scholarly journals COVID-19 cognitive deficits after respiratory assistance in the subacute phase: A COVID-rehabilitation unit experience

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246590
Author(s):  
Federica Alemanno ◽  
Elise Houdayer ◽  
Anna Parma ◽  
Alfio Spina ◽  
Alessandra Del Forno ◽  
...  
Keyword(s):  
Acute Phase ◽  
Cognitive Functions ◽  
Rating Scale ◽  
Functional Independence ◽  
Functional Impairments ◽  
Rehabilitation Unit ◽  
Subacute Phase ◽  
Respiratory Assistance ◽  
The Impact

Introduction COVID-19 complications can include neurological, psychiatric, psychological, and psychosocial impairments. Little is known on the consequences of SARS-COV-2 on cognitive functions of patients in the sub-acute phase of the disease. We aimed to investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit of the San Raffaele Hospital (Milan, Italy). Material and methods 87 patients admitted to the COVID-19 Rehabilitation Unit from March 27th to June 20th 2020 were included. Patients underwent Mini Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Functional Independence Measure (FIM). Data were divided in 4 groups according to the respiratory assistance in the acute phase: Group1 (orotracheal intubation), Group2 (non-invasive ventilation using Biphasic Positive Airway Pressure), Group3 (Venturi Masks), Group4 (no oxygen therapy). Follow-ups were performed at one month after home-discharge. Results Out of the 87 patients (62 Male, mean age 67.23 ± 12.89 years), 80% had neuropsychological deficits (MoCA and MMSE) and 40% showed mild-to-moderate depression. Group1 had higher scores than Group3 for visuospatial/executive functions (p = 0.016), naming (p = 0.024), short- and long-term memory (p = 0.010, p = 0.005), abstraction (p = 0.024), and orientation (p = 0.034). Group1 was younger than Groups2 and 3. Cognitive impairments correlated with patients’ age. Only 18 patients presented with anosmia. Their data did not differ from the other patients. FIM (<100) did not differ between groups. Patients partly recovered at one-month follow-up and 43% showed signs of post-traumatic stress disorder. Conclusion Patients with severe functional impairments had important cognitive and emotional deficits which might have been influenced by the choice of ventilatory therapy, but mostly appeared to be related to aging, independently of FIM scores. These findings should be integrated for correct neuropsychiatric assistance of COVID-19 patients in the subacute phase of the disease, and show the need for long-term psychological support and treatment of post-COVID-19 patients.

scholarly journals COVID-19 COGNITIVE DEFICITS AFTER RESPIRATORY ASSISTANCE IN THE SUBACUTE PHASE: A COVID-REHABILITATION UNIT EXPERIENCE

2020 ◽  
Author(s):  
Federica Alemanno ◽  
Elise Houdayer ◽  
Anna Parma ◽  
Alfio Spina ◽  
Alessandra Del Forno ◽  
...  
Keyword(s):  
Acute Phase ◽  
Cognitive Functions ◽  
Rating Scale ◽  
Functional Independence ◽  
Functional Impairments ◽  
Rehabilitation Unit ◽  
Subacute Phase ◽  
Respiratory Assistance ◽  
The Impact

AbstractIntroductionCOVID-19 complications can include neurological, psychiatric, psychological, and psychosocial impairments. Little is known on the consequences of SARS-COV-2 on cognitive functions of patients in the sub-acute phase of the disease. We aimed to investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit of the San Raffaele Hospital (Milan, Italy).Material and Methods87 patients admitted to the COVID-19 Rehabilitation Unit from March 27th to June 20th 2020 were included. Patients underwent Mini Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Functional Independence Measure (FIM). Data were divided in 4 groups according to the respiratory assistance in the acute phase: Group1 (orotracheal intubation), Group2 (non-invasive ventilation using Biphasic Positive Airway Pressure), Group3 (Venturi Masks), Group4 (no oxygen therapy). Follow-ups were performed at one month after home-discharge.ResultsOut of the 87 patients (62 Male, mean age 67.23 ± 12.89 years), 80% had neuropsychological deficits (MoCA and MMSE) and 40% showed mild-to-moderate depression. Group1 had higher scores than Group3 for visuospatial/executive functions (p=0.016), naming (p=0.024), short- and long-term memory (p=0.010, p=0.005), abstraction (p=0.024), and orientation (p=0.034). Group1 was younger than Groups2 and 3. Cognitive impairments correlated with patients’ age. Only 18 patients presented with anosmia. Their data did not differ from the other patients. FIM (<100) did not differ between groups. Patients partly recovered at one-month follow-up and 43% showed signs of post-traumatic stress disorder.ConclusionPatients with severe functional impairments had important cognitive and emotional deficits which might have been influenced by the choice of ventilatory therapy, but mostly appeared to be related to aging, independently of FIM scores. These findings should be integrated for decision-making in respiratory and neuropsychiatric assistance of COVID-19 patients in the subacute phase of the disease, and show the need for long-term support and psychological treatment of post-COVID-19 patients.

