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Jesus Pereira I, Santos M, Sganzerla D, Robinson CC, de Souza D, Kochhann R, Falavigna M, Azevedo L, Bozza F, Sharshar T, Goulart Rosa R, Granja C, Teixeira C. Long term cognitive dysfunction among critical care survivors: associated factors and quality of life-a multicenter cohort study. Ann Intensive Care 2024; 14:116. [PMID: 39073625 PMCID: PMC11286902 DOI: 10.1186/s13613-024-01335-w] [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] [Received: 12/23/2023] [Accepted: 06/16/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVES To identify the prevalence and associated factors of cognitive dysfunction, 1 year after ICU discharge, among adult patients, and it´s relation with quality of life. METHODS Multicenter, prospective cohort study including ICUs of 10 tertiary hospitals in Brazil, between May 2014 and December 2018. The patients included were 452 adult ICU survivors (median age 60; 47.6% women) with an ICU stay greater than 72 h. RESULTS At 12 months after ICU discharge, a Montreal Cognitive Assessment (tMOCA) telephone score of less than 12 was defined as cognitive dysfunction. At 12 months, of the 452 ICU survivors who completed the cognitive evaluation 216 (47.8%) had cognitive dysfunction. In multivariable analyses, the factors associated with long-term (1-year) cognitive dysfunction were older age (Prevalence Ratio-PR = 1.44, P < 0.001), absence of higher education (PR = 2.81, P = 0.005), higher comorbidities on admission (PR = 1.089; P = 0.004) and delirium (PR = 1.13, P < 0.001). Health-related Quality of life (HRQoL), assessed by the mental and physical dimensions of the SF-12v2, was significantly better in patients without cognitive dysfunction (Mental SF-12v2 Mean difference = 2.54; CI 95%, - 4.80/- 0.28; p = 0.028 and Physical SF-12v2 Mean difference = - 2.85; CI 95%, - 5.20/- 0.50; P = 0.018). CONCLUSIONS Delirium was found to be the main modifiable predictor of long-term cognitive dysfunction in ICU survivors. Higher education consistently reduced the probability of having long-term cognitive dysfunction. Cognitive dysfunction significantly influenced patients' quality of life, leading us to emphasize the importance of cognitive reserve for long-term prognosis after ICU discharge.
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Affiliation(s)
- Isabel Jesus Pereira
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
- SIM-FMUP-Simulation Center, Faculty of Medicine, University of Porto, Porto, Portugal.
- CriticalMed-Critical Care & Emergency Medicine, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal.
- Intensive Care Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal.
| | - Mariana Santos
- MEDCIDS-Medicina da Comunidade, Informação E Decisão Em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
| | | | | | - Denise de Souza
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Renata Kochhann
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Maicon Falavigna
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Brazil
- Institute for Health Technology Assessment, Postgraduate Program in Epidemiology, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
- Postgraduate Program in Epidemiology, UFRGS, Porto Alegre, Brazil
| | - Luis Azevedo
- MEDCIDS-Medicina da Comunidade, Informação E Decisão Em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
| | - Fernando Bozza
- Department of Critical Care, D'Or Institute for Research and Education, Rio de Janeiro, RJ, Brazil
| | - Tarek Sharshar
- Anesthesia and Intensive Care Department, Institute of Psychiatry, GHU Paris Psychiatrie Et NeurosciencesSainte-Anne HospitalNeurosciences of Paris, INSERM U1266, Université Paris Cité, Pole Neuro, ParisParis, France
| | - Regis Goulart Rosa
- Department of Internal Medicine, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
- Brazilian Research in Intensive Care Network, São Paulo, SP, Brazil
| | - Cristina Granja
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- SIM-FMUP-Simulation Center, Faculty of Medicine, University of Porto, Porto, Portugal
- CriticalMed-Critical Care & Emergency Medicine, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal
- CINTESIS@RISE-Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
- Anaesthesiology Department, University Hospital Center São João, Porto, Portugal
| | - Cassiano Teixeira
- Brazilian Research in Intensive Care Network, São Paulo, SP, Brazil
- Intensive Care Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- UFCSPA Medical School, Porto Alegre, RS, Brazil
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Shahim P, Pham DL, van der Merwe AJ, Moore B, Chou Y, Lippa SM, Kenney K, Diaz‐Arrastia R, Chan L. Serum NfL and GFAP as biomarkers of progressive neurodegeneration in TBI. Alzheimers Dement 2024; 20:4663-4676. [PMID: 38805359 PMCID: PMC11247683 DOI: 10.1002/alz.13898] [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: 11/29/2023] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND We examined spatial patterns of brain atrophy after mild, moderate, and severe traumatic brain injury (TBI), the relationship between progression of brain atrophy with initial traumatic axonal injury (TAI), cognitive outcome, and with serum biomarkers of brain injury. METHODS A total of 143 patients with TBI and 43 controls were studied cross-sectionally and longitudinally up to 5 years with multiple assessments, which included brain magnetic resonance imaging, cognitive testing, and serum biomarkers. RESULTS TBI patients showed progressive volume loss regardless of injury severity over several years, and TAI was independently associated with accelerated brain atrophy. Cognitive performance improved over time. Higher baseline serum neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) were associated with greater rate of brain atrophy over 5 years. DISCUSSSION Spatial patterns of atrophy differ by injury severity and TAI is associated with the progression of brain atrophy. Serum NfL and GFAP show promise as non-invasive prognostic biomarkers of progressive neurodegeneration in TBI. HIGHLIGHTS In this longitudinal study of patient with mild, moderate, and severe traumatic brain injury (TBI) who were assessed with paired magnetic resonance imaging (MRI), blood biomarkers, and cognitive assessments, we found that brain atrophy after TBI is progressive and continues for many years even after a mild head trauma without signs of brain injury on conventional MRI. We found that spatial pattern of brain atrophy differs between mild, moderate, and severe TBI, where in patients with mild TBI , atrophy is mainly seen in the gray matter, while in those with moderate to severe brain injury atrophy is predominantly seen in the subcortical gray matter and whiter matter. Cognitive performance improves over time after a TBI. Serum measures of neurofilament light or glial fibrillary acidic protein are associated with progression of brain atrophy after TBI.
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Affiliation(s)
- Pashtun Shahim
- Rehabilitation Medicine DepartmentNational Institutes of Health (NIH) Clinical CenterBethesdaMarylandUSA
- National Institutes of Neurological Disorders and Stroke, NIHBethesdaMarylandUSA
- Department of NeurologyMedStar Georgetown University Hospital, Pasquerilla Healthcare CenterWashingtonDistrict of ColumbiaUSA
- The Military Traumatic Brain Injury Initiative (MTBI2)BethesdaMarylandUSA
- The Henry M. Jackson Foundation for the Advancement of Military MedicineBethesdaMarylandUSA
| | - Dzung L. Pham
- The Military Traumatic Brain Injury Initiative (MTBI2)BethesdaMarylandUSA
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Andre J. van der Merwe
- Rehabilitation Medicine DepartmentNational Institutes of Health (NIH) Clinical CenterBethesdaMarylandUSA
- The Military Traumatic Brain Injury Initiative (MTBI2)BethesdaMarylandUSA
- The Henry M. Jackson Foundation for the Advancement of Military MedicineBethesdaMarylandUSA
| | - Brian Moore
- Rehabilitation Medicine DepartmentNational Institutes of Health (NIH) Clinical CenterBethesdaMarylandUSA
- The Military Traumatic Brain Injury Initiative (MTBI2)BethesdaMarylandUSA
- The Henry M. Jackson Foundation for the Advancement of Military MedicineBethesdaMarylandUSA
| | - Yi‐Yu Chou
- The Military Traumatic Brain Injury Initiative (MTBI2)BethesdaMarylandUSA
- The Henry M. Jackson Foundation for the Advancement of Military MedicineBethesdaMarylandUSA
| | - Sara M. Lippa
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
- National Intrepid Center of Excellence, Walter Reed National Military Medical CenterBethesdaMarylandUSA
| | - Kimbra Kenney
- Uniformed Services University of the Health SciencesBethesdaMarylandUSA
- National Intrepid Center of Excellence, Walter Reed National Military Medical CenterBethesdaMarylandUSA
| | - Ramon Diaz‐Arrastia
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Leighton Chan
- Rehabilitation Medicine DepartmentNational Institutes of Health (NIH) Clinical CenterBethesdaMarylandUSA
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Gao Y, Zhou W, Wang Y, Liu B, Liu J, Wang Q, Zhou L. Nursing management of cognitive dysfunction in adults with brain injury: Summary of best evidence-practiced strategies. J Clin Nurs 2024; 33:2496-2508. [PMID: 38366758 DOI: 10.1111/jocn.17058] [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: 07/17/2023] [Revised: 11/14/2023] [Accepted: 01/23/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To summarize the best evidence-based strategies for the management of cognitive dysfunction in patients with brain injury and to provide a reference for clinical nursing practice. DESIGN Review. METHODS The review was presented using PRISMA guidelines. A systematic search of evidence on the management of cognitive dysfunction in patients with brain injury was conducted in computerized decision systems, guideline websites, professional association websites and comprehensive databases from the date of creation to 21 June 2023. The types of evidence included were clinical decision making, guidelines, evidence summaries, best practices, recommended practices, expert consensus, systematic reviews and meta-analyses. Two researchers trained in evidence-based methodological systems independently evaluated the quality of the literature and extracted, integrated and graded the evidence for inclusion. RESULTS A total of 20 articles were selected, including nine guidelines, three expert consensus articles, one clinical practice article and seven systematic reviews, and the overall quality of the literature was high. Thirty pieces of evidence were summarized in seven areas: assessment, multidisciplinary team, rehabilitation program, cognitive intervention, exercise intervention, music intervention and medication management. CONCLUSIONS This study summarizes the latest evidence on the management of cognitive dysfunction in the care of adults with brain injury and provides a reference for clinical nursing practice. The best evidence should be selected for localized and individualized application in clinical work, and the best evidence should be continuously updated to standardize nursing practice. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Patients with cognitive impairment after brain injury often suffer from memory loss, attention deficit and disorientation and are unable to have a normal life and experience much enjoyment, which seriously affects their physical and mental health and creates a great burden of care for their families and society. Best evidence-based strategies for the nursing management of cognitive impairment in brain injury are essential for standardizing clinical nursing practice and providing timely, professional, systematic and comprehensive nursing interventions for patients. REPORTING METHOD This review is reported following the PRISMA 2020 statement guidelines, as applicable, to enhance transparency in reporting the evidence synthesis. TRIAL AND PROTOCOL REGISTRATION This study has been registered with the Fudan University Centre for Evidence-based Nursing, a JBI Centre of Excellence under registration number ES20232566, http://ebn.nursing.fudan.edu.cn/myRegisterList. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Yitian Gao
- Second Military Medical University, Shanghai, China
| | | | - Ying Wang
- Shanghai First Rehabilitation Hospital, Shanghai, China
| | - Beixue Liu
- Second Military Medical University, Shanghai, China
| | - Jing Liu
- Second Military Medical University, Shanghai, China
| | - Qiuyi Wang
- Second Military Medical University, Shanghai, China
| | - Lanshu Zhou
- Second Military Medical University, Shanghai, China
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Zhang R, Martyna M, Cornwell J, Teramoto M, Selfridge M, Brown A, Ghajar J, Lumba-Brown A. Anxiety and Mood Disruption in Collegiate Athletes Acutely Following Mild Traumatic Brain Injury. Diagnostics (Basel) 2024; 14:1276. [PMID: 38928691 PMCID: PMC11202808 DOI: 10.3390/diagnostics14121276] [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: 04/02/2024] [Revised: 05/20/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE To report the symptom burden of anxiety and mood-related indicators following mTBI in collegiate student-athletes. STUDY DESIGN Retrospective cohort study of varsity collegiate athletes. SETTING University sports medicine at a tertiary care center. PATIENTS Division I college varsity athletes diagnosed with mTBI at a single institution between 2016 and 2019. INDEPENDENT VARIABLES Pre- and post-injury. MAIN OUTCOME MEASURES Comparisons between baseline testing and post-mTBI symptom scale assessments were made to determine changes in scores at the individual and group levels. The primary outcome was the prevalence of post-mTBI symptoms from within 72 h of injury through return to play. Associations with sport, sex, age, and return-to-play time were included. RESULTS Compared to baseline, mood and anxiety symptom scores were significantly higher acutely following mTBI (2.1 ± 3.3 vs. 14.3 ± 12.2; p < 0.001). A family history of migraine was significantly associated with higher mood and anxiety symptom scores (20.0 ± 14.9 with history vs. 13.3 ± 11.3 without history; p = 0.042). Mood and anxiety symptom scores were highly correlated with non-mood and anxiety symptom scores for all athletes, including the subgroup with prolonged symptoms (r = 0.769; p < 0.001). CONCLUSIONS Symptoms of anxiety or mood disruption are common during the acute period post-injury in varsity college athletes. Risk factors for higher symptom reports immediately following mTBI and for prolonged symptoms (>10 days) included female sex, those with a family history of migraine, and those with an overall higher symptom burden post-injury.
