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Dupuy EG, Vincent T, Lecchino C, Boisvert A, Trépanier L, Nadeau S, de Guise E, Bherer L. Prefrontal engagement predicts the effect of museum visit on psychological well-being: an fNIRS exploration. Front Psychiatry 2024; 15:1263351. [PMID: 38501080 PMCID: PMC10944881 DOI: 10.3389/fpsyt.2024.1263351] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/20/2024] [Indexed: 03/20/2024] Open
Abstract
Recent research suggests that museum visits can benefit psychological well-being by reducing symptoms of stress and anxiety. However, these reported relaxing effects remain inconsistent between studies. Shedding light on the underlying cerebral mechanisms of museum visits might support a better understanding of how it affects psychological well-being. This study aimed to investigate the prefrontal engagement evoked by artwork analysis during a museum visit and to determine if these prefrontal substrates are associated with the museum's effect on psychological well-being in older adults. Nineteen adults aged between 65 and 79, toured a Baroque-style exhibit at the Montreal Museum of Fine Arts for approximately 20 minutes while equipped with a near-infrared spectroscopy system measuring the prefrontal cortex's hemodynamic activity. For each painting, participants received the instruction to either (1): analyze the painting and produce a personal interpretation of its signification (analytic condition) or (2) visualize the painting without any specific thoughts (visualization condition). Questionnaires measuring stress, anxiety, and well-being were administered before and after the visit. Sixteen older women (71.5 ± 4 years) were included in the analyses. Results showed that, at the group level, the analytic condition was associated with an increased activation pattern in the left ventrolateral prefrontal region, typically related to attentional processes (not observed in the visualization condition). The activation associated with the analytic condition predicted pre-/post-visit reductions in self-reported anxiety and stress in the sample of older women. These observations suggest that the level of engagement of attentional processes during artwork analysis may play a major role in the effect of a museum's visit on self-reported symptoms of anxiety.
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Affiliation(s)
- Emma Gabrielle Dupuy
- Centre EPIC et centre de Recherche, Montreal Heart Insitute, Montreal, QC, Canada
- Département de Médecine, Université de Montréal, Montreal, QC, Canada
| | - Thomas Vincent
- Centre EPIC et centre de Recherche, Montreal Heart Insitute, Montreal, QC, Canada
| | - Catia Lecchino
- Centre EPIC et centre de Recherche, Montreal Heart Insitute, Montreal, QC, Canada
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Annabelle Boisvert
- Centre EPIC et centre de Recherche, Montreal Heart Insitute, Montreal, QC, Canada
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Laurence Trépanier
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
- CRIR—IURDPM, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - Sylvie Nadeau
- CRIR—IURDPM, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
- École de Réadaptation, Université de Montréal, Montreal, QC, Canada
| | - Elaine de Guise
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
- CRIR—IURDPM, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - Louis Bherer
- Centre EPIC et centre de Recherche, Montreal Heart Insitute, Montreal, QC, Canada
- Département de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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2
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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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Boucher V, Frenette J, Neveu X, Tardif PA, Mercier É, Chauny JM, Berthelot S, Archambault P, Lee J, Perry JJ, McRae A, Lang E, Moore L, Cameron P, Ouellet MC, de Guise E, Swaine B, Émond M, Le Sage N. Lack of association between four biomarkers and persistent post-concussion symptoms after a mild traumatic brain injury. J Clin Neurosci 2023; 118:34-43. [PMID: 37857062 DOI: 10.1016/j.jocn.2023.10.007] [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] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/07/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
Approximately 15 % of individuals who sustained a mild Traumatic Brain Injury (TBI) develop persistent post-concussion symptoms (PPCS). We hypothesized that blood biomarkers drawn in the Emergency Department (ED) could help predict PPCS. The main objective of this project was to measure the association between four biomarkers and PPCS at 90 days post mild TBI. We conducted a prospective cohort study in seven Canadian EDs. Patients aged ≥ 14 years presenting to the ED within 24 h of a mild TBI who were discharged were eligible. Clinical data and blood samples were collected in the ED, and a standardized questionnaire was administered 90 days later to assess the presence of symptoms. The following biomarkers were analyzed: S100B protein, Neuron Specific Enolase (NSE), cleaved-Tau (c-Tau) and Glial Fibrillary Acidic Protein (GFAP). The primary outcome measure was the presence of PPCS at 90 days after trauma. Relative risks and Areas Under the Curve (AUC) were computed. A total of 595 patients were included, and 13.8 % suffered from PPCS at 90 days. The relative risk of PPCS was 0.9 (95 % CI: 0.5-1.8) for S100B ≥ 20 pg/mL, 1.0 (95 % CI: 0.6-1.5) for NSE ≥ 200 pg/mL, 3.4 (95 % CI: 0.5-23.4) for GFAP ≥ 100 pg/mL, and 1.0 (95 % CI: 0.6-1.8) for C-Tau ≥ 1500 pg/mL. AUC were 0.50, 0.50, 0.51 and 0.54, respectively. Among mild TBI patients, S100B protein, NSE, c-Tau or GFAP do not seem to predict PPCS. Future research testing of other biomarkers is needed to determine their usefulness in predicting PPCS.
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Affiliation(s)
- Valérie Boucher
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada
| | - Jérôme Frenette
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada; Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada
| | - Xavier Neveu
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada
| | - Pier-Alexandre Tardif
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada
| | - Éric Mercier
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada; Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada; VITAM-Centre de recherche en santé durable, 2480 Chem. de la Canardière, Québec, Québec G1J 2G1, Canada
| | - Jean-Marc Chauny
- Faculté de médecine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montréal, Québec H3T 1J4, Canada
| | - Simon Berthelot
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada; Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada
| | - Patrick Archambault
- Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada; VITAM-Centre de recherche en santé durable, 2480 Chem. de la Canardière, Québec, Québec G1J 2G1, Canada; Centre de recherche du CISSS de Chaudière-Appalaches, 143 Rue Wolfe, Lévis, Québec, QC G6V 3Z1, Canada
| | - Jacques Lee
- Sunnybrook Health Science Center, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada; Schwartz-Reisman Emergency Medicine Institute, Mount Sinai Hospital, 600 University Ave, Toronto, Ontario M5G 1X5, Canada
| | - Jeffrey J Perry
- The Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, Ontario K1H 8L6, Canada; Department of Emergency Medicine, University of Ottawa, 75 Laurier Ave E, Ottawa, Ontario K1N 6N5, Canada
| | - Andrew McRae
- Department of Emergency Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N 1N4, Canada; Foothills Medical Centre, 1403 29 St NW, Calgary, Alberta T2N 2T9, Canada
| | - Eddy Lang
- Department of Emergency Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N 1N4, Canada; Foothills Medical Centre, 1403 29 St NW, Calgary, Alberta T2N 2T9, Canada
| | - Lynne Moore
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada; Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada
| | - Peter Cameron
- Alfred Emergency and Trauma Centre, Monash University, 55 Commercial Rd, Melbourne, VIC 3004, Australia
| | - Marie-Christine Ouellet
- Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada; Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), 525 Bd Wilfrid-Hamel, Québec, Québec G1M 2S8, Canada
| | - Elaine de Guise
- Département de psychologie, Université de Montréal, 2900, boul. Édouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Centre de recherche interdisciplinaire en réadaptation (CRIR) du Montréal métropolitain, 6363, chemin Hudson, Montréal, Québec H3S 1M9, Canada
| | - Bonnie Swaine
- Faculté de médecine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montréal, Québec H3T 1J4, Canada; Centre de recherche interdisciplinaire en réadaptation (CRIR) du Montréal métropolitain, 6363, chemin Hudson, Montréal, Québec H3S 1M9, Canada
| | - Marcel Émond
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada; Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada; VITAM-Centre de recherche en santé durable, 2480 Chem. de la Canardière, Québec, Québec G1J 2G1, Canada
| | - Natalie Le Sage
- CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Québec, Québec G1J 1Z4, Canada; Faculté de médecine, Université Laval, 1050 Av. de la Médecine, Québec, Québec G1V 0A6, Canada; VITAM-Centre de recherche en santé durable, 2480 Chem. de la Canardière, Québec, Québec G1J 2G1, Canada.
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4
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Tabet S, Tinawi S, Frenette LC, Abouassaly M, de Guise E. Relationships between predisposing, precipitating, and perpetuating factors and executive functioning following mild traumatic brain injury. Brain Inj 2022; 36:1247-1257. [PMID: 36093900 DOI: 10.1080/02699052.2022.2120208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/14/2022]
Abstract
INTRODUCTION The aim of this study was to determine the sociodemographic and MTBI-related variables associated with executive functioning (EF). METHODS Based on the theoretical model of Hou and colleagues, data on predisposing (age, education, premorbid IQ), precipitating (post-traumatic amnesia, loss of consciousness, presence of frontal lesions, post-accident time to evaluation) and perpetuating (anxious and depressive affects and post-concussive symptoms) factors were retrospectively collected from the medical records of 172 patients with MTBI. EF data based on the 3 processes included in Miyake's prediction model (2000) (updating, cognitive flexibility and inhibition) were collected using respectively the Digit span task of the Weschler - 4th edition, the Trails A and B as well as the initiation time on the Tower of London- Drexel University. RESULTS Updating was significantly associated with education, premorbid IQ, age, anxiety, and depressive affect. Inhibition was associated with education and age. No variable was associated with cognitive flexibility. CONCLUSIONS Following a MTBI, clinicians should consider that level of education and pre-morbid IQ may "predispose" patients to higher EF performances. They should also measure level of anxiety and depressive affect knowing that these may "perpetuate" some EF impairments (specifically the updating process).
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Affiliation(s)
- Sabrina Tabet
- Department of Psychology, Université de Montréal, Quebec, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Quebec, Canada
| | - Simon Tinawi
- Traumatic brain injury program, McGill University Health Center, Quebec, Canada
| | - Lucie C Frenette
- Department of Psychology, Université de Montréal, Quebec, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Quebec, Canada
| | - Michel Abouassaly
- Traumatic brain injury program, McGill University Health Center, Quebec, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Quebec, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Quebec, Canada.,Research Institute-McGill University Health Center, Quebec, Canada
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5
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Alarie C, Gagnon I, de Guise E, McKerral M, Kersalé M, Hoog BVH, Swaine B. A Remotely Delivered Progressive Walking Intervention for Adults With Persistent Symptoms of a Mild Traumatic Brain Injury: Feasibility and Exploration of Its Impact. Front Rehabilit Sci 2022; 3:898804. [PMID: 36189010 PMCID: PMC9397951 DOI: 10.3389/fresc.2022.898804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022]
Abstract
Introduction Persistent post-concussion symptoms following a mild traumatic brain injury (mTBI) can impact function and participation of adults. Physical activity is recommended to reduce symptoms and foster return to normal activities. Adults with a mTBI may have personal factors or experience accessibility issues restricting physical activity. Walking is a physical activity accessible to most that could be delivered remotely. Objectives Determine the feasibility, safety, and acceptability of a remotely delivered progressive walking intervention designed for adults with persistent mTBI symptoms and explore its effects on health-related outcomes. Methodology This feasibility study using a single-group pre-post mixed methods convergent parallel design was conducted remotely. Adults aged 18–65 years with a mTBI reporting persistent symptoms for ≥3 months were recruited. The 8-week remote progressive walking intervention aimed to increase the weekly number of steps walked by 40% based on a 1-week baseline measured by a Fitbit Inspire 2 activity monitor. Feasibility measures were about the intervention, its remote delivery, safety, and acceptability. Health-related outcomes were post-concussion symptoms, kinesiophobia, mood, sleep, fatigue, and quality of life. Semi-structured exit interviews were recorded and transcribed verbatim. Quantitative and qualitative data were analyzed separately, and results merged, compared, and contrasted. Descriptive statistics and paired samples t-tests were used. The qualitative analyses followed an iterative content analysis approach using reflexivity and triangulation of sources. Results Twenty adults (16 women) aged 42.5 ± 11.51 years with persisting symptoms for 9.25 ± 6.43 months participated, adhered to 94.38% of sessions, completed the intervention, and found it to be feasible, safe and acceptable. Participants increased weekly total number of steps walked (change = 14,886 ± 18,283; t = 3.55, p = 0.002). Severity of post-concussion symptoms (change = −6.42 ± 10.69; t = −2.62, p = 0.018), kinesiophobia (change = −5 ± 6.86; t = 3.18, p = 0.005), anxiety (change = −1.53 ± 3.01; t = −2.21, p = 0.04), and fatigue (change = −10.21 ± 10.20; t = −4.37, p < 0.001) were reduced, whilst quality of life improved (change = 10.58 ± 13.35; t = 3.46, p = 0.003). Participants' perceptions corroborate most quantitative results; they felt improved self-efficacy about physical activity and provided five key recommendations. Discussion This study demonstrates the feasibility, safety, and acceptability of the remote 8-week progressive walking intervention, a promising approach to reduce persisting symptoms, improve physical activity level health-related outcomes and quality of life of adults with persistent post-concussion symptoms following a mTBI.
