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Rogne AG, Sigurdardottir S, Raudeberg R, Hassel B, Dahlberg D. Cognitive and everyday functioning after bacterial brain abscess: a prospective study of functional recovery from 8 weeks to 1 year post-treatment. Brain Inj 2024; 38:787-795. [PMID: 38676705 DOI: 10.1080/02699052.2024.2347565] [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: 05/02/2023] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE A bacterial brain abscess may damage surrounding brain tissue by mass effect, inflammatory processes, and bacterial toxins. The aim of this study was to examine cognitive and functional outcomes at 8 weeks and 1 year following acute treatment. METHODS Prospective study of 20 patients with bacterial brain abscess (aged 17-73 years; 45% females) with neuropsychological assessment at 8 weeks and 1 year post-treatment. Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and Patient Competence Rating Scale (PCRS) were used to assess everyday functioning and administered to patients and informants. RESULTS Cognitive impairment was found in 30% of patients at 8 weeks and 22% at 1 year. Significant improvements were seen on tests of perceptual reasoning, attention, verbal fluency, and motor abilities (p < 0.05). At 1 year, 45% had returned to full-time employment. Nevertheless, patients and their informants obtained scores within the normal range on measures of everyday functioning (PCRS and BRIEF-A) at 8 weeks and 1 year. No significant improvements on these measures emerged over time. CONCLUSION Residual long-term cognitive impairment and diminished work ability affected 22% and 45% of patients one year after BA. Persistent cognitive impairment emphasizes the importance of prompt acute treatment and cognitive rehabilitation.
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Affiliation(s)
- Ane Gretesdatter Rogne
- Department, of Neurohabilitation and Complex Neurology, Oslo University Hospital, Oslo, Norway
- Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | | | - Rune Raudeberg
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Bjørnar Hassel
- Department, of Neurohabilitation and Complex Neurology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Daniel Dahlberg
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
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2
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Sood NT, Godfrey C, Youn S, Chavez Arana C, Anderson V, Payne JM, Catroppa C. The decision-making task: Development and evaluation in a paediatric traumatic brain injury population. Neuropsychol Rehabil 2024; 34:919-937. [PMID: 37542710 DOI: 10.1080/09602011.2023.2242618] [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: 01/20/2022] [Accepted: 07/21/2023] [Indexed: 08/07/2023]
Abstract
Assessment measures that quantify decision-making abilities in children and adolescents are limited. In the current study, a novel computerized Decision-Making Task (DMT), which identifies the process that is involved in decision-making, was developed based on an existing information-boards paradigm. The overall aim was to validate the DMT in a paediatric TBI population. This prospective study investigated the performance on the DMT for children post-TBI (n = 49; 7-15 years) compared to typically developing controls (n = 22; 7-15 years), and investigated the psychometric properties of the DMT by examining internal consistency-related reliability, convergent validity (measures of decision-making, working memory, functional outcomes, and behaviour), and divergent validity (vocabulary). Significant differences were detected for performance on the DMT between children post-TBI and the control group. Psychometric properties of the DMT were acceptable, with variable findings for convergent validity (working memory, functional outcomes, and behaviour). This is the first study to develop and investigate a novel computerised task to assess decision-making skills in a paediatric TBI population. Results cautiously suggest that the DMT is a valid and a reliable measure of decision-making in our clinical sample.
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Affiliation(s)
- Nikita Tuli Sood
- Murdoch Children's Research Institute, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Murdoch Children's Research Institute, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Sarah Youn
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Clara Chavez Arana
- Department of Psychology, Education, & Child Studies, Erasmus School of Social and Behavioural Sciences, Rotterdam, Netherlands
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Jonathan M Payne
- Murdoch Children's Research Institute, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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3
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Hacker BJ, Imms PE, Dharani AM, Zhu J, Chowdhury NF, Chaudhari NN, Irimia A. Identification and Connectomic Profiling of Concussion Using Bayesian Machine Learning. J Neurotrauma 2024; 41:1883-1900. [PMID: 38482793 DOI: 10.1089/neu.2023.0509] [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: 04/30/2024] Open
Abstract
Accurate early diagnosis of concussion is useful to prevent sequelae and improve neurocognitive outcomes. Early after head impact, concussion diagnosis may be doubtful in persons whose neurological, neuroradiological, and/or neurocognitive examinations are equivocal. Such individuals can benefit from novel accurate assessments that complement clinical diagnostics. We introduce a Bayesian machine learning classifier to identify concussion through cortico-cortical connectome mapping from magnetic resonance imaging in persons with quasi-normal cognition and without neuroradiological findings. Classifier features are generated from connectivity matrices specifying the mean fractional anisotropy of white matter connections linking brain structures. Each connection's saliency to classification was quantified by training individual classifier instantiations using a single feature type. The classifier was tested on a discovery sample of 92 healthy controls (HCs; 26 females, age μ ± σ: 39.8 ± 15.5 years) and 471 adult mTBI patients (158 females, age μ ± σ: 38.4 ± 5.9 years). Results were replicated in an independent validation sample of 256 HCs (149 females, age μ ± σ: 55.3 ± 12.1 years) and 126 patients with concussion (46 females, age μ ± σ: 39.0 ± 17.7 years). Classifier accuracy exceeds 99% in both samples, suggesting robust generalizability to new samples. Notably, 13 bilateral cortico-cortical connection pairs predict diagnostic status with accuracy exceeding 99% in both discovery and validation samples. Many such connection pairs are between prefrontal cortex structures, fronto-limbic and fronto-subcortical structures, and occipito-temporal structures in the ventral ("what") visual stream. This and related connectivity form a highly salient network of brain connections that is particularly vulnerable to concussion. Because these connections are important in mediating cognitive control, memory, and attention, our findings explain the high frequency of cognitive disturbances after concussion. Our classifier was trained and validated on concussed participants with cognitive profiles very similar to those of HCs. This suggests that the classifier can complement current diagnostics by providing independent information in clinical contexts where patients have quasi-normal cognition but where concussion diagnosis stands to benefit from additional evidence.
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Affiliation(s)
- Benjamin J Hacker
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
- Mork Family Department of Chemical Engineering and Materials Science, Viterbi School of Engineering, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Phoebe E Imms
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Ammar M Dharani
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Jessica Zhu
- Corwin D. Denney Research Center, Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Nahian F Chowdhury
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Nikhil N Chaudhari
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
- Corwin D. Denney Research Center, Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
- Corwin D. Denney Research Center, Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
- Department of Quantitative and Computational Biology, Dana and David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, California, USA
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Carmichael J, Ponsford J, Gould KR, Tiego J, Forbes MK, Kotov R, Fornito A, Spitz G. A Transdiagnostic, Hierarchical Taxonomy of Psychopathology Following Traumatic Brain Injury (HiTOP-TBI). J Neurotrauma 2024. [PMID: 38970424 DOI: 10.1089/neu.2024.0006] [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: 07/08/2024] Open
Abstract
Psychopathology, including depression, anxiety, and post-traumatic stress, is a significant yet inadequately addressed feature of moderate-severe traumatic brain injury (TBI). Progress in understanding and treating post-TBI psychopathology may be hindered by limitations associated with conventional diagnostic approaches, specifically the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). The Hierarchical Taxonomy of Psychopathology (HiTOP) offers a promising, transdiagnostic alternative to psychiatric classification that may more effectively capture the experiences of individuals with TBI. However, HiTOP lacks validation in the TBI population. To address this gap, we administered a comprehensive questionnaire battery, including 56 scales assessing homogeneous symptom components and maladaptive traits within HiTOP, to 410 individuals with moderate-severe TBI. We evaluated the reliability and unidimensionality of each scale and revised those with psychometric problems. Using a top-down, exploratory latent variable approach (bass-ackwards modeling), we subsequently constructed a hierarchical model of psychopathological dimensions tailored to TBI. The results showed that, relative to norms, participants with moderate-severe TBI experienced greater problems in the established HiTOP internalizing and detachment spectra, but fewer problems with thought disorder and antagonism. Fourteen of the 56 scales demonstrated psychometric problems, which often appeared reflective of the TBI experience and associated disability. The Hierarchical Taxonomy of Psychopathology Following Traumatic Brain Injury (HiTOP-TBI) model encompassed broad internalizing and externalizing spectra, splitting into seven narrower dimensions: Detachment, Dysregulated Negative Emotionality, Somatic Symptoms, Compensatory and Phobic Reactions, Self-Harm and Psychoticism, Rigid Constraint, and Harmful Substance Use. This study presents the most comprehensive empirical classification of psychopathology after TBI to date. It introduces a novel, TBI-specific transdiagnostic questionnaire battery and model, which addresses the limitations of conventional DSM and ICD diagnoses. The empirical structure of psychopathology after TBI largely aligned with the established HiTOP model (e.g., a detachment spectrum). However, these constructs need to be interpreted in relation to the unique experiences associated with TBI (e.g., considering the injury's impact on the person's social functioning). By overcoming the limitations of conventional diagnostic approaches, the HiTOP-TBI model has the potential to accelerate our understanding of the causes, correlates, consequences, and treatment of psychopathology after TBI.
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Affiliation(s)
- Jai Carmichael
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Kate Rachel Gould
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Roman Kotov
- Stony Brook University, New York, New York, USA
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Gershon Spitz
- Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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5
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Wolff B, Glasson EJ, Babikian T, Pestell CF. Self-Reported Traumatic Brain Injury and Its Biopsychosocial Risk Factors in Siblings of Individuals with Neurodevelopmental Conditions. Dev Neuropsychol 2024:1-18. [PMID: 38994713 DOI: 10.1080/87565641.2024.2377689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
Siblings of individuals with neurodevelopmental conditions (NDCs) are situated within a complex system of risk and resilience factors for poor outcomes, many of which overlap with the risk of traumatic brain injury (TBI) and correlate with poorer recovery trajectories. This study used Bayesian analyses to characterize and compare TBI and biopsychosocial risk factors among 632 siblings (207 NDC, 425 controls; mean age 20.54 years, range 10-30, 78.48% female). NDC siblings had a higher self-reported lifetime history of TBI compared to controls (14.98% versus 6.35%), with most reporting more than one TBI, and at an earlier age. TBI history was associated with psychiatric diagnoses and subclinical NDC features. Family and structural factors related to TBI included poorer parent-child relationship, NDC diagnoses of autism or fetal alcohol spectrum disorder, minority ethnicity, and lower income. Findings have implications for health literacy, TBI education and screening, and implementation of family support.
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Affiliation(s)
- Brittany Wolff
- Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, and Jane & Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences and UCLA Steve Tisch BrainSPORT Program, Department of Neurosurgery, UCLA David Geffen School of Medicine, Los Angeles, California, US
| | - Carmela F Pestell
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
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Rahman Z, Pasam T, Rishab, Dandekar MP. Binary classification model of machine learning detected altered gut integrity in controlled-cortical impact model of traumatic brain injury. Int J Neurosci 2024; 134:163-174. [PMID: 35758006 DOI: 10.1080/00207454.2022.2095271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
Aim of the study: To examine the effect of controlled-cortical impact (CCI), a preclinical model of traumatic brain injury (TBI), on intestinal integrity using a binary classification model of machine learning (ML).Materials and methods: Adult, male C57BL/6 mice were subjected to CCI surgery using a stereotaxic impactor (Impact One™). The rotarod and hot-plate tests were performed to assess the neurological deficits.Results: Mice underwent CCI displayed a remarkable neurological deficit as noticed by decreased latency to fall and lesser paw withdrawal latency in rotarod and hot plate test, respectively. Animals were sacrificed 3 days post-injury (dpi). The colon sections were stained with hematoxylin and eosin (H&E) to integrate with machinery tool-based algorithms. Several stained colon images were captured to build a dataset for ML model to predict the impact of CCI vs sham procedure. The best results were obtained with VGG16 features with SVM RBF kernel and VGG16 features with stacked fully connected layers on top. We achieved a test accuracy of 84% and predicted the disrupted gut permeability and epithelium wall of colon in CCI group as compared to sham-operated mice.Conclusion: We suggest that ML may become an important tool in the development of preclinical TBI model and discovery of newer therapeutics.
