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Levitin MO, Rawlins LE, Sanchez-Andrade G, Arshad OA, Collins SC, Sawiak SJ, Iffland PH, Andersson MHL, Bupp C, Cambridge EL, Coomber EL, Ellis I, Herkert JC, Ironfield H, Jory L, Kretz PF, Kant SG, Neaverson A, Nibbeling E, Rowley C, Relton E, Sanderson M, Scott EM, Stewart H, Shuen AY, Schreiber J, Tuck L, Tonks J, Terkelsen T, van Ravenswaaij-Arts C, Vasudevan P, Wenger O, Wright M, Day A, Hunter A, Patel M, Lelliott CJ, Crino PB, Yalcin B, Crosby AH, Baple EL, Logan DW, Hurles ME, Gerety SS. Models of KPTN-related disorder implicate mTOR signalling in cognitive and overgrowth phenotypes. Brain 2023; 146:4766-4783. [PMID: 37437211 PMCID: PMC10629792 DOI: 10.1093/brain/awad231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/31/2023] [Accepted: 06/18/2023] [Indexed: 07/14/2023] Open
Abstract
KPTN-related disorder is an autosomal recessive disorder associated with germline variants in KPTN (previously known as kaptin), a component of the mTOR regulatory complex KICSTOR. To gain further insights into the pathogenesis of KPTN-related disorder, we analysed mouse knockout and human stem cell KPTN loss-of-function models. Kptn -/- mice display many of the key KPTN-related disorder phenotypes, including brain overgrowth, behavioural abnormalities, and cognitive deficits. By assessment of affected individuals, we have identified widespread cognitive deficits (n = 6) and postnatal onset of brain overgrowth (n = 19). By analysing head size data from their parents (n = 24), we have identified a previously unrecognized KPTN dosage-sensitivity, resulting in increased head circumference in heterozygous carriers of pathogenic KPTN variants. Molecular and structural analysis of Kptn-/- mice revealed pathological changes, including differences in brain size, shape and cell numbers primarily due to abnormal postnatal brain development. Both the mouse and differentiated induced pluripotent stem cell models of the disorder display transcriptional and biochemical evidence for altered mTOR pathway signalling, supporting the role of KPTN in regulating mTORC1. By treatment in our KPTN mouse model, we found that the increased mTOR signalling downstream of KPTN is rapamycin sensitive, highlighting possible therapeutic avenues with currently available mTOR inhibitors. These findings place KPTN-related disorder in the broader group of mTORC1-related disorders affecting brain structure, cognitive function and network integrity.
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Affiliation(s)
- Maria O Levitin
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Evox Therapeutics Limited, Oxford OX4 4HG, UK
| | - Lettie E Rawlins
- RILD Wellcome Wolfson Medical Research Centre, University of Exeter, Exeter EX2 5DW, UK
- Peninsula Clinical Genetics Service, Royal Devon University Healthcare NHS Foundation Trust, Exeter EX1 2ED, UK
| | | | - Osama A Arshad
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Stephan C Collins
- INSERM Unit 1231, Université de Bourgogne Franche-Comté, Dijon 21078, France
| | - Stephen J Sawiak
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Phillip H Iffland
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Malin H L Andersson
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Caleb Bupp
- Spectrum Health, Helen DeVos Children’s Hospital, Grand Rapids, MI 49503, USA
| | - Emma L Cambridge
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Eve L Coomber
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Ian Ellis
- Department of Clinical Genetics, Alder Hey Children’s Hospital, Liverpool L14 5AB, UK
| | - Johanna C Herkert
- Department of Genetics, University Medical Centre, University of Groningen, Groningen 9713 GZ, The Netherlands
| | - Holly Ironfield
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Logan Jory
- Haven Clinical Psychology Practice Ltd, Bude, Cornwall EX23 9HP, UK
| | | | - Sarina G Kant
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015 GD, The Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden 2300 RC, The Netherlands
| | - Alexandra Neaverson
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Department of Genetics, University of Cambridge, Cambridge CB2 3EH, UK
| | - Esther Nibbeling
- Laboratory for Diagnostic Genome Analysis, Department of Clinical Genetics, Leiden University Medical Center, Leiden 3015 GD, The Netherlands
| | - Christine Rowley
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Institute of Metabolic Science, Cambridge University, Cambridge CB2 0QQ, UK
| | - Emily Relton
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Faculty of Health and Medical Science, University of Surrey, Guildford GU2 7YH, UK
| | - Mark Sanderson
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Ethan M Scott
- New Leaf Center, Clinic for Special Children, Mount Eaton, OH 44659, USA
| | - Helen Stewart
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Trust, Oxford OX3 7HE, UK
| | - Andrew Y Shuen
- London Health Sciences Centre, London, ON N6A 5W9, Canada
- Division of Medical Genetics, Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5W9, Canada
| | - John Schreiber
- Department of Neurology, Children’s National Medical Center, Washington DC 20007, USA
| | - Liz Tuck
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - James Tonks
- Haven Clinical Psychology Practice Ltd, Bude, Cornwall EX23 9HP, UK
| | - Thorkild Terkelsen
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Conny van Ravenswaaij-Arts
- Department of Genetics, University Medical Centre, University of Groningen, Groningen 9713 GZ, The Netherlands
| | - Pradeep Vasudevan
- Department of Clinical Genetics, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester LE1 7RH, UK
| | - Olivia Wenger
- New Leaf Center, Clinic for Special Children, Mount Eaton, OH 44659, USA
| | - Michael Wright
- Institute of Human Genetics, International Centre for Life, Newcastle upon Tyne NE1 7RU, UK
| | - Andrew Day
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Qkine Ltd., Cambridge CB5 8HW, UK
| | - Adam Hunter
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Minal Patel
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Christopher J Lelliott
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Institute of Metabolic Science, Cambridge University, Cambridge CB2 0QQ, UK
| | - Peter B Crino
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Binnaz Yalcin
- INSERM Unit 1231, Université de Bourgogne Franche-Comté, Dijon 21078, France
| | - Andrew H Crosby
- RILD Wellcome Wolfson Medical Research Centre, University of Exeter, Exeter EX2 5DW, UK
| | - Emma L Baple
- RILD Wellcome Wolfson Medical Research Centre, University of Exeter, Exeter EX2 5DW, UK
- Peninsula Clinical Genetics Service, Royal Devon University Healthcare NHS Foundation Trust, Exeter EX1 2ED, UK
| | - Darren W Logan
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Waltham Petcare Science Institute, Waltham on the Wolds LE14 4RT, UK
| | - Matthew E Hurles
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Sebastian S Gerety
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Open Targets, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
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Spencer APC, Lequin MH, de Vries LS, Brooks JCW, Jary S, Tonks J, Cowan FM, Thoresen M, Chakkarapani E. Mammillary body abnormalities and cognitive outcomes in children cooled for neonatal encephalopathy. Dev Med Child Neurol 2023; 65:792-802. [PMID: 36335569 PMCID: PMC10952753 DOI: 10.1111/dmcn.15453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022]
Abstract
AIM To evaluate mammillary body abnormalities in school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy (cases) and matched controls, and associations with cognitive outcome, hippocampal volume, and diffusivity in the mammillothalamic tract (MTT) and fornix. METHOD Mammillary body abnormalities were scored from T1-weighted magnetic resonance imaging (MRI) in 32 cases and 35 controls (median age [interquartile range] 7 years [6 years 7 months-7 years 7 months] and 7 years 4 months [6 years 7 months-7 years 7 months] respectively). Cognition was assessed using the Wechsler Intelligence Scale for Children, Fourth Edition. Hippocampal volume (normalized by total brain volume) was measured from T1-weighted MRI. Radial diffusivity and fractional anisotropy were measured in the MTT and fornix, from diffusion-weighted MRI using deterministic tractography. RESULTS More cases than controls had mammillary body abnormalities (34% vs 0%; p < 0.001). Cases with abnormal mammillary bodies had lower processing speed (p = 0.016) and full-scale IQ (p = 0.028) than cases without abnormal mammillary bodies, and lower scores than controls in all cognitive domains (p < 0.05). Cases with abnormal mammillary bodies had smaller hippocampi (left p = 0.016; right p = 0.004) and increased radial diffusivity in the right MTT (p = 0.004) compared with cases without mammillary body abnormalities. INTERPRETATION Cooled children with mammillary body abnormalities at school-age have reduced cognitive scores, smaller hippocampi, and altered MTT microstructure compared with those without mammillary body abnormalities, and matched controls. WHAT THIS PAPER ADDS Cooled children are at higher risk of mammillary body abnormalities than controls. Abnormal mammillary bodies are associated with reduced cognitive scores and smaller hippocampi. Abnormal mammillary bodies are associated with altered mammillothalamic tract diffusivity.
