavior in this population.
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12
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Clough S, Morrow E, Mutlu B, Turkstra L, Duff MC. Emotion recognition of faces and emoji in individuals with moderate-severe traumatic brain injury. Brain Inj 2023; 37:596-610. [PMID: 36847497 PMCID: PMC10175112 DOI: 10.1080/02699052.2023.2181401] [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] [Received: 05/26/2022] [Revised: 01/11/2023] [Accepted: 02/13/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Facial emotion recognition deficits are common after moderate-severe traumatic brain injury (TBI) and linked to poor social outcomes. We examine whether emotion recognition deficits extend to facial expressions depicted by emoji. METHODS Fifty-one individuals with moderate-severe TBI (25 female) and fifty-one neurotypical peers (26 female) viewed photos of human faces and emoji. Participants selected the best-fitting label from a set of basic emotions (anger, disgust, fear, sadness, neutral, surprise, happy) or social emotions (embarrassed, remorseful, anxious, neutral, flirting, confident, proud). RESULTS We analyzed the likelihood of correctly labeling an emotion by group (neurotypical, TBI), stimulus condition (basic faces, basic emoji, social emoji), sex (female, male), and their interactions. Participants with TBI did not significantly differ from neurotypical peers in overall emotion labeling accuracy. Both groups had poorer labeling accuracy for emoji compared to faces. Participants with TBI (but not neurotypical peers) had poorer accuracy for labeling social emotions depicted by emoji compared to basic emotions depicted by emoji. There were no effects of participant sex. DISCUSSION Because emotion representation is more ambiguous in emoji than human faces, studying emoji use and perception in TBI is an important consideration for understanding functional communication and social participation after brain injury.
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Affiliation(s)
- Sharice Clough
- Department of Hearing and Speech Sciences, Vanderbilt
University Medical Center
| | - Emily Morrow
- Department of Hearing and Speech Sciences, Vanderbilt
University Medical Center
| | - Bilge Mutlu
- Department of Computer Sciences, University of
Wisconsin-Madison
| | - Lyn Turkstra
- School of Rehabilitation Science, McMaster University
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt
University Medical Center
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13
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Sarah A, Ownsworth T, Clough B, Neumann DL. Impairments in Physiological Reactivity to Emotive Stimuli After Traumatic Brain Injury: A Systematic Review of Skin Conductance and Heart Rate Variability Evidence. J Head Trauma Rehabil 2023; 38:214-230. [PMID: 35862893 DOI: 10.1097/htr.0000000000000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine evidence of impairments in physiological reactivity to emotive stimuli following traumatic brain injury (TBI). METHODS A search of PsychINFO, CINAHL (Cumulative Index to Allied Health Literature), Web of Science, EMBASE (Excerpta Medica dataBASE), and Scopus databases was conducted from 1991 to June 24, 2021, for studies comparing changes in skin conductance or heart rate variability to emotive stimuli between adults with TBI and controls. Two reviewers independently assessed eligibility and rated methodological quality. RESULTS Twelve eligible studies examined physiological reactivity to laboratory-based emotive stimuli, which included nonpersonal pictures/videos, posed emotion, stressful events, and personal event recall. Overall, 9 reported evidence that individuals with TBI experience lower physiological reactivity to emotive stimuli compared with healthy controls, although the findings varied according to the type and valence of emotional stimuli and physiological parameter. Most studies using nonpersonal pictures or videos found evidence of lower physiological reactivity in TBI participants compared with controls. CONCLUSIONS Based on laboratory-based studies, individuals with TBI may experience lower physiological reactivity to emotive stimuli. Further research is needed to investigate physiological responses to personally relevant emotional stimuli in real-world settings and to understand the interplay between physiological reactivity, subjective experiences, and behavior.
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Affiliation(s)
- Alysha Sarah
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia (Ms Sarah and Drs Ownsworth, Clough, and Neumann); and The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Australia (Ms Sarah and Dr Ownsworth)
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14
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Cappelle T, Neumann CS, Cook AM, Kim E, Harenski CL, Edwards BG, Clarke GJB, Decety J, Kiehl KA. Traumatic Brain Injury and Psychopathic Traits in Justice-Involved Adult Women. J Pers Disord 2023; 37:195-212. [PMID: 37002938 DOI: 10.1521/pedi.2023.37.2.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Studies have documented associations between traumatic brain injury (TBI) and mental disorders. The relationship between psychopathic personality and TBI remains poorly understood, though both are associated with similar characteristics (e.g., low empathy, aggression, disturbances in social/moral behavior). Yet, it is not clear whether assessment of psychopathic features is influenced by presence versus absence of TBI, and which aspects of TBI may be associated with psychopathic traits. This study examined the psychopathy-TBI association in justice-involved women (N = 341) with structural equation modeling. We tested if measurement invariance of psychopathic traits was evident among those with versus without TBI and which TBI variables (number, severity, age at first TBI) predicted psychopathic features in conjunction with symptoms of psychopathology, IQ, and age. Results provided evidence of measurement invariance, and more women with TBI, compared to those without, met criteria for psychopathy. Younger age of TBI and TBI severity predicted interpersonal-affective psychopathic features.
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Affiliation(s)
- Tessa Cappelle
- Department of Psychology, College of Arts and Sciences, University of New Mexico, Albuquerque, New Mexico
| | - Craig S Neumann
- College of Arts and Sciences, University of North Texas, Denton, Texas
| | | | - Esther Kim
- Department of Psychology, College of Arts and Sciences, University of New Mexico, Albuquerque, New Mexico
- Department of Psychology, University of North Texas, Denton, Texas
| | | | - Bethany G Edwards
- Department of Psychology, College of Arts and Sciences, University of New Mexico, Albuquerque, New Mexico
- Mind Research Network, Albuquerque, New Mexico
| | | | - Jean Decety
- Division of the Social Sciences, University of Chicago, Chicago, Illinois
| | - Kent A Kiehl
- Department of Psychology, College of Arts and Sciences, University of New Mexico, Albuquerque, New Mexico
- Mind Research Network, Albuquerque, New Mexico
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15
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Byom LJ, Whalen M, Turkstra LS. Working Memory for Emotions in Adolescents and Young Adults with Traumatic Brain Injury. BRAIN IMPAIR 2022; 22:296-310. [PMID: 36703704 PMCID: PMC9873224 DOI: 10.1017/brimp.2021.20] [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] [Indexed: 02/01/2023]
Abstract
This preliminary study investigated the interaction between working memory and social cognition in adolescents and young adults with traumatic brain injury (TBI). It was hypothesized that participants with or without TBI would better recognize social information when working memory or social cognitive load was low, and that adolescents and young adults with TBI would be more affected by increased cognitive demand than their uninjured peers. Eight adolescents and young adults with complicated mild-severe TBI (aged 14-22 years) and eight age- and sex-matched typically developing (TD) adolescents completed computer-based n-back tasks requiring recognition of either face identity or facial affect, with 0-back, 1-, and 2-back conditions. The TBI group had lower scores overall than the TD group, and scores for both groups were lower for affect recognition than identity recognition. Scores for both groups were lower in conditions with a higher working memory load. There was a significant group-by-working memory interaction, with larger group differences in high-working memory conditions. Study results and their potential implications for social outcomes are discussed.
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Affiliation(s)
- Lindsey J Byom
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Meaghan Whalen
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
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16
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Alderman N, Williams C, Wood RL. Using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) to determine prevalence and predictors of neurobehavioural disability amongst survivors with traumatic brain injury in the community. Neuropsychol Rehabil 2022; 32:2342-2369. [PMID: 34180770 DOI: 10.1080/09602011.2021.1946092] [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: 12/27/2022]
Abstract
Studies using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) confirm neurobehavioural disability (NBD) is highly prevalent in inpatient Neurobehavioural Rehabilitation and Stroke samples. However, a recent study amongst a Danish community sample of acquired brain injury survivors found a relative paucity of NBD symptoms; and when symptoms were present, they tended to be of mild severity. The current observational study employed the SASNOS to explore prevalence of NBD in survivors with traumatic brain injury (TBI) living in the community, the extent of survivors' self-awareness of NBD symptoms, and constructed prediction models of NBD. A de-identified data set was compiled, comprising data for 97 TBI survivors (74.2% men, mean time since injury 2.8 years). In addition to SASNOS self- and proxy-ratings, various demographic, clinical and injury-related characteristics were captured. NBD was found to be highly characteristic, although severity varied depending on subtype. Statistical comparison of self- and proxy-ratings did not support reduced self awareness regarding NBD, whereas treating the problem as one of inter-rater reliability suggested this was an issue. Executive impairment, depressed mood and sex were especially prognostic of NBD. Reasons accounting for differences in NBD between the community samples are discussed and recommendations for future research made.
