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Tabet S, Laguë-Beauvais M, Francoeur C, Sheehan A, Abouassaly M, Marcoux J, Dagher JH, Ursulet A, Colucci E, de Guise E. Longitudinal recovery of executive functions and social participation prediction following traumatic brain injury. Appl Neuropsychol Adult 2024; 31:134-143. [PMID: 34807801 DOI: 10.1080/23279095.2021.2002866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is heterogeneity across studies and a lack of knowledge about recovery of EFs over time following traumatic brain injury (TBI). Also, EFs are associated with functional outcome, but there is still a gap in knowledge concerning the association between EFs and social participation following TBI. For this reason, we aim to (1) measure the recovery of the three executive function subcomponents of Miyake's model, namely flexibility, updating and inhibition between the acute phase (T1) and 6 months post TBI (T2) and (2) measure the relationship between EFs and social participation after TBI. Thus, a prospective longitudinal study that included 75 patients with TBI (mild and moderate-severe) and 50 patients with orthopedic injuries (controls) without brain damage was carried out. An extensive EFs test battery was administered at T1 and T2 whereas the Mayo-Portland Adaptability Inventory-4 (MPAI-4) was administered only at T2. In contrast with the controls, both TBI groups improved significantly between T1 and T2 on WMS-III Mental Control test (MC) and the D-KEFS Category Switching Condition of the Verbal Fluency task (SVF). Results also showed a simple time effect for the WAIS-IV Digit span and the Hayling tests. Moreover, there was an association between the SVF test and social participation (MPAI-4) at T2. In conclusion, the MC and SVF tests were found to be the best tools for measuring recovery of EFs following TBI. The SVF test was the most likely measure of EFs to give the neuropsychologist an idea of the patient's social participation.
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Affiliation(s)
- Sabrina Tabet
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Maude Laguë-Beauvais
- Department of Psychology, Université de Montréal, Laval, Canada
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
| | - Coralie Francoeur
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Audrey Sheehan
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Michel Abouassaly
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
| | - Judith Marcoux
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
| | - Jehane H Dagher
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
- Traumatic brain Injury Program, McGill University Health Center, Montreal, Canada
- Physical Medicine and Rehabilitation Service, McGill University Health Centre-Montreal General Hospital, Quebec, Canada
| | - Adriana Ursulet
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Emma Colucci
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Laval, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montreal, Canada
- Research Institute-McGill University Health Center, Montreal, Canada
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Haikal L, Boissonnault È, Boudier-Revéret M, Dagher JH. Dancers' Perceptions of Accessibility and Quality of the Relationship with Healthcare Professionals in Quebec. Med Probl Perform Art 2021; 36:245-262. [PMID: 34854460 DOI: 10.21091/mppa.2021.4028] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 09/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To understand dancers' perception of accessibility to care and quality of the relationship with healthcare practitioners in Quebec; to identify the key elements of an optimal dancer-physician relationship; and to propose recommendations for improvement. METHODS An online questionnaire consisting of multiple choice, "yes/no," and short answer questions was sent to professional dance organizations, companies, agencies, and schools in Quebec, Canada. Information regarding the dance artists' sociodemographics, dance background, dance-related injuries, and access to a primary care physician were collected. Experiences and expectations regarding the dancer-physician relationship were surveyed. One-way ANOVA analyses and Pearson correlations were performed to assess differences of perception between dancers' demographic characteristics and associations between the variables. RESULTS Out of 161 participants, 144 met inclusion criteria, consisting of largely French-speaking females, North American or European decent, self-employed contemporary dancers with an average age of 33.13 ± 10.81 yrs. Dance artists sought medical care from osteopaths (47.9%) and physiotherapists (36.1%) more frequently than from physicians (8.3%). Fully employed dancers had more favorable perceptions of the dancer-physician relationship compared to self-employed dancers and those who had mixed streams of income. The perception of most participants was that physicians do not comprehend the unique dance-associated impacts on health (81.8%). The most important aspect affecting perception of the relationship with the physician was diagnostic acumen (41.3%). Most participants (79.0%) selected "works with other health professionals [...] and gives expert advice" as an important expectation from physicians. CONCLUSION This research is the first investigation of the dancer-physician relationship in Quebec. It reveals a desire amongst the dance artist community to improve the dancer-physician relationship and the overall quality of their unique healthcare requirements.
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Affiliation(s)
| | - Ève Boissonnault
- Hôtel-Dieu du Centre hospitalier de l'Université de Montréal, 3840, rue Saint-Urbain, Montréal, QC, H2W 1T8, Canada.