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Affiliation(s)
- Zara Rahman
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad, India
| | - Tulasi Pasam
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad, India
| | - Rishab
- Department of Computer Science and Engineering, International Institute of Information Technology (IIIT), Hyderabad, India
| | - Manoj P Dandekar
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad, India
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Tabet S, Laguë-Beauvais M, Francoeur C, Sheehan A, Abouassaly M, Marcoux J, Dagher JH, Ursulet A, Colucci E, de Guise E. Longitudinal recovery of executive functions and social participation prediction following traumatic brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:134-143. [PMID: 34807801 DOI: 10.1080/23279095.2021.2002866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is heterogeneity across studies and a lack of knowledge about recovery of EFs over time following traumatic brain injury (TBI). Also, EFs are associated with functional outcome, but there is still a gap in knowledge concerning the association between EFs and social participation following TBI. For this reason, we aim to (1) measure the recovery of the three executive function subcomponents of Miyake's model, namely flexibility, updating and inhibition between the acute phase (T1) and 6 months post TBI (T2) and (2) measure the relationship between EFs and social participation after TBI. Thus, a prospective longitudinal study that included 75 patients with TBI (mild and moderate-severe) and 50 patients with orthopedic injuries (controls) without brain damage was carried out. An extensive EFs test battery was administered at T1 and T2 whereas the Mayo-Portland Adaptability Inventory-4 (MPAI-4) was administered only at T2. In contrast with the controls, both TBI groups improved significantly between T1 and T2 on WMS-III Mental Control test (MC) and the D-KEFS Category Switching Condition of the Verbal Fluency task (SVF). Results also showed a simple time effect for the WAIS-IV Digit span and the Hayling tests. Moreover, there was an association between the SVF test and social participation (MPAI-4) at T2. In conclusion, the MC and SVF tests were found to be the best tools for measuring recovery of EFs following TBI. The SVF test was the most likely measure of EFs to give the neuropsychologist an idea of the patient's social participation.
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Affiliation(s)
- Sabrina Tabet
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Maude Laguë-Beauvais
- Department of Psychology, Université de Montréal, Laval, Canada
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
| | - Coralie Francoeur
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Audrey Sheehan
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Michel Abouassaly
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
| | - Judith Marcoux
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
| | - Jehane H Dagher
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
- Physical Medicine and Rehabilitation Service, McGill University Health Centre-Montreal General Hospital, Quebec, Canada
| | - Adriana Ursulet
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Emma Colucci
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
- Research Institute-McGill University Health Center, Montreal, Canada
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Juengst SB, Wright B, Vos L, Perna R, Williams M, Dudek E, DeMello A, Taiwo Z, Novelo LL. Emotional, Behavioral, and Cognitive Symptom Associations With Community Participation in Chronic Traumatic Brain Injury. J Head Trauma Rehabil 2024; 39:E83-E94. [PMID: 37582176 PMCID: PMC10864677 DOI: 10.1097/htr.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVES To determine the association between self-reported emotional and cognitive symptoms and participation outcomes in chronic traumatic brain injury (TBI) and to explore the relative contribution of self-reported versus performance-based cognition to participation outcomes. SETTING Community. PARTICIPANTS Community-dwelling adults ( n = 135) with a lifetime history of mild to severe TBI. DESIGN Secondary analysis of a cross-sectional study on neurobehavioral symptoms in chronic TBI. MAIN MEASURES Behavioral Assessment Screening Tool (BAST) (Negative Affect, Fatigue, Executive Dysfunction, Impulsivity, Substance Abuse subscales) measured self-reported neurobehavioral symptoms; Participation Assessment with Recombined Tools (Productivity, Social Relations, and Out and About) measured self-reported participation outcomes; and Brief Test of Adult Cognition by Telephone (BTACT) measured performance-based cognition (Episodic Memory and Executive Function summary scores) in a subsample ( n = 40). RESULTS The BAST Executive Dysfunction was significantly associated with less frequent participation and had the strongest effect on participation in all participation domains. No other BAST subscales were associated with participation, after adjusting for all subscale scores and age, with the exception of BAST Impulsivity, which was associated with more frequent Social Relationships. Exploratory analysis in the sample including the BTACT revealed that, after accounting for subjective Executive Dysfunction using the BAST, performance-based Executive Function was associated with Productivity and Working Memory was associated with Social Relations, but neither was associated with being Out and About; the BAST Executive Dysfunction remained significant in all models even after including BTACT scores. CONCLUSIONS Self-reported Executive Dysfunction contributed to participation outcomes after mild to severe TBI in community-dwelling adults, whereas self-reported emotional and fatigue symptoms did not. Performance-based cognition measures may capture different variability in participation after injury.
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Affiliation(s)
- Shannon B Juengst
- Author Affiliations: TIRR Memorial Hermann, Houston, Texas (Drs Juengst, Perna, and Taiwo); Departments of Physical Medicine & Rehabilitation (Dr Juengst) and Biostatistics and Data Science (Dr Novelo), The University of Texas Health Science Center at Houston; Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas (Drs Juengst and Wright); Spectrum Health Medical Group, Neurosciences, Grand Rapids, Michigan (Dr Vos); Department of Psychology, University of Houston, Houston, Texas (Dr Williams and Ms Dudek); School of Nursing, The University of Texas Medical Branch, Galveston (Dr DeMello); and Department of Neurology, Section of Neuropsychology, Baylor College of Medicine, Houston, Texas (Dr Taiwo)
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9
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Eliav R, Nadler Tzadok Y, Segal-Rotenberg S, Kizony R. Efficacy of Intervention of Participation and Executive Functions (I-PEX) for Adults Following Traumatic Brain Injury: A Preliminary Pilot Randomized Controlled Trial. Neurorehabil Neural Repair 2024:15459683241231529. [PMID: 38375580 DOI: 10.1177/15459683241231529] [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: 02/21/2024]
Abstract
BACKGROUND Participation restrictions following traumatic brain injury are associated with executive function (EF) deficits (EFDs). The subacute recovery phase's specific characteristics (enhanced brain plasticity and impaired self-awareness) and contextual factors (inpatient setting) warrant adjusting cognitive rehabilitation protocols. The Intervention of Participation and Executive Functions (I-PEX) was designed to improve EFDs during subacute inpatient rehabilitation. OBJECTIVE To investigate the I-PEX's preliminary efficacy to improve EFDs during the performance of complex daily activities and enhance self-awareness, cognitive self-efficacy, participation, and quality of life postdischarge. METHODS A pilot pre-, post-, and follow-up double-blind randomized controlled trial with 25 participants randomly allocated to the I-PEX (n = 13) or treatment-as-usual (n = 12) group. Cognitive assessments were administered pre- and postintervention, and quality of life and participation questionnaires 1-month postdischarge. Data analysis included repeated measures analysis of variance mixed design and independent t-tests, extracting effect sizes. RESULTS Significant group-by-time interaction effect with a medium effect size was found for the primary outcome measure; EFs manifested in complex daily activities, indicating a larger improvement for the experimental group. The group effect was not significant. The experimental group's mean delta score (pre-post improvement) was significantly higher (1.75 ± 2.89; t(23) = 2.52, P = .019), with a large effect size (d = 1.012, 95% confidence interval [0.166-1.840]). We found no significant group and interaction effects for EFs, self-awareness, and cognitive self-efficacy or no significant differences in participation or quality of life postdischarge. CONCLUSIONS Results provide initial evidence for the I-PEX efficacy in treating EFDs in the subacute phase and could help determine effect size for future studies. CLINICAL TRIAL REGISTRY NUMBER ClinicalTrial.gov NCT04292925.
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Affiliation(s)
- Rotem Eliav
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Occupational Therapy, Loewenstein Rehabilitation Medical Center, Ra'anana, Israel
| | - Yael Nadler Tzadok
- Department of Occupational Therapy, Loewenstein Rehabilitation Medical Center, Ra'anana, Israel
| | - Shir Segal-Rotenberg
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Occupational Therapy, Loewenstein Rehabilitation Medical Center, Ra'anana, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Depatrment of Occupational Therapy, Sheba Medical Center, Tel-Hashomer, Israel
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10
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Tang TZ, Zhao Y, Agarwal D, Tharzeen A, Patrikeev I, Zhang Y, DeJesus J, Bossmann SH, Natarajan B, Motamedi M, Szczesny B. Serum amyloid A and mitochondrial DNA in extracellular vesicles are novel markers for detecting traumatic brain injury in a mouse model. iScience 2024; 27:108932. [PMID: 38323004 PMCID: PMC10844832 DOI: 10.1016/j.isci.2024.108932] [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: 09/15/2023] [Revised: 12/06/2023] [Accepted: 01/12/2024] [Indexed: 02/08/2024] Open
Abstract
This study investigates the potential use of circulating extracellular vesicles' (EVs) DNA and protein content as biomarkers for traumatic brain injury (TBI) in a mouse model. Despite an overall decrease in EVs count during the acute phase, there was an increased presence of exosomes (CD63+ EVs) during acute and an increase in microvesicles derived from microglia/macrophages (CD11b+ EVs) and astrocytes (ACSA-2+ EVs) in post-acute TBI phases, respectively. Notably, mtDNA exhibited an immediate elevation post-injury. Neuronal (NFL) and microglial (Iba1) markers increased in the acute, while the astrocyte marker (GFAP) increased in post-acute TBI phases. Novel protein biomarkers (SAA, Hp, VWF, CFD, CBG) specific to different TBI phases were also identified. Biostatistical modeling and machine learning identified mtDNA and SAA as decisive markers for TBI detection. These findings emphasize the importance of profiling EVs' content and their dynamic release as an innovative diagnostic approach for TBI in liquid biopsies.
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Affiliation(s)
- Tony Z. Tang
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Yingxin Zhao
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Deepesh Agarwal
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS, USA
| | - Aabila Tharzeen
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS, USA
| | - Igor Patrikeev
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Yuanyi Zhang
- Department of Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, USA
| | - Jana DeJesus
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Stefan H. Bossmann
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Massoud Motamedi
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Bartosz Szczesny
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
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11
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Eliav R, Hason S, Kizony R. Profiles of executive functioning following traumatic brain injury and stroke using the assessment of participation and executive functions: combined cross-sectional and longitudinal designs. J Rehabil Med 2024; 56:jrm12427. [PMID: 38235968 PMCID: PMC10807544 DOI: 10.2340/jrm.v56.12427] [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: 05/03/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES The Assessment of Participation and Executive Functions (A-PEX) evaluates executive functioning through daily participation in complex daily activities. This study examines its ability to discriminate between executive functioning profiles post-traumatic brain injury and post-stroke and its sensitivity to changes. DESIGN Cross-sectional with a longitudinal component. PATIENTS Adults with post-traumatic brain injury (n = 28) and post-stroke (n = 26) in a rehabilitation facility. METHODS Patients were administered the A-PEX, Multiple Errands Test-Hospital version and Color Trail Test at 2 time-points 1 month apart. The Montreal Cognitive Assessment was administered at the first time-point, and Executive Functions Performance Test's Internet-based Bill Payment subtest at the second. The analysis used Mann-Whitney and Wilcoxon signed-rank tests. RESULTS The stroke group's A-PEX scores were higher than the traumatic brain injury group's at the first time-point (p < 0.05). No differences were found in the other assessments. Within-group differences in both groups were significant in the A-PEX (-3.7 < r < - 2.3, p < 0.05) and Multiple Errands Test-Hospital version (-3.4 < r < -3.3, p < 0.01). CONCLUSION The A-PEX may provide valuable information about the uniqueness of executive functioning profiles and patients' progress.