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Affiliation(s)
- Arthur P. C. Spencer
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Clinical Research and Imaging CentreUniversity of BristolBristolUK
| | - Maarten H. Lequin
- Department of Radiology and Nuclear MedicineUniversity Medical Center Utrecht/Wilhelmina Children's HospitalUtrechtthe Netherlands
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
| | - Linda S. de Vries
- Department of NeonatologyUniversity Medical Center UtrechtUtrechtthe Netherlands
- Department of NeonatologyLeiden University Medical CenterLeidenthe Netherlands
| | - Jonathan C. W. Brooks
- Clinical Research and Imaging CentreUniversity of BristolBristolUK
- School of PsychologyUniversity of East AngliaNorwichUK
| | - Sally Jary
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - James Tonks
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- University of Exeter Medical SchoolExeterUK
| | - Frances M. Cowan
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Department of PaediatricsImperial College LondonLondonUK
| | - Marianne Thoresen
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Faculty of MedicineInstitute of Basic Medical Sciences, University of OsloOsloNorway
| | - Ela Chakkarapani
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Neonatal Intensive Care UnitSt Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
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Spencer APC, Lee-Kelland R, Brooks JCW, Jary S, Tonks J, Cowan FM, Thoresen M, Chakkarapani E. Brain volumes and functional outcomes in children without cerebral palsy after therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy. Dev Med Child Neurol 2023; 65:367-375. [PMID: 35907252 PMCID: PMC10087533 DOI: 10.1111/dmcn.15369] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/11/2022] [Accepted: 07/12/2022] [Indexed: 02/03/2023]
Abstract
AIM To investigate whether brain volumes were reduced in children aged 6 to 8 years without cerebral palsy, who underwent therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy (patients), and matched controls, and to examine the relation between subcortical volumes and functional outcome. METHOD We measured regional brain volumes in 31 patients and 32 controls (median age 7 years and 7 years 2 months respectively) from T1-weighted magnetic resonance imaging (MRI). We assessed cognition using the Wechsler Intelligence Scales for Children, Fourth Edition and motor ability using the Movement Assessment Battery for Children, Second Edition (MABC-2). RESULTS Patients had lower volume of whole-brain grey matter, white matter, pallidi, hippocampi, and thalami than controls (false discovery rate-corrected p < 0.05). Differences in subcortical grey-matter volumes were not independent of total brain volume (TBV). In patients, hippocampal and thalamic volumes correlated with full-scale IQ (hippocampi, r = 0.477, p = 0.010; thalami, r = 0.452, p = 0.016) and MABC-2 total score (hippocampi, r = 0.526, p = 0.004; thalami, r = 0.505, p = 0.006) independent of age, sex, and TBV. No significant correlations were found in controls. In patients, cortical injury on neonatal MRI was associated with reduced volumes of hippocampi (p = 0.001), thalami (p = 0.002), grey matter (p = 0.015), and white matter (p = 0.013). INTERPRETATION Children who underwent therapeutic hypothermia have reduced whole-brain grey and white-matter volumes, with associations between hippocampal and thalamic volumes and functional outcomes.
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Affiliation(s)
- Arthur P C Spencer
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Clinical Research and Imaging Centre, University of Bristol, Bristol, UK
| | - Richard Lee-Kelland
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan C W Brooks
- Clinical Research and Imaging Centre, University of Bristol, Bristol, UK.,School of Psychology, University of East Anglia, Norwich, UK
| | - Sally Jary
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - James Tonks
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,University of Exeter Medical School, Exeter, UK
| | - Frances M Cowan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Paediatrics, Imperial College London, London, UK
| | - Marianne Thoresen
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ela Chakkarapani
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Neonatal Intensive Care Unit, St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Moraes ÍAP, Lima JA, Silva NM, Simcsik AO, Silveira AC, Menezes LDC, Araújo LV, Crocetta TB, Voos MC, Tonks J, Silva TD, Dawes H, Monteiro CBM. Effect of Longitudinal Practice in Real and Virtual Environments on Motor Performance, Physical Activity and Enjoyment in People with Autism Spectrum Disorder: A Prospective Randomized Crossover Controlled Trial. Int J Environ Res Public Health 2022; 19:14668. [PMID: 36429386 PMCID: PMC9690405 DOI: 10.3390/ijerph192214668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: People with ASD commonly present difficulty performing motor skills and a decline in physical activity (PA) level and low enjoyment of PA. We aimed to evaluate whether longitudinal practice of an activity in virtual and real environments improves motor performance and whether this improvement is transferred to a subsequent practice when changing the environment, promoting PA and providing enjoyment; (2) Methods: People with ASD, aged between 10 and 16 years, were included and distributed randomly into two opposite sequences. The participants performed a 10 session protocol, with five sessions practicing in each environment (virtual or real). Heart rate measurement was carried out and an enjoyment scale was applied; (3) Results: 22 participants concluded the protocol. Sequence A (virtual first) presented an improvement in accuracy and precision and transferred this when changing environment; they also had a greater change in heart rate reserve. The majority of participants reported "fun" and "great fun" levels for enjoyment; (4) Conclusions: The virtual reality activity presented a higher level of difficulty, with greater gains in terms of transference to the real environment. Considering PA, our task provided very light to light activity and the majority of participants enjoyed the task.
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Affiliation(s)
- Íbis A. P. Moraes
- Rehabilitation Sciences, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil
- College of Medicine and Health, St Lukes Campus, University of Exeter, Exeter EX1 2LU, UK
| | - Joyce A. Lima
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
| | - Nadja M. Silva
- Medicine (Cardiology), Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 04021-001, Brazil
| | - Amanda O. Simcsik
- Rehabilitation Sciences, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil
| | - Ana C. Silveira
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
| | - Lilian D. C. Menezes
- Medicine (Cardiology), Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 04021-001, Brazil
| | - Luciano V. Araújo
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
| | - Tânia B. Crocetta
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
| | - Mariana C. Voos
- Faculty of Humanities and Health Sciences, Pontifical Catholic University of São Paulo (PUC-SP), São Paulo 05014-901, Brazil
| | - James Tonks
- College of Medicine and Health, St Lukes Campus, University of Exeter, Exeter EX1 2LU, UK
| | - Talita D. Silva
- Rehabilitation Sciences, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil
- Medicine (Cardiology), Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), São Paulo 04021-001, Brazil
- Faculty of Medicine, University City of São Paulo (UNICID), São Paulo 03071-000, Brazil
| | - Helen Dawes
- College of Medicine and Health, St Lukes Campus, University of Exeter, Exeter EX1 2LU, UK
- Department of Paediatrics, University of Oxford, Oxford OX3 9DU, UK
| | - Carlos B. M. Monteiro
- Rehabilitation Sciences, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil
- Physical Activity Sciences, School of Arts, Science and Humanities, University of São Paulo (EACH-USP), São Paulo 03828-000, Brazil
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Spencer APC, Brooks JCW, Masuda N, Byrne H, Lee-Kelland R, Jary S, Thoresen M, Tonks J, Goodfellow M, Cowan FM, Chakkarapani E. Disrupted brain connectivity in children treated with therapeutic hypothermia for neonatal encephalopathy. Neuroimage Clin 2021; 30:102582. [PMID: 33636541 PMCID: PMC7906894 DOI: 10.1016/j.nicl.2021.102582] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/18/2021] [Accepted: 01/28/2021] [Indexed: 11/27/2022]
Abstract
We studied brain structure in case children cooled for neonatal encephalopathy. Cases did not have cerebral palsy and were matched with controls. Cases had reduced fractional anisotropy in several white matter tracts. Several whole-brain structural connectivity network metrics correlated with IQ. We identified subnetworks associated with case status, IQ and processing speed.
Therapeutic hypothermia following neonatal encephalopathy due to birth asphyxia reduces death and cerebral palsy. However, school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal encephalopathy still have reduced performance on cognitive and motor tests, attention difficulties, slower reaction times and reduced visuo-spatial processing abilities compared to typically developing controls. We acquired diffusion-weighted imaging data from school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal encephalopathy at birth, and a matched control group. Voxelwise analysis (33 cases, 36 controls) confirmed reduced fractional anisotropy in widespread areas of white matter in cases, particularly in the fornix, corpus callosum, anterior and posterior limbs of the internal capsule bilaterally and cingulum bilaterally. In structural brain networks constructed using probabilistic tractography (22 cases, 32 controls), graph-theoretic measures of strength, local and global efficiency, clustering coefficient and characteristic path length were found to correlate with IQ in cases but not controls. Network-based statistic analysis implicated brain regions involved in visuo-spatial processing and attention, aligning with previous behavioural findings. These included the precuneus, thalamus, left superior parietal gyrus and left inferior temporal gyrus. Our findings demonstrate that, despite the manifest successes of therapeutic hypothermia, brain development is impaired in these children.
