1
|
de Geus EQJ, Milders MV, van Horn JE, Jonker FA, Fassaert T, Hutten JC, Kuipers F, Grimbergen C, Noordermeer SDS. A literature review of outcome and treatment options after acquired brain injury: Suggestions for adult offenders using knowledge from the general population. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2024; 34:311-338. [PMID: 38527155 DOI: 10.1002/cbm.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Acquired brain injury (ABI) is a major health problem, often with negative effects on behaviour and mental health as well as cognition. Prevalence of ABI is exceptionally high among offenders and increases their re-offending risk. Information on risk factors for ABI and its outcomes among offenders that could guide effective treatment for them is, nevertheless, scarce and dispersed. However, there is a more substantial literature about the general population that could inform work with brain-injured offenders, especially when selecting for samples or subgroups with similar relevant characteristics, such as lower socio-economic status (SES), pre-injury lower tested intelligence score (<85) and pre-injury mental health problems. AIMS To explore brain injury data from non-offender samples of otherwise similar socio-economic and mental health and ability characteristics to offenders then, first, to describe their untreated outcomes and, secondly, outcomes after frequently used interventions in these circumstances, noting factors associated with their effectiveness. METHOD Three databases were systematically searched for the years 2010-2022; first, using terms for brain injury or damage and cognitive (dys)function, mental health or quality of life. Second, in a separate search, we used these terms and terms for interventions and rehabilitation. In the second review, studies were selected for clear, distinguishable data on age, sex, SES and lifestyle factors to facilitate inferences for offenders. A narrative analytical approach was adopted for both reviews. RESULTS Samples with characteristics that are typical in offender groups, including lower SES, lower pre-injury intelligence quotient (<85), prior cognitive impairments and prior mental health problems, had poorer cognitive and behavioural outcomes following ABI than those without such additional problems, together with lower treatment adherence. With respect to treatment, adequate motivation and self-awareness were associated with better cognitive and behavioural outcomes than when these were low or absent, regardless of the outcome measured. CONCLUSIONS More complex pre-injury mental health problems and social disadvantages typical of offenders are associated with poorer post-brain injury recovery. This paper adds to practical knowledge by bringing together work that follows specific outcome trajectories. Overall, succesful ABI-interventions in the general population that aim at pre-injury difficulties comparable to those seen among offenders, show that personalising injury-specific treatments and taking account of these difficulties, maximised positive outcomes.
Collapse
Affiliation(s)
- Esther Q J de Geus
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maarten V Milders
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Frank A Jonker
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Altrecht, Vesalius, Amsterdam, The Netherlands
| | | | | | | | | | - Siri D S Noordermeer
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
2
|
Studer M, Guggisberg AG, Gyger N, Gutbrod K, Henke K, Heinemann D. Accelerated long-term forgetting in patients with acquired brain injury. Brain Inj 2024; 38:377-389. [PMID: 38385560 DOI: 10.1080/02699052.2024.2311349] [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: 03/29/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Recent research suggests that patients with neurological disorders without overt seizures may also experience accelerated long-term forgetting (ALF). This term describes unimpaired learning and memory performance after standard retention intervals, but an excessive rate of forgetting over delays of days or weeks. The objective of this retrospective study was to investigate ALF in patients with an acquired brain injury (ABI) and to associate memory performance with executive functions. METHODS Verbal memory performance (short-term recall, 30-min recall, 1-week recall) was assessed in 34 adult patients with ABI and compared to a healthy control group (n = 54) using an auditory word learning and memory test. RESULTS Repeated measure analysis showed significant effects of time and group as well as interaction effects between time and group regarding recall and recognition performance. Patients with ABI had a significantly impaired 1-week recall and recognition performance compared to the healthy control group. Correlations between recall performance and executive functions were nonsignificant. DISCUSSION Our results demonstrate that non-epileptic patients with ABI, especially patients with frontal and fronto-temporal lesions, are prone to ALF. Additionally, our data support the assumption that ALF results from a consolidation impairment since verbal recall and recognition were impaired in patients with ABI.
Collapse
Affiliation(s)
- M Studer
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital Basel (UKBB), Basel, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - A G Guggisberg
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - N Gyger
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - K Gutbrod
- Neurozentrum Bern, Bern, Switzerland
| | - K Henke
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - D Heinemann
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
| |
Collapse
|
3
|
Mitchell JT, Covington NV, Morrow E, de Riesthal M, Duff MC. Memory and Traumatic Brain Injury: Assessment and Management Practices of Speech-Language Pathologists. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:279-306. [PMID: 38032245 PMCID: PMC10950318 DOI: 10.1044/2023_ajslp-23-00231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/14/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Memory impairments are among the most commonly reported deficits and among the most frequent rehabilitation targets for individuals with traumatic brain injury (TBI). Memory and learning are also critical for rehabilitation success and broader long-term outcomes. Speech-language pathologists (SLPs) play a central role in memory management for individuals with TBI across the continuum of care. Yet, little is known about the current practice patterns of SLPs for post-TBI memory disorders. This study aims to examine the clinical management of memory disorders in adults with TBI by SLPs and identify opportunities to improve post-TBI memory outcomes. METHOD SLPs from across the continuum of care were recruited to complete an online survey. The survey assessed key practice areas specific to memory and memory disorders post-TBI, including education and training, knowledge and confidence, and assessment and treatment patterns. RESULTS Surveys from 155 SLPs were analyzed. Results revealed that TBI-specific training remains low in the field. Respondents varied in their practice patterns in assessing and treating memory disorders. Most SLPs do not appear to have access to appropriate standardized assessments to measure unique forms of memory. Respondents also reported a range of barriers and opportunities to advance memory outcomes following TBI and provided suggestions of areas in which they would like to see more basic and clinical research. CONCLUSIONS These findings establish a baseline of the current practices for clinical management of memory impairment in adults with TBI by SLPs. Improved opportunities for clinician training, the development of a single tool to assess multiple forms of memory, better access to existing memory assessments, and implementation of evidence-based interventions promise to lead to improved memory outcomes for individuals with TBI.
Collapse
Affiliation(s)
- Jade T. Mitchell
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Natalie V. Covington
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis
- Courage Kenny Research, Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Emily Morrow
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN
| | - Michael de Riesthal
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa C. Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
4
|
Espiritu AI, Hara T, Tolledo JK, Blair M, Burhan AM. Repetitive transcranial magnetic stimulation for apathy in patients with neurodegenerative conditions, cognitive impairment, stroke, and traumatic brain injury: a systematic review. Front Psychiatry 2023; 14:1259481. [PMID: 38034914 PMCID: PMC10684725 DOI: 10.3389/fpsyt.2023.1259481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Background We aimed to determine the effects and tolerability of repetitive transcranial magnetic stimulation (rTMS) on apathy in patients with neurodegenerative conditions, mild cognitive impairment (MCI), stroke, and traumatic brain injury (TBI) via systematic review. Methods We conducted a systematic search in major electronic health databases, including PubMed, Scopus, and PsycINFO, covering the period from inception to June 2023. Comparative clinical trials and cohort studies, and studies with before-after designs were considered for inclusion. We used the Cochrane Risk of Bias and the National Institutes of Health (NIH) tools to assess methodological quality. Results Out of 258 records identified, 14 studies met our eligibility criteria (11 randomized controlled trials (RCT) and 3 studies utilized before-and-after designs) with a total of 418 patients (overall female-to-male ratio 1:1.17) included in the review. The overall methodological quality of the included studies was assessed to be fair to good. The stimulation parameters used varied considerably across the studies. The summary findings of our review indicate the following observations on the effects of rTMS on apathy: (1) the results of all included studies in Alzheimer's disease investigating the effects of rTMS on apathy have consistently shown a positive impact on apathy; (2) the majority of studies conducted in Parkinson's disease have not found statistically significant results; (3) a single study (RCT) on patients with primary progressive aphasia demonstrated significant beneficial effects of rTMS on apathy; (4) the trials conducted on individuals with MCI yielded varying conclusions; (5) one study (RCT) in chronic stroke suggested that rTMS might have the potential to improve apathy; (6) one study conducted on individuals with mild TBI did not find a significant favorable association on apathy; and (7) the use of different rTMS protocols on the populations described is generally safe. Conclusion The feasibility of utilizing rTMS as a treatment for apathy has been suggested in this review. Overall, limited evidence suggests that rTMS intervention may have the potential to modify apathy among patients with AD, PPA, MCI and chronic stroke, but less so in PD and mild TBI. These findings require confirmation by larger, well-designed clinical trials.
Collapse
Affiliation(s)
- Adrian I. Espiritu
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
- Department of Psychiatry and Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Takatoshi Hara
- Department of Rehabilitation Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Mervin Blair
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
- Lawson Research Institute, London, ON, Canada
| | - Amer M. Burhan
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
5
|
Alashram AR, Padua E, Annino G. Noninvasive brain stimulation for cognitive rehabilitation following traumatic brain injury: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:814-829. [PMID: 35771044 DOI: 10.1080/23279095.2022.2091440] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Traumatic brain injury (TBI) can cause numerous cognitive deficits. These deficits are associated with disability and reduction in quality of life. Noninvasive brain stimulation (NIBS) provides excitatory or inhibitory stimuli to the cerebral cortex. This review aimed to examine the effectiveness of NIBS (i.e., rTMS and tDCS) on cognitive functions in patients with TBI. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched from inception to May 2021. The risk of bias in the randomized controlled trials was assessed using the Cochrane Collaboration's instrument. The Physiotherapy Evidence Database (PEDro) scale was applied to evaluate the risk of bias in the non-randomized controlled trials. Ten studies met our inclusion criteria. Six studies used repetitive Transcranial Magnetic Stimulation (rTMS), and four used transcranial Direct Current Stimulation (tDCS) as cognitive rehabilitation interventions. The results showed heterogenous evidence for the effects of rTMS and tDCS on cognitive function outcomes in individuals with TBI. The evidence for the effects of NIBS on cognition following TBI was limited. TDCS and rTMS are safe and well-tolerated interventions post-TBI. The optimal stimulation sites and stimulation parameters remain unknown. Combining NIBS with traditional rehabilitation interventions may contribute to greater enhancements in cognitive functions post-TBI.
