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Welk B. The impact of anticholinergics on cognitive function in patients with neurogenic lower urinary tract dysfunction: A narrative review. Indian J Urol 2024; 40:82-87. [PMID: 38725892 PMCID: PMC11078446 DOI: 10.4103/iju.iju_352_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 05/12/2024] Open
Abstract
This narrative review discusses the relationship between anticholinergic medications and cognitive change specifically in patients with neurogenic lower urinary tract dysfunction (NLUTD). NLUTD is prevalent in various conditions, including spinal cord injury (SCI), spina bifida (SB), multiple sclerosis (MS), Parkinson's, stroke, and dementia and often requires anticholinergic overactive bladder (OAB) medications. In the general population, and among those with OAB, several studies have found a significant association between this class of medications and cognitive side effects, mostly when used for > 90 days. These cognitive side effects may be particularly relevant to people with NLUTD due to their higher baseline risk of cognitive impairment. Two studies (one in people with SCI and another in MS) found evidence of cognitive impairment with the use of OAB anticholinergics (specifically oxybutynin and tolterodine). People with dementia commonly use OAB anticholinergics, and there is evidence that oxybutynin and tolterodine may impair cognition in this population. Two recent studies in children with SB studied 12 months of solifenacin and 6 months of fesoterodine/oxybutynin and found there was no significant change in neuropsychological testing. Clinical studies in people with Parkinson's disease and prior stroke have not shown that trospium, darifenacin, or fesoterodine have a significant impact on cognitive measures. In summary, oxybutynin and tolterodine may pose a higher risk of cognitive impairment than newer OAB anticholinergics in people with NLUTD; there is no evidence that children with SB experience cognitive impairment with OAB anticholinergics. Further study is necessary to confirm cognitive safety, particularly as the NLUTD population may have a high exposure to OAB anticholinergics. Advocating for potentially safer OAB medications is necessary if there is concern about cognitive risks.
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Affiliation(s)
- Blayne Welk
- Department of Surgery, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
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Calderone A, Cardile D, De Luca R, Quartarone A, Corallo F, Calabrò RS. Cognitive, behavioral and psychiatric symptoms in patients with spinal cord injury: a scoping review. Front Psychiatry 2024; 15:1369714. [PMID: 38572000 PMCID: PMC10987747 DOI: 10.3389/fpsyt.2024.1369714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Spinal Cord Injury (SCI) is a condition where the spinal cord is damaged and experiences partial or complete loss of motor and/or sensory function, which is typically less than normal. After SCI, patients may exhibit more severe psychiatric symptoms and experience cognitive impairments, including reduced speed and attention processing capacity, as well as difficulties with executive function and episodic memory retention. Among the behavioral and psychiatric symptoms, depression, anxiety, substance use disorder, and posttraumatic stress disorder are the most common. This review aims to investigate the cognitive, behavioral, or psychiatric symptoms of the patient with SCI and their influence on the rehabilitation process. Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases. Studies published between 2013-2023 were selected. This review has been registered on OSF (n) 3KB2U. We have found that patients with SCI are at high risk of cognitive impairment and experience a wide range of difficulties, including tasks based on processing speed and executive function. This clinical population may experience adjustment disorders with depression and anxiety, as well as other psychiatric symptoms such as fatigue, stress, and suicidal ideation. This review has demonstrated that SCI patients may experience psychiatric symptoms and cognitive impairments that affect their functioning. At the same time, these patients may be more prone to various adjustment and mood disorders. Moreover, these two aspects may interact with each other, causing a range of symptoms, increasing the risk of hospitalization, and delaying the rehabilitation process.
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Affiliation(s)
- Andrea Calderone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Moro V, Beccherle M, Scandola M, Aglioti SM. Massive body-brain disconnection consequent to spinal cord injuries drives profound changes in higher-order cognitive and emotional functions: A PRISMA scoping review. Neurosci Biobehav Rev 2023; 154:105395. [PMID: 37734697 DOI: 10.1016/j.neubiorev.2023.105395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/01/2023] [Accepted: 09/17/2023] [Indexed: 09/23/2023]
Abstract
Spinal cord injury (SCI) leads to a massive disconnection between the brain and the body parts below the lesion level representing a unique opportunity to explore how the body influences a person's mental life. We performed a systematic scoping review of 59 studies on higher-order cognitive and emotional changes after SCI. The results suggest that fluid abilities (e.g. attention, executive functions) and emotional regulation (e.g. emotional reactivity and discrimination) are impaired in people with SCI, with progressive deterioration over time. Although not systematically explored, the factors that are directly (e.g. the severity and level of the lesion) and indirectly associated (e.g. blood pressure, sleeping disorders, medication) with the damage may play a role in these deficits. The inconsistency which was found in the results may derive from the various methods used and the heterogeneity of samples (i.e. the lesion completeness, the time interval since lesion onset). Future studies which are specifically controlled for methods, clinical and socio-cultural dimensions are needed to better understand the role of the body in cognition.