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Affiliation(s)
- Arthur P C Spencer
- Clinical Research and Imaging Centre, University of Bristol, Bristol, United Kingdom
| | - Jonathan C W Brooks
- Clinical Research and Imaging Centre, University of Bristol, Bristol, United Kingdom; School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Naoki Masuda
- Department of Mathematics, State University of New York at Buffalo, Buffalo, NY, United States; Computational and Data-Enabled Science and Engineering Program, State University of New York at Buffalo, Buffalo, NY, United States
| | - Hollie Byrne
- Clinical Research and Imaging Centre, University of Bristol, Bristol, United Kingdom
| | - Richard Lee-Kelland
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sally Jary
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Marianne Thoresen
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - James Tonks
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; University of Exeter Medical School, Exeter, United Kingdom
| | - Marc Goodfellow
- Living Systems Institute, University of Exeter, Exeter, United Kingdom; Wellcome Trust Centre for Biomedical Modelling and Analysis, University of Exeter, Exeter, United Kingdom; EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, United Kingdom; College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Frances M Cowan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Department of Paediatrics, Imperial College London, London, United Kingdom
| | - Ela Chakkarapani
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Neonatal Intensive Care Unit, St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom.
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de Menezes LDC, da Silva TD, Capelini CM, Tonks J, Watson S, de Moraes ÍAP, Malheiros SRP, Mustacchi Z, Monteiro CBDM. Can individuals with down syndrome improve their performance after practicing a game on a mobile phone?—A new insight study. Learning and Motivation 2020. [DOI: 10.1016/j.lmot.2020.101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Massetti T, Herrero D, Alencar J, Silva T, Moriyama C, Gehrke F, Tonks J, Fonseca F, Watson S, Monteiro C, Voos M. Clinical characteristics of children with congenital Zika syndrome: a case series. Arq Neuropsiquiatr 2020; 78:403-411. [PMID: 32627805 DOI: 10.1590/0004-282x20200020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/13/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The congenital Zika syndrome involves structural brain changes, including ventriculomegaly, thin cerebral cortices, abnormal gyral pattern, cortical malformations, hypoplasia of the corpus callosum, myelination delay, subcortical diffuse calcifications, brainstem hypoplasia, and microcephaly in newborns. OBJECTIVE This study aimed to describe the clinical characteristics of children with congenital Zika syndrome; to compare the outcomes of infants infected in the first (1T, n=20) and second trimesters of pregnancy (2T, n=11); to investigate correlations between birth weight, birth and follow-up head circumference, birth gestational age, and gross motor scores. METHODS Participants were evaluated with Alberta Infant Motor Scale (AIMS) and part A of the Gross Motor Function Measure (GMFM-A). ANOVA compared head circumference, birth gestational age, birth weight, and gross motor performance of 1T and 2T. RESULTS The correlations were investigated by Pearson correlation coefficients. ANOVA showed differences in birth and follow-up head circumferences. Head circumference was smaller in 1T, compared to 2T. Motor performance was classified as below the fifth percentile in AIMS in all children and 1T showed lower scores in prone, sitting, and total AIMS score, compared to 2T. Children ranged from 8 to 78% on GMFM-A and there was a poorer motor performance of 1T. Nineteen children showed hypertonia, six showed normal tone and six showed hypotonia. Birth head circumference was correlated with AIMS prone postural control. Follow-up head circumference was correlated to prone, supine and total AIMS scores. Smaller head circumference at birth and follow-up denoted poorer postural control. DISCUSSION Children with congenital Zika syndrome showed microcephaly at birth and follow-up. Smaller head circumferences and poorer motor outcomes were observed in 1T. Infants showed poor visual and motor outcomes. Moderate positive correlations between birth and follow-up head circumference and gross motor function were found.
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Affiliation(s)
- Thais Massetti
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Dafne Herrero
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Talita Silva
- Programa de Pós-Graduação em Cardiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Cristina Moriyama
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Flavia Gehrke
- Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
| | - James Tonks
- Paediatric Neuropsychology, University of Exeter, United Kingdom
| | | | - Suzanna Watson
- The Cambridge Centre for Paediatric Neurorehabilitation, Cambridge, United Kingdom
| | - Carlos Monteiro
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Mariana Voos
- Departamento Teorias e Métodos em Fisioterapia e Fonoaudiologia, Curso de Fisioterapia, Pontifícia Universidade Católica de São Paulo, São Paulo, SP, Brazil
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Antão JYFDL, Abreu LCD, Barbosa RTDA, Crocetta TB, Guarnieri R, Massetti T, Antunes TPC, Tonks J, Monteiro CBDM. Use of Augmented Reality with a Motion-Controlled Game Utilizing Alphabet Letters and Numbers to Improve Performance and Reaction Time Skills for People with Autism Spectrum Disorder. Cyberpsychol Behav Soc Netw 2020; 23:16-22. [PMID: 31976770 DOI: 10.1089/cyber.2019.0103] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Augmented reality (AR) uses the real-world setting but enables a person to interact with virtual objects. In this study, we aimed to explore the use of alphabet letter and number in an AR task and its influence in reaction time in a population with autism spectrum disorders (ASD) compared with the performance of typical developing (TD) controls. We evaluated reaction time before and after AR tasks that consisted of identifying correct numbers and alphabet letters in 48 people with ASD and 48 with TD controls. Results indicate that total points for TD group were higher (M = 86.4 and M = 79.0) when compared with the ASD group (M = 54.5 and M = 51.5) for alphabet letters and numbers, respectively. Moreover, in analysis of reaction time results, only the ASD group showed an improvement in performance after the practice of an AR task. The control group was faster before (M = 553.7) and after (M = 560.5) when compared with the ASD group (M = 2616.0 and M = 2374.6, respectively). Despite the need for further studies, our results support that there is potential for clinical use of an AR task-based intervention for people with ASD.
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Affiliation(s)
| | - Luiz Carlos de Abreu
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC (FMABC), Santo André, Brazil
| | | | - Tânia Brusque Crocetta
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC (FMABC), Santo André, Brazil
| | - Regiani Guarnieri
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC (FMABC), Santo André, Brazil
| | - Thaís Massetti
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade de São Paulo (USP), São Paulo, Brazil
| | | | - James Tonks
- University of Exeter Medical School, Exeter, United Kingdom.,Haven Clinical Psychology Practice, Cornwall, United Kingdom
| | - Carlos Bandeira de Mello Monteiro
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC (FMABC), Santo André, Brazil.,Programa de Pós-Graduação em Ciências da Reabilitação, Universidade de São Paulo (USP), São Paulo, Brazil.,Escola de Artes, Ciências e Humanidades (EACH), Universidade de São Paulo (USP), São Paulo, Brazil
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9
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Lee-Kelland R, Jary S, Tonks J, Cowan FM, Thoresen M, Chakkarapani E. School-age outcomes of children without cerebral palsy cooled for neonatal hypoxic-ischaemic encephalopathy in 2008-2010. Arch Dis Child Fetal Neonatal Ed 2020; 105:8-13. [PMID: 31036702 DOI: 10.1136/archdischild-2018-316509] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/26/2019] [Accepted: 03/08/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Since therapeutic hypothermia became standard care for neonatal hypoxic-ischaemic encephalopathy (HIE), even fewer infants die or have disability at 18-month assessment than in the clinical trials. However, longer term follow-up of apparently unimpaired children is lacking. We investigated the cognitive, motor and behavioural performances of survivors without cerebral palsy (CP) cooled for HIE, in comparison with matched non-HIE control children at 6-8 years. DESIGN Case-control study. PARTICIPANTS 29 case children without CP, cooled in 2008-2010 and 20 age-matched, sex-matched and social class-matched term-born controls. MEASURES Wechsler Intelligence Scales for Children, Fourth UK Edition, Movement Assessment Battery for Children, Second Edition (MABC-2) and Strengths and Difficulties Questionnaire. RESULTS Cases compared with controls had significantly lower mean (SD) full-scale IQ (91 [10.37]vs105[13.41]; mean difference (MD): -13.62, 95% CI -20.53 to -6.71) and total MABC-2 scores (7.9 [3.26]vs10.2[2.86]; MD: -2.12, 95% CI -3.93 to -0.3). Mean differences were significant between cases and controls for verbal comprehension (-8.8, 95% CI -14.25 to -3.34), perceptual reasoning (-13.9, 95% CI-20.78 to -7.09), working memory (-8.2, 95% CI-16.29 to -0.17), processing speed (-11.6, 95% CI-20.69 to -2.47), aiming and catching (-1.6, 95% CI-3.26 to -0.10) and manual dexterity (-2.8, 95% CI-4.64 to -0.85). The case group reported significantly higher median (IQR) total (12 [6.5-13.5] vs 6 [2.25-10], p=0.005) and emotional behavioural difficulties (2 [1-4.5] vs 0.5 [0-2.75], p=0.03) and more case children needed extra support in school (34%vs5%, p=0.02) than the control group. CONCLUSIONS School-age children without CP cooled for HIE still have reduced cognitive and motor performance and more emotional difficulties than their peers, strongly supporting the need for school-age assessments.