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Affiliation(s)
- Rotem Eliav
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Israel; Department of Occupational Therapy, Loewenstein Rehabilitation Medical Center, Ra'anana, Israel.
| | - Sivan Hason
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Israel; Department of Occupational Therapy, Loewenstein Rehabilitation Medical Center, Ra'anana, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, Faculty of Welfare and Health Sciences, University of Haifa, Israel; Department of Occupational Therapy, Sheba Medical Center, Tel-Hashomer, Israel; Department of Occupation Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
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12
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Šarkić B, Douglas JM, Simpson A. A cross-sectional survey of non-specialist Australian audio-vestibular clinical practice for traumatic brain injury and rehabilitation. BRAIN IMPAIR 2023; 24:611-628. [PMID: 38167366 DOI: 10.1017/brimp.2022.35] [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: 01/09/2023]
Abstract
OBJECTIVE This study explored non-specialist audiological clinical practice in the context of traumatic brain injury (TBI), and whether such practices incorporated considerations of TBI-related complexities pertaining to identification, diagnosis and management of associated auditory and vestibular disturbances. DESIGN A cross-sectional online survey exploring clinical practice, TBI-related training and information provision was distributed to audiologists across Australia via Audiology Australia and social media. Fifty audiologists, 80% female and 20% male, participated in this study. Years of professional practice ranged from new graduate to more than 20 years of experience. RESULTS Clear gaps of accuracy in knowledge and practice across all survey domains relating to the identification, diagnosis and management of patients with auditory and/or vestibular deficits following TBI were evident. Further, of the surveyed audiologists working in auditory and vestibular settings, 91% and 86%, respectively, reported not receiving professional development for the diagnosis and management of post-traumatic audio-vestibular deficits. CONCLUSION Inadequate resources, equipment availability and TBI-related training may have contributed to the gaps in service provision, influencing audiological management of patients with TBI. A tailored TBI approach to identification, diagnosis and management of post-traumatic auditory and vestibular disturbances is needed.
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Affiliation(s)
- Bojana Šarkić
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Jacinta M Douglas
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Andrea Simpson
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- College of Health & Human Services, Charles Darwin University, Northern Territory, Australia
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13
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Jansen JM. Mediating effects of impulsivity and alexithymia in the association between traumatic brain injury and aggression in incarcerated males. Aggress Behav 2023; 49:629-642. [PMID: 37405946 DOI: 10.1002/ab.22101] [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: 04/13/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023]
Abstract
Studies suggest both alexithymia and impulsivity (partially) explain aggressive behavior in traumatic brain injury (TBI) patients, but none of these studies use both questionnaire and performance-based measures as recommended, nor simultaneously investigate both impulsivity and alexithymia. The available studies therefore likely miss part of the constructs of alexithymia and impulsivity, and do not comprehensively assess the mediating effects of both constructs in the relationship between TBI and aggression. A sample of N = 281 incarcerated individuals were recruited from Dutch penitentiary institutions, and completed the Buss Perry Aggression Questionnaire (aggression), BIS-11 (impulsivity) and Toronto Alexithymia Scale-20 (alexithymia) questionnaires, as well as a stop-signal task and an emotion recognition paradigm. Several multiple mediation analyses were conducted using structural equation modelling, to assess the viability of a causal theoretical model of aggression. The final planned models were the original models with a good fit with the data (comparative fit index > 0.95, root mean square error of approximation and Standardized root mean square residual < 0.05), and results indicate that only questionnaire-based impulsivity mediated the relationship between TBI and aggression. TBI was unrelated to alexithymia, stop-signal or emotion recognition performance. Aggression was predicted by both alexithymia and impulsivity, but not by the performance measures. Post hoc analyses shows that alexithymia moderates the relationship between impulsivity and aggression. These results imply that aggressive incarcerated individuals showing impulsive behavior should be screened for TBI, since TBI is often overlooked or misdiagnosed, and indicate that both impulsivity and alexithymia are potential focus points for aggression reduction treatment in TBI patients.
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Affiliation(s)
- Jochem M Jansen
- Institute for Criminal Law & Criminology, Faculty of Law, Leiden University, Leiden, Netherlands
- Arkin, Amsterdam, Netherlands
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14
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De Luca R, Bonanno M, Rifici C, Quartarone A, Calabrò RS. Post-traumatic olfactory dysfunction: a scoping review of assessment and rehabilitation approaches. Front Neurol 2023; 14:1193406. [PMID: 37521284 PMCID: PMC10374209 DOI: 10.3389/fneur.2023.1193406] [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: 03/24/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Post-traumatic Olfactory Dysfunction (PTOD) consists of a complete or partial loss of olfactory function that may occur after a traumatic brain injury (TBI). PTOD may be linked to some neuropsychiatric features, such as social, cognitive and executive dysfunction, as well as behavioral symptoms, especially when TBI involves the orbito-frontal cortex. The diagnosis of PTOD is based on medical history and clinical data and it is supported by psychometric tests (i.e., subjective tools) as well as electrophysiological and neuroimaging measures (i.e., objective methods). The assessment methods allow monitoring the changes in olfactory function over time and help to establish the right therapeutic and rehabilitative approach. In this context, the use of the olfactory training (OT), which is a non-pharmacological and non-invasive treatment option, could promote olfactory function through top-down (central) and bottom-up (peripheral) processes. To better manage patients with TBI, PTOD should be detected early and properly treated using the various therapeutic rehabilitative possibilities, both conventional and advanced, also taking into consideration the emerging neuromodulation approach.
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15
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Fusi G, Crepaldi M, Palena N, Segatta C, Bariselli M, Cerrano C, Rusconi ML, Vascello MGF. Decision-making abilities under risk and ambiguity in adults with traumatic brain injury: what do we know so far? A systematic review and meta-analysis. J Clin Exp Neuropsychol 2023; 45:389-410. [PMID: 37585702 DOI: 10.1080/13803395.2023.2245107] [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: 02/27/2023] [Accepted: 07/21/2023] [Indexed: 08/18/2023]
Abstract
Traumatic brain injury (TBI) is a major health and socio-economic problem since it is one of the major sources of death and disability worldwide. TBI patients usually show high heterogeneity in their clinical features, including both cognitive and emotional/behavioral alterations. As it specifically concerns cognitive functioning, these patients usually show decision-making (DM) deficits. DM is commonly considered a complex and multistep process that is strictly linked to both hot and cold executive functioning and is pivotal for daily life functioning and patients' autonomy. However, the results are not always in agreement, with some studies that report huge alterations in the DM processes, while others do not. The present systematic review and meta-analysis aims to integrate past literature on this topic, providing a clear and handy picture both for researchers and clinicians. Thirteen studies addressing domain-general DM abilities were included from an initial N = 968 (from three databases). Results showed low heterogeneity between the studies (I2 = 7.90, Q (12) = 13.03, p = .37) supporting the fact that, overall, TBI patients showed lower performance in DM tasks as compared to healthy controls (k = 899, g = .48, 95% CI [0.33; 0.62]) both in tasks under ambiguity and under risk. The evidence that emerged from this meta-analysis denotes a clear deficit of DM abilities in TBI patients. However, DM tasks seemed to have good sensitivity but low specificity. A detailed description of patients' performances and the role of both bottom-up, hot executive functions and top-down control functions have been further discussed. Finally, future directions and practical implications for both researchers and clinicians have been put forward.
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Affiliation(s)
- Giulia Fusi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Maura Crepaldi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Nicola Palena
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Cecilia Segatta
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Martina Bariselli
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Costanza Cerrano
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Maria Luisa Rusconi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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16
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De Luca R, Bonanno M, Marra A, Rifici C, Pollicino P, Caminiti A, Castorina MV, Santamato A, Quartarone A, Calabrò RS. Can Virtual Reality Cognitive Rehabilitation Improve Executive Functioning and Coping Strategies in Traumatic Brain Injury? A Pilot Study. Brain Sci 2023; 13:brainsci13040578. [PMID: 37190543 DOI: 10.3390/brainsci13040578] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Executive dysfunction is among the most common and disabling facets of cognitive impairment following traumatic brain injury (TBI), and may include deficits in reasoning, planning, mental flexibility, some aspects of attention and orientation, awareness and behavior. Rehabilitation programs based on cognitive-behavioral approaches to retrain planning and problem-solving and other executive deficits may improve such cognitive dysfunction. The purpose of this study is to investigate the effects of non-immersive virtual reality-based training to improve executive abilities and to reduce anxiety and depression symptoms in patients with TBI. Twenty patients with moderate to severe TBI were enrolled at our Neurorehabilitation Unit and divided to receive either the standard cognitive training or the virtual reality (VR) based cognitive training using the virtual reality rehabilitation system (VRRS-Evo). Each group received the same amount of rehabilitative training, including ROT (Reality Orientation Therapy) and Executive Training (ET), but using a different approach, i.e., a paper and pencil and an advanced approach. All patients were evaluated with a specific psychometric battery before (T0) and after the end (T1) of each program. Comparing pre- and post- treatment scores, in the VR-CT group, we found statistically significant differences in all administered outcome measures for cognitive and executive functioning, i.e., MoCA (p < 0.005), FAB (p < 0.005), TMT-A (p < 0.005), TMT-B (p < 0.005), TMT-BA (p < 0.001), and mood, i.e., HRS-D (p < 0.008). In the Conventional cognitive training (C-CT) group, we found a significant improvement only in MoCA (p < 0.03), FAB (p < 0.02) and in TMT-BA (p < 0.01). Coping strategies also improved, with better results in the VR-CT group. Our results suggest that VR rehabilitation, using the VRRS system, may be a valuable and motivational approach to improve visuo-executive abilities and coping strategies as well as mood in chronic TBI patients.
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Affiliation(s)
- Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Angela Marra
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | | | - Angelo Caminiti
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | | | - Andrea Santamato
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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17
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Heffernan T, Hamilton C, Neave N. Self-reported memory and executive function in adult non-clinical hoarders. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:153-158. [PMID: 34061688 DOI: 10.1080/23279095.2021.1917578] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Hoarding is the excessive acquisition of, and failure to discard of, large numbers of items, leading to personal distress. Impairments on memory and executive functions have been systematically associated with hoarding behavior, predominantly focusing upon clinical (mainly middle-aged-elderly) patients with hoarding and/or PTSD. We were interested in hoarding-related memory and executive problems in younger non-clinical hoarders or non-hoarders, based on their Saving Inventory-Revised scores. In total, 113 young adults (aged 18-35 years) were assigned to either a hoarder group (N = 40) or non-hoarder group (N = 73) determined by their scores on the Saving Inventory-Revised (SI-R). Working memory (WM) and inhibition control (IC) were measured using the Adult Executive Functioning Inventory (ADEXI) and the Dysexecutive Questionnaire Revised (DEX-R) measured general executive function (EF). The Hospital Anxiety and Depression Scale measured anxiety and depression. After controlling for gender and anxiety, the analysis revealed that the hoarders reported significantly more problems than the non-hoarders on both the IC and general EF. There was no significant between-group difference on the WM sub-scale ADEXI. Self-reported deficits in IC and EF are associated with hoarding behavior. The IC deficits cold explain hoarders' inability to resist urges to buy, and general EF deficits suggest other domains are involved.
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Affiliation(s)
- Tom Heffernan
- Hoarding Research Group, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Colin Hamilton
- Hoarding Research Group, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Nick Neave
- Hoarding Research Group, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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18
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Trajtenberg N, Sánchez de Ribera O, Cook S, Ireland JL. Executive functioning as mediator of the association between traumatic brain injury and prison bullying. Brain Inj 2023; 37:1-13. [PMID: 36748998 DOI: 10.1080/02699052.2023.2170467] [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: 10/02/2021] [Revised: 01/06/2023] [Accepted: 01/16/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study examined whether executive functioning (EF) mediated the relationship between childhood traumatic brain injury (TBI) and engaging in bullying in prison (BP). PARTICIPANTS A sample of male adults in custody in Uruguay (N = 236), drawn from five prisons. METHODS Inmates filled out self-report questionnaires examining TBI (Head Injury Questionnaire), EF (Behavior Rating Inventory of Executive Function Adult, BRIEF-A) and bullying in prison (Direct and Indirect Prisoner Behavior Checklist - revised, SCALED, DIPC-SCALED-r). RESULTS Findings showed that TBI was associated with prison bullying after controlling for age, level of education, socioeconomic status, and civil status. The mediation analysis indicated that the relationship between TBI and bullying was fully mediated via executive impairment, especially through the behavioral regulation component (mainly inhibition and emotional control). CONCLUSION These findings suggested that compensating for EF difficulties in adult inmates with brain injuries might help to decrease the bullying in prison.
