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Kumar M, Sharma R. Editorial: Role of acquired brain injury in brain-aging: new insight and evidence. Front Neurosci 2024; 18:1408921. [PMID: 38694897 PMCID: PMC11061505 DOI: 10.3389/fnins.2024.1408921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 05/04/2024] Open
Affiliation(s)
- Manish Kumar
- Department of Pediatrics-Pulmonary, University of Alabama at Birmingham, Birmingham, AL, United States
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Edwards MGP, Andersen JR, Curtis DJ, Riberholt CG, Poulsen I. Diet-induced ketosis in adult patients with subacute acquired brain injury: a feasibility study. Front Med (Lausanne) 2024; 10:1305888. [PMID: 38571572 PMCID: PMC10990248 DOI: 10.3389/fmed.2023.1305888] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/23/2023] [Indexed: 04/05/2024] Open
Abstract
Background Research in animal models on cerebral metabolism after brain injury highlights the potential benefits of ketosis in reducing secondary brain injury, but studies in humans are lacking. Aim This study aimed to examine if a 6-week ketogenic diet intervention with added medium-chain triglycerides (MCT) was feasible in adult patients with acquired brain injury in the subacute phase, whether ketosis could be achieved and maintained, and to what extent serious adverse reactions, adverse reactions, serious adverse events, and adverse events occured. Methods Patients ≥18 years of age diagnosed with subacute acquired brain injury and an expectation of hospitalisation ≥6 weeks were included in the intervention group. Patients not included in the intervention group were included in a standard care reference group. The intervention consisted of a ketogenic diet supplemented with MCT to obtain a plasma concentration of β-hydroxybutyrate (BHB) ≥0.5 mmol/L. Patients who were enterally fed were given KetoCal® 2.5:1 LQ MCT Multi Fiber (Nutricia A/S, Allerød, Denmark), supplemented with Liquigen® (Nutricia A/S, Allerød, Denmark). Patients consuming oral nutrition were given KetoCal® 2.5:1 LQ MCT Multi Fiber supplemented with Liquigen®, in addition to ketogenic meals. Results During a 13-week inclusion period, 12 of 13 eligible patients (92% [95% CI: 67% to 99%]) were included in the intervention group, and 17 of 18 excluded patients (94% [95% CI: 74% to 99%]) were included in the reference group. Eight patients (67%) completed the 6-week intervention. It took a median of 1 day to achieve ketosis from starting a 100% MCT ketogenic diet, and it was maintained for 97% of the intervention period after ketosis was obtained. There were no serious adverse reactions to the MCT ketogenic diet, and patients experienced adverse reactions not considered serious in 9.5% of days with the intervention. The MCT ketogenic diet was accepted by patients on all intervention days, and in the two patients transitioning from enteral feeding to oral intake, there were no complications related to transitioning. Conclusion Intervention with MCT ketogenic diet is feasible and tolerated for 6 weeks in hospitalised adult patients with subacute acquired brain injury. Randomised controlled trials are needed to assess the benefits and harms of the MCT ketogenic diet and the effect on patients' recovery.Clinical trial registration: ClinicalTrials.gov, identifier [NCT04308577].