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Affiliation(s)
- Richard Lee-Kelland
- Faculty of Health Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sally Jary
- Faculty of Health Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - James Tonks
- Faculty of Health Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Psychology, University of Exeter, Exeter, UK
| | - Frances M Cowan
- Faculty of Health Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Paediatrics, Imperial College London, London, UK
| | - Marianne Thoresen
- Faculty of Health Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ela Chakkarapani
- Faculty of Health Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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10
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Law C, Amore TL, Williams WH, Tonks J. Training emotional recognition in a child with acquired brain injury: A single case study. Appl Neuropsychol Child 2019; 10:384-392. [PMID: 31835913 DOI: 10.1080/21622965.2019.1699094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emotional processing is affected by childhood brain injury. Ineffective emotional processing and poor understanding of social cues affect the development of social relationships leading to social isolation and a poorer quality of life in the long-term. Facial expression recognition is a non-verbal social cue that is used to interpret the thoughts and feelings of others. Children with brain injury have shown deficits identifying even basic emotions from facial expression, yet few intervention studies have explored how to develop facial expression recognition in children with brain injury. Enhancing the ability to recognize and interpret facial expressions for these children would have implications for their emotional processing and social-emotional behavior. In this paper we report on a short single case study intervention to increase facial expression recognition using the Facial Affect Recognition training (FAR) for a 10-year-old-child with brain injury. Following intervention, there was not only an increase in facial expression recognition but also changes in social-emotional behavior indicating some generalization to other contexts. The results suggest that rehabilitation of emotional processing difficulties may indeed be possible, and further intervention studies aimed at developing these skills in children with brain injury are warranted.
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Affiliation(s)
- Caroline Law
- Department of Linguistics, Macquarie University, Sydney, Australia.,Simply Speech Ltd., Glastonbury, UK
| | | | | | - James Tonks
- University of Exeter Medical School, Exeter University, Exeter, UK.,Haven Clinical Psychology Ltd., Bude, UK
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11
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Jary S, Lee‐Kelland R, Tonks J, Cowan FM, Thoresen M, Chakkarapani E. Motor performance and cognitive correlates in children cooled for neonatal encephalopathy without cerebral palsy at school age. Acta Paediatr 2019; 108:1773-1780. [PMID: 30883895 DOI: 10.1111/apa.14780] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/06/2019] [Accepted: 03/12/2019] [Indexed: 12/29/2022]
Abstract
AIM To investigate whether motor performance in school-age children without cerebral palsy (CP), cooled for neonatal encephalopathy, is associated with perinatal factors and 18-month developmental scores and to explore relationships between school-age motor and cognitive performance. METHODS Motor and cognitive performance was assessed in 29 previously cooled children at six to eight years using the Movement Assessment Battery for Children-2 (MABC-2) and the Wechsler Intelligence Scale for Children (WISC-IV). Associations between MABC-2 scores less than/equal (≤) 15th centile and perinatal factors, social/family background, 18-month Bayley-III scores and WISC-IV scores were explored. RESULTS Eleven of the 29 (38%) children had MABC-2 scores ≤15th centile including 7 (24%) ≤5th centile. No significant perinatal or socio-economic risk factors were identified. Motor scores <85 at 18 months failed to identify children with MABC-2 scores ≤15th centile. MABC-2 scores ≤15th centile were associated with lower Full Scale IQ (p = 0.045), Working Memory (p = 0.03) and Perceptual Reasoning (p = 0.005) scores at six to eight years and receiving greater support in school (p = 0.01). CONCLUSION A third of cooled children without CP had MABC-2 scores indicating motor impairment at school age that was not identified at 18 months by Bayley-III. Most children with low MABC scores needed support at school. Sub-optimal MABC-2 scores indicate need for detailed school-age cognitive evaluation.
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Affiliation(s)
- S Jary
- Translational Health Sciences Bristol Medical School University of Bristol Bristol UK
| | - R Lee‐Kelland
- Translational Health Sciences Bristol Medical School University of Bristol Bristol UK
| | - J Tonks
- University of Exeter Medical School Exeter UK
| | - F M Cowan
- Translational Health Sciences Bristol Medical School University of Bristol Bristol UK
| | - M Thoresen
- Translational Health Sciences Bristol Medical School University of Bristol Bristol UK
- University of Oslo Oslo Norway
| | - E Chakkarapani
- Translational Health Sciences Bristol Medical School University of Bristol Bristol UK
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12
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Tonks J, Cloke G, Lee-Kelland R, Jary S, Thoresen M, Cowan FM, Chakkarapani E. Attention and visuo-spatial function in children without cerebral palsy who were cooled for neonatal encephalopathy: a case-control study. Brain Inj 2019; 33:894-898. [DOI: 10.1080/02699052.2019.1597163] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- James Tonks
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University of Exeter Medical School, Exeter, UK
| | - Grace Cloke
- School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Richard Lee-Kelland
- Translational Health Sciences, Bristol Medical School, St Michael’s Hospital, University of Bristol, UK
| | - Sally Jary
- Translational Health Sciences, Bristol Medical School, St Michael’s Hospital, University of Bristol, UK
| | - Marianne Thoresen
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University of Oslo, Oslo, Norway
| | - Frances M Cowan
- Translational Health Sciences, Bristol Medical School, St Michael’s Hospital, University of Bristol, UK
| | - Ela Chakkarapani
- Translational Health Sciences, Bristol Medical School, St Michael’s Hospital, University of Bristol, UK
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13
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Tonks J, Whitfield CK, Williams WH, Slater AM, Frampton IJ. "Must try harder." Is effort and performance validity testing a necessary part of pediatric neuropsychological assessment? Appl Neuropsychol Child 2018; 9:97-105. [PMID: 30583707 DOI: 10.1080/21622965.2018.1524766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Neuropsychological assessments results have significant implications for pediatric populations, based upon the assumption that the young person has adopted an effortful approach and has engaged in assessment. There is a commonly-accepted risk to assuming the validity of neuropsychological assessment results with adults, and, therefore, performance validity testing (PVT) has become a major topic of research and investigation and has become an accepted part of routine assessment. The same approach has not been adopted in assessment with children and a paucity of studies has focused on PVT in children. We review studies that demonstrate that children are equal to adults in their ability to use deception and that clinicians cannot detect false-effort without use of validity tests. We explore how frequently such tests are used and how well they work in assessment with children, and the limits, complexities, and constraints of adapting adult tests. We advocate that adequate performance validity testing is essential in order to maximize confidence in the results and we hypothesize that assessment with pediatric populations should take into account a range of influences, such as neuro-developmental factors associated with age of the child and suitability of proposed measures according to the evidence-base.
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Affiliation(s)
- James Tonks
- 1University of Exeter Medical School, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Charlotte Katie Whitfield
- 2School of Psychology, Cardiff University, Cardiff, United Kingdom of Great Britain and Northern Ireland
| | - W Huw Williams
- 3School of Psychology, Washington Singer Laboratories, University of Exeter College of Life and Environmental Sciences, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Alan M Slater
- School of Psychology, Washington Singer Laboratories, University of Exeter College of Life and Environmental Sciences, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Ian J Frampton
- School of Psychology, Washington Singer Laboratories, University of Exeter College of Life and Environmental Sciences, Exeter, United Kingdom of Great Britain and Northern Ireland
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14
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Massetti T, da Silva TD, Crocetta TB, Guarnieri R, de Freitas BL, Bianchi Lopes P, Watson S, Tonks J, de Mello Monteiro CB. The Clinical Utility of Virtual Reality in Neurorehabilitation: A Systematic Review. J Cent Nerv Syst Dis 2018; 10:1179573518813541. [PMID: 30515028 PMCID: PMC6262495 DOI: 10.1177/1179573518813541] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/19/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Virtual reality (VR) experiences (through games and virtual environments) are increasingly being used in physical, cognitive, and psychological interventions. However, the impact of VR as an approach to rehabilitation is not fully understood, and its advantages over traditional rehabilitation techniques are yet to be established. Method: We present a systematic review which was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). During February and March of 2018, we conducted searches on PubMed (Medline), Virtual Health Library Search Portal databases (BVS), Web of Science (WOS), and Embase for all VR-related publications in the past 4 years (2015, 2016, 2017, and 2018). The keywords used in the search were “neurorehabilitation” AND “Virtual Reality” AND “devices.” Results: We summarize the literature which highlights that a range of effective VR approaches are available. Studies identified were conducted with poststroke patients, patients with cerebral palsy, spinal cord injuries, and other pathologies. Healthy populations have been used in the development and testing of VR approaches meant to be used in the future by people with neurological disorders. A range of benefits were associated with VR interventions, including improvement in motor functions, greater community participation, and improved psychological and cognitive function. Conclusions: The results from this review provide support for the use of VR as part of a neurorehabilitation program in maximizing recovery.