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Affiliation(s)
- Nicolás Trajtenberg
- School of Social Science, School of Social Science, University of Manchester, Manchester, UK
| | - Olga Sánchez de Ribera
- School of Social Science, University of Manchester, Manchester, UK
- Department of Psychology, Universidad de la República, Montevideo, Uruguay
| | - Steven Cook
- Department of Epidemiology, School of Public Health, University of Michigan, Washington, USA
| | - Jane L Ireland
- Ashworth Research Centre, Mersey Care NHS Trust and University of Central Lancashire, UK
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19
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Olson L, Vaughn MG. Traumatic Brain Injury and Psychopathic Features Among Juvenile Offenders: Does it Matter Which Traits? INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:184-206. [PMID: 34622698 DOI: 10.1177/0306624x211049200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Psychopathic traits and a history of traumatic brain injury (TBI) are common among imprisoned individuals. Although previous research has examined correlates of TBI among juvenile offenders, little research has explored the relationship between psychopathic traits and TBI among this population. Study objectives included: (1) examine the association between the history of a TBI and psychopathic traits among juvenile offenders and (2) determine if the history of a TBI predicts the manifestation of different psychopathic factors among juvenile offenders. Cross-sectional data from the Multidimensional Youth Residential Inventory consisted of 226 juvenile offenders. Bivariate and multivariate analyses were conducted. Results of linear regression analyses showed that history of a TBI significantly predicted callous unemotional and impulsive irresponsible traits. Clinical implications suggest early intervention is needed to treat the potential long-term effects of TBIs and the development of psychopathic traits. Recommendations for further research are discussed.
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20
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So I, Meusel LAC, Sharma B, Monette GA, Colella B, Wheeler AL, Rabin JS, Mikulis DJ, Green REA. Longitudinal Patterns of Functional Connectivity in Moderate-to-Severe Traumatic Brain Injury. J Neurotrauma 2023; 40:665-682. [PMID: 36367163 DOI: 10.1089/neu.2022.0242] [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: 11/13/2022] Open
Abstract
Longitudinal neuroimaging studies aid our understanding of recovery mechanisms in moderate-to-severe traumatic brain injury (TBI); however, there is a dearth of longitudinal functional connectivity research. Our aim was to characterize longitudinal functional connectivity patterns in two clinically important brain networks, the frontoparietal network (FPN) and the default mode network (DMN), in moderate-to-severe TBI. This inception cohort study of prospectively collected longitudinal data used resting-state functional magnetic resonance imaging (fMRI) to characterize functional connectivity patterns in the FPN and DMN. Forty adults with moderate-to-severe TBI (mean ± standard deviation [SD]; age = 39.53 ± 16.49 years, education = 13.92 ± 3.20 years, lowest Glasgow Coma Scale score = 6.63 ± 3.24, sex = 70% male) were scanned at approximately 0.5, 1-1.5, and 3+ years post-injury. Seventeen healthy, uninjured participants (mean ± SD; age = 38.91 ± 15.57 years, education = 15.11 ± 2.71 years, sex = 29% male) were scanned at baseline and approximately 11 months afterwards. Group independent component analyses and linear mixed-effects modeling with linear splines that contained a knot at 1.5 years post-injury were employed to investigate longitudinal network changes, and associations with covariates, including age, sex, and injury severity. In patients with TBI, functional connectivity in the right FPN increased from approximately 0.5 to 1.5 years post-injury (unstandardized estimate = 0.19, standard error [SE] = 0.07, p = 0.009), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.21, SE = 0.11, p = 0.009), and marginally declined afterwards (estimate = -0.10, SE = 0.06, p = 0.079). Functional connectivity in the DMN increased from approximately 0.5 to 1.5 years (estimate = 0.15, SE = 0.05, p = 0.006), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.19, SE = 0.08, p = 0.021), and was estimated to decline from 1.5 to 3+ years (estimate = -0.04, SE = 0.04, p = 0.303). Similarly, the left FPN increased in functional connectivity from approximately 0.5 to 1.5 years post-injury (estimate = 0.15, SE = 0.05, p = 0.002), contained a slope change in the opposite direction, from positive to negative at 1.5 years post-injury (estimate = -0.18, SE = 0.07, p = 0.008), and was estimated to decline thereafter (estimate = -0.04, SE = 0.03, p = 0.254). At approximately 0.5 years post-injury, patients showed hypoconnectivity compared with healthy, uninjured participants at baseline. Covariates were not significantly associated in any of the models. Findings of early improvement but a tapering and possible decline in connectivity thereafter suggest that compensatory effects are time-limited. These later reductions in connectivity mirror growing evidence of behavioral and structural decline in chronic moderate-to-severe TBI. Targeting such declines represents a novel avenue of research and offers potential for improving clinical outcomes.
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Affiliation(s)
- Isis So
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Liesel-Ann C Meusel
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Bhanu Sharma
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,Department of Medical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Georges A Monette
- Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - Brenda Colella
- KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer S Rabin
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - David J Mikulis
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Imaging, Toronto Western Hospital-University Health Network, Toronto, Ontario, Canada
| | - Robin E A Green
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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21
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Panovka P, Salman Y, Hel-Or H, Rosenblum S, Toglia J, Josman N, Adamit T. Using machine learning to modify and enhance the daily living questionnaire. Digit Health 2023; 9:20552076231169818. [PMID: 37124330 PMCID: PMC10134182 DOI: 10.1177/20552076231169818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
The Daily Living Questionnaire (DLQ) constitutes one of a number of functional cognitive measures, commonly employed in a range of medical and rehabilitation settings. One of the drawbacks of the DLQ is its length which poses an obstacle to conducting efficient and widespread screening of the public and which incurs inaccuracies due to the length and fatigue of the subjects. Objective This study aims to use Machine Learning (ML) to modify and abridge the DLQ without compromising its fidelity and accuracy. Method Participants were interviewed in two separate research studies conducted in the United States of America and Israel, and one unified file was created for ML analysis. An ML-based Computerized Adaptive Testing (ML-CAT) algorithm was applied to the DLQ database to create an adaptive testing instrument-with a shortened test form adapted to individual test scores. Results The ML-CAT approach was shown to reduce the number of tests required on average by 25% per individual when predicting each of the seven DLQ output scores independently and reduce by over 50% when predicting all seven scores concurrently using a single model. These results maintained an accuracy of 95% (5% error) across subject scores. The study pinpoints which DLQ items are more informative in predicting DLQ scores. Conclusions Applying the ML-CAT model can thus serve to modify, refine and even abridge the current DLQ, thereby enabling wider community screening while also enhancing clinical and research utility.
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Affiliation(s)
- Peleg Panovka
- Department of Computer Science, University of Haifa, Haifa, Israel
| | - Yaron Salman
- Department of Computer Science, University of Haifa, Haifa, Israel
| | - Hagit Hel-Or
- Department of Computer Science, University of Haifa, Haifa, Israel
- Hagit Hel-Or, Department of Computer Science, University of Haifa, Abba Khoushy Ave 199, Haifa 3498838, Israel.
| | - Sara Rosenblum
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Joan Toglia
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, USA
| | - Naomi Josman
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Tal Adamit
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
- Maccabi Health-Care Services, Tel-Aviv, Israel
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22
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Bray MJC, Bryant BR, Esagoff AI, Richey LN, Rodriguez C, Krieg A, McCullough G, Tsai J, Tobolowsky W, Jahed S, Cullum CM, LoBue C, Ismail Z, Yan H, Lyketsos CG, Peters ME. Effect of traumatic brain injury on mild behavioral impairment domains prior to all-cause dementia diagnosis and throughout disease progression. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12364. [PMID: 36514440 PMCID: PMC9735270 DOI: 10.1002/trc2.12364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 09/09/2022] [Accepted: 10/28/2022] [Indexed: 12/14/2022]
Abstract
Introduction Traumatic brain injury (TBI) may alter dementia progression, although co-occurring neuropsychiatric symptoms (NPS) have received less attention. Originally designed to evaluate behavioral disruption prior to dementia diagnosis, the mild behavioral impairment (MBI) construct relates NPS to underlying neural circuit disruptions, with probable relevance across the progression of neurodegenerative disease. Therefore, the MBI construct may represent a valuable tool to identify and evaluate related NPS both preceding diagnosis of all-cause dementia throughout the progression of disease, representing an important area of inquiry regarding TBI and dementia. This investigation sought to evaluate the effect of TBI on NPS related by the MBI construct in participants progressing from normal cognitive status to all-cause dementia. Methods Using National Alzheimer's Coordinating Center data, individuals progressing from normal cognition to all-cause dementia (clinician diagnosed) over 7.6 ± 3.0 years were studied to estimate prevalence of MBI domains in 124 participants with prior TBI history (57 with loss of consciousness [LOC] <5 minutes, 22 with LOC >5 min, 45 unknown severity) compared to 822 without. MBI domain prevalence was evaluated (1) prior to dementia onset (including only time points preceding time at dementia diagnosis, as per MBI's original definition) and (2) throughout dementia progression (evaluating all available time points, including both before and after dementia diagnosis). Results More severe TBI (LOC >5 minutes) was associated with the social inappropriateness MBI domain (adjusted odds ratio = 4.034; P = 0.024) prior to dementia onset, and the abnormal perception/thought content domain looking across dementia progression (adjusted hazard ratio [HRadj] = 3.703; P = 0.005). TBI (all severities) was associated with the decreased motivation domain looking throughout dementia progression (HRadj. = 1.546; P = 0.014). Discussion TBI history is associated with particular MBI profiles prior to onset and throughout progression of dementia. Understanding TBI's impact on inter-related NPS may help elucidate underlying neuropathology with implications for surveillance, detection, and treatment of behavioral concerns in aging TBI survivors. Highlights The mild behavioral impairment (MBI) construct links related neuropsychiatric symptoms (NPS) by probable underlying neural network dysfunction.Traumatic brain injury (TBI) with loss of consciousness (LOC) > 5 minutes was associated with pre-dementia social inappropriateness.TBI was associated with decreased motivation looking across dementia progression.TBI with LOC > 5 minutes was associated with abnormal perception/thought content.The MBI construct may be useful for examining related NPS across dementia progression.
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Affiliation(s)
- Michael J. C. Bray
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Barry R. Bryant
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Aaron I. Esagoff
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Lisa N. Richey
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Carla Rodriguez
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Akshay Krieg
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Gardner McCullough
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jerry Tsai
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - William Tobolowsky
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Sahar Jahed
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Psychiatry and Behavioral MedicineMedical College of WisconsinMilwaukeeWisconsinUSA
| | - C. Munro Cullum
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Christian LoBue
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Zahinoor Ismail
- Department of Psychiatry, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Haijuan Yan
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Constantine G. Lyketsos
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Matthew E. Peters
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Transgender Youth Executive Functioning: Relationships with Anxiety Symptoms, Autism Spectrum Disorder, and Gender-Affirming Medical Treatment Status. Child Psychiatry Hum Dev 2022; 53:1252-1265. [PMID: 34146208 DOI: 10.1007/s10578-021-01195-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
Executive function (EF) underlies broad health and adaptive outcomes. For transgender youth, navigating gender discernment and gender affirmation demand EF. Yet, factors associated with transgender youth EF are unknown. We investigate hypothesized predictors of EF: over-represented conditions among transgender youth (anxiety and depression symptoms, autism spectrum disorder [ASD]) and gender-affirming care. One-hundred twenty-four transgender 11-21-year-olds participated. Parents/caregivers completed EF and mental health report measures. ASD diagnostics and gender-affirming medication histories were collected. 21 % of non-autistic and 69 % of autistic transgender youth had clinically elevated EF problems. Membership in the gender-affirming hormone treatment group was associated with better EF. ASD, anxiety symptoms, and membership in the long-duration pubertal suppression group were associated with poorer EF. Given the importance of EF skills for multiple outcomes, and the unique and additional EF demands specific to transgender youths' experiences, EF skill monitoring-and when appropriate, supports-should be considered for transgender youth.
