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Zuo S, Feng Y, Sun J, Liu G, Cai H, Zhang X, Hu Z, Liu Y, Yao Z. The assessment of consciousness status in primary brainstem hemorrhage (PBH) patients can be achieved by monitoring changes in basic vital signs. Geriatr Nurs 2024; 59:498-506. [PMID: 39146640 DOI: 10.1016/j.gerinurse.2024.07.006] [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: 03/07/2024] [Revised: 06/28/2024] [Accepted: 07/13/2024] [Indexed: 08/17/2024]
Abstract
The objective of the study was to explore the association between basic vital signs and consciousness status in patients with primary brainstem hemorrhage (PBH). Patients with PBH were categorized into two groups based on Glasgow Coma Scale (GCS) scores: disturbance of consciousness (DOC) group (GCS=3-8) and non-DOC group (GCS=15). Within DOC group, patients were further divided into behavioral (GCS=4-8) and non-behavioral (GCS=3) subgroups. Basic vital signs, such as body temperature, heart rate, and respiratory rate, were monitored every 3 hours during the acute bleeding phase (1st day) and the bleeding stable phase (7th day) of hospitalization. The findings revealed a negative correlation between body temperature and heart rate with GCS scores in DOC group at both time points. Moreover, basic vital signs were notably higher in the DOC group compared to non-DOC group. Specifically, the non-behavioral subgroup within DOC group exhibited significantly elevated heart rates on the 1st day of hospitalization and moderately increased respiratory rates on the 7th day compared to the control group. Scatter plots illustrated a significant relationship between body temperature and heart rate with consciousness status, while no significant correlation was observed with respiratory rate. In conclusion, the study suggests that monitoring basic vital signs, particularly body temperature and heart rate, can serve as valuable indicators for evaluating consciousness status in PBH patients. These basic vital signs demonstrated variations corresponding to lower GCS scores. Furthermore, integrating basic vital sign monitoring with behavioral assessment could enhance the assessment of consciousness status in PBH patients.
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Affiliation(s)
- Shiyi Zuo
- Department of Pain and Rehabilitation, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yuting Feng
- Department of Pain and Rehabilitation, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Juan Sun
- Department of Pain and Rehabilitation, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Guofang Liu
- Department of Radiology, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hanxu Cai
- Department of Physiology, College of Basic Medical Sciences, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiaolong Zhang
- Department of Physiology, College of Basic Medical Sciences, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhian Hu
- Department of Physiology, College of Basic Medical Sciences, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yong Liu
- Department of Pain and Rehabilitation, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhongxiang Yao
- Department of Physiology, College of Basic Medical Sciences, Army Medical University (Third Military Medical University), Chongqing, China.
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Yildirim D, Kavala A, Değirmenci Öz S, Sezer E, Kuğu E, Coşkun Z. Inter-rater reliability in the assessment of consciousness in patients receiving palliative care in intensive care: A prospective cross sectional observational study. Nurs Crit Care 2024. [PMID: 38508739 DOI: 10.1111/nicc.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/14/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The Glasgow Coma Scale (GCS) is one of the methods that has validity for evaluating the consciousness levels of patients in the literature and is accepted by health authorities. AIM The purpose of this study was to evaluate the inter-rater reliability of GCS in intensive care patients receiving palliative care. STUDY DESIGN A prospective cross sectional observational study. The study was conducted in a general intensive care unit with 20 beds with patients receiving palliative care. In the unit, 18 nurses worked in two shifts, day and night. Each patient's primary palliative care nurse and two additional researchers were given one minute to independently record the patient's GCS total and subscale scores. All observations were completed within 5 min as there could be significant changes in the patient's GCS score during observations. RESULTS A total of 258 assessments were completed. For the GCS total scoring, a moderate agreement was found between palliative care nurses and the first researcher-observer (49.0%) and also between palliative care nurses and the second researcher-observer (47.7%). In addition, there was a substantial agreement between the first and second researchers (78.9%) and also between all observers (61.5%) (all p = .001). CONCLUSIONS Although there was a near-perfect agreement between the two researcher-observers, we found only moderate agreement among all observers (palliative care nurses and two researcher-observers) in the evaluation of GCS total and subscale scores. RELEVANCE TO CLINICAL PRACTICE We found that lack of knowledge and training on the standardized use of GCS is still a problem for palliative and intensive care units. Because of the diversity of patients requiring GCS assessment in palliative care units, refresher training programs and hands-on workshops on consciousness assessment should be organized regularly for more experienced nurses.
