Relationship Between Cognition and Gait at 2- and 12-Months Post-Traumatic Brain Injury

Background: A common and debilitating challenge experienced by people with TBI is gait-associated mobility impairment and persisting cognitive impairments. Cognitive and physical impairments are often addressed independently during rehabilitation, however, increasing evidence links cognitive and motor processes more closely.Objectives: (1) To determine if correlations exist between measures of cognitive and gait recovery, post-TBI. (2) To investigate the predictive power of cognition at 2-months on gait outcomes at 12-months post-TBI.Methods: In this secondary, longitudinal study of cognitive and neural recovery, data from 93 participants admitted to an inpatient neurorehabilitation program were analyzed. Spatiotemporal gait variables [velocity, step time variability (STV), step length variability (SLV)] were collected along with cognitive variables [Trail Making Test-B (TMT-B), Digit Span-Forward (DS-F)]. Spearman's correlation coefficients were calculated between gait and cognitive variables. Multilinear and step wise regression analyses were calculated to determine predictive value of cognitive variables at 2-months on gait performance at 12-months-post TBI.Results: At 2-months post-injury, TMT-B was significantly correlated with gait velocity and STV; and DS-F was significantly correlated with velocity. At 12-months post-injury, TMT-B and DS-F was still significant correlated with velocity. TMT-B at 2-months was correlated with SLV and STV at 12-months; and DS-F correlated significantly with velocity. Regression models showed TMT-B at 2-months predicting STV, SLV, and velocity at 12-months.Conclusions: Significant associations and predictions between physical and cognitive recovery post-TBI were observed in this study. Future directions may consider a “neural internetwork” model as a salient rehabilitation approach in TBI that integrates physical and cognitive functions.

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Comparison of Neuropsychological Assessment by Videoconference and Face to Face

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000679 ◽

2021 ◽

pp. 1-11

Author(s):

Richard Gnassounou ◽

Bénédicte Defontaines ◽

Séverine Denolle ◽

Stéphanie Brun ◽

Raphaël Germain ◽

...

Keyword(s):

Neuropsychological Assessment ◽

Digit Span ◽

Cognitive Disorders ◽

Face To Face ◽

Complex Figure ◽

Selective Reminding ◽

Trail Making ◽

Neuropsychological Assessments ◽

Figure Test ◽

Selective Reminding Test

Abstract Objective: To compare the administration of neuropsychological tests by teleneuropsychology (TeleNP) and face to face (F-F) in order to determine the feasibility and reliability of TeleNP. Method: At the inclusion visit, all participants underwent a traditional F-F neuropsychological assessment as part of their standard care. Four months after inclusion, they were randomized to undergo an additional neuropsychological assessment either by F-F administration or by TeleNP. Results: A total of 150 adults with cognitive complaints, but with no major cognitive or sensorial impairment were included. At 4 months, 69 participants were randomized in the F-F arm and 71 in TeleNP arm (10 lost in the follow-up). The overall satisfaction was high: 87.1% in the TeleNP arm were “very satisfied”, and 82.9% indicated no preference between F-F and TeleNP. In agreement with previous data from the literature, neuropsychological assessments gave similar results across both administration conditions for a large majority of tests [Mini-Mental State Examination (MMSE), Free and Cued Selective Reminding Test (FCSRT) French version, Mahieux gestural praxis battery, Frontal Assessment Battery (FAB), time of completion of the Trail making Test (TMT) A and B, number of errors of the TMT B, Rey complex figure test, categorical et phonological verbal fluency tests] and minor differences for others [80-picture naming test (DO-80), FAB, Digit Span forward and backward and number of errors in the TMT A]. Conclusions: TeleNP is a promising method to be able to test patients as an alternative to F-F condition. Before this procedure can be generalized, it is now necessary to standardize the adaptation of certain tests and to test them in populations with more significant cognitive disorders.

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Latent Structure of a Brief Clinical Battery of Neuropsychological Tests Administered In-Home Via Telephone

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa111 ◽

2020 ◽

Author(s):

Anastasia Matchanova ◽

Michelle A Babicz ◽

Luis D Medina ◽

Samina Rahman ◽

Briana Johnson ◽

...