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Affiliation(s)
- Maria G. P. Edwards
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Department of Brain and Spinal Cord Injury, Neuroscience Centre, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
| | - Jens R. Andersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Derek J. Curtis
- Department of Brain and Spinal Cord Injury, Neuroscience Centre, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
| | - Christian G. Riberholt
- Department of Brain and Spinal Cord Injury, Neuroscience Centre, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
| | - Ingrid Poulsen
- Department of Brain and Spinal Cord Injury, Neuroscience Centre, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
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Janssen E, Spauwen P, Rijnen S, Ponds R. Exploration of eye movement desensitization and reprocessing in treating posttraumatic stress-disorder in patients with acquired brain injury: a retrospective case series. Eur J Psychotraumatol 2023; 14:2264117. [PMID: 37860867 PMCID: PMC10591538 DOI: 10.1080/20008066.2023.2264117] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/10/2023] [Indexed: 10/21/2023] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is prevalent in people with acquired brain injury (ABI). Despite the established efficacy of eye movement desensitization and reprocessing (EMDR) for PTSD in general, evaluation studies on EMDR in ABI patients with PTSD are limited.Objective: The aim of this study is to explore clinical features, treatment characteristics, feasibility and first indications of efficacy of EMDR in adult ABI patients with PTSD.Method: This retrospective consecutive case series included ABI patients, who received at least one session of EMDR for PTSD between January 2013 and September 2020. PTSD symptoms were measured using the Impact of Event Scale (IES) pre- and post-treatment. Affective distress was measured using the Subjective Units of Distress (SUD) pre- and post-treatment of the first target.Results: Sixteen ABI patients (median age 46 years, 50% males), with predominantly moderate or severe TBI (50%) or stroke (25%) were included. Treatment duration was a median of seven sessions. Post-treatment IES scores were significantly lower than pre-treatment scores (p < .001). In 81% of the cases there was an individual statistically and clinically relevant change in IES score. Mean SUD scores of the first target were significantly lower at the end of treatment compared to scores at the start of treatment (p < .001). In 88% of the patients full desensitization to a SUD of 0-1 of the first target was accomplished. Only few adjustments to the standard EMDR protocol were necessary.Conclusions: Findings suggest that EMDR is a feasible, well tolerated and potentially effective treatment for PTSD in ABI patients. For clinical practice in working with ABI patients, it is advised to consider EMDR as a treatment option.
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Affiliation(s)
- E.P.J. Janssen
- Multidisciplinary Specialist Center for Brain Injury and Neuropsychiatry, GGZ Oost Brabant, Boekel, the Netherlands
- Limburg Brain Injury Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - P.J.J. Spauwen
- Multidisciplinary Specialist Center for Brain Injury and Neuropsychiatry, GGZ Oost Brabant, Boekel, the Netherlands
- Clinical Center of Excellence for Personality Disorders in Older Adults, Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
| | - S.J.M. Rijnen
- Multidisciplinary Specialist Center for Brain Injury and Neuropsychiatry, GGZ Oost Brabant, Boekel, the Netherlands
- Limburg Brain Injury Center, Maastricht, the Netherlands
| | - R.W.H.M. Ponds
- Limburg Brain Injury Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Medical Psychology, Amsterdam University Medical Centre location Vrije Universiteit, Amsterdam, the Netherlands
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Nemeth JM, Glasser AM, Hinton A, Macisco JM, Wermert A, Smith R, Kemble H, Sasser G. Brain Injury Is Prevalent and Precedes Tobacco Use among Youth and Young Adults Experiencing Homelessness. Int J Environ Res Public Health 2023; 20:5169. [PMID: 36982077 PMCID: PMC10049052 DOI: 10.3390/ijerph20065169] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
70%+ of youth and young adults experiencing homelessness (YYEH; 14-24 years old) smoke combustible tobacco. Little is known about the prevalence of acquired brain injury (ABI) among youth and young adult smokers experiencing homelessness (YYSEH) and its impact on tobacco use progression-the aim of our study. Through an interviewer-administered survey, YYSEH were asked about timing of tobacco use; exposure to causes of ABI; including brain oxygen deprivation (BOD; strangulation; accidental; choking games) and blunt force head trauma (BFHT; intentional; shaken violently; accidental); and perpetrators of intentional assault. Participants (n = 96) were on average 22 years old and from populations who experience structural disparities; including those minoritized by race (84.4%) and gender/sexual orientation (26.0%). In total, 87% of participants reported at least one exposure to BFHT and 65% to BOD. Intentional injury was more common than accidental. Furthermore, 60.4% of participants (n = 59) were classified as having ABI using the Brain Injury Severity Assessment. A significant proportion of YYSEH living with ABI were exposed to both BFHT and BOD prior to trying (68.5%, p = 0.002) and to first regular use (82.8%, p < 0.001) of tobacco. Among YYSEH with ABI; injury exposure occurred a median of 1 and 5 years before age of first regular tobacco use, dependent on injury mechanism. ABI from intentional violence is prevalent and precedes tobacco use among YYSEH.