Collapse
Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
| |
Collapse
|
6
|
Ownsworth T, Mitchell J, Griffin J, Bell R, Gibson E, Shirota C. Electronic Assistive Technology to Support Memory Function After Traumatic Brain Injury: A Systematic Review of Efficacy and User Perspectives. J Neurotrauma 2023; 40:1533-1556. [PMID: 36792919 DOI: 10.1089/neu.2022.0434] [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: 02/17/2023] Open
Abstract
Abstract Rapid technology advances have led to diverse assistive technology (AT) options for use in memory rehabilitation after traumatic brain injury (TBI). This systematic review aimed to evaluate the efficacy of electronic AT for supporting phases of memory in daily life after TBI. A secondary aim was to examine user perspectives on the utility of AT and factors influencing uptake or use. A systematic search of PsycINFO, MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Excerpta Medica database (Embase), Scopus, and Cochrane Library was conducted from database inception to June 13, 2022, to identify eligible studies. Methodological quality was assessed by two independent reviewers. Nineteen eligible articles involving a total of 311 participants included four randomized controlled trials (RCTs; Class I), five single-case experimental designs (Class II), and 10 pre-post group (n > 10) or single-case studies without experimental control (Class III). Three Class I studies, two Class II studies and eight Class III studies supported the efficacy of AT for supporting memory functioning. Treatment fidelity was not examined in any study. There was the most empirical support for the efficacy of AT for facilitating retrieval and execution phases of memory (i.e., supported by 6/9 studies) with external support to encode memory intentions or pre-programmed reminders. Further controlled studies are needed to determine whether outcomes vary according to individuals' level of independence with use (e.g., self-initiated vs. pre-programmed reminders) and to examine user characteristics and design features influencing uptake and effectiveness. Greater involvement of end-users with brain injury in the design and evaluation of AT features is also recommended to enhance usability and uptake in daily life.
Collapse
Affiliation(s)
- Tamara Ownsworth
- School of Applied Psychology, Griffith University, Mt. Gravatt, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
| | - Jessie Mitchell
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
| | - Janelle Griffin
- Brain Injury Rehabilitation Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Ryan Bell
- Brain Injury Rehabilitation Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Emily Gibson
- Brain Injury Rehabilitation Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
| |
Collapse
|
7
|
Tapia JL, Taberner-Bonastre MT, Collado-Martínez D, Pouptsis A, Núñez-Abad M, Duñabeitia JA. Effectiveness of a Computerized Home-Based Cognitive Stimulation Program for Treating Cancer-Related Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4953. [PMID: 36981862 PMCID: PMC10049401 DOI: 10.3390/ijerph20064953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Cancer patients assert that after chemotherapy their cognitive abilities have deteriorated. Cognitive stimulation is the clinical treatment of choice for reversing cognitive decline. The current study describes a computerized home-based cognitive stimulation program in patients who survived breast cancer. It aims to assess safety and effectiveness of cognitive stimulation in the oncology population. A series of 45-min training sessions was completed by the participants. A thorough assessment was performed both before and after the intervention. The mini-Mental Adjustment to Cancer Scale, the Cognitive Assessment for Chemo Fog Research, and the Functionality Assessment Instrument in Cancer Treatment-Cognitive Function served as the main assessment tools. The State-Trait Anxiety Inventory, Beck Depression Inventory, Brief Fatigue Inventory, and Measuring Quality of Life-The World Health Organization data were gathered as secondary outcomes. Home-based cognitive stimulation demonstrated beneficial effects in the oncology population, with no side effects being reported. Cognitive, physical, and emotional improvements were observed, along with decreased interference in daily life activities and a better overall quality of life.
Collapse
Affiliation(s)
- Jose L. Tapia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, 28015 Madrid, Spain
| | | | - David Collado-Martínez
- Servicio de Oncología Médica, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| | - Athanasios Pouptsis
- Servicio de Oncología Médica, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| | - Martín Núñez-Abad
- Servicio de Oncología Médica, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| | - Jon Andoni Duñabeitia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, 28015 Madrid, Spain
- AcqVA Aurora Center, The Arctic University of Norway, 9019 Tromsø, Norway
| |
Collapse
|
8
|
Cámara-Barrio S, Esteso-Orduña B, Vara-Arias MT, Rodríguez-Palero S, Fournier-Del Castillo MC. A neuropsychological approach in a paediatric acquired brain injury unit under the public health system. Neurologia 2023; 38:8-14. [PMID: 36162700 DOI: 10.1016/j.nrleng.2020.04.027] [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: 09/14/2019] [Accepted: 04/01/2020] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Paediatric acquired brain injury (ABI) causes cognitive and behavioural difficulties and alters the course of child development. The ABI unit at Hospital Infantil Universitario Niño Jesús is the first within the public Spanish health system to provide comprehensive coverage to these patients and their families. OBJECTIVE This study aims to show the working methodology followed with patients and their families, and to describe the clinical characteristics of the patients treated and the outcomes of treatment. PATIENTS Fifty-three patients aged between 3 months and 16 and a half years received treatment. The conditions treated were brain tumours, stroke, traumatic brain injury, damage secondary to epilepsy surgery, and hypoxia. METHODS All patients were evaluated at admission and at discharge. Treatments were adapted to each patient's difficulties and their severity, as well as to the patient's age. Families received individual and group therapy. RESULTS Older age was associated with better cognitive recovery and shorter duration of treatment. Different conditions show differential impact on intelligence quotient and developmental quotient scores at the beginning of treatment, with hypoxia and encephalitis being associated with greatest severity. Intelligence quotient and developmental quotient scores and visual memory and attention scores at discharge improved significantly after the faceted neuropsychological treatment with respect to scores registered at admission. CONCLUSIONS The care of patients with ABI should include neuropsychological rehabilitation programmes and provide emotional support to the family so that they may actively participate in the recovery of the child or adolescent.
Collapse
Affiliation(s)
- S Cámara-Barrio
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, Spain.
| | - B Esteso-Orduña
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, Spain
| | - M T Vara-Arias
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, Spain
| | - S Rodríguez-Palero
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, Spain
| | - M C Fournier-Del Castillo
- Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, Spain
| |
Collapse
|
9
|
Hauger SL, Borgen IMH, Løvstad M, Lu J, Forslund MV, Kleffelgård I, Andelic N, Røe C. Community-Based Interventions After Acquired Brain Injury-A Systematic Review of Intervention Types and Their Effectiveness. J Head Trauma Rehabil 2022; 37:E355-E369. [PMID: 35125426 DOI: 10.1097/htr.0000000000000765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Comprehensive review of existing types and effectiveness of community-based interventions delivered to adults (mean age 18-65 years) with long-lasting (≥6 months) difficulties following acquired brain injury (ABI). DESIGN Systematic review of controlled intervention studies published until February 2021. MAIN MEASURES Systematic searches in databases (MEDLINE, PsycINFO, Database of Abstracts of Reviews of Effects [Cochrane Library], and Cochrane Central Register of Controlled Trials [Cochrane Library]) and inclusion of English peer-reviewed full-text articles; randomized or controlled community-based intervention studies; sample size of 20 or more participants; and 3 or more intervention sessions. Two reviewers independently extracted data for the synthesis and assessed the methodological quality. Data extraction included study characteristics, demographics of participants, content and dose of intervention, outcome measures, and findings. RESULT The search returned 7386 publications, of which 49 eligible studies were included, revealing a diverse range of community-based interventions and a myriad of outcome measures applied for assessing functional capacities, participation, and quality of life in the chronic phase of ABI. Intervention types encompassed 14 holistic, 23 physical, and 12 specific interventions. A large heterogeneity regarding intervention frequency and intensity was found. Meta-analyses performed on the holistic, physical, and specific interventions did not indicate any significant pooled effects but showed highly variable effects between individuals, both in persons with traumatic and nontraumatic brain injuries. CONCLUSIONS Because of lack of pooled effects within types of community-based interventions, specific evidence-based recommendations within holistic, physical, and specific interventions designed to mitigate long-lasting ABI problems cannot be made. This review highlights the need for future studies to address methodological issues concerning larger sample size, lack of clear description interventions and comparator, missing reports of effects in change scores, need for consistent use of recommended outcome measures, and investigating the wide variety in intervention responsiveness among participants with ABI. Systematic review registration: PROSPERO (CRD42019124949).