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Affiliation(s)
- Thais Massetti
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Talita Dias da Silva
- School of Arts, Sciences and Humanities (EACH), University of São Paulo (USP), São Paulo, Brazil
| | | | | | - Bruna Leal de Freitas
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Israelite Hospital Albert Einstein, São Paulo, Brazil
| | | | - Suzanna Watson
- The Cambridge Centre for Paediatric Neurorehabilitation, Cambridge, UK
| | - James Tonks
- Medical School, University of Exeter, Exeter, UK.,Haven Clinical Psychology Practice, Cornwall, UK
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15
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Williams WH, Chitsabesan P, Fazel S, McMillan T, Hughes N, Parsonage M, Tonks J. Traumatic brain injury: a potential cause of violent crime? Lancet Psychiatry 2018; 5:836-844. [PMID: 29496587 PMCID: PMC6171742 DOI: 10.1016/s2215-0366(18)30062-2] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 12/07/2017] [Accepted: 01/08/2018] [Indexed: 12/28/2022]
Abstract
Traumatic brain injury (TBI) is the biggest cause of death and disability in children and young people. TBI compromises important neurological functions for self-regulation and social behaviour and increases risk of behavioural disorder and psychiatric morbidity. Crime in young people is a major social issue. So-called early starters often continue for a lifetime. A substantial majority of young offenders are reconvicted soon after release. Multiple factors play a role in crime. We show how TBI is a risk factor for earlier, more violent, offending. TBI is linked to poor engagement in treatment, in-custody infractions, and reconviction. Schemes to assess and manage TBI are under development. These might improve engagement of offenders in forensic psychotherapeutic rehabilitation and reduce crime.
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Affiliation(s)
- W Huw Williams
- Department of Psychology, University of Exeter, Exeter, UK.
| | | | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Tom McMillan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nathan Hughes
- Sociological Studies, University of Sheffield, Sheffield, UK
| | | | - James Tonks
- Medical School, University of Exeter, Exeter, UK
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16
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Quadrado VH, Silva TDD, Favero FM, Tonks J, Massetti T, Monteiro CBDM. Motor learning from virtual reality to natural environments in individuals with Duchenne muscular dystrophy. Disabil Rehabil Assist Technol 2017; 14:12-20. [DOI: 10.1080/17483107.2017.1389998] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Virgínia Helena Quadrado
- Department of Physical Therapy, Speech and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Talita Dias da Silva
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Francis Meire Favero
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - James Tonks
- University of Exeter Medical School, Exeter, UK
- Haven Clinical Psychology Practice, Cornwall, UK
| | - Thais Massetti
- Department of Physical Therapy, Speech and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Carlos Bandeira de Mello Monteiro
- Department of Physical Therapy, Speech and Occupational Therapy, University of São Paulo, São Paulo, Brazil
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
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17
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de Araújo AVL, Barbosa VRN, Galdino GS, Fregni F, Massetti T, Fontes SL, de Oliveira Silva D, da Silva TD, Monteiro CBDM, Tonks J, Magalhães FH. Effects of high-frequency transcranial magnetic stimulation on functional performance in individuals with incomplete spinal cord injury: study protocol for a randomized controlled trial. Trials 2017; 18:522. [PMID: 29110687 PMCID: PMC5674824 DOI: 10.1186/s13063-017-2280-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/25/2017] [Indexed: 01/29/2023] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) has been investigated as a new tool in neurological rehabilitation of individuals with spinal cord injury (SCI). However, due to the inconsistent results regarding the effects of rTMS in people with SCI, a randomized controlled double-blind crossover trial is needed to clarify the clinical utility and to assess the effect size of rTMS intervention in this population. Therefore, this paper describes a study protocol designed to investigate whether the use of rTMS can improve the motor and sensory function, as well as reduce spasticity in patients with incomplete SCI. Methods A double-blind randomized sham-controlled crossover trial will be performed by enrolling 20 individuals with incomplete SCI. Patients who are at least six months post incomplete SCI (aged 18–60 years) will be recruited through referral by medical practitioners or therapists. Individuals will be randomly assigned to either group 1 or group 2 in a 1:1 ratio, with ten individuals in each group. The rTMS protocol will include ten sessions of high-frequency rTMS (5 Hz) over the bilateral lower-limb motor area positioned at the vertex (Cz). Clinical evaluations will be performed at baseline and after rTMS active and sham. Discussion rTMS has produced positive results in treating individuals with physical impairments; thus, it might be promising in the SCI population. The results of this study may provide new insights to motor rehabilitation thereby contributing towards the better usage of rTMS in the SCI population. Trial registration ClinicalTrials.gov, NCT02899637. Registered on 25 August 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2280-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Gilma Serra Galdino
- Department of Physiotherapy - UEPB, Paraíba State University, Campina Grande, Brazil
| | - Felipe Fregni
- Harvard Center for Noninvasive Brain Stimulation, Harvard Medical School, Boston, MA, USA
| | - Thais Massetti
- School of Arts, Sciences and Humanities, EACH - USP, University of São Paulo, São Paulo, Brazil
| | - Sara Lynn Fontes
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Talita Dias da Silva
- School of Arts, Sciences and Humanities, EACH - USP, University of São Paulo, São Paulo, Brazil
| | | | - James Tonks
- University of Exeter Medical School, Exeter, UK.,University of Lincoln, Lincoln, UK.,Haven Clinical Psychology Practice, Cornwall, UK
| | - Fernando Henrique Magalhães
- School of Arts, Sciences and Humanities, EACH - USP, University of São Paulo, São Paulo, Brazil. .,Biomedical Engineering Laboratory, Department of Telecommunication and Control, Avenida Professor Luciano Gualberto, Travessa 3, n. 158. Cidade Universitária, São Paulo, SP, 05508-010, Brazil.
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18
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de Paula JN, de Mello Monteiro CB, da Silva TD, Capelini CM, de Menezes LDC, Massetti T, Tonks J, Watson S, Nicolai Ré AH. Motor performance of individuals with cerebral palsy in a virtual game using a mobile phone. Disabil Rehabil Assist Technol 2017; 13:609-613. [DOI: 10.1080/17483107.2017.1392620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Talita Dias da Silva
- Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Thais Massetti
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - James Tonks
- University of Exeter Medical School, Exeter, UK
- Haven Clinical Psychology Practice, Cornwall, UK
| | - Suzanna Watson
- The Cambridge Centre for Pediatric Neurorehabilitation, Cambridge, UK
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19
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Tonks J, Williams WH, Slater A, Frampton I. Is damage to the pre-frontal cortex dormant until adolescence, or difficult to detect? Looking for keys that unlock executive functions in children in the wrong place. Med Hypotheses 2017; 108:24-30. [PMID: 29055394 DOI: 10.1016/j.mehy.2017.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 01/09/2023]
Abstract
A range of functions can be negatively affected by pre-frontal cortex (PFC) injury, but observed behavioural and social changes are commonly linked to post-injury changes in executive function. Executive functioning is a complex neuropsychological construct which is further complicated by neuro-developmental processes when applied to children. There is a substantial and continuing evidence base that supports the view that early childhood pre-frontal cortex (PFC) injury results in hidden, dormant, or sleeping effects. In contrast, recent and rapidly accruing contemporary studies provide preliminary evidence that challenge the view that PFC associated impairments are completely 'hidden'. Studies that examine the various functions of the PFC and differentiate these to provide preliminary evidence to indicate earlier EF development than that which develops upon reaching adolescence, are reviewed here, together with research that identifies early predictors of later EF impairments. It remains that studies of PFC function and/or structural brain-changes are substantially complicated by issues related to definition regarding functions of the PFC, measurement of EF and other PFC-related functions that may be better understood as meta-processes. These issues are discussed in the concluding sections of this paper.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Lincoln, Lincoln, UK; University of Exeter Medical School, Exeter, UK.
| | | | - Alan Slater
- School of Psychology, University of Exeter, Exeter, UK
| | - Ian Frampton
- School of Psychology, University of Lincoln, Lincoln, UK; School of Psychology, University of Exeter, Exeter, UK
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20
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Bowman P, Hattersley AT, Knight BA, Broadbridge E, Pettit L, Reville M, Flanagan SE, Shepherd MH, Ford TJ, Tonks J. Neuropsychological impairments in children with KCNJ11 neonatal diabetes. Diabet Med 2017; 34:1171-1173. [PMID: 28477417 DOI: 10.1111/dme.13375] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- P Bowman
- University of Exeter Medical School, NIHR Clinical Research Facility, Exeter, UK
- Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - A T Hattersley
- University of Exeter Medical School, NIHR Clinical Research Facility, Exeter, UK
- Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - B A Knight
- University of Exeter Medical School, NIHR Clinical Research Facility, Exeter, UK
- Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - E Broadbridge
- Department of Clinical Psychology, Dame Hannah Rogers Trust, Newton Abbot, UK
| | - L Pettit
- Department of Clinical Psychology, Dame Hannah Rogers Trust, Newton Abbot, UK
| | - M Reville
- Department of Clinical Psychology, Dame Hannah Rogers Trust, Newton Abbot, UK
| | - S E Flanagan
- University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, UK
| | - M H Shepherd
- University of Exeter Medical School, NIHR Clinical Research Facility, Exeter, UK
- Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - T J Ford
- University of Exeter Medical School, Institute of Health Research, Exeter, UK
| | - J Tonks
- Department of Clinical Psychology, Dame Hannah Rogers Trust, Newton Abbot, UK
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Capelini CM, da Silva TD, Tonks J, Watson S, Alvarez MPB, de Menezes LDC, Favero FM, Caromano FA, Massetti T, de Mello Monteiro CB. Improvements in motor tasks through the use of smartphone technology for individuals with Duchenne muscular dystrophy. Neuropsychiatr Dis Treat 2017; 13:2209-2217. [PMID: 28860778 PMCID: PMC5571857 DOI: 10.2147/ndt.s125466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In individuals severely affected with Duchenne muscular dystrophy (DMD), virtual reality has recently been used as a tool to enhance community interaction. Smartphones offer the exciting potential to improve communication, access, and participation, and present the unique opportunity to directly deliver functionality to people with disabilities. OBJECTIVE To verify whether individuals with DMD improve their motor performance when undertaking a visual motor task using a smartphone game. PATIENTS AND METHODS Fifty individuals with DMD and 50 healthy, typically developing (TD) controls, aged 10-34 years participated in the study. The functional characterization of the sample was determined through Vignos, Egen Klassifikation, and the Motor Function Measure scales. To complete the task, individuals moved a virtual ball around a virtual maze and the time in seconds was measured after every attempt in order to analyze improvement of performance after the practice trials. Motor performance (time to finish each maze) was measured in phases of acquisition, short-term retention, and transfer. RESULTS Use of the smartphone maze game promoted improvement in performance during acquisition in both groups, which remained in the retention phase. At the transfer phases, with alternative maze tasks, the performance in DMD group was similar to the performance of TD group, with the exception of the transfer to the contralateral hand (nondominant). However, the group with DMD demonstrated longer movement time at all stages of learning, compared with the TD group. CONCLUSION The practice of a visual motor task delivered via smartphone game promoted an improvement in performance with similar patterns of learning in both groups. Performance can be influenced by task difficulty, and for people with DMD, motor deficits are responsible for the lower speed of execution. This study indicates that individuals with DMD showed improved performance in a short-term motor learning protocol using a smartphone. We advocate that this technology could be used to promote function in this population.