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Affiliation(s)
- Nick Alderman
- Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, Swindon, UK.,Department of Psychology, Swansea University, Swansea, UK
| | - Claire Williams
- Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, Swindon, UK.,Department of Psychology, Swansea University, Swansea, UK
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17
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Buunk AM, Gerritsen MJJ, Jeltema HR, Wagemakers M, Metzemaekers JDM, Groen RJM, Spikman JM. Emotion Recognition in Patients with Low-Grade Glioma before and after Surgery. Brain Sci 2022; 12:brainsci12091259. [PMID: 36138995 PMCID: PMC9497049 DOI: 10.3390/brainsci12091259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022] Open
Abstract
Research on patients with low-grade gliomas (LGGs) showed neurocognitive impairments in various domains. However, social cognition has barely been investigated. Facial emotion recognition is a vital aspect of social cognition, but whether emotion recognition is affected in LGG patients is unclear. Therefore, we aimed to investigate the effect of LGG and resection by examining emotion recognition pre- and postoperatively. Additionally, the relationships among emotion recognition and general cognition and tumor location were investigated. Thirty patients with LGG who underwent resective surgery were included and matched with 63 healthy control participants (HCs). Emotion recognition was measured with the Facial Expressions of Emotion–Stimuli and Tests (FEEST) and general cognition with neuropsychological tests. Correlations and within-group and between-group comparisons were calculated. Before surgery, patients performed significantly worse than the HCs on FEEST-Total and FEEST-Anger. Paired comparisons showed no significant differences between FEEST scores before and post-surgery. No significant correlations with general cognition and tumor location were found. To conclude, the results of this study indicate that the tumor itself contributes significantly to social cognitive dysfunction and that surgery causes no additional deficit. Impairments were not related to general cognitive deficits or tumor location. Consequently, incorporating tests for emotion recognition into the neuropsychological assessment of patients with LGG is important.
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Affiliation(s)
- Anne M. Buunk
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
- Correspondence: ; Tel.: +31-5036-12408; Fax: +31-5036-14227
| | - Marleen J. J. Gerritsen
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Jan D. M. Metzemaekers
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Rob J. M. Groen
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Jacoba M. Spikman
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
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18
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Rodríguez-Rajo P, García-Rudolph A, Sánchez-Carrión R, Aparicio-López C, Enseñat-Cantallops A, García-Molina A. Social and nonsocial cognition: Are they linked? A study on patients with moderate-to-severe traumatic brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:1039-1048. [PMID: 33174449 DOI: 10.1080/23279095.2020.1845171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The first aim was to study the relationship between Social Cognition (SC) and nonsocial Cognition (n-SC) measures in a group of patients with moderate or severe traumatic brain injury (TBI) to assess the dependence or independence of both types of cognition. The second aim was to explore the relationships between SC measures and generate a model based on the results of these relationships. METHODS AND PROCEDURES Forty-three subacute patients with TBI were included in the study. They were administered a SC battery and n-SC battery. SC battery included the following measures: International Affective Picture System (IAPS); Facial Expressions of Emotion-Stimuli Test (FEEST); Moving Shapes Paradigm (MSP); Reading the Mind in the Eyes Test- Revised Version (RMET); Social Decision Making Task (SDMT). n-SC battery included Digit Span Forwards and Backwards; Trail Making Test (Part A); Rey's Auditory Verbal Learning Test; Letter-Number Sequencing; and verbal fluency test (PMR). RESULTS FEEST, MSP and RMET were related to n-SC measures. The exploratory factor analysis shows a two-factor SC structure: Factor 1: Emotional recognition and mentalization (FEEST, MSP and RMET) and Factor 2: Acquisition and contextualization (IAPS and SDMT). CONCLUSION The performance of subjects with moderate-to-severe TBI in the SC measures is related, at least partially, by the performance in the n-SC measures. Our SC model shows a two-factor structure characterized by a first factor that brings together SC measures that are highly related to n-SC domains and a second factor that brings together measures whose performance is not influenced by n-SC domains.
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Affiliation(s)
- P Rodríguez-Rajo
- Institut Guttmann, Institut Universitari de Neurorehabilitació affiliated to the UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - A García-Rudolph
- Institut Guttmann, Institut Universitari de Neurorehabilitació affiliated to the UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - R Sánchez-Carrión
- Institut Guttmann, Institut Universitari de Neurorehabilitació affiliated to the UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - C Aparicio-López
- Institut Guttmann, Institut Universitari de Neurorehabilitació affiliated to the UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - A Enseñat-Cantallops
- Institut Guttmann, Institut Universitari de Neurorehabilitació affiliated to the UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - A García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació affiliated to the UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
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19
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Sherer M, Clark AN, Sander AM, Struchen MA, Bogaards J, Leon-Novelo L, Ngan E. Relationships of self-awareness and facial affect recognition to social communication ability in persons with traumatic brain injury. Neuropsychol Rehabil 2022; 32:2013-2028. [PMID: 35666684 DOI: 10.1080/09602011.2022.2084118] [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: 10/18/2022]
Abstract
Traumatic brain injury (TBI) can cause changes to the injured person's physical ability, cognitive functioning, and social interactions. Since these attributes largely determine a person's concept of who they are, TBI poses a threat to sense of self. Due to the importance of social communication skills for community integration, impairment of these skills is a particular threat to sense of self. The present investigation sought to explore characteristics that influence social communication abilities. We hypothesized that both ability to interpret facial affect and self-awareness would be associated with communication ability. We also expected that facial affect recognition would influence self-awareness and that the effect of facial affect recognition on social communication would be partially mediated by self-awareness. For this prospective cohort study, participants were 77 individuals with documented TBI. Of these, 65% were male and 83% sustained severe injuries. The hypothesized association of facial affect recognition with social communication was demonstrated with path analysis as was the effect of facial affect recognition on self-awareness. However, the effect of facial affect recognition on social communication was not mediated by self-awareness. In addition, social communication was associated with employment, social integration, and loneliness. Findings highlighted the importance of social communication after TBI.
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Affiliation(s)
- Mark Sherer
- Brain Injury Research Center TIRR Memorial Hermann, Houston, TX, USA.,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Allison N Clark
- Brain Injury Research Center TIRR Memorial Hermann, Houston, TX, USA.,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.,Department of Physical Medicine and Rehabilitation, Harris Health System, Houston, TX, USA
| | - Angelle M Sander
- Brain Injury Research Center TIRR Memorial Hermann, Houston, TX, USA.,H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.,Department of Physical Medicine and Rehabilitation, Harris Health System, Houston, TX, USA
| | - Margaret A Struchen
- Center for Rehabilitation Psychology and Neuropsychology, PC, Walnut Creek, CA, USA
| | - Jay Bogaards
- 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
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20
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Filipčíková M, Wearne T, Li R, McDonald S. The prevalence, predictors, associated symptoms, and outcomes of social disinhibition following moderate-to-severe TBI: A scoping review of quantitative evidence. J Clin Exp Neuropsychol 2021; 43:716-736. [PMID: 34930093 DOI: 10.1080/13803395.2021.2000589] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present study aimed to map existing quantitative evidence of research related to the nature of social disinhibition following moderate-to-severe traumatic brain injury (TBI), with a specific focus on its prevalence, predictors, associated symptoms and outcomes in studies that met minimal methodological criteria. We conducted a scoping review of the literature following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for Scoping Reviews (PRISMA-ScR). Seventeen peer-reviewed articles including 1440 participants met the inclusion criteria and were included in the qualitative synthesis. Results of the study indicate that social disinhibition is a common and significant consequence of moderate-to-severe TBI with its prevalence estimates ranging from 21% to 32%. Inappropriate sexual behavior appears to be more prevalent in men and younger survivors. Rule-breaking/perseverative errors in fluency tests are significantly associated with social disinhibition. The perceived burden of caregivers of people with TBI is a very common outcome. An interesting finding was an association between higher social disinhibition and higher emotional empathy levels. However, similarly to many potential predictors, this was only found in a single study and therefore requires further investigation. Some common methodological flaws are discussed, such as the use of non-probability sampling, lack of sample size justification or not including a control group. Due to the heterogeneity of measures used to assess social disinhibition in the reviewed articles, conducting a meta-analysis was not possible. In conclusion, social disinhibition is a significant consequence of moderate-to-severe TBI, as it impacts both the TBI survivor and their family/caregivers. The present study extends the scope of the prior overview by offering a clearer picture of social disinhibition after surviving moderate-to-severe TBI, as it focuses on studies with strong methodology and validated measures. It also assesses potential predictors other than executive dysfunction, such as demographics and injury characteristics.