Collapse
Affiliation(s)
- Solveig Lægreid Hauger
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway (Drs Hauger and Løvstad); Department of Psychology, Faculty of Social Sciences (Drs Hauger and Løvstad and Ms Borgen), Institute of Clinical Medicine, Faculty of Medicine (Dr Røe), and Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society (Dr Andelic), University of Oslo, Norway; Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, USA (Dr Lu); and Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Norway (Ms Borgen and Drs Forslund, Kleffelgård, Andelic, and Røe)
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Effect of transcranial direct-current stimulation on executive function and resting EEG after stroke: A pilot randomized controlled study. J Clin Neurosci 2022; 103:141-147. [PMID: 35872448 DOI: 10.1016/j.jocn.2022.07.010] [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: 09/23/2021] [Revised: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The effects of transcranial direct current stimulation (tDCS) on post-stroke executive impairment (PSEI) remain controversial. Resting stateelectroencephalogram (EEG) can assist in the diagnosis and assessment of executive dysfunction. OBJECTIVES We aimed to use EEG to explore the effect of tDCS on executive function among stroke patients. METHODS Twenty-four patients with PSEI were randomly divided into experimental and control groups, which received real and sham stimulation, respectively. Anodal electrical stimulation was applied to the left dorsolateral prefrontal lobe (F3). The stimulation intensity was 2 mA for 20 min once daily for 7 days. Executive function was monitored using neuropsychological scales. RESULTS The experimental group outperformed the control group in clinical scale results, with significant differences in the following scores: symbol digital modalities test, TMT-A, TMT-B, and digital span test. In the left central zone, theta band power was significantly higher after anodal electrical stimulation than before. Analysis of the correlation between EEG power and psychometric scores revealed that the power change was positively correlated with the scores on the symbol digital modality test (r = 0.435, p < 0.05). CONCLUSION Anodal tDCS can enhance executive function in patients with PSEI, and tDCS-related improvements are related to the enhancement of theta power in the affected region.
Collapse
|
11
|
Xiao Z, Wang Z, Ge S, Zhong Y, Zhang W. Rehabilitation efficacy comparison of virtual reality technology and computer-assisted cognitive rehabilitation in patients with post-stroke cognitive impairment: A network meta-analysis. J Clin Neurosci 2022; 103:85-91. [PMID: 35849864 DOI: 10.1016/j.jocn.2022.07.005] [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: 04/02/2022] [Revised: 06/24/2022] [Accepted: 07/09/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Virtual reality (VR) and computer-assisted cognitive rehabilitation (CACR) are two emerging rehabilitation therapies for stroke patients. The aim of this study was to compare the rehabilitation efficacy of these two treatments for patients with post-stroke cognitive impairment (PSCI). METHODS A network search of Embase, Web of Science, PubMed, Cochrane Library, VIP, WanFang Data, and CNKI databases was performed from their inception to February 2022 for screening randomized controlled trials related to VR and CACR in the treatment of PSCI. The quality of the included studies was assessed using the Cochrane risk bias assessment tool. The primary outcomes of the included studies contained at least one of the following clinical outcome measures: Mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MoCA). After screening the literature, assessing the quality and extracting the data, a network meta-analysis was performed with STATA software. RESULTS A total of 21 randomized controlled trials were included, including 1,047 patients. The results of network meta-analysis showed that under MMSE index, VR group (p = 0.067) and CACR group (p = 0.054) tended to be superior to CT group, but it was not significant. Both the VR (p = 0.024) and CACR (p < 0.001) groups had significantly better outcomes compared to the conventional therapy group in terms of MoCA. The ranking results under both indicators showed that CACR had the best treatment effect, followed by VR. CONCLUSION In general, VR and CACR have superior efficacy compared with conventional therapy, in which CACR may be the best treatment option.
Collapse
Affiliation(s)
- Zihao Xiao
- Department of Rehabilitation Therapy, Shanghai Ruijin Rehabilitation Hospital, Shanghai 200023, China
| | - Zhenni Wang
- Department of Rehabilitation Therapy, Shanghai Ruijin Rehabilitation Hospital, Shanghai 200023, China
| | - Song Ge
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ying Zhong
- Department of Rehabilitation Therapy, Shanghai Ruijin Rehabilitation Hospital, Shanghai 200023, China
| | - Weiming Zhang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| |
Collapse
|
12
|
Tapia JL, Puertas FJ, Duñabeitia JA. Study Protocol for a Randomized Controlled Trial Assessing the Effectiveness of Personalized Computerized Cognitive Training for Individuals With Insomnia. Front Behav Neurosci 2022; 16:779990. [PMID: 35296055 PMCID: PMC8919067 DOI: 10.3389/fnbeh.2022.779990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
Insomnia is a frequent and heightened pathology in the general population of developed countries, and its condition generally leads to health discomfort and performance drop in daily and work-related tasks. As current pharmacological treatments for insomnia do not always seem sufficient to mitigate impairment, contemporary cognitive approaches might shed light on developing complementary therapies for this population. We propose a cognitive stimulation intervention program based on the importance of cognitive abilities as precipitating and maintenance variables of sleep disturbances. A full phase I-II-III clinical trial is proposed in which the first two studies will serve to assess the safety of the intervention and to identify the maximum tolerated time of the computerized cognitive training (phase I) and the minimum effective number of training sessions (phase II) in the absence of adverse events or side effects. Next, a phase-III double-blind randomized controlled trial design will be set. Sixty individuals with insomnia aged 25 to 55 years will enroll in a home-based personalized computerized cognitive stimulation program for a total time of 8 weeks, training 5 days per week. Sixty insomnia patients matched in a variety of factors will constitute the active control group, where the orthogonal activities will not be cognitively demanding. Sleep, cognitive, emotional, and quality of life variables will be measured before and immediately after training. A linear mixed model and hierarchical regression analysis will be used to investigate intervention effects. The results derived from this study will be precious for future research and treatment in cognitive performance and clinical pathologies. Clinical Trial Registration: [https://clinicaltrials.gov/], identifier [NCT05050292].
Collapse
Affiliation(s)
- Jose Luis Tapia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Antonio de Nebrija, Madrid, Spain
| | - Francisco Javier Puertas
- Unidad Sueño, Hospital Universitario de la Ribera-FISABIO, Valencia, Spain
- Facultad de Medicina, Universidad Católica de Valencia, Valencia, Spain
| | - Jon Andoni Duñabeitia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Antonio de Nebrija, Madrid, Spain
- AcqVA Aurora Center, The Arctic University of Norway, Tromsø, Norway
- *Correspondence: Jon Andoni Duñabeitia,
| |
Collapse
|
13
|
Stavropoulos I, Pak HL, Valentin A. Neuromodulation in Super-refractory Status Epilepticus. J Clin Neurophysiol 2021; 38:494-502. [PMID: 34261110 DOI: 10.1097/wnp.0000000000000710] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY Status epilepticus (SE) is a severe condition that needs immediate pharmacological treatment to tackle brain damage and related side effects. In approximately 20% of cases, the standard treatment for SE does not control seizures, and the condition evolves to refractory SE. If refractory status epilepticus lasts more than 24 hours despite the use of anesthetic treatment, the condition is redefined as super-refractory SE (srSE). sRSE is a destructive condition, potentially to cause severe brain damage. In this review, we discuss the clinical neuromodulation techniques for controlling srSE when conventional treatments have failed: electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation. Data show that neuromodulation therapies can abort srSE in >80% of patients. However, no randomized, prospective, and controlled trials have been completed, and data are provided only by retrospective small case series and case reports with obvious inclination to publication bias. There is a need for further investigation into the use of neuromodulation techniques as an early treatment of srSE and to address whether an earlier intervention can prevent long-term complications.
Collapse
Affiliation(s)
- Ioannis Stavropoulos
- Department of Clinical Neurophysiology, King's College Hospital, London, United Kingdom
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; and
| | - Ho Lim Pak
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Antonio Valentin
- Department of Clinical Neurophysiology, King's College Hospital, London, United Kingdom
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; and
| |
Collapse
|
14
|
Nie P, Liu F, Lin S, Guo J, Chen X, Chen S, Yu L, Lin R. The effects of computer-assisted cognitive rehabilitation on cognitive impairment after stroke: A systematic review and meta-analysis. J Clin Nurs 2021; 31:1136-1148. [PMID: 34459041 DOI: 10.1111/jocn.16030] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the effectiveness of computer-assisted cognitive rehabilitation in improving cognitive function in patients with post-stroke cognitive impairment. BACKGROUND In recent years, computer-assisted cognitive rehabilitation has been accepted as a good substitute or supplement for traditional cognitive rehabilitation. Some clinical randomised controlled trials have been carried out, but no relevant systematic evaluations have been performed. Therefore, we conducted a systematic review of studies involving computer-assisted cognitive rehabilitation to provide evidence-based data for its promotion and application. METHODS Nine databases (Cochrane Library, PubMed, Web of Science, Embase, OVID, Wanfang Data, CNKI, VIP and SinoMed databases) were systematically searched. Randomised controlled trials that assessed computer-assisted cognitive rehabilitation for patients with post-stroke cognitive impairment were included. Two reviewers appraised the risks of bias through the Cochrane Collaboration's tool and performed the meta-analysis, including the assessment of heterogeneity. We follow the PRISMA 2020 guidelines. RESULTS Thirty-two studies comprising 1837 participants were included. Compared with conventional therapy alone, the addition of computer-assisted cognitive rehabilitation significantly improved the global cognition of patients, evaluated using the Montreal cognitive assessment, mini-mental state examination and Loewenstein occupational therapy cognitive assessment (p < .01 for all tests). The therapy also significantly improved activities of daily living, assessed using the Barthel index, modified Barthel index and functional independence measure (p < .05 for all tests). CONCLUSION Computer-assisted cognitive rehabilitation significantly improved the cognitive function and activities of daily living of patients with post-stroke cognitive impairment. RELEVANCE TO CLINICAL PRACTICE Computer-assisted cognitive rehabilitation can be a valuable technique for cognitive rehabilitation after stroke. It is advantageous for improving patient cognition and restoring the overall functional state of patients. Moreover, the research findings can provide suggestions and inspiration for researchers to implement the proposal, which is conducive to the design of more rigorous and high-quality randomised controlled trials.