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Walker CD, Sexton HG, Hyde J, Greene B, Risher ML. Diverging Effects of Adolescent Ethanol Exposure on Tripartite Synaptic Development across Prefrontal Cortex Subregions. Cells 2022; 11:3111. [PMID: 36231073 PMCID: PMC9561972 DOI: 10.3390/cells11193111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/26/2022] Open
Abstract
Adolescence is a developmental period that encompasses, but is not limited to, puberty and continues into early adulthood. During this period, maturation and refinement are observed across brain regions such as the prefrontal cortex (PFC), which is critical for cognitive function. Adolescence is also a time when excessive alcohol consumption in the form of binge drinking peaks, increasing the risk of long-term cognitive deficits and the risk of developing an alcohol use disorder later in life. Animal models have revealed that adolescent ethanol (EtOH) exposure results in protracted disruption of neuronal function and performance on PFC-dependent tasks that require higher-order decision-making. However, the role of astrocytes in EtOH-induced disruption of prefrontal cortex-dependent function has yet to be elucidated. Astrocytes have complex morphologies with an extensive network of peripheral astrocyte processes (PAPs) that ensheathe pre- and postsynaptic terminals to form the 'tripartite synapse.' At the tripartite synapse, astrocytes play several critical roles, including synaptic maintenance, dendritic spine maturation, and neurotransmitter clearance through proximity-dependent interactions. Here, we investigate the effects of adolescent binge EtOH exposure on astrocyte morphology, PAP-synaptic proximity, synaptic stabilization proteins, and dendritic spine morphology in subregions of the PFC that are important in the emergence of higher cognitive function. We found that adolescent binge EtOH exposure resulted in subregion specific changes in astrocyte morphology and astrocyte-neuronal interactions. While this did not correspond to a loss of astrocytes, synapses, or dendritic spines, there was a corresponding region-specific and EtOH-dependent shift in dendritic spine phenotype. Lastly, we found that changes in astrocyte-neuronal interactions were not a consequence of changes in the expression of key synaptic structural proteins neurexin, neuroligin 1, or neuroligin 3. These data demonstrate that adolescent EtOH exposure results in enduring effects on neuron-glia interactions that persist into adulthood in a subregion-specific PFC manner, suggesting selective vulnerability. Further work is necessary to understand the functional and behavioral implications.
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Affiliation(s)
- Christopher Douglas Walker
- Department of Biomedical Research, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
- Neurobiology Research Laboratory, Hershel ‘Woody’ Williams Veterans Affairs Medical Center, Huntington, WV 25704, USA
| | - Hannah Gray Sexton
- Department of Biomedical Research, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
- Neurobiology Research Laboratory, Hershel ‘Woody’ Williams Veterans Affairs Medical Center, Huntington, WV 25704, USA
| | - Jentre Hyde
- Department of Biomedical Research, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
| | - Brittani Greene
- Department of Biomedical Research, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
| | - Mary-Louise Risher
- Department of Biomedical Research, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
- Neurobiology Research Laboratory, Hershel ‘Woody’ Williams Veterans Affairs Medical Center, Huntington, WV 25704, USA
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Alderman N, Williams C, Wood RL. Using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) to determine prevalence and predictors of neurobehavioural disability amongst survivors with traumatic brain injury in the community. Neuropsychol Rehabil 2022; 32:2342-2369. [PMID: 34180770 DOI: 10.1080/09602011.2021.1946092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Studies using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) confirm neurobehavioural disability (NBD) is highly prevalent in inpatient Neurobehavioural Rehabilitation and Stroke samples. However, a recent study amongst a Danish community sample of acquired brain injury survivors found a relative paucity of NBD symptoms; and when symptoms were present, they tended to be of mild severity. The current observational study employed the SASNOS to explore prevalence of NBD in survivors with traumatic brain injury (TBI) living in the community, the extent of survivors' self-awareness of NBD symptoms, and constructed prediction models of NBD. A de-identified data set was compiled, comprising data for 97 TBI survivors (74.2% men, mean time since injury 2.8 years). In addition to SASNOS self- and proxy-ratings, various demographic, clinical and injury-related characteristics were captured. NBD was found to be highly characteristic, although severity varied depending on subtype. Statistical comparison of self- and proxy-ratings did not support reduced self awareness regarding NBD, whereas treating the problem as one of inter-rater reliability suggested this was an issue. Executive impairment, depressed mood and sex were especially prognostic of NBD. Reasons accounting for differences in NBD between the community samples are discussed and recommendations for future research made.
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Affiliation(s)
- Nick Alderman
- Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, Swindon, UK.,Department of Psychology, Swansea University, Swansea, UK
| | - Claire Williams
- Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, Swindon, UK.,Department of Psychology, Swansea University, Swansea, UK
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Zheng L, Pang Q, Xu H, Guo H, Liu R, Wang T. The Neurobiological Links between Stress and Traumatic Brain Injury: A Review of Research to Date. Int J Mol Sci 2022; 23:ijms23179519. [PMID: 36076917 PMCID: PMC9455169 DOI: 10.3390/ijms23179519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
Neurological dysfunctions commonly occur after mild or moderate traumatic brain injury (TBI). Although most TBI patients recover from such a dysfunction in a short period of time, some present with persistent neurological deficits. Stress is a potential factor that is involved in recovery from neurological dysfunction after TBI. However, there has been limited research on the effects and mechanisms of stress on neurological dysfunctions due to TBI. In this review, we first investigate the effects of TBI and stress on neurological dysfunctions and different brain regions, such as the prefrontal cortex, hippocampus, amygdala, and hypothalamus. We then explore the neurobiological links and mechanisms between stress and TBI. Finally, we summarize the findings related to stress biomarkers and probe the possible diagnostic and therapeutic significance of stress combined with mild or moderate TBI.
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Affiliation(s)
- Lexin Zheng
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Qiuyu Pang
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Heng Xu
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Hanmu Guo
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Rong Liu
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
| | - Tao Wang
- Department of Forensic Medicine, School of Basic Medicine and Biological Sciences, Soochow University, Suzhou 215123, China
- Shanghai Key Lab of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice, China (Academy of Forensic Science), Shanghai 200063, China
- Correspondence:
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Vilca LW. The moderating role of sex in the relationship between executive functions and academic procrastination in undergraduate students. Front Psychol 2022; 13:928425. [PMID: 36072020 PMCID: PMC9444057 DOI: 10.3389/fpsyg.2022.928425] [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: 04/25/2022] [Accepted: 07/29/2022] [Indexed: 12/04/2022] Open
Abstract
The objective of the study was to determine if sex plays a moderating role in the relationship between executive functions and academic procrastination in 106 university students of both genders (28.3% male and 71.7% female) between the ages of 18 and 30 years (M = 19.7; SD = 2.7). The Academic Procrastination Scale and the Neuropsychological Battery of Executive Functions and Frontal Lobes (BANFE-2) were used to measure the variables. The results of the study showed that the degree of prediction of the tasks linked to the orbitomedial cortex (involves the orbitofrontal cortex [OFC] and the medial prefrontal cortex [mPFC]) on academic procrastination is significantly moderated by the sex of the university students (β3 = 0.53; p < 0.01). For men, the estimated effect of the tasks linked to the orbitomedial cortex on the degree of academic procrastination is −0.81. For women, the estimated effect of the tasks linked to the orbitomedial cortex on the degree of academic procrastination is −0.28. In addition, it was shown that sex does not play a moderating role in the relationship between the tasks linked to the dorsolateral prefrontal cortex (dlPFC) and academic procrastination (β3 = 0.12; p > 0.05). It was also determined that sex does not play a moderating role in the relationship between the tasks linked to the anterior prefrontal cortex (aPFC) and academic procrastination (β3 = 0.05; p > 0.05). It is concluded that only the executive functions associated with the orbitomedial cortex are moderated by the sex of the university students, where the impact of the tasks linked to the orbitomedial cortex on academic procrastination in men is significantly greater than in women.
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Nadler Tzadok Y, Eliav R, Portnoy S, Rand D. Establishing the Validity of the Internet-Based Bill-Paying Task to Assess Executive Function Deficits Among Adults With Traumatic Brain Injury. Am J Occup Ther 2022; 76:23305. [PMID: 35727641 DOI: 10.5014/ajot.2022.047266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Executive function (EF) deficits are common after traumatic brain injury (TBI). During rehabilitation, it is important to identify EF deficits and understand their impact on daily function. The internet-based Bill-Paying Task, modified from the Executive Function Performance Test, has not yet been validated for use with people with TBI. OBJECTIVE To examine the known-groups, convergent, and ecological validity of the internet-based Bill-Paying Task for assessing EF deficits after TBI. DESIGN Cross-sectional study with two consecutive parts based on the study's objectives. SETTING Inpatient rehabilitation and community. PARTICIPANTS Part 1 included 42 adults with TBI and 47 healthy adults; Part 2 included 28 of the 42 adults with TBI. MEASURES Assessments included the Internet-based Bill-Paying Task, WebNeuro neurocognitive computerized battery, Semantic Verbal Fluency test, Behavioural Assessment of the Dysexecutive Syndrome (BADS), Dysexecutive Questionnaire (DEX), and cognitive items of the FIM® and the Functional Assessment Measure (cognitive FIM+FAM). RESULTS For Part 1, participants with TBI required significantly more cues and longer completion time to perform the internet-based Bill-Paying Task. For Part 2, moderate significant correlations were found between the internet-based Bill-Paying Task total score and the WebNeuro, Semantic Verbal Fluency test, BADS, DEX, and cognitive FIM+FAM. CONCLUSIONS AND RELEVANCE This study supports the known-groups, convergent, and ecological validity of the internet-based Bill-Paying Task for assessing EF deficits among adults with preserved basic cognitive abilities after TBI. Therefore, it can be used to assist with rehabilitation treatment planning after TBI. What This Article Adds: The internet-based Bill-Paying Task, an online payment task relevant to today's technological world, is valid to assess higher cognitive abilities of people after a traumatic brain injury. This assessment may contribute to a better understanding of patients' cognitive profiles and their potential impact on daily performance.
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Affiliation(s)
- Yael Nadler Tzadok
- Yael Nadler Tzadok, OT, MSc, is Occupational Therapist, Department of Occupational Therapy, Loewenstein Rehabilitation Center, Ra'anana, Israel. At the time of the research, Tzadok was Graduate Student, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rotem Eliav
- Rotem Eliav, OT, MSc, is Occupational Therapist, Department of Occupational Therapy, Loewenstein Rehabilitation Center, Ra'anana, Israel. At the time of the research, Eliav was Graduate Student, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Portnoy
- Sigal Portnoy, Eng, PhD, is Senior Lecturer, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Debbie Rand
- Debbie Rand, OT, PhD, is Associate Professor, Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
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29
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Gibson JM, Howland CP, Ren C, Howland C, Vernino A, Tsai PT. A Critical Period for Development of Cerebellar-Mediated Autism-Relevant Social Behavior. J Neurosci 2022; 42:2804-2823. [PMID: 35190469 PMCID: PMC8973277 DOI: 10.1523/jneurosci.1230-21.2021] [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] [Received: 06/15/2021] [Revised: 10/25/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022] Open
Abstract
The cerebellum has been increasingly implicated in autism spectrum disorder (ASD) with many ASD-linked genes impacting both cerebellar function and development. However, the precise timing and critical periods of when abnormal cerebellar neurodevelopment contributes to ASD-relevant behaviors remains poorly understood. In this study, we identify a critical period for the development of ASD-relevant behaviors in a cerebellar male mouse model of tuberous sclerosis complex (TSC), by using the mechanistic target of rapamycin (mTOR) inhibitor, rapamycin, to pharmacologically inhibit dysregulated downstream signaling. We find independent critical periods during which abnormal ASD-relevant behaviors develop for the two core ASD diagnostic criteria, social impairments and behavioral flexibility, and delineate an anatomic, physiological, and behavioral framework. These findings not only further our understanding of the genetic mechanisms underlying the timing of ASD-relevant behaviors but also have the capacity to inform potential therapies to optimize treatment interventions.SIGNIFICANCE STATEMENT No targeted treatments currently exist for autism spectrum disorder (ASD). This complex developmental disorder has established links to genetic and circuit aberrations, yet the precise timing and coordination of these underlying mechanisms that contribute to the spectrum of physiological and behavioral abnormalities remains unclear. Cerebellar pathology is consistently seen in ASD individuals; therefore, we sought to identify the specific windows for cerebellar involvement in the development of ASD-relevant behaviors. Using pharmacologic treatment paradigms, we outline distinct critical periods of developmental vulnerability for ASD-relevant social and inflexible behaviors. From this study, we posit a refined window of time during which ASD symptoms develop that will inform therapeutic timing.