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Affiliation(s)
- Rachel Zhang
- Department of Emergency Medicine, Stanford University, Stanford, CA 94304, USA
| | - Michael Martyna
- Department of Psychiatry, Stanford University, Stanford, CA 94304, USA;
| | - Jordan Cornwell
- Department of Emergency Medicine, Stanford University, Stanford, CA 94304, USA
| | - Masaru Teramoto
- Department of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT 84108, USA
| | - Mollie Selfridge
- Department of Sports Medicine, Stanford University, Stanford, CA 94304, USA; (M.S.)
| | - Amanda Brown
- Department of Sports Medicine, Stanford University, Stanford, CA 94304, USA; (M.S.)
| | - Jamshid Ghajar
- Department of Neurosurgery, Brain Performance Center, Stanford University, Stanford, CA 94304, USA
| | - Angela Lumba-Brown
- Department of Emergency Medicine, Stanford University, Stanford, CA 94304, USA
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Zhang H, Zhao Y, Qu Y, Du J, Peng Y. Transcutaneous Cervical Vagus Nerve Magnetic Stimulation in Patients With Traumatic Brain Injury: A Feasibility Study. Neuromodulation 2024; 27:672-680. [PMID: 37865889 DOI: 10.1016/j.neurom.2023.09.004] [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: 06/09/2023] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES Transcutaneous vagus nerve stimulation has shown promising results in improving cognitive and motor function after stroke. However, to our knowledge, there have been no studies in the modulation of the cervical vagus nerve using repetitive transcranial magnetic stimulation (rTMS) in patients with traumatic brain injury (TBI) with cognitive dysfunction. Thus, we conducted a single-arm feasibility trial to assess the safety and effectiveness of rTMS of the vagus nerve in patients with TBI. MATERIALS AND METHODS We enrolled ten patients with TBI and administered half-hour vagus nerve magnetic stimulation (VNMS) sessions for ten days to evaluate the feasibility of the treatment. The Montreal cognitive assessment-Beijing (MoCA-B), the Digit Span Test, and the Auditory Verbal Learning Test (AVLT) were used to measure cognitive function before and after the VNMS treatment. Physiological parameters of all subjects were assessed by electrocardiogram. RESULTS The findings showed that daily half-hour VNMS for ten days was feasible in patients with TBI, with minimal side effects and no clinically significant effects on physiological parameters. Eight patients showed improvement in MoCA-B, and five patients showed improvement in immediate memory as measured by AVLT. CONCLUSIONS We conclude that VNMS is a safe and feasible treatment option for patients with TBI with cognitive dysfunction. However, further controlled studies are necessary to establish the efficacy of VNMS in promoting cognitive recovery after TBI. SIGNIFICANCE This study is, to our knowledge, the first study to investigate the feasibility of VNMS for cognitive dysfunction in patients with TBI. Our findings offer the possibility of rTMS applied to the vagus nerve in clinical practice.
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Affiliation(s)
- Han Zhang
- Department of Rehabilitation Medicine, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, Sichuan, China; Department of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China; College of Sports Medicine and Rehabilitation, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yu Zhao
- Department of Rehabilitation Medicine, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, Sichuan, China; College of Sports Medicine and Rehabilitation, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yun Qu
- Department of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Juan Du
- Department of Rehabilitation Medicine, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, Sichuan, China
| | - Yi Peng
- Department of Rehabilitation Medicine, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, Sichuan, China
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Huang Z, Feng Y, Zhang Y, Ma X, Zong X, Jordan JD, Zhang Q. Enhancing axonal myelination: Clemastine attenuates cognitive impairment in a rat model of diffuse traumatic brain injury. Transl Res 2024; 268:40-50. [PMID: 38246342 PMCID: PMC11081842 DOI: 10.1016/j.trsl.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/10/2023] [Accepted: 01/18/2024] [Indexed: 01/23/2024]
Abstract
Traumatic brain injury (TBI) has a significant impact on cognitive function, affecting millions of people worldwide. Myelin loss is a prominent pathological feature of TBI, while well-functioning myelin is crucial for memory and cognition. Utilizing drug repurposing to identify effective drug candidates for TBI treatment has gained attention. Notably, recent research has highlighted the potential of clemastine, an FDA-approved allergy medication, as a promising pro-myelinating drug. Therefore, in this study, we aim to investigate whether clemastine can enhance myelination and alleviate cognitive impairment following mild TBI using a clinically relevant rat model of TBI. Mild diffuse TBI was induced using the Closed-Head Impact Model of Engineered Rotational Acceleration (CHIMERA). Animals were treated with either clemastine or an equivalent volume of the vehicle from day 1 to day 14 post-injury. Following treatment, memory-related behavioral tests were conducted, and myelin pathology in the cortex and hippocampus was assessed through immunofluorescence staining and ProteinSimple® capillary-based immunoassay. Our results showed that TBI leads to significant myelin loss, axonal damage, glial activation, and a decrease in mature oligodendrocytes in both the cortex and hippocampus. The TBI animals also exhibited notable deficits in memory-related tests. In contrast, animals treated with clemastine showed an increase in mature oligodendrocytes, enhanced myelination, and improved performance in the behavioral tests. These preliminary findings support the therapeutic value of clemastine in alleviating TBI-induced cognitive impairment, with substantial clinical translational potential. Our findings also underscore the potential of remyelinating therapies for TBI.
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Affiliation(s)
- Zhihai Huang
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 1501 Kings Highway, LA 71103 USA
| | - Yu Feng
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 1501 Kings Highway, LA 71103 USA
| | - Yulan Zhang
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 1501 Kings Highway, LA 71103 USA
| | - Xiaohui Ma
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 1501 Kings Highway, LA 71103 USA
| | - Xuemei Zong
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 1501 Kings Highway, LA 71103 USA
| | - J. Dedrick Jordan
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 1501 Kings Highway, LA 71103 USA
| | - Quanguang Zhang
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 1501 Kings Highway, LA 71103 USA
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Kaurani P, Moreira de Marchi Apolaro AV, Kunchala K, Maini S, Rges HAF, Isaac A, Lakkimsetti M, Raake M, Nazir Z. Advances in Neurorehabilitation: Strategies and Outcomes for Traumatic Brain Injury Recovery. Cureus 2024; 16:e62242. [PMID: 39006616 PMCID: PMC11244718 DOI: 10.7759/cureus.62242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Traumatic brain injury (TBI) consists of an external physical force that causes brain function impairment or pathology and globally affects 50 million people each year, with a cost of 400 billion US dollars. Clinical presentation of TBI can occur in many forms, and patients usually require prolonged hospital care and lifelong rehabilitation, which leads to an impact on the quality of life. For this narrative review, no particular method was used to extract data. With the aid of health descriptors and Medical Subject Heading (MeSH) terms, a search was thoroughly conducted in databases such as PubMed and Google Scholar. After the application of exclusion and inclusion criteria, a total of 146 articles were effectively used for this review. Results indicate that rehabilitation after TBI happens through neuroplasticity, which combines neural regeneration and functional reorganization. The role of technology, including artificial intelligence, virtual reality, robotics, computer interface, and neuromodulation, is to impact rehabilitation and life quality improvement significantly. Pharmacological intervention, however, did not result in any benefit when compared to standard care and still needs further research. It is possible to conclude that, given the high and diverse degree of disability associated with TBI, rehabilitation interventions should be precocious and tailored according to the individual's needs in order to achieve the best possible results. An interdisciplinary patient-centered care health team and well-oriented family members should be involved in every stage. Lastly, strategies must be adequate, well-planned, and communicated to patients and caregivers to attain higher functional outcomes.
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Affiliation(s)
- Purvi Kaurani
- Neurology, DY Patil University School of Medicine, Navi Mumbai , IND
| | | | - Keerthi Kunchala
- Internal Medicine, Sri Venkateswara Medical College, Tirupati, IND
| | - Shriya Maini
- Medicine and Surgery, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Huda A F Rges
- Mental Health, National Authority for Mental Health and Psychosocial Support, Benghazi, LBY
| | - Ashley Isaac
- General Medicine, Isra University Hospital, Hyderabad, PAK
| | | | | | - Zahra Nazir
- Internal Medicine, Combined Military Hospital, Quetta, PAK
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Liu T, Liu M, Nie M, Zhao Z, Liu X, Qian Y, Yu Y, Sha Z, Wu C, Yuan J, Jiang W, Lv C, Mi L, Tian Y, Zhang J, Jiang R. Effect of l-oxiracetam and oxiracetam on memory and cognitive impairment in mild-to-moderate traumatic brain injury patients: Study protocol for a randomized controlled trial. Aging Med (Milton) 2024; 7:341-349. [PMID: 38975302 PMCID: PMC11222749 DOI: 10.1002/agm2.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/25/2024] [Accepted: 05/29/2024] [Indexed: 07/09/2024] Open
Abstract
Objectives Patients with traumatic brain injury (TBI) often suffer memory and cognitive impairments, and oxiracetam-like drugs are considered to have a positive impact on these symptoms potentially. However, the efficacy and safety of l-oxiracetam and oxiracetam in TBI patients have not been sufficiently investigated. Methods The study adopts a multicenter, randomized, double-blind, parallel-group, phase 3 clinical trial design in 74 centers across 51 hospitals in China. A total of 590 TBI patients meeting criteria will be randomly allocated into three groups in a 2:2:1 ratio: l-oxiracetam group, oxiracetam group, and placebo group. The treatment period is 14 days, with a follow-up period of 90 days. The primary outcome measure is the change in the Loewenstein Occupational Therapy Cognitive Assessment score at 90 days after treatment. Secondary outcomes include changes in other cognitive assessments, neurological function, activities of daily living, and safety assessments. Discussion There is no robust evidence to suggest that l-oxiracetam and oxiracetam can enhance memory and cognitive function in patients with mild to moderate TBI. This study has the potential to answer this crucial clinical question. Trial registration chinadrugtrials.org.cn, identifier CTR20192539; ClinicalTrials.gov, identifier NCT04205565.
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Affiliation(s)
- Tao Liu
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Mingqi Liu
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
- Department of Rehabilitation MedicineZhejiang Provincial People's HospitalHangzhouChina
| | - Meng Nie
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Zhihao Zhao
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Xuanhui Liu
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Yu Qian
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Yunhu Yu
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
- Department of Clinical Research Center for Neurological DiseaseThe People's Hospital of HongHuaGang District of ZunYiZunyiChina
| | - Zhuang Sha
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Chenrui Wu
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Jiangyuan Yuan
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Weiwei Jiang
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Chuanxiang Lv
- Department of NeurosurgeryThe First Hospital of Jilin UniversityChangchunChina
| | - Liang Mi
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Yu Tian
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Jianning Zhang
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
| | - Rongcai Jiang
- Department of NeurosurgeryTianjin Neurological Institute, State Key Laboratory of Experimental Hematology, Key Laboratory of Post‐Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin & Ministry of Education, Tianjin Medical University General HospitalTianjinChina
- State Key Laboratory of Experimental HematologyTianjin Medical University General HospitalTianjinChina
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9
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Quilico EL, Wilkinson S, Bédard E, Duncan LR, Sweet SN, Swaine BR, Colantonio A. COVID-19's impact on a community-based physical activity program for adults with moderate-to-severe TBI. Disabil Rehabil 2024; 46:2014-2022. [PMID: 37184357 DOI: 10.1080/09638288.2023.2212180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE Physical activity (PA) is proposed for long-term problems after traumatic brain injury (TBI) with mood, quality of life, and participation. However, COVID-19 mitigation strategies resulted in widespread closures of community-based fitness centres, including one housing a peer-assisted PA program (TBI-Health). The purpose of this study was to provide an in-depth exploration of COVID-19's impact on the TBI-Health program for adults with moderate-to-severe TBI and determine how their PA behaviours could be supported in the pandemic. METHODS Interpretative phenomenological analysis was employed to collect and analyze data from semi-structured Zoom-facilitated interviews with seven female and nine male adults with moderate-to-severe TBI (including program participants and mentors). RESULTS Three major themes were identified. Need for PA after TBI included specific benefits of PA after TBI and desire for an adapted PA program. Lasting Impacts of the TBI-Health Program identified belonging to the TBI-Health community, benefits, and knowledge transfer from the program. Resilience and Loss through the Pandemic comprised the repercussions of COVID-19, loss of the PA program, adapting PA to the pandemic, and resilience after TBI. CONCLUSION This study provides insights about impacts of participating in community-based peer-assisted PA programs after moderate-to-severe TBI and ways to support PA in unforeseen circumstances.
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Affiliation(s)
- E L Quilico
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
- Applied Human Sciences, Concordia University, Montreal, Canada
| | - S Wilkinson
- Applied Human Sciences, Concordia University, Montreal, Canada
| | - E Bédard
- Kinesiology and Physical Education, McGill University, Montreal, Canada
| | - L R Duncan
- Kinesiology and Physical Education, McGill University, Montreal, Canada
| | - S N Sweet
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
- Kinesiology and Physical Education, McGill University, Montreal, Canada
| | - B R Swaine
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | - A Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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10
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Mamman R, Grewal J, Garrone JN, Schmidt J. Biopsychosocial factors of quality of life in individuals with moderate to severe traumatic brain injury: a scoping review. Qual Life Res 2024; 33:877-901. [PMID: 37925675 PMCID: PMC10972932 DOI: 10.1007/s11136-023-03511-0] [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] [Accepted: 08/24/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Individuals with moderate to severe traumatic brain injury (TBI) experience changes in their quality-of-life (QOL) post-injury. Given the vast literature that exists about QOL after TBI, a scoping review was performed to identify the different biopsychosocial factors that affect a person's QOL after a moderate to severe TBI. METHODS A scoping review was conducted using the following electronic databases: MEDLINE, CINAHL, Embase, and PsycINFO. Terms relating to TBI and QOL were used. RESULTS There were 7576 articles obtained from the databases, resulting in 535 full-text articles. Ultimately, 52 articles were extracted, which consisted of biopsychosocial QOL factors after TBI. The biopsychosocial factors of QOL after TBI included 19 biological factors (i.e., sex, TBI severity, cognition), 16 psychological factors (i.e., depression, self-efficacy, coping styles), and 19 social factors (i.e., employment, social participation, social support). Factors such as fatigue, self-awareness, transition, and discharge from hospitals are known issues in TBI literature but were minimally reported in studies in this review, identifying them as potential gaps in research. CONCLUSION Identifying biopsychosocial factors relating to QOL after TBI can enable health services to develop targeted rehabilitation programs for individuals with TBI.
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Affiliation(s)
- Rinni Mamman
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Jasleen Grewal
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | | | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada.