scholarly journals Depletion of acetate-producing bacteria from the gut microbiota facilitates cognitive impairment through the gut-brain neural mechanism in diabetic mice

Microbiome ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Hong Zheng ◽  
Pengtao Xu ◽  
Qiaoying Jiang ◽  
Qingqing Xu ◽  
Yafei Zheng ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Gut Microbiota ◽  
Cognitive Functions ◽  
Neural Mechanism ◽  
Fecal Microbiota ◽  
Protective Role ◽  
Fecal Microbiota Transplant ◽  
Memory Impairments ◽  
The Impact

Abstract Background Modification of the gut microbiota has been reported to reduce the incidence of type 1 diabetes mellitus (T1D). We hypothesized that the gut microbiota shifts might also have an effect on cognitive functions in T1D. Herein we used a non-absorbable antibiotic vancomycin to modify the gut microbiota in streptozotocin (STZ)-induced T1D mice and studied the impact of microbial changes on cognitive performances in T1D mice and its potential gut-brain neural mechanism. Results We found that vancomycin exposure disrupted the gut microbiome, altered host metabolic phenotypes, and facilitated cognitive impairment in T1D mice. Long-term acetate deficiency due to depletion of acetate-producing bacteria resulted in the reduction of synaptophysin (SYP) in the hippocampus as well as learning and memory impairments. Exogenous acetate supplement or fecal microbiota transplant recovered hippocampal SYP level in vancomycin-treated T1D mice, and this effect was attenuated by vagal inhibition or vagotomy. Conclusions Our results demonstrate the protective role of microbiota metabolite acetate in cognitive functions and suggest long-term acetate deficiency as a risk factor of cognitive decline.

scholarly journals Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients

2021 ◽  
Vol 18 (5) ◽  
pp. 2695
Author(s):  
Marc Spielmanns ◽  
Anna-Maria Pekacka-Egli ◽  
Sabine Schoendorf ◽  
Wolfram Windisch ◽  
Matthias Hermann
Keyword(s):  
Acute Phase ◽  
Pulmonary Rehabilitation ◽  
Lung Diseases ◽  
Rating Scale ◽  
Functional Independence ◽  
Significant Enhancement ◽  
Walk Test ◽  
Prospective Design ◽  
Feeling Thermometer ◽  
Functional Independence Measurement

Background: Severe COVID-19 infection often leads to impairments requiring pulmonary rehabilitation (PR) following the acute phase. Little is known about the efficacy of PR in these patients. We therefore compared post-COVID-19 patients (PG) referred to PR patients with other lung diseases (LG). Methods: 99 PG were admitted to PR. In a prospective design, the results of PG were collected and compared to the results of LG of 2019 (n = 419) according to Functional Independence Measurement (FIM), Cumulative Illness Rating Scale (CIRS), 6-min walk test (6-MWT), duration of PR, and Feeling Thermometer (FT). Results: According to age, sex, and CIRS, both groups showed no significant differences. The improvements in the 6-MWT in the pre to post comparison were on average 180 (±101) meters for PG and 102 (±89) meters for LG (p < 0.001). FT showed a significant enhancement for PG of 21 (±14) points and for LG of 17 (±16) points (p < 0.039), while FIM significantly increased by 11 (±10) points in PG and 7 (±8) points in LG (p < 0.001). Conclusions: Comprehensive PR in PG is very effective according to the results in FIM, 6-MWT and FT. Therefore, we recommend PR following severe post-COVID-19 infections.