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Affiliation(s)
| | - Travis Wearne
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Ranran Li
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
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21
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IMPAIRED VISUAL EMOTION RECOGNITION AFTER MINOR ISCHEMIC STROKE. Arch Phys Med Rehabil 2021; 103:958-963. [PMID: 34813741 DOI: 10.1016/j.apmr.2021.10.024] [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: 08/28/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the prevalence of impaired visual emotion recognition in patients who have suffered a minor ischemic stroke in the subacute phase and to determine associated factors of impaired visual emotion recognition. DESIGN A prospective observational study. SETTING Stroke-unit of a teaching hospital. PARTICIPANTS 112 patients with minor ischemic stroke. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patients with minor stroke underwent a neuropsychological assessment in the sub-acute phase for visual emotion recognition by the Ekman 60 Faces Test and for general cognition. Univariable linear regression analyses were performed to identify associated factors of emotion recognition impairment. RESULTS In 112 minor stroke patients we found a prevalence of 25% of impaired visual emotion recognition. This was significantly correlated with impaired general cognition. Nevertheless 10.9% of patients with normal general cognition still had impaired emotion recognition. Mood was negatively associated. Stroke localization, hemisphere side and gender were not associated. CONCLUSION Impaired visual emotion recognition is found in about a quarter of patients with minor ischemic stroke.
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Vassallo S, Douglas J. Visual scanpath training to emotional faces following severe traumatic brain injury: A single case design. J Eye Mov Res 2021; 14. [PMID: 34760060 PMCID: PMC8575428 DOI: 10.16910/jemr.14.4.6] [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: 11/18/2022] Open
Abstract
The visual scanpath to emotional facial expressions was recorded in BR, a 35-year-old male with chronic severe traumatic brain injury (TBI), both before and after he underwent intervention. The novel intervention paradigm combined visual scanpath training with verbal feedback and was implemented over a 3-month period using a single case design (AB) with one follow up session. At baseline BR's scanpath was restricted, characterised by gaze allocation primarily to salient facial features on the right side of the face stimulus. Following intervention his visual scanpath became more lateralised, although he continued to demonstrate an attentional bias to the right side of the face stimulus. This study is the first to demonstrate change in both the pattern and the position of the visual scanpath to emotional faces following intervention in a person with chronic severe TBI. In addition, these findings extend upon our previous work to suggest that modification of the visual scanpath through targeted facial feature training can support improved facial recognition performance in a person with severe TBI.
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Affiliation(s)
- Suzane Vassallo
- La Trobe University, Melbourne, Australia.,University of Technology, Sydney, Australia
| | - Jacinta Douglas
- La Trobe University, Melbourne, Australia.,Summer Foundation, Melbourne, Australia
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Behaviors of Concern after Acquired Brain Injury: The Role of Negative Emotion Recognition and Anger Misattribution. J Int Neuropsychol Soc 2021; 27:1015-1023. [PMID: 33441210 DOI: 10.1017/s135561772000140x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Behavioral changes are common after acquired brain injury (ABI) and may be caused by social cognition impairments. We investigated whether impaired emotion recognition, specifically Negative Emotion Recognition (NER) and Anger Misattribution (AM), after ABI was related to behavioral problems, so-called Behaviors of Concern (BoC). METHOD The study included 139 participants with ABI and 129 healthy controls. BoC was measured using four scales of the Brock Adaptive Functioning Questionnaire (BAFQ): Impulsivity, Aggression, Social Monitoring, and Empathy. Both self-ratings and informant ratings of BoC were obtained. Emotion recognition was measured with the Ekman 60 Faces Test (FEEST). A NER score was composed of the summed scores on Anger, Disgust, Fear, and Sadness. An AM score was composed of the number of facial expressions wrongly recognized as Anger. RESULTS Total FEEST scores in ABI participants were significantly worse than in healthy controls. The effect size is moderate. Informants rated significantly more problems in Social Monitoring and Empathy than participants. Effect sizes were small. Scores on FEEST total, NER, and AM were significantly correlated to informant ratings of Social Monitoring. Correlations were weak to moderate. CONCLUSIONS Worse NER and more profound AM were related to more informant-rated problems in social monitoring. In addition, informants rated more problems in social monitoring and empathy than participants. This strongly suggests problems in self-awareness in ABI participants. Consequently, social cognition tests and informant ratings should be used in clinical practice to improve the detection and treatment of BoC after ABI.
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Strijkert F, Huitema RB, Spikman JM. Measuring emotion recognition: Added value in diagnosing dementia of the Alzheimer's disease type. J Neuropsychol 2021; 16:263-282. [PMID: 34661375 PMCID: PMC9298196 DOI: 10.1111/jnp.12263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 09/01/2021] [Indexed: 11/27/2022]
Abstract
Neuropsychological tests, particularly for episodic memory, are used to classify patients in memory clinics. Still, the differential diagnosis between dementia of the Alzheimer’s disease type (Dementia‐AD), mild cognitive impairment (MCI), or major depressive disorder (MDD) is challenging. However, impairments in other domains, such as emotion recognition, an aspect of social cognition, might have additional value in distinguishing Dementia‐AD from MCI and MDD and hence signal progression of neurodegeneration. We evaluated this in patients visiting a memory clinic. Sixty healthy controls (HC) and 143 first time attendants of an academic hospital memory clinic who were eventually classified as Dementia‐AD (n = 45), MCI (n = 47), MDD (n = 27), or No Impairment (NI, n = 24) were included. We assessed group differences in Emotion Recognition (Ekman 60 Faces Test (EFT)) and episodic memory (Dutch Rey Auditory Verbal Learning Test (RAVLT)). With multinomial and binomial regression analysis, we assessed whether EFT was added to RAVLT in distinguishing patient groups. Dementia‐AD patients had significantly worse emotion recognition than HC, MCI, MDD, and NI groups, but no other between‐group differences were found. Episodic memory was impaired in Dementia‐AD and MCI patients. We found no memory impairments in the MDD and NI groups. Emotion recognition in addition to episodic memory was significantly better in predicting group membership than episodic memory alone. In conclusion, emotion recognition measurement had added value for differentiation between patients first visiting memory clinics, in particular in distinguishing Dementia‐AD from MCI. We recommend the standard inclusion of emotion recognition testing in neuropsychological assessment in memory clinics.
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Affiliation(s)
- Fijanne Strijkert
- Department of Geriatrics, University Medical Center Groningen, The Netherlands
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25
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Neumann R, Völker J, Hajba Z, Seiler S. Lesions and reduced working memory impair emotion recognition in self and others. Cogn Emot 2021; 35:1527-1542. [PMID: 34623214 DOI: 10.1080/02699931.2021.1983521] [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: 10/20/2022]
Abstract
ABSTRACTEmotion recognition (ER) can be conceived of as an integration of affective cues in working memory. We examined whether reduced working memory capacity and brain lesions in neural networks involved in emotion processing interactively impair ER of both one's own and another person's emotions. To assess the recognition of one's own and other's emotions, pictures from the International Affective Picture System (IAPS) and facial expressions from the Karolinska Directed Emotional Faces (KDEF) database representing fear, anger, disgust, and sadness were presented to 40 lesioned patients and 40 healthy students. To manipulate working memory, a math task was imposed between exposure to the stimuli and collection of responses. Participants indicated the intensity of each of the four emotions for each picture. ER was computed as the difference between trials where the elicited emotion matched the requested emotion and trials where the elicited and requested emotions did not match. Whereas lesions impaired ER in both self and others, working memory load exclusively decreased recognition of other persons' emotions.
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Affiliation(s)
- Roland Neumann
- Department of Psychology, University of Trier, Trier, Germany
| | - Juliane Völker
- Department of Psychology, University of Trier, Trier, Germany
| | - Zsuzsanna Hajba
- Department of Psychology, University of Trier, Trier, Germany
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26
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van den Berg NS, de Haan EHF, Huitema RB, Spikman JM. The neural underpinnings of facial emotion recognition in ischemic stroke patients. J Neuropsychol 2021; 15:516-532. [PMID: 33554463 PMCID: PMC8518120 DOI: 10.1111/jnp.12240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/16/2020] [Indexed: 01/19/2023]
Abstract
Deficits in facial emotion recognition occur frequently after stroke, with adverse social and behavioural consequences. The aim of this study was to investigate the neural underpinnings of the recognition of emotional expressions, in particular of the distinct basic emotions (anger, disgust, fear, happiness, sadness and surprise). A group of 110 ischaemic stroke patients with lesions in (sub)cortical areas of the cerebrum was included. Emotion recognition was assessed with the Ekman 60 Faces Test of the FEEST. Patient data were compared to data of 162 matched healthy controls (HC's). For the patients, whole brain voxel-based lesion-symptom mapping (VLSM) on 3-Tesla MRI images was performed. Results showed that patients performed significantly worse than HC's on both overall recognition of emotions, and specifically of disgust, fear, sadness and surprise. VLSM showed significant lesion-symptom associations for FEEST total in the right fronto-temporal region. Additionally, VLSM for the distinct emotions showed, apart from overlapping brain regions (insula, putamen and Rolandic operculum), also regions related to specific emotions. These were: middle and superior temporal gyrus (anger); caudate nucleus (disgust); superior corona radiate white matter tract, superior longitudinal fasciculus and middle frontal gyrus (happiness) and inferior frontal gyrus (sadness). Our findings help in understanding how lesions in specific brain regions can selectively affect the recognition of the basic emotions.