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Affiliation(s)
- Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Allison M. Glasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Alice Hinton
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Joseph M. Macisco
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Raya Smith
- College of Arts and Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - Hannah Kemble
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
- Division of Health Services, Management, and Policy, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Georgia Sasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
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Barclay L, Coker J, Chang FH. Editorial: Promoting participation following neurotrauma. Front Rehabil Sci 2023; 3:1121684. [PMID: 36712784 PMCID: PMC9879768 DOI: 10.3389/fresc.2022.1121684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Linda Barclay
- Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia,Correspondence: Linda Barclay
| | - Jennifer Coker
- Research Department, Craig Hospital, Englewood, CO, United States
| | - Feng-Hang Chang
- College of Public Health, Taipei Medical University, Taipei, Taiwan
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Jenkin T, Anderson VA, D'Cruz K, Scheinberg A, Knight S. Family-centred service in paediatric acquired brain injury rehabilitation: Bridging the gaps. Front Rehabil Sci 2022; 3:1085967. [PMID: 36619530 PMCID: PMC9816340 DOI: 10.3389/fresc.2022.1085967] [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] [Received: 10/31/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Background Children and adolescents who sustain an acquired brain injury (ABI) can experience acute and ongoing difficulties in a range of cognitive and functional domains, and their families often experience significant life changes and challenges. Family-centred service is therefore considered best practice in paediatric ABI rehabilitation. Despite widespread acceptance of family-centred service in this context, recent literature indicates that family needs are often unrecognised and unmet following paediatric ABI. Although family-centred service was introduced in the field of developmental disability over five decades ago, there remains a lack of clarity about how this approach is implemented in practice. Additionally, limited literature has discussed the implementation of family-centred service in paediatric ABI rehabilitation despite key differences between ABI and developmental disability, including nature and timing of onset, rehabilitation foci, and impacts on families. Aims In this review, we aim to: (i) outline common sequelae of paediatric ABI with a focus on family outcomes; (ii) summarise paediatric rehabilitation and highlight opportunities for family support and involvement; (iii) discuss and synthesise literature across paediatric ABI rehabilitation and family-centred service to highlight gaps in knowledge and practice; and (v) identify clinical implications and future research directions. Conclusions There is a clear need for greater clarity and consensus regarding the implementation of family-centred service in paediatric ABI rehabilitation. This review highlights the importance of providing professional development opportunities for clinicians to increase competency in practising in a family-centred manner, and opportunities to actively involve, empower and support families within rehabilitation. This review also emphasises the importance of services implementing relevant supports to address family needs where possible and developing clear referral pathways so that families can access further support elsewhere when needed.
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Affiliation(s)
- Taylor Jenkin
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Vicki A. Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
- Brain and Mind, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Psychology Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Kate D'Cruz
- Summer Foundation, Melbourne, VIC, Australia
| | - Adam Scheinberg
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sarah Knight
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
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Witten JA, Coetzer R, Turnbull OH. Shades of Rage: Applying the Process Model of Emotion Regulation to Managing Anger After Brain Injury. Front Psychol 2022; 13:834314. [PMID: 35369166 PMCID: PMC8971361 DOI: 10.3389/fpsyg.2022.834314] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/28/2022] [Indexed: 11/30/2022] Open
Abstract
Uncontrollable anger is common following an acquired brain injury (ABI), with impaired emotion regulation (ER) being one of the main contributors. Existing psychological interventions appear moderately effective, though studies typically include limitations such as small sample sizes, issues of long-term efficacy, and standardization of content. While ER has been a popular research field, the study of ER for anger management after ABI is less well investigated, and contains few interventions based on the widely used Process Model of ER. This review surveys the efficacy of ER strategies in individuals with ABI, and proposes a novel research design for future interventions. Recommendations are made about: strategy number and type, shared decision-making, approaches to data analysis, and mode of delivery.