The Functional Independence Measure and the Functional Assessment Measure (FIM + FAM) as an effective tool for the evaluation of functional status in stroke rehabilitation

2021 ◽  
Author(s):  
L. Shuranova ◽  
J. Vacková
Keyword(s):  
Functional Assessment ◽  
Clinical Decision Making ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Hospital Treatment ◽  
Common Cause ◽  
Assessment Measure ◽  
Rehabilitation Period

The Functional Independence Measure and Functional Assessment Measure (FIM + FAM) is an effective, efficient, and objective tool for tracking changes in the motor, cognitive, and psychosocial functions of patients over the entire treatment and rehabilitation period. It is estimated that in the Czech Republic (CR), stroke is the third most common cause of death and the most common cause of adult disability. To develop faster, better, and more cost‑effective stroke treatments and reduce or mitigate functional losses and restrictive situations, it is very important that patients be objectively evaluated, relative to their functional abilities, as soon as possible after a stroke. A critical part of stroke treatment is to calculate the length of in‑hospital treatment and estimate the length of the rehabilitation period after the stroke. Contemporary methods for evaluating and analyzing a patient’s condition are based on test results and evidence.The FIM offers a more sensitive rating scale compared to BI due to the presence of cognitive items and is used worldwide for assessment during the acute stage of the disease. Thus, it is an efficient instrument for setting therapy goals and evaluating the effects of rehabilitation. Not only can it assist the therapist in clinical decision making, but it also functions as a tool for evaluating rehabilitation outcomes. Based on this test, short‑term and long‑term rehabilitation plans can be determined. At the end of the rehabilitation process, assessing the patient’s functional condition helps to predict the specific long‑term rehabilitation services the patient will need as they return to society and regain their quality of life.

scholarly journals Correlation of cardiovascular and respiratory comorbidities with motor functional independence in the elderly after hip fracture

2021 ◽  
Vol 74 (1-2) ◽  
pp. 20-24
Author(s):  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Sofija Radosavljevic ◽  
Mirko Grajic ◽  
Ksenija Boskovic
Keyword(s):  
Hip Fracture ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Severity Index ◽  
The Elderly ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Significant Difference ◽  
Different Levels

Introduction. The aim of the study was to evaluate the correlation between different levels of examined comorbidities using the Cumulative Illness Rating Scale for Geriatrics and motor Functional Independence Measure test in the elderly after hip fracture. Material and Methods. The study included 203 geriatric patients, 65 years of age and older, who were referred to a rehabilitation program at the Institute for Rehabilitation after hip fracture. The following comorbidities were analyzed: cardiac, vascular, and respiratory. The motor component of Functional Independence Measure was used to assess functional recovery. The Cumulative Illness Rating Scale for Geriatrics was used to calculate the comorbidity index. The patients were assessed on 4 different occasions: on admission, on discharge, 3 months after discharge, and 6 months after discharge. The short-term and long-term efficiency of rehabilitation treatment was measured. Results. There is a significant difference in motor Functional Independence Measure scores between different levels of vascular (p = 0.010) and respiratory (p = 0.047) comorbidities only on admission, while at other times of observation no significant difference (p > 0.05) was found. The highest level of correlation was found in level 3 comorbidity severity index for cardiac comorbidity (discharge/3 months) (Pearson?s correlation - R = 0.938) and vascular comorbidity (discharge/3 months) (R = 0.912), and level 2 comorbidity severity index for respiratory comorbidity (discharge/3 months) (R = 0.941). Conclusion. Rehabilitation treatment of the elderly after hip fracture plays a significant role both in short-term and long-term recovery, particularly in the functional domains even in persons with significant comorbidities. Early inclusion and an individually designed rehabilitation program with continuous monitoring of the elderly after hip fractures results in functional improvement and better quality of life.

Excessive Shear Force at the Digits May Contribute to Unstable Grip Following Stroke

2009 ◽  
Author(s):  
Na Jin Seo ◽  
Derek G. Kamper
Keyword(s):  
Upper Extremity ◽  
Daily Living ◽  
The United States ◽  
Functional Independence ◽  
Stroke Survivors ◽  
Functional Importance ◽  
Rehabilitation Unit ◽  
Sensory Impairments ◽  
Hand Grasp