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Affiliation(s)
- Nils S. van den Berg
- Department of PsychologyUniversity of AmsterdamThe Netherlands
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | | | - Rients B. Huitema
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | - Jacoba M. Spikman
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
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27
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Padua L, Fredda G, Coraci D, Reale G, Glorioso D, Loreti C, Pecchioli C, Bernabei R. COVID-19 and hospital restrictions: physical disconnection and digital re-connection in disorders of consciousness. Brain Inj 2021; 35:1134-1142. [PMID: 34495807 DOI: 10.1080/02699052.2021.1972335] [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: 10/20/2022]
Abstract
Purpose: The coronavirus disease 2019 (COVID-19) pandemic forced hospitals to adopt tighter restrictions, the most impacting is no access to visitors. Disorder of consciousness (DOC) due to severe acquired brain injury is a condition needing neurorehabilitation and the role of relatives is essential, hence besides physical "disconnection" digital "re-connection" is crucial. We aimed to assess whether digital communication benefits in patients with DOC, considering the sensorial and emotional deprivation due to the COVID-19 emergency lock-down.Methods: For eleven consecutive patients with DOC admitted to our Intensive Neurorehabilitation Care (mean age: 45; females: 9), two observers registered neurobehavioral changes during a video-calls with their relatives. Heart-rate variability was measured before and during the calls. The video-call was performed by using two displays of different sizes: tablet (T-video-call) and large screen (LS-Video-call).Results: The video-calls impacted on the patients' vigilance and in the relationship with relatives. Moreover, positively impacted on their relatives. The current results showed significant greater impact on patients during the LS-video-call than when they are exposed to T-video-call.Conclusions: During the COVID-19 pandemic, besides the physical disconnection to stop the contagion spread, a "digital re-connection" is needed for all and especially for fragile population groups as patients with DOC.
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Affiliation(s)
- Luca Padua
- Department of Orthopaedics and Geriatrics, Università Cattolica Del Sacro Cuore, Rome, Italy.,UOC High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Fredda
- UOS Clinical Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniele Coraci
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Giuseppe Reale
- UOC High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide Glorioso
- Department of Orthopaedics and Geriatrics, Università Cattolica Del Sacro Cuore, Rome, Italy.,UOC High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Loreti
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Roberto Bernabei
- Department of Orthopaedics and Geriatrics, Università Cattolica Del Sacro Cuore, Rome, Italy.,Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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28
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Dromer E, Kheloufi L, Azouvi P. Impaired self-awareness after traumatic brain injury: A systematic review. Part 2. Consequences and predictors of poor self-awareness. Ann Phys Rehabil Med 2021; 64:101542. [PMID: 34029754 DOI: 10.1016/j.rehab.2021.101542] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Impaired self-awareness (ISA) has frequently been found both frequent and deleterious in patients with moderate to severe traumatic brain injury (TBI). OBJECTIVES This is the second of a two-part systematic review on ISA after TBI, focusing on the consequences and predictors of ISA after TBI. METHODS Following the PRISMA guidelines, 95 articles meeting the inclusion criteria were included; 46 were specifically related to this second part of the review. RESULTS Among 16 studies that investigated the effect of ISA on outcome, most (n=13) found poor self-awareness associated with poor rehabilitation, functional, social and vocational outcome and with increased burden on relatives. Multiple factors have been found associated with increased frequency of ISA. ISA was found significantly related to injury severity in 8 of 10 studies, impaired executive functions in 12 of 15 studies, and poor social cognition in 3 studies, but paradoxically inverse associations were repeatedly found between self-awareness and emotional status (11 of 12 studies). Finally, although research in the field is still scarce, ISA seems associated with a dysfunction within brain networks involving the anterior cingulate cortex, anterior insula and fronto-parietal control network. CONCLUSIONS ISA is a complex and multifaceted disorder associated with poor rehabilitation outcome, severe injuries, and deficits of executive functions and social cognition but has an inverse association with mood impairments.
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Affiliation(s)
- Emilie Dromer
- AP-HP, GHU Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré, Garches, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - Lyes Kheloufi
- AP-HP, GHU Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré, Garches, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - Philippe Azouvi
- AP-HP, GHU Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré, Garches, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France.
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29
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Race NS, Andrews KD, Lungwitz EA, Vega Alvarez SM, Warner TR, Acosta G, Cao J, Lu KH, Liu Z, Dietrich AD, Majumdar S, Shekhar A, Truitt WA, Shi R. Psychosocial impairment following mild blast-induced traumatic brain injury in rats. Behav Brain Res 2021; 412:113405. [PMID: 34097900 DOI: 10.1016/j.bbr.2021.113405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 01/30/2023]
Abstract
Traumatic brain injury (TBI) is associated with increased risk for mental health disorders, impacting post-injury quality of life and societal reintegration. TBI is also associated with deficits in psychosocial processing, defined as the cognitive integration of social and emotional behaviors, however little is known about how these deficits manifest and their contributions to post-TBI mental health. In this pre-clinical investigation using rats, a single mild blast TBI (mbTBI) induced impairment of psychosocial processing in the absence of confounding physical polytrauma, post-injury motor deficits, affective abnormalities, or deficits in non-social behavior. Impairment severity correlated with acute upregulations of a known oxidative stress metabolite, 3-hydroxypropylmercapturic acid (3-HPMA), in urine. Resting state fMRI alterations in the acute post-injury period implicated key brain regions known to regulate psychosocial behavior, including orbitofrontal cortex (OFC), which is congruent with our previous report of elevated acrolein, a marker of neurotrauma and 3-HPMA precursor, in this region following mbTBI. OFC of mbTBI-exposed rats demonstrated elevated mRNA expression of metabotropic glutamate receptors 1 and 5 (mGluR1/5) and injection of mGluR1/5-selective agonist in OFC of uninjured rats approximated mbTBI-induced psychosocial processing impairment, demonstrating a novel role for OFC in this psychosocial behavior. Furthermore, OFC may serve as a hotspot for TBI-induced disruption of psychosocial processing and subsequent mental health disorders.
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Affiliation(s)
- Nicholas S Race
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Medical Scientist Training Program, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Katharine D Andrews
- Medical Scientist Training Program, Indiana University School of Medicine, Indianapolis, IN, USA; Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Program in Medical Neuroscience, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Elizabeth A Lungwitz
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Program in Medical Neuroscience, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sasha M Vega Alvarez
- PULSe Interdisciplinary Life Science Program, Purdue University, West Lafayette, IN, USA
| | - Timothy R Warner
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Anatomy, Cellular Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Glen Acosta
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Jiayue Cao
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA
| | - Kun-Han Lu
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA; School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Zhongming Liu
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA; School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Amy D Dietrich
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Anatomy, Cellular Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sreeparna Majumdar
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Program in Medical Neuroscience, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Anantha Shekhar
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Clinical and Translational Sciences Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - William A Truitt
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Anatomy, Cellular Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Riyi Shi
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; PULSe Interdisciplinary Life Science Program, Purdue University, West Lafayette, IN, USA; Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA; Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA; Center for Paralysis Research, West Lafayette, IN, USA.
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O'Connell K, Marsh AA, Edwards DF, Dromerick AW, Seydell-Greenwald A. Emotion recognition impairments and social well-being following right-hemisphere stroke. Neuropsychol Rehabil 2021; 32:1337-1355. [PMID: 33615994 PMCID: PMC8379297 DOI: 10.1080/09602011.2021.1888756] [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: 12/21/2022]
Abstract
Accurately recognizing and responding to the emotions of others is essential for proper social communication and helps bind strong relationships that are particularly important for stroke survivors. Emotion recognition typically engages cortical areas that are predominantly right-lateralized including superior temporal and inferior frontal gyri - regions frequently impacted by right-hemisphere stroke. Since prior work already links right-hemisphere stroke to deficits in emotion recognition, this research aims to extend these findings to determine whether impaired emotion recognition after right-hemisphere stroke is associated with worse social well-being outcomes. Eighteen right-hemisphere stroke patients (≥6 months post-stroke) and 21 neurologically healthy controls completed a multimodal emotion recognition test (Geneva Emotion Recognition Test - Short) and reported engagement in social/non-social activities and levels of social support. Right-hemisphere stroke was associated with worse emotion recognition accuracy, though not all patients exhibited impairment. In line with hypotheses, emotion recognition impairments were associated with greater loss of social activities after stroke, an effect that could not be attributed to stroke severity or loss of non-social activities. Impairments were also linked to reduced patient-reported social support. Results implicate emotion recognition difficulties as a potential antecedent of social withdrawal after stroke and warrant future research to test emotion recognition training post-stroke.
