Effects of Systematic Categorization Training on Cognitive Performance in Healthy Older Adults and in Adults with Traumatic Brain Injury

This study investigated the effects of hierarchical cognitive training using the categorization program (CP), designed initially for adults with cognitive deficits associated with traumatic brain injury (TBI). Fifty-eight participants were included: a group of fifteen young adults with TBI (ages 18-48), another group of fifteen noninjured young adults (ages 18-50), and two groups of adults over 60 randomly assigned into the experimental group (n=14) or the control group (n=14). Following neuropsychological testing, the two young adult groups and the experimental older adult group received the CP training for 10-12 weeks. The CP training consisted of 8 levels targeting concept formation, object categorization, and decision-making abilities. Two CP tests (administered before and after the training) and three probe tasks (administered at specified intervals during the training) assessed skills relating to categorization. All treated groups showed significant improvement in their categorization performance, although younger participants (with or without TBI) demonstrated greater gains. Gains on the categorization measures were maintained by a subgroup of older adults up to four months posttraining. Implications of these findings in terms of adult cognitive learning and directions for future research on adult cognitive rehabilitation and cognitive stimulation programs are discussed.

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The Neuropsychology of Traumatic Brain Injury: Looking Back, Peering Ahead

Journal of the International Neuropsychological Society ◽

10.1017/s1355617717000686 ◽

2017 ◽

Vol 23 (9-10) ◽

pp. 806-817 ◽

Cited By ~ 8

Author(s):

Keith Owen Yeates ◽

Harvey S. Levin ◽

Jennie Ponsford

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Rehabilitation ◽

Neuropsychological Testing ◽

Critical Role ◽

Future Research ◽

Common Data Elements ◽

The Past ◽

Data Elements

AbstractThe past 50 years have been a period of exciting progress in neuropsychological research on traumatic brain injury (TBI). Neuropsychologists and neuropsychological testing have played a critical role in these advances. This study looks back at three major scientific advances in research on TBI that have been critical in pushing the field forward over the past several decades: The advent of modern neuroimaging; the recognition of the importance of non-injury factors in determining recovery from TBI; and the growth of cognitive rehabilitation. Thanks to these advances, we now have a better understanding of the pathophysiology of TBI and how recovery from the injury is also shaped by pre-injury, comorbid, and contextual factors, and we also have increasing evidence that active interventions, including cognitive rehabilitation, can help to promote better outcomes. The study also peers ahead to discern two important directions that seem destined to influence research on TBI over the next 50 years: the development of large, multi-site observational studies and randomized controlled trials, bolstered by international research consortia and the adoption of common data elements; and attempts to translate research into health care and health policy by the application of rigorous methods drawn from implementation science. Future research shaped by these trends should provide critical evidence regarding the outcomes of TBI and its treatment, and should help to disseminate and implement the knowledge gained from research to the betterment of the quality of life of persons with TBI. (JINS, 2017,23, 806–817)

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The impact of multimodal cognitive rehabilitation on executive functions in older adults with traumatic brain injury (TBI)

10.1101/2020.10.26.20220012 ◽

2020 ◽

Author(s):

Eduardo Cisneros ◽

Véronique Beauséjour ◽

Elaine de Guise ◽

Sylvie Belleville ◽

Michelle McKerral

Keyword(s):

Older Adults ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Active Control ◽

Cognitive Rehabilitation ◽

Daily Life ◽

Control Group ◽

Active Control Group ◽

Daily Life Activities ◽

The Impact

AbstractObjectivesThis study evaluated the impact of a multimodal cognitive rehabilitation intervention, the Cognitive Enrichment Program (CEP), on executive functioning (EF) and resumption of daily activities following traumatic brain injury (TBI) in older individuals, in comparison to an active control group having received holistic rehabilitation as usual care.MethodsThe CEP’sexecutive function module included planning, problem solving, and goal management training, as well as strategies focusing on self-awareness. Effectiveness was evaluated by psychometric tests (Modified Six Elements Task-adapted – MSET-A, D-KEFS Sorting test and Stroop four-color version), while generalization was measured through self-reported questionnaires about daily functioning (Dysexecutive Functioning Questionnaire – DEX, Forsaken daily life activities). Measures were obtained before and after intervention, and six months later.ResultsANCOVA results showed significant group-by-time interactions on Tackling the 6 subtasks and Avoiding rule-breaking measures of the MSET-A, with moderate effect sizes. Despite improvements in Sorting and Stroop scores, there were no group-by-time interaction on these measures. DEX generalization measure showed a significant reduction in patient/significant other difference on the Executive Cognition subscale. There was a reduction in the number of Forsaken daily life activities in the experimental group compared to controls which was not significant immediately after CEP, but that was significant six months later.ConclusionsOur study shows that older adults with TBI can improve their executive functioning with a positive impact on everyday activities after receiving multimodal cognitive training compared to an active control group.