Stroke is a leading cause of long-term disability in the United States and the third most frequent cause of death, following diseases of the heart and cancer [1]. Of the more than 700,000 Americans who experience a stroke each year [1], two-thirds survive [2]. Currently there are more than five million stroke survivors in the U.S. [1], many of whom have long-term motor and sensory impairments, especially in the arm and hand [3]. Studies report that 69% of patients who were admitted to a rehabilitation unit following stroke have mild to severe upper extremity dysfunction [4], and only 14% to 16% of stroke survivors with initial upper extremity hemiparesis regained near-complete motor function [3,4]. Chronic deficits following stroke are especially prevalent in the hand and therefore diminish the capacity to grasp [5]. Hand grasp has great functional importance for performing activities of daily living. The impairment in grasping significantly lowers stroke survivors’ functional independence.

scholarly journals Long-Term Effects of Psychological Symptoms after Occupational Injury on Return to Work: A 6-Year Follow-Up

2019 ◽  
Vol 16 (2) ◽  
pp. 235 ◽  
Author(s):  
Po-Ching Chu ◽  
Wei-Shan Chin ◽  
Yue Leon Guo ◽  
Judith Shu-Chu Shiao
Keyword(s):  
Return To Work ◽  
Injury Severity ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Occupational Injuries ◽  
Significant Risk ◽  
Injured Workers ◽  
Early Screening ◽  
The Impact

Psychological factors may compromise return to work among workers with occupational injuries, and little is known about the long-term consequences of psychological symptoms relating to return to work. The study examined the impact of psychological symptoms on return to work as well as exploring factors associated with return to work among injured workers. A total of 572 workers who experienced occupational injuries were recruited in this prospective cohort study. Surveys of the psychological symptoms using the 5-item Brief Symptom Rating Scale (BSRS-5) were conducted at 3 and 12 months after the injury. All of the workers were invited to join the study at year 6 after the injury. Sociodemographic factors, psychological symptoms, injury severity, and return-to-work status were collected. Approximately 10% of injured workers could not return to work even 6 years after the injury. Severe psychological symptoms within 1 year after the injury presented a significant risk factor for not returning to work 6 years after the injury (adjusted OR = 0.7, 95% CI: 0.5–0.8). Furthermore, age, education level, length of hospitalization, and injury-induced changes in appearance had significant independent influence on return to work as well. These findings highlight the importance of the effects of mental health within 1 year post injury on return to work, and support the concept of early screening, detection, and intervention in at-risk occupational injured workers with severe psychological symptoms.

The effect of concomitant benzodiazepine use on neurocognition in stable, long-term patients with bipolar disorder

2020 ◽  
pp. 000486742096981
Author(s):  
Yolanda Cañada ◽  
Ana Sabater ◽  
Pilar Sierra ◽  
Vicent Balanzá-Martínez ◽  
Michael Berk ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Scale Score ◽  
Processing Speed ◽  
Visual Memory ◽  
Rating Scale ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Depressive Episodes ◽  
The Impact

Objective: Neurocognitive dysfunction is a common feature of bipolar disorder even in euthymia, and psychopharmacological treatment could have an effect on cognition. Long-term prescription of benzodiazepines in bipolar disorder is a common practice, and their effect on neurocognition has not been well studied in this population. The aim of this study was to evaluate the impact of concomitant benzodiazepine long-term use on neurocognitive function in stable euthymic bipolar disorder patients. Methods: Seventy-three euthymic bipolar disorder outpatients and 40 healthy individuals were assessed using a neurocognitive battery. Patients were classified in two groups according to the presence of benzodiazepines in their treatment: the benzodiazepine group ( n = 34) and the non- benzodiazepine group ( n = 39). Neurocognitive performance was compared between the groups using a multivariate analysis of covariance, considering age, number of depressive episodes, adjuvant antipsychotic drugs, Young Mania Rating Scale score and Hamilton Depression Rating Scale score as covariates. Results: Both bipolar disorder groups (benzodiazepine and non-benzodiazepine) showed an impairment in memory domains (Immediate Visual Memory [ p = 0.013], Working Memory [ p < 0.001], and Letter-Number Sequence [ p < 0.001] from the Wechsler Memory Scale-Revised-III) and slower processing speed functions (Stroop Colour [ p < 0.001]) relative to the control group. Nevertheless, the benzodiazepine group showed a greater impairment in executive functions (Conceptual Level Responses [ p = 0.024] from the Wisconsin Card Sorting Test and Frontal Assessment Battery [ p = 0.042]). Conclusion: Although memory and processing speed impairments were found in bipolar disorder, regardless of their benzodiazepine treatment, benzodiazepine users presented additional neurocognitive impairments in terms of executive functioning. These findings support restricted prescription of benzodiazepines in individuals with bipolar disorder.