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Affiliation(s)
- Christophe Alarie
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Trauma Center and Pediatric Emergency Medicine, Montreal Children's Hospital, McGill University Health Center and Research Institute of the McGill University Health Center, Montréal, QC, Canada
| | - Elaine de Guise
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
- Département de Psychologie, Faculté des Arts et des Sciences, Université de Montréal, Montréal, QC, Canada
| | - Michelle McKerral
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
- Département de Psychologie, Faculté des Arts et des Sciences, Université de Montréal, Montréal, QC, Canada
| | - Marietta Kersalé
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
| | - Béatrice van het Hoog
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
| | - Bonnie Swaine
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
- *Correspondence: Bonnie Swaine
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6
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Santonen T, Petsani D, Julin M, Garschall M, Kropf J, Van der Auwera V, Bernaerts S, Losada R, Almeida R, Garatea J, Muñoz I, Nagy E, Kehayia E, de Guise E, Nadeau S, Azevedo N, Segkouli S, Lazarou I, Petronikolou V, Bamidis P, Konstantinidis E. Cocreating a Harmonized Living Lab for Big Data-Driven Hybrid Persona Development: Protocol for Cocreating, Testing, and Seeking Consensus. JMIR Res Protoc 2022; 11:e34567. [PMID: 34989697 PMCID: PMC8778542 DOI: 10.2196/34567] [Citation(s) in RCA: 2] [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] [Received: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background Living Labs are user-centered, open innovation ecosystems based on a systematic user cocreation approach, which integrates research and innovation processes in real-life communities and settings. The Horizon 2020 Project VITALISE (Virtual Health and Wellbeing Living Lab Infrastructure) unites 19 partners across 11 countries. The project aims to harmonize Living Lab procedures and enable effective and convenient transnational and virtual access to key European health and well-being research infrastructures, which are governed by Living Labs. The VITALISE consortium will conduct joint research activities in the fields included in the care pathway of patients: rehabilitation, transitional care, and everyday living environments for older adults. This protocol focuses on health and well-being research in everyday living environments. Objective The main aim of this study is to cocreate and test a harmonized research protocol for developing big data–driven hybrid persona, which are hypothetical user archetypes created to represent a user community. In addition, the use and applicability of innovative technologies will be investigated in the context of various everyday living and Living Lab environments. Methods In phase 1, surveys and structured interviews will be used to identify the most suitable Living Lab methods, tools, and instruments for health-related research among VITALISE project Living Labs (N=10). A series of web-based cocreation workshops and iterative cowriting processes will be applied to define the initial protocols. In phase 2, five small-scale case studies will be conducted to test the cocreated research protocols in various real-life everyday living settings and Living Lab infrastructures. In phase 3, a cross-case analysis grounded on semistructured interviews will be conducted to identify the challenges and benefits of using the proposed research protocols. Furthermore, a series of cocreation workshops and the consensus seeking Delphi study process will be conducted in parallel to cocreate and validate the acceptance of the defined harmonized research protocols among wider Living Lab communities. Results As of September 30, 2021, project deliverables Ethics and safety manual and Living lab standard version 1 have been submitted to the European Commission review process. The study will be finished by March 2024. Conclusions The outcome of this research will lead to harmonized procedures and protocols in the context of big data–driven hybrid persona development among health and well-being Living Labs in Europe and beyond. Harmonized protocols enable Living Labs to exploit similar research protocols, devices, hardware, and software for interventions and complex data collection purposes. Economies of scale and improved use of resources will speed up and improve research quality and offer novel possibilities for open data sharing, multidisciplinary research, and comparative studies beyond current practices. Case studies will also provide novel insights for implementing innovative technologies in the context of everyday Living Lab research. International Registered Report Identifier (IRRID) DERR1-10.2196/34567
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Affiliation(s)
- Teemu Santonen
- Department of Research, Development, Innovation and Business Development, Laurea University of Applied Sciences, Espoo, Finland
| | - Despoina Petsani
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessalonki, Greece
| | - Mikko Julin
- Department of Research, Development, Innovation and Business Development, Laurea University of Applied Sciences, Espoo, Finland
| | - Markus Garschall
- Center for Technology Experience, AIT Austrian Institute of Technology, Vienna, Austria
| | | | | | - Sylvie Bernaerts
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium.,Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Raquel Losada
- Fundación INTRAS, Research, Development and Innovation Projects Department, Spain, Valladolid, Spain
| | - Rosa Almeida
- Fundación INTRAS, Research, Development and Innovation Projects Department, Spain, Valladolid, Spain
| | - Jokin Garatea
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, Basque Country, Spain
| | - Idoia Muñoz
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, Basque Country, Spain
| | - Eniko Nagy
- Nagykovácsi Wellbeing Living Lab, Nagykovácsi, Hungary
| | - Eva Kehayia
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Elaine de Guise
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Sylvie Nadeau
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Nancy Azevedo
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Sofia Segkouli
- Centre for Research and Technology-Hellas (CERTH)/Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Ioulietta Lazarou
- Centre for Research and Technology-Hellas (CERTH)/Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Vasileia Petronikolou
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessalonki, Greece
| | - Panagiotis Bamidis
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessalonki, Greece
| | - Evdokimos Konstantinidis
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessalonki, Greece.,European Network of Living Labs, Brussels, Belgium
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7
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Bernaerts S, De Witte NAJ, Van der Auwera V, Bonroy B, Muraru L, Bamidis P, Frantzidis C, Kourtidou-Papadeli C, Azevedo N, Garatea J, Muñoz I, Almeida R, Losada R, Fung J, Kehayia E, Lamontagne A, de Guise E, Duclos C, Higgins J, Nadeau S, Beaudry L, Konstantinidis E. Rehabilitation supported by technology: Protocol for an international co-creation and user experience study (Preprint). JMIR Res Protoc 2021; 11:e34537. [PMID: 35266874 PMCID: PMC8949709 DOI: 10.2196/34537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background Living labs in the health and well-being domain have become increasingly common over the past decade but vary in available infrastructure, implemented study designs, and outcome measures. The Horizon 2020 Project Virtual Health and Wellbeing Living Lab Infrastructure aims to harmonize living lab procedures and open living lab infrastructures to facilitate and promote research activities in the health and well-being domain in Europe and beyond. This protocol will describe the design of a joint research activity, focusing on the use of innovative technology for both rehabilitation interventions and data collection in a rehabilitation context. Objective With this joint research activity, this study primarily aims to gain insight into each living lab’s infrastructure and procedures to harmonize health and well-being living lab procedures and infrastructures in Europe and beyond, particularly in the context of rehabilitation. Secondarily, this study aims to investigate the potential of innovative technologies for rehabilitation through living lab methodologies. Methods This study has a mixed methods design comprising multiple phases. There are two main phases of data collection: cocreation (phase 1) and small-scale pilot studies (phase 2), which are preceded by a preliminary harmonization of procedures among the different international living labs. An intermediate phase further allows the implementation of minor adjustments to the intervention or protocol depending on the input that was obtained in the cocreation phase. A total of 6 small-scale pilot studies using innovative technologies for intervention or data collection will be performed across 4 countries. The target study sample comprises patients with stroke and older adults with mild cognitive impairment. The third and final phases involve Delphi procedures to reach a consensus on harmonized procedures and protocols. Results Phase 1 data collection will begin in March 2022, and phase 2 data collection will begin in June 2022. Results will include the output of the cocreation sessions, small-scale pilot studies, and advice on harmonizing procedures and protocols for health and well-being living labs focusing on rehabilitation. Conclusions The knowledge gained by the execution of this research will lead to harmonized procedures and protocols in a rehabilitation context for health and well-being living labs in Europe and beyond. In addition to the harmonized procedures and protocols in rehabilitation, we will also be able to provide new insights for improving the implementation of innovative technologies in rehabilitation. International Registered Report Identifier (IRRID) PRR1-10.2196/34537
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Affiliation(s)
- Sylvie Bernaerts
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerpen, Belgium
| | - Nele A J De Witte
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerpen, Belgium
| | | | - Bert Bonroy
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Luiza Muraru
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Panagiotis Bamidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Frantzidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chrysoula Kourtidou-Papadeli
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Aerospace Medical Association and Space Research, Thessaloniki, Greece
| | - Nancy Azevedo
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Jokin Garatea
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, San Sebastian, Spain
| | - Idoia Muñoz
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, San Sebastian, Spain
| | - Rosa Almeida
- Fundación INTRAS, Research, Development and Innovation Department, Valladolid, Spain
| | - Raquel Losada
- Fundación INTRAS, Research, Development and Innovation Department, Valladolid, Spain
| | - Joyce Fung
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Eva Kehayia
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Anouk Lamontagne
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Elaine de Guise
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Cyril Duclos
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Johanne Higgins
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Sylvie Nadeau
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Lucie Beaudry
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Dance Department, Université du Québec à Montréal, Montreal, QC, Canada
| | - Evdokimos Konstantinidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- European Network of Living Labs, Brussels, Belgium
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8
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Anderson KS, Gosselin N, Sadikot AF, Laguë-Beauvais M, Kang ESH, Fogarty AE, Marcoux J, Dagher J, de Guise E. Pitch and Rhythm Perception and Verbal Short-Term Memory in Acute Traumatic Brain Injury. Brain Sci 2021; 11:1173. [PMID: 34573194 PMCID: PMC8469559 DOI: 10.3390/brainsci11091173] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022] Open
Abstract
Music perception deficits are common following acquired brain injury due to stroke, epilepsy surgeries, and aneurysmal clipping. Few studies have examined these deficits following traumatic brain injury (TBI), resulting in an under-diagnosis in this population. We aimed to (1) compare TBI patients to controls on pitch and rhythm perception during the acute phase; (2) determine whether pitch and rhythm perception disorders co-occur; (3) examine lateralization of injury in the context of pitch and rhythm perception; and (4) determine the relationship between verbal short-term memory (STM) and pitch and rhythm perception. Music perception was examined using the Scale and Rhythm tests of the Montreal Battery of Evaluation of Amusia, in association with CT scans to identify lesion laterality. Verbal short-term memory was examined using Digit Span Forward. TBI patients had greater impairment than controls, with 43% demonstrating deficits in pitch perception, and 40% in rhythm perception. Deficits were greater with right hemisphere damage than left. Pitch and rhythm deficits co-occurred 31% of the time, suggesting partly dissociable networks. There was a dissociation between performance on verbal STM and pitch and rhythm perception 39 to 42% of the time (respectively), with most individuals (92%) demonstrating intact verbal STM, with impaired pitch or rhythm perception. The clinical implications of music perception deficits following TBI are discussed.