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B-72 The Relationship between Anxiety and Postconcussive Symptomology in patients with Mild Traumatic Brain Injury

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.155 ◽

2019 ◽

Vol 34 (6) ◽

pp. 1020-1020

Author(s):

K Cornett

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Injury Severity ◽

Small Sample ◽

Future Research ◽

Control Group ◽

Patient Report ◽

The Relationship ◽

Report Measure

Abstract Objective Research literature has demonstrated the role that pre-morbid anxiety has in prolonging recovery from mild traumatic brain injury (mTBI). The aim of this investigation is to clarify the degree of the relationship between anxiety and postconcussive symptomology in patients with mTBI. Method This study compared scores from a patient-report measure of anxiety, the General Anxiety Disorder-7 (GAD-7), to scores from a patient-report measure of postconcussion symptom severity, the Neurobehavioral Symptom Inventory (NSI). Participants were recruited from September 2018 to December 2019 who had been referred for clinical evaluation to Rehabilitation Institute of Washington’s Brain Injury Services (a privately-run, interdisciplinary, outpatient clinic). 39 adult participants (30 males and nine females) completed both the GAD-7 and NSI. No control group was used. Injury severity level was ascertained via review of the medical records. Patients underwent an abbreviated evaluation with a clinical neuropsychologist. As a part of this initial evaluation, patients completed an intake packet, which included the NSI and GAD-7. Results The relationship between the ordinal variables (i.e., anxiety and postconscussive symptomology) was assessed using spearman’s rho. Anxiety had a strong, statistically significant relationship with postconcussive symptomology (rho = 0.670, p = 0.000). Conclusions Anxiety and postconcussive symptomology severity are associated in this population of patients with mTBI. Limitations of this current investigation include a small sample size and no control group. This study indicates the need for controlled studies in future research to address the above-encountered limitations. Nevertheless, this study lends support to the prevalence of anxiety in those with elevated postconcussive symptomology and the need to monitor this in assessment and treatment.

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In-Hospital Mortality Following Traumatic Brain Injury Among Older Medicare Beneficiaries, Comparing Statin Users With Nonusers

Journal of Pharmacy Technology ◽

10.1177/8755122517735656 ◽

2017 ◽

Vol 33 (6) ◽

pp. 225-236 ◽

Cited By ~ 2

Author(s):

Bilal Khokhar ◽

Linda Simoni-Wastila ◽

Julia F. Slejko ◽

Eleanor Perfetto ◽

Min Zhan ◽

...

Keyword(s):

Older Adults ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Hospital Mortality ◽

Health Concern ◽

Future Research ◽

Small Scale ◽

Medicare Beneficiaries ◽

The Impact ◽

Statin Use

Background: Traumatic brain injury (TBI) is a significant public health concern for older adults. Small-scale human studies have suggested pre-TBI statin use is associated with decreased in-hospital mortality following TBI, highlighting the need for large-scale translational research. Objective: To investigate the relationship between pre-TBI statin use and in-hospital mortality following TBI. Methods: A retrospective study of Medicare beneficiaries 65 and older hospitalized with a TBI during 2006 to 2010 was conducted to assess the impact of pre-TBI statin use on in-hospital mortality following TBI. Exposure of interest included atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, and simvastatin. Beneficiaries were classified as current, recent, past, and nonusers of statins prior to TBI. The outcome of interest was in-hospital mortality. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) comparing current, recent, and prior statin use to nonuse. Results: Most statin users were classified as current users (90%). Current atorvastatin (OR = 0.88; 95% = CI 0.82, 0.96), simvastatin (OR = 0.84; 95% CI = 0.79, 0.91), and rosuvastatin (OR = 0.79; 95% CI = 0.67, 0.94) use were associated with a significant decrease in the risk of in-hospital mortality following TBI. Conclusions: In addition to being the most used statins, current use of atorvastatin, rosuvastatin, and simvastatin was associated with a significant decrease in in-hospital mortality following TBI among older adults. Future research must include clinical trials to help exclude the possibility of a healthy user effect in order to better understand the impact of statin use on in-hospital mortality following TBI.

