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Li L, Zhou Y, Zou S, Wang Y. The Effects of High-Altitude Mountaineering on Cognitive Function in Mountaineers: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5101. [PMID: 36982007 PMCID: PMC10049572 DOI: 10.3390/ijerph20065101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Nowadays, with the convenience of international traveling and driven by many individuals' fond dreams of challenging high-altitude exercises, high-altitude mountaineering is becoming increasingly popular worldwide. Therefore, we performed a meta-analysis to determine the effects of high-altitude mountaineering on cognitive functions in mountaineers before and after climbing. METHODS After a thorough electronic literature search and selection, eight studies were included in this meta-analysis, and the conducted test cycles ranged from 8 to 140 days. Eight variables were included in this meta-analysis: the Trail-Making Test (TMB), Digit Span-Forward (DSF), Digit Span-Backward (DSB), Finger Tapping Test-Right (FTR) Finger Tapping Test-Left (FTL), Wechsler Memory Scale Visual (WMSV), the Aphasia Screening Test (Verbal Items) (AST-Ver), and the Aphasia Screening Test (Visual Motor Errors) (AST-Vis). The effect sizes (ES) and forest plots of these eight variables were generated. RESULTS Five variables (TMB, ES = 0.39; DSF, ES = 0.57; FTR, ES = 0.50; FTL, ES = 0.16; WMSV, ES = 0.63) out of eight were significantly improved after high-altitude mountaineering, whereas the ES values of DSB, AST-Ver, and AST-Vis did not show significant improvement after climbing. CONCLUSION Despite two limitations, namely, methodological issues inherent in the meta-analysis and the inability to explain high heterogeneity between studies, this study is the first meta-analysis that has attempted to specify and compare the cognitive functions of mountaineers before and after high-altitude mountaineering. Furthermore, as a short-term plateau exercise, high-altitude mountaineering has no significant negative impacts on the cognitive functions of climbers. Future research is needed for a long period of high-altitude mountaineering.
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Affiliation(s)
- Lun Li
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yun Zhou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Shisi Zou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yongtai Wang
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY 14623, USA
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2
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Transcutaneous vagal nerve stimulation to treat disorders of consciousness: Protocol for a double-blind randomized controlled trial. Int J Clin Health Psychol 2023; 23:100360. [PMCID: PMC9712558 DOI: 10.1016/j.ijchp.2022.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background Patients with disorders of consciousness (DoC) are a challenging population prone to misdiagnosis with limited effective treatment options. Among neuromodulation techniques, transcutaneous auricular vagal nerve stimulation (taVNS) may act through a bottom-up manner to modulate thalamo-cortical connectivity and promote patients’ recovery. In this clinical trial, we aim to (1) assess the therapeutic clinical effects of taVNS in patients with DoC; (2) investigate the neural mechanisms underlying the effects of its action; (3) assess the feasibility and safety of the procedure in this challenging population; (4) define the phenotype of clinical responders; and (5) assess the long-term efficacy of taVNS in terms of functional outcomes. Methods We will conduct a prospective parallel randomized controlled double-blind clinical trial investigating the effects of taVNS as a treatment in DoC patients. Forty-four patients in the early period post-injury (7 to 90 days following the injury) will randomly receive 5 days of either active bilateral vagal stimulation (45 min duration with 30s alternative episodes of active/rest periods; 3mA; 200-300μs current width, 25Hz.) or sham stimulation. Behavioural (i.e., Coma Recovery Scale-Revised, CRS-R) and neurophysiological (i.e., high-density electroencephalography, hd-EEG) measures will be collected at baseline and at the end of the 5-day treatment. Analyses will seek for changes in the CRS-R and the EEG metrics (e.g., alpha band power spectrum, functional connectivity) at the group and individual (i.e., responders) levels. Discussion These results will allow us to investigate the vagal afferent network and will contribute towards a definition of the role of taVNS for the treatment of patients with DoC. We aim to identify the neural correlates of its action and pave the way to novel targeted therapeutic strategies. Clinical trial registration Clinicaltrials.gov n° NCT04065386.
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Cognition and Neuropsychological Changes at Altitude-A Systematic Review of Literature. Brain Sci 2022; 12:brainsci12121736. [PMID: 36552195 PMCID: PMC9775937 DOI: 10.3390/brainsci12121736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/05/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
High-altitude (HA) exposure affects cognitive functions, but studies have found inconsistent results. The aim of this systematic review was to evaluate the effects of HA exposure on cognitive functions in healthy subjects. A structural overview of the applied neuropsychological tests was provided with a classification of superordinate cognitive domains. A literature search was performed using PubMed up to October 2021 according to PRISMA guidelines. Eligibility criteria included a healthy human cohort exposed to altitude in the field (at minimum 2440 m [8000 ft]) or in a hypoxic environment in a laboratory, and an assessment of cognitive domains. The literature search identified 52 studies (29 of these were field studies; altitude range: 2440 m-8848 m [8000-29,029 ft]). Researchers applied 112 different neuropsychological tests. Attentional capacity, concentration, and executive functions were the most frequently studied. In the laboratory, the ratio of altitude-induced impairments (64.7%) was twice as high compared to results showing no change or improved results (35.3%), but altitudes studied were similar in the chamber compared to field studies. In the field, the opposite results were found (66.4 % no change or improvements, 33.6% impairments). Since better acclimatization can be assumed in the field studies, the findings support the hypothesis that sufficient acclimatization has beneficial effects on cognitive functions at HA. However, it also becomes apparent that research in this area would benefit most if a consensus could be reached on a standardized framework of freely available neurocognitive tests.
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Mikkelsen ACD, Thomsen KL, Mookerjee RP, Hadjihambi A. The role of brain inflammation and abnormal brain oxygen homeostasis in the development of hepatic encephalopathy. Metab Brain Dis 2022; 38:1707-1716. [PMID: 36326976 DOI: 10.1007/s11011-022-01105-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Hepatic encephalopathy (HE) is a frequent complication of chronic liver disease (CLD) and has a complex pathogenesis. Several preclinical and clinical studies have reported the presence of both peripheral and brain inflammation in CLD and their potential impact in the development of HE. Altered brain vascular density and tone, as well as compromised cerebral and systemic blood flow contributing to the development of brain hypoxia, have also been reported in animal models of HE, while a decrease in cerebral metabolic rate of oxygen and cerebral blood flow has consistently been observed in patients with HE. Whilst significant strides in our understanding have been made over the years, evaluating all these mechanistic elements in vivo and showing causal association with development of HE, have been limited through the practical constraints of experimentation. Nonetheless, improvements in non-invasive assessments of different neurophysiological parameters, coupled with techniques to assess changes in inflammatory and metabolic pathways, will help provide more granular insights on these mechanisms. In this special issue we discuss some of the emerging evidence supporting the hypothesis that brain inflammation and abnormal oxygen homeostasis occur interdependently during CLD and comprise important contributors to the development of HE. This review aims at furnishing evidence for further research in brain inflammation and oxygen homeostasis as additional therapeutic targets and potentially diagnostic markers for HE.
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Affiliation(s)
| | - Karen Louise Thomsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- UCL Institute of Liver and Digestive Health, University College London, London, UK
| | - Rajeshwar Prosad Mookerjee
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- UCL Institute of Liver and Digestive Health, University College London, London, UK
| | - Anna Hadjihambi
- The Roger Williams Institute of Hepatology London, Foundation for Liver Research, London, SE5 9NT, UK.
- Faculty of Life Sciences and Medicine, King's College London, London, UK.
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Roberts H, Ford TJ, Karl A, Reynolds S, Limond J, Adlam ALR. Mood Disorders in Young People With Acquired Brain Injury: An Integrated Model. Front Hum Neurosci 2022; 16:835897. [PMID: 35754774 PMCID: PMC9218558 DOI: 10.3389/fnhum.2022.835897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose/Objective Young people with paediatric acquired brain injury (pABI) are twice as likely to develop a mood disorder as their peers, frequently have significant unmet socio-emotional needs, and are at over double the risk of going on to use adult mental health services. Recent years have seen significant advances in the development of interventions for young people with mood disorders. However, evidence-based approaches to mood disorders in pABI are lacking and surprisingly little work has evaluated clinical and neuro-developmental models of mood disorders in this population. Method We review the literature regarding key mechanisms hypothesised to account for the increased vulnerability to mood disorders in pABI: First, we summarise the direct neurocognitive consequences of pABI, considering the key areas of the brain implicated in vulnerability to mood disorders within a neurodevelopmental framework. Second, we outline five key factors that contribute to the heightened prevalence of mood disorders in young people following ABI. Finally, we synthesise these, integrating neuro-cognitive, developmental and systemic factors to guide clinical formulation. Results and Implications We present a framework that synthesises the key mechanisms identified in our review, namely the direct effects of pABI, neurocognitive and neuroendocrine factors implicated in mood and anxiety disorders, maladaptive neuroplasticity and trauma, structural and systemic factors, and psychological adjustment and developmental context. This framework is the first attempt to provide integrated guidance on the multiple factors that contribute to elevated life-long risk of mood disorders following pABI.
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Affiliation(s)
| | - Tamsin J Ford
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Anke Karl
- Psychology, University of Exeter, Exeter, United Kingdom
| | - Shirley Reynolds
- Department of Psychology, University of Reading, Reading, United Kingdom
| | - Jenny Limond
- Psychology, University of Exeter, Exeter, United Kingdom
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Treatment Trials in Disorders of Consciousness: Challenges and Future Directions. Brain Sci 2022; 12:brainsci12050569. [PMID: 35624956 PMCID: PMC9139017 DOI: 10.3390/brainsci12050569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
The evidence base supporting treatment interventions for patients with disorders of consciousness is limited, and rigorous treatment trials are needed to guide future management of this complex patient population. There are many potential study designs that can be employed to develop this evidence, but the process of selecting the optimal study design is challenging. This article reviews common obstacles that impede research progress in this population and a range of study designs that may be employed. In addition, we consider how the particular practical and scientific obstacles may drive selection of the optimal design and, in particular, how the optimal design changes as treatment research proceeds along the translational continuum from mechanistic discovery to real-world clinical impact.
