Profiles of Executive Function Across Children with Distinct Brain Disorders: Traumatic Brain Injury, Stroke, and Brain Tumor

2017 ◽  
Vol 23 (7) ◽  
pp. 529-538 ◽  
Author(s):  
Gabriel C. Araujo ◽  
Tanya N. Antonini ◽  
Vicki Anderson ◽  
Kathryn A. Vannatta ◽  
Christina G. Salley ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Tumor ◽  
Executive Function ◽  
Brain Injury ◽  
Executive Functions ◽  
Control Group ◽  
Medical Illness ◽  
Brain Disorders ◽  
Brain Disorder ◽  
Orthopedic Injury

AbstractObjectives:This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder.Methods:Participants were children with traumatic brain injury (N=82; 8–13 years of age), arterial ischemic stroke (N=36; 6–16 years of age), and brain tumor (N=74; 9–18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children’s Version (TEA-Ch) subtests: Creature Counting, Walk-Don’t-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age.Results:As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups.Conclusions:Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017,23, 529–538)

scholarly journals Executive Function Training in Chronic Traumatic Brain Injury Patients: Study Protocol

2019 ◽  
Author(s):  
Daniel Krawczyk ◽  
Kihwan Han ◽  
David Martinez ◽  
Jelena Rakic ◽  
Matthew Kmiecik ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Executive Function ◽  
Brain Injury ◽  
Executive Functions ◽  
Inhibitory Control ◽  
Cognitive Rehabilitation ◽  
Daily Life ◽  
Chronic Phase ◽  
Post Injury

Abstract Background: Some individuals who sustain traumatic brain injuries (TBIs) continue to experience significant cognitive impairments chronically (months-to-years post-injury). Many tests of executive function are insensitive to these executive function impairments, as such impairments may only appear during complex daily life conditions. Daily life often requires us to divide our attention and focus on abstract goals. In the current study, we compare the effects of two one-month electronic cognitive rehabilitation programs for individuals with chronic TBI. The active program (Expedition: Strategic Advantage) focuses on improving goal-directed executive functions including working memory, planning, long-term memory, and inhibitory control by challenging participants to accomplish life-like cognitive simulations. The challenge level of the simulations increase in accordance with participant achievement. The control intervention (Expedition: Informational Advantage) is identical to the active; however, the cognitive demand level is capped preventing participants from advancing beyond a set level. We will evaluate these interventions with a military veteran TBI population. Methods: One hundred individuals will be enrolled in this double-blinded clinical trial (all participants and testers are blinded to condition). Each individual will be randomly assigned to one of two interventions. The primary anticipated outcomes are improvement of daily life cognitive function skills and daily life functions. These are measured by a daily life performance task, which tests cognitive skills, and a survey that evaluates daily life functions. Secondary outcomes are also predicted to include improvements in working memory, attention, planning, and inhibitory control as measured by a neuropsychological test battery. Lastly, neuroimaging measures will be used to evaluate changes in brain networks supporting cognition pre-intervention and post-intervention. Discussion: We will test whether electronically delivered cognitive rehabilitation aimed at improving daily life functional skills will provide cognitive and daily life functional improvements for individuals in the chronic phase of TBI recovery (greater than three months post-injury). We aim to better understand the cognitive processes involved in recovery and the characteristics of individuals most likely to benefit. This study will also address the potential to observe generalizability, or transfer, from a software-based cognitive training tool toward daily life improvement. Trial Registration: ClinicalTrials.gov Identifier: NCT03704116 (retrospectively registered) https://clinicaltrials.gov/ct2/show/NCT03704116?term=tbi+krawczyk&rank=1 Keywords: Cognitive rehabilitation, traumatic brain injury, executive functions, daily life functions, memory, attention, planning. Support: Joint Warfighter Program; U. S. Dept. of Defense W81XWH-16-1-0053

Decision Making after Traumatic Brain Injury: A Temporal Discounting Paradigm

2013 ◽  
Vol 19 (2) ◽  
pp. 181-188 ◽  
Author(s):  
Rodger Ll. Wood ◽  
Louise McHugh
Keyword(s):  
Traumatic Brain Injury ◽  
Decision Making ◽  
Executive Function ◽  
Brain Injury ◽  
Temporal Discounting ◽  
Monetary Reward ◽  
Control Group ◽  
Neuropsychological Measures ◽  
And Gender ◽  
The Impact