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Affiliation(s)
- Katherine O'Connell
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, USA
| | - Abigail A Marsh
- Department of Psychology, Georgetown University, Washington, DC, USA
| | - Dorothy Farrar Edwards
- Department of Kinesiology and Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Alexander W Dromerick
- MedStar National Rehabilitation Hospital, Washington, DC, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
| | - Anna Seydell-Greenwald
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
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31
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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: 12] [Impact Index Per Article: 4.0] [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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32
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Experiences of offenders with traumatic brain injury. BRAIN IMPAIR 2020. [DOI: 10.1017/brimp.2020.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractPurpose:Traumatic brain injury is recognised as a significant and pervasive health issue among offender populations. Despite this, no qualitative research exists exploring the experiences and perceptions of offenders with TBI in prison.Methods:Qualitative interviews were conducted with male and female offenders housed in a UK prison. Interviews examined what participants felt led them to offend, experiences of incarceration, and post-release plans. Presence of TBI was assessed via the Brain Injury Screening Index. Data were analysed by means of inductive content analysis.Findings:Both male and female prisoners primarily attributed their incarceration to drugs and alcohol use, with males also referencing more issues with aggression, while mental illness and past abuse were more commonly mentioned among females. A lack of recognition for the possible role of TBI was noted, with several males describing themselves as ‘stupid’ or prone to making ‘poor lifestyle choices’. Both groups indicated a desire to return to education or work post-release.Conclusions:Despite significant rates of injury, there is a clear lack of understanding and consideration of the role of TBI in the behaviour and presentation of offenders. There is need for improved identification and education around TBI early in the criminal justice process.
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Pacella V, Scandola M, Beccherle M, Bulgarelli C, Avesani R, Carbognin G, Agostini G, Thiebaut de Schotten M, Moro V. Anosognosia for theory of mind deficits: A single case study and a review of the literature. Neuropsychologia 2020; 148:107641. [PMID: 33058921 PMCID: PMC7116409 DOI: 10.1016/j.neuropsychologia.2020.107641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/20/2020] [Accepted: 09/29/2020] [Indexed: 12/11/2022]
Abstract
Being aware of one's own ability to interact socially is crucial to everyday life. After a brain injury, patients may lose their capacity to understand others' intentions and beliefs, that is, the Theory of Mind (ToM). To date, the debate on the association between ToM and other cognitive deficits (in particular executive functions and behavioural disorders) remains open and data regarding awareness of ToM deficits are meagre. By means of an ad-hoc neuropsychological battery of tests, we report on a patient who suffers from ToM deficits and is not aware of these disorders, although aware of his other symptoms. The study is accompanied by a review of the literature (PRISMA guidelines) demonstrating that ToM deficits are independent of executive functions. Furthermore, an advanced lesion analysis including tractography was executed. The results indicate that: i) ToM deficits can be specific and independent of other cognitive symptoms; ii) unawareness may be specific for ToM impairment and not involve other disorders and iii) the medial structures of the limbic, monitoring and attentional systems may be involved in anosognosia for ToM impairment.
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Affiliation(s)
- Valentina Pacella
- Social and Cognitive Neuroscience Laboratory, Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185, Rome, Italy; NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129, Verona, Italy.
| | - Michele Scandola
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129, Verona, Italy.
| | - Maddalena Beccherle
- Social and Cognitive Neuroscience Laboratory, Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185, Rome, Italy; NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129, Verona, Italy.
| | - Cristina Bulgarelli
- Department of Rehabilitation, IRCSS Sacro Cuore-Don Calabria Hospital, via Don A. Sempreboni 5, 37024, Negrar, Verona, Italy.
| | - Renato Avesani
- Department of Rehabilitation, IRCSS Sacro Cuore-Don Calabria Hospital, via Don A. Sempreboni 5, 37024, Negrar, Verona, Italy.
| | - Giovanni Carbognin
- Department of Radiology, IRCSS Sacro Cuore-Don Calabria Hospital, via Don A. Sempreboni 5, 37024, GC, Italy.
| | - Giulia Agostini
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129, Verona, Italy.
| | - Michel Thiebaut de Schotten
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Rue Léo Saignat 146, 33000, Bordeaux, France.
| | - Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129, Verona, Italy.
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Khosdelazad S, Jorna LS, McDonald S, Rakers SE, Huitema RB, Buunk AM, Spikman JM. Comparing static and dynamic emotion recognition tests: Performance of healthy participants. PLoS One 2020; 15:e0241297. [PMID: 33112932 PMCID: PMC7592751 DOI: 10.1371/journal.pone.0241297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/12/2020] [Indexed: 11/19/2022] Open
Abstract
Facial expressions have a communicatory function and the ability to read them is a prerequisite for understanding feelings and thoughts of other individuals. Impairments in recognition of facial emotional expressions are frequently found in patients with neurological conditions (e.g. stroke, traumatic brain injury, frontotemporal dementia). Hence, a standard neuropsychological assessment should include measurement of emotion recognition. However, there is debate regarding which tests are most suitable. The current study evaluates and compares three different emotion recognition tests. 84 healthy participants were included and assessed with three tests, in varying order: a. Ekman 60 Faces Test (FEEST) b. Emotion Recognition Task (ERT) c. Emotion Evaluation Test (EET). The tests differ in type of stimuli from static photographs (FEEST) to more dynamic stimuli in the form of morphed photographs (ERT) to videos (EET). Comparing performances on the three tests, the lowest total scores (67.3% correct answers) were found for the ERT. Significant, but moderate correlations were found between the total scores of the three tests, but nearly all correlations between the same emotions across different tests were not significant. Furthermore, we found cross-over effects of the FEEST and EET to the ERT; participants attained higher total scores on the ERT when another emotion recognition test had been administered beforehand. Moreover, the ERT proved to be sensitive to the effects of age and education. The present findings indicate that despite some overlap, each emotion recognition test measures a unique part of the construct. The ERT seemed to be the most difficult test: performances were lowest and influenced by differences in age and education and it was the only test that showed a learning effect after practice with other tests. This highlights the importance of appropriate norms.
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Affiliation(s)
- Sara Khosdelazad
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- * E-mail:
| | - Lieke S. Jorna
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Sandra E. Rakers
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Rients B. Huitema
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anne M. Buunk
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jacoba M. Spikman
- Department of Neuropsychology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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Faroqi AH, Lim MJ, Kee EC, Lee JH, Burgess JD, Chen R, Di Virgilio F, Delenclos M, McLean PJ. In Vivo Detection of Extracellular Adenosine Triphosphate in a Mouse Model of Traumatic Brain Injury. J Neurotrauma 2020; 38:655-664. [PMID: 32935624 PMCID: PMC7898407 DOI: 10.1089/neu.2020.7226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Traumatic brain injury (TBI) is traditionally characterized by primary and secondary injury phases, both contributing to pathological and morphological changes. The mechanisms of damage and chronic consequences of TBI remain to be fully elucidated, but synaptic homeostasis disturbances and impaired energy metabolism are proposed to be a major contributor. It has been proposed that an increase of extracellular (eATP) adenosine triphosphate (ATP) in the area immediately surrounding impact may play a pivotal role in this sequence of events. After tissue injury, rupture of cell membranes allows release of intracellular ATP into the extracellular space, triggering a cascade of toxic events and inflammation. ATP is a ubiquitous messenger; however, simple and reliable techniques to measure its concentration have proven elusive. Here, we integrate a sensitive bioluminescent eATP sensor known as pmeLUC, with a controlled cortical impact mouse model to monitor eATP changes in a living animal after injury. Using the pmeLUC probe, a rapid increase of eATP is observed proximal to the point of impact within minutes of the injury. This event is significantly attenuated when animals are pretreated with an ATP hydrolyzing agent (apyrase) before surgery, confirming the contribution of eATP. This new eATP reporter could be useful for understanding the role of eATP in the pathogenesis in TBI and may identify a window of opportunity for therapeutic intervention.
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Affiliation(s)
- Ayman H Faroqi
- Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA.,Neuroscience PhD Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Melina J Lim
- Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Emma C Kee
- Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Jannifer H Lee
- Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA.,Neuroscience PhD Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Jeremy D Burgess
- Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA.,Neuroscience PhD Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Ridong Chen
- APT Therapeutics, Inc., St. Louis, Missouri, USA
| | - Francesco Di Virgilio
- Department of Morphology Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Marion Delenclos
- Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Pamela J McLean
- Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA.,Neuroscience PhD Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, Florida, USA
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36
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Aben HP, Visser-Meily JMA, Biessels GJ, de Kort PLM, Spikman JM. High occurrence of impaired emotion recognition after ischemic stroke. Eur Stroke J 2020; 5:262-270. [PMID: 33072880 PMCID: PMC7538761 DOI: 10.1177/2396987320918132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 03/05/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Deficits of emotion recognition after ischemic stroke are often overlooked by clinicians, and are mostly not spontaneously reported by patients. However, impaired emotion recognition after stroke negatively affects the ability to return to work and the quality of life. It is still unknown how often impairments of emotion recognition occur shortly after ischemic stroke. We aimed to estimate the occurrence of impaired emotion recognition after ischemic stroke and to characterise these patients with impaired emotion recognition. PATIENTS AND METHODS Two hundred thirty patients were included, derived from a prospective study of cognitive recovery. Five weeks after ischemic stroke a neuropsychological assessment was performed, including an emotion recognition task (i.e. Ekman 60-faces test). Emotion recognition was regarded as impaired if the total score was below the fifth percentile for a large independent reference sample. RESULTS Emotion recognition was impaired in 33.5% of patients. Patients with impaired emotion recognition were more likely to have an abnormal Montreal Cognitive Assessment during hospitalisation, and 5 weeks after their stroke, a higher proportion of them had a vascular cognitive disorder (VCD). Even 20% of patients without VCD had impaired emotion recognition.Discussion: Emotion recognition was often impaired after ischemic stroke. This is clinically relevant, since impaired emotion recognition negatively impacts social functioning.Conclusion: Even when there was no cognitive disorder in traditional cognitive domains, emotion recognition was impaired in 1 out of 5 patients. Clinicians should systematically ask patients and their caregivers about deficits in emotion recognition, and, if needed, test for these deficits.