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van Amsterdam J, Brunt TM, Pereira FR, Crunelle CL, van den Brink W. Cognitive Impairment Following Clinical or Recreational Use of Gammahydroxybutyric Acid (GHB): A Systematic Review. Curr Neuropharmacol 2022; 20:809-819. [PMID: 34151766 PMCID: PMC9878963 DOI: 10.2174/1570159x19666210610094352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/24/2021] [Accepted: 05/05/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND GHB (gamma-hydroxybutyric acid; sodium oxybate) is a general anaesthetic that is clinically used for the treatment of narcolepsy, cataplexy, alcohol withdrawal and alcohol relapse prevention. In addition, GHB is recreationally used. Most clinical and recreational users regard GHB as an innocent drug devoid of adverse effects, despite its high dependence potential and possible neurotoxic effects. At high doses, GHB may lead to a comatose state. This paper systematically reviews possible cognitive impairments due to clinical and recreational GHB use. METHODS PubMed and PsychINFO were searched for literature data about the acute and residual cognitive deficits following GHB use. This review is conducted using the PRISMA protocol. RESULTS A total of 43 reports covering human and animal data on GHB-induced cognitive impairments were eligible and reviewed. This systematic review found no indication for cognitive impairments after clinical GHB use. However, it supports the view that moderate GHB use may result in acute short-term cognitive impairments, whereas regular high-dose GHB use and/or multiple GHB-induced comas are probably neurotoxic resulting in long-term residual cognitive impairments. CONCLUSION These results emphasize the need for awareness among clinicians and recreational users to minimize negative health consequences of recreational GHB use, particularly when high doses are used and GHB-induced comas occur.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands;,Address correspondence to this author at the Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands; E-mails: ;
| | - Tibor M. Brunt
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Filipa R. Pereira
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Cleo L. Crunelle
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
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Committeri G, Bondi D, Sestieri C, Di Matteo G, Piervincenzi C, Doria C, Ruffini R, Baldassarre A, Pietrangelo T, Sepe R, Navarra R, Chiacchiaretta P, Ferretti A, Verratti V. Neuropsychological and Neuroimaging Correlates of High-Altitude Hypoxia Trekking During the "Gokyo Khumbu/Ama Dablam" Expedition. High Alt Med Biol 2022; 23:57-68. [PMID: 35104160 DOI: 10.1089/ham.2021.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Committeri Giorgia, Danilo Bondi, Carlo Sestieri, Ginevra Di Matteo, Claudia Piervincenzi, Christian Doria, Roberto Ruffini, Antonello Baldassarre, Tiziana Pietrangelo, Rosamaria Sepe, Riccardo Navarra, Piero Chiacchiaretta, Antonio Ferretti, and Vittore Verratti. Neuropsychological and neuroimaging correlates of high-altitude hypoxia trekking during the "Gokyo Khumbu/Ama Dablam" expedition. High Alt Med Biol 00:000-000, 2021. Background: Altitude hypoxia exposure may produce cognitive detrimental adaptations and damage to the brain. We aimed at investigating the effects of trekking and hypoxia on neuropsychological and neuroimaging measures. Methods: We recruited two balanced groups of healthy adults, trekkers (n = 12, 6 F and 6 M, trekking in altitude hypoxia) and controls (gender- and age-matched), who were tested before (baseline), during (5,000 m, after 9 days of trekking), and after the expedition for state anxiety, depression, verbal fluency, verbal short-term memory, and working memory. Personality and trait anxiety were also assessed at a baseline level. Neuroimaging measures of cerebral perfusion (arterial spin labeling), white-matter microstructural integrity (diffusion tensor imaging), and resting-state functional connectivity (functional magnetic resonance imaging) were assessed before and after the expedition in the group of trekkers. Results: At baseline, the trekkers showed lower trait anxiety (p = 0.003) and conscientiousness (p = 0.03) than the control group. State anxiety was lower in the trekkers throughout the study (p < 0.001), and state anxiety and depression decreased at the end of the study in both groups (p = 0.043 and p = 0.007, respectively). Verbal fluency increased at the end of the study in both groups (p < 0.001), whereas verbal short-term memory and working memory performance did not change. No significant differences between before and after the expedition were found for neuroimaging measures. Conclusions: We argue that the observed differences in the neuropsychological measures mainly reflect aspecific familiarity and learning effects due to the repeated execution of the same questionnaires and task. The present results thus suggest that detrimental effects on neuropsychological and neuroimaging measures do not necessarily occur as a consequence of short-term exposure to altitude hypoxia up to 5,000 m, especially in the absence of altitude sickness.
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Affiliation(s)
- Giorgia Committeri
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Carlo Sestieri
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Ginevra Di Matteo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | | | - Christian Doria
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Roberto Ruffini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Antonello Baldassarre
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | | | - Riccardo Navarra
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Duff K, Suhrie KR, Dalley BCA, Porter SM, Dixon AM. Recognition subtests for the Repeatable Battery for the Assessment of Neuropsychological Status: Preliminary data in cognitively intact older adults, amnestic Mild Cognitive Impairment, and Alzheimer's disease. Clin Neuropsychol 2021; 35:1415-1425. [PMID: 32883179 PMCID: PMC7925698 DOI: 10.1080/13854046.2020.1812724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
Objective: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has three delayed recall subtests (list, story, figure), but only one delayed recognition subtest (list). Since comparisons between delayed recall and recognition can be useful in clinical neuropsychology, the current study sought to develop and preliminarily examine two proposed new subtests for Form A of the RBANS, Story Recognition and Figure Recognition. Method: A sample of older adults who were cognitively intact (n = 48) or classified with amnestic Mild Cognitive Impairment (MCI, n = 29) or mild Alzheimer's disease (AD, n = 24) were administered the RBANS and the two new recognition subtests. Results: In the primary analyses, cognitively intact participants performed significantly better than the two memory-impaired groups on all twelve scores (one recall and three recognition [total, hits, false positive errors] for the list, story, and figure). For amnestic MCI and AD participants, they showed statistically comparable scores on 7 of the 12 variables, where those with MCI performed better than those with AD on the other five scores. Across the three groups, effect sizes were large (e.g., Cohen's d = 1.0-2.9). In secondary analyses, all of the List Recall and Recognition scores significantly correlated with one another, and this pattern was observed for all of the Story Recall and Recognition scores and most of the Figure Recall and Recognition scores. Conclusions: Although preliminary, these new recognition scores appear to provide useful information and may improve the sensitivity of the RBANS in identifying cortical/subcortical profiles in clinical and research settings.
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Affiliation(s)
- Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Kayla R Suhrie
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Bonnie C A Dalley
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Sariah M Porter
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Ava M Dixon
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
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Zhong W, Ji Z, Sun C. A Review of Monitoring Methods for Cerebral Blood Oxygen Saturation. Healthcare (Basel) 2021; 9:healthcare9091104. [PMID: 34574878 PMCID: PMC8466732 DOI: 10.3390/healthcare9091104] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/13/2021] [Accepted: 07/31/2021] [Indexed: 01/02/2023] Open
Abstract
In recent years, cerebral blood oxygen saturation has become a key indicator during the perioperative period. Cerebral blood oxygen saturation monitoring is conducive to the early diagnosis and treatment of cerebral ischemia and hypoxia. The present study discusses the three most extensively used clinical methods for cerebral blood oxygen saturation monitoring from different aspects: working principles, relevant parameters, current situations of research, commonly used equipment, and relative advantages of different methods. Furthermore, through comprehensive comparisons of the methods, we find that near-infrared spectroscopy (NIRS) technology has significant potentials and broad applications prospects in terms of cerebral oxygen saturation monitoring. Despite the current NIRS technology, the only bedside non-invasive cerebral oxygen saturation monitoring technology, still has many defects, it is more in line with the future development trend in the field of medical and health, and will become the main method gradually.
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Affiliation(s)
- Wentao Zhong
- College of Bioengineering, Chongqing University, Chongqing 400044, China; (W.Z.); (C.S.)
| | - Zhong Ji
- College of Bioengineering, Chongqing University, Chongqing 400044, China; (W.Z.); (C.S.)
- Key Laboratory of Biorheological Science and Technology, Chongqing University, Ministry of Education, Chongqing 400044, China
- Correspondence:
| | - Changlong Sun
- College of Bioengineering, Chongqing University, Chongqing 400044, China; (W.Z.); (C.S.)
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Esopenko C, Meyer J, Wilde EA, Marshall AD, Tate DF, Lin AP, Koerte IK, Werner KB, Dennis EL, Ware AL, de Souza NL, Menefee DS, Dams-O'Connor K, Stein DJ, Bigler ED, Shenton ME, Chiou KS, Postmus JL, Monahan K, Eagan-Johnson B, van Donkelaar P, Merkley TL, Velez C, Hodges CB, Lindsey HM, Johnson P, Irimia A, Spruiell M, Bennett ER, Bridwell A, Zieman G, Hillary FG. A global collaboration to study intimate partner violence-related head trauma: The ENIGMA consortium IPV working group. Brain Imaging Behav 2021; 15:475-503. [PMID: 33405096 PMCID: PMC8785101 DOI: 10.1007/s11682-020-00417-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
Intimate partner violence includes psychological aggression, physical violence, sexual violence, and stalking from a current or former intimate partner. Past research suggests that exposure to intimate partner violence can impact cognitive and psychological functioning, as well as neurological outcomes. These seem to be compounded in those who suffer a brain injury as a result of trauma to the head, neck or body due to physical and/or sexual violence. However, our understanding of the neurobehavioral and neurobiological effects of head trauma in this population is limited due to factors including difficulty in accessing/recruiting participants, heterogeneity of samples, and premorbid and comorbid factors that impact outcomes. Thus, the goal of the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium Intimate Partner Violence Working Group is to develop a global collaboration that includes researchers, clinicians, and other key community stakeholders. Participation in the working group can include collecting harmonized data, providing data for meta- and mega-analysis across sites, or stakeholder insight on key clinical research questions, promoting safety, participant recruitment and referral to support services. Further, to facilitate the mega-analysis of data across sites within the working group, we provide suggestions for behavioral surveys, cognitive tests, neuroimaging parameters, and genetics that could be used by investigators in the early stages of study design. We anticipate that the harmonization of measures across sites within the working group prior to data collection could increase the statistical power in characterizing how intimate partner violence-related head trauma impacts long-term physical, cognitive, and psychological health.