Collapse
Affiliation(s)
- Pingying Nie
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Fang Liu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shaohong Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiaying Guo
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xinming Chen
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | | | - Liqiang Yu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ruhui Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| |
Collapse
|
15
|
The effectiveness of memory remediation strategies after traumatic brain injury: Systematic review and meta-analysis. Ann Phys Rehabil Med 2021; 64:101530. [PMID: 33957294 DOI: 10.1016/j.rehab.2021.101530] [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: 09/01/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a steadily rising health concern associated with significant risk of emotional, behavioral and cognitive impairments. Cognitive memory impairment is one of the most concerning outcomes after TBI, affecting a wide range of everyday activities, social interactions and employment. Several comparative and comprehensive reviews on the effects of cognitive interventions in individuals with TBI have been conducted but usually with a qualitative rather than quantitative approach. Thus, evidence synthesis of the effects of TBI interventions on memory difficulties is limited. OBJECTIVE In this meta-analysis, we examined the memory-remediating effects of internal and external interventions, injury severity and the interaction of both factors for patients with TBI. METHODS Data were extracted from studies published between 1980 and 2020 that used objective memory measures (computerized or pencil-and-paper), and multiple meta-analyses were conducted to compare effectiveness across these interventions. Publication bias was assessed, as was quality of evidence using the Cochrane Risk of Bias tool for randomized controlled studies. Our final meta-analysis included 16 studies of 17 interventions classified into 3 categories: internal, external and mixed. RESULTS Mixed interventions demonstrated the highest average effect size for memory difficulties (Morris d=0.79). An evaluation of injury severity yielded 2 categories: mild-moderate and moderate-severe. Analyses demonstrated a homogenous medium effect size of improvement across injury severity, with moderate-severe injury with the largest average effect size (Morris d=0.65). Further evaluation of injury severity interaction with intervention type revealed a mediating effect for both factors, demonstrating the largest effect size for mixed interventions with moderate-severe injury (Morris d=0.81). CONCLUSION This study highlights the effectiveness of memory remediation interventions on memory impairment after TBI. A wide range of interventions are more effective because they address individual variability for severity and memory deficits. The study further supports and expands existing intervention standards and guidelines.
Collapse
|
16
|
Tapia JL, Duñabeitia JA. Improving Language Acquisition and Processing With Cognitive Stimulation. Front Psychol 2021; 12:663773. [PMID: 34054668 PMCID: PMC8160283 DOI: 10.3389/fpsyg.2021.663773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/19/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- José Luis Tapia
- Centro de Ciencia Cognitiva (C3), Universidad Antonio de Nebrija, Madrid, Spain
| | - Jon Andoni Duñabeitia
- Centro de Ciencia Cognitiva (C3), Universidad Antonio de Nebrija, Madrid, Spain.,AcqVA Aurora Center, The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
17
|
The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review. Diagnostics (Basel) 2021; 11:diagnostics11040627. [PMID: 33807188 PMCID: PMC8066265 DOI: 10.3390/diagnostics11040627] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 12/14/2022] Open
Abstract
In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with traumatic brain injury (TBI). However, there is no systematic NIBS review of TBI cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study was to conduct a systematic review examining the effectiveness and safety of NIBS for cognitive impairment after a TBI. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). All English articles from the following databases were searched from inception up to 31 December 2020: Pubmed/MEDLINE, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals with TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included. A total of five studies met eligibility criteria. Two studies used repetitive transcranial magnetic stimulation (rTMS) and three studies used transcranial direct current stimulation (tDCS). The pooled sample size was 44 individuals for rTMS and 91 for tDCS. Three of five studies combined cognitive training or additional therapy (computer assisted) with NIBS. Regarding rTMS, target symptoms included attention (n = 2), memory (n = 1), and executive function (n = 2); only one study showing significant improvement compared than control group with respect to attention. In tDCS studies, target symptoms included cognition (n = 2), attention (n = 3), memory (n = 3), working memory (WM) (n = 3), and executive function (n = 1); two of three studies showed significant improvement compared to the control group with respect to attention and memory. The evidence for NIBS effectiveness in rehabilitation of cognitive function in TBI is still in its infancy, more studies are needed. In all studies, dorsolateral prefrontal cortex (DLPFC) was selected as the stimulation site, along with the stimulation pattern promoting the activation of the left DLPFC. In some studies, there was a significant improvement compared to the control group, but neither rTMS nor tDCS had sufficient evidence of effectiveness. To the establishment of evidence we need the evaluation of brain activity at the stimulation site and related areas using neuroimaging on how NIBS acts on the neural network.
Collapse
|
18
|
The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2021; 11:diagnostics11020227. [PMID: 33546266 PMCID: PMC7913379 DOI: 10.3390/diagnostics11020227] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/19/2022] Open
Abstract
Background: In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with stroke. There are various NIBS methods depending on the stimulation site and stimulation parameters. However, there is no systematic NIBS review of post-stroke cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study is to conduct a systematic review and meta-analysis on effectiveness and safety of NIBS for cognitive impairment after a stroke to obtain new insights. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). Methods: All English articles from MEDLINE, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL were searched from inception up to 31 December 2020. Randomized and prospective controlled trials were included for the analysis. Studies with at least five individuals post-stroke, whereby at least five sessions of NIBS were provided and using standardized neuropsychological measurement of cognition, were included. We assessed the methodological quality of selected studies as described in the Physiotherapy Evidence Database (PEDro) scoring system. Results: A total of 10 studies met eligibility criteria. Six studies used repetitive transcranial magnetic stimulation (rTMS) and four studies used transcranial direct current stimulation (tDCS). The pooled sample size was 221 and 196 individuals who received rTMS and tDCS respectively. Eight studies combined general rehabilitation, cognitive training, or additional therapy with NIBS. In rTMS studies, target symptoms included global cognition (n = 4), attention (n = 3), memory (n = 4), working memory (WM) (n = 3), and executive function (n = 2). Five studies selected the left dorsolateral prefrontal cortex (DPLFC) as the stimulation target. One rTMS study selected the right DLPFC as the inhibitory stimulation target. Four of six studies showed significant improvement. In tDCS studies, target symptoms included global cognition (n = 2), attention (n = 4), memory (n = 2) and WM (n = 2). Three studies selected the frontal area as the stimulation target. All studies showed significant improvement. In the meta-analysis, rTMS showed a significant effect on attention, memory, WM and global cognition classified by neuropsychological tests. On the other hand, tDCS had no significant effect. Conclusions: In post-stroke patients with deficits in cognitive function, including attention, memory, and WM, NIBS shows promising positive effects. However, this effect is limited, suggesting that further studies are needed with more precision in stimulation sites and stimulation parameters. Future studies using advanced neurophysiological and neuroimaging tools to allow for a network-based approach to treat cognitive symptoms post-stroke with NIBS are warranted.