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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11
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McCabe C, Sica A, Doody N, Fortune DG. Self-awareness and quality of relationships after acquired brain injury: Systematic review without meta-analysis (SWiM). Neuropsychol Rehabil 2024; 34:335-361. [PMID: 36908086 DOI: 10.1080/09602011.2023.2186437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/25/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Relational aspects of self-awareness following Acquired Brain Injury (ABI) are increasingly being recognized. However, research underpinning the nature of the association between self-awareness and quality of relationships has yet to be synthesized. METHOD Searches, which were completed between February 2022 and February 2023, consisted of combining terms related to ABI, self-awareness, and quality of relationships. Data were analyzed using the Synthesis Without Meta-Analysis (SWiM) approach. RESULTS Associations between self-awareness and relationship quality across eight studies identified for this review differed in direction and significance. A more consistent pattern emerged, however, when studies assessing the quality of specific types of relationships i.e., spousal (N = 1) and therapeutic (N = 3), were compared to studies assessing the quality of a person's broader network of relationships (N = 4). In particular, good awareness was positively associated with the quality of specific relationships (r = 0.66) whereas it was negatively associated with the quality of a person's broader network of relationships (r = -0.35). CONCLUSION Results are discussed with consideration given to measures assessing the quality of specific relationships. In particular, such measures may tap into important patterns of interaction between two individuals, such as those related to attunement or communication, which may be valuable preconditions for improving awareness.
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Affiliation(s)
- Corinne McCabe
- Department of Psychology, University of Limerick, Co Limerick, Limerick, Ireland
| | - Andrea Sica
- Acquired Brain Injury Ireland, Dublin, Ireland
| | - Niamh Doody
- Department of Psychology, University of Limerick, Co Limerick, Limerick, Ireland
| | - Donal G Fortune
- Department of Psychology, University of Limerick, Co Limerick, Limerick, Ireland
- HSE CHO 3 Mid West, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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12
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Zhou Y, Yang H, You M, Feng Z, Dong X. Cognition-Enhancement Effect of Median Nerve Electrical Stimulation in Patients with Cognitive Impairment: A Retrospective Cohort Study. World Neurosurg 2024; 184:e537-e545. [PMID: 38320650 DOI: 10.1016/j.wneu.2024.01.165] [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: 01/25/2024] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE People with cognitive impairment often face quality-of-life problems and require ongoing support, which has profound consequences for caregivers and society. Noninvasive brain stimulation techniques, such as median nerve electrical stimulation (MNS), have shown promising potentials in improving cognitive ability in patients with cognitive impairment. Therefore, we aimed to investigate the positive effect and safety of MNS in cognitive impairment. METHODS Patients diagnosed with cognitive impairment from the hospital record management system of the First Affiliated Hospital of Nanchang University from April 1, 2020, to December 31, 2022, were enrolled. Data on patients' basic characteristics, treatment records, and examination results such as the Mini-Mental State Examination (MMSE), activities of daily living (ADL), and P300 event-related potentials before and after treatment were collected. RESULTS Overall, 146 patients with cognitive impairment were enrolled, including 71 patients who underwent conventional therapy (standard treatment group) and 75 patients who underwent conventional therapy and MNS operation (active MNS group). Before treatment, there were no differences between the standard treatment and active MNS groups in terms of age, sex, etiology, duration of symptoms before therapy, hospital stay, whether they had undergone surgery, MMSE score, ADL score, and amplitude and latency of the P300 event-related potentials (P > 0.05). After treatment, we observed significant improvements in the MMSE score, ADL score, amplitude of P300, and decreased latency of P300 event-related potentials in both groups compared with before treatment (P < 0.05). In addition, we observed that the active MNS group showed higher MMSE and ADL scores, higher amplitude of P300 event-related potentials, and lower latency of P300 event-related potentials than the standard treatment group after treatment (P < 0.05). Furthermore, no side effects were associated with MNS operation. CONCLUSIONS These preliminary data provide early evidence that MNS may be a positive effect and safe method for promoting the recovery of cognitive ability in patients with cognitive impairment.
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Affiliation(s)
- Yifan Zhou
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Haihua Yang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Mengyu You
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoyang Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
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13
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Stolwyk RJ, Mihaljcic T, Wong DK, Hernandez DR, Wolff B, Rogers JM. Post-stroke Cognition is Associated with Stroke Survivor Quality of Life and Caregiver Outcomes: A Systematic Review and Meta-analysis. Neuropsychol Rev 2024:10.1007/s11065-024-09635-5. [PMID: 38466357 DOI: 10.1007/s11065-024-09635-5] [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: 01/18/2022] [Accepted: 02/05/2024] [Indexed: 03/13/2024]
Abstract
Disability arising from post-stroke cognitive impairment is a likely contributor to the poor quality of life (QoL) stroke survivors and their carers frequently experience, but this has not been summarily quantified. A systematic literature review and meta-analysis was completed examining the association between general and domain-specific post-stroke cognitive functioning and adult stroke survivor QoL, caregiver QoL, and caregiver burden. Five databases were systematically searched, and eligibility for inclusion, data extraction, and study quality were evaluated by two reviewers using a standardised protocol. Effects sizes (r) were estimated using a random effects model. Thirty-eight studies were identified, generating a sample of 7365 stroke survivors (median age 63.02 years, range 25-93) followed for 3 to 132 months post-stroke. Overall cognition (all domains combined) demonstrated a significant small to medium association with QoL, r = 0.23 (95% CI 0.18-0.28), p < 0.001. The cognitive domains of speed, attention, visuospatial, memory, and executive skills, but not language, also demonstrated a significant relationship with QoL. Regarding caregiver outcomes, 15 studies were identified resulting in a sample of 2421 caregivers (median age 58.12 years, range 18-82) followed for 3 to 84 months post-stroke. Stroke survivor overall cognitive ability again demonstrated a significant small to medium association with caregiver outcomes (QoL and burden combined), r = 0.17 (95% CI 0.10-0.24), p < 0.001. In conclusion, lower post-stroke cognitive performance is associated with significant reductions in stroke survivor QoL and poorer caregiver outcomes. Cognitive assessment is recommended early to identify those at risk and implement timely interventions to support both stroke survivors and their caregivers.
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Affiliation(s)
- Renerus J Stolwyk
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Monash Clayton Campus, Melbourne, VIC, 3800, Australia.
| | - Tijana Mihaljcic
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Monash Clayton Campus, Melbourne, VIC, 3800, Australia
| | - Dana K Wong
- School of Psychology & Public Health, La Trobe University, Bundoora, Australia
| | - Diana Ramirez Hernandez
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Monash Clayton Campus, Melbourne, VIC, 3800, Australia
| | - Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia
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14
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Huerta de la Cruz S, Santiago-Castañeda C, Rodríguez-Palma EJ, Rocha L, Sancho M. Lateral fluid percussion injury: A rat model of experimental traumatic brain injury. Methods Cell Biol 2024; 185:197-224. [PMID: 38556449 DOI: 10.1016/bs.mcb.2024.02.011] [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] [Indexed: 04/02/2024]
Abstract
Traumatic brain injury (TBI) represents one of the leading causes of disability and death worldwide. The annual economic impact of TBI-including direct and indirect costs-is high, particularly impacting low- and middle-income countries. Despite extensive research, a comprehensive understanding of the primary and secondary TBI pathophysiology, followed by the development of promising therapeutic approaches, remains limited. These fundamental caveats in knowledge have motivated the development of various experimental models to explore the molecular mechanisms underpinning the pathogenesis of TBI. In this context, the Lateral Fluid Percussion Injury (LFPI) model produces a brain injury that mimics most of the neurological and systemic aspects observed in human TBI. Moreover, its high reproducibility makes the LFPI model one of the most widely used rodent-based TBI models. In this chapter, we provide a detailed surgical protocol of the LFPI model used to induce TBI in adult Wistar rats. We further highlight the neuroscore test as a valuable tool for the evaluation of TBI-induced sensorimotor consequences and their severity in rats. Lastly, we briefly summarize the current knowledge on the pathological aspects and functional outcomes observed in the LFPI-induced TBI model in rodents.
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Affiliation(s)
- Saúl Huerta de la Cruz
- Department of Pharmacology, University of Vermont, Burlington, VT, United States; Departamento de Farmacobiología, Cinvestav Sede Sur, Ciudad de México, México.
| | | | - Erick J Rodríguez-Palma
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, Sede Sur, Mexico City, Mexico
| | - Luisa Rocha
- Departamento de Farmacobiología, Cinvestav Sede Sur, Ciudad de México, México
| | - Maria Sancho
- Department of Pharmacology, University of Vermont, Burlington, VT, United States; Department of Physiology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
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15
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Markovic G, Bartfai A, Schult ML, Ekholm J. Rehabilitation with intensive attention training early after acquired brain injury promotes better long-term status on health-related quality of life, daily activities, work ability and return to work. J Rehabil Med 2024; 56:jrm5308. [PMID: 38214119 PMCID: PMC10802788 DOI: 10.2340/jrm.v56.5308] [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: 11/11/2022] [Accepted: 10/31/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To describe long-term effects on activity, participation, and quality of life (i) at different post-injury starting time points of attention training and (ii) of two different types of rehabilitation with attention training in patients after stroke or traumatic brain injury; and to describe their functioning level. DESIGN 2 years after rehabilitation intervention, comparisons were made in one cohort receiving attention training subacute (< 4 months) or post-acute (4-12 months) and in one cohort with two different training methods, a process-based and an activity-based method respectively. PATIENTS 100 patients were recruited from our earlier RCT study. They had mild to moderate stroke or traumatic brain injury with relatively limited symptomatology, and all had moderate to severe attention impairment. METHODS A questionnaire-based interview: EuroQol 5 dimensions, Occupational Gaps Questionnaire, Work Ability Index, self-assessed work status, self-reported employment conditions, sick leave, and experienced cognitive limitations in work performance. RESULTS An advantage for patients receiving subacute attention training regarding daily activities, work ability and returning to work. CONCLUSION The results indicate that subacute rehabilitation with attention training (< 4 months) is preferable compared to post-acute intervention (4-12 months). There were only minor differences between the training methods.
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Affiliation(s)
- Gabriela Markovic
- aKarolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden; Division of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden.
| | - Aniko Bartfai
- Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden; Division of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Marie-Louise Schult
- Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden; Division of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Jan Ekholm
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
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16
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Baker TL, Wright DK, Uboldi AD, Tonkin CJ, Vo A, Wilson T, McDonald SJ, Mychasiuk R, Semple BD, Sun M, Shultz SR. A pre-existing Toxoplasma gondii infection exacerbates the pathophysiological response and extent of brain damage after traumatic brain injury in mice. J Neuroinflammation 2024; 21:14. [PMID: 38195485 PMCID: PMC10775436 DOI: 10.1186/s12974-024-03014-w] [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: 10/21/2023] [Accepted: 01/04/2024] [Indexed: 01/11/2024] Open
Abstract
Traumatic brain injury (TBI) is a key contributor to global morbidity that lacks effective treatments. Microbial infections are common in TBI patients, and their presence could modify the physiological response to TBI. It is estimated that one-third of the human population is incurably infected with the feline-borne parasite, Toxoplasma gondii, which can invade the central nervous system and result in chronic low-grade neuroinflammation, oxidative stress, and excitotoxicity-all of which are also important pathophysiological processes in TBI. Considering the large number of TBI patients that have a pre-existing T. gondii infection prior to injury, and the potential mechanistic synergies between the conditions, this study investigated how a pre-existing T. gondii infection modified TBI outcomes across acute, sub-acute and chronic recovery in male and female mice. Gene expression analysis of brain tissue found that neuroinflammation and immune cell markers were amplified in the combined T. gondii + TBI setting in both males and females as early as 2-h post-injury. Glutamatergic, neurotoxic, and oxidative stress markers were altered in a sex-specific manner in T. gondii + TBI mice. Structural MRI found that male, but not female, T. gondii + TBI mice had a significantly larger lesion size compared to their uninfected counterparts at 18-weeks post-injury. Similarly, diffusion MRI revealed that T. gondii + TBI mice had exacerbated white matter tract abnormalities, particularly in male mice. These novel findings indicate that a pre-existing T. gondii infection affects the pathophysiological aftermath of TBI in a sex-dependent manner, and may be an important modifier to consider in the care and prognostication of TBI patients.
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Affiliation(s)
- Tamara L Baker
- Department of Neuroscience, Central Clinical School, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - David K Wright
- Department of Neuroscience, Central Clinical School, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Alessandro D Uboldi
- Division of Infectious Disease and Immune Defense, , The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Christopher J Tonkin
- Division of Infectious Disease and Immune Defense, , The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Anh Vo
- Monash Health Translation Precinct, Monash University, Melbourne, VIC, Australia
| | - Trevor Wilson
- Monash Health Translation Precinct, Monash University, Melbourne, VIC, Australia
| | - Stuart J McDonald
- Department of Neuroscience, Central Clinical School, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Central Clinical School, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Bridgette D Semple
- Department of Neuroscience, Central Clinical School, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Mujun Sun
- Department of Neuroscience, Central Clinical School, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Sandy R Shultz
- Department of Neuroscience, Central Clinical School, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
- Health Sciences, Vancouver Island University, Nanaimo, BC, Canada.