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Affiliation(s)
- Carrie Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107, USA.
- Department of Health Informatics, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107, USA.
| | - Jessica Meyer
- Department of Psychiatry, Summa Health System, Akron, OH, 44304, USA
| | - Elisabeth A Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
| | - Amy D Marshall
- Department of Psychology, Pennsylvania State University, University Park, PA, 16802, USA
| | - David F Tate
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
| | - Alexander P Lin
- Department of Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Inga K Koerte
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, 80336, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Kimberly B Werner
- College of Nursing, University of Missouri, St. Louis, MO, 63121, USA
| | - Emily L Dennis
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
| | - Ashley L Ware
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- Department of Psychology, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Nicola L de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | | | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Dan J Stein
- Department of Psychiatry and Neuroscience Institute, South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, 7501, South Africa
| | - Erin D Bigler
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
| | - Martha E Shenton
- College of Nursing, University of Missouri, St. Louis, MO, 63121, USA
- Departments of Psychiatry and Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Veterans Affairs, Boston Healthcare System, Boston, MA, 02130, USA
| | - Kathy S Chiou
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA
| | - Judy L Postmus
- School of Social Work, University of Maryland, Baltimore, USA
| | - Kathleen Monahan
- School of Social Welfare, Stony Brook University, Stony Brook, NY, 11794-8231, USA
| | | | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Tricia L Merkley
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Carmen Velez
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
| | - Cooper B Hodges
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
| | - Hannah M Lindsey
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
| | - Paula Johnson
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
- Neuroscience Center, Brigham Young University, Provo, UT, 84602, USA
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA
- Denney Research Center Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, 90089, USA
| | - Matthew Spruiell
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Esther R Bennett
- Rutgers University School of Social Work, New Brunswick, NJ, 08901, USA
| | - Ashley Bridwell
- Barrow Concussion and Brain Injury Center, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Glynnis Zieman
- Barrow Concussion and Brain Injury Center, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Frank G Hillary
- Department of Psychology, Pennsylvania State University, University Park, PA, 16802, USA
- Social Life and Engineering Sciences Imaging Center, University Park, PA, 16802, USA
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12
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Physiology, pathophysiology and (mal)adaptations to chronic apnoeic training: a state-of-the-art review. Eur J Appl Physiol 2021; 121:1543-1566. [PMID: 33791844 PMCID: PMC8144079 DOI: 10.1007/s00421-021-04664-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
Breath-hold diving is an activity that humans have engaged in since antiquity to forage for resources, provide sustenance and to support military campaigns. In modern times, breath-hold diving continues to gain popularity and recognition as both a competitive and recreational sport. The continued progression of world records is somewhat remarkable, particularly given the extreme hypoxaemic and hypercapnic conditions, and hydrostatic pressures these athletes endure. However, there is abundant literature to suggest a large inter-individual variation in the apnoeic capabilities that is thus far not fully understood. In this review, we explore developments in apnoea physiology and delineate the traits and mechanisms that potentially underpin this variation. In addition, we sought to highlight the physiological (mal)adaptations associated with consistent breath-hold training. Breath-hold divers (BHDs) are evidenced to exhibit a more pronounced diving-response than non-divers, while elite BHDs (EBHDs) also display beneficial adaptations in both blood and skeletal muscle. Importantly, these physiological characteristics are documented to be primarily influenced by training-induced stimuli. BHDs are exposed to unique physiological and environmental stressors, and as such possess an ability to withstand acute cerebrovascular and neuronal strains. Whether these characteristics are also a result of training-induced adaptations or genetic predisposition is less certain. Although the long-term effects of regular breath-hold diving activity are yet to be holistically established, preliminary evidence has posed considerations for cognitive, neurological, renal and bone health in BHDs. These areas should be explored further in longitudinal studies to more confidently ascertain the long-term health implications of extreme breath-holding activity.
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13
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Brownlee NNM, Wilson FC, Curran DB, Lyttle N, McCann JP. Neurocognitive outcomes in adults following cerebral hypoxia: A systematic literature review. NeuroRehabilitation 2021; 47:83-97. [PMID: 32716324 DOI: 10.3233/nre-203135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hypoxic ischemic brain injury (HIBI) occurs as a result of complete or partial disruption of cerebral oxygen supply. The physical and cognitive sequelae of adults following hypoxia varies widely. OBJECTIVE To systematically review studies exploring the neuropsychological outcomes following hypoxic brain insult in adults. METHODS Data was sourced using six databases (CINAHL, Cochrane, Embase, Medline, PsycInfo and Web of Science). Initial MESH terms identified 2,962 articles. After a three-stage independent review process, 18 articles, 9 case studies and 9 group studies were available for data synthesis from 1990-2012. Case study data was converted to standardised scores and compared to available test norms. Cohen's d was calculated to permit group data interpretation. RESULTS Intellectual decrement was observed in some studies although difficult to delineate given the lack of use of measures of premorbid ability. Cognitive sequelae varied albeit with predominant disturbance in verbal memory, learning ability and executive function observed across studies. Wechsler Memory Scale Revised (WMS-R) visual memory was comparable to normative data. Impaired Rey Osterrieth Complex Figure (ROCFT) performance was found among group studies. Across visuo-constructional and attention domains, performance varied, although no significant difference relative to reported means was observed. CONCLUSIONS Future studies should consider the use of standardised assessment protocols, which include measures of premorbid functioning and performance validity.
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Affiliation(s)
| | | | - David B Curran
- Clinical Psychology Department, Queen's University Belfast, Belfast, Ireland
| | - Nigel Lyttle
- Regional Neurosciences Centre, The Royal Victoria Hospital, Belfast, Ireland
| | - John P McCann
- Regional Acquired Brain Injury Unit (R.A.B.I.U.), Musgrave Park Hospital, Belfast, Ireland
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14
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Garcia S, Hampstead BM. HD-tDCS as a neurorehabilitation technique for a case of post-anoxic leukoencephalopathy. Neuropsychol Rehabil 2020; 32:946-966. [PMID: 33208043 DOI: 10.1080/09602011.2020.1845749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Post-anoxic leukoencephalopathy is a rare event that causes global demyelination secondary to anoxic injury. Given the nature and extent of the damage, cognitive and functional deficits are typically chronic even after standard therapies. Here, we describe a novel treatment approach that used high definition transcranial direct-current stimulation (HD-tDCS) with a 62-year-old male who was 5 years post-anoxic leukoencephalopathy secondary to an accidental drug overdose. HD-tDCS was administered over the left lateral prefrontal cortex across 29 daily sessions at 2 mA (20 min/session) in order to address dysexecutive behaviors. Results demonstrated improved delayed memory and trends for improved visuospatial and semantic fluency performance as well as improved insight and daily functioning, all of which returned to baseline by the end of a 10 week no-contact follow up period. Resting state fMRI connectivity results mirrored these changes by showing increased dorsal attention and cingulo-opercular but reduced ventral attention network connectivity after session 29, all of which returned to baseline at follow-up. These findings suggest HD-tDCS may benefit functioning even following serious and pervasive anoxic injury. Findings also suggest the need for continued HD-tDCS for maintenance purposes, though future work is needed to identify optimal dose-response information.
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Affiliation(s)
- Sarah Garcia
- Psychology Department, Stetson University, DeLand, FL, USA
| | - Benjamin M Hampstead
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Research Program on Cognition and Neuromodulation Based Interventions, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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15
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Wilson DL, Barnes M, Ellett L, Permezel M, Jackson M, Crowe SF. Reduced Verbal Memory Retention is Unrelated to Sleep Disturbance During Pregnancy. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2012.00076.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Danielle L Wilson
- School of Psychological Science, La Trobe University
- Institute for Breathing and Sleep, Austin Health
| | - Maree Barnes
- Institute for Breathing and Sleep, Austin Health
- Department of Medicine, University of Melbourne
| | - Lenore Ellett
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women
| | - Michael Permezel
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women
- Department of Obstetrics and Gynaecology, University of Melbourne
| | | | - Simon F Crowe
- School of Psychological Science, La Trobe University
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16
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Curtis JA, Seikaly ZN, Troche MS. Respiratory-Swallow Coordination Training Improves Swallowing Safety and Efficiency in a Person With Anoxic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1965-1975. [PMID: 32755487 DOI: 10.1044/2020_ajslp-20-00095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The aim of this study was to assess the effects of respiratory-swallow coordination training (RSCT) on respiratory-swallow coordination (RSC), swallowing safety (penetration/aspiration), and swallowing efficiency (pharyngeal residue) in a person with anoxic brain injury. Method A 68-year-old man with anoxic brain injury, tachypnea, and severe dysphagia was recruited to participate in a prospective AABAA single-subject experimental design. RSC, swallowing safety, and swallowing efficiency were measured at each assessment using respiratory inductive plethysmography and flexible endoscopic evaluations of swallowing. Data were analyzed descriptively using Cohen's d effect size. Outcome measures were compared pre-RSCT to post-RSCT, and pre-RSCT to a 1-month retention assessment. Results Improvements in RSC were observed immediately post-RSCT (d = 0.60). These improvements were maintained upon retention assessment 1 month later (d = 0.60). Additionally, improvements in swallowing safety (d = 1.73), efficiency (d = 1.73), and overall dysphagia severity (d = 1.73) were observed immediately post-RSCT and were maintained upon retention assessment 1 month later (d = 1.73). Conclusions Clinically meaningful improvements in RSC were observed following four sessions of RSCT, which were subsequently associated with large improvements in swallowing safety and efficiency. RSCT may be an efficacious, clinically feasible skill-based exercise for people with anoxic brain injury, suboptimal RSC, and dysphagia. Future work is needed to expand these findings in a larger cohort of people with dysphagia.