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Effect of 3-Months Home-Based Exercise Program on Changes of Cognitive Functioning in Older Adults Living in Old People’s Home

Acta Facultatis Educationis Physicae Universitatis Comenianae ◽

10.1515/afepuc-2016-0002 ◽

2016 ◽

Vol 56 (1) ◽

pp. 16-29 ◽

Cited By ~ 2

Author(s):

Dagmar Nemček ◽

Alexander Simon

Keyword(s):

Older Adults ◽

Cognitive Functioning ◽

Cognitive Functions ◽

Cognitive Rehabilitation ◽

Exercise Program ◽

Cognitive Stimulation ◽

Rank Test ◽

Control Group ◽

Home Based ◽

And Control

SummaryThe aim of the study was to determine the effect of regular participation in home-based exercise programme on cognitive functioning changes in institutionalised older adults. Two groups of participants were recruited for the study: experimental (n = 17) in mean age 76 ± 5.6 years, who participated in home-based exercise program and control (n = 14) in mean age 80 ± 4.2 years. The standardised Stroop Color-Word Test-Victoria version (VST) was used to measure the level of cognitive functions. Group differences were analyzed with Mann-Whitney U-test for independent samples and for differences between pre-measurements and post-measurements on experimental and control group we used non-parametric Wilcoxon Signed - Rank Test. The level of significance was α < 0.05. Application of 3-months home-based exercise program significantly improved the cognitive functions only in one (Word condition; p<0.01) from three VST conditions in institutionalised older adults. That’s why we recommend longer participation in home-based exercise program, at least 6- months, with combination of various types of cognitive interventions, like concepts of cognitive training, cognitive rehabilitation, and cognitive stimulation to improve cognitive functioning in older adults living in old peoples’ homes.

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Rejecting familiar distracters during recognition in young adults with traumatic brain injury and in healthy older adults

Journal of the International Neuropsychological Society ◽

10.1017/s1355617710000202 ◽

2010 ◽

Vol 16 (3) ◽

pp. 556-565 ◽

Cited By ~ 11

Author(s):

LANA J. OZEN ◽

ERIN I. SKINNER ◽

MYRA A. FERNANDES

Keyword(s):

Older Adults ◽

Traumatic Brain Injury ◽

Young Adults ◽

Brain Injury ◽

Older Adult ◽

Digit Span ◽

Normal Aging ◽

Study Phase ◽

Healthy Older Adults ◽

Cognitive Complaint

AbstractThe most common cognitive complaint reported by healthy older adults and young adults with traumatic brain injury (TBI) is memory difficulties. We investigated the effects of normal aging and the long-term effects of TBI in young adults on the susceptibility to incorrectly endorse distracter information on a memory test. Prior to a study phase, participants viewed a “pre-exposure” list containing distracter words, presented once or three times, and half of the target study words. Subsequently, during the study phase, all target words were presented such that, across lists, study words were viewed either once or three times. On the recognition test, TBI and older adult participants were more likely to falsely endorse “pre-exposed” distracter words viewed three times as being from the target study list, compared to non-head-injured young controls. Normal aging and head injury in young may similarly compromise one’s ability to reject highly familiar, but distracting, information during recognition. Older adult and TBI participants were also slower to complete the Trail Making task and had poorer output on a Digit Span task, suggesting these two populations share a deficit in executive function and working memory. Similar changes in frontal lobe function may underlie these shared cognitive deficits. (JINS, 2010,16, 556–565.)

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Cognitive Rehabilitation Following Mild Traumatic Brain Injury using Hypnotic Suggestion

10.31219/osf.io/cxqth ◽

2019 ◽

Author(s):

Jonas Kristoffer Lindeløv

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Cognitive Rehabilitation ◽

Digit Span ◽

Depression Scale ◽

Cost Effective ◽

Future Research ◽

Neurological Patient ◽

Hypnotic Suggestion

Introduction: Cost-effective rehabilitation of persistent cognitive problems following Mild Traumatic Brain Injury (MTBI) remains elusive. Method: Here, we extend previous findings on hypnotic suggestion for neurological patient groups by administering it to 22 participants suffering from persistent reduced vocational performance following MTBI. Results: Following eight weekly 1-hour treatments, we observed large effects on the Mental Fatigue Scale and Digit Span. There were medium-sized effects on the Hospital Anxiety and Depression Scale, but no effect on the Trail Making Test. Effect sizes were larger for participants with no ongoing litigation. Conclusion: In terms of effectiveness, the results compare well to conventional treatments for MTBI. We discuss limitations and propose avenues for future research.