Collapse
|
19
|
das Nair R, Bradshaw LE, Carpenter H, Clarke S, Day F, Drummond A, Fitzsimmons D, Harris S, Montgomery AA, Newby G, Sackley C, Lincoln NB. A group memory rehabilitation programme for people with traumatic brain injuries: the ReMemBrIn RCT. Health Technol Assess 2020; 23:1-194. [PMID: 31032782 DOI: 10.3310/hta23160] [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: 12/30/2022] Open
Abstract
BACKGROUND People with traumatic brain injuries (TBIs) commonly report memory impairments. These are persistent, debilitating and reduce quality of life, but patients do not routinely receive memory rehabilitation after discharge from hospital. OBJECTIVE To assess the clinical effectiveness and cost-effectiveness of a group memory rehabilitation programme for people with TBI. DESIGN Multicentre, pragmatic, cluster randomised controlled trial. Qualitative and health economic evaluations were also undertaken. SETTING Community settings in nine sites in England. PARTICIPANTS Participants were aged 18-69 years, had undergone a TBI > 3 months prior to recruitment, reported memory problems, were able to travel to a site to attend group sessions, could communicate in English and gave informed consent. RANDOMISATION AND BLINDING Clusters of four to six participants were randomised to the memory rehabilitation arm or the usual-care arm on a 1 : 1 ratio. Randomisation was based on a computer-generated pseudo-random code using random permuted blocks of randomly varying size, stratified by study site. Participants and therapists were aware of the treatment allocation whereas outcome assessors were blinded. INTERVENTIONS In the memory rehabilitation arm 10 weekly sessions of a manualised memory rehabilitation programme were provided in addition to usual care. Participants were taught restitution strategies to retrain impaired memory functions and compensation strategies to enable them to cope with memory problems. The usual-care arm received usual care only. MAIN OUTCOME MEASURES Outcomes were assessed at 6 and 12 months after randomisation. Primary outcome: patient-completed Everyday Memory Questionnaire - patient version (EMQ-p) at 6 months' follow-up. Secondary outcomes: Rivermead Behavioural Memory Test - third edition (RBMT-3), General Health Questionnaire 30-item version, European Brain Injury Questionnaire, Everyday Memory Questionnaire - relative version and individual goal attainment. Costs (based on a UK NHS and Personal Social Services perspective) were collected using a service use questionnaire, with the EuroQol-5 Dimensions, five-level version, used to derive quality-adjusted life-years (QALYs). A Markov model was developed to explore cost-effectiveness at 5 and 10 years, with a 3.5% discount applied. RESULTS We randomised 328 participants (memory rehabilitation, n = 171; usual care, n = 157), with 129 in the memory rehabilitation arm and 122 in the usual-care arm included in the primary analysis. We found no clinically important difference on the EMQ-p between the two arms at 6 months' follow-up (adjusted difference in mean scores -2.1, 95% confidence interval -6.7 to 2.5; p = 0.37). For secondary outcomes, differences favouring the memory rehabilitation arm were observed at 6 months' follow-up for the RBMT-3 and goal attainment, but remained only for goal attainment at 12 months' follow-up. There were no differences between arms in mood or quality of life. The qualitative results suggested positive experiences of participating in the trial and of attending the groups. Participants reported that memory rehabilitation was not routinely accessible in usual care. The primary health economics outcome at 12 months found memory rehabilitation to be £26.89 cheaper than usual care but less effective, with an incremental QALY loss of 0.007. Differences in costs and effects were not statistically significant and non-parametric bootstrapping demonstrated considerable uncertainty in these findings. No safety concerns were raised and no deaths were reported. LIMITATIONS As a pragmatic trial, we had broad inclusion criteria and, therefore, there was considerable heterogeneity within the sample. The study was not powered to perform further subgroup analyses. Participants and therapists could not be blinded to treatment allocation. CONCLUSIONS The group memory rehabilitation delivered in this trial is very unlikely to lead to clinical benefits or to be a cost-effective treatment for people with TBI in the community. Future studies should examine the selection of participants who may benefit most from memory rehabilitation. TRIAL REGISTRATION Current Controlled Trials ISRCTN65792154. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 16. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Roshan das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.,Institute of Mental Health, Nottingham, UK.,Department of Clinical Psychology and Neuropsychology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lucy E Bradshaw
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Hannah Carpenter
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Sara Clarke
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Florence Day
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Shaun Harris
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Gavin Newby
- Newby Psychological Services Ltd, Northwich, UK
| | - Catherine Sackley
- Division of Health and Social Care, King's College London, London, UK
| | - Nadina B Lincoln
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| |
Collapse
|
20
|
Stramba-Badiale C, Mancuso V, Cavedoni S, Pedroli E, Cipresso P, Riva G. Transcranial Magnetic Stimulation Meets Virtual Reality: The Potential of Integrating Brain Stimulation With a Simulative Technology for Food Addiction. Front Neurosci 2020; 14:720. [PMID: 32760243 PMCID: PMC7372037 DOI: 10.3389/fnins.2020.00720] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/16/2020] [Indexed: 12/23/2022] Open
Abstract
The aim of this perspective is to propose and discuss the integration of transcranial magnetic stimulation (TMS) over the dorsolateral prefrontal cortex with virtual reality (VR) food exposure for therapeutic interventions for food addiction. "Food addiction" is a dysfunctional eating pattern which is typically observed in eating disorders (ED) such as bulimia nervosa and binge eating disorder. Food addiction has been compared to substance use disorder due to the necessity of consuming a substance (food) and the presence of a dependence behavior. In recent years, VR has been applied in the treatment of ED because it triggers psychological and physiological responses through food exposure in place of real stimuli. Virtual reality-Cue exposure therapy has been proven as a valid technique for regulating anxiety and food craving in ED. More, TMS has been proven to modulate circuits and networks implicated in neuropsychiatric disorders and is effective in treating addiction such as nicotine craving and consumption and cocaine use disorder. The combination of a simulative technology and a neurostimulation would presumably provide better improvement compared to a single intervention because it implies the presence of both cognitive and neuropsychological techniques. The possible advantage of this approach will be discussed in the perspective.
Collapse
Affiliation(s)
- Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Valentina Mancuso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Silvia Cavedoni
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Department of Psychology, E-Campus University, Novedrate, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| |
Collapse
|
21
|
Cámara Barrio S, Esteso Orduña B, Vara Arias MT, Rodríguez Palero S, Fournier Del Castillo MC. A neuropsychological approach in a paediatric acquired brain injury unit under the public health system. Neurologia 2020; 38:S0213-4853(20)30127-4. [PMID: 32586695 DOI: 10.1016/j.nrl.2020.04.019] [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: 09/14/2019] [Revised: 03/06/2020] [Accepted: 04/01/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Paediatric acquired brain injury (ABI) causes cognitive and behavioural difficulties and alters the course of child development. The ABI unit at Hospital Infantil Universitario Niño Jesús is the first within the public Spanish health system to provide comprehensive coverage to these patients and their families. OBJECTIVE This study aims to show the working methodology followed with patients and their families, and to describe the clinical characteristics of the patients treated and the outcomes of treatment. PATIENTS Fifty-three patients aged between three months and 16 and a half years received treatment. The conditions treated were brain tumours, stroke, traumatic brain injury, damage secondary to epilepsy surgery, and hypoxia. METHODS All patients were evaluated at admission and at discharge. Treatments were adapted to each patient's difficulties and their severity, as well as to the patient's age. Families received individual and group therapy. RESULTS Older age was associated with better cognitive recovery and shorter duration of treatment. Different conditions show differential impact on intelligence quotient and developmental quotient scores at the beginning of treatment, with hypoxia and encephalitis being associated with greatest severity. Intelligence quotient and developmental quotient scores and visual memory and attention scores at discharge improved significantly after the faceted neuropsychological treatment with respect to scores registered at admission. CONCLUSIONS The care of patients with ABI should include neuropsychological rehabilitation programmes and provide emotional support to the family so that they may actively participate in the recovery of the child or adolescent.
Collapse
Affiliation(s)
- S Cámara Barrio
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, España.
| | - B Esteso Orduña
- Unidad de Daño Cerebral Adquirido, Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, España
| | - M T Vara Arias
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, España
| | - S Rodríguez Palero
- Unidad de Daño Cerebral Adquirido, Servicio de Rehabilitación, Hospital Universitario Niño Jesús, Madrid, España
| | - M C Fournier Del Castillo
- Unidad de Neuropsicología Clínica, Servicio de Psiquiatría y Psicología, Hospital Universitario Niño Jesús, Madrid, España
| |
Collapse
|
22
|
Spreij LA, Sluiter D, Gosselt IK, Visser-Meily JMA, Nijboer TCW. CoCo - participation: The development and clinical use of a novel inventory measuring cognitive complaints in daily life. Neuropsychol Rehabil 2019; 31:255-277. [PMID: 31790631 DOI: 10.1080/09602011.2019.1691017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cognitive difficulties can be subtle and only come to light when patients return home from inpatient care and start to participate in society. Subjective cognitive complaints often interfere with participation, hence capturing cognitive complaints systematically is important. We developed a patient- and relative-reported measure to assess cognitive complaints during daily life activities across the memory, attention and executive domain for patients with acquired brain injury (ABI). The inventory Cognitive Complaints - Participation (CoCo-P) was created based on a literature review, consultations with experts, semi-structured interviews with patients, and a quantitative study. The inventory was administered to patients with ABI (n = 46), their relatives (n = 33) and healthy controls (n = 102) to finalize the inventory. We examined the reported complaints per daily life activity and cognitive domain of patients and healthy controls, and we compared the patients' and relatives' reports. The majority of patients (87-96%) experienced cognitive complaints, mostly related to attention, at work/education, during leisure activities, and in contact with family/friends and community. Patients reported more cognitive complaints than relatives. The CoCo-P seems appropriate to capture cognitive complaints in daily life in patients with mild ABI. Additional research is needed in terms of reliability and validity.
Collapse
Affiliation(s)
- Lauriane A Spreij
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - David Sluiter
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Netherlands
| | - Isabel K Gosselt
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Netherlands
| | - Tanja C W Nijboer
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
23
|
Neurorehabilitation of Spatial Memory Using Virtual Environments: A Systematic Review. J Clin Med 2019; 8:jcm8101516. [PMID: 31547137 PMCID: PMC6833109 DOI: 10.3390/jcm8101516] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/10/2019] [Accepted: 09/19/2019] [Indexed: 12/27/2022] Open
Abstract
In recent years, virtual reality (VR) technologies have become widely used in clinical settings because they offer impressive opportunities for neurorehabilitation of different cognitive deficits. Specifically, virtual environments (VEs) have ideal characteristics for navigational training aimed at rehabilitating spatial memory. A systematic search, following PRISMA guidelines, was carried out to explore the current scenario in neurorehabilitation of spatial memory using virtual reality. The literature on this topic was queried, 5048 papers were screened, and 16 studies were included, covering patients presenting different neuropsychological diseases. Our findings highlight the potential of the navigational task in virtual environments (VEs) for enhancing navigation and orientation abilities in patients with spatial memory disorders. The results are promising and suggest that VR training can facilitate neurorehabilitation, promoting brain plasticity processes. An overview of how VR-based training has been implemented is crucial for using these tools in clinical settings. Hence, in the current manuscript, we have critically debated the structure and the length of training protocols, as well as a different type of exploration through VR devices with different degrees of immersion. Furthermore, we analyzed and highlighted the crucial role played by the selection of the assessment tools.