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Affiliation(s)
- Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria, 17, 37129 Verona, Italy.
| | - Maddalena Beccherle
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria, 17, 37129 Verona, Italy; Department of Psychology, Sapienza University of Rome and cln2s@sapienza Istituto Italiano di Tecnologia, Italy.
| | - Michele Scandola
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria, 17, 37129 Verona, Italy
| | - Salvatore Maria Aglioti
- Department of Psychology, Sapienza University of Rome and cln2s@sapienza Istituto Italiano di Tecnologia, Italy; Fondazione Santa Lucia IRCCS, Roma, Italy
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Duong V, Iwamoto A, Pennycuff J, Kudish B, Iglesia C. A systematic review of neurocognitive dysfunction with overactive bladder medications. Int Urogynecol J 2021; 32:2693-2702. [PMID: 34213600 DOI: 10.1007/s00192-021-04909-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study is to report cognitive dysfunction with commonly used antimuscarinic overactive bladder medications in patients suffering from overactive bladder disorder with and without baseline neurologic conditions. METHODS We conducted an Ovid MEDLINE, Embase, and PsycINFO search from January 1998 to December 2018 using PRISMA guidelines. Eighteen studies met the inclusion criteria, including 5 randomized controlled trials and 13 observational studies. RESULTS Cognitive decline was reported with oxybutynin use (5 of 8 studies) and tolterodine use (4 of 7 studies) among patients with and without baseline cognitive impairment. Oxybutynin use was linked to functional, mental, and behavioral decline among patients with Alzheimer's disease (2 studies). No cognitive decline was detected among patients with and without baseline cognitive impairment taking trospium (6 studies), darifenacin (3 studies), imidafenacin (2 studies), and fesoterodine (1 study). Solifenacin was not associated with cognitive decline (2 studies) but was linked to an increased risk of dementia among patients with diabetes (1 study). CONCLUSION In this review, cognitive decline was reported with oxybutynin and tolterodine use and should be used with caution in adults over 65 years of age. Solifenacin, fesoterodine, and imidafenacin showed mixed results related to central nervous system effect. Trospium and darifenacin were not associated with cognitive decline among patients with and without baseline cognitive impairment.
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Affiliation(s)
- Vi Duong
- Department of Obstetrics and Gynecology, Medstar Washington Hospital Center/Georgetown University School of Medicine, 110 Irving St. NW, Washington, DC, 20010, USA.
| | - Aya Iwamoto
- Department of Obstetrics and Gynecology, University of Iowa Hospitals, 5 Boyd Tower, Iowa City, IA, 52242, USA
| | - Jon Pennycuff
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Medstar Washington Hospital Center/Georgetown University School of Medicine, 106 Irving St. NW, 405 POB-S, Washington, DC, 20010, USA
| | - Bela Kudish
- Department of Obstetrics and Gynecology, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Cheryl Iglesia
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Medstar Washington Hospital Center/Georgetown University School of Medicine, 106 Irving St. NW, 405 POB-S, Washington, DC, 20010, USA
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Truzzi JC, de Almeida FG, Sacomani CA, Reis J, Rocha FET. Neurogenic bladder - concepts and treatment recommendations. Int Braz J Urol 2021; 48:220-243. [PMID: 34156189 PMCID: PMC8932021 DOI: 10.1590/s1677-5538.ibju.2021.0098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/15/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction: Bladder and urinary sphincter malfunctioning that results from some change in the central and/or peripheral nervous system is defined as neurogenic bladder. The urinary tract symptoms that can be related to its filling, emptying, or both have a significant impact on the quality of life of individuals. The present review was based on the document prepared for the public health system in Brazil as a treatment guidelines proposal. Material and Methods: Survey questions were structured as per PICO (Population, Intervention, Control, and Outcome). Search strategies were defined and performed in the MEDLINE/Pubmed, Embase, Epistemonikos and Google Scholar databases. The selection of articles followed the evidence hierarchy concept; evidence body was identified, and the quantitative study data were extracted. The quality of evidence and grade of recommendation were qualitatively assessed according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Results: A total of 2.707 articles were identified, with 49 of them being selected to compose the basis for this review. Neurogenic bladder treatments were classified according to their focus on filling or emptying symptoms and sub- classified in pharmacological and surgical treatments. Conclusion: Treatment guidelines are important tools for the public health system to promote the best practice when treating neurogenic bladder patients.