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Affiliation(s)
- Jennifer M Gibson
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Cleone P Howland
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Chongyu Ren
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Cyrena Howland
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Alexandra Vernino
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Peter T Tsai
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX 75390
- Departments of Pediatrics and Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
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30
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Buchan LD, McMillan TM. Prisoner knowledge about head injury is Improved by brief psychoeducation. Brain Inj 2022; 36:401-405. [PMID: 35143348 DOI: 10.1080/02699052.2022.2034187] [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
INTRODUCTION The high prevalence of head injury (HI) in prisoners and its association with offending indicates a need for interventions. However, there is little evidence and none for the effectiveness of psychoeducation in improving prisoner knowledge about HI and its effects. METHODS Small groups of males in two Scottish prisons underwent a 1 hour psychoeducation session delivered by PowerPoint and combined with question and answer, video clips and a booklet about HI. A pre-post intervention design was used to assess knowledge about HI from vignettes. Participants indicated effects of HI using unprompted free recall and then with a questionnaire (the Symptom Checklist; SCL), pre-education (n = 34), post-education (n = 19) and at 4-week follow-up (n = 11). Free recall was scored using symptom lists from national guidelines (FR-SIGN) or the SCL (FR-SCL). Within-subject comparisons were made between pre-intervention, post-intervention and follow-up scores. RESULTS Knowledge about HI significantly increased pre- to post-education for FR-SIGN (d = 0.91; 95% CI 0.62, 2.53) and FR-SCL (d = 0.99; 95% CI 0.95, 4.00) without decrement at follow-up (FR-SIGN d = 1.27; 95% CI 0.53, 2.56; FR-SCL r = 0.60). Scores on the SCL did not change over time (p > .05). CONCLUSION Prisoner knowledge about HI was improved by brief psychoeducation suitable for delivery in prisons.
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Affiliation(s)
- Louise D Buchan
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, Scotland
| | - Tom M McMillan
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, Scotland
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31
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Newstead S, Lewis J, Roderique-Davies G, Heirene RM, John B. The Paradox of the Frontal Lobe Paradox. A Scoping Review. Front Psychiatry 2022; 13:913230. [PMID: 35935412 PMCID: PMC9353325 DOI: 10.3389/fpsyt.2022.913230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
The "frontal lobe paradox" highlights a phenomenon in which a subset of patients who possess frontal lobe damage and exhibit marked impairments in everyday life are still able to able to verbally describe a logical course of action relating to a task and perform well in interview and test settings. Such cases pose a challenge with regard to the assessment of mental capacity within clinical settings. Recent position articles state that the frontal lobe paradox is a well-known phenomenon within the field of neuropsychology, anecdotal reports from clinicians in the UK suggest this is not the case. Consequently, we conducted a scoping review to examine the breadth and depth of literature relating to the frontal lobe paradox. Searches were conducted using electronic databases and search engines, which were supplemented with a snowball search of the references used within relevant literature. We identified and reviewed 28 documents specifically related to the frontal lobe paradox. Nearly 50% of all identified academic texts published since 2000 were position articles that cited a handful of case studies published between 1936 and 1986 as evidence for the phenomenon. We also observed instances of articles citing position articles as evidence of the frontal lobe paradox. Overall, our findings indicate a lack of readily accessible research specific to the frontal lobe paradox. In particular, there is a lack of contemporary research specific to the subject and an absence of clarification as to which syndromes and disorders are included within the term.
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Affiliation(s)
- Simon Newstead
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
| | - Julia Lewis
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom.,Gwent Specialist Substance Misuse Service, Newport, United Kingdom
| | - Gareth Roderique-Davies
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
| | - Robert M Heirene
- School of Psychology, College of Health and Human Sciences, Charles Darwin University, Darwin, NT, Australia
| | - Bev John
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
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Sahu R, Upadhayay S, Mehan S. Inhibition of extracellular regulated kinase (ERK)-1/2 signaling pathway in the prevention of ALS: Target inhibitors and influences on neurological dysfunctions. Eur J Cell Biol 2021; 100:151179. [PMID: 34560374 DOI: 10.1016/j.ejcb.2021.151179] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/18/2021] [Accepted: 09/15/2021] [Indexed: 12/13/2022] Open
Abstract
Cell signal transduction pathways are essential modulators of several physiological and pathological processes in the brain. During overactivation, these signaling processes may lead to disease progression. Abnormal protein kinase activation is associated with several biological dysfunctions that facilitate neurodegeneration under different biological conditions. As a result, these signaling pathways are essential in understanding brain disorders' development or progression. Recent research findings indicate the crucial role of extracellular signal-regulated kinase-1/2 (ERK-1/2) signaling during the neuronal development process. ERK-1/2 is a key component of its mitogen-activated protein kinase (MAPK) group, controlling certain neurological activities by regulating metabolic pathways, cell proliferation, differentiation, and apoptosis. ERK-1/2 also influences neuronal elastic properties, nerve growth, and neurological and cognitive processing during brain injuries. The primary goal of this review is to elucidate the activation of ERK1/2 signaling, which is involved in the development of several ALS-related neuropathological dysfunctions. ALS is a rare neurological disorder category that mainly affects the nerve cells responsible for regulating voluntary muscle activity. ALS is progressive, which means that the symptoms are getting worse over time, and there is no cure for ALS and no effective treatment to avoid or reverse. Genetic abnormalities, oligodendrocyte degradation, glial overactivation, and immune deregulation are associated with ALS progression. Furthermore, the current review also identifies ERK-1/2 signaling inhibitors that can promote neuroprotection and neurotrophic effects against the clinical-pathological presentation of ALS. As a result, in the future, the potential ERK-1/2 signaling inhibitors could be used in the treatment of ALS and related neurocomplications.
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Affiliation(s)
- Rakesh Sahu
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab, India
| | - Shubham Upadhayay
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab, India
| | - Sidharth Mehan
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab, India.
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Barrios-Fernandez S, Gozalo M, Amado-Fuentes M, Carlos-Vivas J, Garcia-Gomez A. A Short Version of the EFECO Online Questionnaire for the Assessment of Executive Functions in School-Age Children. CHILDREN (BASEL, SWITZERLAND) 2021; 8:799. [PMID: 34572231 PMCID: PMC8465183 DOI: 10.3390/children8090799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/01/2021] [Accepted: 09/10/2021] [Indexed: 01/06/2023]
Abstract
Executive function (EF) is a group of processes that allow individuals to be goal-oriented and to have adaptive functioning, so that adequate performance is essential for success in activities of daily living, at school and in other activities. The present study aims to create a short version of the Executive Functioning Questionnaire (EFECO) since there is a gap in the Spanish literature due to the lack of behavioural observation questionnaires at school age. A total of 3926 participants completed the online questionnaire. Subsequently, the validity and reliability of the data are analysed. The results show that the short version of the questionnaire, the EFECO-S, has a structure with five dimensions (emotional self-control, initiation, working memory, inhibition, and spatial organisation), as well as a second-order factor (global executive skill) and high reliability (ordinal Alpha = 0.68-0.88). The EFECO is composed of 67 items, while the EFECO-S has 20 items, four per factor, which turns it into a quick and easy to apply test. Therefore, it becomes an interesting alternative to be applied in screening processes with children who may be experiencing executive difficulties.
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Affiliation(s)
- Sabina Barrios-Fernandez
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Cáceres, Spain;
| | - Margarita Gozalo
- Psychology and Anthropology Department, University of Extremadura, 10003 Cáceres, Spain;
| | - Maria Amado-Fuentes
- Psychology and Anthropology Department, University of Extremadura, 10003 Cáceres, Spain;
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Andres Garcia-Gomez
- Education Sciences Department, University of Extremadura, 10003 Cáceres, Spain;
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McMillan TM, Aslam H, Crowe E, Seddon E, Barry SJE. Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study. Lancet Psychiatry 2021; 8:512-520. [PMID: 33992149 PMCID: PMC8139871 DOI: 10.1016/s2215-0366(21)00082-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND The prevalence of head injury is estimated to be as high as 55% in women in prison and might be a risk factor for violent offending, but evidence is equivocal. The extent of persisting disability is unknown, making decisions about service needs difficult. The UN recognises vulnerabilities in women in prison, but does not include head injury. This study aimed to investigate relationships among head injury, comorbidities, disability, and offending in women in prison. METHODS In this cross-sectional study, women were recruited between Feb 2, 2018, and Sept 30, 2019, from four prisons across Scotland, UK: Her Majesty's Prison (HMP) Cornton Vale, Her Majesty's Young Offenders Institute Polmont, HMP Edinburgh, and HMP Greenock (detaining approximately 355 individuals at the time of recruitment). Women were included if they were aged older than 16 years, fluent in English, able to participate in face-to-face assessment and provide informed consent, and did not have a severe acute disorder of cognition or communication. Head injury, cognition, disability, mental health, and history of abuse and problematic substance use were assessed by interview. History of head injury was assessed with the Ohio State University Traumatic Brain Injury Identification method and disability was assessed with the Glasgow Outcome at Discharge Scale. Comparisons were made between women with and without a history of significant head injury. FINDINGS We recruited 109 (31%) of the 355 women in these prisons. The sample was demographically representative of the approximately 400 individuals in women's prisons in Scotland. Significant head injury (SHI) was found in 85 (78%) of 109 women, of whom 34 (40%) had associated disability. Repeat head injury was reported in 71 (84%) of the 85 women with SHI and, in most cases, this resulted from domestic abuse that had occurred over many years. Women with a history of SHI were significantly more likely to have a history of violent offences than those without a history of SHI (66 [79%] of 85 women in the SHI group vs 13 [54%] of 24 women in the no-SHI group had committed a violent offence; odds ratio [OR] 3·1, 95% CI 1·2-8·1). This effect remained significant after adjusting for current factors (3·1, 1·1-9·0), including comorbidities associated with post-traumatic stress disorder, and was no longer statistically significant after adjusting for historical factors (3·3, 1·0-10·9), such as abuse as a child or adult. Women with SHI had spent longer in prison than women without SHI after adjustment for current (rate ratio 3·4, 1·3-8·4) or historical (3·5, 1·3-9·2) risk factors. INTERPRETATION It is recognised that women in prison are vulnerable because of histories of abuse and problematic substance use; however, history of SHI needs to be included when developing criminal justice policy, interventions to reduce mental health morbidity, and assessment and management of risk of violent offending. FUNDING The Scottish Government.
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Affiliation(s)
- Tom M McMillan
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK.
| | - Hira Aslam
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - Eimear Crowe
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - Eleanor Seddon
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - Sarah J E Barry
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
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DiBona VL, Shah MK, Krause KJ, Zhu W, Voglewede MM, Smith DM, Crockett DP, Zhang H. Metformin reduces neuroinflammation and improves cognitive functions after traumatic brain injury. Neurosci Res 2021; 172:99-109. [PMID: 34023358 PMCID: PMC8449802 DOI: 10.1016/j.neures.2021.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/17/2021] [Accepted: 05/16/2021] [Indexed: 01/27/2023]
Abstract
Within the brain, traumatic brain injury (TBI) alters synaptic plasticity and increases neuroinflammation and neuronal death. Yet, there lacks effective TBI treatments providing pleiotropic beneficial effects on these diverse cellular processes necessary for functional recovery. Here, we show the diabetes drug, metformin, significantly improves cognitive functions after controlled cortical impact (CCI) injury in mice, showing improved spatial learning and nest building. Furthermore, injured animals treated with metformin exhibit increased ramification of microglia processes, indicating reduced neuroinflammation. Finally, metformin treatment in vitro increased neuronal activation of partitioning defective 1 (Par1), a family of Ser/Thr kinases playing a key role in synaptic plasticity and neuroinflammation. These results suggest metformin is a promising therapeutic agent for targeting multiple cellular processes necessary for functional TBI recovery.