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Affiliation(s)
- Kirsten S Anderson
- Psychology Department, University of Montreal, Montreal, QC H2V 2S9, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
- International Laboratory for Brain, Music and Sound Research (BRAMS), and Centre for Research on Brain, Language, and Music (CRBLM), Montreal, QC H2V2S9, Canada
| | - Nathalie Gosselin
- Psychology Department, University of Montreal, Montreal, QC H2V 2S9, Canada
- International Laboratory for Brain, Music and Sound Research (BRAMS), and Centre for Research on Brain, Language, and Music (CRBLM), Montreal, QC H2V2S9, Canada
| | - Abbas F Sadikot
- Neurology and Neurosurgery Department, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Maude Laguë-Beauvais
- Neurology and Neurosurgery Department, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Traumatic Brain Injury Program, McGill University Health Centre, Montreal, QC H3G 1A4, Canada
| | - Esther S H Kang
- Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Alexandra E Fogarty
- Department of Neurology, Division of Physical Medicine and Rehabilitation, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Judith Marcoux
- Neurology and Neurosurgery Department, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Traumatic Brain Injury Program, McGill University Health Centre, Montreal, QC H3G 1A4, Canada
| | - Jehane Dagher
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
- Traumatic Brain Injury Program, McGill University Health Centre, Montreal, QC H3G 1A4, Canada
| | - Elaine de Guise
- Psychology Department, University of Montreal, Montreal, QC H2V 2S9, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
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9
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Cisneros E, Beauséjour V, de Guise E, Belleville S, McKerral M. The impact of multimodal cognitive rehabilitation on executive functions in older adults with traumatic brain injury. Ann Phys Rehabil Med 2021; 64:101559. [PMID: 34303000 DOI: 10.1016/j.rehab.2021.101559] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study evaluated the impact of a 12-week, 24-session multimodal group cognitive rehabilitation intervention, the Cognitive Enrichment Program (CEP), on executive functioning and resumption of daily activities after traumatic brain injury (TBI) in older individuals as compared with an active control group that received individual holistic rehabilitation as usual care. METHODS In total, 37 patients with a TBI and aged 57 to 90 years were assigned to experimental (n = 23) and control (n = 14) groups in a semi-randomized, controlled, before-after intervention trial with follow-up at 6 months, with blinded outcome measurement. The CEP's executive function module included planning, problem solving, and goal management training as well as strategies focusing on self-awareness. Efficacy was evaluated by neuropsychological tests (Six Elements Task-Adapted [SET-A], D-KEFS Sorting test and Stroop four-color version); generalization was measured by self-reporting questionnaires about daily functioning (Dysexecutive Functioning Questionnaire, forsaken daily activities). RESULTS ANCOVA results showed significant group-by-time interactions; the experimental group showed a statistically significant improvement on Tackling the 6 subtasks and Avoiding rule-breaking measures of the SET-A, with medium effect sizes. The generalization measure, the Dysexecutive Functioning Questionnaire, showed a significant reduction in experimental patient-significant other difference on the Executive cognition subscale. The number of forsaken daily activities was reduced in the experimental versus control group, which was not significant immediately after the CEP but was significant 6 months later. CONCLUSIONS Our study shows that older adults with TBI can improve their executive functioning, with a positive impact on everyday activities, after receiving multimodal cognitive training with the CEP. ClinicalTrials.gov Identifier: NCT04590911.
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Affiliation(s)
- Eduardo Cisneros
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada.
| | - Véronique Beauséjour
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Elaine de Guise
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada; Research Institute of the Montreal University Hospital Centre, Montreal, QC, Canada
| | - Sylvie Belleville
- Department of Psychology, Université de Montréal, Montreal, QC, Canada; Research Centre of the Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Michelle McKerral
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada.
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10
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Cisneros E, de Guise E, Belleville S, McKerral M. A controlled clinical efficacy trial of multimodal cognitive rehabilitation on episodic memory functioning in older adults with traumatic brain injury. Ann Phys Rehabil Med 2021; 64:101563. [PMID: 34325040 DOI: 10.1016/j.rehab.2021.101563] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/28/2021] [Accepted: 05/14/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to evaluate the impact of a 12-week, 24-session multimodal group cognitive intervention, the Cognitive Enrichment Program (CEP), on episodic memory in older adults with traumatic brain injury (TBI) compared to an active control group that received usual care in the form of individual holistic rehabilitation. METHODS In total, 37 patients with a TBI who were 57 to 90 years old were assigned to experimental (n = 23) and control (n = 14) groups in a semi-randomized, controlled, before-after intervention trial with follow-up at 6 months, with blinded outcome measurement. The CEP's Memory module consisted of memory strategies to promote encoding. Efficacy was evaluated by using Face-name association, Word list recall, and Text memory measures, and generalization was assessed with the Self-Evaluation Memory Questionnaire (SEMQ), the Psychological General Well-Being Index, and a satisfaction questionnaire. RESULTS ANCOVA mixed model repeated-measures analysis revealed a strong group-by-time interaction, with the experimental group showing statistically significant improvement on the Face-name association test, with a large effect size. We also found a statistically significant group-by-time interaction on 3 dimensions of the SEMQ generalization measure: the experimental group showed increased memorization of the content of Conversations, reduced Slips of attention, and increased memory of Political and social events, with medium to large effect sizes. The group also showed clinically significant improvements in psychological well-being. Scores on the satisfaction questionnaire indicated a perceived positive impact on daily life habits requiring memory abilities. CONCLUSIONS The CEP is a promising cognitive rehabilitation program for older individuals with TBI, showing high satisfaction in participants, that could improve their episodic memory functioning as well as enhance their psychological well-being. ClinicalTrials.gov Identifier: NCT04590911.
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Affiliation(s)
- Eduardo Cisneros
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada.
| | - Elaine de Guise
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada; Research Institute of the Montreal University Hospital Centre, Montreal, QC, Canada
| | - Sylvie Belleville
- Department of Psychology, Université de Montréal, Montreal, QC, Canada; Research Centre of the Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Michelle McKerral
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Psychology, Université de Montréal, Montreal, QC, Canada.
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11
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Audrit H, Beauchamp MH, Tinawi S, Laguë-Beauvais M, Saluja R, de Guise E. Multidimensional Psychoeducative and Counseling Intervention (SAAM) for Symptomatic Patients With Mild Traumatic Brain Injury: A Pilot Randomized Controlled Trial. J Head Trauma Rehabil 2021; 36:E249-E261. [PMID: 33656475 DOI: 10.1097/htr.0000000000000653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/26/2022]
Abstract
OBJECTIVE To estimate feasibility and explore the treatment effect of a psychoeducative and counseling intervention program targeting 4 postconcussion symptoms (SAAM: Sleep/fatigue, Attention, Anxiety/mood, Memory). SETTING Level 1 trauma center. PARTICIPANTS Twenty-five patients with postconcussion symptoms enrolled 1 to 3 months post-accident. DESIGN Parallel-group (experimental and wait-list control), randomized controlled trial, with masked outcome assessment the week following the last intervention session. The Experimental group received the SAAM intervention (1 session/week during 4 weeks); care as usual was maintained for both groups. MAIN MEASURE Rivermead Post-concussion Symptoms Questionnaire (RPQ). SECONDARY MEASURES Hospital Anxiety and Depression Scale (HADS-A/-D); Pittsburgh Sleep Quality Index (PSQI); Multidimensional Fatigue Inventory (MFI); attention and memory neuropsychological battery; Community Integration Questionnaire (CIQ). TOLERABILITY MEASURE A 10-item satisfaction questionnaire for the experimental group. RESULTS 15.67% of the participants evaluated for eligibility were randomized and completed the evaluation at T0. High rates of satisfaction regarding the SAAM intervention were found in the experimental group (n = 10). One participant (experimental group) withdrew after T0. Exploratory results showed that the group × time interaction was not significant, but had a large effect size for the RPQ (P = .051, η2 = .16) and HADS-D (P = .052, η2 = 0.17), and a significant interaction was found with a large effect size for the PSQI (P = .017, η2 = .24) and MFI (P = .041, η2 = .18). Post-hoc analyses revealed a significant reduction of these variables post-intervention. No significant group × time interaction was observed for cognitive measures and CIQ. CONCLUSION The pilot study demonstrates the feasibility and tolerability of the SAAM intervention. Preliminary data suggest that SAAM intervention delivered post-acutely might reduce postconcussion symptoms, depression symptoms, fatigue, and sleep difficulties. A larger scale randomized control trial is warranted to confirm these promising results.
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Affiliation(s)
- Hélène Audrit
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada (Drs Beauchamp and de Guise and Ms Audrit); Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, Quebec, Canada (Dr de Guise and Ms Audrit); Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada (Dr Beauchamp); Traumatic Brain Injury Program, McGill University Health Centre, Montreal, Quebec, Canada (Drs Tinawi, Laguë-Beauvais, and Saluja); and Research Institute of McGill University Health Centre, Montreal, Quebec, Canada (Drs de Guise and Saluja)
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12
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LeBlanc J, Seresova A, Laberge-Poirier A, Tabet S, Alturki AY, Feyz M, de Guise E. Cognitive-communication performance following mild traumatic brain injury: Influence of sex, age, education, site of lesion and bilingualism. Int J Lang Commun Disord 2021; 56:130-144. [PMID: 33368845 DOI: 10.1111/1460-6984.12589] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/19/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although previous research studies have defined several prognostic factors that affect cognitive-communication performance in patients with all traumatic brain injury (TBI) severity, little is known about what variables are associated with cognitive-communication impairment in complicated mild TBI (mTBI) specifically. AIMS To determine which demographic and trauma-related factors are associated with cognitive-communication performance in the early recovery phase of acute care following a complicated mTBI. METHODS & PROCEDURES Demographic and accident-related data as well as the scores on cognitive-communication skill measures in the areas of auditory comprehension (complex ideational material subtest of the Boston Diagnostic Aphasia Examination), verbal reasoning (verbal absurdities subtest of the Detroit Test of Learning Aptitude), confrontation naming (short form of the Boston Naming Test), verbal fluency (semantic category and letter category naming), and conversational discourse (conversational checklist of the Protocole Montréal d'évaluation de la communication) were retrospectively collected from the medical records of 128 patients with complicated mTBI admitted to a tertiary care trauma hospital. Multiple linear regressions analyses were carried out on the variables sex, age, education level, Glasgow Coma Scale (GCS) score, lesion site and bilingualism. OUTCOMES & RESULTS Females performed better than males on letter-category naming, while those more advanced in age performed worse on most cognitive-communication measures. Patients with higher education achieved better confrontation and letter-category naming, whereas reading comprehension results were worse with a lower GCS score. Bilingual individuals presented more difficulty in conversational discourse skills than those who spoke only one language. In terms of site of lesion, the presence of a right frontal injury was associated with worse auditory and reading comprehension and an occipital lesion was related to worse confrontation naming. CONCLUSIONS & IMPLICATIONS Cognitive-communication skills should be evaluated early in all patients with complicated mTBI, but especially in those who are advanced in age, those with fewer years of education and those who present with lower GCS scores, in order to determine rehabilitation needs. The findings of this study will allow acute care clinicians to better understand how various demographic and injury-related factors affect cognitive-communication skills after complicated mTBI and to better nuance the interpretation of their evaluation results in order to improve clinical care. Further study is required regarding the influence of lesion location, sex and bilingualism following complicated mTBI. What this paper adds What is already known on the subject In early acute recovery studies including all severity of TBI, cognitive-communication performance was poorer in individuals with more advanced age, those with fewer years of education and with more severe TBI. It is not yet known which demographic and injury-related variables predict cognitive-communication performance after a complicated mTBI specifically. What this paper adds to existing knowledge We confirmed that age, level of education and TBI severity, as measured with the GCS score, were associated with some areas of cognitive-communication performance for a group of patients in the acute stage of recovery from a complicated mTBI. We also identified that sex, bilingualism and site of lesion were new variables that show an influence on aspects of cognitive-communication skills in this group of patients. What are the potential or actual clinical implications of this work? The findings of this study on prognostic factors in the case of complicated mTBI will help acute care clinicians to better understand evaluation results knowing the variables that can influence cognitive-communication performance and to nuance the interpretation of these results with the goal of determining rehabilitation needs and enhancing clinical care.