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Affiliation(s)
| | - Talita Dias da Silva
- Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - James Tonks
- University of Exeter Medical School, Exeter.,University of Lincoln, Lincoln.,Haven Clinical Psychology Practice, Cornwall
| | - Suzanna Watson
- The Cambridge Centre for Paediatric Neuropsychologicial Rehabilitation, Cambridge, UK
| | | | | | - Francis Meire Favero
- Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Thais Massetti
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of São Paulo
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Bowman P, Broadbridge E, Knight BA, Pettit L, Flanagan SE, Reville M, Tonks J, Shepherd MH, Ford TJ, Hattersley AT. Psychiatric morbidity in children with KCNJ11 neonatal diabetes. Diabet Med 2016; 33:1387-91. [PMID: 27086753 PMCID: PMC5031218 DOI: 10.1111/dme.13135] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 11/29/2022]
Abstract
AIMS Mutations in the KCNJ11 gene, which encodes the Kir6.2 subunit of the pancreatic KATP channel, cause neonatal diabetes. KCNJ11 is also expressed in the brain, and ~ 20% of those affected have neurological features, which may include features suggestive of psychiatric disorder. No previous studies have systematically characterized the psychiatric morbidity in people with KCNJ11 neonatal diabetes. We aimed to characterize the types of psychiatric disorders present in children with KCNJ11 mutations, and explore their impact on families. METHODS The parents and teachers of 10 children with neonatal diabetes due to KCNJ11 mutations completed the Strengths and Difficulties Questionnaire and the Development and Wellbeing Assessment. Strengths and Difficulties Questionnaire scores were compared with normative data. Diagnoses from the Development and Wellbeing Assessment were compared with known clinical diagnoses. RESULTS Strengths and Difficulties Questionnaire scores indicated high levels of psychopathology and impact. Psychiatric disorder(s) were present in all six children with the V59M or R201C mutation, and the presence of more than one psychiatric disorder was common. Only two children had received a formal clinical diagnosis, with a further one awaiting assessment, and the coexistence of more than one psychiatric disorder had been missed. Neurodevelopmental (attention deficit hyperactivity disorder and autism) and anxiety disorders predominated. CONCLUSIONS Systematic assessment using standardized validated questionnaires reveals a range of psychiatric morbidity in children with KCNJ11 neonatal diabetes. This is under-recognized clinically and has a significant impact on affected children and their families. An integrated collaborative approach to clinical care is needed to manage the complex needs of people with KCNJ11 neonatal diabetes.
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Affiliation(s)
- P Bowman
- NIHR Exeter Clinical Research Facility, University of Exeter, Exeter, UK.
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
| | | | - B A Knight
- NIHR Exeter Clinical Research Facility, University of Exeter, Exeter, UK
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - L Pettit
- Dame Hannah Rogers Trust, Newton Abbot, UK
- Department of Psychology, University of Exeter, Exeter, UK
| | - S E Flanagan
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - M Reville
- Dame Hannah Rogers Trust, Newton Abbot, UK
- Department of Psychology, University of Exeter, Exeter, UK
| | - J Tonks
- Dame Hannah Rogers Trust, Newton Abbot, UK
| | - M H Shepherd
- NIHR Exeter Clinical Research Facility, University of Exeter, Exeter, UK
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - T J Ford
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - A T Hattersley
- NIHR Exeter Clinical Research Facility, University of Exeter, Exeter, UK
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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Littlefield MM, Dietz MJ, Fitzgerald D, Knudsen KJ, Tonks J. Being asked to tell an unpleasant truth about another person activates anterior insula and medial prefrontal cortex. Front Hum Neurosci 2015; 9:553. [PMID: 26539094 PMCID: PMC4611149 DOI: 10.3389/fnhum.2015.00553] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 09/21/2015] [Indexed: 12/02/2022] Open
Abstract
“Truth” has been used as a baseline condition in several functional magnetic resonance imaging (fMRI) studies of deception. However, like deception, telling the truth is an inherently social construct, which requires consideration of another person's mental state, a phenomenon known as Theory of Mind. Using a novel ecological paradigm, we examined blood oxygenation level dependent (BOLD) responses during social and simple truth telling. Participants (n = 27) were randomly divided into two competing teams. Post-competition, each participant was scanned while evaluating performances from in-group and out-group members. Participants were asked to be honest and were told that their evaluations would be made public. We found increased BOLD responses in the medial prefrontal cortex, bilateral anterior insula and precuneus when participants were asked to tell social truths compared to simple truths about another person. At the behavioral level, participants were slower at responding to social compared to simple questions about another person. These findings suggest that telling the truth is a nuanced cognitive operation that is dependent on the degree of mentalizing. Importantly, we show that the cortical regions engaged by truth telling show a distinct pattern when the task requires social reasoning.
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Affiliation(s)
- Melissa M Littlefield
- Department of Kinesiology and Community Health, Department of English, and The Beckman Institute, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Martin J Dietz
- Center for Functionally Integrative Neuroscience, Institute of Clinical Medicine, Aarhus University Aarhus, Denmark
| | - Des Fitzgerald
- School of Social Sciences, Cardiff University Cardiff, UK ; Hubbub-The Hub at Wellcome Collection London, UK
| | - Kasper J Knudsen
- Section for Anthropology and Ethnography, Department of Culture and Society, Aarhus University Aarhus, Denmark
| | - James Tonks
- Department of Psychology, University of Lincoln Lincoln, UK ; Dame Hannah Rogers Trust Exeter, UK
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Fitzgerald D, Littlefield MM, Knudsen KJ, Tonks J, Dietz MJ. Ambivalence, equivocation and the politics of experimental knowledge: a transdisciplinary neuroscience encounter. Soc Stud Sci 2014; 44:701-721. [PMID: 25362830 DOI: 10.1177/0306312714531473] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article is about a transdisciplinary project between the social, human and life sciences, and the felt experiences of the researchers involved. 'Transdisciplinary' and 'interdisciplinary' research-modes have been the subject of much attention lately--especially as they cross boundaries between the social/humanistic and natural sciences. However, there has been less attention, from within science and technology studies, to what it is actually like to participate in such a research-space. This article contributes to that literature through an empirical reflection on the progress of one collaborative and transdisciplinary project: a novel experiment in neuroscientific lie detection, entangling science and technology studies, literary studies, sociology, anthropology, clinical psychology and cognitive neuroscience. Its central argument is twofold: (1) that, in addition to ideal-type tropes of transdisciplinary conciliation or integration, such projects may also be organized around some more subterranean logics of ambivalence, reserve and critique; (2) that an account of the mundane ressentiment of collaboration allows for a more careful attention to the awkward forms of 'experimental politics' that may flow through, and indeed propel, collaborative work more broadly. Building on these claims, the article concludes with a suggestion that such subterranean logics may be indissociable from some forms of collaboration, and it proposes an ethic of 'equivocal speech' as a way to live with and through these kinds of transdisciplinary experiences.