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Affiliation(s)
- Dilek Yildirim
- Faculty of Health Sciences, Department of Nursing, Istanbul Aydın University, Istanbul, Turkey
| | - Arzu Kavala
- Faculty of Health Sciences, Department of Nursing, Istanbul Aydın University, Istanbul, Turkey
| | - Seda Değirmenci Öz
- Faculty of Health Sciences, Department of Nursing Administration, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Esra Sezer
- Faculty of Health Sciences, Department of Nursing, Acibadem University, Istanbul, Turkey
| | - Emre Kuğu
- Vocational School of Health Services, Department of Medical Services and Techniques, Anesthesia Programme, Fenerbahçe University, Istanbul, Turkey
| | - Zeynep Coşkun
- Medical Park Florya Hospital, Istanbul Aydin University, Istanbul, Turkey
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Alzoubi E, Shaheen F, Yousef K. Delirium incidence, predictors and outcomes in the intensive care unit: A prospective cohort study. Int J Nurs Pract 2024; 30:e13154. [PMID: 37044382 DOI: 10.1111/ijn.13154] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/16/2023] [Accepted: 03/19/2023] [Indexed: 04/14/2023]
Abstract
AIM The aim of this study was to investigate the incidence, predictors, and outcomes of delirium in intensive care units. BACKGROUND Delirium is a common complication in intensive care units. In developing countries, it can be misdiagnosed or unrecognised. DESIGN Prospective cohort study reported according to the strengthening the reporting of observational studies in epidemiology criteria. METHODS We included patients who were conscious, >18 years old, and admitted to the intensive care units for at least 8 h between December 2019 and February 2020. Patients with a Richmond score of -4 or -5, mental disability, receptive aphasia and/or visual or auditory impairment were excluded from the study. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU), whereas the functional outcome was assessed by the Katz Activity of Daily Living Index. RESULTS This study included 111 patients with a delirium incidence of 31.5%. The severity of illness was the only significant predictor of delirium. Patients with delirium had longer intensive care unit and in-hospital stays in contrast to those without delirium. Delirium was associated with in-hospital and 4-month mortality but not the activities of daily living. CONCLUSIONS Delirium is associated with increased length of stay and mortality. Further investigation to determine whether delirium management can improve outcomes is warranted.
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Affiliation(s)
- Elaf Alzoubi
- King Abdullah University Hospital, Irbid, Jordan
| | | | - Khalil Yousef
- School of Nursing, University of Jordan, Amman, Jordan
- School of Humanities, Social Science, and Health, University of Wollongong in Dubai, Dubai, United Arab Emirates
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Tavares GS, Oliveira CC, Mendes LPS, Velloso M. Muscle strength and mobility of individuals with COVID-19 compared with non-COVID-19 in intensive care. Heart Lung 2023; 62:233-239. [PMID: 37603954 DOI: 10.1016/j.hrtlng.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Critical illness may affect muscle strength and mobility. OBJECTIVES To compare muscle strength, mobility, and in intensive care unit (ICU)-acquired weakness (ICUAW) prevalence among individuals with COVID-19 and other critical illnesses; to identify factors associated with muscle strength, mobility, and length of stay in COVID-19; and to determine the Perme Intensive Care Unit Mobility Score (PICUMS) cut-off point for ICUAW. METHODS We included individuals aged ≥18 in ICU who require mechanical ventilation. We excluded those diagnosed with neuromusculoskeletal diseases or who did not understand the study procedures. The Medical Research Council - sum score (MRC-SS) and the PICUMS were applied before ICU and hospital discharge. Analysis of covariance, Quade´s test, and Fisher's exact test compared groups. Partial correlations were analized between the MRC-SS and PICUMS with clinical variables. Regression models identified the predictors of hospital length of stay. The ROC curve verified the PICUMS related to ICUAW. Significance was set as P<.05. RESULTS 25 individuals were included in the COVID-19 group and 23 in the non-COVID-19 group. No between-groups difference was observed in MRC-SS and PICUMS at discharge from ICU or hospital. The MRC-SS and PICUMS at ICU discharge predicted the length of hospital stay in the COVID-19 group. The PICUMS cut-off related to ICUAW was 18. CONCLUSIONS Muscle strength, mobility, and ICUAW are similar between COVID-19 and non-COVID-19. However, muscle strength and mobility at ICU discharge are associated with the length of stay during COVID-19. A PICUMS<18 at ICU discharge may indicate impaired physical functioning due to ICUAW.