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Affiliation(s)
- Joanne LeBlanc
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, QC, Canada
| | - Alena Seresova
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, QC, Canada
| | | | - Sabrina Tabet
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Abdulrahman Y Alturki
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Adult Neurosurgery Department, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, QC, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, QC, Canada
- Research Institute, McGill University Health Center, Montreal, QC, Canada
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de Guise E, Degré C, Beaujean O, Julien J, Lague-Beauvais M, Dagher J, Marcoux J. Comparison of executive functions and functional outcome between older patients with traumatic brain injury and normal older controls. Applied Neuropsychology: Adult 2020; 29:1174-1187. [DOI: 10.1080/23279095.2020.1862118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Elaine de Guise
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Centre de Recherche Interdisciplinaire en Readaptation du Montreal Metropolitain, Montreal, Quebec, Canada
| | - Catherine Degré
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Océane Beaujean
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Jessica Julien
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Maude Lague-Beauvais
- Traumatic Brain Injury Program-McGill University Health Center, Montreal, Canada
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14
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Tabet S, LeBlanc J, Frenette LC, Seresova A, Laberge-Poirier A, Alturki AY, Marcoux J, Maleki M, de Guise E. Early reading comprehension and speed of reading impairments in individuals with uncomplicated and complicated mild traumatic brain injury. J Commun Disord 2020; 88:106047. [PMID: 33035943 DOI: 10.1016/j.jcomdis.2020.106047] [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] [Received: 10/09/2019] [Revised: 08/31/2020] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Several studies have investigated cognitive-communication disorders affecting oral expression skills following TBI but very few have dealt with reading comprehension abilities. The current study aims to measure reading comprehension and speed of reading in adults with uncomplicated and complicated mild traumatic brain injury (TBI) and to determine which demographic and TBI-related variables are predictive of their performance. METHOD The performances of three groups of participants were compared on the Chapman-Cook Speed of Reading Test (CCSRT). The CCSRT was administered in an acute care setting to 85 hospitalized participants with mild TBI showing traumatic cerebral lesions (complicated mild TBI), to 15 hospitalized participants with uncomplicated mild TBI (no cerebral lesions) and to 68 adults without TBI. Linear regression analyses were performed to determine which variables among sex, age, education, TBI severity (measured by the Glasgow Coma Scale score), speed of processing skills, and site of cerebral lesions significantly predicted CCSRT performances. RESULTS The control group showed a lower percentage of errors than both TBI groups. On the total score of the CCSRT, the uncomplicated and complicated TBI groups performed worse than the control group. Moreover, as age and speed of processing skills increased, and education decreased, the odds of having a lower score on the CCSRT increased. CONCLUSION These findings suggest that reading abilities are compromised after mild TBI. Furthermore, the CCSRT may be a useful bedside tool for clinicians who work with individuals with mild TBI.
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Affiliation(s)
- Sabrina Tabet
- Department of Psychology, Université de Montréal, 1700, Jacques-Tétreault, Laval, Qc, H7N 0B6, Laval, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), 6363, Hudson Road, Montreal, Qc, H3S 1M9, Montréal, Canada.
| | - Joanne LeBlanc
- Traumatic Brain Injury Program-McGill University Health Center, 1650 Cedar, Montréal, Qc, H3G 1A4, Montréal, Canada.
| | - Lucie C Frenette
- Department of Psychology, Université de Montréal, 1700, Jacques-Tétreault, Laval, Qc, H7N 0B6, Laval, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), 6363, Hudson Road, Montreal, Qc, H3S 1M9, Montréal, Canada.
| | - Alena Seresova
- Traumatic Brain Injury Program-McGill University Health Center, 1650 Cedar, Montréal, Qc, H3G 1A4, Montréal, Canada.
| | - Andréanne Laberge-Poirier
- Traumatic Brain Injury Program-McGill University Health Center, 1650 Cedar, Montréal, Qc, H3G 1A4, Montréal, Canada.
| | - Abdulrahman Yaqub Alturki
- Department of Neurology and Neurosurgery, McGill University, 1650 Avenue Cedar, Montréal, Qc, H3G 1A4, Montréal, Canada; Adult Neurosurgery Department, National Neurosciences Institute, King Fahad Medical City P.O. Box. 59046, Riyadh 11525, Saudi Arabia.
| | - Judith Marcoux
- Department of Neurology and Neurosurgery, McGill University, 1650 Avenue Cedar, Montréal, Qc, H3G 1A4, Montréal, Canada.
| | - Mohammed Maleki
- Department of Neurology and Neurosurgery, McGill University, 1650 Avenue Cedar, Montréal, Qc, H3G 1A4, Montréal, Canada.
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, 1700, Jacques-Tétreault, Laval, Qc, H7N 0B6, Laval, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), 6363, Hudson Road, Montreal, Qc, H3S 1M9, Montréal, Canada; Research Institute-McGill University Health Center, 2155, Guy street, Montreal, Qc, H3H 2R9, Montréal, Canada.
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15
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LeBlanc J, Seresova A, Laberge-Poirier A, Tabet S, Correa JA, Alturki AY, Feyz M, de Guise E. Cognitive-communication skills and acute outcome following mild traumatic brain injury. Brain Inj 2020; 34:1472-1479. [PMID: 32857623 DOI: 10.1080/02699052.2020.1802669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/23/2022]
Abstract
PURPOSE Little is known about cognitive-communication skills post mild traumatic brain injury (mTBI). We aimed to determine how performance on cognitive-communication measures in the acute recovery period relates to early outcome following complicated mTBI. METHOD Results of language and communication skill measures, demographic and accident-related data, length of stay (LOS), Glasgow Outcome Scale-Extended (GOSE) scores and discharge destinations were retrospectively gathered for 128 admitted patients with complicated mTBI. RESULTS More than half of the individuals required rehabilitation services post discharge from hospital with over a third needing in-patient rehabilitation. Patients with poorer skills in auditory comprehension, verbal reasoning, confrontation naming, verbal fluency and conversational discourse were more likely to require in-patient rehabilitation. Subjects with worse skills in naming, conversational discourse and letter-category verbal fluency had a greater chance of being referred to out-patient rehabilitation services. Thus patients with both auditory comprehension and oral expression deficits were more likely to require in-patient services whereas those who had oral expression deficits but no significant difficulty in auditory comprehension were more often referred to out-patient services. Also, worse conversational discourse skills and semantic-category naming ability were related to lower GOSE scores and the chance of a longer LOS was greater when letter-category naming was poorer. CONCLUSION The likelihood of individuals requiring rehabilitation services post mTBI was related to performance on several oral expression and auditory comprehension measures. It is therefore important to evaluate cognitive-communication skills early to determine rehabilitation needs.
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Affiliation(s)
- Joanne LeBlanc
- Traumatic Brain Injury Program, McGill University Health Center , Montreal, Canada
| | - Alena Seresova
- Traumatic Brain Injury Program, McGill University Health Center , Montreal, Canada
| | | | - Sabrina Tabet
- Department of Psychology, Université de Montréal , Montreal, Canada
| | - José A Correa
- Department of Mathematics and Statistics, McGill University , Montreal, Canada
| | - Abdulrahman Y Alturki
- Department of Neurology and Neurosurgery, McGill University , Montreal, Canada.,Adult Neurosurgery Department, National Neurosciences Institute, King Fahad Medical City , Riyadh, Saudi Arabia
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Center , Montreal, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal , Montreal, Canada.,Department of Neurology and Neurosurgery, McGill University , Montreal, 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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Audrit H, Beauchamp MH, Tinawi S, Laguë-Beauvais M, de Guise E. Development and description of SAAM intervention: A brief, multidimensional and psycho-educational intervention for adults with mild traumatic brain injury. Ann Phys Rehabil Med 2020; 64:101424. [PMID: 32771586 DOI: 10.1016/j.rehab.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/06/2020] [Accepted: 07/12/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Mild traumatic brain injury (mTBI) is associated with persistent post-concussive symptoms (PCSs) in approximately 15% of cases. These symptoms can be somatic (e.g., headache), cognitive (e.g., forgetfulness, poor attention and concentration capacities), emotional (e.g., anxiety, depression, irritability) and/or sleep-arousal complaints (e.g., fatigue, sleep problems). Although practice guidelines recommend early intervention to prevent and treat PCS, we still lack an effective, standardized, integrative, post-acute intervention based on a sound and validated theoretical model. OBJECTIVES The purpose of this article is to present the development and theoretical background underpinning a novel intervention for patients with PCSs in the post-acute phase after mTBI (1-3 months post-injury). PROCEDURE With a biopsychosocial approach (Hou et al., 2012) and best practice recommendations, we developed a novel multidimensional intervention targeting factors that perpetuate PCSs and that can be changed with the intervention. This individual-session intervention provides practical tools for managing PCSs and is designed to provide psycho-education and reassurance, reinforce individual objectives and promote a return to activities. Each session targets one category of PCSs: Sleep/fatigue, Attention, Anxiety/depressed mood, Memory/Organization (SAAM intervention). The rationale underlying the choices of format and content for the intervention is discussed, as are the associated strengths, limitations, opportunities and challenges. CONCLUSION This article could support researchers and clinicians to develop, replicate and/or implement interventions addressing current best practices in mTBI management.
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Affiliation(s)
- Hélène Audrit
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - Simon Tinawi
- McGill University Health Centre, Traumatic Brain Injury program, Montreal, Quebec, Canada
| | - Maude Laguë-Beauvais
- McGill University Health Centre, Traumatic Brain Injury program, Montreal, Quebec, Canada
| | - Elaine de Guise
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada; Research Institute of McGill University Health Centre, Montreal, Quebec, Canada.