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Tonks J, Yates PJ, Williams HW, Frampton I, Slater A. Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift. Child Adolesc Ment Health 2014; 19:151-158. [PMID: 32878380 DOI: 10.1111/camh.12043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND SCOPE In this article, we provide a brief overview of the principles that guide paediatric neuropsychological assessment, the methods used and some examples of the measures available. FINDINGS We explore intellectual, adaptive and social functioning from a neuropsychological perspective and describe suitable measures for use in paediatric neuropsychological assessment in each domain. CONCLUSIONS We provide an example of assessment and interpretation using a fictional character (Tom Swift) to demonstrate that neuropsychological assessment is important in understanding the everyday questions that arise in children's services around risk, needs, level of understanding and capacity to engage with services.
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Affiliation(s)
- James Tonks
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Phil J Yates
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Huw W Williams
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Ian Frampton
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Alan Slater
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
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Littlefield MM, Fitzgerald D, Knudsen K, Tonks J, Dietz MJ. Contextualizing neuro-collaborations: reflections on a transdisciplinary fMRI lie detection experiment. Front Hum Neurosci 2014; 8:149. [PMID: 24744713 PMCID: PMC3978358 DOI: 10.3389/fnhum.2014.00149] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/27/2014] [Indexed: 11/13/2022] Open
Abstract
Recent neuroscience initiatives (including the E.U.'s Human Brain Project and the U.S.'s BRAIN Initiative) have reinvigorated discussions about the possibilities for transdisciplinary collaboration between the neurosciences, the social sciences, and the humanities. As STS scholars have argued for decades, however, such inter- and transdisciplinary collaborations are potentially fraught with tensions between researchers. This essay build on such claims by arguing that the tensions of transdisciplinary research also exist within researchers' own experiences of working between disciplines - a phenomenon that we call "disciplinary double consciousness" (DDC). Building on previous work that has characterized similar spaces (and especially on the Critical Neuroscience literature), we argue that "neuro-collaborations" inevitably engage researchers in DDC - a phenomenon that allows us to explore the useful dissonance that researchers can experience when working between a "home" discipline and a secondary discipline. Our case study is a five-year research project in functional magnetic resonance imaging (fMRI) lie detection involving a transdisciplinary research team made up of social scientists, a neuroscientist, and a humanist. In addition to theorizing neuro-collaborations from the inside-out, this essay presents practical suggestions for developing transdisciplinary infrastructures that could support future neuro-collaborations.
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Affiliation(s)
- Melissa M Littlefield
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign Urbana, IL, USA ; Department of English, University of Illinois at Urbana-Champaign Urbana, IL, USA
| | - Des Fitzgerald
- Department of Social Science, Health and Medicine, Kings College London London, UK ; Interacting Minds Center, Aarhus University Aarhus, Denmark
| | - Kasper Knudsen
- Department of Culture and Society, Section for Anthropology and Ethnography, Aarhus University Aarhus, Denmark
| | - James Tonks
- Dame Hannah Rogers Trust and Department of Psychology, University of Exeter Exeter, UK
| | - Martin J Dietz
- Center for Functionally Integrative Neuroscience, Institute of Clinical Medicine, Aarhus University Aarhus, Denmark
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Tonks J, Williams WH, Frampton I, Yates P, Slater A. The Neurological Bases of Emotional Dys-Regulation Arising From Brain Injury in Childhood: A ‘When and Where’ Heuristic. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.8.2.143] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractLasting emotional and social communication deficits are common among children who have suffered brain injury. Concerns have been raised that current assessment and treatment methods are inadequate in addressing the needs of such children in rehabilitation. We advocate that a proportion of reported deficits occur as a result of compromise to emotion processing systems in the brain. In this article we review adult brain injury research, which indicates that dissociable subsystems are involved in distinguishing the nuances of emotional expression. Findings previously reported in the literature have been integrated into a dissociable heuristic framework, which offers a novel representation of subcomponents of the emotion processing system. In considering the development of the subcomponents of emotion processing, evidence indicates that intrinsic arousal systems are operational from birth, systems associated with sensory/spatial skills that are essential in reading emotional expression develop rapidly from birth, and systems utilised in executive system synthesis become increasingly sophisticated with development, stemming across childhood and into adulthood. In conclusion, it is proposed that the heuristic is a useful tool on which assessment measures may be based when considering the primary effects of brain injury in children.
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Tonks J, Williams WH, Mounce L, Harris D, Frampton I, Yates P, Slater A. 'Trails B or not Trails B?' Is attention-switching a useful outcome measure? Brain Inj 2011; 25:958-64. [PMID: 21745176 DOI: 10.3109/02699052.2011.589792] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE Difficulties with attention contribute to behavioural and cognitive problems during childhood and may reflect subtle deficits in executive functioning (EF). Attention problems in early childhood have also been found to predict higher levels of anxiety and depression symptoms at 10 years old. It has also been reported that attention problems during childhood may be differentially related to later-emerging distinct EF difficulties. Many of these findings, however, rely on teacher-ratings of attention difficulties. METHODS AND PROCEDURES This study administered neuropsychological tests of attention-switching and EF to 67 healthy children aged 9-15 years of age. It additionally measured socio-emotional behavioural functioning. MAIN OUTCOMES AND RESULTS A critical phase of improvement was found at 10 years of age. Correlations were found between attention-switching skills and EF. Attention-switching skills were also correlated with socio-emotional functioning. CONCLUSIONS Attention-switching skills have some interdependence with EF, but in paediatric assessment such skills are easier to routinely assess than many of the currently available tests of EF. It is suggested that attention-switching ability may prove to be a useful predictor of EF performance in understanding long-term outcome after a neurological event such as traumatic brain injury.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter , Exeter, Devon , UK.
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Tonks J, Yates P, Frampton I, Williams WH, Harris D, Slater A. Resilience and the mediating effects of executive dysfunction after childhood brain injury: A comparison between children aged 9–15 years with brain injury and non-injured controls. Brain Inj 2011; 25:870-81. [PMID: 21631188 DOI: 10.3109/02699052.2011.581641] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter, Exeter, Devon, UK.
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Tonks J, Williams WH, Yates P, Slater A. Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood: comparisons between groups of children aged under and over 10 years of age. Clin Child Psychol Psychiatry 2011; 16:185-94. [PMID: 21571762 DOI: 10.1177/1359104511403583] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children with traumatic brain injuries (TBI) commonly present with socioemotional difficulties, as well as accompanying multiple cognitive impairments. Often difficulties worsen at around 10 years old. This change is associated with frontal system changes, and tests of executive function (EF) predict outcome. However, children with TBI sometimes present with socioemotional difficulties despite apparent cognitive recovery. Our aims were to explore potential cognitive and socioemotional effects following childhood TBI, before and after the age of 10 years. We also wanted to identify cognitive correlates of psychosocial dysfunction. Measures of cognitive function and socioemotional disturbance administered to 14 children with TBI aged 8-10 years, and 14 children with TBI aged 10-16 years, were compared to control data from 22 non-injured 8- to 10 year-olds and 67 non-injured 10- to 16-year-olds. Results indicated that only the older group of children with TBI were impaired in tests of EF, but significant socioemotional difficulties were commonly evident in both groups. Processing speed (as well as EF) was found to correlate with socioemotional disturbance. We conclude that poor processing speed may also index the risk of socioemotional difficulties, but our general findings indicate that cognitive functions relevant to socioemotional functioning are not readily testable in younger children and are not strongly associated with such outcomes as they may be in adults.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter, UK.
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Haslam C, Jetten J, Haslam SA, Pugliese C, Tonks J. ‘I remember therefore I am, and I am therefore I remember’: Exploring the contributions of episodic and semantic self-knowledge to strength of identity. Br J Psychol 2011; 102:184-203. [DOI: 10.1348/000712610x508091] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Tonks J, Yates P, Williams WH, Frampton I, Slater A. Peer-relationship difficulties in children with brain injuries: Comparisons with children in mental health services and healthy controls. Neuropsychol Rehabil 2010; 20:922-35. [DOI: 10.1080/09602011.2010.519209] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Huw Williams W, Cordan G, Mewse AJ, Tonks J, Burgess CNW. Self-reported traumatic brain injury in male young offenders: A risk factor for re-offending, poor mental health and violence? Neuropsychol Rehabil 2010; 20:801-12. [DOI: 10.1080/09602011.2010.519613] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
PRIMARY OBJECTIVE As children with acquired brain injuries (ABI) mature to become adolescents they develop a range of previously undetected social and emotional difficulties, which are commonly associated with executive dysfunctions. The authors wanted to determine whether visual-spatial performance is subject to age-related improvement, whether such skills can differentiate between children with ABI and healthy children and whether visual-spatial performance is a correlate of socioemotional functioning. RESEARCH DESIGN The 'Cube analysis' and 'Dot discrimination' tests from the 'Visual Object Space Perception (VOSP)' battery and the Strengths and Difficulties Questionnaire (SDQ) were administered for 18 children, 9-15 years, with ABI and compared against 67 'healthy' children. RESULTS Cube analysis scores improved significantly at approximately 10 years old in the control group. The ABI group performed the task significantly poorer than controls. Analysis indicated that visual discrimination skill did not account for performance difficulties. Visual-spatial performance was correlated with greater impact of reported difficulties on the SDQ. CONCLUSIONS Visual-spatial tests are sensitive in differentiating between healthy children and children with ABI. Impairment of visuo-spatial skills may provide an index of psychosocial risk during later teenage years and adulthood.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter, Exeter, UK.