Keyword(s):

Executive Functions ◽

Factor Structure ◽

Neuropsychological Tests ◽

Factor Model ◽

Digit Span ◽

Neuropsychological Battery ◽

Memory And Attention ◽

Sociodemographic Correlates ◽

List Learning ◽

Trail Making

Abstract Objective To examine the factor structure and sociodemographic correlates of a battery of clinical neuropsychological tests administered in-home and via telephone. Method Participants included 280 healthy adults who completed a 35–40 min battery consisting of seven auditory-verbal neuropsychological tests (i.e., 10 variables) that included digit span, list learning and memory, prospective memory, verbal fluency, and oral trail making. Results After removing oral trail making part A, a three-factor model comprised of executive functions, memory and attention demonstrated the best fit to the data. Nevertheless, the shared variance between the nine remaining neuropsychological variables was also adequately explained by a single-factor model and a two-factor model comprised of executive functions and memory. Factor scores were variably associated with education, race/ethnicity, and IQ, but not with sex or age. Conclusions Findings provide preliminary support for the feasibility and factor structure and sociodemographic correlates of a brief telephone-based screening neuropsychological battery comprised mostly of commonly administered clinical measures. Future studies are needed to determine the test–retest reliability, sensitivity, and ecological relevance of this battery, as well as equivalency to in-person assessment.

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Gait and Balance Changes with Investigational Peripheral Nerve Cell Therapy during Deep Brain Stimulation in People with Parkinson’s Disease

Brain Sciences ◽

10.3390/brainsci11040500 ◽

2021 ◽

Vol 11 (4) ◽

pp. 500

Author(s):

Geetanjali Gera ◽

Zain Guduru ◽

Tritia Yamasaki ◽

Julie A. Gurwell ◽

Monica J. Chau ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Peripheral Nerve ◽

Brain Stimulation ◽

Step Length ◽

Gait Velocity ◽

Balance Performance ◽

Improved Performance ◽

Deep Brain

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess the role of APNG implantation alone. We hypothesized that APNG might improve gait and balance deficits associated with PD. Results: While people with a degenerative movement disorder typically worsen with time, none of the gait parameters significantly changed across visits in this 24 month study. The postural stability item in the UPDRS did not worsen from baseline to the 24-month follow-up. However, we measured gait and balance improvements in the two most affected individuals, who had moderate PD. In these two individuals, we observed an increase in gait velocity and step length that persisted over 6 and 24 months. Conclusions: Participants did not show worsening of gait and balance performance in the off therapy state two years after surgery, while the two most severely affected participants showed improved performance. Further studies may better address the long-term maintanenace of these results.

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Regional Associations of Cortical Thickness With Gait Variability: The Tasmanian Study of Cognition and Gait

Innovation in Aging ◽

10.1093/geroni/igaa057.750 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 232-233

Author(s):

Oshadi Jayakody ◽

Monique Breslin ◽

Richard Beare ◽

Velandai Srikanth ◽

Helena Blumen ◽

...

Keyword(s):

Cortical Thickness ◽

Step Length ◽

Gait Variability ◽

Thickness Ratio ◽

Sensory Function ◽

Time Variability ◽

Step Width ◽

Time Step ◽

Cortical Regions ◽

Regional Associations

Abstract Gait variability is a marker of cognitive decline. However, there is limited understanding of the cortical regions associated with gait variability. We examined associations between regional cortical thickness and gait variability in a population-based sample of older people without dementia. Participants (n=350, mean age 71.9±7.1) were randomly selected from the electoral roll. Variability in step time, step length, step width and double support time (DST) were calculated as the standard deviation of each measure, obtained from the GAITRite walkway. MRI scans were processed through FreeSurfer to obtain cortical thickness of 68 regions. Bayesian regression was used to determine regional associations of mean cortical thickness and thickness ratio (regional thickness/overall mean thickness) with gait variability. Smaller overall cortical thickness was only associated with greater step width and step time variability. Smaller mean thickness in widespread regions important for sensory, cognitive and motor functions were associated with greater step width and step time variability. In contrast, smaller thickness in a few frontal and temporal regions were associated with DST variability and the right cuneus was associated with step length variability. Smaller thickness ratio in frontal and temporal regions important for motor planning, execution and sensory function and, greater thickness ratio in the anterior cingulate was associated with greater variability in all measures. Examining individual cortical regions is important in understanding the relationship between gray matter and gait variability. Cortical thickness ratio highlights that smaller regional thickness relative to global thickness may be important for the consistency of gait.