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Affiliation(s)
- Graziele S Tavares
- Postgraduate Research Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil; Department of Physical Therapy, Hospital Metropolitano Dr. Célio de Castro, Belo Horizonte, Brazil
| | - Cristino C Oliveira
- Postgraduate Research Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil; Postgraduate Research Program in Rehabilitation Sciences and Physical Function Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Liliane P S Mendes
- Postgraduate Research Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Marcelo Velloso
- Postgraduate Research Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Pinggera D, Geiger P, Thomé C. [Traumatic brain injury]. DER NERVENARZT 2023; 94:960-972. [PMID: 37676293 PMCID: PMC10575816 DOI: 10.1007/s00115-023-01546-9] [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] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
Traumatic brain injury (TBI) describes parenchymal brain damage caused by external forces to the head. It has a massive personal and socioeconomic impact, as it is a disease with high morbidity and mortality. Both young and old people are affected, as a result of traffic or sports accidents as well as due to falls at home. The term TBI encompasses various clinical pictures, differing considerably in cause, prognosis and therapy. What they all have in common is the pathophysiological cascade that develops immediately after the initial trauma and which can persist for several days and weeks. In this phase, medical treatment, whether surgical or pharmacological, attempts to reduce the consequences of the primary damage. The aim is to maintain adequate cerebral perfusion pressure and to reduce intracranial pressure.
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Affiliation(s)
- D Pinggera
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
| | - P Geiger
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - C Thomé
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
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Welsch E, Vashisht A, Stutzman SE, Olson DM. Family Presence May Reduce Postoperative Delirium After Spinal Surgery. J Neurosci Nurs 2023; 55:97-102. [PMID: 37094374 DOI: 10.1097/jnn.0000000000000704] [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: 04/26/2023]
Abstract
ABSTRACT BACKGROUND: Delirium is associated with worse outcomes, but there is a gap in literature identifying nurse-led interventions to reduce delirium in postoperative (postop) surgical spine patients. Because family presence has been associated with a variety of beneficial effects, we aimed to examine whether family presence in the spine intensive care unit (ICU) during the night after surgery was associated with less confusion or delirium on postop day 1. METHODS: This is a prospective nonrandomized pilot clinical trial with pragmatic sampling. Group designation was assigned by natural history. The family-present group was designated as patients for whom a family member remained present during the first night after surgery. The unaccompanied group was designated as patients who did not have a family member stay the night. Data include the Richmond Agitation Sedation Scale, the Confusion Assessment Method for the ICU, the 4AT (Alertness, Attention, Abbreviated mental test, and Acute change) score, and confusion measured with the orientation item on the Glasgow Coma Scale. Baseline data were collected after admission to the spine ICU and compared with the same data collected in the morning of postop day 1. RESULTS: At baseline, 5 of 16 patients in the family-present group (31.3%) had at least 1 incidence of delirium or confusion. Similarly, 6 of 14 patients in the unaccompanied group (42.9%) had at least 1 incidence of delirium or confusion. There was a clinically relevant, but not statistically significant, reduction in postop day 1 delirium or confusion comparing the family-present (6.3%) and unaccompanied (21.4%) groups ( P = .23). CONCLUSION: Family presence may reduce delirium and confusion for patients after spine surgery. The results support continued research into examining nurse-led interventions to reduce delirium and improve outcomes for this population.