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Affiliation(s)
- Jade Abigail Witten
- School of Human and Behavioral Sciences, Bangor University, Bangor, United Kingdom
| | - Rudi Coetzer
- School of Human and Behavioral Sciences, Bangor University, Bangor, United Kingdom
- The Disabilities Trust, Wakefield, United Kingdom
| | - Oliver H. Turnbull
- School of Human and Behavioral Sciences, Bangor University, Bangor, United Kingdom
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Briand MM, Lejeune N, Zasler N, Formisano R, Bodart O, Estraneo A, Magee WL, Thibaut A. Management of Epileptic Seizures in Disorders of Consciousness: An International Survey. Front Neurol 2022; 12:799579. [PMID: 35087474 PMCID: PMC8788407 DOI: 10.3389/fneur.2021.799579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/21/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Epileptic seizures/post-traumatic epilepsy (ES/PTE) are frequent in persons with brain injuries, particularly for patients with more severe injuries including ones that result in disorders of consciousness (DoC). Surprisingly, there are currently no best practice guidelines for assessment or management of ES in persons with DoC. This study aimed to identify clinician attitudes toward epilepsy prophylaxis, diagnosis and treatment in patients with DoC as well as current practice in regards to the use of amantadine in these individuals. A cross-sectional online survey was sent to members of the International Brain Injury Association (IBIA). Fifty physician responses were included in the final analysis. Withdrawal of antiepileptic drug/anti-seizure medications (AED/ASM) therapy was guided by the absence of evidence of clinical seizure whether or not the AED/ASM was given prophylactically or for actual seizure/epilepsy treatment. Standard EEG was the most frequent diagnostic method utilized. The majority of respondents ordered an EEG if there were concerns regarding lack of neurological progress. AED/ASM prescription was reported to be triggered by the first clinically evident seizure with levetiracetam being the AED/ASM of choice. Amantadine was frequently prescribed although less so in patients with epilepsy and/or EEG based epileptic abnormalities. A minority of respondents reported an association between amantadine and seizure. Longitudinal studies on epilepsy management, epilepsy impact on neurologic prognosis, as well as potential drug effects on seizure risk in persons with DoC appear warranted with the goal of pushing guideline development forward and improving clinical assessment and management of seizures in this unique, albeit challenging, population.
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Affiliation(s)
- Marie-Michèle Briand
- Coma Science Group, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA) Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Physical Medicine and Rehabilitation Department, Institut de Réadaptation en Déficience Physique de Québec, Quebec, QC, Canada
- Research Center of the Sacré-Coeur Hospital of Montreal, Montreal, QC, Canada
| | - Nicolas Lejeune
- Coma Science Group, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA) Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- DoC Care Unit, Centre Hospitalier Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium
- Institute of NeuroScience, UCLouvain, Brussels, Belgium
| | - Nathan Zasler
- Concussion Care Centre of Virginia, Ltd., Richmond, VA, United States
- Tree of Life Services Inc., Richmond, VA, United States
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States
| | | | - Olivier Bodart
- Epileptology Unit, Neurology Department, University Hospital of Liege, Liège, Belgium
| | - Anna Estraneo
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi, Florence, Italy
- Neurology Unit, Santa Maria della Pietà General Hospital, Nola, Italy
| | - Wendy L. Magee
- Boyer College of Music and Dance, Temple University, Philadelphia, PA, United States
| | - Aurore Thibaut
- Coma Science Group, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA) Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
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Gooden JR, Petersen V, Bolt GL, Curtis A, Manning V, Cox CA, Lubman DI, Arunogiri S. Maybe It's Not the Meth: Considering Biopsychosocial Contributors to Cognitive Impairment in Methamphetamine Polydrug Use. Front Psychiatry 2022; 13:795400. [PMID: 35237189 PMCID: PMC8882579 DOI: 10.3389/fpsyt.2022.795400] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/19/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE In considering the cognitive harms of methamphetamine (MA) use, there is currently a limited appreciation of the profile of pre-existing, comorbid, or modifiable risk factors for cognitive impairment in individuals with MA-polydrug use who present to clinical services. This is in contrast to the well-recognized evidence in alcohol use groups. The aim of this study was to investigate the biopsychosocial and neuropsychological profiles of MA-polysubstance using individuals reporting cognitive impairment in comparison to an alcohol-using group. METHODS A retrospective file audit was undertaken of individuals who presented for assessment to a specialist addiction neuropsychology service and reported either more than 1 year of heavy MA use as part of a polydrug use history (n = 40) or having only used alcohol (n = 27). Clinical histories including demographic, medical, mental health, substance use, and neuropsychological assessment results were extracted from medical records. Between group comparisons were conducted to explore differences in the MA-polydrug vs. the alcohol group. RESULTS Individuals in the MA-polydrug group were significantly younger, commenced substance use at an earlier age, were more likely to have an offending history, and experienced an overdose than those in the alcohol group. No differences in comorbid neurodevelopmental, psychiatric or acquired brain injury diagnoses were observed between groups. For neuropsychological functioning, significant group differences were observed in overall IQ, semantic verbal fluency, and psychomotor tracking, where individuals in the alcohol group performed significantly worse. CONCLUSIONS Neuropsychological profiles were largely equivalent between groups across cognitive domains, with minor differences in favor of the MA-polydrug group. Relative to the general population, cognitive functioning was reduced for both groups across a range of domains. High rates of comorbid mental health concerns were common across both groups, however, individuals in the MA-polydrug group presented with a higher risk of overall harm from substance use at a significantly younger age which is a unique concern for this group. These findings highlight the importance of considering the biopsychosocial factors, such as age of first use, emotional distress, indirect substance related harms including overdose and blood born virus infection that may be relevant to experiences of cognitive difficulty in MA-polydrug users.