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17
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Domensino AF, Tas J, Donners B, Kooyman J, van der Horst ICC, Haeren R, Ariës MJH, van Heugten C. Long-Term Follow-Up of Critically Ill Patients With Traumatic Brain Injury: From Intensive Care Parameters to Patient and Caregiver-Reported Outcome. J Neurotrauma 2024; 41:123-134. [PMID: 37265152 DOI: 10.1089/neu.2022.0474] [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] [Indexed: 06/03/2023] Open
Abstract
Abstract Traumatic brain injury (TBI) is associated with a high social and financial burden due to persisting (severe) disabilities. The consequences of TBI after intensive care unit (ICU) admission are generally measured with global disability screeners such as the Glasgow Outcome Scale-Extended (GOSE), which may lack precision. To improve outcome measurement after brain injury, a comprehensive clinical outcome assessment tool called the Minimal Dataset for Acquired Brain Injury (MDS-ABI) was recently developed. The MDS-ABI covers 12 life domains (demographics, injury characteristics, comorbidity, cognitive functioning, emotional functioning, energy, mobility, self-care, communication, participation, social support, and quality of life), as well as informal caregiver capacity and strain. In this cross-sectional study, we used the MDS-ABI among formerly ICU admitted patients with TBI to explore the relationship between dichotomized severity of TBI and long-term outcome. Our objectives were to: 1) summarize demographics, clinical characteristics, and long-term outcomes of patients and their informal caregivers, and 2) compare differences between long-term outcomes in patients with mild-moderate TBI and severe TBI based on Glasgow Coma Scale (GCS) scores at admission. Participants were former patients of a Dutch university hospital (total n = 52; mild-moderate TBI n = 23; severe TBI n = 29) and their informal caregivers (n = 45). Hospital records were evaluated, and the MDS-ABI was administered during a home visit. On average 3.2 years after their TBI, 62% of the patients were cognitively impaired, 62% reported elevated fatigue, and 69% experienced restrictions in ≥2 participation domains (most frequently work or education and going out). Informal caregivers generally felt competent to provide necessary care (81%), but 31% experienced a disproportionate caregiver burden. All but four patients lived at home independently, often together with their informal caregiver (81%). Although the mild-moderate TBI group and the severe TBI group had significantly different clinical trajectories, there were no persisting differences between the groups for patient or caregiver outcomes at follow-up. As a large proportion of the patients experienced long-lasting consequences beyond global disability or independent living, clinicians should implement a multi-domain outcome set such as the MDS-AB to follow up on their patients.
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Affiliation(s)
- Anne-Fleur Domensino
- School for Mental Health and Neuroscience (MHeNS), Faculty of Psychology and Neuroscience (FPN), Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Centre, Maastricht, The Netherlands
| | - Jeanette Tas
- School for Mental Health and Neuroscience (MHeNS), Faculty of Psychology and Neuroscience (FPN), Maastricht University, Maastricht, The Netherlands
- Department of Intensive Care Medicine, Maastricht University, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Babette Donners
- Department of Intensive Care Medicine, Maastricht University, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Joyce Kooyman
- School for Mental Health and Neuroscience (MHeNS), Faculty of Psychology and Neuroscience (FPN), Maastricht University, Maastricht, The Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University, Maastricht University Medical Center+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Roel Haeren
- School for Mental Health and Neuroscience (MHeNS), Faculty of Psychology and Neuroscience (FPN), Maastricht University, Maastricht, The Netherlands
- Department of Neurosurgery, Maastricht University, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Marcel J H Ariës
- School for Mental Health and Neuroscience (MHeNS), Faculty of Psychology and Neuroscience (FPN), Maastricht University, Maastricht, The Netherlands
- Department of Intensive Care Medicine, Maastricht University, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Caroline van Heugten
- School for Mental Health and Neuroscience (MHeNS), Faculty of Psychology and Neuroscience (FPN), Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Centre, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience (FPN), Maastricht University, Maastricht, The Netherlands
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18
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Misiura VB, Ruban LA, Honcharov OH, Yefimenko PB, Litovchenko AV. The results of the corrective rehabilitation program on the gait of amateur athletes with long-term consequences of brain injury. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:233-240. [PMID: 38592983 DOI: 10.36740/wlek202402107] [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: 04/11/2024]
Abstract
OBJECTIVE Aim: To study the results of the quality of life, the state of vestibular disorders and the nature of walking of amateur athletes with the consequences of a combat craniocerebral injury after rehabilitation treatment according to a correctional program. PATIENTS AND METHODS Materials and Methods: The study was conducted on the basis of the Ukrainian Scientific Research Institute of Prosthetics in Kharkov. Under observation were 38 men aged 25-42 years with long-term consequences of a closed craniocerebral injury in the late long-term period. In all patients, complications after TBI were persistent headache, decreased muscle strength in the lower extremities, impaired coordination and balance, and walking patterns. All patients were involved in amateur sports before injury. The following research methods were used during the examination: visual analogue pain scale (VAS), Lovett manual muscle test, Bohannon test, ≪Timed Up and Go test≫. RESULTS Results: All patients were randomly divided into two groups. Patients Gr.1 (n=20) were trained according to the developed program, which included training according to the PNF method, kinesiotherapy, classes on the C-mill sensory treadmill and the Hunova computer device, segmental reflex massage. Patients Gr. 2 (n=18) underwent a course of physical rehabilitation according to the generally accepted methodology of the Ministry of Health of Ukraine. After working with patients according to the developed correction and rehabilitation program, the following dynamics were observed: the quality of life on the VAS scale in Gr.1 patients had a statistically significant difference (p<0.05) compared to the primary indicator. The dynamics of the Lovett manual muscle test indicated an increase in the muscle strength of the extensor and flexor muscle groups of the lower extremities, the dynamics of the balance indicator in the standing position behind Bohann in all Gr.1 patients and acquired statistical significance (p<0,05). According to the test "Timed Up and Go" patients Gr.1 approached the standard value (p<0,05). In all patients of Gr. 2, the studied characteristics had a positive trend (p>0,05). CONCLUSION Conclusions: Individual selection of physical exercises, development of correctional and rehabilitation programs, multidisciplinary approach has a positive impact on changes in the functional state of amateur athletes, quality of life and contributes to the return to an active social life.
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Affiliation(s)
| | - Larysa A Ruban
- KHARKIV STATE ACADEMY OF PHYSICAL CULTURE, KHARKIV, UKRAINE
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19
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Soltani A, Chugaeva UY, Ramadan MF, Saleh EAM, Al-Hasnawi SS, Romero-Parra RM, Alsaalamy A, Mustafa YF, Zamanian MY, Golmohammadi M. A narrative review of the effects of dexamethasone on traumatic brain injury in clinical and animal studies: focusing on inflammation. Inflammopharmacology 2023; 31:2955-2971. [PMID: 37843641 DOI: 10.1007/s10787-023-01361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
Traumatic brain injury (TBI) is a type of brain injury resulting from a sudden physical force to the head. TBI can range from mild, such as a concussion, to severe, which might result in long-term complications or even death. The initial impact or primary injury to the brain is followed by neuroinflammation, excitotoxicity, and oxidative stress, which are the hallmarks of the secondary injury phase, that can further damage the brain tissue. Dexamethasone (DXM) has neuroprotective effects. It reduces neuroinflammation, a critical factor in secondary injury-associated neuronal damage. DXM can also suppress the microglia activation and infiltrated macrophages, which are responsible for producing pro-inflammatory cytokines that contribute to neuroinflammation. Considering the outcomes of this research, some of the effects of DXM on TBI include: (1) DXM-loaded hydrogels reduce apoptosis, neuroinflammation, and lesion volume and improves neuronal cell survival and motor performance, (2) DXM treatment elevates the levels of Ndufs2, Gria3, MAOB, and Ndufv2 in the hippocampus following TBI, (3) DXM decreases the quantity of circulating endothelial progenitor cells, (4) DXM reduces the expression of IL1, (5) DXM suppresses the infiltration of RhoA + cells into primary lesions of TBI and (6) DXM treatment led to an increase in fractional anisotropy values and a decrease in apparent diffusion coefficient values, indicating improved white matter integrity. According to the study, the findings show that DXM treatment has neuroprotective effects in TBI. This indicates that DXM is a promising therapeutic approach to treating TBI.
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Affiliation(s)
- Afsaneh Soltani
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Uliana Y Chugaeva
- Department of Pediatric, Preventive Dentistry and Orthodontics, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - Ebraheem Abdu Musad Saleh
- Department of Chemistry, Prince Sattam Bin Abdulaziz University, College of Arts and Science, 11991, Wadi Al-Dawasir, Saudi Arabia
| | | | | | - Ali Alsaalamy
- College of Technical Engineering, Imam Ja'afar Al-Sadiq University, Al-Muthanna, 66002, Iraq
| | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, 41001, Iraq
| | - Mohammad Yasin Zamanian
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, 6718773654, Iran.
- Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, 6718773654, Iran.
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, 6718773654, Iran.
| | - Maryam Golmohammadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Cherup NP, Robayo LE, Vastano R, Fleming L, Levin BE, Widerström-Noga E. Neuropsychological Function in Traumatic Brain Injury and the Influence of Chronic Pain. Percept Mot Skills 2023; 130:1495-1523. [PMID: 37219529 DOI: 10.1177/00315125231174082] [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] [Indexed: 05/24/2023]
Abstract
Cognitive dysfunction, pain, and psychological morbidity all present unique challenges to those living with traumatic brain injury (TBI). In this study we examined (a) the impact of pain across domains of attention, memory, and executive function, and (b) the relationships between pain and depression, anxiety, and post-traumatic stress disorder (PTSD) in persons with chronic TBI. Our sample included 86 participants with a TBI and chronic pain (n = 26), patients with TBI and no chronic pain (n = 23), and a pain-free control group without TBI (n = 37). Participants visited the laboratory and completed a comprehensive battery of neuropsychological tests as part of a structured interview. Multivariate analysis of covariance using education as a covariate, failed to detect a significant group difference for neuropsychological composite scores of attention, memory, and executive function (p = .165). A follow-up analysis using multiple one-way analysis of variance (ANOVA) was conducted for individual measures of executive function. Post-hoc testing indicated that those in both TBI groups preformed significantly worse on measures of semantic fluency when compared to controls (p < 0.001, ηρ2 = .16). Additionally, multiple ANOVAs indicated that those with TBI and pain scored significantly worse across all psychological assessments (p < .001). We also found significant associations between measures of pain and most psychological symptoms. A follow-up stepwise linear regression among those in the TBI pain group indicated that post concussive complaints, pain severity, and neuropathic pain symptoms differentially contributed to symptoms of depression, anxiety, and PTSD. These findings suggest deficits in verbal fluency among those living with chronic TBI, with results also reinforcing the multidimensional nature of pain and its psychological significance in this population.
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Affiliation(s)
- Nicholas P Cherup
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Linda E Robayo
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Roberta Vastano
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Loriann Fleming
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
| | - Bonnie E Levin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eva Widerström-Noga
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Project to Cure Paralysis, UHealth/Jackson Memorial, Miami, FL, USA
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
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21
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Sibilia F, Custer RM, Irimia A, Sepehrband F, Toga AW, Cabeen RP. Life After Mild Traumatic Brain Injury: Widespread Structural Brain Changes Associated With Psychological Distress Revealed With Multimodal Magnetic Resonance Imaging. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:374-385. [PMID: 37519474 PMCID: PMC10382710 DOI: 10.1016/j.bpsgos.2022.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 01/01/2023] Open
Abstract
Background Traumatic brain injury (TBI) can alter brain structure and lead to onset of persistent neuropsychological symptoms. This study investigates the relationship between brain injury and psychological distress after mild TBI using multimodal magnetic resonance imaging. Methods A total of 89 patients with mild TBI from the TRACK-TBI (Transforming Research and Clinical Knowledge in Traumatic Brain Injury) pilot study were included. Subscales of the Brief Symptoms Inventory 18 for depression, anxiety, and somatization were used as outcome measures of psychological distress approximately 6 months after the traumatic event. Glasgow Coma Scale scores were used to evaluate recovery. Magnetic resonance imaging data were acquired within 2 weeks after injury. Perivascular spaces (PVSs) were segmented using an enhanced PVS segmentation method, and the volume fraction was calculated for the whole brain and white matter regions. Cortical thickness and gray matter structures volumes were calculated in FreeSurfer; diffusion imaging indices and multifiber tracts were extracted using the Quantitative Imaging Toolkit. The analysis was performed considering age, sex, intracranial volume, educational attainment, and improvement level upon discharge as covariates. Results PVS fractions in the posterior cingulate, fusiform, and postcentral areas were found to be associated with somatization symptoms. Depression, anxiety, and somatization symptoms were associated with the cortical thickness of the frontal-opercularis and occipital pole, putamen and amygdala volumes, and corticospinal tract and superior thalamic radiation. Analyses were also performed on the two hemispheres separately to explore lateralization. Conclusions This study shows how PVS, cortical, and microstructural changes can predict the onset of depression, anxiety, and somatization symptoms in patients with mild TBI.
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Affiliation(s)
- Francesca Sibilia
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Rachel M. Custer
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California
| | - Farshid Sepehrband
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Ryan P. Cabeen
- Laboratory of Neuro Imaging, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
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Torregrossa W, Raciti L, Rifici C, Rizzo G, Raciti G, Casella C, Naro A, Calabrò RS. Behavioral and Psychiatric Symptoms in Patients with Severe Traumatic Brain Injury: A Comprehensive Overview. Biomedicines 2023; 11:biomedicines11051449. [PMID: 37239120 DOI: 10.3390/biomedicines11051449] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Traumatic brain injury (TBI) is defined as an altered brain structure or function produced by an external force. Adults surviving moderate and severe TBI often experience long-lasting neuropsychological and neuropsychiatric disorders (NPS). NPS can occur as primary psychiatric complications or could be an exacerbation of pre-existing compensated conditions. It has been shown that changes in behavior following moderate to severe TBI have a prevalence rate of 25-88%, depending on the methodology used by the different studies. Most of current literature has found that cognitive behavioral and emotional deficit following TBI occurs within the first six months whereas after 1-2 years the condition becomes stable. Identifying the risk factors for poor outcome is the first step to reduce the sequelae. Patients with TBI have an adjusted relative risk of developing any NPS several-fold higher than in the general population after six months of moderate-severe TBI. All NPS features of an individual's life, including social, working, and familiar relationships, may be affected by the injury, with negative consequences on quality of life. This overview aims to investigate the most frequent psychiatric, behavioral, and emotional symptoms in patients suffering from TBI as to improve the clinical practice and tailor a more specific rehabilitation training.