Collapse
|
24
|
Tinga AM, de Back TT, Louwerse MM. Non-invasive neurophysiological measures of learning: A meta-analysis. Neurosci Biobehav Rev 2019; 99:59-89. [PMID: 30735681 DOI: 10.1016/j.neubiorev.2019.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 12/22/2018] [Accepted: 02/04/2019] [Indexed: 01/09/2023]
Abstract
In a meta-analysis of 113 experiments we examined neurophysiological outcomes of learning, and the relationship between neurophysiological and behavioral outcomes of learning. Findings showed neurophysiology yielding large effect sizes, with the majority of studies examining electroencephalography and eye-related outcome measures. Effect sizes on neurophysiological outcomes were smaller than effect sizes on behavioral outcomes, however. Neurophysiological outcomes were, but behavioral outcomes were not, influenced by several modulating factors. These factors included the sensory system in which learning took place, number of learning days, whether feedback on performance was provided, and age of participants. Controlling for these factors resulted in the effect size differences between behavior and neurophysiology to disappear. The findings of the current meta-analysis demonstrate that neurophysiology is an appropriate measure in assessing learning, particularly when taking into account factors that could have an influence on neurophysiology. We propose a first model to aid further studies that are needed to examine the exact interplay between learning, neurophysiology, behavior, individual differences, and task-related aspects.
Collapse
Affiliation(s)
- Angelica M Tinga
- Department of Cognitive Science & Artificial Intelligence, Tilburg University, Dante Building, Room D 330, Warandelaan 2, 5037 AB Tilburg, The Netherlands.
| | - Tycho T de Back
- Department of Cognitive Science & Artificial Intelligence, Tilburg University, Dante Building, Room D 330, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| | - Max M Louwerse
- Department of Cognitive Science & Artificial Intelligence, Tilburg University, Dante Building, Room D 330, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| |
Collapse
|
25
|
Grabljevec K, Singh R, Denes Z, Angerova Y, Nunes R, Boldrini P, Delargy M, Laxe S, Kiekens C, Varela Donoso E, Christodoulou N. Evidence-based position paper on Physical and Rehabilitation Medicine professional practice for Adults with Acquired Brain Injury. The European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med 2018; 54:971-979. [PMID: 30160441 DOI: 10.23736/s1973-9087.18.05502-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Acquired brain injury (ABI) is damage to the brain that occurs after birth caused either by a traumatic or by a nontraumatic injury. The rehabilitation process following ABI should be performed by a multi-professional team, working in an interdisciplinary way, with the aim of organizing a comprehensive and holistic approach to persons with every severity of ABI. This Evidence Based Position Paper represents the official position of the European Union through the UEMS Physical and Rehabilitation Medicine (PRM) Section and designates the professional role of PRM physicians for people with ABI. The aim was to formulate recommendations on the PRM physician's professional practice for persons with ABI in order to promote their functioning and enhance quality of life. METHODS This paper has been developed according to the methodology defined by the Professional Practice Committee of the UEMS-PRM Section: a systematic literature search has been performed in PubMed and Core Clinical Journals. On the basis of the selected papers, recommendations have been made as a result of five Delphi rounds. RESULTS The literature review as well as thirty-one recommendations are presented. CONCLUSIONS The expert consensus is that structured, comprehensive and holistic rehabilitation program delivered by the multi-professional team, working in an interdisciplinary way, with the leadership and coordination of the PRM physician, is likely to be effective, especially for those with severe disability after brain injury.
Collapse
Affiliation(s)
- Klemen Grabljevec
- Department for Acquired Brain Injury Rehabilitation, University Rehabilitation Institute, Ljubljana, Slovenia -
| | - Rajiv Singh
- Unit of Osborn Neurorehabilitation, Department of Rehabilitation Medicine, Sheffield Teaching Hospitals, Sheffield, UK.,Faculty of Medicine, Dentistry and Health, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Zoltan Denes
- National Institute for Medical Rehabilitation, Budapest, Hungary
| | - Yvona Angerova
- Department of Rehabilitation Medicine, Charles University, Prague, Czech Republic.,The First Faculty of Medicine, General University Hospital, Prague, Czech Republic
| | - Renato Nunes
- Centro de Reabilitação do Norte, Francelos, Porto, Portugal
| | - Paolo Boldrini
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Rome, Italy
| | - Mark Delargy
- National Rehabilitation Hospital, Dublin, Ireland
| | - Sara Laxe
- Unit of Neurorehabilitation, Guttmann Institute Foundation, University Institute of Neurorehabilitation affiliated to UAB, Badalona, Barcelona, Spain.,Autonomous University of Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Enrique Varela Donoso
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University, Madrid, Spain.,UEMS PRM Committee for Professional Practice Chairman
| | - Nicolas Christodoulou
- Limassol Center of Physical and Rehabilitation Medicine, Cyprus.,UEMS PRM Section President
| |
Collapse
|
26
|
Mesa-Gresa P, Gil-Gómez H, Lozano-Quilis JA, Gil-Gómez JA. Effectiveness of Virtual Reality for Children and Adolescents with Autism Spectrum Disorder: An Evidence-Based Systematic Review. SENSORS (BASEL, SWITZERLAND) 2018; 18:E2486. [PMID: 30071588 PMCID: PMC6111797 DOI: 10.3390/s18082486] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 12/18/2022]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disease that is specially characterized by impairments in social communication and social skills. ASD has a high prevalence in children, affecting 1 in 160 subjects. Virtual reality (VR) has emerged as an effective tool for intervention in the health field. Different recent papers have reviewed the VR-based treatments in ASD, but they have an important limitation because they only use clinical databases and do not include important technical indexes such as the Web of Science index or the Scimago Journal & Country Rank. To our knowledge, this is the first contribution that has carried out an evidence-based systematic review including both clinical and technical databases about the effectiveness of VR-based intervention in ASD. The initial search identified a total of 450 records. After the exclusion of the papers that are not studies, duplicated articles, and the screening of the abstract and full text, 31 articles met the PICO (Population, Intervention, Comparison and Outcomes) criteria and were selected for analysis. The studies examined suggest moderate evidence about the effectiveness of VR-based treatments in ASD. VR can add many advantages to the treatment of ASD symptomatology, but it is necessary to develop consistent validations in future studies to state that VR can effectively complement the traditional treatments.
Collapse
Affiliation(s)
- Patricia Mesa-Gresa
- Departamento de Psicobiología, Facultad de Psicología, Universitat de València, Blasco Ibáñez 21, 46010 Valencia, Spain.
| | - Hermenegildo Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain.
| | - José-Antonio Lozano-Quilis
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain.
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain.
| |
Collapse
|
27
|
Withiel TD, Sharp VL, Wong D, Ponsford JL, Warren N, Stolwyk RJ. Understanding the experience of compensatory and restorative memory rehabilitation: A qualitative study of stroke survivors. Neuropsychol Rehabil 2018; 30:503-522. [PMID: 29886809 DOI: 10.1080/09602011.2018.1479275] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Memory impairment is common following stroke. Memory skills groups (MSGs) utilising compensatory strategies and computerised cognitive training (CCT) are two rehabilitation approaches available to improve memory function; however, there is no consensus as to which is more effective following stroke. This study aimed to explore and contrast the qualitative experiences of 20 stroke survivors (Mage = 61.90, SD = 10.48, range: 34-77 years) who received six weeks' training in MSG (manualised memory skills group, n = 10) or individual-CCT (LumosityTM, n = 10). Using semi-structured interviews, data were collected and analysed thematically, adopting a critical realist approach. Six themes were identified: (1) Facilitators and barriers to intervention engagement, (2) Improving knowledge and understanding, (3) Connecting with others, (4) Perception of the intervention, (5) Impact on everyday memory and (6) Impact on emotions and sense of purpose. Encouragingly, most participants valued and enjoyed participating in the memory interventions, irrespective of rehabilitation approach. MSG participants reported learning and sharing with similar others as important to the experience and described everyday memory improvements. CCT participants described enjoyment of its game-like nature, yet reported frustration associated with game-specific characteristics, and did not report everyday memory improvements.
Collapse
Affiliation(s)
- Toni D Withiel
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia.,Allied Health, Royal Melbourne Hospital, Melbourne, Australia
| | - Vanessa L Sharp
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Dana Wong
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jennie L Ponsford
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Narelle Warren
- School of Social Sciences, Monash University, Melbourne, Australia
| | - Renerus J Stolwyk
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| |
Collapse
|
28
|
Resch C, Rosema S, Hurks P, de Kloet A, van Heugten C. Searching for effective components of cognitive rehabilitation for children and adolescents with acquired brain injury: A systematic review. Brain Inj 2018; 32:679-692. [PMID: 29621405 DOI: 10.1080/02699052.2018.1458335] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM Cognitive rehabilitation is of interest after paediatric acquired brain injury (ABI). The present systematic review examined studies investigating cognitive rehabilitation interventions for children with ABI, while focusing on identifying effective components. Components were categorized as (1) metacognition and/or strategy use, (2) (computerized) drill-based exercises, and (3) external aids. METHODS The databases PubMed (including MEDLINE), PsycInfo, and CINAHL were searched until 22nd June 2017. Additionally, studies were identified through cross-referencing and by consulting experts in the field. RESULTS A total of 20 articles describing 19 studies were included. Metacognition/strategy use trainings (five studies) mainly improved psychosocial functioning. Drill-based interventions (six studies) improved performance on tasks similar to training tasks. Interventions combining these two components (six studies) benefited cognitive and psychosocial functioning. External aids (two studies) improved everyday memory. No studies combined external aids with drill-based interventions or all three components. CONCLUSION Available evidence suggests that multi-component rehabilitation, e.g. combining metacognition/strategy use and drill-based training is most promising, as it can lead to improvements in both cognitive and psychosocial functioning of children with ABI. Intervention setting and duration may play a role. Conclusions remain tentative due to small sample sizes of included studies heterogeneity regarding outcome measures, intervention and therapist variables, and patient characteristics.