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Affiliation(s)
- James R Gooden
- Turning Point, Eastern Health, Richmond, VIC, Australia.,The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | | | | | - Ashlee Curtis
- Centre for Drug Use, Addictive and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | | | - Dan I Lubman
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
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Newstead S, Lewis J, Roderique-Davies G, Heirene RM, John B. The Paradox of the Frontal Lobe Paradox. A Scoping Review. Front Psychiatry 2022; 13:913230. [PMID: 35935412 PMCID: PMC9353325 DOI: 10.3389/fpsyt.2022.913230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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] [Received: 04/05/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
The "frontal lobe paradox" highlights a phenomenon in which a subset of patients who possess frontal lobe damage and exhibit marked impairments in everyday life are still able to able to verbally describe a logical course of action relating to a task and perform well in interview and test settings. Such cases pose a challenge with regard to the assessment of mental capacity within clinical settings. Recent position articles state that the frontal lobe paradox is a well-known phenomenon within the field of neuropsychology, anecdotal reports from clinicians in the UK suggest this is not the case. Consequently, we conducted a scoping review to examine the breadth and depth of literature relating to the frontal lobe paradox. Searches were conducted using electronic databases and search engines, which were supplemented with a snowball search of the references used within relevant literature. We identified and reviewed 28 documents specifically related to the frontal lobe paradox. Nearly 50% of all identified academic texts published since 2000 were position articles that cited a handful of case studies published between 1936 and 1986 as evidence for the phenomenon. We also observed instances of articles citing position articles as evidence of the frontal lobe paradox. Overall, our findings indicate a lack of readily accessible research specific to the frontal lobe paradox. In particular, there is a lack of contemporary research specific to the subject and an absence of clarification as to which syndromes and disorders are included within the term.
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Affiliation(s)
- Simon Newstead
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
| | - Julia Lewis
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom.,Gwent Specialist Substance Misuse Service, Newport, United Kingdom
| | - Gareth Roderique-Davies
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
| | - Robert M Heirene
- School of Psychology, College of Health and Human Sciences, Charles Darwin University, Darwin, NT, Australia
| | - Bev John
- Addictions Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
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11
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Nygård L, Ryd C, Astell A, Nedlund AC, Boger J, Mäki Petäjä Leinonen A, Issakainen M, Larsson Lund M. Self-initiated management approaches in everyday occupations used by people with acquired cognitive impairment. Scand J Occup Ther 2021; 29:139-151. [PMID: 34410888 DOI: 10.1080/11038128.2021.1925740] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 10/20/2022]
Abstract
BACKGROUND Striving to cope with day-to-day challenges is a basic human behaviour. Self-initiated management approaches provide a resource that has yet to be discovered and systematically used in occupational therapy practice. This resource might be especially important for people with dementia who are less likely to adopt management approaches initiated by others. AIMS/OBJECTIVES Based on the findings of former studies on management and problem-solving actions among people with cognitive impairment, this article aims to identify and categorize the study participants' self-initiated management approaches and how these may be manifested in strategies in everyday occupations. MATERIAL AND METHODS The study utilized a form of meta-synthesis; an aggregated analysis, where findings from 11 studies published 2004-2020 were compared and categorized, incorporating the views of participants with dementia/mild cognitive impairment, or acquired brain injury. RESULTS Thirty strategies were identified and grouped into seven categories of management approaches, used in a variety of everyday occupations and situations. A majority of the strategies were found in both populations, suggesting that management approaches are more similar than different across populations with cognitive impairment. CONCLUSIONS AND SIGNIFICANCE Attending to the rich variation of self-initiated management approaches/strategies among persons with cognitive impairment offers possibilities for developing occupational therapy interventions.