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Affiliation(s)
- James A Curtis
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Zeina N Seikaly
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Michelle S Troche
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
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17
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Geva S, Jentschke S, Argyropoulos GPD, Chong WK, Gadian DG, Vargha-Khadem F. Volume reduction of caudate nucleus is associated with movement coordination deficits in patients with hippocampal atrophy due to perinatal hypoxia-ischaemia. Neuroimage Clin 2020; 28:102429. [PMID: 33010533 PMCID: PMC7530343 DOI: 10.1016/j.nicl.2020.102429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
Acute sentinel hypoxia-ischaemia in neonates can target the hippocampus, mammillary bodies, thalamus, and the basal ganglia. Our previous work with paediatric patients with a history of hypoxia-ischaemia has revealed hippocampal and diencephalic damage that impacts cognitive memory. However, the structural and functional status of other brain regions vulnerable to hypoxia-ischaemia, such as the basal ganglia, has not been investigated in these patients. Furthermore, it is not known whether there are any behavioural sequelae of such damage, especially in patients with no diagnosis of neurological disorder. Based on the established role of the basal ganglia and the thalamus in movement coordination, we studied manual motor function in 20 participants exposed to neonatal hypoxia-ischaemia, and a group of 17 healthy controls of comparable age. The patients' handwriting speed and accuracy was within the normal range (Detailed Assessment of Speed of Handwriting), and their movement adaptation learning (Rotary Pursuit task) was comparable to the control group's performance. However, as a group, patients showed an impairment in the Grooved Pegboard task and a trend for impairment in speed of movement while performing the Rotary Pursuit task, suggesting that some patients have subtle deficits in fine, complex hand movements. Voxel-based morphometry and volumetry showed bilateral reduction in grey matter volume of the thalamus and caudate nucleus. Reduced volumes in the caudate nucleus correlated across patients with performance on the Grooved Pegboard task. In summary, the fine movement coordination deficit affecting the hand and the wrist in patients exposed to early hypoxic-ischaemic brain injury may be related to reduced volumes of the caudate nucleus, and consistent with anecdotal parental reports of clumsiness and coordination difficulties in this cohort.
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Affiliation(s)
- Sharon Geva
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
| | - Sebastian Jentschke
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
| | - Georgios P D Argyropoulos
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
| | - W K Chong
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, United Kingdom.
| | - David G Gadian
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
| | - Faraneh Vargha-Khadem
- Cognitive Neuroscience and Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
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18
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Byron-Alhassan A, Tulloch HE, Collins B, Quinlan B, Fang Z, Chakraborty S, Le May M, Duchesne L, Smith AM. Exploratory Analyses of Cerebral Gray Matter Volumes After Out-of-Hospital Cardiac Arrest in Good Outcome Survivors. Front Psychol 2020; 11:856. [PMID: 32435222 PMCID: PMC7218079 DOI: 10.3389/fpsyg.2020.00856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 04/06/2020] [Indexed: 01/15/2023] Open
Abstract
Background Survival rates of cardiac arrest have increased over recent years, however, survivors may still be left with significant morbidity and functional impairment. A primary concern in cardiac arrest survivors is the effect of prolonged hypoxia/ischemia on the brain. The objectives of the present study were threefold: (1) to explore the effect of cardiac arrest on brain gray matter volumes (GMV) in “good outcome” survivors of out-of-hospital cardiac arrest (OHCA), (2) to examine the relationship between GMV, cognitive functioning and arrest factors, and (3) to explore whether OHCA patients differ from a group of patients with myocardial infarction (MI) uncomplicated by cardiac arrest and a group of healthy controls in terms of GMV. Methods Medically stable OHCA survivors with preserved neurological function and who were eligible for magnetic resonance imaging scanning (MRI; n = 9), were compared to: (1) patients who had experienced a MI (n = 19) and (2) healthy controls (n = 12). Participants underwent brain MRI on a 3T Siemens Trio MRI scanner and GMV was measured by voxel-based morphometry. A comprehensive neuropsychological assessment was also conducted. Global GMV was compared in the three samples using analyses of variance. The relationships between cognition and GMV were examined within group using correlations. Results The OHCA and MI groups showed a similar pattern of differences compared to the healthy control group. Both groups had decreased GMV in the anterior cingulate cortex, bilateral hippocampus, right dorsolateral prefrontal cortex, right putamen, and bilateral cerebellum. There were no significant differences in global or regional GMV between the OHCA and MI groups. Cognitive functioning was correlated with global GMV in the OHCA group; no such correlation was observed in the MI group. Conclusion Regional atrophy was observed in OHCA and MI survivors, compared to a healthy control group, suggesting a common mechanism, presumably preexisting cardiovascular disease. Although similar regional volume differences were observed between the MI and OHCA groups, the relationship between GMV and cognition was only observed in OHCA survivors. We suggest the acute hypoxia/ischemia ensuing from the arrest may interact with diminished neural reserve in select brain areas to expose occult cognitive dysfunction.
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Affiliation(s)
- Aziza Byron-Alhassan
- Department of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada.,School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Heather E Tulloch
- Department of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada.,School of Psychology, University of Ottawa, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Barbara Collins
- Department of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada.,School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Bonnie Quinlan
- Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Zhuo Fang
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Santanu Chakraborty
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada
| | - Michel Le May
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Lloyd Duchesne
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Andra M Smith
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
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19
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Nordio S, Burgio F, D'Imperio D, De Biagi F, Cosentino E, Meneghello F. Communicative and swallowing disorders in anoxic patients: A retrospective study on clinical outcomes and performance measures. NeuroRehabilitation 2019; 45:453-461. [PMID: 31868687 DOI: 10.3233/nre-192884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Anoxic brain injury (ABI) is a neurological condition associated to a severe deterioration of brain functioning, whose symptomatology and clinical outcomes may be heterogeneous: cognitive deficits, language disorders like dysarthria and swallowing impairments. Nevertheless, there is still a lack of information on the rehabilitation outcomes. OBJECTIVE To confirm the occurrence of communication and swallowing deficits in 37 ABI patients and to examine whether intensive rehabilitation may contribute to any improvements and its relation to ABI severity and functional autonomy. METHODS 37 patients, hospitalized at IRCCS San Camillo Hospital from 2011 to 2018 were analyzed retrospectively. All patients completed a functional evaluation and a language and swallowing assessment, within one week from hospital admission (T0). The assessment was repeated after an intensive rehabilitation treatment (T1). RESULTS Results show that dysphagia is a frequent and severe outcome in anoxic patients, whereas communication disorders (aphasia and dysarthria) are less severe. Moreover, ABI patients seem to be positively sensitive to an intensive rehabilitation program. CONCLUSIONS An early multidisciplinary management of communicative-linguistic and swallowing functions is crucial in order to prevent adverse events and to plan a tailored rehabilitation pathway.
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20
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Cognitive Impairment among Cardiac Arrest Survivors in the ICU: A Retrospective Study. Emerg Med Int 2019; 2019:2578258. [PMID: 31781396 PMCID: PMC6875163 DOI: 10.1155/2019/2578258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/04/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022] Open
Abstract
Background Recent studies have presented the effects of cardiac arrest on long-term cognitive function and quality of life. However, no study has evaluated cognitive function in the early stage after regaining consciousness. Purpose The objectives of this study were to analyse the incidence, clinical course, and associated factors of cognitive impairment of cardiac arrest survivors in intensive care unit (ICU). Patients and methods We administered the Mini-Mental State Examination (MMSE) to cardiac arrest survivors who were treated with targeted temperature management (TTM) immediately after regaining consciousness. Patients whose MMSE scores indicated impaired cognitive function (MMSE < 24) were retested before ICU discharge. Results In 92 patients, the median MMSE score was 21.0 (interquartile range (IQR), 16.0–24.0), and cognitive impairment was found in 64 patients. Fifty-three patients completed follow-up MMSEs, and the median scores were 20.0 (IQR, 13.5–23.0) for the first and 25.0 (IQR, 21.5–28.0) for the last test. Of the specific domains, recall (0.0 (IQR, 0.0–1.0) to 2.0 (IQR, 1.0–3.0)) and attention/calculation (3.0 (IQR, 1.0–4.0) to 4.0 (IQR, 2.0–5.0)) were the most affected domains until ICU discharge. The factors that were correlated with cognitive impairment on the last MMSE were older age (OR, 1.07 (95% CI, 1.01–1.14), p=0.016), increased time to return of spontaneous circulation (ROSC) (OR, 1.08 (95% CI, 1.02–1.15), p=0.012), and length of hospital stay (OR, 1.07 (95% CI, 1.00–1.14), p=0.044). Conclusions Cognitive impairments were common immediately after patients regained consciousness but recovered substantially before ICU discharge. Recall and attention/calculation still were impaired until ICU discharge, and older age, increased time to ROSC, and LOS were associated with this cognitive decline.
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21
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Watanabe T. Meaningful Assessment in Patients with Acquired Brain Injuries. Phys Med Rehabil Clin N Am 2019; 29:437-444. [PMID: 30626506 DOI: 10.1016/j.pmr.2018.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There are several key components to the meaningful and comprehensive assessment of patients with acquired brain injuries with respect to management of the upper motor neuron syndrome. Type of brain injury, trajectory of recovery, relevant concomitant complications, development of appropriate goals, and an understanding of resources available for patients are all factors to assess when developing a treatment plan. Using appropriate outcome measures will help monitor the efficacy of interventions and guide ongoing management of spasticity.
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Affiliation(s)
- Thomas Watanabe
- MossRehab at Elkins Park, Einstein Healthcare Network, Elkins Park, PA, USA; Department of Physical Medicine and Rehabilitation, Temple University School of Medicine, Philadelphia, PA, USA.