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Affiliation(s)
- William Torregrossa
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Loredana Raciti
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Carmela Rifici
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Giuseppina Rizzo
- Azienda Ospedaliera Universitaria (AOU) Policlinico G. Martino, Via Consolare Valeria, 1, 98124 Messina, Italy
| | - Gianfranco Raciti
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
| | - Carmela Casella
- Azienda Ospedaliera Universitaria (AOU) Policlinico G. Martino, Via Consolare Valeria, 1, 98124 Messina, Italy
| | - Antonino Naro
- Azienda Ospedaliera Universitaria (AOU) Policlinico G. Martino, Via Consolare Valeria, 1, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino Pulejo, Via Palermo S.S. 113 C.da Casazza, 98124 Messina, Italy
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23
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Peng YY, Lu XM, Li S, Tang C, Ding Y, Wang HY, Yang C, Wang YT. Effects and mechanisms of extremely cold environment on body response after trauma. J Therm Biol 2023; 114:103570. [PMID: 37344028 DOI: 10.1016/j.jtherbio.2023.103570] [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: 11/21/2022] [Revised: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 06/23/2023]
Abstract
With the outbreak of the Ukrainian crisis, extremely cold environment warfare has once again become the focus of international attention. People exposed to extremely cold environments may suffer from cold damage, further aggravate trauma, trigger high disability and mortality rates, and even cause serious sequelae. To declare the effects and mechanisms of the extremely cold environment on the body after trauma, this paper reviews, firstly, physiological reaction of human body in an extremely cold environment. Then, the post-traumatic body response in an extremely cold environment was introduced, and finally, the sequelae of trauma in extremely cold environment was further summarized in the paper. The results indicated that extremely cold environment can cause a series of damage to the body, especially the body after trauma. The extremely cold factor is a double-edged sword, showing a favorable and unfavorable side in different aspects. Moreover, in addition to the trauma suffered by the body, the subsequent sequelae such as cognitive dysfunction, anxiety, depression and even post-traumatic stress disorder may also be induced. The paper summarizes the human body's physiological response in an extremely cold environment, and declares the effects and mechanisms of the extremely cold environment on the body after trauma, which may provide a theoretical basis for effectively improving the level of combat trauma treatment in extremely cold regions.
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Affiliation(s)
- Yu-Yuan Peng
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China; College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Xiu-Min Lu
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Sen Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Can Tang
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Yang Ding
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Hai-Yan Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Ce Yang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yong-Tang Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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24
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Del Giovane M, Trender WR, Bălăeţ M, Mallas EJ, Jolly AE, Bourke NJ, Zimmermann K, Graham NS, Lai H, Losty EJ, Oiarbide GA, Hellyer PJ, Faiman I, Daniels SJ, Batey P, Harrison M, Giunchiglia V, Kolanko MA, David MC, Li LM, Demarchi C, Friedland D, Sharp DJ, Hampshire A. Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales. EClinicalMedicine 2023; 59:101980. [PMID: 37152359 PMCID: PMC10154960 DOI: 10.1016/j.eclinm.2023.101980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 05/09/2023] Open
Abstract
Background Online technology could potentially revolutionise how patients are cognitively assessed and monitored. However, it remains unclear whether assessments conducted remotely can match established pen-and-paper neuropsychological tests in terms of sensitivity and specificity. Methods This observational study aimed to optimise an online cognitive assessment for use in traumatic brain injury (TBI) clinics. The tertiary referral clinic in which this tool has been clinically implemented typically sees patients a minimum of 6 months post-injury in the chronic phase. Between March and August 2019, we conducted a cross-group, cross-device and factor analyses at the St. Mary's Hospital TBI clinic and major trauma wards at Imperial College NHS trust and St. George's Hospital in London (UK), to identify a battery of tasks that assess aspects of cognition affected by TBI. Between September 2019 and February 2020, we evaluated the online battery against standard face-to-face neuropsychological tests at the Imperial College London research centre. Canonical Correlation Analysis (CCA) determined the shared variance between the online battery and standard neuropsychological tests. Finally, between October 2020 and December 2021, the tests were integrated into a framework that automatically generates a results report where patients' performance is compared to a large normative dataset. We piloted this as a practical tool to be used under supervised and unsupervised conditions at the St. Mary's Hospital TBI clinic in London (UK). Findings The online assessment discriminated processing-speed, visual-attention, working-memory, and executive-function deficits in TBI. CCA identified two significant modes indicating shared variance with standard neuropsychological tests (r = 0.86, p < 0.001 and r = 0.81, p = 0.02). Sensitivity to cognitive deficits after TBI was evident in the TBI clinic setting under supervised and unsupervised conditions (F (15,555) = 3.99; p < 0.001). Interpretation Online cognitive assessment of TBI patients is feasible, sensitive, and efficient. When combined with normative sociodemographic models and autogenerated reports, it has the potential to transform cognitive assessment in the healthcare setting. Funding This work was funded by a National Institute for Health Research (NIHR) Invention for Innovation (i4i) grant awarded to DJS and AH (II-LB-0715-20006).
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Affiliation(s)
- Martina Del Giovane
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - William R. Trender
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Maria Bălăeţ
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Emma-Jane Mallas
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Amy E. Jolly
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, Queen Square, WC1N 3BG, London, United Kingdom
| | - Niall J. Bourke
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AB, London, United Kingdom
| | - Karl Zimmermann
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Neil S.N. Graham
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Helen Lai
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Ethan J.F. Losty
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Garazi Araña Oiarbide
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Peter J. Hellyer
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, SE5 8AF, London, United Kingdom
| | - Irene Faiman
- Clinical Neuropsychology Service, St George's University Hospital NHS Foundation Trust, Blackshaw Road, SW17 0QT, London, United Kingdom
| | - Sarah J.C. Daniels
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Philippa Batey
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- The Helix Centre, Imperial College London, and the Royal College of Arts, St. Mary’s Hospital, 3rd Floor Paterson Building, 20 South Wharf Road, Paddington, W2 1PE, London, United Kingdom
| | - Matthew Harrison
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- The Helix Centre, Imperial College London, and the Royal College of Arts, St. Mary’s Hospital, 3rd Floor Paterson Building, 20 South Wharf Road, Paddington, W2 1PE, London, United Kingdom
| | - Valentina Giunchiglia
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Magdalena A. Kolanko
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Michael C.B. David
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Lucia M. Li
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Célia Demarchi
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Daniel Friedland
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - David J. Sharp
- UK Dementia Research Institute, Care Research & Technology Centre, Imperial College and the University of Surrey, 9th Floor, Sir Michael Uren Hub, 86 Wood Ln, W12 0BZ, London, United Kingdom
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, United Kingdom. Burlington Danes, The Hammersmith Hospital, Du Cane Road, W12 0NN, London, United Kingdom
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Verhulst MMLH, Glimmerveen AB, van Heugten CM, Helmich RCG, Hofmeijer J. MRI factors associated with cognitive functioning after acute onset brain injury: Systematic review and meta-analysis. Neuroimage Clin 2023; 38:103415. [PMID: 37119695 PMCID: PMC10165272 DOI: 10.1016/j.nicl.2023.103415] [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: 01/13/2023] [Revised: 03/22/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023]
Abstract
Impairments of memory, attention, and executive functioning are frequently reported after acute onset brain injury. MRI markers hold potential to contribute to identification of patients at risk for cognitive impairments and clarification of mechanisms. The aim of this systematic review was to summarize and value the evidence on MRI markers of memory, attention, and executive functioning after acute onset brain injury. We included ninety-eight studies, on six classes of MRI factors (location and severity of damage (n = 15), volume/atrophy (n = 36), signs of small vessel disease (n = 15), diffusion-weighted imaging measures (n = 36), resting-state functional MRI measures (n = 13), and arterial spin labeling measures (n = 1)). Three measures showed consistent results regarding their association with cognition. Smaller hippocampal volume was associated with worse memory in fourteen studies (pooled correlation 0.58 [95% CI: 0.46-0.68] for whole, 0.11 [95% CI: 0.04-0.19] for left, and 0.34 [95% CI: 0.17-0.49] for right hippocampus). Lower fractional anisotropy in cingulum and fornix was associated with worse memory in six and five studies (pooled correlation 0.20 [95% CI: 0.08-0.32] and 0.29 [95% CI: 0.20-0.37], respectively). Lower functional connectivity within the default-mode network was associated with worse cognition in four studies. In conclusion, hippocampal volume, fractional anisotropy in cingulum and fornix, and functional connectivity within the default-mode network showed consistent associations with cognitive performance in all types of acute onset brain injury. External validation and cut off values for predicting cognitive impairments are needed for clinical implementation.
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Affiliation(s)
- Marlous M L H Verhulst
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands.
| | - Astrid B Glimmerveen
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands; Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rick C G Helmich
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands; Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jeannette Hofmeijer
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
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Zhang J, Xu X, Zhang X, Yin Y, Wang J. Self-perceived care needs and quality of life in people with cognitive impairment during routine care at home: cross-sectional results of the interventional study. BMC Geriatr 2023; 23:185. [PMID: 36991348 PMCID: PMC10061730 DOI: 10.1186/s12877-023-03846-w] [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] [Received: 07/30/2022] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Cognitive impairment (CI) is one of the most common disabling symptoms in the elderly, and people with CI face a variety of unmet care needs. There is limited evidence on the relationship between unmet needs and quality of life (QoL) of people with CI. The aim of this study is to analyse the current situation of unmet needs and QoL among people with CI, and to explore the correlation between QoL and unmet needs. METHODS The analyses use baseline data of the intervention trial, which recruited 378 participants to complete the questionnaire including the Camberwell Assessment of Need for the Elderly (CANE), and the Medical Outcomes Study 36-item Short-Form (SF-36). The SF-36 was further gathered into physical component summary (PCS) and mental component summary (MCS). Multiple linear regression analysis was conducted to explore the correlations between unmet care needs and PCS and MCS of SF-36. RESULTS The mean score of each of the eight domains of SF-36 was significantly lower than the Chinese population norm. The incidence of unmet needs ranged from 0 to 65.1%. Multiple linear regression results showed that living in rural areas (Beta=-0.16, P < 0.001), having unmet physical needs (Beta=-0.35, P < 0.001), and unmet psychological needs (Beta=-0.24, P < 0.001) were associated with lower PCS scores, whereas duration of CI > 2 years (Beta=-0.21, P < 0.001), unmet environmental needs (Beta=-0.20, P < 0.001), and unmet psychological needs (Beta=-0.15, P < 0.001) were associated with lower MCS scores. CONCLUSION The main results support the important view that lower QoL scores are associated with unmet needs in people with CI, depending on the domain. Given that the more unmet needs can further worsen QoL, it is recommended that more strategies should be taken, especially for those with unmet care needs, so as to improve their QoL.
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Affiliation(s)
- Juxia Zhang
- Clinical Educational Department, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China
| | - Xiaoqin Xu
- Neurology Department, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China
| | - Xiaoli Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China
| | - Yuhuan Yin
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China
| | - Jiancheng Wang
- Geriatrics Department, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, China.
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Da Costa IGR, Brugnaro BH, Lima CRG, Kraus de Camargo O, Fumincelli L, Pavão SL, Rocha NACF. Perceived Social Support and Quality of Life of Children with and without Developmental Disabilities and Their Caregivers during the COVID-19 Pandemic in Brazil: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4449. [PMID: 36901463 PMCID: PMC10001514 DOI: 10.3390/ijerph20054449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Social support and Quality of life (QoL) are important aspects of life and should be explored during the specific scenario of the pandemic. AIMS (i) to compare the perceived social support (PSS) in caregivers and the domains of QoL of the caregiver and the child with developmental disabilities (DD) and typical development (TD); (ii) to verify the existence of the association, in each group, between the PSS, and the domain of QoL of the caregiver and the child. METHODS AND PROCEDURES 52 caregivers of children with DD and 34 with TD participated remotely. We assessed PSS (Social Support Scale), children's QoL (PedsQL-4.0-parent proxy) and caregivers' QoL (PedsQL-Family Impact Module). The groups were compared for the outcomes using the Mann-Whitney test, and Spearman's test evaluated the correlation between the PSS and the QoL (child and caregiver) in each of the groups. OUTCOMES AND RESULTS There was no difference between groups for PSS. Children with DD presented lower values in PedsQL total, psychosocial health, physical health, social activities, and school activity. Caregivers of children with TD presented lower values in PedsQL family total, physical capacity, emotional aspect, social aspect, daily activities, and higher value in communication. In the DD group, we found a positive relationship between PSS with child: Psychosocial Health (r = 0.350) and Emotional Aspect (r = 0.380), and with family: Total (r = 0.562), Physical Capacity (r = 0.402), Emotional Aspect (r = 0.492), Social Aspect (r = 0.606), Communication (r = 0.535), Concern (r = 0.303), Daily Activities (r = 0.394) and Family Relationships (r = 0.369). In the TD group, we found that PSS was positively associated with Family: Social Aspect (r = 0.472) and Communication (r = 0.431). CONCLUSIONS AND IMPLICATIONS During the COVID-19 pandemic, despite both groups presenting similar PSS, there are important differences in QoL between them. For both groups, greater levels of perceived social support are associated with greater caregiver-reported in some domains of the child's and caregiver's QoL. These associations are more numerous, especially for the families of children with DD. This study provides a unique view into the relationships between perceived social support and QoL during the "natural experiment" of living through a pandemic.