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Affiliation(s)
- Hugo P Aben
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg,
the Netherlands
- Department of Neurology and Neurosurgery, UMC Utrecht Brain
Center, Utrecht, the Netherlands
| | - Johanna MA Visser-Meily
- Department of Rehabilitation, Physical Therapy Science &
Sports, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain
Center, Utrecht, the Netherlands
| | - Paul LM de Kort
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg,
the Netherlands
| | - Jacoba M Spikman
- Department of Clinical and Experimental Neuropsychology,
University of Groningen, Groningen, the Netherlands
| | - on behalf of the PROCRAS study group
- Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg,
the Netherlands
- Department of Neurology and Neurosurgery, UMC Utrecht Brain
Center, Utrecht, the Netherlands
- Department of Rehabilitation, Physical Therapy Science &
Sports, UMC Utrecht Brain Center, Utrecht, the Netherlands
- Department of Clinical and Experimental Neuropsychology,
University of Groningen, Groningen, the Netherlands
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37
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McDonald S, Wilson E, Wearne T, Darke L, Cassel A, Rosenberg H. The complex audio visual emotion assessment task (CAVEAT): development of a shorter version for clinical use. Disabil Rehabil 2020; 44:1498-1507. [PMID: 32787689 DOI: 10.1080/09638288.2020.1803425] [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: 10/23/2022]
Abstract
PURPOSE The Complex Audio Visual Emotion Assessment Task (CAVEAT) is a measure of emotion recognition using dynamic, naturalistic videos to assess recognition of 22 different emotional states (11 positive, 11 negative). It has established construct validity and demonstrated sensitivity to emotion perception impairments in those with moderate-severe traumatic brain injury (TBI). Despite this, its lengthy administration has limited its use in clinical practice and rehabilitation. The current paper aimed to develop shortened versions of the CAVEAT and examine their psychometric properties. METHODS The CAVEAT-S A and CAVEAT-S B (22 items each) and the CAVEAT-S AB (44 items) were developed using the original data. Comparability, reliability, construct and predictive validity were examined in the original sample (Study 1: 32 people with TBI and 32 demographically matched control participants) and a replication sample (Study 2: 18 adults with TBI and 21 demographically matched controls). RESULTS All short forms produced comparable accuracy ratings to the full measure, as well as discriminating between people with or without a TBI. Shortened forms all correlated with other measures of emotion perception and social cognition and also predicted psychosocial outcomes in terms of self-reported interpersonal relationships. Internal reliability of the short forms was low relative to the longer forms, especially for the two very short measures. CONCLUSIONS The new shortened forms of the CAVEAT are promising tools that are sensitive and valid for assessing emotion perception in people with TBI for clinical purposes. Their application in other clinical disorders is yet to be examined.Implications for rehabilitationEmotion perception deficits are present in many clinical populations and an important target for rehabilitation.CAVEAT Short provides ecologically valid emotional stimuli. Such stimuli are important for assessing real world function and to set rehabilitation targets.By having parallel versions of CAVEAT, there is the opportunity to test pre and post intervention while minimising practice effects.Alternatively, one version of CAVEAT-S can be used for assessment, while the other is used for training purposes during remediation.
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Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Emily Wilson
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Travis Wearne
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Lillian Darke
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Anneli Cassel
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Hannah Rosenberg
- School of Psychology, University of New South Wales, Sydney, Australia
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Calvillo M, Irimia A. Neuroimaging and Psychometric Assessment of Mild Cognitive Impairment After Traumatic Brain Injury. Front Psychol 2020; 11:1423. [PMID: 32733322 PMCID: PMC7358255 DOI: 10.3389/fpsyg.2020.01423] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/27/2020] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) can be serious partly due to the challenges of assessing and treating its neurocognitive and affective sequelae. The effects of a single TBI may persist for years and can limit patients’ activities due to somatic complaints (headaches, vertigo, sleep disturbances, nausea, light or sound sensitivity), affective sequelae (post-traumatic depressive symptoms, anxiety, irritability, emotional instability) and mild cognitive impairment (MCI, including social cognition disturbances, attention deficits, information processing speed decreases, memory degradation and executive dysfunction). Despite a growing amount of research, study comparison and knowledge synthesis in this field are problematic due to TBI heterogeneity and factors like injury mechanism, age at or time since injury. The relative lack of standardization in neuropsychological assessment strategies for quantifying sequelae adds to these challenges, and the proper administration of neuropsychological testing relative to the relationship between TBI, MCI and neuroimaging has not been reviewed satisfactorily. Social cognition impairments after TBI (e.g., disturbed emotion recognition, theory of mind impairment, altered self-awareness) and their neuroimaging correlates have not been explored thoroughly. This review consolidates recent findings on the cognitive and affective consequences of TBI in relation to neuropsychological testing strategies, to neurobiological and neuroimaging correlates, and to patient age at and assessment time after injury. All cognitive domains recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are reviewed, including social cognition, complex attention, learning and memory, executive function, language and perceptual-motor function. Affect and effort are additionally discussed owing to their relationships to cognition and to their potentially confounding effects. Our findings highlight non-negligible cognitive and affective impairments following TBI, their gravity often increasing with injury severity. Future research should study (A) language, executive and perceptual-motor function (whose evolution post-TBI remains under-explored), (B) the effects of age at and time since injury, and (C) cognitive impairment severity as a function of injury severity. Such efforts should aim to develop and standardize batteries for cognitive subdomains—rather than only domains—with high ecological validity. Additionally, they should utilize multivariate techniques like factor analysis and related methods to clarify which cognitive subdomains or components are indeed measured by standardized tests.
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Affiliation(s)
- Maria Calvillo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States.,Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
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Vassallo S, Douglas J. A novel combined visual scanning and verbal cuing intervention improves facial affect recognition after chronic severe traumatic brain injury: A single case design. Neuropsychol Rehabil 2020; 31:863-888. [PMID: 32188336 DOI: 10.1080/09602011.2020.1742744] [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: 10/24/2022]
Abstract
A single case design (AB with follow up) was used to determine the effect of a combined visual scanning and verbal cuing intervention technique in improving facial affect recognition after traumatic brain injury (TBI). A 35-year-old male (BR) with impaired ability to recognize facial emotions as a result of severe TBI participated in the study over a 3-month duration. BR's mean accuracy across six universal static facial expressions of emotion improved significantly during intervention and was maintained at follow up. BR was most impaired in labelling negative (sad, angry, disgusted, anxious) versus positive facial expressions (surprised, happy). BR's accuracy to negative facial affect significantly improved during intervention. No further improvement was possible for positive expressions because a ceiling effect was observed at baseline. Overall BR's mean response times across emotions was reduced at baseline but increased significantly during intervention. This was also recorded for both positive and negative expressions, respectively. This novel combined intervention has potential to improve facial affect recognition after TBI. Further evaluation using a multiple-baseline design is recommended. Additional research is needed to determine whether improved facial affect recognition following training translates to improvements in social function and communication in people with TBI.
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Affiliation(s)
- Suzane Vassallo
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia.,Discipline of Orthoptics, School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Melbourne, Australia.,Summer Foundation, Melbourne, Australia.,Moving Ahead Centre of Research Excellence in Brain Recovery, Australia
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40
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Maza A, Moliner B, Ferri J, Llorens R. Visual Behavior, Pupil Dilation, and Ability to Identify Emotions From Facial Expressions After Stroke. Front Neurol 2020; 10:1415. [PMID: 32116988 PMCID: PMC7016192 DOI: 10.3389/fneur.2019.01415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/27/2019] [Indexed: 11/16/2022] Open
Abstract
Social cognition is the innate human ability to interpret the emotional state of others from contextual verbal and non-verbal information, and to self-regulate accordingly. Facial expressions are one of the most relevant sources of non-verbal communication, and their interpretation has been extensively investigated in the literature, using both behavioral and physiological measures, such as those derived from visual activity and visual responses. The decoding of facial expressions of emotion is performed by conscious and unconscious cognitive processes that involve a complex brain network that can be damaged after cerebrovascular accidents. A diminished ability to identify facial expressions of emotion has been reported after stroke, which has traditionally been attributed to impaired emotional processing. While this can be true, an alteration in visual behavior after brain injury could also negatively contribute to this ability. This study investigated the accuracy, distribution of responses, visual behavior, and pupil dilation of individuals with stroke while identifying emotional facial expressions. Our results corroborated impaired performance after stroke and exhibited decreased attention to the eyes, evidenced by a diminished time and number of fixations made in this area in comparison to healthy subjects and comparable pupil dilation. The differences in visual behavior reached statistical significance in some emotions when comparing individuals with stroke with impaired performance with healthy subjects, but not when individuals post-stroke with comparable performance were considered. The performance dependence of visual behavior, although not determinant, might indicate that altered visual behavior could be a negatively contributing factor for emotion recognition from facial expressions.