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22
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Jonin PY, Besson G, La Joie R, Pariente J, Belliard S, Barillot C, Barbeau EJ. Superior explicit memory despite severe developmental amnesia: In-depth case study and neural correlates. Hippocampus 2018; 28:867-885. [PMID: 29995351 DOI: 10.1002/hipo.23010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/18/2018] [Accepted: 07/01/2018] [Indexed: 11/09/2022]
Abstract
The acquisition of new semantic memories is sometimes preserved in patients with hippocampal amnesia. Robust evidence for this comes from case reports of developmental amnesia suggesting that low-to-normal levels of semantic knowledge can be achieved despite compromised episodic learning. However, it is unclear whether this relative preservation of semantic memory results from normal acquisition and retrieval or from residual episodic memory, combined with effortful repetition. Furthermore, lesion studies have mainly focused on the hippocampus itself, and have seldom reported the state of structures in the extended hippocampal system. Preserved components of this system may therefore mediate residual episodic abilities, contributing to the apparent semantic preservation. We report an in-depth study of Patient KA, a 27-year-old man who had severe hypoxia at birth, in which we carefully explored his residual episodic learning abilities. We used novel speeded recognition paradigms to assess whether KA could explicitly acquire and retrieve new context-free memories. Despite a pattern of very severe amnesia, with a 44-point discrepancy between his intelligence and memory quotients, KA exhibited normal-to-superior levels of knowledge, even under strict time constraints. He also exhibited normal-to-superior recognition memory for new material, again under strict time constraints. Multimodal neuroimaging revealed an unusual pattern of selective atrophy within each component of the extended hippocampal system, contrasting with the preservation of anterior subhippocampal cortices. A cortical thickness analysis yielded a pattern of thinner but also thicker regional cortices, pointing toward specific temporal lobe reorganization following early injury. We thus report the first case of superior explicit learning and memory in a severe case of amnesia, raising important questions about how such knowledge can be acquired.
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Affiliation(s)
- Pierre-Yves Jonin
- Brain and Cognition Research Center, CNRS UMR 5549, Université de Toulouse Paul Sabatier, Toulouse, France.,IRISA, UMR CNRS 6074, VisAGeS U1228, INSERM, INRIA, Université de Rennes 1, Rennes, France.,Neurology Department, Pontchaillou University Hospital, Rennes, France
| | - Gabriel Besson
- Brain and Cognition Research Center, CNRS UMR 5549, Université de Toulouse Paul Sabatier, Toulouse, France
| | - Renaud La Joie
- "Neuropsychology and Imaging of Human Memory" Research Unit, Normandy University-PSL Research University-INSERM U1077, Caen University Hospital, Caen, France
| | - Jérémie Pariente
- Toulouse Neuroimaging Center, INSERM U1214, Université de Toulouse Paul Sabatier, Toulouse, France
| | - Serge Belliard
- Neurology Department, Pontchaillou University Hospital, Rennes, France.,"Neuropsychology and Imaging of Human Memory" Research Unit, Normandy University-PSL Research University-INSERM U1077, Caen University Hospital, Caen, France
| | - Christian Barillot
- IRISA, UMR CNRS 6074, VisAGeS U1228, INSERM, INRIA, Université de Rennes 1, Rennes, France
| | - Emmanuel J Barbeau
- Brain and Cognition Research Center, CNRS UMR 5549, Université de Toulouse Paul Sabatier, Toulouse, France
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23
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Kim HH, Min YG. Anterograde Amnesia after Acute Glufosinate Ammonium Intoxication. Acute Crit Care 2018; 33:110-113. [PMID: 31723872 PMCID: PMC6849054 DOI: 10.4266/acc.2016.00444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/28/2016] [Accepted: 09/05/2016] [Indexed: 11/30/2022] Open
Abstract
Glufosinate ammonium (GA) intoxication causes several neurologic complications. We report a rare but typical case of GA intoxication associated with anterograde amnesia and bilateral hippocampal involvement. A 53-year-old woman with GA intoxication presented to the emergency department. Initial general and neurologic examinations were unremarkable but, from the day after admission, she exhibited anterograde amnesia. On brain magnetic resonance imaging, the signal intensity in the hippocampus was symmetrically and bilaterally increased. She was discharged with no medical problems, but the anterograde amnesia remained. Eleven days after the onset of amnesia, she returned to the neurology outpatient department with persisting anterograde amnesia but improving symptoms.
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Affiliation(s)
- Hyuk-Hoon Kim
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Young-Gi Min
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
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Abstract
BACKGROUND Carbon monoxide (CO) poisoning is the leading cause of accidental poisoning worldwide. This study undertook a meta-analysis to examine differences in neuropsychological functioning in patients with CO poisoning as compared to healthy controls, and examined the longer-term neuropsychological effects of CO poisoning. METHODS Studies performed between the years 1995 and 2016 were identified through a search of the electronic databases Medline and PsycInfo. Data from the papers identified were pooled to determine standard mean differences using a random-effects model. RESULTS Ten studies were included in the analysis, with healthy controls performing significantly better than CO poisoned participants on the domains of divided attention, immediate memory, and processing speed. No statistically significant differences were found for sustained attention, recent memory, working memory, visuospatial/constructional ability, and expressive language. Performance by participants with CO poisoning for the domains of sustained attention, recent memory, visuospatial/constructional abilities, and working memory significantly improved over time after initial exposure, demonstrating recovery of these functions over time. No statistically significant differences were evident for divided attention or expressive language. CONCLUSIONS This evidence indicates that healthy controls perform better than do individuals with CO poisoning on a range of neuropsychological domains; however, it also indicates that performance in some domains does improve over time. (JINS, 2018, 24, 405-415).
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Are rehabilitation outcomes after severe anoxic brain injury different from severe traumatic brain injury? A matched case–control study. Int J Rehabil Res 2018; 41:47-51. [DOI: 10.1097/mrr.0000000000000261] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Long-term effects of brief hypoxia due to cardiac arrest: Hippocampal reductions and memory deficits. Resuscitation 2018; 126:65-71. [PMID: 29474878 DOI: 10.1016/j.resuscitation.2018.02.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/01/2018] [Accepted: 02/15/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the effects of brief hypoxia (<7 min) due to cardiac arrest on the integrity of the brain and performance on memory and executive functions tasks. METHODS Patients after out-of-hospital cardiac arrest (CA) (n = 9), who were deemed neurologically intact on discharge, were compared to matched patients with myocardial infarction (MI) (n = 9). A battery of clinical and experimental memory and executive functions neuropsychological tests were administered and MRI scans for all patients were collected. Measures of subcortical and cortical volumes and cortical thickness were obtained using FreeSurfer. Manual segmentations of the hippocampus were also performed. APACHE-II scores were calculated based on metrics collected at admission to ICCU for all patients. RESULTS Significant differences between the two groups were observed on several verbal memory tests. Both hippocampi were significantly reduced (p < 0.05) in the CA patients, relative to MI patients. Hippocampal subfields segmentation showed significantly reduced presubiculum volumes bilaterally. CA patients had on average 10% reduction in volumes bilaterally across hippocampal subfields. No cortical thickness differences survived correction. Significant correlations were observed in the CA group only between the hippocampal volumes and performance on verbal memory tasks, including recollection. Hippocampal volumes and several memory measures (but not other cognitive domains) were strongly correlated with APACHE-II scores on admission in the CA group, but not in the MI group CONCLUSIONS: Chronic patients with cardiac arrest who were discharged from hospital in "good neurological condition" showed an average of 10% reduction in hippocampal volume bilaterally and significant verbal memory deficits relative to matched controls with myocardial infarction, suggesting even brief hypoxic periods suffice to lead to specific hippocampal damage.
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Apathy and Cognitive Deficits in Patients with Transient Global Ischemia After Cardiac Arrest. Cogn Behav Neurol 2017; 30:172-175. [DOI: 10.1097/wnn.0000000000000139] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Billaut F, Gueit P, Faure S, Costalat G, Lemaître F. Do elite breath-hold divers suffer from mild short-term memory impairments? Appl Physiol Nutr Metab 2017; 43:247-251. [PMID: 29053942 DOI: 10.1139/apnm-2017-0245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Repeated apneas are associated with severe hypoxemia that may ultimately lead to loss of consciousness in some breath-hold divers. Despite increasing number of practitioners, the relationship between apnea-induced hypoxia and neurocognitive functions is still poorly understood in the sport of free diving. To shed light onto this phenomenon, we examined the impact of long-term breath-hold diving training on attentional processing, short-term memory, and long-term mnesic and executive functions. Thirty-six men matched for age, height, and weight were separated into the following 3 groups: (i) 12 elite breath-hold divers (EBHD), mean static apnea best time 371 s, 105 months mean apnea experience; (ii) 12 novice breath-hold divers, mean best time 243 s, 8.75 months mean apnea experience; and (iii) 12 physical education students with no breath-hold diving experience; all of these participants performed varied written and computerized neuropsychological tasks. Compared with the 2 other groups, the EBHD group was slower to complete the interference card during a Stroop test (F[1,33] = 4.70, p < 0.05), and presented more errors on the interference card (F[1,33] = 2.96, p < 0.05) and a lower total interference score (F[1,33] = 5.64, p < 0.05). The time to complete the interference card test was positively correlated with maximal static apnea duration (r = 0.73, p < 0.05) and the number of years of breath-hold diving training (r = 0.79, p < 0.001). These findings suggest that breath-hold diving training over several years may cause mild, but persistent, short-term memory impairments.