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Structural and functional changes related to memory deficit in non-demential elderly individuals

Medicina (Ribeirao Preto Online) ◽

10.11606/issn.2176-7262.v49i6p533-548 ◽

2016 ◽

Vol 49 (6) ◽

pp. 533

Author(s):

Nísea De A. Corrêa ◽

Maria P. Foss ◽

Paula R. B. Diniz

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Digit Span ◽

Meta Analysis ◽

Memory Deficit ◽

Trail Making Test ◽

Elderly Individuals ◽

Functional Changes ◽

Wechsler Memory Scale ◽

Trail Making

Objetivo: Verificar as alterações estruturais e funcionais, evidenciadas através da imagem por ressonância magnética, relacionadas aos déficits de memória identificados em idosos normais, quando comparados a adultos jovens. Metodologia: Procedeu-se à revisão sistemática, cujo protocolo obedeceu ao fluxograma do Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Foram investigadas as bases de dados PubMed, Scopus, EBSCO, utilizando o gerenciador de referências JabRef, na versão 2.10, e o Web of Science, pelo website. Foram incluídos artigos de estudos quase experimentais, transversais, em coorte ou tipo caso-controle, publicados entre 2005 e 2014, em periódicos indexados nacionais e internacionais, cuja amostra incluísse idosos a partir de 60 anos, não dementes, submetidos à investigação de alterações estruturais e funcionais do sistema nervoso central, por ressonância magnética e sua associação com déficits de memória avaliados por testes neuropsicológicos. Resultados: Quanto à técnica de imagem empregada, identificaram-se dois estudos com imagem por ressonância magnética estrutural, seis estudos com utilização de imagem por ressonância magnética funcional, e quatro estudos que empregaram ambas as técnicas. Nos 12 estudos foi identificado o emprego de 38 testes neuropsicológicos distintos, com uma média de cinco testes por estudo, com variação de um a 12 testes. Dentre os testes mais usados, estiveram o WAIS Digit Span Backwards (em sete estudos), o Trail Making Test A and B (em quatro estudos) e o Wechsler Memory Scale (em quatro estudos). Conclusão: Os estudos demonstraram que no envelhecimento normal, ocorre redução do volume de substância branca para-hipocampal, do volume do hipocampo e do córtex entorrinal com redução de memória verbal, possivelmente por desmielinização das fibras; redução das vias que ligam o lobo temporal e frontal, contribuindo para a redução da memória episódica, da memória de trabalho e da fluência verbal; redução da supressão de informações irrelevantes, o que contribui para menor registro de informação; alterações das áreas frontal e parietal que comprometem a memória de reconhecimento; modificações na atividade e na conectividade do default mode network; reorganização das funções cognitivas, bem como alentecimento de resposta por provável redução de ativação do córtex pré- frontal

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Neuropsychological correlates of schizophrenic syndromes in patients treated with atypical neuroleptics

European Psychiatry ◽

10.1016/s0924-9338(01)00591-0 ◽

2001 ◽

Vol 16 (6) ◽

pp. 354-361 ◽

Cited By ~ 51

Author(s):

S. Moritz ◽

B. Andresen ◽

D. Jacobsen ◽

K. Mersmann ◽

U. Wilke ◽

...