Collapse
Affiliation(s)
- Christine Resch
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands.,b Limburg Brain Injury Center , Maastricht , The Netherlands
| | - Stefanie Rosema
- c Sophia Rehabilitation , The Hague , The Netherlands.,d Department of Complex Behavioral Disorders and Forensic Psychiatry , De Bascule, Academic Center for Child- and Adolescent Psychiatry , Amsterdam , The Netherlands.,e Department of Child- and Adolescent Psychiatry , VU University Medical Center , Amsterdam , The Netherlands
| | - Petra Hurks
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands
| | - Arend de Kloet
- c Sophia Rehabilitation , The Hague , The Netherlands.,f The Hague University of Applied Sciences , the Hague , The Netherlands
| | - Caroline van Heugten
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands.,b Limburg Brain Injury Center , Maastricht , The Netherlands.,g School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences , Maastricht University Medical Center , Maastricht , The Netherlands
| |
Collapse
|
29
|
De Luca R, Leonardi S, Spadaro L, Russo M, Aragona B, Torrisi M, Maggio MG, Bramanti A, Naro A, De Cola MC, Calabrò RS. Improving Cognitive Function in Patients with Stroke: Can Computerized Training Be the Future? J Stroke Cerebrovasc Dis 2018; 27:1055-1060. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.11.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/19/2017] [Accepted: 11/05/2017] [Indexed: 12/29/2022] Open
|
30
|
Välimäki M, Mishina K, Kaakinen JK, Holm SK, Vahlo J, Kirjonen M, Pekurinen V, Tenovuo O, Korkeila J, Hämäläinen H, Sarajuuri J, Rantanen P, Orenius T, Koponen A. Digital Gaming for Improving the Functioning of People With Traumatic Brain Injury: Randomized Clinical Feasibility Study. J Med Internet Res 2018; 20:e77. [PMID: 29555622 PMCID: PMC5881042 DOI: 10.2196/jmir.7618] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 11/15/2017] [Accepted: 01/02/2018] [Indexed: 11/13/2022] Open
Abstract
Background Traumatic brain injury (TBI) is a major health problem that often requires intensive and long-term rehabilitation. Objective The aim of this study was to determine whether rehabilitative digital gaming facilitates cognitive functioning and general well-being in people with TBI. Methods A total of 90 Finnish-speaking adults with TBI (18-65 years) were recruited from an outpatient neuroscience clinic. The participants were randomly allocated to one of the three groups: a rehabilitation gaming group (n=29, intervention), an entertainment gaming group (n=29, active control), or a passive control group (n=32). The gaming groups were instructed to engage in gaming for a minimum of 30 min per day for 8 weeks. Primary and secondary outcomes were measured at three time points: before the intervention, after the intervention, and 3 months following the intervention. The primary outcome was cognitive status measured by processing speed and visuomotor tasks (The Trail Making Test; Wechsler Adult Intelligence Scale-Fourth Edition, WAIS-IV, symbol search, coding, and cancellation tasks). Secondary outcomes were attention and executive functions (Simon task), working memory (WAIS-IV digit span and Paced Auditory Serial Addition Test, PASAT), depression (Patient Health Questionnaire-9), self-efficacy (General Self-efficacy Scale), and executive functions (Behavior Rating Inventory of Executive Function-Adult Version). Feasibility information was assessed (acceptability, measurement instruments filled, dropouts, adherence, usability, satisfaction, and possible future use). Cognitive measurements were conducted in face-to-face interviews by trained psychologists, and questionnaires were self-administered. Results The effects of rehabilitation gaming did not significantly differ from the effects of entertainment gaming or being in a passive control group. For primary outcomes and PASAT tests, the participants in all three groups showed overall improvement in test scores across the three measurement points. However, depression scores increased significantly between baseline and after 8 weeks and between baseline and after 3 months in the rehabilitative gaming group. No differences were found in patients’ self-efficacy between the three measuring points in any of the groups. Participants did use the games (rehabilitation group: 93%, 27/29; entertainment group 100%, 29/29). Games were seen as a usable intervention (rehabilitation group: 70%, 14/29; entertainment group: 83%, 20/29). The rehabilitation group was less satisfied with the gaming intervention (68%, 13/29 vs 83%, 20/29), but they were more willing to use the game after the intervention period (76%, 16/29 vs 63%, 15/29). Total time spent on gaming during the intervention period was low (15.22 hour rehabilitation gaming group, 19.22 hour entertainment gaming group). Conclusions We did not find differences between the groups in improvement in the outcome measures. The improvements in test performance by all three groups may reflect rehearsal effects. Entertainment gaming had elements that could be considered when rehabilitative games are designed for, implemented in, and assessed in larger clinical trials for persons with TBI. Trial Registration ClinicalTrials.gov NCT02425527; https://clinicaltrials.gov/ct2/show/NCT02425527 (Archived by WebCite at http://www.webcitation.org/6esKI1uDH)
Collapse
Affiliation(s)
- Maritta Välimäki
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Kaisa Mishina
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Johanna K Kaakinen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Suvi K Holm
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Jukka Vahlo
- Turku School of Economics, Centre for Collaborative Research, University of Turku, Turku, Finland
| | - Markus Kirjonen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Virve Pekurinen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Olli Tenovuo
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Faculty of Medicine, University of Turku, Turku, Finland
| | - Jyrki Korkeila
- Faculty of Medicine, University of Turku, Turku, Finland.,Psychiatric Care Division, Satakunta Hospital District, Harjavalta, Finland
| | - Heikki Hämäläinen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | | | | | - Tage Orenius
- Orton Orthopaedic Hospital, Orton, Helsinki, Finland
| | - Aki Koponen
- Turku School of Economics, Centre for Collaborative Research, University of Turku, Turku, Finland
| |
Collapse
|
31
|
Cooper JM, Lockett S, McIlroy A, Gonzalez L. Virtual peer-delivered memory intervention: a single-case experimental design in an adolescent with chronic memory impairment. Brain Inj 2017; 32:350-362. [PMID: 29283279 DOI: 10.1080/02699052.2017.1419282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Children and adolescents with chronic memory impairment may develop coping strategies that enable functioning, yet these often remain undetectable using traditional psychometric measures. Personalized intervention studies that promote the use of such strategies designed specifically for use by this young cohort are scarce. OBJECTIVE To investigate the effect of a novel virtual reality peer-delivered memory intervention on the everyday functioning and well-being of SE, a 17-year-old female with a history of chronic verbal memory issues, impaired autobiographical event recall and elevated mood symptoms. RESEARCH DESIGN A single-case ABA experimental design study was used to assess change. METHODS Following initial baseline assessment using objective neuropsychological and subjective functional questionnaires and intervention training, case SE used the intervention daily for 3 weeks before repeating key outcome measures. RESULTS Using non-overlap of all pairs and qualitative feedback analysis, the results revealed a significant increase in event recall and self-reported positive changes to levels of everyday functioning. CONCLUSION Supporting autobiographical event recall and prospective memory via a virtual peer-delivered intervention may lead to reduction in cognitive load, and benefit overall well-being and everyday functioning.
Collapse
Affiliation(s)
- Janine M Cooper
- a Discipline of Psychological Sciences, Australian College of Applied Psychology , Melbourne , Australia.,b Department of Child Neuropsychology, Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute , Melbourne , Australia
| | - Stephen Lockett
- a Discipline of Psychological Sciences, Australian College of Applied Psychology , Melbourne , Australia.,c Department of Psychology, RMIT , Melbourne , Australia
| | - Alissandra McIlroy
- b Department of Child Neuropsychology, Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute , Melbourne , Australia
| | - Linda Gonzalez
- d Psychology Service, Royal Childrens Hospital , Melbourne , Australia
| |
Collapse
|
32
|
MacDonald S. Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury. Brain Inj 2017; 31:1760-1780. [DOI: 10.1080/02699052.2017.1379613] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Sheila MacDonald
- Adjunct Lecturer, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
- Owner, Sheila MacDonald & Associates, Guelph, Ontario, Canada
| |
Collapse
|
33
|
Improvement of higher brain dysfunction after brain injury by repetitive transcranial magnetic stimulation and intensive rehabilitation therapy. Neuroreport 2017; 28:800-807. [DOI: 10.1097/wnr.0000000000000830] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
34
|
Abstract
ECT is the oldest and most effective therapy available for the treatment of severe major depression. It is highly effective in individuals with treatment resistance and when a rapid response is required. However, ECT is associated with memory impairment that is the most concerning side-effect of the treatment, substantially contributing to the controversy and stigmatization surrounding this highly effective treatment. There is overwhelming evidence for the efficacy and safety of an acute course of ECT for the treatment of a severe major depressive episode, as reflected by the recent FDA advisory panel recommendation to reclassify ECT devices from Class III to the lower risk category Class II. However, its application for other indications remains controversial, despite strong evidence to the contrary. This article reviews the indication of ECT for major depression, as well as for other conditions, including catatonia, mania, and acute episodes of schizophrenia. This study also reviews the growing evidence supporting the use of maintenance ECT to prevent relapse after an acute successful course of treatment. Although ECT is administered uncommonly to patients under the age of 18, the evidence supporting its use is also reviewed in this patient population. Finally, memory loss associated with ECT and efforts at more effectively monitoring and reducing it are reviewed.