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Affiliation(s)
- François Billaut
- a Département de kinésiologie, Faculté de Médecine, Université Laval, 2300, rue de la Terrasse, Québec, QC G1V 0A6, Canada
| | - Patrice Gueit
- b Centre d'Etudes des Transformations des Activités Physiques et Sportives, EA n°3832, Faculté des Sciences du Sport et de l'Education Physique de Rouen, Université de Rouen, Mont-Saint-Aignan 76130, France
| | - Sylvane Faure
- c Laboratoire d'Anthropologie et de Psychologie Cognitives et Sociales, EA 7278, Université Nice - Sophia-Antipolis, Nice 06357, France
| | - Guillaume Costalat
- d Laboratoire Adaptations Physiologiques à l'Exercice et Réadaptation à l'effort (APERE), EA n°3300, Université de Picardie Jules Verne, Amiens 80025, France
| | - Frédéric Lemaître
- b Centre d'Etudes des Transformations des Activités Physiques et Sportives, EA n°3832, Faculté des Sciences du Sport et de l'Education Physique de Rouen, Université de Rouen, Mont-Saint-Aignan 76130, France
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Neuropsychological Outcome following Resuscitation after Out-of-Hospital Cardiac Arrest: A One-Year Follow-Up. Case Rep Cardiol 2017; 2017:7283606. [PMID: 28845315 PMCID: PMC5563396 DOI: 10.1155/2017/7283606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/19/2017] [Accepted: 07/03/2017] [Indexed: 11/18/2022] Open
Abstract
A 61-year-old woman survived resuscitation after out-of-hospital cardiac arrest. The heterogeneity of the resulting cognitive impairments and the recovery over a one-year period are presented, highlighting the need for standardized neuropsychological testing even after short cardiac arrests and for effective treatment both out of hospital and in hospital.
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Wazeer MM, John S, Rajashekhar B. Neurogenic speech sequelae following suicide attempt by hanging: a case report. Int J Adolesc Med Health 2017; 29:/j/ijamh.2017.29.issue-2/ijamh-2015-0039/ijamh-2015-0039.xml. [PMID: 26360492 DOI: 10.1515/ijamh-2015-0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/02/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Attempting suicide by hanging has become one of the most preferred means among adolescents. Individuals who survive a suicide attempt by hanging have a range of deficits, including neuropsychological, neuropsychiatric, pulmonary and even speech and language deficits. Literature regarding speech and language deficits in cases of near hanging is especially limited. OBJECTIVE This study aimed to demonstrate the sequelae of neurogenic speech deficits following a suicide attempt by hanging, the treatment strategies, and prognostic issues in one such case. METHODS We report of Patient X who attempted suicide by hanging. The patient was admitted and a detailed speech and language evaluation was completed. RESULTS Patient X was diagnosed with hypoxic-ischemic encephalopathy with organic amnesic syndrome. Consequent to the neurogenic insult, the patient demonstrated speech deficits that were characterized by moderate flaccid dysarthria and neurogenic stuttering. Patient X underwent a week of treatment, subsequent to which there was an improvement in certain speech subsystems. However, the neurogenic stuttering symptoms did not resolve completely even post therapy. CONCLUSION Individuals who survive a suicide attempt by hanging have a range of deficits, including speech deficits that need to be addressed by a speech language pathologist. This case report is an eye opener for speech language pathologists regarding their role in such cases.
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Affiliation(s)
| | - Sunila John
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka
| | - Bellur Rajashekhar
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka
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Aneja J, Jangli S, Kulhara P, Bathla M. Neuropsychiatric sequelae of attempted hanging and diagnostic dilemmas. Ind Psychiatry J 2017; 26:239-242. [PMID: 30089976 PMCID: PMC6058448 DOI: 10.4103/ipj.ipj_46_15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Suicide is an important cause of death worldwide, and India is not immune to this major health problem. Suicide by hanging is one of the lethal methods widely practiced. However, literature is very sparse as well as old in the context of neuropsychiatric consequences seen in those who survive such attempts. We present a case of a young boy who survived an attempted hanging and was left with neuropsychiatric sequelae in the form of retro/anterograde amnesia, aggression, lability of affect, and impaired memory and visuomotor deficits. The associated diagnostic dilemmas, namely whether to diagnose such patients with Korsakoff's psychosis, organic amnesic syndrome, or major neurocognitive syndrome, are discussed and a brief review of literature of this largely ignored area is also presented.
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Affiliation(s)
- Jitender Aneja
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Satyarth Jangli
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Parmanand Kulhara
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Manish Bathla
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
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32
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Dhamapurkar SK, Wilson BA, Rose A, Florschutz G. Brugada syndrome and the story of Dave. Neuropsychol Rehabil 2017; 28:259-267. [PMID: 28486839 DOI: 10.1080/09602011.2017.1323649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Brugada syndrome (BrS) is a little known genetic condition that causes severe disturbances in cardiac rhythm and may result in sudden unexpected cardiac death in an apparently healthy person. The heart structure is typically normal but there are problems with electrical activity. The syndrome is named after Spanish brothers who are cardiologists, Pedro and Josep Brugada. BrS is the major cause of sudden unexplained death syndrome (SUDS), also known as sudden arrhythmic death syndrome (SADS). Following a description of the syndrome, including its prevalence and incidence, how it is diagnosed and how it can be treated, we consider those who survive a cardiac arrest and what problems they may face. Most publications focus on the medical aspects of BrS but, of course, cardiac arrest can result in hypoxic brain damage. We conclude with the story of Dave, a 25-year-old man diagnosed with BrS following a nose bleed and subsequent cardiac arrest. He was left with a visual impairment, dystonia, hypersensitivity, and language and cognitive dysfunction. We look at Dave's strengths and weaknesses, his response to offered treatment, and his consequent improvement. We stress the contributions from members of the multidisciplinary team and offer suggestions for the rehabilitation of other survivors of BrS.
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Affiliation(s)
| | - Barbara A Wilson
- b Neuropsychology Department , The Raphael Medical Centre , Kent , UK.,c Neuropsychology Department , The Oliver Zangwill Centre , Kent , UK
| | - Anita Rose
- b Neuropsychology Department , The Raphael Medical Centre , Kent , UK
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Konoike N, Miwa M, Ishigami A, Nakamura K. Hypoxemia after single-shot anesthesia in common marmosets. J Med Primatol 2017; 46:70-74. [DOI: 10.1111/jmp.12262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Naho Konoike
- Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Miki Miwa
- Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Akiyo Ishigami
- Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Katsuki Nakamura
- Primate Research Institute; Kyoto University; Inuyama Aichi Japan
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34
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Muñoz-López M, Hoskote A, Chadwick MJ, Dzieciol AM, Gadian DG, Chong K, Banks T, de Haan M, Baldeweg T, Mishkin M, Vargha-Khadem F. Hippocampal damage and memory impairment in congenital cyanotic heart disease. Hippocampus 2017; 27:417-424. [PMID: 28032672 PMCID: PMC5363353 DOI: 10.1002/hipo.22700] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 11/17/2022]
Abstract
Neonatal hypoxia can lead to hippocampal atrophy, which can lead, in turn, to memory impairment. To test the generalizability of this causal sequence, we examined a cohort of 41 children aged 8‐16, who, having received the arterial switch operation to correct for transposition of the great arteries, had sustained significant neonatal cyanosis but were otherwise neurodevelopmentally normal. As predicted, the cohort had significant bilateral reduction of hippocampal volumes relative to the volumes of 64 normal controls. They also had significant, yet selective, impairment of episodic memory as measured by standard tests of memory, despite relatively normal levels of intelligence, academic attainment, and verbal fluency. Across the cohort, degree of memory impairment was correlated with degree of hippocampal atrophy suggesting that even as early as neonatal life no other structure can fully compensate for hippocampal injury and its special role in serving episodic long term memory. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Mónica Muñoz-López
- Cognitive Neuroscience & Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Aparna Hoskote
- Cardiac Intensive Care Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Martin J Chadwick
- Cognitive Neuroscience & Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Anna M Dzieciol
- Cognitive Neuroscience & Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - David G Gadian
- Developmental Imaging and Biophysics Section, UCL Institute of Child Health, London, United Kingdom
| | - Kling Chong
- Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Tina Banks
- Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Michelle de Haan
- Cognitive Neuroscience & Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Torsten Baldeweg
- Cognitive Neuroscience & Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mortimer Mishkin
- Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, Maryland
| | - Faraneh Vargha-Khadem
- Cognitive Neuroscience & Neuropsychiatry Section, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Department of Neuropsychology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
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35
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Ferdinand P, Roffe C. Hypoxia after stroke: a review of experimental and clinical evidence. EXPERIMENTAL & TRANSLATIONAL STROKE MEDICINE 2016; 8:9. [PMID: 27980710 PMCID: PMC5143450 DOI: 10.1186/s13231-016-0023-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/26/2016] [Indexed: 02/08/2023]
Abstract
Background Hypoxia is a common occurrence following stroke and associated with poor clinical and functional outcomes. Normal oxygen physiology is a finely controlled mechanism from the oxygenation of haemoglobin in the pulmonary capillaries to its dissociation and delivery in the tissues. In no organ is this process more important than the brain, which has a number of vascular adaptions to be able to cope with a certain threshold of hypoxia, beyond which further disruption of oxygen delivery potentially leads to devastating consequences. Hypoxia following stroke is common and is often attributed to pneumonia, aspiration and respiratory muscle dysfunction, with sleep apnoea syndromes, pulmonary embolism and cardiac failure being less common but important treatable causes. As well as treating the underlying cause, oxygen therapy is a vital element to correcting hypoxia, but excessive use can itself cause molecular and clinical harm. As cerebral vascular occlusion completely obliterates oxygen delivery to its target tissue, the use of supplemental oxygen, even when not hypoxic, would seem a reasonable solution to try and correct this deficit, but to date randomised clinical trials have not shown benefit. Conclusion Whilst evidence for the use of supplemental oxygen therapy is currently lacking, it is vital to rapidly identify and treat all causes of hypoxia in the acute stroke patient, as a failure to will lead to poorer clinical outcomes. The full results of a large randomised trial looking at the use of supplemental oxygen therapy are currently pending.