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Boissonnault È, Higgins J, LaGarde G, Barthélemy D, Lamarre C, H Dagher J. Brain stimulation in attention deficits after traumatic brain injury: a literature review and feasibility study. Pilot Feasibility Stud 2021; 7:115. [PMID: 34059152 PMCID: PMC8165970 DOI: 10.1186/s40814-021-00859-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND After a traumatic brain injury, disturbances in the attentional processes have a direct negative effect on functional recovery and on return to complex activities. To date, there is no good attention remediation treatment available. The primary objective of this review and pilot study is to provide an overview of the research evidence and to evaluate the feasibility of implementing a tDCS protocol to improve attention disorders in patients with mild complicated to severe subacute TBI, hospitalized in an inpatient rehabilitation facility. Our secondary objective is to extract preliminary data and observational information on participants' response to treatment. METHODS Participants were recruited from a consecutive series of patients admitted to the TBI unit of a subspecialized regional rehabilitation center. They received a 20-min tDCS stimulation 3 times a week for 3 weeks. A neuropsychological evaluation was performed before and after the intervention. We collected participants' sociodemographic and clinical characteristics as well as information about satisfaction, tolerability, and adverse effects. RESULTS One hundred sixty-four patients were admitted between September 2018 and January 2020. One hundred fifty-eight were excluded, and 6 patients with presumed attentional deficits were enrolled. None completed the protocol as intended. No major side effects occurred. CONCLUSION Non-invasive brain neurostimulation is promising to enhance attention deficits in patients with TBI. Implementation of a tDCS protocol to fulfill this purpose in an intensive inpatient rehabilitation center has its limitations. We made recommendations to facilitate the implementation of similar projects in the future. TRIAL REGISTRATION ISRCTN, ISRCTN55243064 . Registered 14 October 2020-retrospectively registered.
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Affiliation(s)
- Ève Boissonnault
- Physical Medicine and Rehabilitation Service, Université de Montréal, Montreal, QC, Canada. .,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada. .,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
| | - Johanne Higgins
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Geneviève LaGarde
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Dorothy Barthélemy
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Céline Lamarre
- Physical Medicine and Rehabilitation Service, Université de Montréal, Montreal, QC, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Jehane H Dagher
- Physical Medicine and Rehabilitation Service, Université de Montréal, Montreal, QC, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6300, avenue de Darlington (Pavillon Gingras), Montréal, QC, H3S 2J4, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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Costa CK, Dagher JH, Lamoureux J, de Guise E, Feyz M. Societal cost of traumatic brain injury: A comparison of cost-of-injuries related to biking with and without helmet use. Brain Inj 2015; 29:843-7. [PMID: 25871491 DOI: 10.3109/02699052.2015.1004758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The goal of this study is to determine if a difference in societal costs exists from traumatic brain injuries (TBI) in patients who wear helmets compared to non-wearers. METHODS This is a retrospective cost-of-injury study of 128 patients admitted to the Montreal General Hospital (MGH) following a TBI that occurred while cycling between 2007-2011. Information was collected from Quebec Trauma Registry. The independent variables collected were socio-demographic, helmet status, clinical and neurological patient information. The dependent variables evaluated societal costs. RESULTS The median costs of hospitalization were significantly higher (p = 0.037) in the no helmet group ($7246.67 vs. $4328.17). No differences in costs were found for inpatient rehabilitation (p = 0.525), outpatient rehabilitation (p = 0.192), loss of productivity (p = 0.108) or death (p = 1.000). Overall, the differences in total societal costs between the helmet and no helmet group were not significantly different (p = 0.065). However, the median total costs for patients with isolated TBI in the non-helmet group ($22, 232.82) was significantly higher (p = 0.045) compared to the helmet group ($13, 920.15). CONCLUSION Cyclists sustaining TBIs who did not wear helmets in this study were found to cost society nearly double that of helmeted cyclists.
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Affiliation(s)
- Camille K Costa
- Physical Medicine and Rehabilitation Department, Institut de Readaptation Gingras Lindsay de Montreal, University of Montreal , Montreal, Quebec , Canada
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Bureau NJ, Moser T, Dagher JH, Shedid D, Li M, Brassard P, Leduc BE. Transforaminal versus intra-articular facet corticosteroid injections for the treatment of cervical radiculopathy: a randomized, double-blind, controlled study. AJNR Am J Neuroradiol 2014; 35:1467-74. [PMID: 24874533 DOI: 10.3174/ajnr.a4026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Transforaminal corticosteroid injections can be performed in the management of cervical radiculopathy but carry the risk of catastrophic complications. This study compares the efficacy of transforaminal and facet corticosteroid injections at 4 weeks' follow-up. MATERIALS AND METHODS We randomly assigned 56 subjects to receive CT-guided transforaminal (15 men, 13 women; mean age, 52 years; range, 28-72 years) or facet (8 men, 20 women; mean, 44 years; range, 26-60 years) injections. The primary outcome was pain severity rated on a Visual Analog Scale (0-100). Secondary outcomes were the Neck Disability Index and the Medication Quantitative Scale. RESULTS In the intention-to-treat and as-treated analyses, for a mean baseline score, facet injections demonstrated a significant pain score reduction of 45.3% (95% CI, 21.4-69.2) and 37.0% (95% CI, 9.2-64.7), while transforaminal injections showed a nonsignificant pain score reduction of 9.8% (95% CI, +11.5-31.2) and 17.8% (95% CI, +6.6-42.2). While facet injections demonstrated an improvement in the Neck Disability Index score of 24.3% (95% CI, +2.9-51.5) and 20.7% (95% CI, +6.2-47.6) as opposed to transforaminal injections of 9.6% (95% CI, +15.2-34.4) and 12.8% (95% CI, +11.2-36.7), the results were not statistically significant. Noninferiority of facet to transforaminal injections was demonstrated for baseline pain scores of ≤60, while noninferiority analysis was inconclusive for baseline pain scores of ≥80 and for the Neck Disability Index. Neither intervention showed a significant medication-intake score reduction with time. CONCLUSIONS Facet injections are effective for the treatment of cervical radiculopathy and represent a valid and safer alternative to transforaminal injections.