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Affiliation(s)
- Victoria L DiBona
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Mihir K Shah
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Kayla J Krause
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Wenxin Zhu
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Mikayla M Voglewede
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Dana M Smith
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - David P Crockett
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Huaye Zhang
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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Banerjee M, Hegde S, Thippeswamy H, Kulkarni GB, Rao N. In search of the 'self': Holistic rehabilitation in restoring cognition and recovering the 'self' following traumatic brain injury: A case report. NeuroRehabilitation 2021; 48:231-242. [PMID: 33664160 DOI: 10.3233/nre-208017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Following mild-moderate traumatic brain injury (TBI), an individual experiences a range of emotional changes. It is often difficult for the patient to reconcile with their post-injury persona, and the memory of pre-injury personhood is particularly painful. Insight into one's cognitive deficits subsequent to injury can lead to an existential crisis and a sense of loss, including loss of self. OBJECTIVE Restoration of cognitive functions and reconciliation with loss of pre-traumatic personhood employing a holistic method of neuropsychological rehabilitation in a patient suffering from TBI. METHODS Ms. K.S, a 25-year-old female, presented with emotional disturbances following TBI. She reported both retrograde and anterograde amnesia. A multidimensional holistic rehabilitation was planned. Treatment addressed cognitive deficits through the basic functions approach. Cognitive behavioural methods for emotional regulation like diary writing helped reduce irritability and anger outbursts. Use of social media created new modes of memory activation and interactions. Compensatory strategies were used to recover lost skills, music-based attention training helped foster an individualised approach to the sense of one's body and self. RESULTS As a result of these differing strategies, changes were reflected in neuro-psychological tests, depression score and the patient's self-evaluation. This helped generate a coherent self-narrative. CONCLUSION Treatment challenges in such cases are increased due to patient's actual deficits caused by neuronal/biochemical changes. Innovative and multi-pronged rehabilitation strategies which involve everyday activities provided an answer to some of these problems. This method of rehabilitation may provide an optimistic context for future research.
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Affiliation(s)
- Meenakshi Banerjee
- Neuropsychology and Cognitive Neuroscience Centre, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Shantala Hegde
- Neuropsychology and Cognitive Neuroscience Centre, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.,Associate Professor and Wellcome DBT India Alliance Intermediate Fellow, Clinical Neuropsychology and Cognitive Neuro Sciences Center, Music Cognition Laboratory, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.,Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Harish Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Girish B Kulkarni
- Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Narasinga Rao
- Department of Surgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
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Hoffman AN, Watson S, Fanselow MS, Hovda DA, Giza C. Region-Dependent Modulation of Neural Plasticity in Limbic Structures Early after Traumatic Brain Injury. Neurotrauma Rep 2021; 2:200-213. [PMID: 33937912 PMCID: PMC8086520 DOI: 10.1089/neur.2020.0045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Traumatic brain injury (TBI)-induced disruptions in synaptic function within brain regions and across networks in the limbic system may underlie a vulnerability for maladaptive plasticity and contribute to behavioral comorbidities. In this study we measured how synaptic proteins respond to lateral fluid percussion injury (FPI) brain regions known to regulate emotion and memory, including the basolateral amygdala (BLA), dorsal and ventral hippocampus (DH, VH), and medial prefrontal cortex (PFC). We investigated proteins involved in regulating plasticity, including synaptic glutamatergic a-amino-3-hydroxy5-methyl-4-isoxazolepropionic acid (AMPA; GluA1, GluA2) and N-methyl-D-aspartate (NMDA; NR1, NR2A, NR2B) receptor subunits as well as inhibitory gamma-aminobutyric acid (GABA) synthetic enzymes (GAD67, GAD65) via western blot. Adult male rats received a mild-moderate lateral FPI or sham surgery and ipsi- and contralateral BLA, DH, VH, and PFC were collected 6 h, 24 h, 48 h, and 7 days post-injury. In the ipsilateral BLA, there was a significant decrease in NR1 and GluA2 24 h after injury, whereas NR2A and NR2B were increased in the contralateral BLA at 48 h compared with sham. GAD67 was increased ipsilaterally at 24 h, but decreased contralaterally at 48 h in the BLA. In the DH, both NMDA (NR2A, NR2B) and GABA-synthetic (GAD65, GAD67) proteins were increased acutely at 6 h compared with sham. GAD67 was also robustly increased in the ipsilateral VH at 6 h. In the contralateral VH, NR2A significantly increased between 6 h and 24 h after FPI, whereas GAD65 was decreased across the same time-points in the contralateral VH. In the medial PFC at 24 h we saw bilateral increases in GAD67 and a contralateral decrease in GluA1. Later, there was a significant decrease in GAD67 in contralateral PFC from 48 h to 7 days post-injury. Collectively, these data suggest that lateral FPI causes a dynamic homeostatic response across limbic networks, leading to an imbalance of the proteins involved in plasticity in neural systems underlying cognitive and emotional regulation.
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Affiliation(s)
- Ann N Hoffman
- Department of Neurosurgery, Brain Injury Research Center, University of California, Los Angeles, Los Angeles, California, USA.,Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA.,Staglin Center for Brain and Behavioral Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Sonya Watson
- Department of Neurosurgery, Brain Injury Research Center, University of California, Los Angeles, Los Angeles, California, USA.,Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Michael S Fanselow
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA.,Staglin Center for Brain and Behavioral Health, University of California, Los Angeles, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - David A Hovda
- Department of Neurosurgery, Brain Injury Research Center, University of California, Los Angeles, Los Angeles, California, USA.,Steve Tisch BrainSPORT Program, University of California, Los Angeles, Los Angeles, California, USA.,Department of Medical and Molecular Pharmacology, University of California, Los Angeles, Los Angeles, California, USA
| | - Christopher Giza
- Department of Neurosurgery, Brain Injury Research Center, University of California, Los Angeles, Los Angeles, California, USA.,Steve Tisch BrainSPORT Program, University of California, Los Angeles, Los Angeles, California, USA.,Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California, USA
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38
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Smith PJ, Potter G, Manson M, Martin M, Cendales LC. Psychosocial considerations in the assessment of hand transplant candidates: A single-center experience and brief literature review. Clin Transplant 2021; 35:e14268. [PMID: 33615558 DOI: 10.1111/ctr.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 11/27/2022]
Abstract
Vascularized composite allograft, including hand transplantation (HT), has gained wider usage as a reconstructive treatment over the past 30 years. HT recipients face unique psychosocial challenges compared to their solid organ and/or bone marrow transplant counterparts. Accordingly, the psychosocial evaluation among HT candidates continues to evolve, leaving a lack of consensus as to the critical psychosocial domains and psychometric testing instruments to help evaluate individuals considering HT. The present manuscript describes the psychosocial evaluation process within the Duke HT program, which been contacted by 80 potential candidates since 2014. The Duke HT evaluation process incorporates a comprehensive psychosocial assessment within domains including personality, cognitive function, mood, behavioral adherence, social support, and substance use history, among others. Our experience underscores the potential utility of collecting thorough psychosocial evaluations, supplemented by psychometric test data, to comprehensively assess potential HT candidates.
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Affiliation(s)
- Patrick J Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,Department of Medicine, Duke University Medical Center, Durham, NC, USA.,Department of Population Health Sciences, Duke University Medical Center, Durham, NC, USA
| | - Guy Potter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Maria Manson
- Duke Office of Clinical Research, Duke School of Medicine, Durham, NC, USA
| | - Michael Martin
- Atlanta VA Healthcare System, Mental Health Service Line, Decatur, GA, USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Linda C Cendales
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
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39
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Siponkoski ST, Koskinen S, Laitinen S, Holma M, Ahlfors M, Jordan-Kilkki P, Ala-Kauhaluoma K, Martínez-Molina N, Melkas S, Laine M, Ylinen A, Zasler N, Rantanen P, Lipsanen J, Särkämö T. Effects of neurological music therapy on behavioural and emotional recovery after traumatic brain injury: A randomized controlled cross-over trial. Neuropsychol Rehabil 2021; 32:1356-1388. [PMID: 33657970 DOI: 10.1080/09602011.2021.1890138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Traumatic brain injury (TBI) causes deficits in executive function (EF), as well as problems in behavioural and emotional self-regulation. Neurological music therapy may aid these aspects of recovery. We performed a cross-over randomized controlled trial where 40 persons with moderate-severe TBI received a 3-month neurological music therapy intervention (2 times/week, 60 min/session), either during the first (AB, n = 20) or second (BA, n = 20) half of a 6-month follow-up period. The evidence from this RCT previously demonstrated that music therapy enhanced general EF and set shifting. In the current study, outcome was assessed with self-report and caregiver-report questionnaires performed at baseline, 3-month, 6-month, and 18-month stages. The results showed that the self-reported Behavioural Regulation Index of the Behaviour Rating Inventory of Executive Function (BRIEF-A) improved more in the AB than BA group from baseline to 3-month stage and the effect was maintained in the 6-month follow-up. No changes in mood or quality of life questionnaires were observed. However, a qualitative content analysis of the feedback revealed that many participants experienced the intervention as helpful in terms of emotional well-being and activity. Our results suggest that music therapy has a positive effect on everyday behavioural regulation skills after TBI.
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Affiliation(s)
- Sini-Tuuli Siponkoski
- Cognitive Brain Research Unit, Music, Aging and Rehabilitation Team, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sanna Koskinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Milla Holma
- Musiikkiterapiaosuuskunta InstruMental (music therapy cooperative InstruMental), Helsinki, Finland
| | | | | | - Katja Ala-Kauhaluoma
- Ludus Oy Tutkimus- ja kuntoutuspalvelut (Assessment and intervention services), Helsinki, Finland
| | - Noelia Martínez-Molina
- Cognitive Brain Research Unit, Music, Aging and Rehabilitation Team, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Susanna Melkas
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Matti Laine
- Department of Psychology, Åbo Akademi University, Helsinki, Finland
| | - Aarne Ylinen
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Tampere University Hospital, Tampere, Finland.,Validia Rehabilitation Helsinki, Helsinki, Finland
| | - Nathan Zasler
- Concussion Care Centre of Virginia, Ltd., and Tree of Life, Richmond, VA, USA
| | - Pekka Rantanen
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland.,Department of Physical and Rehabilitation Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Music, Aging and Rehabilitation Team, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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40
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de Guise E, Degré C, Beaujean O, Julien J, Lague-Beauvais M, Dagher J, Marcoux J. Comparison of executive functions and functional outcome between older patients with traumatic brain injury and normal older controls. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:1174-1187. [DOI: 10.1080/23279095.2020.1862118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Elaine de Guise
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Centre de Recherche Interdisciplinaire en Readaptation du Montreal Metropolitain, Montreal, Quebec, Canada
| | - Catherine Degré
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Océane Beaujean
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Jessica Julien
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Maude Lague-Beauvais
- Traumatic Brain Injury Program-McGill University Health Center, Montreal, Canada
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Khan DM, Kamel N, Muzaimi M, Hill T. Effective Connectivity for Default Mode Network Analysis of Alcoholism. Brain Connect 2020; 11:12-29. [PMID: 32842756 DOI: 10.1089/brain.2019.0721] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Introduction: With the recent technical advances in brain imaging modalities such as magnetic resonance imaging, positron emission tomography, and functional magnetic resonance imaging (fMRI), researchers' interests have inclined over the years to study brain functions through the analysis of the variations in the statistical dependence among various brain regions. Through its wide use in studying brain connectivity, the low temporal resolution of the fMRI represented by the limited number of samples per second, in addition to its dependence on brain slow hemodynamic changes, makes it of limited capability in studying the fast underlying neural processes during information exchange between brain regions. Materials and Methods: In this article, the high temporal resolution of the electroencephalography (EEG) is utilized to estimate the effective connectivity within the default mode network (DMN). The EEG data are collected from 20 subjects with alcoholism and 25 healthy subjects (controls), and used to obtain the effective connectivity diagram of the DMN using the Partial Directed Coherence algorithm. Results: The resulting effective connectivity diagram within the DMN shows the unidirectional causal effect of each region on the other. The variations in the causal effects within the DMN between controls and alcoholics show clear correlation with the symptoms that are usually associated with alcoholism, such as cognitive and memory impairments, executive control, and attention deficiency. The correlation between the exchanged causal effects within the DMN and symptoms related to alcoholism is discussed and properly analyzed. Conclusion: The establishment of the causal differences between control and alcoholic subjects within the DMN regions provides valuable insight into the mechanism by which alcohol modulates our cognitive and executive functions and creates better possibility for effective treatment of alcohol use disorder.