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Lefebvre G, Guay S, Chamard E, Theaud G, de Guise E, Bacon BA, Descoteaux M, De Beaumont L, Théoret H. Diffusion Tensor Imaging in Contact and Non-Contact University-Level Sport Athletes. J Neurotrauma 2020; 38:529-537. [PMID: 32640880 DOI: 10.1089/neu.2020.7170] [Citation(s) in RCA: 4] [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: 01/16/2023] Open
Abstract
Subconcussive hits to the head and physical fitness both have been associated with alterations in white matter (WM) microstructure in partly overlapping areas of the brain. The aim of the present study was to determine whether WM damage associated with repeated exposure to subconcussive hits to the head in university level contact sports athletes is modulated by high levels of fitness. To this end, 72 students were recruited: 24 athletes practicing a varsity contact sport (A-CS), 24 athletes practicing a varsity non-contact sport (A-NCS), and 24 healthy non-athletes (NA). Participants underwent a magnetic resonance imaging session that included diffusion-weighted imaging. Between-groups, statistical analyses were performed with diffusion tensor imaging measures extracted by tractometry of sections of the corpus callosum and the corticospinal tract. Most significant effects were found in A-NCS who exhibited higher fractional anisotropy (FA) values than A-CS in almost all segments of the corpus callosum and in the corticospinal tract. The A-NCS also showed higher FA compared with NA in the anterior regions of the corpus callosum and the corticospinal tracts. No group difference was found between the A-CS and the NA groups. These data suggest that repeated subconcussive hits to the head lead to anisotropic changes in the WM that may counteract the beneficial effects associated with high levels of fitness.
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Affiliation(s)
- Geneviève Lefebvre
- Department of Psychology and Université de Montréal, Montréal, Québec, Canada
| | - Samuel Guay
- Department of Psychology and Université de Montréal, Montréal, Québec, Canada
| | - Emilie Chamard
- Department of Psychology and Université de Montréal, Montréal, Québec, Canada
| | - Guillaume Theaud
- Sherbrooke Connectivity Imaging Laboratory (SCIL), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Elaine de Guise
- Department of Psychology and Université de Montréal, Montréal, Québec, Canada
| | | | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Laboratory (SCIL), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis De Beaumont
- Department of Surgery, Université de Montréal, Montréal, Québec, Canada
| | - Hugo Théoret
- Department of Psychology and Université de Montréal, Montréal, Québec, Canada.,Research Center, CHU Sainte-Justine, Montréal, Québec, Canada
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Lecuyer Giguere F, Jobin B, Robert J, Bastien L, Giguère JF, De Beaumont L, de Guise E, Frasnelli J. Early parosmia signs and affective states predicts depression and anxiety symptoms six months after a mild Traumatic Brain Injury. Chem Senses 2020; 45:bjaa037. [PMID: 32516412 DOI: 10.1093/chemse/bjaa037] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Indexed: 02/28/2024] Open
Abstract
This longitudinal study aimed to evaluate qualitative (parosmia) and quantitative (hyposmia/anosmia) olfaction 2-4 weeks (baseline) and six months (follow-up) after a mild traumatic brain injury (mTBI). We further evaluated the predictive value of baseline depression, anxiety and olfaction scores on depression and anxiety at follow-up. At baseline, olfactory function and affective state were assessed in 107 participants (53 patients with mild TBI; 54 healthy controls). At follow-up, data were collected on 71 participants (32 patients, 39 controls). Both at baseline and follow-up, patients with mild TBI showed more signs of parosmia, depression and anxiety, compared to controls. However, patients did not, neither at baseline nor follow-up, show quantitative olfactory impairment. Moreover, while baseline scores of depression and anxiety helped predict the development of symptoms of depression and anxiety at follow up, adding parosmia scores to the prediction model significantly increased the amount of explained variances. Clinicians should implement affective and olfactory evaluation to predict patients' affective outcome.
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Affiliation(s)
- Fanny Lecuyer Giguere
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
| | - Benoit Jobin
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
| | - Joëlle Robert
- Department of Psychology, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Laurianne Bastien
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
| | | | - Louis De Beaumont
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
- Department of Surgery, University of Montréal, Montréal, Québec, Canada
| | - Elaine de Guise
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Québec, Canada
- Research Institute-McGill University Health Centre, Montreal, Quebec, Canada
| | - Johannes Frasnelli
- Department of Psychology, University of Montréal, Montréal, Québec, Canada
- Research Center, (CIUSSS-NIM), Montréal, Québec, Canada
- Department of Anatomy, University of Québec in Trois-Rivières (UQTR), Trois-Rivières, Québec, Canada
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19
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Masson M, Lamoureux J, de Guise E. Self-reported risk-taking and sensation-seeking behavior predict helmet wear amongst Canadian ski and snowboard instructors. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement 2020. [DOI: 10.1037/cbs0000153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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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Gauthier B, Dupont C, Gosselin N, de Guise E. Neuropsychology supervision: A survey of practices in Quebec and a cross-cultural comparison. Clin Neuropsychol 2020; 35:1232-1257. [DOI: 10.1080/13854046.2020.1732467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bruno Gauthier
- Department of Psychology, University of Montreal, Montreal, Canada
| | - Caroline Dupont
- Department of Psychology, University of Montreal, Montreal, Canada
| | | | - Elaine de Guise
- Department of Psychology, University of Montreal, Montreal, Canada
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21
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de Guise E, Higgins J, Kehayia E, Poldma T, Saj A, Beauchet O, Bastien T, Azevedo N, Nadeau S. Caractériser l’interaction environnement – personne lors d’une visite muséale : une étude de faisabilité de collectes de données multiples et ponctuelles de la mobilité dans l’espace public. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.10.153] [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] Open
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22
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Scotti P, Séguin C, Lo BWY, de Guise E, Troquet JM, Marcoux J. Antithrombotic agents and traumatic brain injury in the elderly population: hemorrhage patterns and outcomes. J Neurosurg 2019; 133:486-495. [PMID: 31277068 DOI: 10.3171/2019.4.jns19252] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/08/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Among the elderly, use of antithrombotics (ATs), antiplatelets (APs; aspirin, clopidogrel), and/or anticoagulants (ACs; warfarin, direct oral ACs [DOACs; dabigatran, rivaroxaban, apixaban]) to prevent thromboembolic events must be carefully weighed against the risk of intracranial hemorrhage (ICH) with trauma. The goal of this study was to assess the risk of sustaining a traumatic brain injury (TBI), ICH, and poorer outcomes in relation to AT use among all patients 65 years or older presenting to a single institution with head trauma. METHODS Data were collected from all head trauma patients 65 years or older presenting to the authors' supraregional tertiary trauma center over a 24-month period and included age, sex, injury mechanism, medical history, international normalized ratio, Glasgow Coma Scale (GCS) score, ICH presence and type, hospital admission, reversal therapy, surgery, discharge destination, Extended Glasgow Outcome Scale (GOSE) score at discharge, and mortality. RESULTS A total of 1365 head trauma patients 65 years or older were included; 724 were on AT therapy (413 on APs, 151 on ACs, 59 on DOACs, 48 on 2 APs, 38 on AP+AC, and 15 on AP+DOAC) and 641 were not. Among all head trauma patients, the risk of sustaining a TBI was associated with AP use after adjusting for covariates. Of the 731 TBI patients, those using ATs had higher rates of ICH (p <0.0001), functional dependency at discharge (GOSE score ≤ 4; p < 0.0001), and mortality (p < 0.0001). Elevated rates of ICH progression on follow-up CT scanning were observed in patients in the warfarin monotherapy (OR 5.30, p < 0.0001) and warfarin + AP (OR 6.15, p = 0.0011). Risk of mortality was not associated with single antiplatelet use but was notably high with 2 APs (OR 4.66, p = 0.0056), warfarin (OR 5.18, p = 0.0003), and DOAC use (OR 5.09, p = 0.0149). CONCLUSIONS Elderly trauma patients on ATs, especially combination therapy, are at elevated risk of ICH and poor outcomes compared with those not on AT therapy. While both AP and warfarin use alone and in combination were associated with significantly elevated odds of sustaining an ICH among TBI patients, only warfarin use was a predictor of hemorrhage progression on follow-up scans. The use of a single AP was not associated with mortality; however, the combination of both aspirin and clopidogrel was. Warfarin and DOAC users had comparable mortality rates; however, DOAC users had lower rates of ICH progression, and fewer survivors were functionally dependent at discharge than were warfarin users. DOACs are an overall safer alternative to warfarin for patients at high risk of falls.
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Affiliation(s)
| | | | | | - Elaine de Guise
- 3Department of Psychology, University of Montreal, Quebec, Canada
| | - Jean-Marc Troquet
- 4Emergency Medicine, McGill University Health Centre, Montreal, Quebec; and
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Auclair-Pilote J, Lalande D, Tinawi S, Feyz M, de Guise E. Satisfaction of basic psychological needs following a mild traumatic brain injury and relationships with post-concussion symptoms, anxiety, and depression. Disabil Rehabil 2019; 43:507-515. [PMID: 31230472 DOI: 10.1080/09638288.2019.1630858] [Citation(s) in RCA: 10] [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: 10/26/2022]
Abstract
PURPOSE Self-determination theory proposes that the satisfaction of basic psychological needs (competence, autonomy, and relatedness) is essential to psychological well-being. This study aims to explore the acute impact of a mild traumatic brain injury on the perception of need satisfaction as well as to better understand which variables among post-concussion symptoms and mood are associated with the satisfaction of these psychological needs. MATERIAL AND METHODS A total of 179 adults with mild traumatic brain injury were included. The Basic Psychological Needs Satisfaction Scale (BPNS) was completed retrospectively to assess need satisfaction pre-injury and after the injury to assess need satisfaction post-injury. The Rivermead Post Concussion Symptoms Questionnaire as well as the Hospital Anxiety and Depression Scale were also completed post injury. RESULTS A significant difference between the perception of need satisfaction pre- and post- was found on the total BPNS score, with lower scores on the post-injury evaluation (less satisfaction). Moreover, higher levels of depression and anxiety were associated with less satisfaction. CONCLUSIONS These results suggest that sustaining a mild traumatic brain injury may have a negative impact on the satisfaction of competence, autonomy, and relatedness needs. To conclude, it is recommended that these concepts be included in psychological intervention programs following mild traumatic brain injury.Implications for rehabilitationA significant decrease in psychological need satisfaction is highlighted following mild traumatic brain injury.It is recommended that the needs of autonomy, competence, and relatedness in intervention programs following mild traumatic brain injury needs to be addressed.The more mild traumatic brain injury patients are anxious and depressed the more likely it is that they will present a diminished satisfaction of needs, expressed by a lower level of perception of their autonomy, competence, and relatedness. Thus, integrative intervention for anxiety as well as depression following mild traumatic brain injury is also recommended.
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Affiliation(s)
- Jennyfer Auclair-Pilote
- Department of Psychology, Université de Montréal, Montréal, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Canada
| | - Daniel Lalande
- Department of Psychology, Université du Québec à Chicoutimi, Chicoutimi, Canada
| | - Simon Tinawi
- Traumatic Brain Injury Program, McGill University Health Center, Montréal, Canada
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Center, Montréal, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Montréal, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Canada.,Research Institute-McGill University Health Center, Montréal, Canada
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24
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L'Ecuyer-Giguère F, Greffou S, Tabet S, Frenette LC, Tinawi S, Feyz M, de Guise E. Visual memory performance following mild traumatic brain injury and its relationship with intellectual functioning. Appl Neuropsychol Adult 2019; 27:219-231. [PMID: 30646771 DOI: 10.1080/23279095.2018.1528263] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To compare the visual memory performance of uncomplicated and complicated mild TBI (mTBI) groups with that of a control group on the Rey Complex Figure Test (RCFT). We also aimed to explore the influence of factors such as age, gender, education, occupation, and intellectual functioning on visual memory in individuals with mTBI. The RCFT and the Wechsler Abbreviated Scale of Intelligence (WASI-II) were administered to 138 participants (90 uncomplicated mTBI patients, 19 complicated mTBI patients, and 29 controls). The mTBI patients demonstrated significantly lower scores than control participants on both immediate and delayed RCFT recall conditions, with performance in the low average and borderline range. However, there was no difference in performance between the two mTBI groups on the recall conditions. In addition, no significant differences were observed across the three groups on the recognition condition. The WASI-II Performance and Verbal IQ scales explained most of the variance in the immediate and delayed RCFT recall conditions but were not associated with performance on the recognition condition. In contrast with the recognition processes involved in visual memory, recall processes seem to be more vulnerable following mTBI and both verbal and performance IQ seem to be related to visual memory performance.