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Affiliation(s)
- W Huw Williams
- School of Psychology, Washington Singer Labs, University of Exeter, Exeter, UK.
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Haslam C, Haslam SA, Jetten J, Bevins A, Ravenscroft S, Tonks J. The social treatment: The benefits of group interventions in residential care settings. Psychol Aging 2010; 25:157-67. [DOI: 10.1037/a0018256] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jetten J, Haslam C, Pugliese C, Tonks J, Haslam SA. Declining autobiographical memory and the loss of identity: Effects on well-being. J Clin Exp Neuropsychol 2009; 32:408-16. [DOI: 10.1080/13803390903140603] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jolanda Jetten
- a University of Queensland , Brisbane, Australia
- b University of Exeter , Exeter, UK
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Tonks J, Williams WH, Frampton I, Yates P, Slater A. Assessing emotion recognition in 9–15-years olds: Preliminary analysis of abilities in reading emotion from faces, voices and eyes. Brain Inj 2009; 21:623-9. [PMID: 17577713 DOI: 10.1080/02699050701426865] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PRIMARY OBJECTIVE Little is known about how emotion recognition abilities develop during childhood and adolescence, although adolescence is a time marked by significant changes in socio-emotional behaviour. The first aim of this study was to explore the range of emotion recognition skills that 9-15-year olds would normally display and whether emotion-reading skills are reliably measurable. Secondly, one wanted to determine whether adolescence is a period during which skills in recognizing emotions improve. METHODS AND PROCEDURES Novel and adapted measures of emotion processing were used in tasks that required 67 9-15-year olds to read emotion from voices, eyes and faces. MAIN OUTCOMES AND RESULTS Findings indicate that emotion recognition abilities are reliably measurable skills. A stage of improvement in facial expression recognition and reading emotion from eyes was found to occur at approximately 11 years of age. CONCLUSIONS The findings show that these skills can be measured and that it is possible to devise assessment tests which are sensitive to developmental improvements in emotion recognition skills in early adolescence, when screening for the effects of child brain injury.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter, Exeter, UK.
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Abstract
Lasting socio-emotional behaviour difficulties are common among children who have suffered brain injuries. A proportion of difficulties may be attributed to impaired cognitive and/or executive skills after injury. A recent and rapidly accruing body of literature indicates that deficits in recognizing and responding to the emotions of others are also common. Little is known about the development of these skills after brain injury. In this paper we summarize emotion-processing systems, and review the development of these systems across the span of childhood and adolescence. We describe critical phases in the development of emotion recognition skills and the potential for delayed effects after brain injury in earlier childhood. We argue that it is important to identify the specific nature of deficits in reading and responding to emotions after brain injury, so that assessments and early intervention strategies can be devised.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter, Exeter, UK.
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Turkstra LS, Williams WH, Tonks J, Frampton I. Measuring social cognition in adolescents: Implications for students with TBI returning to school. NeuroRehabilitation 2008. [DOI: 10.3233/nre-2008-23606] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Tonks J, Williams WH, Frampton I, Yates P, Wall SE, Slater A. Reading emotions after childhood brain injury: case series evidence of dissociation between cognitive abilities and emotional expression processing skills. Brain Inj 2008; 22:325-32. [PMID: 18365846 DOI: 10.1080/02699050801968303] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PRIMARY OBJECTIVE A previous study has shown that children with brain injuries are worse than their same age peers at reading emotions. It has not clearly been established that cognitive impairments and emotion processing impairments are dissociable in children and the question of whether emotion-reading skills can be selectively impaired in children after brain injury is explored here. RESEARCH DESIGN This study addresses this issue by testing a case series of seven children with brain injuries, who were identified as experiencing emotional or behavioural difficulties, according to a social-behavioural measure. METHODS AND PROCEDURES A battery of tests of cognitive function and measures that assess ability in reading emotions from faces, voices and eyes was administered to each child. MAIN OUTCOMES AND RESULTS Some cases demonstrate broadly based deficits that affect both cognitive and emotion processing domains, whilst other cases demonstrate highly selective deficits in reading emotions. CONCLUSIONS Based on the profile of results across the cases, this study reports that modality-specific, selective impairments in reading emotional expression can be found in children after brain injury. In addition, the data provide evidence of dissociation between cognitive abilities and emotional expression processing.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter, Exeter, UK.
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Tonks J, Williams WH, Frampton I, Yates P, Slater A. Reading emotions after child brain injury: a comparison between children with brain injury and non-injured controls. Brain Inj 2008; 21:731-9. [PMID: 17653947 DOI: 10.1080/02699050701426899] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PRIMARY OBJECTIVE Child brain injury can have a lasting, detrimental effect upon socio-emotional behaviour, but little is known about underlying impairments that cause behavioural disturbance. This study explored the possibility that a proportion of difficulties result from compromise to systems in the brain which function in reading emotion in others from eyes, face expression or vocal tone. METHODS AND PROCEDURES Measures of ability in reading emotion from faces, voices and eyes were used in conjunction with a battery of tests of cognitive function, in gathering data from 18 children aged between 9-17 with acquired brain injuries (ABI). Performance levels were compared against the normative data from 67 matched 'healthy' children. Questionnaires were used as a measure of socio-emotional behaviour. MAIN OUTCOMES AND RESULTS The ABI children in the sample were worse than their same age peers at reading emotions. Regression analyses revealed that emotion recognition skills and cognitive abilities were generally unrelated. Some relationships between emotion reading difficulties and behaviour disturbance were found, however there were limitations associated with this particular finding. CONCLUSIONS Emotion-recognition skills, which are not routinely assessed following child brain injury, can be adversely affected as a consequence of brain injury in childhood.
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Affiliation(s)
- James Tonks
- School of Psychology, Washington Singer Laboratories, University of Exeter, Exeter, UK.
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Turkstra LS, Williams WH, Tonks J, Frampton I. Measuring social cognition in adolescents: implications for students with TBI returning to school. NeuroRehabilitation 2008; 23:501-509. [PMID: 19127003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In everyday adolescent communication, the ability to empathise with the mental state of others, recognise or infer intentions, or make judgements about emotional state, is a non-conscious but vital prerequisite of relating. Execution of these skills in social interactions supports both the exchange of social knowledge and also the development and maintenance of personal relationships. Thus, adolescents with impairments in these skills are at risk for a variety of negative outcomes. In this paper, we present data to illustrate that adolescents with traumatic brain injury (TBI) are likely to have impairments in processes such as emotion recognition and mental state attribution, and that these might not be identified on standardised tests. This is considered from the perspective of clinical assessment and intervention in school contexts.
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Affiliation(s)
- Lyn S Turkstra
- Department of Communicative Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI 53706, USA.
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Abstract
This paper outlines the programs that support country high school students with the potential to take tertiary health training, particularly in medicine and the details of mentor support and the transition into medical undergraduate training. Also, the establishment of rural clubs in Adelaide and Flinders Universities, together with their aims, objectives and activities are highlighted together with details of the evaluation process which has confirmed the success of rural clubs. The establishment of an effective database is described, with a summary of its objectives and scope.
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Affiliation(s)
- D Gill
- Rural Practice Training Unit, Modbury, South Australia, Australia
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Woodruff DR, Tonks J. Relationship between time of anthesis and grain yield of wheat genotypes with differing developmental pattern. ACTA ACUST UNITED AC 1983. [DOI: 10.1071/ar9830001] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This paper reports studies of the effects of time of planting and genotype on wheat grown with and without irrigation in Queensland. Under irrigation, and in the absence of frost damage, the grain yield of a number of semidwarf wheat genotypes was highest when anthesis occurred in midwinter. There was a linear decline in grain yield with departure from this anthesis period, associated with rising evaporative demand and daily mean temperature. Genotype variation in this yield pattern was due to different growth durations and in particular to the leaf areas developed by anthesis, which were often limiting yield especially in very early planting of quick genotypes. Under dryland conditions similar patterns of grain yield variation with anthesis date occurred, although the genotype variation about this pattern depended upon the interaction between growth duration and leaf area development on the one hand, and water use on the other. These results suggest that some consideration be given to altering the agronomy, in regions of low frost risk, to take advantage of the higher yield potential associated with midwinter anthesis dates. The effects of growth duration, anthesis date and environment could be integrated into a yield index of the form Grain yield index = a + b(T/E0) x (l/Tm), where a and b are constants, T, E0 and Tm are transpiration (mm), pan evaporation (mm) and mean daily temperature (�C) respectively, all estimated or measured within � 10 days of anthesis (r2 = 0.801, n = 112). The regression slope was constant across sites, times of planting and irrigation treatments for closely related semidwarf genotypes, but was significantly lower for a group of taller wheats tested. These groupings were associated with differences in grain number per mZ. The similarity between this yield index and the crop growth index of de Wit suggests that grain yield in wheat is closely linked to the growth potential over a short period around anthesis.
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