scholarly journals Mild Depressive Symptoms Mediate the Impact of Childhood Trauma on Long-Term Functional Outcome in Early Psychosis Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. s800-s800
Author(s):  
L. Alameda ◽  
G. Philippe ◽  
B. Philipp ◽  
D. Kim Q. ◽  
C. Philippe
Keyword(s):  
Depressive Symptoms ◽  
Functional Outcome ◽  
Childhood Trauma ◽  
Rating Scale ◽  
Mediating Effect ◽  
Early Psychosis ◽  
Time Points ◽  
Early Trauma ◽  
The Impact

IntroductionThe mechanism linking childhood trauma (CT) to the functional deficits observed in early psychosis (EP) patients is as yet unknown.ObjectivesTo examine the potential mediating effect of depressive symptoms in this well-established association.MethodsTwo hundred nine EP subjects aged 18-35 were assessed for functioning and psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Patients were classified into early-trauma if they had faced at least one experience of abuse (physical, sexual, or emotional) or neglect (physical or emotional) before age 12, and late-trauma if the exposure had occurred between ages 12 and 16. Psychopathology was assessed with the Positive and Negative Syndrome Scale and the Montgomery-Asberg Depression Rating Scale. Functioning was measured with the Global Assessment of Functioning (GAF) and the Social and Occupational Functioning Assessment Scale (SOFAS). Mediation analyses were performed in order to study whether the relationship between CT and functioning was mediated by depressive symptoms.ResultsWhen compared with nonexposed patients, early but not late trauma patients showed lower levels of GAF and SOFAS scores over all the time points, excepting after the first assessment. After 30 and 36 months, the effect of early trauma on functioning was completely mediated by depressive symptoms. No mediating effect of positive or negative symptoms was highlighted at those time points.ConclusionMild depressive symptoms mediated the impact of early trauma on long-term functional outcome. Intensifying pharmacologic and/or psychotherapeutic treatment, focused on the depressive dimension, may help traumatized EP patients to improve their functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Effect of Lacosamide and Ethosuximide Chronic Treatment on Neural Precursor Cells and Cognitive Functions after Pilocarpine Induced Status Epilepticus in Mice

2021 ◽  
Vol 11 (8) ◽  
pp. 1014
Author(s):  
Aleksandra Szewczyk ◽  
Mirosław Zagaja ◽  
Joanna Szala-Rycaj ◽  
Maciej Maj ◽  
Marta Andres-Mach
Keyword(s):  
Status Epilepticus ◽  
Cognitive Functions ◽  
Term Treatment ◽  
Cell Counting ◽  
Resonance Spectroscopy ◽  
Long Term Treatment ◽  
Newborn Neurons ◽  
Imagej Software ◽  
The Impact

Seizures in about 40% of patients with epilepsy fail to respond to anti-seizure medication (ASM) and may lead to uncontrolled and prolonged seizures often inducing status epilepticus (SE). The aim of the study was to evaluate the impact of a long-term treatment with two different generation ASMs: ethosuximide (ETS, a classic ASM) and lacosamide (LCM, a 3rd generation ASM) on neural stem cells’ (NSCs’) proliferation and learning and memory functions after pilocarpine (PILO)-induced SE in mice. The following drugs were used: LCM (10 mg/kg), ETS (20 mg/kg), and PILO (300 mg/kg). Cell counting was done using confocal microscope and ImageJ software. Cognitive functions were evaluated with the Morris water maze (MWM) test. The level of several selected neurometabolites was measured with magnetic resonance spectroscopy (MRS). Obtained results indicated no significant impact of ETS treatment on the neurogenesis process in PILO mice. Interestingly, LCM significantly decreased the total amount of newborn neurons. The MWM test indicated no significant changes in the time and distance traveled by the ETS and LCM groups compared to PILO control mice, although all measured parameters were more favorable for the PILO mice treated with ASM. Conclusions: The presented results show that long term treatment with LCM and ETS seems to be safe for the cognitive functions and the proper course of neurogenesis in the mouse PILO-induced SE model, although one should remember that LCM administered chronically may act to reduce new neurons’ formation.

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