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Affiliation(s)
- Anny Maza
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Belén Moliner
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Valencia, Spain
| | - Joan Ferri
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Valencia, Spain
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain.,NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Valencia, Spain
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41
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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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42
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Allain P, Hamon M, Saoût V, Verny C, Dinomais M, Besnard J. Theory of Mind Impairments Highlighted With an Ecological Performance-Based Test Indicate Behavioral Executive Deficits in Traumatic Brain Injury. Front Neurol 2020; 10:1367. [PMID: 32038455 PMCID: PMC6987386 DOI: 10.3389/fneur.2019.01367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/10/2019] [Indexed: 12/13/2022] Open
Abstract
Background: In view of the recent literature, the negative impact of traumatic brain injury (TBI) on social cognition remains a debated issue. On one hand, a considerable number of studies reported significant impairments in emotion recognition, empathy, moral reasoning, social problem solving, and mentalizing or theory of mind (ToM) abilities in patients with TBI. On the other hand, the ecological validity of social cognition tasks is still a matter of concern and debate for clinicians and researchers. Objectives: The objectives of the present study were 2-fold: (1) to assess social cognition in TBI with an ecological performance-based test which focuses on ToM ability, and (2) to study the relationship between performances on this task and behavioral disorders. To this end, 47 patients with moderate to severe TBI in the chronic stage were assessed with a ToM task, the Movie for the Assessment of Social Cognition (MASC), a film displaying social interactions in natural settings and asking for an evaluation of the emotions, thoughts, and intentions of the characters. Behavioral disorders were assessed with the Behavioral Dysexecutive Syndrome Inventory (BDSI), a structured interview of an informant in assessing changes compared with previous behavior in 12 domains. Results: Patients were significantly less accurate in mental state attribution than a demographically matched group of 38 healthy control subjects. Significant others of patients also reported more behavioral executive problems than controls' relatives on most of the domains of the BDSI. In addition, social cognition performance in the MASC was significantly correlated with behavioral dysexecutive problems rated by proxies on the BDSI. Conclusions: This study is the first to find association between impairments in mentalizing abilities in the MASC and behavioral impairments in patients with TBI, confirming the added value of this ecological task and that the recognition of social signals is a key element for adequate behavioral functioning.
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Affiliation(s)
- Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), University of Angers, Angers, France.,Department of Neurology, Angers University Hospital, Angers, France
| | - Martin Hamon
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), University of Angers, Angers, France
| | | | - Christophe Verny
- Department of Neurology, Angers University Hospital, Angers, France
| | - Mickaël Dinomais
- Department of Physical and Rehabilitation Medicine, Angers University Hospital, Angers, France
| | - Jeremy Besnard
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), University of Angers, Angers, France
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43
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Law C, Amore TL, Williams WH, Tonks J. Training emotional recognition in a child with acquired brain injury: A single case study. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 10:384-392. [PMID: 31835913 DOI: 10.1080/21622965.2019.1699094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emotional processing is affected by childhood brain injury. Ineffective emotional processing and poor understanding of social cues affect the development of social relationships leading to social isolation and a poorer quality of life in the long-term. Facial expression recognition is a non-verbal social cue that is used to interpret the thoughts and feelings of others. Children with brain injury have shown deficits identifying even basic emotions from facial expression, yet few intervention studies have explored how to develop facial expression recognition in children with brain injury. Enhancing the ability to recognize and interpret facial expressions for these children would have implications for their emotional processing and social-emotional behavior. In this paper we report on a short single case study intervention to increase facial expression recognition using the Facial Affect Recognition training (FAR) for a 10-year-old-child with brain injury. Following intervention, there was not only an increase in facial expression recognition but also changes in social-emotional behavior indicating some generalization to other contexts. The results suggest that rehabilitation of emotional processing difficulties may indeed be possible, and further intervention studies aimed at developing these skills in children with brain injury are warranted.
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Affiliation(s)
- Caroline Law
- Department of Linguistics, Macquarie University, Sydney, Australia.,Simply Speech Ltd., Glastonbury, UK
| | | | | | - James Tonks
- University of Exeter Medical School, Exeter University, Exeter, UK.,Haven Clinical Psychology Ltd., Bude, UK
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44
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Rigon A, Turkstra LS, Mutlu B, Duff MC. Facial-affect recognition deficit as a predictor of different aspects of social-communication impairment in traumatic brain injury. Neuropsychology 2019; 32:476-483. [PMID: 29809034 DOI: 10.1037/neu0000368] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To examine the relationship between facial-affect recognition and different aspects of self- and proxy-reported social-communication impairment following moderate-severe traumatic brain injury (TBI). METHOD Forty-six adults with chronic TBI (>6 months postinjury) and 42 healthy comparison (HC) adults were administered the La Trobe Communication Questionnaire (LCQ) Self and Other forms to assess different aspects of communication competence and the Emotion Recognition Test (ERT) to measure their ability to recognize facial affects. RESULTS Individuals with TBI underperformed HC adults in the ERT and self-reported, as well as were reported by close others, as having more communication problems than did HC adults. TBI group ERT scores were significantly and negatively correlated with LCQ-Other (but not LCQ-Self) scores (i.e., participants with lower emotion-recognition scores were rated by close others as having more communication problems). Multivariate regression analysis revealed that adults with higher ERT scores self-reported more problems with disinhibition-impulsivity and partner sensitivity and had fewer other-reported problems with disinhibition-impulsivity and conversational effectiveness. CONCLUSIONS Our findings support growing evidence that emotion-recognition deficits play a role in specific aspects of social-communication outcomes after TBI and should be considered in treatment planning. (PsycINFO Database Record
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Affiliation(s)
- Arianna Rigon
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
| | | | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison
| | - Melissa C Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
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45
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Lancaster K, Venkatesan UM, Lengenfelder J, Genova HM. Default Mode Network Connectivity Predicts Emotion Recognition and Social Integration After Traumatic Brain Injury. Front Neurol 2019; 10:825. [PMID: 31447760 PMCID: PMC6696510 DOI: 10.3389/fneur.2019.00825] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022] Open
Abstract
Moderate-severe traumatic brain injury (TBI) may result in difficulty with emotion recognition, which has negative implications for social functioning. As aspects of social cognition have been linked to resting-state functional connectivity (RSFC) in the default mode network (DMN), we sought to determine whether DMN connectivity strength predicts emotion recognition and level of social integration in TBI. To this end, we examined emotion recognition ability of 21 individuals with TBI and 27 healthy controls in relation to RSFC between DMN regions. Across all participants, decreased emotion recognition ability was related to increased connectivity between dorsomedial prefrontal cortex (dmPFC) and temporal regions (temporal pole and parahippocampal gyrus). Furthermore, within the TBI group, connectivity between dmPFC and parahippocampal gyrus predicted level of social integration on the Community Integration Questionnaire, an important index of post-injury social functioning in TBI. This finding was not explained by emotion recognition ability, indicating that DMN connectivity predicts social functioning independent of emotion recognition. These results advance our understanding of the neural underpinnings of emotional and social processes in both healthy and injured brains, and suggest that RSFC may be an important marker of social outcomes in individuals with TBI.
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Affiliation(s)
- Katie Lancaster
- Kessler Foundation, West Orange, NJ, United States.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
| | | | - Jean Lengenfelder
- Kessler Foundation, West Orange, NJ, United States.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Helen M Genova
- Kessler Foundation, West Orange, NJ, United States.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
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Buunk AM, Spikman JM, Metzemaekers JDM, van Dijk JMC, Groen RJM. Return to work after subarachnoid hemorrhage: The influence of cognitive deficits. PLoS One 2019; 14:e0220972. [PMID: 31398223 PMCID: PMC6688815 DOI: 10.1371/journal.pone.0220972] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/26/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cognitive deficits are frequently found after subarachnoid hemorrhage (SAH), but their influence on return to work is largely unknown. To improve identification of those patients at-risk for long-term return to work problems, we aimed to examine the value of cognitive deficits in the prediction of long-term return to work after subarachnoid hemorrhage. METHODS SAH patients (N = 71) who were employed before SAH and were able to undergo neuropsychological assessment, were included. Demographic characteristics and acute SAH-related variables (SAH-type and external cerebrospinal fluid drainage) were taken into account. Neuropsychological tests for memory, speed, attention, executive function, and emotion recognition and a questionnaire for executive functions were used. Return to work was assessed using the Role Resumption List. RESULTS Results showed that patients with incomplete return to work had significantly lower scores on neuropsychological measures for complex attention and executive functions (p < 0.05) compared to patients with complete return to work. Return to work could not be significantly predicted using only demographic characteristics and acute SAH-related variables, but adding measures of complex attention and executive functions resulted in a prognostic model that could reliably distinguish between complete and incomplete return to work. Statistically significant predictors in the final model were cerebrospinal fluid drainage and scores on a questionnaire for executive functions: patients with cerebrospinal fluid drainage and higher scores on the a questionnaire for executive functions were less likely to return to work. DISCUSSION Together, these findings show that neuropsychological measures, especially for complex attention and executive functions, have added value to acute SAH-related and demographic variables in the prediction of long-term return to work after SAH.