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Affiliation(s)
| | - Christine Roffe
- Stroke Research in Stoke, Institute for Applied Clinical Studies, Keele University, Keele, Staffordshire UK
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36
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Ruffieux N, Ramon M, Lao J, Colombo F, Stacchi L, Borruat FX, Accolla E, Annoni JM, Caldara R. Residual perception of biological motion in cortical blindness. Neuropsychologia 2016; 93:301-311. [DOI: 10.1016/j.neuropsychologia.2016.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/19/2016] [Accepted: 11/09/2016] [Indexed: 11/25/2022]
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37
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Dzieciol AM, Bachevalier J, Saleem KS, Gadian DG, Saunders R, Chong WKK, Banks T, Mishkin M, Vargha-Khadem F. Hippocampal and diencephalic pathology in developmental amnesia. Cortex 2016; 86:33-44. [PMID: 27880886 PMCID: PMC5264402 DOI: 10.1016/j.cortex.2016.09.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/10/2016] [Accepted: 09/18/2016] [Indexed: 01/01/2023]
Abstract
Developmental amnesia (DA) is a selective episodic memory disorder associated with hypoxia-induced bilateral hippocampal atrophy of early onset. Despite the systemic impact of hypoxia-ischaemia, the resulting brain damage was previously reported to be largely limited to the hippocampus. However, the thalamus and the mammillary bodies are parts of the hippocampal-diencephalic network and are therefore also at risk of injury following hypoxic-ischaemic events. Here, we report a neuroimaging investigation of diencephalic damage in a group of 18 patients with DA (age range 11-35 years), and an equal number of controls. Importantly, we uncovered a marked degree of atrophy in the mammillary bodies in two thirds of our patients. In addition, as a group, patients had mildly reduced thalamic volumes. The size of the anterior-mid thalamic (AMT) segment was correlated with patients' visual memory performance. Thus, in addition to the hippocampus, the diencephalic structures also appear to play a role in the patients' memory deficit.
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Affiliation(s)
- Anna M Dzieciol
- University College London Great Ormond Street Institute of Child Health, London, UK.
| | | | | | - David G Gadian
- University College London Great Ormond Street Institute of Child Health, London, UK
| | | | - W K Kling Chong
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Tina Banks
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
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Woods D, Chantavarin S. Serial neuropsychological assessment of an adolescent girl after suffering a sudden out-of-hospital-cardiac-arrest following recreational inhalant use. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:378-387. [PMID: 27216834 DOI: 10.1080/21622965.2016.1185372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sudden out-of-hospital-cardiac-arrest (OHCA) following recreational inhalant use is well documented in the literature. The present case study reports the long-term neuropsychological sequelae of a 14-year-old girl who suffered an OHCA secondary to recreational butane gas inhalation. The patient was assessed on day-13 as an inpatient, and again at 3- and 12-month outpatient follow-ups. Acutely the patient demonstrated significant impairment on tasks associated with verbal and non-verbal memory and executive functioning. Re-testing at 3-months post-acute state suggested improved executive and non-verbal functions while showing continued deficits in verbal memory. At 12-months she was cognitively performing at levels expected for her age. This case is reported for its rarity in successfully being able to track the patient's clinical course from hospital discharge to the successful reintegration back into school and community settings.
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Affiliation(s)
- Damith Woods
- a Faculty of Psychology, Cognitive Neuroscience Laboratory , Chulalongkorn University , Bangkok , Thailand
| | - Suphasiree Chantavarin
- a Faculty of Psychology, Cognitive Neuroscience Laboratory , Chulalongkorn University , Bangkok , Thailand
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Hopkins RO, Woon FLM. Neuroimaging, Cognitive, and Neurobehavioral Outcomes Following Carbon Monoxide Poisoning. ACTA ACUST UNITED AC 2016; 5:141-55. [PMID: 16891556 DOI: 10.1177/1534582306289730] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Carbon monoxide is a colorless, odorless gas produced as a byproduct of combustion. Carbon monoxide is the leading cause of poisoning injury and death worldwide. Morbidity following CO poisoning includes neurologic sequelae, neuropathologic abnormalities on brain imaging, neurobehavioral changes, and cognitive impairments. It is estimated that as high as 50% of individuals with carbon monoxide poisoning will develop neurologic, neurobehavioral, or cognitive sequelae. Carbon monoxide related cognitive impairments included impaired memory, attention, executive function, motor, visual spatial, and slow mental processing speed. Given the high rate of brain related morbidity and the fact that the majority of carbon monoxide is avoidable, awareness and prevention of carbon monoxide poisoning is warranted.
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Esfahani-Bayerl N, Finke C, Braun M, Düzel E, Heekeren HR, Holtkamp M, Hasper D, Storm C, Ploner CJ. Visuo-spatial memory deficits following medial temporal lobe damage: A comparison of three patient groups. Neuropsychologia 2016; 81:168-179. [PMID: 26765639 DOI: 10.1016/j.neuropsychologia.2015.12.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/01/2015] [Accepted: 12/22/2015] [Indexed: 10/22/2022]
Abstract
The contributions of the hippocampal formation and adjacent regions of the medial temporal lobe (MTL) to memory are still a matter of debate. It is currently unclear, to what extent discrepancies between previous human lesion studies may have been caused by the choice of distinct patient models of MTL dysfunction, as disorders affecting this region differ in selectivity, laterality and mechanisms of post-lesional compensation. Here, we investigated the performance of three distinct patient groups with lesions to the MTL with a battery of visuo-spatial short-term memory tasks. Thirty-one subjects with either unilateral damage to the MTL (postsurgical lesions following resection of a benign brain tumor, 6 right-sided lesions, 5 left) or bilateral damage (10 post-encephalitic lesions, 10 post-anoxic lesions) performed a series of tasks requiring short-term memory of colors, locations or color-location associations. We have shown previously that performance in the association task critically depends on hippocampal integrity. Patients with postsurgical damage of the MTL showed deficient performance in the association task, but performed normally in color and location tasks. Patients with left-sided lesions were almost as impaired as patients with right-sided lesions. Patients with bilateral post-encephalitic lesions showed comparable damage to MTL sub-regions and performed similarly to patients with postsurgical lesions in the association task. However, post-encephalitic patients showed additional impairments in the non-associative color and location tasks. A strikingly similar pattern of deficits was observed in post-anoxic patients. These results suggest a distinct cerebral organization of associative and non-associative short-term memory that was differentially affected in the three patient groups. Thus, while all patient groups may provide appropriate models of medial temporal lobe dysfunction in associative visuo-spatial short-term memory, additional deficits in non-associative memory tasks likely reflect damage of regions outside the MTL. Importantly, the choice of a patient model in human lesion studies of the MTL significantly influences overall performance patterns in visuo-spatial memory tasks.
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Affiliation(s)
| | - Carsten Finke
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität, Berlin, Germany
| | - Mischa Braun
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Emrah Düzel
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE) Site, Magdeburg, Germany; Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Hauke R Heekeren
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany; Cluster of Excellence "Languages of Emotion", Freie Universität Berlin, Berlin, Germany
| | - Martin Holtkamp
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Epilepsy-Center Berlin-Brandenburg, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | - Dietrich Hasper
- Department of Nephrology and Medical Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Storm
- Department of Nephrology and Medical Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph J Ploner
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Schrieff-Elson LE, Thomas KGF, Rohlwink UK, Figaji AA. Low brain oxygenation and differences in neuropsychological outcomes following severe pediatric TBI. Childs Nerv Syst 2015; 31:2257-68. [PMID: 26337700 DOI: 10.1007/s00381-015-2892-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 08/24/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children. Preventing secondary injury by controlling physiological parameters (e.g. intracranial pressure [ICP], cerebral perfusion pressure [CPP] and brain tissue oxygen [PbtO2]) has a potential to improve outcome. Low PbtO2 is independently associated with poor clinical outcomes in both adults and children. However, no studies have investigated associations between low PbtO2 and neuropsychological and behavioural outcomes following severe pediatric TBI (pTBI). METHODS We used a quasi-experimental case-control design to investigate these relationships. A sample of 11 TBI patients with a Glasgow Coma Scale score ≤8 who had PbtO2 and ICP monitoring at the Red Cross War Memorial Children's Hospital underwent neuropsychological evaluation ≥1 year post-injury. Their performance was compared to that of 11 demographically matched healthy controls. We then assigned each TBI participant into one of two subgroups, (1) children who had experienced at least one episode of PbtO2 ≤ 10 mmHg or (2) children for whom PbtO2 > 10 mmHg throughout the monitoring period, and compared their results on neuropsychological evaluation. RESULTS TBI participants performed significantly more poorly than controls in several cognitive domains (IQ, attention, visual memory, executive functions and expressive language) and behavioural (e.g. externalizing behaviour) domains. The PbtO2 ≤ 10 mmHg group performed significantly worse than the PbtO2 > 10 mmHg group in several cognitive domains (IQ, attention, verbal memory, executive functions and expressive language), but not on behavioural measures. CONCLUSION Results demonstrate that low PbtO2 may be prognostic of not only mortality but also neuropsychological outcomes.
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Affiliation(s)
- L E Schrieff-Elson
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa.
| | - K G F Thomas
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - U K Rohlwink
- Division of Neurosurgery, Department of Surgery, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - A A Figaji
- Division of Neurosurgery, Department of Surgery, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
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Choi WS, Kim JJ, Yang HJ. Brain Magnetic Resonance Imaging in Patients with Favorable Outcomes after Out-of-Hospital Cardiac Arrest: Many Have Encephalopathy Even with a Good Cerebral Performance Category Score. Korean J Crit Care Med 2015. [DOI: 10.4266/kjccm.2015.30.4.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bohr I, McDonald C, He J, Kerr S, Newton JL, Blamire AM. Brain oxygenation responses to an autonomic challenge: a quantitative fMRI investigation of the Valsalva manoeuvre. AGE (DORDRECHT, NETHERLANDS) 2015; 37:91. [PMID: 26318855 PMCID: PMC5005835 DOI: 10.1007/s11357-015-9833-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/20/2015] [Indexed: 06/04/2023]
Abstract
In late age, the autonomic nervous system (ANS) has diminished ability to maintain physiological homeostasis in the brain in response to challenges such as to systemic blood pressure changes caused by standing. We devised an fMRI experiment aiming to map the cerebral effects of an ANS challenge (Valsalva manoeuvre (VM)). We used dual-echo fMRI to measure the effective transverse relaxation rate (R2*, which is inversely proportional to brain tissue oxygenation levels) in 45 elderly subjects (median age 80 years old, total range 75-89) during performance of the VM. In addition, we collected fluid-attenuated inversion recovery (FLAIR) data from which we quantified white matter hyperintensity (WMH) volumes. We conducted voxelwise analysis of the dynamic changes in R2* during the VM to determine the distribution of oxygenation changes due to the autonomic stressor. In white matter, we observed significant decreases in oxygenation levels. These effects were predominantly located in posterior white matter and to a lesser degree in the right anterior brain, both concentrated around the border zones (watersheds) between cerebral perfusion territories. These areas are known to be particularly vulnerable to hypoxia and are prone to formation of white matter hyperintensities. Although we observed overlap between localisation of WMH and triggered deoxygenation on the group level, we did not find significant association between these independent variables using subjectwise statistics. This could suggest other than recurrent transient hypoxia mechanisms causing/contributing to the formation of WMH.