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Affiliation(s)
- N J Bureau
- From the Department of Radiology (N.J.B., T.M.)Research Center (N.J.B., T.M.)
| | - T Moser
- From the Department of Radiology (N.J.B., T.M.)Research Center (N.J.B., T.M.)
| | - J H Dagher
- Institut de réadaptation Gingras-Lindsay-de-Montréal (J.H.D.), Université de Montréal, Montreal, Quebec, Canada
| | | | - M Li
- Department of Surgery (M.L.), Division of Neurosurgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, Canada
| | - P Brassard
- Division of Clinical Epidemiology (P.B.), McGill University Health Center, Montreal, Quebec, Canada
| | - B E Leduc
- Division of Neurosurgery, and Department of Medicine (B.E.L.), Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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Dagher JH, Richard-Denis A, Lamoureux J, de Guise E, Feyz M. Acute global outcome in patients with mild uncomplicated and complicated traumatic brain injury. Brain Inj 2013; 27:189-99. [DOI: 10.3109/02699052.2012.729288] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Jehane H. Dagher
- Physical Medicine and Rehabilitation Department, McGill University Health Centre-Montreal General Hospital,
Montreal, Quebec, Canada
- Physical Medicine and Rehabilitation Department, Institut de Readaptation Lindsay Gingras de Montreal,
| | - Andreane Richard-Denis
- Physical Medicine and Rehabilitation Department, Institut de Readaptation Lindsay Gingras de Montreal,
| | - Julie Lamoureux
- Social and Preventive Medicine Department, University of Montreal,
Montreal, Quebec, Canada
| | - Elaine de Guise
- Traumatic Brain Injury Program,
- Neurology and Neurosurgery Department, McGill University Health Centre-Montreal General Hospital,
Montreal, Quebec, Canada
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Dagher JH, Habra N, Lamoureux J, De Guise E, Feyz M. Global outcome in acute phase of treatment following moderate-to-severe traumatic brain injury from motor vehicle collisions vs assaults. Brain Inj 2011; 24:1389-98. [PMID: 20887096 DOI: 10.3109/02699052.2010.523042] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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 To compare socio-demographic, medical characteristics and acute outcomes between patients with traumatic brain injuries (TBIs) from motor vehicle collision (MVC) or assault in an acute care setting. RESEARCH DESIGN This descriptive, comparative retrospective cohort study included 415 patients with moderate and severe TBI secondary to an assault (n¼91) vs a motor vehicle collision (n=324). METHODS AND PROCEDURES Outcome measures were length of stay (LOS) in the intensive care unit and in hospital, Extended Glasgow Outcome Scale (GOS-E), FIM® instrument (‘FIM’) and discharge destination. MAIN OUTCOMES AND RESULTS Patients with TBI from MVC had a higher percentage of polytrauma, higher injury severity scores, required more orthopaedic surgeries and thoracic drain insertions. Patients with TBI from assault were more often non-Caucasian, young single men, less educated with higher unemployment rates and criminal records, with a history of alcohol and drug abuse and were more often intoxicated on admission. There was no significant group difference in the LOS and FIM ratings, but patients with assault-related TBI were more often discharged home and had a more favourable GOS-E. CONCLUSION Variables such as injury severity, age, level of intoxication on admission and presence of surgeries should be considered when determining acute outcome.
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Affiliation(s)
- Jehane H Dagher
- Physical Medicine and Rehabilitation Department, McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada.
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de Guise E, LeBlanc J, Gosselin N, Marcoux J, Champoux MC, Couturier C, Lamoureux J, Dagher JH, Maleki M, Feyz M. Neuroanatomical correlates of the clock drawing test in patients with traumatic brain injury. Brain Inj 2010; 24:1568-74. [DOI: 10.3109/02699052.2010.523052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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