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Affiliation(s)
- Anne M. Buunk
- Department of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jacoba M. Spikman
- Department of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jan D. M. Metzemaekers
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J. Marc C. van Dijk
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rob J. M. Groen
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Drapeau J, Gosselin N, Peretz I, McKerral M. Electrophysiological Responses to Emotional Facial Expressions Following a Mild Traumatic Brain Injury. Brain Sci 2019; 9:E142. [PMID: 31216634 PMCID: PMC6627801 DOI: 10.3390/brainsci9060142] [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: 06/03/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to measure neural information processing underlying emotional recognition from facial expressions in adults having sustained a mild traumatic brain injury (mTBI) as compared to healthy individuals. We thus measured early (N1, N170) and later (N2) event-related potential (ERP) components during presentation of fearful, neutral, and happy facial expressions in 10 adults with mTBI and 11 control participants. Findings indicated significant differences between groups, irrespective of emotional expression, in the early attentional stage (N1), which was altered in mTBI. The two groups showed similar perceptual integration of facial features (N170), with greater amplitude for fearful facial expressions in the right hemisphere. At a higher-level emotional discrimination stage (N2), both groups demonstrated preferential processing for fear as compared to happiness and neutrality. These findings suggest a reduced early selective attentional processing following mTBI, but no impact on the perceptual and higher-level cognitive processes stages. This study contributes to further improving our comprehension of attentional versus emotional recognition following a mild TBI.
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Affiliation(s)
- Joanie Drapeau
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Nathalie Gosselin
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Isabelle Peretz
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3C 3J7, Canada.
| | - Michelle McKerral
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC H3S 2J4, Canada.
- Departement of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada.
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Horan WP, Wynn JK, Gabrielian S, Glynn SM, Hellemann GS, Kern RS, Lee J, Marder SR, Sugar CA, Green MF. Motivational and cognitive correlates of community integration in homeless veterans entering a permanent supported housing program. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2019; 90:181-192. [PMID: 31021133 DOI: 10.1037/ort0000420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Homelessness is a major public health problem, and serious mental illness (SMI) is highly prevalent in the homeless population. Although supported housing services-which provide permanent housing in the community along with case management-improve housing outcomes, community integration typically remains poor, and little is known about the underlying determinants of poor community integration postresidential placement. The general SMI literature has indicated that motivational and cognitive ability factors are key determinants of successful community integration, which provides a foundation for examining this issue. This study evaluated whether interview- and performance-based assessments of motivation, nonsocial and social-cognitive ability, and psychiatric symptoms were associated with community integration indices in 2 samples of homeless veterans either with (N = 96) or without (N = 80) a psychotic disorder who had recently been admitted to a supported housing program but who had not yet attained housing. Motivation indices, including experiential negative symptoms and defeatist performance attitudes, stood out as the most robust correlates (rs = -.30 to -.69) of community integration across both samples, particularly for social role participation. Demographics, general psychiatric symptoms, and nonsocial cognition showed generally weak relations with community integration, though social cognition showed a few relations. The consistent findings across samples point to the importance of motivational factors for understanding the determinants of poor community integration in this complex population. Further, interventions that target motivational challenges may have widespread usefulness for enhancing community integration outcomes beyond obtaining housing. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Nijsse B, Spikman JM, Visser-Meily JMA, de Kort PLM, van Heugten CM. Social cognition impairments are associated with behavioural changes in the long term after stroke. PLoS One 2019; 14:e0213725. [PMID: 30875394 PMCID: PMC6420004 DOI: 10.1371/journal.pone.0213725] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/27/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Behavioural changes after stroke might be explained by social cognition impairments. The aim of the present study was to investigate whether performances on social cognition tests (including emotion recognition, Theory of Mind (ToM), empathy and behaviour regulation) were associated with behavioural deficits (as measured by proxy ratings) in a group of patients with relatively mild stroke. METHODS Prospective cohort study in which 119 patients underwent neuropsychological assessment with tests for social cognition (emotion recognition, ToM, empathy, and behaviour regulation) 3-4 years post stroke. Test scores were compared with scores of 50 healthy controls. Behavioural problems were assessed with the Dysexecutive Questionnaire (DEX) self rating and proxy rating scales. Pearson correlations were used to determine the relationship between the social cognition measures and DEX scores. RESULTS Patients performed significantly worse on emotion recognition, ToM and behaviour regulation tests than controls. Mean DEX-self score did not differ significantly from the mean DEX-proxy score. DEX-proxy ratings correlated with tests for emotion recognition, empathy, and behavioural regulation (lower scores on these items were associated with more problems on the DEX-proxy scale). CONCLUSIONS Social cognition impairments are present in the long term after stroke, even in a group of mildly affected stroke patients. Most of these impairments also turned out to be associated with a broad range of behavioural problems as rated by proxies of the patients. This strengthens the proposal that social cognition impairments are part of the underlying mechanism of behavioural change. Since tests for social cognition can be administered in an early stage, this would allow for timely identification of patients at risk for behavioural problems in the long term.
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Affiliation(s)
- Britta Nijsse
- Elisabeth-Tweesteden Hospital, Department of Neurology, Tilburg, The Netherlands
| | - Jacoba M. Spikman
- University of Groningen, Department of Clinical and Developmental Neuropsychology, Groningen, The Netherlands
- University Medical Center Groningen, Department of Neurology, Groningen, The Netherlands
| | - Johanna M. A. Visser-Meily
- Center of Excellence in Rehabilitation Medicine, collaboration between University Medical Center Utrecht and Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Rehabilitation, Physical Therapy Science and Sports, Utrecht, The Netherlands
| | - Paul L. M. de Kort
- Elisabeth-Tweesteden Hospital, Department of Neurology, Tilburg, The Netherlands
| | - Caroline M. van Heugten
- Maastricht University, Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht, The Netherlands
- Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht, The Netherlands
- * E-mail:
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Westerhof-Evers HJ, Visser-Keizer AC, Fasotti L, Spikman JM. Social cognition and emotion regulation: a multifaceted treatment (T-ScEmo) for patients with traumatic brain injury. Clin Rehabil 2019; 33:820-833. [PMID: 30798631 PMCID: PMC6482595 DOI: 10.1177/0269215519829803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Many patients with moderate to severe traumatic brain injury have deficits in social cognition. Social cognition refers to the ability to perceive, interpret, and act upon social information. Few studies have investigated the effectiveness of treatment for impairments of social cognition in patients with traumatic brain injury. Moreover, these studies have targeted only a single aspect of the problem. They all reported improvements, but evidence for transfer of learned skills to daily life was scarce. We evaluated a multifaceted treatment protocol for poor social cognition and emotion regulation impairments (called T-ScEmo) in patients with traumatic brain injury and found evidence for transfer to participation and quality of life. PURPOSE In the current paper, we describe the theoretical underpinning, the design, and the content of our treatment of social cognition and emotion regulation (T-ScEmo). THEORY INTO PRACTICE The multifaceted treatment that we describe is aimed at improving social cognition, regulation of social behavior and participation in everyday life. Some of the methods taught were already evidence-based and derived from existing studies. They were combined, modified, or extended with newly developed material. PROTOCOL DESIGN T-ScEmo consists of 20 one-hour individual sessions and incorporates three modules: (1) emotion perception, (2) perspective taking and theory of mind, and (3) regulation of social behavior. It includes goal-setting, psycho-education, function training, compensatory strategy training, self-monitoring, role-play with participation of a significant other, and homework assignments. RECOMMENDATIONS It is strongly recommended to offer all three modules, as they build upon each other. However, therapists can vary the time spent per module, in line with the patients' individual needs and goals. In future, development of e-learning modules and virtual reality sessions might shorten the treatment.
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Affiliation(s)
- Herma J Westerhof-Evers
- 1 Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.,2 Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annemarie C Visser-Keizer
- 2 Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Luciano Fasotti
- 3 Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,4 Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - Jacoba M Spikman
- 1 Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.,5 Department of Neuropsychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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