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Affiliation(s)
- Fanny L'Ecuyer-Giguère
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Centre de recherche interdisciplinaire en readaptation du Montreal metropolitain, Montreal, Quebec, Canada
| | - Selma Greffou
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Sabrina Tabet
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Centre de recherche interdisciplinaire en readaptation du Montreal metropolitain, Montreal, Quebec, Canada
| | - Lucie C Frenette
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Centre de recherche interdisciplinaire en readaptation du Montreal metropolitain, Montreal, Quebec, Canada
| | - Simon Tinawi
- McGill University Health Center-Montreal General Hospital, Montreal, Quebec, Canada
| | - Mitra Feyz
- McGill University Health Center-Montreal General Hospital, Montreal, Quebec, Canada
| | - Elaine de Guise
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Centre de recherche interdisciplinaire en readaptation du Montreal metropolitain, Montreal, Quebec, Canada.,Research Institute-McGill, University Health Center, Montreal, Quebec, Canada
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Gauthier S, LeBlanc J, Seresova A, Laberge-Poirier A, A Correa J, Alturki AY, Marcoux J, Maleki M, Feyz M, de Guise E. Acute prediction of outcome and cognitive-communication impairments following traumatic brain injury: The influence of age, education and site of lesion. J Commun Disord 2018; 73:77-90. [PMID: 29709658 DOI: 10.1016/j.jcomdis.2018.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 02/28/2018] [Accepted: 04/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Communication impairment following a traumatic brain injury (TBI) has been well documented, yet information regarding communication skills in the acute period following the injury is limited in the literature. Also, little is known about the influence of TBI severity (mild, moderate or severe) on cognitive-communication impairments and how these impairments are related to short-term functional outcome. The goal of this study was to assess the performance of adults with mild, moderate and severe TBI on different language tests and to determine how this performance is related to functional capacity. We also aimed to explore which variables among age, sex, education, TBI severity and site of cerebral damage would predict initial language impairments. METHODS Several language tests were administered to a sample of 145 adult patients with TBI of a range of severities admitted to an acute care service and to 113 healthy participants from the community. RESULTS TBI patients of a range of severities performed poorly on all language tests in comparison to the healthy controls. In addition, patients with mild TBI performed better than the moderate and severe groups, except on the reading test and on the semantic naming test. In addition, their performance on verbal fluency, conversational discourse and procedural discourse tasks predicted acute functional outcome. Finally, age, education and TBI severity and site of lesion predicted some language performance. A left temporal lesion was associated with poorer performance in conversational discourse and auditory comprehension tasks, a left frontal lesion with a decrease in the verbal fluency results and a right parietal lesion with decreased auditory comprehension and reasoning skills. CONCLUSION Health care professionals working in the acute care setting should be aware of the possible presence of cognitive-communication impairments in patients with TBI, even for those with mild TBI. These deficits can lead to functional communication problems and assistance may be required for tasks frequently encountered in acute care requiring intact comprehension and expression.
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Affiliation(s)
- Sandra Gauthier
- Department of Psychology, Université de Montréal, Montréal, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Canada
| | - Joanne LeBlanc
- Traumatic Brain Injury Program-McGill University Health Center, Montréal, Canada
| | - Alena Seresova
- Traumatic Brain Injury Program-McGill University Health Center, Montréal, Canada
| | | | - José A Correa
- Department of Mathematics and Statistics, McGill University, Montréal, Canada
| | - Abdulrahman Y Alturki
- Department of Neurology and Neurosurgery, McGill University, Montréal, Canada; Department of Neurosurgery, the National Neuroscience Institute, Riyadh, Saudi Arabia
| | - Judith Marcoux
- Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Mohammed Maleki
- Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Mitra Feyz
- Traumatic Brain Injury Program-McGill University Health Center, Montréal, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Montréal, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, Canada; Department of Neurosurgery, the National Neuroscience Institute, Riyadh, Saudi Arabia; Research Institute-McGill University Health Center, Montréal, Canada.
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Lefebvre G, Chamard E, Proulx S, Tremblay S, Halko M, Soman S, de Guise E, Pascual-Leone A, Théoret H. Increased Myo-Inositol in Primary Motor Cortex of Contact Sports Athletes without a History of Concussion. J Neurotrauma 2018; 35:953-962. [PMID: 29279021 DOI: 10.1089/neu.2017.5254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/14/2022] Open
Abstract
The objective of the study was to determine whether repetitive hits to the head at a subclinical level are associated with structural and functional brain abnormalities and whether these effects are influenced by high levels of fitness associated with intense physical activity. Seventy-two college students were recruited: 24 nonathletic, 24 athletes practicing a varsity contact sport, and 24 athletes practicing a varsity noncontact sport. They were recruited for a neuropsychological evaluation and a magnetic resonance imaging session that included magnetic resonance spectroscopy of primary motor cortex (M1) and prefrontal cortex and susceptibility-weighted imaging. There was no evidence for reduced cognitive performance or presence of micro bleeds in contact sports athletes. Abnormalities in contact sports athletes were found for myo-inositol concentration (mIns) in M1, where levels were significantly higher compared with noncontact sports athletes (p = 0.016) and nonathletes (p = 0.029). In prefrontal cortex, glutamate + glutamine (Glx) was significantly reduced in contact sports athletes compared with noncontact sports athletes (p = 0.016), and a similar reduction was observed for gamma-aminobutyric acid (GABA) levels (p = 0.005). Varsity contact sports are associated with area-specific alterations in mIns concentration in the primary motor cortex. In the prefrontal cortex, high levels of fitness could modulate the effects of head impact exposure on prefrontal metabolite concentration. Indeed, although athletes in contact and noncontact sports show different neurometabolic profiles, they do not differ from sedentary controls.
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Affiliation(s)
- Geneviève Lefebvre
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
| | - Emilie Chamard
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
| | | | - Sara Tremblay
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
| | - Mark Halko
- Division of Cognitive Neurology and Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Salil Soman
- Department of Radiology, Division of Neuroradiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Elaine de Guise
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
| | - Alvaro Pascual-Leone
- Division of Cognitive Neurology and Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Institut de Neurorrehabilitacion Guttmann, Universitat Autonoma, Barcelona, Spain
| | - Hugo Théoret
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
- Research Center, CHU Sainte-Justine, Montreal, Québec, Canada
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Rojas N, Laguë-Beauvais M, Belisle A, Lamoureux J, AlSideiri G, Marcoux J, Maleki M, Alturki AY, Anchouche S, Alquraini H, Feyz M, Guise ED. Frontal assessment battery (FAB) performance following traumatic brain injury hospitalized in an acute care setting. Applied Neuropsychology: Adult 2018; 26:319-330. [DOI: 10.1080/23279095.2017.1422506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Natalia Rojas
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
| | - Maude Laguë-Beauvais
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Arielle Belisle
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
| | - Julie Lamoureux
- Department of Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Ghusn AlSideiri
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Judith Marcoux
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Mohammed Maleki
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Abdulrahman Y. Alturki
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Sonia Anchouche
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Hanan Alquraini
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Center, Montreal, Quebec, Canada
| | - Elaine de Guise
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montreal, Quebec, Canada
- Research Institute, McGill University Health Center, Montreal, Quebec, Canada
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Mercier E, Tardif PA, Cameron PA, Émond M, Moore L, Mitra B, Ouellet MC, Frenette J, de Guise E, Le Sage N. Prognostic value of neuron-specific enolase (NSE) for prediction of post-concussion symptoms following a mild traumatic brain injury: a systematic review. Brain Inj 2017; 32:29-40. [PMID: 29157007 DOI: 10.1080/02699052.2017.1385097] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 02/06/2023]
Abstract
BACKGROUND This systematic review aimed to determine the prognostic value of neuron-specific enolase (NSE) to predict post-concussion symptoms following mild traumatic brain injury (TBI). METHODS Seven databases were searched for studies evaluating the association between NSE levels and post-concussion symptoms assessed ≥ 3 months (persistent) or ≥ 7 days < 3 months (early) after mild TBI. Two researchers independently screened studies for inclusion, extracted data and appraised quality using the Quality in Prognostic Studies (QUIPS) tool. RESULTS The search strategy yielded a total of 23,298 citations from which 8 cohorts presented in 10 studies were included. Studies included between 45 and 141 patients (total 608 patients). The outcomes most frequently assessed were post-concussion syndrome (PCS, 12 assessments) and neuropsychological performance deficits (10 assessments). No association was found between an elevated NSE serum level and PCS. Only one study reported a statistically significant association between a higher NSE serum level and alteration of at least three cognitive domains at 2 weeks but this association was no longer significant at 6 weeks. Overall, risk of bias of the included studies was considered moderate. CONCLUSIONS Early NSE serum level is not a strong independent predictor of post-concussion symptoms following mild TBI.
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Affiliation(s)
- Eric Mercier
- a Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , Canada.,b Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada.,c Emergency and Trauma Centre , The Alfred Hospital, Alfred Health , Melbourne , Australia.,d School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
| | - Pier-Alexandre Tardif
- b Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada
| | - Peter A Cameron
- c Emergency and Trauma Centre , The Alfred Hospital, Alfred Health , Melbourne , Australia.,d School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.,e National Trauma Research Institute , The Alfred Hospital , Melbourne , VIC , Australia
| | - Marcel Émond
- a Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , Canada.,b Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada.,f Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Vieillissement, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada
| | - Lynne Moore
- b Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada.,g Département de Médecine Sociale et Préventive, Faculté de Médecine , Université Laval , Québec , Canada
| | - Biswadev Mitra
- c Emergency and Trauma Centre , The Alfred Hospital, Alfred Health , Melbourne , Australia.,d School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.,e National Trauma Research Institute , The Alfred Hospital , Melbourne , VIC , Australia
| | - Marie-Christine Ouellet
- b Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada.,h Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS) , Québec , Québec , Canada
| | - Jérôme Frenette
- h Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS) , Québec , Québec , Canada
| | - Elaine de Guise
- i Research-Institute , McGill University Health Centre , Montreal , Québec , Canada.,j Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) , Montréal , Québec , Canada
| | - Natalie Le Sage
- a Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , Canada.,b Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec , Université Laval , Québec , Canada
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Julien J, Alsideiri G, Marcoux J, Hasen M, Correa JA, Feyz M, Maleki M, de Guise E. Antithrombotic agents intake prior to injury does not affect outcome after a traumatic brain injury in hospitalized elderly patients. J Clin Neurosci 2017; 38:122-125. [PMID: 28110930 DOI: 10.1016/j.jocn.2016.12.032] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The purpose of this study is to investigate the effect of risk factors including International Normalized Ratio (INR) as well as the Partial Thromboplastin Time (PTT) scores on several outcomes, including hospital length of stay (LOS) and The Extended Glasgow Outcome Scale (GOSE) following TBI in the elderly population. METHODS Data were retrospectively collected on patients (n=982) aged 65 and above who were admitted post TBI to the McGill University Health Centre-Montreal General Hospital from 2000 to 2011. Age, Injury Severity Score (ISS), Glasgow Coma Scale score (GCS), type of trauma (isolated TBI vs polytrauma including TBI), initial CT scan results according to the Marshall Classification and the INR and PTT scores and prescriptions of antiplatelet or anticoagulant agents (AP/AC) were collected. RESULTS Results also indicated that age, ISS and GSC score have an effect on the GOSE score. We also found that taking AC/AP has an effect on GOSE outcome, but that this effects depends on PTT, with lower odds of a worse outcome for those taking AC/AP agents as the PTT value goes up. However, this effect only becomes significant as the PTT value reaches 60 and above. CONCLUSION Age and injury severity rather than antithrombotic agent intake are associated with adverse acute outcome such as GOSE in hospitalized elderly TBI patients.