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Affiliation(s)
- Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden
| | - Charlotta Ryd
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Arlene Astell
- Occupational Sciences & Occupational Therapy and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ann-Charlotte Nedlund
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Unit of Health care Analysis, Linköping University, Linköping, Sweden
| | - Jennifer Boger
- Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | | | - Mervi Issakainen
- Faculty of Social Sciences and Business Studies, Department of Social Sciences, University of Eastern Finland, Finland
| | - Maria Larsson Lund
- Division of Health, Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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Molteni E, Ranzini MBM, Beretta E, Modat M, Strazzer S. Individualized Prognostic Prediction of the Long-Term Functional Trajectory in Pediatric Acquired Brain Injury. J Pers Med 2021; 11:675. [PMID: 34357142 PMCID: PMC8305391 DOI: 10.3390/jpm11070675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022] Open
Abstract
In pediatric acquired brain injury, heterogeneity of functional response to specific rehabilitation treatments is a key confound to medical decisions and outcome prediction. We aimed to identify patient subgroups sharing comparable trajectories, and to implement a method for the early prediction of the long-term recovery course from clinical condition at first discharge. 600 consecutive patients with acquired brain injury (7.4 years ± 5.2; 367 males; median GCS = 6) entered a standardized rehabilitation program. Functional Independent Measure scores were measured yearly, until year 7. We classified the functional trajectories in clusters, through a latent class model. We performed single-subject prediction of trajectory membership in cases unseen during model fitting. Four trajectory types were identified (post.prob. > 0.95): high-start fast (N = 92), low-start fast (N = 168), slow (N = 130) and non-responders (N = 210). Fast responders were older (chigh = 1.8; clow = 1.1) than non-responders and suffered shorter coma (chigh = -14.7; clow = -4.3). High-start fast-responders had shorter length of stay (c = -1.6), and slow responders had lower incidence of epilepsy (c = -1.4), than non-responders (p < 0.001). Single-subject trajectory could be predicted with high accuracy at first discharge (accuracy = 0.80). In conclusion, we stratified patients based on the evolution of their response to a specific treatment program. Data at first discharge predicted the response over 7 years. This method enables early detection of the slow responders, who show poor post-acute functional gains, but achieve recovery comparable to fast responders by year 7. Further external validation in other rehabilitation programs is warranted.
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Affiliation(s)
- Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EU, UK; (E.M.); (M.B.M.R.); (M.M.)
| | - Marta Bianca Maria Ranzini
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EU, UK; (E.M.); (M.B.M.R.); (M.M.)
| | - Elena Beretta
- Acquired Brain Injury Unit, Scientific Institute IRCCS E. Medea, 22040 Bosisio Parini, Italy;
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EU, UK; (E.M.); (M.B.M.R.); (M.M.)
| | - Sandra Strazzer
- Acquired Brain Injury Unit, Scientific Institute IRCCS E. Medea, 22040 Bosisio Parini, Italy;
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Jones C, Richard N, Thaut M. Investigating music-based cognitive rehabilitation for individuals with moderate to severe chronic acquired brain injury: A feasibility experiment. NeuroRehabilitation 2021; 48:209-220. [PMID: 33664158 DOI: 10.3233/nre-208015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/15/2022]
Abstract
BACKGROUND Acquired brain injuries often cause cognitive impairment, significantly impacting participation in rehabilitation and activities of daily living. Music can influence brain function, and thus may serve as a uniquely powerful cognitive rehabilitation intervention. OBJECTIVE This feasibility study investigated the potential effectiveness of music-based cognitive rehabilitation for adults with chronic acquired brain injury. METHODS The control group participated in three Attention Process Training (APT) sessions, while the experimental group participated in three Music Attention Control Training (MACT) sessions. Pre-and post- testing used the Trail Making A & B, Digit Symbol, and Brown-Peterson Task as neuropsychological tests. RESULTS ANOVA analyses showed no significant difference between groups for Trail A Test, Digit Symbol, and Brown-Peterson Task. Trail B showed significant differences at post-test favouring MACT over APT. The mean difference time between pre-and post-tests for the Trail B Test was also significantly different between APT and MACT in favour of MACT using a two-sample t-test as well as a follow-up nonparametric Mann Whitney U-test. CONCLUSIONS The group differences found in the Trail B tests provided preliminary evidence for the efficacy of MACT to arouse and engage attention in adults with acquired brain injury.