Collapse
Affiliation(s)
- Richard D Weiner
- a Department of Psychiatry and Behavioral Sciences , Duke University School of Medicine , Durham , NC , USA
| | - Irving M Reti
- b Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| |
Collapse
|
35
|
Abstract
Brain training is topical yet controversial. Effects are often limited to trained tasks; and near and far effects to untrained tasks or everyday life measures are often small or lacking altogether. More recent approaches use evidence from cognitive neuroscience on neuroplasticity, resulting in novel cognitive interventions. This special issue encompasses the state of the art of these interventions. Two systematic reviews and nine experimental studies in a variety of patient groups or healthy participants are included, the results of which mostly confirm earlier findings: effects on trained tasks are consistently reported, but generalisation in terms of functional outcome is limited and little evidence is found of long-term effects. In general, the studies show promising, yet challenging training effects on cognition in healthy persons and patients with cognitive deficits. As such, they may be seen as positive "proof of principle" studies, highlighting that cognitive enhancement is possible. The field of brain training, however, is in urgent need of larger and more thoroughly designed studies. These future studies should also include outcome measures on daily functioning, self-efficacy and quality of life in addition to neuropsychological tests or tasks related to cognitive functioning.
Collapse
Affiliation(s)
- Caroline M van Heugten
- a Department Neuropsychology and Psychopharmacology , Maastricht University , Maastricht , The Netherlands.,b School for Mental Health and Neuroscience , Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Rudolf W H M Ponds
- b School for Mental Health and Neuroscience , Maastricht University Medical Centre , Maastricht , The Netherlands.,c Department of Psychology , Maastricht University Medical Centre , Maastricht , The Netherlands.,d Adelante Rehabilitation Center , Hoensbroek , The Netherlands
| | - Roy P C Kessels
- e Donders Institute for Brain, Cognition and Behaviour, Radboud University , Nijmegen , The Netherlands.,f Department of Medical Psychology & Radboudumc Alzheimer Center , Radboud University Medical Center , Nijmegen , The Netherlands.,g Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry , Venray , The Netherlands
| |
Collapse
|
36
|
Evidence-Based Practice for the Use of Internal Strategies as a Memory Compensation Technique After Brain Injury: A Systematic Review. J Head Trauma Rehabil 2016; 31:E1-E11. [DOI: 10.1097/htr.0000000000000181] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
37
|
Sigmundsdottir L, Longley WA, Tate RL. Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF). Neuropsychol Rehabil 2016; 26:673-741. [PMID: 26965034 DOI: 10.1080/09602011.2016.1140657] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Computerised cognitive training (CCT) is an increasingly popular intervention for people experiencing cognitive symptoms. This systematic review evaluated the evidence for CCT in adults with acquired brain injury (ABI), focusing on how outcome measures used reflect efficacy across components of the International Classification of Functioning, Disability and Health. Database searches were conducted of studies investigating CCT to treat cognitive symptoms in adult ABI. Scientific quality was rated using the PEDro-P and RoBiNT Scales. Ninety-six studies met the criteria. Most studies examined outcomes using measures of mental functions (93/96, 97%); fewer studies included measures of activities/participation (41/96, 43%) or body structures (8/96, 8%). Only 14 studies (15%) provided Level 1 evidence (randomised controlled trials with a PEDro-P score ≥ 6/10), with these studies suggesting strong evidence for CCT improving processing speed in multiple sclerosis (MS) and moderate evidence for improving memory in MS and brain tumour populations. There is a large body of research examining the efficacy of CCT, but relatively few Level 1 studies and evidence is largely limited to body function outcomes. The routine use of outcome measures of activities/participation would provide more meaningful evidence for the efficacy of CCT. The use of body structure outcome measures (e.g., neuroimaging) is a newly emerging area, with potential to increase understanding of mechanisms of action for CCT.
Collapse
Affiliation(s)
- Linda Sigmundsdottir
- a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia.,b Brain Injury Rehabilitation Unit , Liverpool Hospital , Sydney , Australia
| | - Wendy A Longley
- a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia
| | - Robyn L Tate
- a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia
| |
Collapse
|
38
|
Välimäki M, Korkeila J, Kauppi K, Kaakinen JK, Holm S, Vahlo J, Tenovuo O, Hämäläinen H, Sarajuuri J, Rantanen P, Orenius T, Koponen A. Digital Gaming for Improving the Functioning of People With Traumatic Brain Injury: Protocol of a Feasibility Study. JMIR Res Protoc 2016; 5:e6. [PMID: 26860741 PMCID: PMC4764786 DOI: 10.2196/resprot.4841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/07/2015] [Accepted: 09/20/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a critical public health problem. The recovery process for people with TBI is typically slow and dependent on complex and intensive assisted rehabilitation programs. OBJECTIVE To evaluate the effects and feasibility of digital games for cognitive functioning and general well-being among people with traumatic brain injury. METHODS This is a single-site feasibility study conducted in Finland, which uses a pragmatic, randomized controlled trial with three arms, and will recruit patients from the Turku University Hospital, Division of Clinical Neurosciences in Finland. Participants must meet the following inclusion criteria: (1) a Finnish speaking adult, aged 18-65 years; (2) diagnosed with a traumatic brain injury (diagnostic criteria ICD-10, S06.X, T90.5) in the University Hospital; (3) access to a TV, a computer, and the Internet at home; (4) not an active digital gamer (5 hours or less a week); (5) willing to participate in the study. Participants must have been discharged from the neurologic treatment period for traumatic brain injury for over 12 months before the commencement of the trial, and they may not have actively participated in cognitive rehabilitation during the 3 months prior to the trial. Written informed consent will be mandatory for acceptance into the trial. Exclusion criteria are as follows: (1) sensory, cognitive, or physical impairment (eg, severe cognitive impairment); (2) a deficiency restricting the use of computers or computer game control system unaided (eg, impairment in vision, severe astigmatism, hemiplegia, disorder in visuospatial perception, dysfunction of the central vestibular system); (3) apathy identified in previous neuropsychological evaluations; (4) diagnosed severe mental disorders (eg, schizophrenia or severe depressive disorders to be identified in medical records as the secondary diagnosis). RESULTS The preparatory phase for the study is fulfilled. Recruitment started in June 2015 and finished November 2015. Results will be reported in 2016. CONCLUSIONS The specific outcomes such as primary outcome measures were selected because they are widely used psychological tests and thought to be sensitive to changes in the cognitive functions related to TBI. TRIAL REGISTRATION Clinicaltrials.gov NCT02425527; https://clinicaltrials.gov/ct2/show/NCT02425527 (Archived by WebCite at http://www.webcitation.org/6esKI1uDH).
Collapse
Affiliation(s)
- Maritta Välimäki
- Faculty of Medicine, Department of Nursing Science, University of Turku, Finland.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Multisensory Stimulation to Improve Low- and Higher-Level Sensory Deficits after Stroke: A Systematic Review. Neuropsychol Rev 2015; 26:73-91. [PMID: 26490254 PMCID: PMC4762927 DOI: 10.1007/s11065-015-9301-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 10/01/2015] [Indexed: 10/24/2022]
Abstract
The aim of this systematic review was to integrate and assess evidence for the effectiveness of multisensory stimulation (i.e., stimulating at least two of the following sensory systems: visual, auditory, and somatosensory) as a possible rehabilitation method after stroke. Evidence was considered with a focus on low-level, perceptual (visual, auditory and somatosensory deficits), as well as higher-level, cognitive, sensory deficits. We referred to the electronic databases Scopus and PubMed to search for articles that were published before May 2015. Studies were included which evaluated the effects of multisensory stimulation on patients with low- or higher-level sensory deficits caused by stroke. Twenty-one studies were included in this review and the quality of these studies was assessed (based on eight elements: randomization, inclusion of control patient group, blinding of participants, blinding of researchers, follow-up, group size, reporting effect sizes, and reporting time post-stroke). Twenty of the twenty-one included studies demonstrate beneficial effects on low- and/or higher-level sensory deficits after stroke. Notwithstanding these beneficial effects, the quality of the studies is insufficient for valid conclusion that multisensory stimulation can be successfully applied as an effective intervention. A valuable and necessary next step would be to set up well-designed randomized controlled trials to examine the effectiveness of multisensory stimulation as an intervention for low- and/or higher-level sensory deficits after stroke. Finally, we consider the potential mechanisms of multisensory stimulation for rehabilitation to guide this future research.
Collapse
|
40
|
Oudman E, Nijboer TCW, Postma A, Wijnia JW, Van der Stigchel S. Procedural Learning and Memory Rehabilitation in Korsakoff's Syndrome - a Review of the Literature. Neuropsychol Rev 2015; 25:134-48. [PMID: 26047664 PMCID: PMC4464729 DOI: 10.1007/s11065-015-9288-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 05/15/2015] [Indexed: 12/01/2022]
Abstract
Korsakoff's syndrome (KS) is a chronic neuropsychiatric disorder caused by alcohol abuse and thiamine deficiency. Patients with KS show restricted autonomy due to their severe declarative amnesia and executive disorders. Recently, it has been suggested that procedural learning and memory are relatively preserved in KS and can effectively support autonomy in KS. In the present review we describe the available evidence on procedural learning and memory in KS and highlight advances in memory rehabilitation that have been demonstrated to support procedural memory. The specific purpose of this review was to increase insights in the available tools for successful memory rehabilitation and give suggestions how to apply these tools in clinical practice to increase procedural learning in KS. Current evidence suggests that when memory rehabilitation is adjusted to the specific needs of KS patients, this will increase their ability to learn procedures and their typically compromised autonomy gets enhanced.
Collapse
Affiliation(s)
- Erik Oudman
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands,
| | | | | | | | | |
Collapse
|