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Affiliation(s)
- Jessica Julien
- Department of Psychology, University of Montreal, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada
| | - Ghusn Alsideiri
- Montreal Neurological Institute & Hospital, McGill University, Canada
| | - Judith Marcoux
- Neurology and Neurosurgery Department, McGill University Health Centre, Canada
| | | | - José A Correa
- Department of Mathematics and Statistics, McGill University, Canada
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Centre, Canada
| | - Mohammed Maleki
- Neurology and Neurosurgery Department, McGill University Health Centre, Canada
| | - Elaine de Guise
- Department of Psychology, University of Montreal, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada; Research Institute-McGill University Health Center, Canada.
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de Guise E, Bélanger S, Tinawi S, Anderson K, LeBlanc J, Lamoureux J, Audrit H, Feyz M. Usefulness of the rivermead postconcussion symptoms questionnaire and the trail-making test for outcome prediction in patients with mild traumatic brain injury. Applied Neuropsychology: Adult 2015; 23:213-22. [DOI: 10.1080/23279095.2015.1038747] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Elaine de Guise
- Psychology Department, University of Montreal, Montreal, Quebec, Canada
- Neurology and Neurosurgery Department, McGill University, Montreal, Quebec, Canada
| | - Sara Bélanger
- Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital, Montreal, Quebec, Canada
| | - Simon Tinawi
- Rehabilitation Medicine Department, McGill University Health Centre-Montreal General Hospital, Montreal, Quebec, Canada
| | - Kirsten Anderson
- Psychology Department, University of Montreal, Montreal, Quebec, Canada
| | - Joanne LeBlanc
- Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital, Montreal, Quebec, Canada
| | - Julie Lamoureux
- Social and Preventive Medicine Department, University of Montreal, Montreal, Quebec, Canada
| | - Hélène Audrit
- Psychology Department, University of Montreal, Montreal, Quebec, Canada
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital, Montreal, Quebec, 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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de Guise E, LeBlanc J, Dagher J, Tinawi S, Lamoureux J, Marcoux J, Maleki M, Feyz M. Traumatic brain injury in the elderly: A level 1 trauma centre study. Brain Inj 2015; 29:558-64. [PMID: 25625679 DOI: 10.3109/02699052.2014.976593] [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
OBJECTIVE To explore the characteristics and outcome of patients with TBI over 65 years old admitted to an acute care Level 1 Trauma centre in Montreal, Canada. METHODS Data were retrospectively collected on patients (n = 1812) who were admitted post-TBI to the McGill University Health Centre-Montreal General Hospital from 2000-2011. The cohort was composed of four groups over 65 years old (65-75; 76-85; 86-95; and 96 and more). Outcome measures used were the extended Glasgow Outcome Scale (GOSE) as well as discharge destination. RESULTS As the patients got older, the odds of having a poor outcome increased (OR = 2.344 for those 75-85 years old, 4.313 for those 86-95 years of age and 3.465 for those aged 96 years of age or older). Also, the proportion of patients going home or going home with out-patient rehabilitation decreased as age increased (p = 0.001 and p < 0.001, respectively). In contrast, the proportion of patients being discharged to long-term care facilities increased significantly as age increased (p < 0.001). CONCLUSION This descriptive study provides a better understanding of characteristics and outcome of different age groups of patients with TBI all over 65 years old in Montreal, Canada.
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Affiliation(s)
- Elaine de Guise
- Neurology and Neurosurgery Department, McGill University Health Centre , Montreal, Quebec , Canada
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LeBlanc J, de Guise E, Champoux MC, Couturier C, Lamoureux J, Marcoux J, Maleki M, Feyz M. Acute evaluation of conversational discourse skills in traumatic brain injury. Int J Speech Lang Pathol 2014; 16:582-593. [PMID: 24447162 DOI: 10.3109/17549507.2013.871335] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 06/03/2023]
Abstract
This study looked at performance on the conversational discourse checklist of the Protocole Montréal d'évaluation de la communication (D-MEC) in 195 adults with TBI of all severity hospitalized in a Level 1 Trauma Centre. To explore validity, results were compared to findings on tests of memory, mental flexibility, confrontation naming, semantic and letter category naming, verbal reasoning, and to scores on the Montreal Cognitive Assessment. The relationship to outcome as measured with the Disability Rating Scale (DRS), the Extended Glasgow Outcome Scale (GOS-E), length of stay, and discharge destinations was also determined. Patients with severe TBI performed significantly worse than mild and moderate groups (χ(2)(KW2df) = 24.435, p = .0001). The total D-MEC score correlated significantly with all cognitive and language measures (p < .05). It also had a significant moderate correlation with the DRS total score (r = -.6090, p < .0001) and the GOS-E score (r = .539, p < .0001), indicating that better performance on conversational discourse was associated with a lower disability rating and better global outcome. Finally, the total D-MEC score was significantly different between the discharge destination groups (F(3,90) = 20.19, p < .0001). Thus, early identification of conversational discourse impairment in acute care post-TBI was possible with the D-MEC and could allow for early intervention in speech-language pathology.
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Affiliation(s)
- Joanne LeBlanc
- McGill University Health Centre-Montreal General Hospital , Montreal , Canada
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de Guise E, LeBlanc J, Dagher J, Tinawi S, Lamoureux J, Marcoux J, Maleki M, Feyz M. Characteristics of patients with acute traumatic brain injury discharged against medical advice in a Level 1 urban trauma centre. Brain Inj 2014; 28:1288-94. [DOI: 10.3109/02699052.2014.916820] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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LeBlanc J, de Guise E, Champoux MC, Couturier C, Lamoureux J, Marcoux J, Maleki M, Feyz M. Early conversational discourse abilities following traumatic brain injury: An acute predictive study. Brain Inj 2014; 28:951-8. [DOI: 10.3109/02699052.2014.888760] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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de Guise E, LeBlanc J, Champoux MC, Couturier C, Alturki AY, Lamoureux J, Desjardins M, Marcoux J, Maleki M, Feyz M. The mini-mental state examination and the montreal cognitive assessment after traumatic brain injury: An early predictive study. Brain Inj 2013; 27:1428-34. [DOI: 10.3109/02699052.2013.835867] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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de Guise E, Alturki AY, LeBlanc J, Champoux MC, Couturier C, Lamoureux J, Desjardins M, Marcoux J, Maleki M, Feyz M. The Montreal Cognitive Assessment in Persons with Traumatic Brain Injury. Applied Neuropsychology: Adult 2013; 21:128-35. [DOI: 10.1080/09084282.2013.778260] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Elaine de Guise
- a Traumatic Brain Injury Program and Neurosurgery Department , McGill University Health Centre-Montreal General Hospital, Montreal , Quebec , Canada
| | - Abdulrahman Yaqub Alturki
- b Neurosurgery Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
- c Neurology and Neurosurgery , The National Neuroscience Institute , Riyadh , Saudi Arabia
| | - Joanne LeBlanc
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Marie-Claude Champoux
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Céline Couturier
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Julie Lamoureux
- e Social and Preventive Medicine Department , University of Montreal , Montreal , Quebec , Canada
| | - Monique Desjardins
- f Psychiatry Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Judith Marcoux
- b Neurosurgery Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Mohammed Maleki
- b Neurosurgery Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Mitra Feyz
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , 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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Gosselin N, Chen JK, Bottari C, Petrides M, Jubault T, Tinawi S, de Guise E, Ptito A. The influence of pain on cerebral functioning after mild traumatic brain injury. J Neurotrauma 2012; 29:2625-34. [PMID: 23016544 DOI: 10.1089/neu.2012.2312] [Citation(s) in RCA: 14] [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: 11/13/2022] Open
Abstract
More than 75% of patients with mild traumatic brain injury (MTBI) report chronic pain whose potential detrimental effects on cognitive recovery need to be identified. The objective of this study was to investigate the relationship between pain, performance on a working memory task, gray matter density, and mid-dorsolateral prefrontal cortex (mid-DLPFC) activation in subjects with a MTBI. For comparison purposes, we performed identical correlation analyses with a group of subjects without MTBI who sustained sports injuries. Twenty-four subjects who experienced a MTBI in the past 12 months, 16 control subjects, and 29 subjects with sport injuries were included. One hour prior to entering the magnetic resonance scanner, the subjects were asked to fill out the pain Visual Analogue Scale. Subsequently, a high-resolution T1-weighted image was acquired followed by a functional magnetic resonance imaging session using the visual externally ordered working memory task. Results showed that MTBI subjects reporting severe pain in the hour preceding the testing had reduced mid-DLPFC activation during the working memory task and poorer performance on the task. Subjects with sport injuries and severe levels of pain showed the reverse pattern: pain was associated with higher activation in the mid-DLPFC and did not correlate with performance. Gray matter density measures were independent of pain level. This study showed that behavioral performance and cerebral functioning are affected by pain after a MTBI. Moreover, this study suggests that pain, cognition, and cerebral functioning interactions could not easily be generalized from one clinical population to another.
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Affiliation(s)
- Nadia Gosselin
- Cognitive Neuroscience Unit, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
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de Guise E, LeBlanc J, Abouassaly M, Lin H, Lamoureux J, Champoux MC, Couturier C, Maleki M, Roger EP, Feyz M. The Relationship between Acute Functional Status and Long-Term Ambulation after Severe Traumatic Brain Injury. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/534856] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective. To correlate long-term physical impairments of patients with severe traumatic brain injury (sTBI) based on their functional status in an acute care setting. Methods. 46 patients with sTBI participated in this prospective study. The Extended Glasgow Outcome Scale (GOSE) and the FIM instrument were rated at discharge from the acute care setting and at followup. The Functional Ambulation Classification (FAC), the Five-Meter Gait Speed, a quantified measure of negotiating stairs (Stair Climbing Speed and Rails used), and the functional reach test were rated at followup. Results. The subject with a score of 6 on the GOSE at discharge remained nonfunctional ambulator at followup. None of the subjects with a GOSE score of 5 became independent ambulators. Fifty percent of the subjects with a GOSE score of 4 were dependent ambulators. 100% of the subjects with a GOSE score of 2 or 3 at discharge were independent ambulators. A higher FIM score at discharge was associated with a greater chance of ambulating independently at 2 to 5 years after TBI (χKW22df). Conclusions. These data will allow physical health professionals in acute rehabilitation settings to provide more precise long-term physical outcome information to patients and families.