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Affiliation(s)
- Cheryl Jones
- University of Toronto, Canada.,Concordia University, Canada.,Wilfred Laurier University, Canada
| | | | - Michael Thaut
- Neuroscience and Rehabilitation Science, St. Michael's Hospital, Toronto, Canada.,CAMH Neuroimaging, St. Michael's Hospital, Toronto, Canada.,Music and Health Sciences, University of Toronto, Canada
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Beretta E, Romei M, Molteni E, Avantaggiato P, Strazzer S. Combined robotic-aided gait training and physical therapy improve functional abilities and hip kinematics during gait in children and adolescents with acquired brain injury. Brain Inj 2015; 29:955-62. [PMID: 25915458 DOI: 10.3109/02699052.2015.1005130] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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
PURPOSE To evaluate the combined effect of robotic-aided gait training (RAGT) and physical therapy (PT) on functional abilities and gait pattern in children and adolescents exiting acquired brain injury (ABI), through functional clinical scales and 3D-Gait Analysis (GA). METHODS A group of 23 patients with ABI underwent 20 sessions of RAGT in addition to traditional manual PT. All the patients were evaluated before and after the training by using the Gross Motor Function Measures (GMFM) and the Functional Assessment Questionnaire. Ambulant children were also evaluated through the 6 Minutes Walk Test (6MinWT) and GA. Finally, results were compared with those obtained from a control group of ABI children who underwent PT only. RESULTS After the training, the GMFM showed significant improvement in both dimensions 'D' (standing) and 'E' (walking). In ambulant patients the 6MinWT showed significant improvement after training and GA highlighted a significant increase in cadence, velocity and stride length. Moreover, hip kinematics on the sagittal plane revealed a statistically significant increase in range of motion (ROM) during the whole gait cycle, increased hip extension during terminal stance and increased ROM during the swing phase. CONCLUSIONS The data suggest that the combined programme RAGT + PT induces improvements in functional activities and gait pattern in children and adolescents with ABI and demonstrated it to be an elective tool for the maintenance of the patients' full compliance throughout the rehabilitative programme.
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Abstract
PRIMARY OBJECTIVE The purpose of this retrospective study was to determine the clinical practices for prescribing yoked prisms, as well as to assess related patient responses, in a sample of visually-symptomatic patients having acquired brain injury (ABI). METHODS The clinical records of individuals with acquired brain injury (ABI) that were assessed for yoked prisms were reviewed retrospectively. This query resulted in 60 patient records for analysis between January 2011 and December 2012. The following diagnostic groups were analysed: homonymous hemianopsia (HH)/homonymous quadranopsia, abnormal egocentric localization (AEL) and visual neglect. RESULTS HH/homonymous quadranopsia (58.3%) was the primary indication to prescribe yoked prisms, followed by visual neglect/unilateral spatial inattention (USI) (40.0%) and AEL (11.7%). The most common favourable patient responses were increased awareness of their blind visual field and improved gait, mobility and balance. The magnitude and direction of prisms prescribed were dependent upon the subjective responses in patients manifesting AEL. In contrast, base direction was dependent upon the direction of visual field loss in patients with HH/homonymous quadranopsia and visual neglect. CONCLUSIONS Two-thirds of the present sample population responded favourably to the yoked prisms. The results of the present study should prove useful to clinicians for the successful prescription of yoked prisms as a treatment modality in patients presenting with the above three diagnoses.
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Affiliation(s)
- Surbhi Bansal
- SUNY College of Optometry, Raymond J. Greenwald Rehabilitation Center (RJGRC) , New York, NY , USA
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