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Affiliation(s)
- Danish M Khan
- Centre for Intelligent Signal & Imaging Research (CISIR), Electrical & Electronic Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar, Malaysia.,Department of Electronic and Telecommunications Engineering, NED University of Engineering & Technology, University Road, Karachi, Pakistan
| | - Nidal Kamel
- Centre for Intelligent Signal & Imaging Research (CISIR), Electrical & Electronic Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar, Malaysia
| | - Mustapha Muzaimi
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian Malaysia
| | - Timothy Hill
- Neurotherapy & Psychology, Brain Therapy Centre, Kent Town, Australia
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Shultz SR, McDonald SJ, Corrigan F, Semple BD, Salberg S, Zamani A, Jones NC, Mychasiuk R. Clinical Relevance of Behavior Testing in Animal Models of Traumatic Brain Injury. J Neurotrauma 2020; 37:2381-2400. [DOI: 10.1089/neu.2018.6149] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Sandy R. Shultz
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Stuart J. McDonald
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Physiology, Anatomy, and Microbiology, La Trobe University, Melbourne, Victoria, Australia
| | - Frances Corrigan
- Department of Anatomy, University of South Australia, Adelaide, South Australia, Australia
| | - Bridgette D. Semple
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Sabrina Salberg
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Akram Zamani
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Nigel C. Jones
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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Novel, non-nitrocatechol catechol-O-methyltransferase inhibitors modulate dopamine neurotransmission in the frontal cortex and improve cognitive flexibility. Psychopharmacology (Berl) 2020; 237:2695-2707. [PMID: 32474681 PMCID: PMC7790123 DOI: 10.1007/s00213-020-05566-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/20/2020] [Indexed: 12/15/2022]
Abstract
RATIONALE Cognitive impairment is a primary feature of many neuropsychiatric disorders and there is a need for new therapeutic options. Catechol-O-methyltransferase (COMT) inhibitors modulate cortical dopaminergic function and have been proposed as potential cognitive enhancers. Unfortunately, currently available COMT inhibitors are not good candidates due to either poor blood-brain barrier penetration or severe toxicity. OBJECTIVES To address the need for safe, brain-penetrant COMT inhibitors, we tested multiple novel compounds in a set of preclinical in vivo efficacy assays in rats to determine their ability to inhibit COMT function and viability as potential clinical candidates. METHODS We measured the change in concentration of dopamine (DA) metabolites in cerebrospinal fluid (CSF) from the cisterna magna and extracellular fluid (ECF) from the frontal cortex produced by our novel compounds. Additionally, we tested the effects of our brain-penetrant COMT inhibitors in an attentional set-shifting assay (ASST). We benchmarked the performance of the novel COMT inhibitors to the effects produced by the known COMT inhibitor tolcapone. RESULTS We found that multiple COMT inhibitors, exemplified by LIBD-1 and LIBD-3, significantly modulated dopaminergic function measured as decreases in homovanillic acid (HVA) and increases in 3,4-Dihydroxyphenylacetic acid (DOPAC), two DA metabolites, in CSF and the frontal cortex. Additionally, we found that LIBD-1 significantly improved cognitive flexibility in the ASST, an effect previously reported following tolcapone administration. CONCLUSIONS These results demonstrate that LIBD-1 is a novel COMT inhibitor with promising in vivo activity and the potential to serve as a new therapy for cognitive impairment.
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Pennington DL, Bielenberg J, Lasher B, Herbst E, Abrams G, Novakovic-Agopian T, Batki SL. A randomized pilot trial of topiramate for alcohol use disorder in veterans with traumatic brain injury: Effects on alcohol use, cognition, and post-concussive symptoms. Drug Alcohol Depend 2020; 214:108149. [PMID: 32712569 PMCID: PMC8370467 DOI: 10.1016/j.drugalcdep.2020.108149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/09/2020] [Accepted: 06/30/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Topiramate is an effective treatment for alcohol use disorder (AUD) and has also been used in the care of mild traumatic brain injury (mTBI). This pilot study aimed to obtain a preliminary assessment of topiramate's efficacy in reducing alcohol use and post-concussive symptoms, and its potential negative impact on cognitive function in 32 Veterans with co-occurring AUD and mTBI. METHODS This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot study of flexible-dose topiramate or placebo. Primary outcome was reduction of drinking days per week within the topiramate arm. Secondary outcomes included between group comparisons of alcohol use and craving, post-concussive symptoms, and cognitive function. RESULTS Drinking days per week significantly decreased within both the topiramate and placebo arm. There were no significant treatment-by-week interactions on alcohol use/craving, or post-concussive symptoms in intent-to-treat analyses. In per-protocol analyses, topiramate significantly reduced number of drinks per week compared with placebo. Topiramate transiently impaired verbal fluency and working memory. Processing speed, cognitive inhibition, and mental flexibility significantly improved between weeks 1 and 12, regardless of treatment arm. CONCLUSIONS Significant improvement occurred in both the topiramate and placebo groups over 12 weeks of treatment in alcohol use and post-concussive symptoms. Among treatment completers there was greater reduction of alcohol use in the topiramate arm. Topiramate was also associated with negative but transient effects on cognitive function. Results suggest both a possible benefit for topiramate treatment in reducing alcohol use and some potential for negative cognitive effects in Veterans with AUD and mTBI.
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Affiliation(s)
- David L Pennington
- University of California, San Francisco, Department of Psychiatry, 4150 Clement St., San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System (SFVAHCS), 4150 Clement St., San Francisco, CA, USA; Northern California Institute for Research and Education (NCIRE), 4150 Clement St., San Francisco, CA, USA.
| | - Jennifer Bielenberg
- San Francisco Veterans Affairs Health Care System (SFVAHCS), 4150 Clement St., San Francisco, CA, USA; Northern California Institute for Research and Education (NCIRE), 4150 Clement St., San Francisco, CA, USA
| | - Brooke Lasher
- San Francisco Veterans Affairs Health Care System (SFVAHCS), 4150 Clement St., San Francisco, CA, USA; Northern California Institute for Research and Education (NCIRE), 4150 Clement St., San Francisco, CA, USA
| | - Ellen Herbst
- University of California, San Francisco, Department of Psychiatry, 4150 Clement St., San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System (SFVAHCS), 4150 Clement St., San Francisco, CA, USA; Northern California Institute for Research and Education (NCIRE), 4150 Clement St., San Francisco, CA, USA
| | - Gary Abrams
- San Francisco Veterans Affairs Health Care System (SFVAHCS), 4150 Clement St., San Francisco, CA, USA
| | - Tatjana Novakovic-Agopian
- University of California, San Francisco, Department of Psychiatry, 4150 Clement St., San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System (SFVAHCS), 4150 Clement St., San Francisco, CA, USA; Northern California Institute for Research and Education (NCIRE), 4150 Clement St., San Francisco, CA, USA
| | - Steven L Batki
- University of California, San Francisco, Department of Psychiatry, 4150 Clement St., San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System (SFVAHCS), 4150 Clement St., San Francisco, CA, USA; Northern California Institute for Research and Education (NCIRE), 4150 Clement St., San Francisco, CA, USA
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Trajectory of 10-Year Neurocognitive Functioning After Moderate-Severe Traumatic Brain Injury: Early Associations and Clinical Application. J Int Neuropsychol Soc 2020; 26:654-667. [PMID: 32098637 DOI: 10.1017/s1355617720000193] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to explore the 10-year trajectories of neurocognitive domains after moderate-severe traumatic brain injury (TBI), to identify factors related to long-term neurocognitive functioning, and to investigate whether performance remained stable or changed over time. METHOD Seventy-nine patients with moderate-severe TBI between the ages of 16 and 55 years were assessed at 3 months, 1, 5, and 10 years postinjury using neuropsychological tests and functional outcomes. Three hierarchical linear models were used to investigate the relationships of domain-specific neurocognitive trajectories (Memory, Executive function, and Reasoning) with injury severity, demographics, functional outcome at 3 months (Glasgow Outcome Scale-Extended) and emotional distress at 1 year (Symptom Checklist 90-Revised). RESULTS Education, injury severity measures, functional outcome, and emotional distress were significantly associated with both Memory and Executive function. Education and emotional distress were related to Reasoning. The interaction effects between time and these predictors in predicting neurocognitive trajectories were nonsignificant. Among patients with data at 1 and 10 year follow-ups (n = 47), 94-96% exhibited stable scores on Executive function and Reasoning tasks, and 83% demonstrated stable scores on Memory tasks. Significant memory decline was presented in 11% of patients. CONCLUSIONS The findings highlight the differential contribution of variables in their relationships with long-term neurocognitive functioning after moderate-severe TBI. Injury severity was important for Memory outcomes, whereas emotional distress influenced all neurocognitive domains. Reasoning (intellectual) abilities were relatively robust after TBI. While the majority of patients appeared to be cognitively stable beyond the first year, a small subset demonstrated a significant memory decline over time.
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Sheth C, Prescot AP, Legarreta M, Renshaw PF, McGlade E, Yurgelun-Todd D. Increased myoinositol in the anterior cingulate cortex of veterans with a history of traumatic brain injury: a proton magnetic resonance spectroscopy study. J Neurophysiol 2020; 123:1619-1629. [DOI: 10.1152/jn.00765.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In this study of veterans, we used a state-of-the-art neuroimaging tool to probe the neurometabolic profile of the anterior cingulate cortex in veterans with traumatic brain injury (TBI). We report significantly elevated myoinositol levels in veterans with TBI compared with those without TBI.
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Affiliation(s)
- Chandni Sheth
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, Utah
| | - Andrew P. Prescot
- Department of Radiology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Margaret Legarreta
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, Utah
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, Utah
| | - Perry F. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, Utah
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, Utah
| | - Erin McGlade
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, Utah
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, Utah
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, Utah
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, Utah
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Chan CH, Su CH. Improvement of hoarding symptoms with low-dose quetiapine treatment in traumatic brain injury: A case report. TAIWANESE JOURNAL OF PSYCHIATRY 2020. [DOI: 10.4103/tpsy.tpsy_4_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ricciardi JN, Bouchard SW, Luiselli JK, Dould T. Integrated Behavioral Intervention and Person-Centered Therapy Within Community-Based Treatment of an Adult With Acquired Brain Injury. Clin Case Stud 2019. [DOI: 10.1177/1534650119890925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present the case of a 30-year-old woman who had acquired brain injury (ABI) and demonstrated clinically challenging behaviors (verbally abusive outbursts toward care providers and elopement) within her community-based group home. Following a baseline phase of evaluation, she collaborated with clinicians and care providers in developing a treatment plan that included personal goal setting, differential token reinforcement, communication training, graphic performance feedback, and reinforcement fading. During 10 months of intervention, clinically challenging behaviors steadily decreased from baseline levels and low-frequency occurrence was maintained at 3-, 6-, and 9-month follow-up assessments. As the result of treatment, the woman also avoided prior psychiatric hospitalizations, enjoyed more frequent access to pleasurable activities outside her residence, and enrolled in a college course. The study illustrates an effective person-centered therapy approach combined with behavioral intervention for persons who have ABI and experience community-living adjustment difficulties.
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Heinrichs RW. The duality of human cognition: operations and intentionality in mental life and illness. Neurosci Biobehav Rev 2019; 108:139-148. [PMID: 31703967 DOI: 10.1016/j.neubiorev.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 11/04/2019] [Indexed: 01/20/2023]
Abstract
What people think about, the intentional aspect of cognition, is distinguished from its operational aspect, or how proficiently they think. Many psychiatric disorders as well as social problems like racism, are defined largely by specified thought contents, whereas neurological disorders including dementia are defined by low proficiency. Intentionality contrasts with operational cognition in resisting objectification and in being expressed primarily in verbal narratives and subjective self-disclosure. This yields insecure data that have slowed progress in fields where intentional cognition plays a key role. The question is how to produce more secure knowledge and open the intentional domain itself to objective investigation. The use of operational methods to infer intentionality has provided only partial answers. However, the science of reconstructing mental events with neural data is providing a new horizon for the study of intentional cognition. Reconstruction science must address major challenges related to fidelity and validity. Nevertheless, this approach is showing the first steps on the road to accessing and revealing objectively the contents of thought.
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Affiliation(s)
- R Walter Heinrichs
- Department of Psychology, York University, Toronto, Ontario, M3J 1P3, Canada.
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Yousefzadeh-Chabok S, Kapourchali FR, Ramezani S. Determinants of long-term health-related quality of life in adult patients with mild traumatic brain injury. Eur J Trauma Emerg Surg 2019; 47:839-846. [DOI: 10.1007/s00068-019-01252-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
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