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Affiliation(s)
- Isabelle Gansella Rocha Da Costa
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Beatriz Helena Brugnaro
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Camila Resende Gâmbaro Lima
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Olaf Kraus de Camargo
- CanChild, Department of Pediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Lais Fumincelli
- Department of Nursing, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Silvia Letícia Pavão
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná (UFPR), Curitiba 80060-000, PR, Brazil
| | - Nelci Adriana Cicuto Ferreira Rocha
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
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Kiwanuka O, Lassarén P, Thelin EP, Hånell A, Sandblom G, Fagerdahl A, Boström L. Long-term health-related quality of life after trauma with and without traumatic brain injury: a prospective cohort study. Sci Rep 2023; 13:2986. [PMID: 36805021 PMCID: PMC9941121 DOI: 10.1038/s41598-023-30082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
To purpose was to assess and compare the health-related quality of life (HRQoL) and risk of depression two years after trauma, between patients with and without traumatic brain injury (TBI) in a mixed Swedish trauma cohort. In this prospective cohort study, TBI and non-TBI trauma patients included in the Swedish Trauma registry 2019 at a level II trauma center in Stockholm, Sweden, were contacted two years after admission. HRQoL was assessed with RAND-36 and EQ-5D-3L, and depression with Montgomery Åsberg depression Rating Scale self-report (MADRS-S). Abbreviated Injury Score (AIS) head was used to grade TBI severity, and American Society of Anesthesiologists (ASA) score was used to assess comorbidities. Data were compared using Chi-squared test, Mann Whitney U test and ordered logistic regression, and Bonferroni correction was applied. A total of 170 of 737 eligible patients were included. TBI was associated with higher scores in 5/8 domains of RAND-36 and 3/5 domains of EQ-5D (p < 0.05). No significant difference in MADRS-S. An AIS (head) of three or higher was associated with lower scores in five domains of RAND-36 and two domains of EQ-5D but not for MADRS-S. An ASA-score of three was associated with lower scores in all domains of both RAND-36 (p < 0.05, except mental health) and EQ-5D (p < 0.001, except anxiety/depression), but not for MADRS-S. In conclusion, patients without TBI reported a lower HRQoL than TBI patients two years after trauma. TBI severity assessed according to AIS (head) was associated with HRQoL, and ASA-score was found to be a predictor of HRQoL, emphasizing the importance of considering pre-injury health status when assessing outcomes in TBI patients.
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Affiliation(s)
- Olivia Kiwanuka
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. .,Department of Surgery, Södersjukhuset, Stockholm, Sweden.
| | - Philipp Lassarén
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Eric P. Thelin
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Hånell
- grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Gabriel Sandblom
- grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Ami Fagerdahl
- grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Lennart Boström
- grid.416648.90000 0000 8986 2221Department of Surgery, Södersjukhuset, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
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Bloch A, Shany-Ur T, Sharoni L, Bar-Lev N, Salomon-Shushan T, Maril S, Druckman E, Hoofien D. Time from injury and age interact in relationship with perceived quality of life outcomes following vocation-focused neuropsychological rehabilitation. Front Psychol 2023; 14:1047615. [PMID: 36844267 PMCID: PMC9950548 DOI: 10.3389/fpsyg.2023.1047615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/19/2023] [Indexed: 02/12/2023] Open
Abstract
At the group level, community-based neuropsychological rehabilitation interventions with a vocational focus are generally effective among individuals with brain injuries. However, individual participants vary significantly in the extent of their improvement, prompting attempts to elucidate individual, injury-related, and environmental factors affecting prognosis. In this study, we examined the relationships between one such factor - "time from injury" (the time between injury and intervention) - and two outcome measures: employment status and perceived quality of life (PQoL), in 157 brain injury survivors, before and after a holistic neuropsychological vocational rehabilitation program. We also examined whether relationships between the variables were moderated by age at onset of treatment and injury severity. In the entire sample, both the proportion of employed participants and average PQoL increased following program participation. Neither, time from injury, severity, nor age at onset of treatment predicted the increase in employment proportion, and severity was not a significant predictor of PQoL. However, an interactive effect indicated that when treatment was started at a younger age, longer time from injury predicted higher levels of PQoL, but when treatment was started at older ages, longer time from injury predicted lower levels of PQoL. When interpreted alongside existing literature, these results suggest that delaying vocational components of rehabilitation can be beneficial for younger participants, while the effectiveness of vocational rehabilitation can be maximized by starting as early as possible among older participants. Most importantly, regardless of age, it appears that vocational rehabilitation can be effective even when initiated many years after injury.
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Affiliation(s)
- Ayala Bloch
- Department of Psychology, Ariel University, Ariel, Israel,The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel,*Correspondence: Ayala Bloch, ✉
| | - Tal Shany-Ur
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel,Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Limor Sharoni
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel
| | - Narkis Bar-Lev
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel
| | | | - Sari Maril
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel
| | - Eran Druckman
- Druckman Research and Statistics Lab, Rishon Lezion, Israel
| | - Dan Hoofien
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel,The School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
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Update on the Efficacy of Cognitive Rehabilitation After Moderate to Severe Traumatic Brain Injury: A Scoping Review. Arch Phys Med Rehabil 2023; 104:315-330. [PMID: 35921874 DOI: 10.1016/j.apmr.2022.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To identify, categorize, and analyze the methodological issues of cognitive rehabilitation of patients with moderate to severe traumatic brain injury and its efficacy. DATA SOURCES Pubmed and PsycINFO were searched for studies published between 2015 and 2021 using keywords for cognitive intervention and traumatic brain injury. STUDY SELECTION Two independent reviewers selected articles concerning cognitive rehabilitation for adults with traumatic brain injury. Of 458 studies, 97 full-text articles were assessed and 46 met the inclusion criteria. DATA EXTRACTION Data were analyzed by 1 reviewer according to criteria concerning the methodological quality of studies. DATA SYNTHESIS Results showed a large scope of 7 cognitive domains targeted by interventions, delivered mostly in individual sessions (83%) with an integrative cognitive approach (48%). Neuroimaging tools as a measure of outcome remained scarce, featuring in only 20% of studies. Forty-three studies reported significant effects of cognitive rehabilitation, among which 7 fulfilled a high methodological level of evidence. CONCLUSIONS Advances and shortcomings in cognitive rehabilitation have both been highlighted and led us to develop methodological key points for future studies. The choice of outcome measures, the selection of control interventions, and the use of combined rehabilitation should be investigated in further studies.
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31
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Chang CW, Tzeng HY, Ma CY, Li ST, Chen KJ, Chiang HH. Effectiveness of exercise in improving quality of life in patients with traumatic brain injury: A systematic review and meta-analysis. Brain Inj 2023; 37:140-146. [PMID: 36625006 DOI: 10.1080/02699052.2023.2165155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a major cause of disability and mortality worldwide. People with TBI exhibit poor quality of life (QOL). Exercise is considered a possible intervention for improving cognitive function and mood, helping improve QOL in patients with TBI. According to our review of the relevant literature, meta-analyses have yet to explore the effect of exercise on QOL in patients with TBI. OBJECTIVES To determine by meta-analysis of relevant studies whether physical exercise could promote QOL in patients with TBI. METHODS A systematic review and meta-analysis of intervention studies involving physical exercise for improving QOL outcomes in TBI populations were conducted according to the PRISMA guideline. Our inclusion criteria were as follows: being randomized or nonrandomized controlled trials with quantitative designs that included patients diagnosed with TBI. RESULTS Thus, six studies met the inclusion criteria. The interventions in four of the six studies had statistically significant effects on QOL improvement. Our meta-analysis revealed a moderate effect size of physical exercise on QOL promotion in patients with TBI. CONCLUSION For TBI, exercise seems to improve QOL. More research with long-term follow-up should be conducted to assess the effect of exercise on patients with TBI.
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Affiliation(s)
- Chia-Wen Chang
- Department of Nursing, Taoyuan Armed Forces, Taoyuan General Hospital, Taoyuan, Taiwan
| | - Hsin-Ya Tzeng
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Ching-Yuan Ma
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Shih-Ting Li
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Kuan-Jung Chen
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Hui-Hsun Chiang
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
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32
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Mohammed FS, Omay SB, Sheth KN, Zhou J. Nanoparticle-based drug delivery for the treatment of traumatic brain injury. Expert Opin Drug Deliv 2023; 20:55-73. [PMID: 36420918 PMCID: PMC9983310 DOI: 10.1080/17425247.2023.2152001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/10/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Traumatic brain injuries (TBIs) impact the breadth of society and remain without any approved pharmacological treatments. Despite successful Phase II clinical trials, the failure of many Phase III clinical trials may be explained by insufficient drug targeting and retention, preventing the proper attainment of an observable dosage threshold. To address this challenge, nanoparticles can be functionalized to protect pharmacological payloads, improve targeted drug delivery to sites of injury, and can be combined with supportive scaffolding to improve secondary outcomes. AREAS COVERED This review briefly covers the pathophysiology of TBIs and their subtypes, the current pre-clinical and clinical management strategies, explores the common models of focal, diffuse, and mixed traumatic brain injury employed in experimental animals, and surveys the existing literature on nanoparticles developed to treat TBIs. EXPERT OPINION Nanoparticles are well suited to improve secondary outcomes as their multifunctionality and customizability enhance their potential for efficient targeted delivery, payload protection, increased brain penetration, low off-target toxicity, and biocompatibility in both acute and chronic timescales.
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Affiliation(s)
- Farrah S. Mohammed
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA
| | - Sacit Bulent Omay
- Department of Neurosurgery, Yale University, New Haven, Connecticut, USA
| | - Kevin N. Sheth
- Department of Neurosurgery, Yale University, New Haven, Connecticut, USA
- Department of Neurology, Yale University, New Haven, Connecticut, USA
| | - Jiangbing Zhou
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA
- Department of Neurosurgery, Yale University, New Haven, Connecticut, USA
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Iverson GL, Iverson IA. Perceived cognitive impairment in high school students in the United States. Front Psychol 2022; 13:1019159. [PMID: 36267070 PMCID: PMC9577466 DOI: 10.3389/fpsyg.2022.1019159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Some youth experience cognitive difficulties that interfere with their ability to learn and function well in a school environment. We examined correlates of perceived cognitive impairment among high school students who completed a national survey conducted by the United States Centers for Disease Control and Prevention (CDC) in 2019. Methods Participants were high school students (grades 9–12) who completed the Youth Risk Behavior Survey (YRBS) in 2019. The CDC uses this survey to monitor risk behaviors. Students answered the following question ‘Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?’ as either ‘yes’ or ‘no.’ Student responses to this question were analyzed in relation to demographic variables and variables pertaining to adversity, mental health problems, and drug use. Results The sample included 8,349 students between the ages of 14 and 18, with 4,093 boys (49%) and 4,256 girls (51%). A large proportion reported having serious difficulty concentrating, remembering, or making decisions due to physical, mental, or emotional problems (38%). A significantly larger proportion of girls (45%) than boys (30%) reported experiencing cognitive impairment [χ2(1) = 212.23, p < 0.001; Odds Ratio = 1.95, 95% confidence interval = 1.78–2.13]. Youth who exercised regularly were significantly less likely to report cognitive impairment. Binary logistic regression was used to examine the associations between perceived cognitive impairment and adversity, mental health, and lifestyle variables separately for boys [χ2(11) = 569.158, p < 0.001; Nagelkerke R2 = 0.212] and girls [χ2(11) = 1,026.189, p < 0.001; Nagelkerke R2 = 0.321]. Being bullied, feeling unsafe or threatened at school, getting very low grades, insufficient sleep, and using illicit drugs were independently associated with perceived cognitive impairment in both boys and girls—after controlling for associations with depression and suicidality. Youth who denied mental health problems, psychosocial adversities, and using illicit drugs reported much lower rates of perceived cognitive impairment (boys = 13%, girls = 15%). Conclusion A remarkably large proportion of high school students in the United States reported experiencing serious difficulty with their cognitive functioning over the past year. Girls were significantly more likely to endorse perceived cognitive difficulties compared to boys. There was a strong association between perceived cognitive impairment and the experience of psychosocial adversity.
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Affiliation(s)
- Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Charlestown, Massachusetts, United States
- MassGeneral Hospital for Children Sports Concussion Program, Boston, Massachusetts, United States
- *Correspondence: Grant L. Iverson,
| | - Ila A. Iverson
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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34
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Zhang H, Li CL, Qu Y, Yang YX, Du J, Zhao Y. Effects and neuroprotective mechanisms of vagus nerve stimulation on cognitive impairment with traumatic brain injury in animal studies: A systematic review and meta-analysis. Front Neurol 2022; 13:963334. [PMID: 36237612 PMCID: PMC9551312 DOI: 10.3389/fneur.2022.963334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/29/2022] [Indexed: 12/09/2022] Open
Abstract
Introduction Cognitive impairment is the main clinical feature after traumatic brain injury (TBI) and is usually characterized by attention deficits, memory loss, and decreased executive function. Vagus nerve stimulation (VNS) has been reported to show potential improvement in the cognition level after traumatic brain injury in clinical and preclinical studies. However, this topic has not yet been systematically reviewed in published literature. In this study, we present a systematic review and meta-analysis of the effects of VNS on cognitive function in animal models of TBI and their underlying mechanisms. Methods We performed a literature search on PubMed, PsycINFO, Web of Science, Embase, Scopus, and Cochrane Library from inception to December 2021 to identify studies describing the effects of VNS on animal models of TBI. Results Overall, nine studies were identified in animal models (36 mice, 268 rats, and 27 rabbits). An analysis of these studies showed that VNS can improve the performance of TBI animals in behavioral tests (beam walk test: SMD: 4.95; 95% confidence interval [CI]: 3.66, 6.23; p < 0.00001) and locomotor placing tests (SMD: -2.39; 95% CI: -4.07, -0.71; p = 0.005), whereas it reduced brain edema (SMD: -1.58; 95% CI: -2.85, -0.31; p = 0. 01) and decrease TNF-α (SMD: -3.49; 95% CI: -5.78, -1.2; p = 0.003) and IL-1β (SMD: -2.84; 95% CI: -3.96, -1.71; p < 0.00001) expression level in the brain tissue. However, the checklist for SYRCLE showed a moderate risk of bias (quality score between 30% and 60%), mainly because of the lack of sample size calculation, random assignment, and blinded assessment. Conclusion The present review showed that VNS can effectively promote cognitive impairment and neuropathology in animal models of TBI. We hope that the results of this systematic review can be applied to improve the methodological quality of animal experiments on TBI, which will provide more important and conclusive evidence on the clinical value of VNS. To further confirm these results, there is a need for high-quality TBI animal studies with sufficient sample size and a more comprehensive outcome evaluation. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021290797, identifier: CRD42021290797.