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Affiliation(s)
- Elaine de Guise
- Traumatic Brain Injury Program, McGill University Health Centre (Montreal General Hospital), Montreal, QC, Canada H3G 1A4
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada H3A 0G4
| | - Joanne LeBlanc
- Traumatic Brain Injury Program, McGill University Health Centre (Montreal General Hospital), Montreal, QC, Canada H3G 1A4
| | - Michel Abouassaly
- Traumatic Brain Injury Program, McGill University Health Centre (Montreal General Hospital), Montreal, QC, Canada H3G 1A4
| | - Howell Lin
- Traumatic Brain Injury Program, McGill University Health Centre (Montreal General Hospital), Montreal, QC, Canada H3G 1A4
| | - Julie Lamoureux
- Social and Preventive Medicine Department, University of Montreal, Montreal, QC, Canada H3C 3J7
| | - Marie-Claude Champoux
- Traumatic Brain Injury Program, McGill University Health Centre (Montreal General Hospital), Montreal, QC, Canada H3G 1A4
| | - Céline Couturier
- Traumatic Brain Injury Program, McGill University Health Centre (Montreal General Hospital), Montreal, QC, Canada H3G 1A4
| | - Mohammed Maleki
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada H3A 0G4
| | - Eric P. Roger
- Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, NY 14260-1660, USA
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Centre (Montreal General Hospital), Montreal, QC, Canada H3G 1A4
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LeBlanc J, de Guise E, Lamoureux J, Meyer K, Duplantie J, Thomas H, Abouassaly M, Champoux MC, Couturier C, Lin H, Lu L, Robinson C, Roger E, Maleki M, Feyz M. Criterion validity of a functional cognitive task in patients with severe traumatic brain injury. Brain Inj 2012; 26:1143-54. [PMID: 22630136 DOI: 10.3109/02699052.2012.666922] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To verify criterion validity of measures from a functional cognitive task (FCT) carried out with patients with severe traumatic brain injury (sTBI) at 2-5 years post-injury. METHODS AND PROCEDURES Forty-six patients with sTBI took part in a long-term outcome study where the FCT and the Neurobehavioural Rating Scale-Revised (NBRS-R) were administered and the FIM™ instrument was rated. The FCT is a telephone information gathering task for evaluating functional cognitive skills. RESULTS Ten of 16 measures of the FCT were significantly correlated with similar or related concepts from the NBRS-R. The FIM™ cognitive score and the individual items of this score were significantly correlated with 13 of the FCT measures and with the percentage of amount of information gathered. Internal consistency was good for 13 of 16 measures. Overall, patients generally had mild difficulty on the FCT concepts. CONCLUSION The FCT can be used with patients with sTBI to evaluate certain aspects of functional cognition. It has good criterion validity and internal consistency, but additional research is required to further measure reliability and its applicability to other severity of TBI and to other phases of recovery.
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Affiliation(s)
- Joanne LeBlanc
- McGill University Health Centre-Montreal General Hospital, Montreal, Québec, Canada.
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de Guise E, LeBlanc J, Tinawi S, Lamoureux J, Feyz M. Acute Relationship between Cognitive and Psychological Symptoms of Patients with Mild Traumatic Brain Injury. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/147285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective. The goal of this study was to explore the relationship between acute psychological reactions and cognition as well as postconcussive symptoms in patients with MTBI. Research Methods. Sociodemographic and medical history data were gathered for 59 patients diagnosed with MTBI. Validated and standardized tools were used to assess anxiety, depression, and cognitive function two weeks after trauma. Postconcussive symptoms were assessed with the Rivermead postconcussive questionnaire. Results. Despite the absence of significant neuropsychological deficits, a very high level of anxiety and depression was observed in our cohort. Level of anxiety and depression were positively related to cognitive performances and to postconcussive symptoms. Moreover, patients with preexisting alcohol and psychological problems were more likely to present with acute depression after MTBI. Conclusions. Early psychological rehabilitation should be provided to decrease the intensity and frequency of postconcussive symptoms and diminish the risk of these problems becoming chronic.
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Affiliation(s)
- Elaine de Guise
- Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital, Montreal, QC, Canada H3G 1A4
- Neurology and Neurosurgery Department, McGill University, Montreal, QC, Canada H3G 1A4
| | - Joanne LeBlanc
- Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital, Montreal, QC, Canada H3G 1A4
| | - Simon Tinawi
- Rehabilitation Medicine Department, McGill University Health Centre-Montreal General Hospital, Montreal, QC, Canada H3G 1A4
| | - Julie Lamoureux
- Social and Preventive Medicine Department, University of Montreal, Montreal, QC, Canada H3C 3J7
| | - Mitra Feyz
- Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital, Montreal, QC, Canada H3G 1A4
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de Guise E, Gosselin N, LeBlanc J, Champoux MC, Couturier C, Lamoureux J, Dagher J, Marcoux J, Maleki M, Feyz M. Clock Drawing and Mini-Mental State Examination in Patients with Traumatic Brain Injury. ACTA ACUST UNITED AC 2011; 18:179-90. [DOI: 10.1080/09084282.2011.595444] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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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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de Guise E, Lepage JF, Tinawi S, LeBlanc J, Dagher J, Lamoureux J, Feyz M. Comprehensive clinical picture of patients with complicated vs uncomplicated mild traumatic brain injury. Clin Neuropsychol 2010; 24:1113-30. [PMID: 20730678 DOI: 10.1080/13854046.2010.506199] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To compare the acute clinical profile of patients with uncomplicated vs complicated mild TBI (MTBI), socio-demographic and medical history variables were gathered for 176 patients diagnosed with MTBI and with (complicated, N = 45) or without (uncomplicated, N = 131) positive findings on cerebral imaging. Neurological examination, neuropsychological assessment and self-evaluation of post-concussive symptoms were done at 2 weeks post trauma. Patients with complicated MTBI were more likely to show auditory and vestibular system dysfunction. Surprisingly, the uncomplicated group reported more severe post-concussive symptoms than patients with positive CT scans. The groups showed no other difference in neurological, psychological, or cognitive outcome. A complete neurological examination should be done acutely in patients with MTBI to determine more specific follow-up required.
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Affiliation(s)
- Elaine de Guise
- Traumatic Brain Injury Program, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, Canada.
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LeBlanc J, de Guise E, Gosselin N, Feyz M. Comparison of functional outcome following acute care in young, middle-aged and elderly patients with traumatic brain injury. Brain Inj 2007; 20:779-90. [PMID: 17060145 DOI: 10.1080/02699050600831835] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [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: 10/24/2022]
Abstract
PRIMARY OBJECTIVE To compare functional physical and cognitive outcome of patients in three age groups with mild, moderate and severe traumatic brain injury (TBI) at discharge from acute care. RESEARCH DESIGN Retrospective database review. METHODS AND PROCEDURES Scores on the Extended Glasgow Outcome Scale (GOSE) and on the FIM instrument,1 discharge destination and length-of-stay (LOS) were gathered and compared for 2327 patients with TBI admitted to a level 1 trauma hospital from 1997-2003 divided into three age groups; 971 patients between 18-39 years, 672 between 40-59 years and 684 aged 60-99 years. MAIN OUTCOMES AND RESULTS Relative to younger adults with similar TBI severity, elderly patients showed worse outcome on the GOSE and FIM instrument (physical and cognitive ratings) and longer LOS. No difference was observed between the young and middle-aged groups except for cognitive FIM ratings and LOS for severe TBI. A higher percentage of elderly patients went to in-patient rehabilitation, to long-term care facilities or died compared to young and middle-aged patients. A higher number of young and middle-aged patients were discharged home. CONCLUSIONS Further development of services in early rehabilitation as well as post-rehabilitation geared to the specific needs of the elderly patient with TBI is required as the population ages.
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Affiliation(s)
- Joanne LeBlanc
- Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital, Montreal, Québec, Canada.
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Abstract
OBJECTIVE To compute outcome probabilities for persons with traumatic brain injury at discharge from acute care. PARTICIPANTS Three hundred thirty-nine patients with traumatic brain injury (239 mild, 48 moderate, 52 severe). SETTING Level I trauma center. MAIN MEASURES Predictor variables considered were age, education, Glasgow Coma Scale score, duration of posttraumatic amnesia, cerebral imaging results, and need for neurosurgical intervention. Outcome measures were Extended Glasgow Outcome Scale and discharge destination. RESULTS Logistic regressions showed that a shorter posttraumatic amnesia decreased the probability of moderate to severe disability. Moreover, discharge home was less probable for patients with positive cerebral imaging. CONCLUSION This model can help predict rehabilitation needs upon discharge from an acute care hospital.
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Affiliation(s)
- Elaine de Guise
- McGill University Health Centre - Montreal General, Montreal, Quebec, Canada.
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Abstract
OBJECTIVE The goal of this study was to provide a general descriptive and cognitive portrait of a population with traumatic brain injury (TBI) at the time of their acute care stay. MATERIAL AND METHODS Three hundred and forty-eight TBI patients were assessed. The following data were collected for each patient: age, level of education, duration of post-traumatic amnesia, Galveston Orientation Amnesia Test score, Glasgow Coma Scale score, results of cerebral imaging, Neurobehavioral Rating Scale score, the Functional Independence Measure cognitive score and the Glasgow Outcome Scale score. RESULTS The clinical profile of the population revealed a mean age of 40.2 (+/-18.7) and a mean of 11.5 (+/-3.6) years of education. Most patients presented with frontal (57.6%) and temporal (40%) lesions. Sixty-two percent had post-traumatic amnesia of less than 24 hours. Seventy percent presented with mild TBI, 14% with moderate and 15% with severe TBI. The cognitive deficits most frequently observed on the Neurobehavioral Rating Scale were in the areas of attention, memory and mental flexibility as well as slowness and mental fatigability. Most patients had good cognitive outcome on the Functional Independence Measure and scores of 2 and 3 were frequent on the GOS. Forty-five percent of the patients returned home after discharge, 51.7% were referred to in or out patient rehabilitation and 3.2% were transferred to long-term care facilities. CONCLUSION Because of the specialized mandate of acute care institutions, the information provided here concerning characteristics of our TBI population is essential for more efficient decision-making and planning/programming with regards to care and service delivery.
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Affiliation(s)
- Elaine de Guise
- Traumatic Brain Injury Program, McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada
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Hernandez MT, Sauerwein HC, Jambaqué I, de Guise E, Lussier F, Lortie A, Dulac O, Lassonde M. Attention, memory, and behavioral adjustment in children with frontal lobe epilepsy. Epilepsy Behav 2003; 4:522-36. [PMID: 14527495 DOI: 10.1016/j.yebeh.2003.07.014] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To explore whether attention, memory, and behavior would be more affected in children with frontal lobe epilepsy than in children with other types of epilepsy, we compared 16 children with frontal lobe epilepsy (FLE), 8 with temporal lobe epilepsy (TLE), and 8 with generalized absence (GEA) seizures on the Performance Speed (PS) and Freedom of Distraction (FD) indices of the WISC-III, the Continuous Performance Test (CPT), the California Verbal Learning Test (CVLT), and Rey-Osterrieth Complex Figure (ROCF). Parents completed Achenbach's Child Behavior Check List. Children with FLE scored significantly lower than the other two groups on the PS and CPT. On the CVLT they made more intrusion errors and were more prone to interference. Furthermore, they had more difficulties copying and recalling the ROCF. Behavior profiles revealed greater attention problems in this group. This may put children with FLE at greater risk of developing school problems than children with TLE and GEA.
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Affiliation(s)
- Maria-Teresa Hernandez
- Groupe de Recherche en Neuropsychologie Expérimentale et Cognition, Département de Psychologie, Université de Montréal, CP 6128, Succ Centre-Ville, Qué, H3C 3J7, Montréal, Canada
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