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Xiong Q, Le K, Tang Y, Ye W, Wang Y, Zhong Y, Zhou Y, Feng Z. Effect of single and combined median nerve stimulation and repetitive transcranial magnetic stimulation in patients with prolonged disorders of consciousness: a prospective, randomized, single-blinded, controlled trial. Front Aging Neurosci 2023; 15:1112768. [PMID: 37168716 PMCID: PMC10164991 DOI: 10.3389/fnagi.2023.1112768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/23/2023] [Indexed: 05/13/2023] Open
Abstract
Objective To investigate the efficacy of median nerve stimulation (MNS) combined with repetitive transcranial magnetic stimulation (rTMS), MNS alone, and rTMS alone in elevating the level of consciousness in patients with prolonged disorders of consciousness (pDOC). Participants and methods We enrolled 75 eligible inpatients suffering from pDOC as a result of traumatic or non-traumatic brain injury. Participants were randomly assigned to one of the following three treatment groups: (1) rTMS+sham-MNS; (2) MNS + sham-rTMS; or (3) MNS + rTMS. The rTMS protocol involved stimulation above the left dorsolateral prefrontal cortex at a 10 Hz frequency and 90% resting motor threshold. The MNS protocol involved the delivery of a 15-20 mA current at the median nerve point 2 cm from the wrist crease of the right distal forearm. The primary outcome was the change from baseline of the Coma Recovery Scale-Revised (CRS-R) score after treatment. Secondary outcomes included post-treatment changes from baseline of the Glasgow Coma Scale (GCS) score, awaken ratio, electroencephalography (EEG) scores, and the latency and amplitude of N20 on somatosensory evoked potentials. Results Before the intervention, there were no significant differences between groups in the CRS-R, GCS scores, age, duration of pDOC, clinical diagnosis, EEG scores, latency and amplitude of N20, sex, job, marital status, education level, or disease etiology. Within the three groups, the total CRS-R, GCS scores and amplitude of N20 on both side significantly increased and latency of N20 on poor side significantly decreased post-intervention. Significantly greater improvement in CRS-R, GCS total scores, amplitude of N20 on both side and latency of N20 on the poor side were observed in the MNS + TMS group compared to those of the groups receiving rTMS alone or MNS alone. The patients receiving TMS and MNS intervention showed a greater EEG activity improvement, and the EEG activity improved ratio significantly differ between groups, while there were no significant differences in the awakening ratios between the three groups. Conclusion The combination of MNS + rTMS was more efficacious in improving the level of consciousness than MNS alone or rTMS alone in patients with pDOC.
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Xiong Q, Wang Y, Wang Z, Tang Y, Huang L, Kang J, Feng Z. Relationship between consciousness level and perfusion computed tomography in patients with prolonged disorders of consciousness. Aging (Albany NY) 2022; 14:9668-9678. [PMID: 36470667 PMCID: PMC9792208 DOI: 10.18632/aging.204417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/23/2022] [Indexed: 12/09/2022]
Abstract
PURPOSE We assessed the relationship between consciousness level and values of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP) obtained by whole-brain perfusion computed tomography (pCT) in patients with prolonged disorders of consciousness (pDOC). METHODS This study included 29 patients in vegetative state (VS), 34 with minimally consciousness state minus (MCS-), and 13 with minimally consciousness state plus (MCS+). All patients were evaluated using the Coma Recovery Scale-Revised (CRS-R), the Glasgow Coma Scale (GCS), and the Full Outline of UnResponsiveness (FOUR). The values of CBF, CBV, MTT, and TTP were obtained from patients who underwent pCT. Differences in CBF, CBV, MTT, and TTP were compared between the three types of pDOC. Correlations between the CRS-R, GCS, and FOUR scores and the pCT results were analyzed. RESULTS Among the three groups, patients in VS showed a significantly decreased CBF in the bilateral frontal lobe, thalamus, temporal lobe, occipital lobe, brainstem, and damaged part. CBV was significantly reduced in patients with VS in the bilateral frontal lobe, thalamus, temporal lobe, brainstem, and damaged part. The total CRS-R, GCS, and FOUR scores were positively correlated with CBF, CBV, and TTP in almost all regions of interest. CONCLUSION Reductions in CBF and CBV calculated with pCT are associated with impaired consciousness and perfusion CT could be a promising tool in evaluating the conscious level in patients with pDOC.