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Affiliation(s)
- Han Zhang
- Department of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
- College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu, China
| | - Chun-liu Li
- Department of Rehabilitation Medicine, Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Yun Qu
- Department of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, China
- College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu, China
| | - Yu-xuan Yang
- Department of Rehabilitation Medicine, Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Juan Du
- Department of Rehabilitation Medicine, Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
| | - Yu Zhao
- Department of Rehabilitation Medicine, Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
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Tani J, Yang YH, Chen CM, Siow CY, Chang TS, Yang K, Yao J, Hu CJ, Sung JY. Domain-Specific Cognitive Prosthesis for Face Memory and Recognition. Diagnostics (Basel) 2022; 12:diagnostics12092242. [PMID: 36140643 PMCID: PMC9497523 DOI: 10.3390/diagnostics12092242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 11/18/2022] Open
Abstract
The present study proposes a cognitive prosthesis device for face memory impairment as a proof-of-concept for the domain-specific cognitive prosthesis. Healthy subjects (n = 6) and a patient with poor face memory were enrolled. An acquaintance face recognition test with and without the use of cognitive prosthesis for face memory impairment, face recognition tests, quality of life, neuropsychological assessments, and machine learning performance of the cognitive prosthesis were followed-up throughout four weeks of real-world device use by the patient. The healthy subjects had an accuracy of 92.38 ± 4.41% and reaction time of 1.27 ± 0.12 s in the initial attempt of the acquaintance face recognition test, which changed to 80.48 ± 6.23% (p = 0.06) and 2.11 ± 0.20 s (p < 0.01) with prosthesis use. The patient had an accuracy of 74.29% and a reaction time of 6.65 s, which improved to 94.29% and 3.28 s with prosthesis use. After four weeks, the patient’s unassisted accuracy and reaction time improved to 100% and 1.23 s. Functional MRI study revealed activation of the left superior temporal lobe during face recognition task without prosthesis use and activation of the right precentral motor area with prosthesis use. The prosthesis could improve the patient’s performance by bypassing the brain area inefficient for facial recognition and employing the area more efficiently for the cognitive task.
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Affiliation(s)
- Jowy Tani
- Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
- Biomed Innovation Center, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Medical University Biomed Accelerator, Taipei Medical University, Taipei 106339, Taiwan
- Taipei Medical University Biodesign Center, Taipei Medical University, Taipei 106339, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Yao-Hua Yang
- Biomed Innovation Center, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
| | - Chao-Min Chen
- Biomed Innovation Center, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
| | - Co Yih Siow
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Tsui-San Chang
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Kai Yang
- MediXgraph Inc., Fremont, CA 94555, USA
| | - Jack Yao
- MediXgraph Inc., Fremont, CA 94555, USA
| | - Chaur-Jong Hu
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Correspondence: (C.-J.H.); (J.-Y.S.); Tel.: +886-2-2930-7930 (ext. 6940) (J.-Y.S.)
| | - Jia-Ying Sung
- Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City 235041, Taiwan
- Correspondence: (C.-J.H.); (J.-Y.S.); Tel.: +886-2-2930-7930 (ext. 6940) (J.-Y.S.)
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Caron L, Ouellet MC, Hudon C, Predovan D, Sirois MJ, de Guise É, Lamontagne MÈ, Émond M, Le Sage N, Beaulieu-Bonneau S. Cognitive functioning following traumatic brain injury in older adults: associations with social participation and health-related quality of life. Brain Inj 2022; 36:1099-1108. [PMID: 35994259 DOI: 10.1080/02699052.2022.2110284] [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: 11/02/2022]
Abstract
OBJECTIVES To describe objective and subjective cognitive functioning older adults who sustained TBI at age 65 or over, and to determine whether cognitive functioning is associated with health-related quality of life (HRQoL) and social participation. METHOD The sample consisted of 40 individuals with TBI (mean age = 73 years; 65% mild, 35% moderate/severe TBI). On average 15 months post-injury, they completed measures of objective and subjective cognitive functioning (Telephone Interview for Cognitive Status-Modified, Alphaflex, Medical Outcomes Study Cognitive Functioning Scale), HRQoL (SF-12), and social participation (Participation Assessment with Recombined Tools - Objective). RESULTS Mean score for objective cognitive functioning was lower than normative values, while mean scores for executive functioning and subjective cognitive functioning were comparable to normative values. There was no relationship between objective and subjective measures. Subjective cognitive functioning and (to a lesser extent) global objective cognitive functioning were significantly associated with mental HRQoL but not with physical HRQoL or social participation. CONCLUSION These results underscore the importance of considering both subjective perception and objective performance when assessing and intervening on cognition to promote better mental HRQoL in older adults with TBI.
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Affiliation(s)
- Laurence Caron
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada
| | - Marie-Christine Ouellet
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada.,Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Carol Hudon
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre de Recherche CERVO Brain Research Center, Québec, QC, Canada
| | - David Predovan
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada
| | - Marie-Josée Sirois
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada.,Département de Réadaptation, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Élaine de Guise
- Département de Psychologie, Université de Montréal, Québec, QC, Canada
| | - Marie-Ève Lamontagne
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada.,Département de Réadaptation, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Marcel Émond
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada.,Département de Médecine Familiale et de Médecine d'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Natalie Le Sage
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada.,Département de Médecine Familiale et de Médecine d'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Simon Beaulieu-Bonneau
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada
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Kim SH, Gwak DW, Jeong JG, Jung H, Min YS, Kim AR, Jung TD. Effect of computerized cognitive rehabilitation in comparison between young and old age after traumatic brain injury. Medicine (Baltimore) 2022; 101:e29874. [PMID: 35984190 PMCID: PMC9388031 DOI: 10.1097/md.0000000000029874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Cognitive dysfunction reduces patients' quality of life and social participation with traumatic brain injury (TBI). Computerized cognitive rehabilitation is increasingly being used for cognitive therapy in TBI patients. The purpose of this study was to investigate the influence of age on the effect of computerized cognitive rehabilitation in cognitive dysfunction after TBI. MATERIAL AND METHODS A total of 34 patients with cognitive dysfunction after TBI were enrolled. Participants performed 30 sessions of computerized cognitive rehabilitation (Comcog) for 6 weeks. A cognitive evaluation was performed before and after treatment with Mini-Mental State Examination (MMSE) and Computerized Neurophyschologic Test (CNT). RESULTS There were no cognitive tests that differed between the young group and the old group at baseline. However, after computerized cognitive rehabilitation, the young group showed significant improvement compared to the old group in verbal memory, visual memory, attention, and visuo-motor coordination tests. The young group showed improvement in MMSE, verbal and visual memory, and visuo-motor coordination tests after computerized cognitive rehabilitation. In contrast, the old group showed significant improvement only in MMSE and visual learning test, one of the visual memory tests. CONCLUSION Our findings demonstrate that age may be an important factor related to the effect of computer cognitive rehabilitation on cognitive dysfunction after TBI. Methodologically more ordered studies with larger sample sizes are needed in the future.
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Affiliation(s)
- Seong-Hun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Dae-Won Gwak
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Jae-Gyeong Jeong
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hyunwoo Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Yu-Sun Min
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- * Correspondence: Tae-Du Jung, Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, 807, Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea (e-mail: )
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Feiss R, Corrigan JD, Ding K, Beaulieu CL, Bogner J, Yang J. Lifetime history of TBI with loss of consciousness and disability among Appalachian and rural residents: 2016–2019 Ohio BRFSS. Inj Epidemiol 2022; 9:25. [PMID: 35965339 PMCID: PMC9377055 DOI: 10.1186/s40621-022-00390-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background While lifetime history of traumatic brain injury (TBI) is associated with increased risk of disabilities, little is known about disability and TBI among Appalachian and other rural residents. This study aimed to examine if the relationship between lifetime history of TBI with loss of consciousness (LOC) and disability differs by location of living (Appalachian vs. non-Appalachian; rural vs. urban). Methods We obtained data on lifetime history of TBI with LOC, location of living, and six sources of disability (auditory, visual, cognitive, mobility, self-care related, and independent living-related impairments) from the 2016–2019 Ohio Behavioral Risk Factor Surveillance System. We modeled the disability outcomes with Appalachian living (or rural living), lifetime history of TBI with LOC, and their interaction as independent variables. Results Of the 16,941 respondents included, 16.9% had a lifetime history of TBI with LOC, 19.5% were Appalachian residents and 22.9% were rural residents. Among Appalachian residents, 56.1% lived in a rural area. Appalachian (ARR = 1.92; 95%CI = 1.71–2.13) and rural residents (ARR = 1.87; 95%CI = 1.69–2.06) who had a lifetime history of TBI with LOC were at greater risk for having any disability compared to non-Appalachian and urban residents without lifetime history of TBI with LOC, respectively. Conclusions Appalachian and rural living and lifetime history of TBI with LOC are risk factors for disability. Future research and health policies should address mechanisms for this risk as well as access to healthcare services following a TBI among Appalachian and rural residents.
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Rivera D, Greving S, Arango-Lasprilla JC, von Steinbuechel N, Zeldovich M. Comparability of (Post-Concussion) Symptoms across Time in Individuals after Traumatic Brain Injury: Results from the CENTER-TBI Study. J Clin Med 2022; 11:jcm11144090. [PMID: 35887853 PMCID: PMC9322034 DOI: 10.3390/jcm11144090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
Post-concussion symptoms often occur after TBI, persist and cause disabilities. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is widely used in this population, but little is known about the comparability of the symptoms over time, i.e., longitudinal measurement invariance (MI). The objectives of this study were to analyze the longitudinal MI of RPQ symptoms from three to twelve months after TBI and to find factors related to RPQ symptoms. The study involved 1023 individuals after TBI who took part in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study and completed the RPQ at three, six and twelve months post-injury. Longitudinal confirmatory factor analysis showed that the three-factor structure (somatic, emotional and cognitive) remains stable within one year after TBI. Linear mixed models revealed that sex, injury cause and prior psychiatric problems were related to the RPQ three-factor structure as well as to the RPQ total score. The study strengthens evidence for the RPQ’s factorial structure stability within one year after TBI and identifies sex, injury cause and prior psychiatric problems as important factors that may help clinicians to prevent future complications of symptomatology after TBI.
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Affiliation(s)
- Diego Rivera
- Department of Health Sciences, Public University of Navarre, Arrosadia Campus, 31006 Pamplona, Spain;
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea Street 3, 31008 Pamplona, Spain
| | - Sven Greving
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (S.G.); (N.v.S.)
| | | | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (S.G.); (N.v.S.)
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany; (S.G.); (N.v.S.)
- Correspondence:
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Mijailović NR, Vesic K, Arsenijevic D, Milojević-Rakić M, Borovcanin MM. Galectin-3 Involvement in Cognitive Processes for New Therapeutic Considerations. Front Cell Neurosci 2022; 16:923811. [PMID: 35875353 PMCID: PMC9296991 DOI: 10.3389/fncel.2022.923811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Cognitive impairment may be a consequence of the normal aging process, but it may also be the hallmark of various neurodegenerative and psychiatric diseases. Early identification of individuals at particular risk for cognitive decline is critical, as it is imperative to maintain a cognitive reserve in these neuropsychiatric entities. In recent years, galectin-3 (Gal-3), a member of the galectin family, has received considerable attention with respect to aspects of neuroinflammation and neurodegeneration. The mechanisms behind the putative relationship between Gal-3 and cognitive impairment are not yet clear. Intrigued by this versatile molecule and its unique modular architecture, the latest data on this relationship are presented here. This mini-review summarizes recent findings on the mechanisms by which Gal-3 affects cognitive functioning in both animal and human models. Particular emphasis is placed on the role of Gal-3 in modulating the inflammatory response as a fine-tuner of microglia morphology and phenotype. A review of recent literature on the utility of Gal-3 as a biomarker is provided, and approaches to strategically exploit Gal-3 activities with therapeutic intentions in neuropsychiatric diseases are outlined.
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Affiliation(s)
- Nataša R. Mijailović
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- *Correspondence: Nataša R. Mijailović,
| | - Katarina Vesic
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Dragana Arsenijevic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Milica M. Borovcanin
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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McEntee CM, LaRocca TJ. Commentary: Type I Interferon Response Is Mediated by NLRX1-cGAS-STING Signaling in Brain Injury. Front Mol Neurosci 2022; 15:947542. [PMID: 35832396 PMCID: PMC9271850 DOI: 10.3389/fnmol.2022.947542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Cali M. McEntee
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
- Center for Healthy Aging, Colorado State University, Fort Collins, CO, United States
| | - Thomas J. LaRocca
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
- Center for Healthy Aging, Colorado State University, Fort Collins, CO, United States
- *Correspondence: Thomas J. LaRocca
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Wang Y, Zhang Q, Li F, Li Q, Jin Y. Effects of tai chi and Qigong on cognition in neurological disorders: A systematic review and meta-analysis. Geriatr Nurs 2022; 46:166-177. [PMID: 35704955 DOI: 10.1016/j.gerinurse.2022.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To explore whether tai chi and Qigong can improve cognitive function in patients with neurological disorders. METHODS The PubMed, Embase, Cochrane Central Register of Controlled Trials, SinoMed Database, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP) databases were searched from inception to December 24, 2021. The methodological quality of the included studies was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions criteria. RESULTS This study included 2,754 participants from 40 randomized controlled trials (RCT)s with low to high methodological quality. Analysis of active and non-active comparisons showed significant effects for tai chi/Qigong (P<0.05) on global cognitive function, executive function, memory, visuospatial ability, and cognitive processing speed. CONCLUSIONS Tai chi and Qigong were effective interventions to improve cognition in patients with Parkinson's disease, stroke, mild cognitive impairment, dementia, and traumatic brain injury; however, no RCTs were performed for other neurological disorders.