AbstractA temporal discounting paradigm was used to examine decision making for hypothetical monetary reward following traumatic brain injury (TBI). A case-control design compared individuals following moderate or severe TBI with a healthy control group matched for age and gender. The impact of intelligence, impulsivity, and mood on temporal discounting performance was examined. A within-subjects design for the TBI group determined the influence of a range of neuropsychological tests on temporal discounting performance. Both patients and controls demonstrated temporal discounting. However, the TBI group discounted more than controls, suggesting that their decision making was more impulsive, consistent with ratings on the impulsiveness questionnaire. Discounting performance was independent of neuropsychological measures of intelligence, memory, and executive function. There was no relationship between temporal discounting and ratings of everyday executive function made by patients' relatives. Low mood did not account for discounting performance. The results of this study suggest that temporal discounting may be a useful neuropsychological paradigm to assess decision making linked to monetary reward following TBI. Performance was relatively independent of intelligence, memory and standard tests of executive ability and may therefore assist when assessing a patient's mental capacity to manage their financial affairs. (JINS, 2013,19, 1–8)

scholarly journals The Effect of Non-Invasive Brain Stimulation (NIBS) on Executive Functioning, Attention and Memory in Rehabilitation Patients with Traumatic Brain Injury: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 627
Author(s):  
Takatoshi Hara ◽  
Aturan Shanmugalingam ◽  
Amanda McIntyre ◽  
Amer M. Burhan
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Brain Injury ◽  
Brain Stimulation ◽  
Control Group ◽  
Attention And Memory ◽  
Stimulation Site ◽  
Non Invasive

In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with traumatic brain injury (TBI). However, there is no systematic NIBS review of TBI cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study was to conduct a systematic review examining the effectiveness and safety of NIBS for cognitive impairment after a TBI. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). All English articles from the following databases were searched from inception up to 31 December 2020: Pubmed/MEDLINE, Scopus, CINAHL, Embase, PsycINFO and CENTRAL. Randomized and prospective controlled trials, including cross-over studies, were included for analysis. Studies with at least five individuals with TBI, whereby at least five sessions of NIBS were provided and used standardized neuropsychological measurement of cognition, were included. A total of five studies met eligibility criteria. Two studies used repetitive transcranial magnetic stimulation (rTMS) and three studies used transcranial direct current stimulation (tDCS). The pooled sample size was 44 individuals for rTMS and 91 for tDCS. Three of five studies combined cognitive training or additional therapy (computer assisted) with NIBS. Regarding rTMS, target symptoms included attention (n = 2), memory (n = 1), and executive function (n = 2); only one study showing significant improvement compared than control group with respect to attention. In tDCS studies, target symptoms included cognition (n = 2), attention (n = 3), memory (n = 3), working memory (WM) (n = 3), and executive function (n = 1); two of three studies showed significant improvement compared to the control group with respect to attention and memory. The evidence for NIBS effectiveness in rehabilitation of cognitive function in TBI is still in its infancy, more studies are needed. In all studies, dorsolateral prefrontal cortex (DLPFC) was selected as the stimulation site, along with the stimulation pattern promoting the activation of the left DLPFC. In some studies, there was a significant improvement compared to the control group, but neither rTMS nor tDCS had sufficient evidence of effectiveness. To the establishment of evidence we need the evaluation of brain activity at the stimulation site and related areas using neuroimaging on how NIBS acts on the neural network.

scholarly journals Remotely delivered environmental enrichment intervention for traumatic brain injury: Study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e039767
Author(s):  
Zorry Belchev ◽  
Mary Ellene Boulos ◽  
Julia Rybkina ◽  
Kadeen Johns ◽  
Eliyas Jeffay ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Active Control ◽  
Environmental Enrichment ◽  
Spatial Navigation ◽  
Controlled Trial ◽  
Control Group ◽  
Hippocampal Atrophy ◽  
Active Control Group ◽  
Navigation Group