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Affiliation(s)
- Iwo Bohr
- Institute of Cellular Medicine and Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK,
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Daulatzai MA. Evidence of neurodegeneration in obstructive sleep apnea: Relationship between obstructive sleep apnea and cognitive dysfunction in the elderly. J Neurosci Res 2015; 93:1778-94. [DOI: 10.1002/jnr.23634] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/02/2015] [Accepted: 08/04/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Mak Adam Daulatzai
- Sleep Disorders Group, EEE/Melbourne School of Engineering, The University of Melbourne; Parkville Victoria Australia
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45
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Colle R, Chupin M, Cury C, Vandendrie C, Gressier F, Hardy P, Falissard B, Colliot O, Ducreux D, Corruble E. Depressed suicide attempters have smaller hippocampus than depressed patients without suicide attempts. J Psychiatr Res 2015; 61:13-8. [PMID: 25555305 DOI: 10.1016/j.jpsychires.2014.12.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Despite known relationship between hippocampal volumes and major depressive episodes (MDE) and the increased suicidality in MDE, the links between hippocampal volumes and suicidality remain unclear in major depressive disorders (MDD). If the hippocampus could be a biomarker of suicide attempts in depression, it could be useful for prevention matters. This study assessed the association between hippocampal volumes and suicide attempts in MDD. METHODS Hippocampal volumes assessed with automatic segmentation were compared in 63 patients with MDD, with (n = 24) or without (n = 39) suicide attempts. Acute (<one month) and past (>one month) suicide attempts were studied. RESULTS Although not different in terms of socio-demographic, MDD and MDE clinical features, suicide attempters had lower total hippocampus volumes than non-attempters (4.61 (± 1.15) cm(3) vs 5.22 (± 0.99) cm(3); w = 625.5; p = 0.03), especially for acute suicide attempts (4.19 (± 0.81) cm(3) vs 5.22 (± 0.99) cm(3); w = 334; p = 0.005), even after adjustment on brain volumes, sex, age, Hamilton Depression Rating Scale (HDRS) scores and MDD duration. A ROC analysis showed that a total hippocampal volume threshold of 5.00 cm(3) had a 98.2% negative predictive value for acute suicide attempts. CONCLUSION Depressed suicide attempters have smaller hippocampus than depressed patients without suicide attempts, independently from socio-demographics and MDD characteristics. This difference is related to acute suicide attempts but neither to past suicide attempts nor to duration since the first suicide attempt, suggesting that hippocampal volume could be a suicidal state marker in MDE. Further studies are required to better understand this association.
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Affiliation(s)
- Romain Colle
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France.
| | - Marie Chupin
- INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France
| | - Claire Cury
- INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France
| | - Christophe Vandendrie
- CNRS IR4M, UMR 8081, Neuroradiology Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Florence Gressier
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Patrick Hardy
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Bruno Falissard
- INSERM UMR 1178, Département de Biostatistiques, Univ Paris Sud, Hôpital Paul Brousse, Assistance Publique Hôpitaux de Paris, 94400 Villejuif, France
| | - Olivier Colliot
- INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France
| | - Denis Ducreux
- CNRS IR4M, UMR 8081, Neuroradiology Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France
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Gomez A, Rousset S, Bonniot C, Charnallet A, Moreaud O. Deficits in egocentric-updating and spatial context memory in a case of developmental amnesia. Neurocase 2015; 21:226-43. [PMID: 24579921 DOI: 10.1080/13554794.2014.890730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Patients with developmental amnesia usually suffer from both episodic and spatial memory deficits. DM, a developmental amnesic, was impaired in her ability to process self-motion (i.e., idiothetic) information while her ability to process external stable landmarks (i.e., allothetic) was preserved when no self-motion processing was required. On a naturalistic and incidental episodic task, DM was severely and predictably impaired on both free and cued recall tasks. Interestingly, when cued, she was more impaired at recalling spatial context than factual or temporal information. Theoretical implications of that co-occurrence of deficits and those dissociations are discussed and testable cerebral hypothesis are proposed.
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Affiliation(s)
- A Gomez
- a LPNC , CNRS, UMR 5105, Université Grenoble Alpes , Grenoble , France
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Wilson M, Staniforth A, Till R, das Nair R, Vesey P. The psychosocial outcomes of anoxic brain injury following cardiac arrest. Resuscitation 2014; 85:795-800. [DOI: 10.1016/j.resuscitation.2014.02.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Revised: 01/01/2014] [Accepted: 02/09/2014] [Indexed: 12/18/2022]
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Serino A, Cecere R, Dundon N, Bertini C, Sanchez-Castaneda C, Làdavas E. When apperceptive agnosia is explained by a deficit of primary visual processing. Cortex 2013; 52:12-27. [PMID: 24607265 DOI: 10.1016/j.cortex.2013.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 07/19/2013] [Accepted: 12/20/2013] [Indexed: 11/25/2022]
Abstract
Visual agnosia is a deficit in shape perception, affecting figure, object, face and letter recognition. Agnosia is usually attributed to lesions to high-order modules of the visual system, which combine visual cues to represent the shape of objects. However, most of previously reported agnosia cases presented visual field (VF) defects and poor primary visual processing. The present case-study aims to verify whether form agnosia could be explained by a deficit in basic visual functions, rather that by a deficit in high-order shape recognition. Patient SDV suffered a bilateral lesion of the occipital cortex due to anoxia. When tested, he could navigate, interact with others, and was autonomous in daily life activities. However, he could not recognize objects from drawings and figures, read or recognize familiar faces. He was able to recognize objects by touch and people from their voice. Assessments of visual functions showed blindness at the centre of the VF, up to almost 5°, bilaterally, with better stimulus detection in the periphery. Colour and motion perception was preserved. Psychophysical experiments showed that SDV's visual recognition deficits were not explained by poor spatial acuity or by the crowding effect. Rather a severe deficit in line orientation processing might be a key mechanism explaining SDV's agnosia. Line orientation processing is a basic function of primary visual cortex neurons, necessary for detecting "edges" of visual stimuli to build up a "primal sketch" for object recognition. We propose, therefore, that some forms of visual agnosia may be explained by deficits in basic visual functions due to widespread lesions of the primary visual areas, affecting primary levels of visual processing.
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Affiliation(s)
- Andrea Serino
- CsrNC, Centro studi e ricerche in Neuroscienze Cognitive, Polo Scientifico-Didattico di Cesena, ALMA MATER STUDIORUM - Università di Bologna, Italy; Dipartimento di Psicologia, ALMA MATER STUDIORUM - Università di Bologna, Italy
| | - Roberto Cecere
- CsrNC, Centro studi e ricerche in Neuroscienze Cognitive, Polo Scientifico-Didattico di Cesena, ALMA MATER STUDIORUM - Università di Bologna, Italy; Dipartimento di Psicologia, ALMA MATER STUDIORUM - Università di Bologna, Italy
| | - Neil Dundon
- CsrNC, Centro studi e ricerche in Neuroscienze Cognitive, Polo Scientifico-Didattico di Cesena, ALMA MATER STUDIORUM - Università di Bologna, Italy; Dipartimento di Psicologia, ALMA MATER STUDIORUM - Università di Bologna, Italy
| | - Caterina Bertini
- CsrNC, Centro studi e ricerche in Neuroscienze Cognitive, Polo Scientifico-Didattico di Cesena, ALMA MATER STUDIORUM - Università di Bologna, Italy; Dipartimento di Psicologia, ALMA MATER STUDIORUM - Università di Bologna, Italy
| | | | - Elisabetta Làdavas
- CsrNC, Centro studi e ricerche in Neuroscienze Cognitive, Polo Scientifico-Didattico di Cesena, ALMA MATER STUDIORUM - Università di Bologna, Italy; Dipartimento di Psicologia, ALMA MATER STUDIORUM - Università di Bologna, Italy.
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49
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Seger CA. The visual corticostriatal loop through the tail of the caudate: circuitry and function. Front Syst Neurosci 2013; 7:104. [PMID: 24367300 PMCID: PMC3853932 DOI: 10.3389/fnsys.2013.00104] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/18/2013] [Indexed: 12/17/2022] Open
Abstract
Although high level visual cortex projects to a specific region of the striatum, the tail of the caudate, and participates in corticostriatal loops, the function of this visual corticostriatal system is not well understood. This article first reviews what is known about the anatomy of the visual corticostriatal loop across mammals, including rodents, cats, monkeys, and humans. Like other corticostriatal systems, the visual corticostriatal system includes both closed loop components (recurrent projections that return to the originating cortical location) and open loop components (projections that terminate in other neural regions). The article then reviews what previous empirical research has shown about the function of the tail of the caudate. The article finally addresses the possible functions of the closed and open loop connections of the visual loop in the context of theories and computational models of corticostriatal function.
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Affiliation(s)
- Carol A Seger
- Program in Molecular, Cellular, and Integrative Neuroscience, Department of Psychology, Colorado State University Fort Collins, CO, USA
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50
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Thaler NS, Reger SL, Ringdahl EN, Mayfield JW, Goldstein G, Allen DN. Neuropsychological profiles of six children with anoxic brain injury. Child Neuropsychol 2013; 19:479-94. [DOI: 10.1080/09297049.2012.696602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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