Keyword(s):

Verbal Fluency ◽

Negative Symptoms ◽

Digit Span ◽

Atypical Neuroleptics ◽

Schizophrenic Patients ◽

Trail Making ◽

Neurocognitive Dysfunctions ◽

Neurocognitive Tasks ◽

Negative Syndrome ◽

Typical Neuroleptics

SummaryThere is widespread evidence that schizophrenic symptomatology is best represented by three syndromes (positive, negative, disorganized). Both the disorganized and negative syndrome have been found to correlate with several neurocognitive dysfunctions. However, previous studies investigated samples predominantly treated with typical neuroleptics, which frequently induce parkinsonian symptoms that are hard to disentangle from primary negative symptoms and may have inflated correlations with neurocognition. A newly developed psychopathological instrument called the Positive and Negative and Disorganized Symptoms Scale (PANADSS) was evaluated in 60 schizophrenic patients. Forty-seven participants treated with atypical neuroleptics performed several neurocognitive tasks.A three-factor solution of schizophrenic symptomatology emerged. Negative symptomatology was associated with diminished creative verbal fluency and digit span backward, whereas disorganization was significantly correlated with impaired Stroop, WCST and Trail-Making Test B performance.Data suggest that disorganization is associated with tasks that demand executive functioning. Previous findings reporting correlations between negative symptomatology and neurocognition may have been confounded by the adverse consequences of typical neuroleptics.

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Alteração na atenção e o tratamento da dor do câncer

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-62342008000100019 ◽

2008 ◽

Vol 42 (1) ◽

pp. 143-151 ◽

Cited By ~ 2

Author(s):

Geana Paula Kurita ◽

Cibele Andrucioli de Mattos Pimenta ◽

José Oswaldo de Oliveira Júnior ◽

Ricardo Caponeiro

Keyword(s):

Digit Span ◽

Trail Making Test ◽

Digit Span Test ◽

Span Test ◽

Trail Making

Os danos à vida diária que a alteração cognitiva pode provocar motivaram a elaboração deste estudo, cujo objetivo foi analisar o impacto do tratamento da dor com opióides sobre a atenção. Os doentes foram divididos em grupos que recebiam (n=14) e não recebiam opióides (n=12). Foram feitas três entrevistas, utilizando-se o Trail Making Test e o Digit Span Test, que avaliam a atenção. Os grupos foram homogêneos nas variáveis sociodemográficas, dor e depressão; não foram homogêneos no índice de Karnofsky e no recebimento de analgésicos adjuvantes. Os doentes sem opióides tiveram melhor desempenho no Digit Span Test - ordem inversa, na segunda avaliação (p=0,29) e não foram observadas diferenças no Trail Making Test. As alterações observadas foram limitadas, mas, enquanto novos estudos não confirmem os achados, doentes, profissionais e cuidadores devem ser alertados dos possíveis efeitos deletérios dos opióides sobre a função cognitiva.

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Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms

Psychological Medicine ◽

10.1017/s0033291709991310 ◽

2009 ◽

Vol 40 (7) ◽

pp. 1215-1223 ◽

Cited By ~ 73

Author(s):

A. Liedl ◽

M. O'Donnell ◽

M. Creamer ◽

D. Silove ◽

A. McFarlane ◽

...

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Structural Equation ◽

Stress Disorder ◽

Traumatic Event ◽

Saturated Model ◽

Post Traumatic Stress ◽

Post Injury ◽

Post Traumatic ◽

The Relationship

BackgroundPain and post-traumatic stress disorder (PTSD) are frequently co-morbid in the aftermath of a traumatic event. Although several models attempt to explain the relationship between these two disorders, the mechanisms underlying the relationship remain unclear. The aim of this study was to investigate the relationship between each PTSD symptom cluster and pain over the course of post-traumatic adjustment.MethodIn a longitudinal study, injury patients (n=824) were assessed within 1 week post-injury, and then at 3 and 12 months. Pain was measured using a 100-mm Visual Analogue Scale (VAS). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Structural equation modelling (SEM) was used to identify causal relationships between pain and PTSD.ResultsIn a saturated model we found that the relationship between acute pain and 12-month pain was mediated by arousal symptoms at 3 months. We also found that the relationship between baseline arousal and re-experiencing symptoms, and later 12-month arousal and re-experiencing symptoms, was mediated by 3-month pain levels. The final model showed a good fit [χ2=16.97, df=12, p>0.05, Comparative Fit Index (CFI)=0.999, root mean square error of approximation (RMSEA)=0.022].ConclusionsThese findings provide evidence of mutual maintenance between pain and PTSD.

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