IntroductionIndividuals with moderate-severe traumatic brain injury (m-sTBI) experience progressive brain and behavioural declines in the chronic stages of injury. Longitudinal studies found that a majority of patients with m-sTBI exhibit significant hippocampal atrophy from 5 to 12 months post-injury, associated with decreased cognitive environmental enrichment (EE). Encouragingly, engaging in EE has been shown to lead to neural improvements, suggesting it is a promising avenue for offsetting hippocampal neurodegeneration in m-sTBI. Allocentric spatial navigation (ie, flexible, bird’s eye view approach), is a good candidate for EE in m-sTBI because it is associated with hippocampal activation and reduced ageing-related volume loss. Efficacy of EE requires intensive daily training, prohibitive within most current health delivery systems. The present protocol is a novel, remotely delivered and self-administered intervention designed to harness principles from EE and allocentric spatial navigation to offset hippocampal atrophy and potentially improve hippocampal functions such as navigation and memory for patients with m-sTBI.Methods and analysisEighty-four participants with chronic m-sTBI are being recruited from an urban rehabilitation hospital and randomised into a 16-week intervention (5 hours/week; total: 80 hours) of either targeted spatial navigation or an active control group. The spatial navigation group engages in structured exploration of different cities using Google Street View that includes daily navigation challenges. The active control group watches and answers subjective questions about educational videos. Following a brief orientation, participants remotely self-administer the intervention on their home computer. In addition to feasibility and compliance measures, clinical and experimental cognitive measures as well as MRI scan data are collected pre-intervention and post-intervention to determine behavioural and neural efficacy.Ethics and disseminationEthics approval has been obtained from ethics boards at the University Health Network and University of Toronto. Findings will be presented at academic conferences and submitted to peer-reviewed journals.Trial registration numberVersion 3, ClinicalTrials.gov Registry (NCT04331392).

scholarly journals Study of the Interaction between Executive Function and Adaptive Behavior at School in Girls with Fragile X Syndrome

Genes ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1108
Author(s):  
Lorena Joga-Elvira ◽  
Jennifer Martinez-Olmo ◽  
María-Luisa Joga ◽  
Carlos Jacas ◽  
Ana Roche-Martínez ◽  
...  
Keyword(s):  
Executive Function ◽  
Executive Functions ◽  
Fragile X Syndrome ◽  
Adaptive Behavior ◽  
Neuropsychological Tests ◽  
Rating Scale ◽  
Fragile X ◽  
School Setting ◽  
Control Group ◽  
The Relationship

The aim of this research is to analyze the relationship between executive functions and adaptive behavior in girls with Fragile X syndrome (FXS) in the school setting. This study is part of a larger investigation conducted at the Hospital Parc Tauli in Sabadell. The sample consists of a total of 40 girls (26 with FXS and 14 control) aged 7–16 years, who were administered different neuropsychological tests (WISC-V, NEPSY-II, WCST, TOL) and questionnaires answered by teachers (ABAS-II, BRIEF 2, ADHD Rating Scale). The results show that there is a greater interaction between some areas of executive function (cognitive flexibility, auditory attention, and visual abstraction capacity) and certain areas of adaptive behavior (conceptual, practical, social, and total domains) in the FXS group than in the control group. These results suggest that an alteration in the executive functions was affecting the daily functioning of the girls with FXS to a greater extent.

Self-Rated Executive Functions in Mild Traumatic Brain Injury

2021 ◽  
Author(s):  
Mirjana Ivanisevic ◽  
Janelle Eloi ◽  
Robert M. Roth ◽  
Fadi M. Tayim ◽  
Laura A. Flashman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Executive Functions ◽  
Mild Traumatic Brain Injury

scholarly journals Endothelin ETB Receptor-Mediated Astrocytic Activation: Pathological Roles in Brain Disorders

2021 ◽  
Vol 22 (9) ◽  
pp. 4333
Author(s):  
Yutaka Koyama
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neurotrophic Factors ◽  
Drug Target ◽  
Therapeutic Strategy ◽  
Reactive Astrocytes ◽  
Brain Disorders ◽  
Etb Receptor ◽  
Target Molecules ◽  
Endothelin B

In brain disorders, reactive astrocytes, which are characterized by hypertrophy of the cell body and proliferative properties, are commonly observed. As reactive astrocytes are involved in the pathogenesis of several brain disorders, the control of astrocytic function has been proposed as a therapeutic strategy, and target molecules to effectively control astrocytic functions have been investigated. The production of brain endothelin-1 (ET-1), which increases in brain disorders, is involved in the pathophysiological response of the nervous system. Endothelin B (ETB) receptors are highly expressed in reactive astrocytes and are upregulated by brain injury. Activation of astrocyte ETB receptors promotes the induction of reactive astrocytes. In addition, the production of various astrocyte-derived factors, including neurotrophic factors and vascular permeability regulators, is regulated by ETB receptors. In animal models of Alzheimer’s disease, brain ischemia, neuropathic pain, and traumatic brain injury, ETB-receptor-mediated regulation of astrocytic activation has been reported to improve brain disorders. Therefore, the astrocytic ETB receptor is expected to be a promising drug target to improve several brain disorders. This article reviews the roles of ETB receptors in astrocytic activation and discusses its possible applications in the treatment of brain disorders.

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