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Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol

BMJ Open ◽

10.1136/bmjopen-2018-028711 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028711

Author(s):

Norhamizan Hamzah ◽

Vairavan Narayanan ◽

Norlisah Ramli ◽

Nor Atikah Mustapha ◽

Nor Adibah Mohammad Tahir ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Outcome Measures ◽

Mild Traumatic Brain Injury ◽

Study Protocol ◽

Effect Size ◽

Cognitive Rehabilitation ◽

Previous History ◽

Psychological Status ◽

Control Group

ObjectivesTo measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population.SettingA single centre study, Malaysia.ParticipantsAdults aged between 18 and 60 years with mTBI as a result of road traffic accident, with no previous history of head trauma, minimum of 9 years education and abnormal cognition at 3 months will be included. The exclusion criteria include pre-existing chronic illness or neurological/psychiatric condition, long-term medication that affects cognitive/psychological status, clinical evidence of substance intoxication at the time of injury and major polytrauma. Based on multiple estimated calculations, the minimum intended sample size is 50 participants (Cohen’s d effect size=0.35; alpha level of 0.05; 85% power to detect statistical significance; 40% attrition rate).InterventionsIntervention group will receive individualised structured cognitive rehabilitation. Control group will receive the best patient-centred care for attention disorders. Therapy frequency for both groups will be 1 hour per week for 12 weeks.Outcome measuresPrimary:Neuropsychological Assessment Battery-Screening Module (S-NAB) scores.Secondary:Diffusion Tensor Imaging (DTI) parameters and Goal Attainment Scaling score (GAS).ResultsResults will include descriptive statistics of population demographics, CogniPlus cognitive program and metacognitive strategies. The effect of intervention will be the effect size of S-NAB scores and mean GAS T scores. DTI parameters will be compared between groups via repeated measure analysis. Correlation analysis of outcome measures will be calculated using Pearson’s correlation coefficient.ConclusionThis is a complex clinical intervention with multiple outcome measures to provide a comprehensive evidence-based treatment model.Ethics and disseminationThe study protocol was approved by the Medical Research Ethics Committee UMMC (MREC ID NO: 2016928–4293). The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT03237676

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Efficacy of Neurofeedback Interventions for Cognitive Rehabilitation Following Brain Injury: Systematic Review and Recommendations for Future Research

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719001061 ◽

2020 ◽

Vol 26 (1) ◽

pp. 31-46 ◽

Cited By ~ 1

Author(s):

Jordan I. Ali ◽

Jeremy Viczko ◽

Colette M. Smart

Keyword(s):

Systematic Review ◽

Brain Injury ◽

Cognitive Rehabilitation ◽

Clinical Intervention ◽

Future Research ◽

Control Group ◽

Eligibility Criteria ◽

Cognitive Domains ◽

Funding Agencies ◽

Future Work

AbstractObjectives:Interest in neurofeedback therapies (NFTs) has grown exponentially in recent years, encouraged both by escalating public interest and the financial support of health care funding agencies. Given NFTs’ growing prevalence and anecdotally reported success in treating common effects of acquired brain injury (ABI), a systematic review of the efficacy of NFTs for the rehabilitation of ABI-related cognitive impairment is warranted.Methods:Eligible studies included adult samples (18+ years) with ABI, the use of neurofeedback technology for therapeutic purposes (as opposed to assessment), the inclusion of a meaningful control group/condition, and clear cognitive–neuropsychological outcomes. Initial automated search identified n = 86 candidate articles, however, only n = 4 studies met the stated eligibility criteria.Results:Results were inconsistent across studies and cognitive domains. Methodological and theoretical limitations precluded robust and coherent conclusions with respect to the cognitive rehabilitative properties of NFTs. We take the results of these systematic analyses as a reflection of the state of the literature at this time. These results offer a constructive platform to further discuss a number of methodological, theoretical, and ethical considerations relating to current and future NFT–ABI research and clinical intervention.Conclusions:Given the limited quantity and quality of the available research, there appears to be insufficient evidence to comment on the efficacy of NFTs within an ABI rehabilitation context at this time. It is imperative that future work increase the level of theoretical and methodological rigour if meaningful advancements are to be made understanding and evaluating NFT–ABI applications.

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