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Affiliation(s)
- Qi Xiong
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, P.R. China
| | - Yong Wang
- Department of Medical Oncology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, P.R. China
| | - Ziwen Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, P.R. China
| | - Yunliang Tang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, P.R. China
| | - Lianghua Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, P.R. China
| | - Junwei Kang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, P.R. China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, P.R. China
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Liu Y, Liu Z, Yang Z, Zhao L, Li H. Clinical efficacy of hyperbaric oxygen combined with different timings of right median-nerve electrical stimulation in patients with brain injury-induced disorders of consciousness. Brain Behav 2022; 12:e2716. [PMID: 35920129 PMCID: PMC9480931 DOI: 10.1002/brb3.2716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate the clinical efficacy of hyperbaric oxygen combined with right median-nerve stimulation (RMNES) in patients with disorders of consciousness caused by brain injury. METHODS A total of 120 patients with consciousness disorders caused by brain injury were selected. They were randomly divided into three groups, a control group, test group 1 (treated with RMNES after hyperbaric oxygen therapy [HBOT]), and test group 2 (treated with RMNES at the same time as HBOT), with 40 patients in each group. Before and after treatment, the Glasgow coma scale (GCS), brainstem auditory-evoked potential (BAEP), electroencephalogram (EEG), and upper-limb sensory-evoked potential (USEP) were evaluated for the three groups of patients. RESULTS The GCS score of patients in the three groups significantly improved compared with that before treatment (p < .05). There were significant differences in GCS scores among the three groups (p < .05), and the GCS score for the patients was test group 2>test group 1>control group. The EEG, BAEP, and USEP scores were significantly improved compared with those before treatment (p < .05), and the degree of improvement of patients in the three groups was test group 2>test group 1>control group (p < .05). The clinical efficacy of test group 2 was higher than that of test group 1, and the clinical efficacy of test group 1 was higher than that of the control group (p < .05). CONCLUSION Hyperbaric oxygen combined with RMNES can improve the state of consciousness and promote the recovery of consciousness for patients with consciousness disorders caused by brain injury, and the effect of RMNES combined with HBOT in the chamber on improving the recovery of consciousness is better than after HBOT outside the chamber.
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Affiliation(s)
- Yan‐Song Liu
- The Scond Department of RehabilitationThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Zi‐bo Liu
- Department of EndocrinologyThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Zhe Yang
- The Scond Department of RehabilitationThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Long Zhao
- The Scond Department of RehabilitationThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Hong‐Ling Li
- The Scond Department of RehabilitationThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
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A novel approach for detection of consciousness level in comatose patients from EEG signals with 1-D convolutional neural network. Biocybern Biomed Eng 2022. [DOI: 10.1016/j.bbe.2021.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Zhou L, Huang X, Li H, Guo R, Wang J, Zhang Y, Lu Z. Rehabilitation effect of rTMS combined with cognitive training on cognitive impairment after traumatic brain injury. Am J Transl Res 2021; 13:11711-11717. [PMID: 34786098 PMCID: PMC8581933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/15/2021] [Indexed: 12/08/2022]
Abstract
OBJECTIVE To innvestigate the rehabilitation effects of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training on cognitive impairment in patients with traumatic brain injury (TBI) by using multimodal magnetic resonance imaging. METHODS Clinical data of 166 patients with cognitive impairment after TBI were retrospectively analyzed. The patients were assigned into an observation group and a control group according to different treatment methods, with 83 cases in each group. The observation group was given rTMS + cognitive training, and the control group was given cognitive training only. The changes in GCS score, the Cho/Cr, Cho/NAA and NAA/Cr ratios examined by MRSI, the score of cognitive impairment, the grading of cognitive impairment, and the changes in modified Barthel index were observed and compared between the two groups. RESULTS The GCS score, and the ratios of Cho/Cr, Cho/NAA and NAA/Cr after treatment were better than those before treatment in both groups and were lower in the observation group compared with the control group (all P<0.05). The score and grading of cognitive impairment as well as modified Barthel index after treatment were all significantly better in the observation group than in the control group (all P<0.05). CONCLUSION rTMS can improve the rehabilitation effect on cognitive impairment in patients after TBI and is recommended for clinical use.
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Affiliation(s)
- Li Zhou
- Department of Rehabilitation, The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou, Guangdong Province, China
| | - Xuming Huang
- Department of Rehabilitation, The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou, Guangdong Province, China
| | - Haiyan Li
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
| | - Ruomi Guo
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
| | - Jihui Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
| | - Yu Zhang
- Department of Pathology, Guangdong Provincial Hospital of Traditional Chinese MedicineGuangzhou, Guangdong Province, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou, Guangdong Province, China
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