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Affiliation(s)
- Yuxin Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qi Zhang
- School of Nursing, Peking University, Beijing, China
| | - Fei Li
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Qi Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yi Jin
- Department of Nursing, Tianjin Huanhu Hospital, Tianjin, China
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Summaka M, Zein H, Daoud R, Naim I, Fares Y, Nasser Z. Cross-cultural adaptation and validation of the Arabic Project for the Epidemiological Analysis of Critical Care Patients (PAEEC) scale in individuals with traumatic brain injury in Lebanon. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 35476535 DOI: 10.1080/23279095.2022.2062671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study is to cross-culturally adapt the Project for the Epidemiological Analysis of Critical Care Patients (PAEEC) Quality of Life (QoL) scale into the Arabic language and to examine its clinimetric properties, including validity and reliability among Lebanese native speaker with traumatic brain injury (TBI). This is a cross-sectional study including 49 men with TBI aged between 20 and 59 years. The Arabic version of the PAEEC (PAEEC-A) was administered to the subjects or their primary caregiver as well as the Short Form Health Survey 36 (SF-36). The internal consistency, test-retest reliability, content, construct and convergent validity were evaluated. The PAEEC-A displayed high internal consistency (Chronbach's alpha = 0.916) and test-retest reliability (Intraclass Correlation coefficient = 0.966). Exploratory factor analysis extracted a 3-factor model that explained 68.48% of the total variance. As for the convergent validity, Spearman correlations between the PAEEC-A total score and the physical and mental components of the SF-36 were -0.788 and -0.794, respectively (p-value < 0.0001 for both). The findings indicate that the PAEEC-A has robust clinimetric properties and is a valid and reliable quality of life measure among Lebanese men with traumatic brain injury.
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Affiliation(s)
- Marwa Summaka
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Hiba Zein
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Rama Daoud
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Ibrahim Naim
- Health, Rehabilitation, Integration and Research Center (HRIR), Beirut, Lebanon
| | - Youssef Fares
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
| | - Zeina Nasser
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Hadath, Lebanon
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Communication, Feeding and Swallowing Disorders in Neurological Diseases. Behav Neurol 2022; 2022:9851424. [PMID: 35496769 PMCID: PMC9050309 DOI: 10.1155/2022/9851424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
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Implementing New Technologies to Improve Visual-Spatial Functions in Patients with Impaired Consciousness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053081. [PMID: 35270773 PMCID: PMC8910167 DOI: 10.3390/ijerph19053081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/13/2023]
Abstract
The quality of life of patients with severe brain damage is compromised by, e.g., impaired cognitive functions and ocular dysfunction. The paper contains research findings regarding participants of an oculomotor training course aimed at the therapy of visual-spatial functions. Five male patients with brain damage who did not communicate, verbally or motorically, participated in the study. Over a six-week period, the subjects solved tasks associated with recognising objects, size perception, colour perception, perception of object structures (letters), perception of object structures (objects), detecting differences between images and assembling image components into the complete image with the use of an eye tracker. The findings present evidence of oculomotor training effectiveness based on a longer duration of the work with the eye tracker and improved visual-spatial functions.
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Blaauw J, Meelis GA, Jacobs B, Gaag NA, Jellema K, Kho KH, Groen RJ, Naalt J, Lingsma HF, den Hertog HM. Presenting symptoms and functional outcome of chronic subdural hematoma patients. Acta Neurol Scand 2022; 145:38-46. [PMID: 34448196 DOI: 10.1111/ane.13518] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/23/2021] [Accepted: 08/04/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Patients with chronic subdural hematoma (CSDH) can present with a variety of signs and symptoms. The relationship of these signs and symptoms with functional outcome is unknown. Knowledge of these associations might aid clinicians in the choice to initiate treatment and may allow them to better inform patients on expected outcomes. OBJECTIVE To investigate if presenting signs and symptoms influence functional outcome in patients with CSDH. METHODS We conducted a retrospective analysis of consecutive CSDH patients in three hospitals. Glasgow Outcome Scale Extended (GOS-E) scores were obtained from the first follow-up visit after treatment. An ordinal multivariable regression analysis was performed, to assess the relationship between the different signs and symptoms on the one hand and functional outcome on the other adjusted for potential confounders. RESULTS We included 1,307 patients, of whom 958 (73%) were male and mean age was 74 (SD ± 11) years. Cognitive complaints were associated with lower GOS-E scores at follow-up (aOR 0.7, 95% CI: 0.5 - 0.8) Headache and higher Glasgow Coma Scale (GCS) scores were associated with higher GOS-E scores. (aOR 1.9, 95% CI: 1.5-2.3 and aOR 1.3, 95% CI: 1.2-1.4). CONCLUSION Cognitive complaints are independently associated with worse functional outcome, whereas headache and higher GCS scores are associated with better outcome. The increased probability of unfavorable outcome in patients with CSDH who present with cognitive complaints favors a more prominent place of assessing cognitive status at diagnosis.
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Affiliation(s)
- Jurre Blaauw
- Department of Neurology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
- Center for Medical Decision Sciences Department of Public Health Erasmus Medical Center Rotterdam The Netherlands
| | | | - Bram Jacobs
- Department of Neurology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
| | - Niels A. Gaag
- University Neurosurgical Center Holland (UNCHLeiden University Medical CenterHaaglanden Medical Center & Haga teaching hospitalLeiden & The Hague The Hague The Netherlands
| | - Korné Jellema
- Department of Neurology Haaglanden Medical Centre The Hague The Netherlands
| | - Kuan H. Kho
- Department of Neurosurgery Medisch Spectrum Twente Enschede The Netherlands
| | - Rob J.M. Groen
- Department of Neurosurgery University Medical Center Groningen Groningen The Netherlands
| | - Joukje Naalt
- Department of Neurology University of GroningenUniversity Medical Center Groningen Groningen The Netherlands
| | - Hester F. Lingsma
- Center for Medical Decision Sciences Department of Public Health Erasmus Medical Center Rotterdam The Netherlands
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Merritt VC, Sakamoto MS, Sorg SF, Clark AL, Bondi MW, Schiehser DM, Delano-Wood L. Elevated Neuropsychological Intraindividual Variability Predicts Poorer Health-Related Quality of Life in Veterans with a History of Mild Traumatic Brain Injury. J Neurotrauma 2022; 39:238-242. [PMID: 33599168 PMCID: PMC8785717 DOI: 10.1089/neu.2020.7516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We examined the association between cognitive functioning and health-related quality of life (HR-QOL) in military veterans with a history of mild traumatic brain injury (mTBI) using two methods to assess cognition: mean performance on cognitive composite scores and across-test intraindividual variability (IIV). The sample included 73 veterans (84.9% male; age, mean = 32.47 years) who completed neuropsychological testing and self-report questionnaires ∼7 years post-injury. Three cognitive composite scores representing mean performance were computed, including memory, attention/processing speed (A/PS), and executive functioning (EF). Three IIV indices were also calculated reflecting degree of dispersion across the same cognitive domains: memory-IIV, A/PS-IIV, and EF-IIV. The Posttraumatic Stress Disorder (PTSD) Checklist-Military Version (PCL-M) was used to assess current PTSD symptoms, and the World Health Organization Quality of Life Short Version Physical Health domain was used to assess HR-QOL. Hierarchical linear regressions adjusting for PTSD symptoms demonstrated that IIV indices, but not mean cognitive composite scores, significantly predicted HR-QOL. Specifically, memory-IIV, A/PS-IIV, and EF-IIV, when taken together, made an independent and significant contribution to the prediction of HR-QOL. Examination of the standardized coefficients showed that the A/PS-IIV index was uniquely associated with HR-QOL, such that higher A/PS-IIV scores significantly predicted poorer HR-QOL. Our results are the first to show that, in veterans with remote mTBI histories, greater fluctuations in cognitive performance significantly contribute to poorer HR-QOL, even after accounting for PTSD symptom severity. Moreover, findings suggest that, compared to traditional mean cognitive performance scores, measures of IIV may represent more sensitive indicators of clinical outcome and better align with subjective experiences of distress.
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Affiliation(s)
- Victoria C. Merritt
- Research and Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - McKenna S. Sakamoto
- Research and Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
| | - Scott F. Sorg
- Research and Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Alexandra L. Clark
- Research and Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Mark W. Bondi
- Research and Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Dawn M. Schiehser
- Research and Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, California, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
| | - Lisa Delano-Wood
- Research and Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, California, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System (VASDHS), San Diego, California, USA
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Fahey AM, Bain KM, Critchfield EA. "I Couldn't Be Better": Assessing Self-Awareness With the Mayo-Portland Adaptability Inventory-4 Following TBI. J Head Trauma Rehabil 2021; 36:E373-E380. [PMID: 33782347 DOI: 10.1097/htr.0000000000000670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION/OBJECTIVE To describe level of awareness, as assessed by the Mayo-Portland Adaptability Inventory-4 (MPAI-4), across physical, cognitive, functional, and emotional domains in individuals with mild, moderate, and severe traumatic brain injury (TBI) participating in a residential rehabilitation program. In addition, this study aimed to examine the relationship between time since injury and awareness. A novel way the MPAI-4 can be used to measure self-awareness is also presented. METHOD Retrospective analysis of existing data. The MPAI-4 was completed by the patient on admission, as well as by provider consensus within 2 weeks of admission. Level of awareness was determined by discrepancy scores, computed as MPAI-4 provider consensus score minus self-report MPAI-4 score, for the total score and for each index score: Ability, Adjustment, and Participation. PARTICIPANTS A total of 101 military veterans and active duty service members admitted to a Veterans Affairs community reintegration rehabilitation program. RESULTS Discrepancies between patient and provider reports of functioning were found among all severities of TBI across the MPAI-4 total score and index domains measuring Ability, Adjustment, and Participation. Interestingly, those with mild TBI endorsed greater impairments than their providers, while those with moderate and severe TBI reported less impairment on the MPAI-4 than providers. The effect of time varied across domains, and those who were more than 1 year postinjury displayed greater self-awareness. CONCLUSION This study highlights the importance of measuring awareness of functional ability over time and across TBI severity and introduces a novel method for doing so, using the MPAI-4 for comparison between staff and patient reports.
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Affiliation(s)
- Amber M Fahey
- Psychology Service, South Texas Veterans Health Care System, San Antonio
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Falkowska Z, Heider N, Resch K, Royko J, Büttner-Kunert J. Die Erhebung von kommunikativ-pragmatischen Fähigkeiten und Lebensqualität nach Schädel-Hirn-Trauma. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2021. [DOI: 10.1024/1016-264x/a000336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Hintergrund: Kommunikationsstörungen nach Schädel-Hirn-Trauma (SHT) können die Betroffenen langfristig in der sozialen Teilhabe und damit in der Lebensqualität (LQ) beeinträchtigen. Der Erfassung dieser Störungen liegt aktuell kein einheitliches Vorgehen zugrunde. Ziele: Ziel des vorliegenden Scoping Reviews war die Erfassung von Diagnostikverfahren, welche die kommunikativ-pragmatischen Kompetenzen und die Auswirkung möglicher kommunikativer Defizite auf soziale Teilhabe und LQ bei Menschen mit SHT überprüfen. Ergebnisse: Eine systematische Datenbankrecherche für den Veröffentlichungszeitraum 2010 bis 2020 identifizierte 14 relevante Testverfahren (6 auf Deutsch verfügbar). Eine inhaltliche und methodische Analyse stellte Verfahren zur Überprüfung der Kommunikationsfähigkeit (z. B. La Trobe Communication Questionnaire [LCQ]) und Verfahren zur Erfassung von Partizipation und LQ (z. B. Quality of Life after Brain Injury [QOLIBRI]) heraus. Zusammenfassung: Trotz der hohen Auftretenshäufigkeit und Persistenz kommunikativer Störungen nach SHT stehen im deutschsprachigen Raum bislang wenige geeignete Diagnostikverfahren zur Ermittlung von Kommunikationsfähigkeiten und LQ zur Verfügung. Eine weiterführende Entwicklung erscheint unerlässlich.
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Affiliation(s)
- Zofia Falkowska
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
| | - Nathalie Heider
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
| | - Katharina Resch
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
| | - Julia Royko
- Masterstudiengang Sprachtherapie, Schwerpunkt „Neurogene Sprach- und Sprechstörungen“, LMU München
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50
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Zhao Y, Lu Y, Zhao W, Wang Y, Ge M, Zhou L, Yue J, Dong B, Hao Q. Long sleep duration is associated with cognitive frailty among older community-dwelling adults: results from West China Health and Aging Trend study. BMC Geriatr 2021; 21:608. [PMID: 34706663 PMCID: PMC8555015 DOI: 10.1186/s12877-021-02455-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/03/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To investigate the association between sleep duration and cognitive frailty among older adults dwelling in western China. METHODS We used the baseline data from West China Health and Aging Trend (WCHAT) study. Sleep duration was classified as short sleep duration (< 6 h), normal sleep duration (6-8 h) and long sleep duration (≥ 9 h). Fried frailty criteria and Short Portable Mental Status Questionnaire were used to measure cognitive frailty. Multinomial logistic regression was conducted to estimate odds ratio (OR) and 95% confidence interval (CI). RESULTS A total of 4093 older adults (age = 67.8 ± 5.9 years, 1708 males and 2385 females) were included in the analysis. The prevalence of cognitive frailty was 11.8% among older adults in western China. Approximately 11.9% participants had short sleep duration (< 6 h); 22.2% had a long sleep duration (≥ 9 h). After adjusting for covariates, only long sleep duration was significantly associated with high risk of cognitive frailty (OR = 2.07, 95%CI = 1.60-2.68, P < 0.001) in western China older adults compared to normal sleep duration. CONCLUSIONS Long sleep duration was significantly related to cognitive frailty in older adults. Intervention for long sleep duration may be helpful to prevent cognitive frailty. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR1800018895 .
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Affiliation(s)
- Yunli Zhao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Ying Lu
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Wanyu Zhao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Yanyan Wang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Meiling Ge
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Lixing Zhou
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Jirong Yue
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China. .,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China.
| | - Qiukui Hao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
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