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Affiliation(s)
- José Carlos Truzzi
- Departamento de Assuntos Médicos, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
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Li F, Huo S, Song W. Multidimensional review of cognitive impairment after spinal cord injury. Acta Neurol Belg 2021; 121:37-46. [PMID: 32989706 DOI: 10.1007/s13760-020-01507-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/19/2020] [Indexed: 12/23/2022]
Abstract
Cognitive impairment is highly prevalent in the population with spinal cord injury (SCI) and exerts a significant impact on functional independence and quality of life in this population. A number of neuroscientists have conducted preliminary investigations of cognitive deficits after SCI, but achieved marginally contradictory results due to some limitations such as the heterogeneity in the sample population, sample size, types of tests utilized, study design, and time since SCI. Therefore, this review mainly focuses on the characteristics, assessments, potential causality and treatment of cognitive impairment for better understanding such deficits in the SCI population.
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Affiliation(s)
- Fang Li
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, 45 Chang Chun Street, Beijing, 100053, People's Republic of China
| | - Su Huo
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, 45 Chang Chun Street, Beijing, 100053, People's Republic of China
| | - Weiqun Song
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, 45 Chang Chun Street, Beijing, 100053, People's Republic of China.
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Sandalic D, Craig A, Arora M, Pozzato I, Simpson G, Gopinath B, Kaur J, Shetty S, Weber G, Cameron I, Tran Y, Middleton J. A prospective cohort study investigating contributors to mild cognitive impairment in adults with spinal cord injury: study protocol. BMC Neurol 2020; 20:341. [PMID: 32917161 PMCID: PMC7484605 DOI: 10.1186/s12883-020-01899-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/23/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Studies report rates of mild cognitive impairment (MCI) in spinal cord injury (SCI) range between 10 and 60%. This broad estimate of MCI in SCI is most likely a result of: (i) inconsistent operationalization of MCI; (ii) heterogeneity among individuals with SCI; (iii) failure to account for MCI subtypes, thereby adding to the heterogeneity of samples; and, (iv) poor control for traumatic brain injury (TBI) that obscures differentiation of MCI attributable to TBI versus other factors. There is a paucity of longitudinal studies following the course of MCI in SCI, and none that account for multiple predictors of MCI, including interactions among predictors. METHODS An inception cohort longitudinal study will assess approximately 100 individuals aged 17-80 years with acute SCI, with measures taken at three timepoints (baseline, 3 months post-baseline, and 12 months post-injury). Data relevant to medical care received within the first 24-48 h of presentation to the emergency department will be analysed, as will measures of cognition, injury characteristics, medical history, personal factors, psychological status, psychosocial functioning, and quality of life. Latent class mixture modelling will determine trajectories for the primary outcome of interest, cognitive functioning and its subtypes, and secondary outcomes of interest such as depression. Multiple regression analyses will identify predictors of MCI and its subtypes. DISCUSSION The prospective design will reveal change in cognitive functioning across time and unveil different outcome trajectories; thus addressing the lack of knowledge on trajectories of MCI and MCI subtypes in SCI. Through subtyping MCI, we hope to yield groups of cognitively impaired individuals with SCI that are potentially more homogenous and thereby stable and predictable. This is the first study to capture emergency department and acute care diagnostic evidence of mild TBI, which has been poorly controlled in previous studies. Our study will also be the first to distinguish the contribution of TBI from other factors to the development of MCI in individuals with SCI. TRIAL REGISTRATION The study was prospectively registered with the Australian and New Zealand Clinical Trial Registry ( ACTRN12619001702101 ) on 3rd December 2019.
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Affiliation(s)
- Danielle Sandalic
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia. .,Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
| | - Ashley Craig
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Mohit Arora
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Ilaria Pozzato
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Grahame Simpson
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Bamini Gopinath
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Jasbeer Kaur
- Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Sachin Shetty
- Prince of Wales Hospital, Randwick, NSW, 2031, Australia
| | | | - Ian Cameron
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, 2113, Australia
| | - James Middleton
- John Walsh Centre Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
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Distel DF, Amodeo M, Joshi S, Abramoff BA. Cognitive Dysfunction in Persons with Chronic Spinal Cord Injuries. Phys Med Rehabil Clin N Am 2020; 31:345-368. [PMID: 32624099 DOI: 10.1016/j.pmr.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cognitive dysfunction (CD) is pervasive in individuals who have chronic spinal cord injuries (SCI). Although classically associated with concomitant traumatic brain injuries, many other causes have been proposed, including premorbid neuropsychological conditions, mood disorders, substance abuse, polypharmacy, chronic pain and fatigue, sleep apnea, autonomic dysregulation, post-intensive care unit syndrome, cortical reorganizations, and neuroinflammation. The consequences of CD are likely widespread, affecting rehabilitation and function. CD in those with SCI should be recognized, and potentially treated, in order to provide the best patient care.
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Affiliation(s)
- Donald F Distel
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania-Perelman School of Medicine, 1800 Lombard Street, Philadelphia, PA 19146, USA
| | - Matthew Amodeo
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania-Perelman School of Medicine, 1800 Lombard Street, Philadelphia, PA 19146, USA
| | - Shawn Joshi
- Drexel School of Medicine, 2900 W. Queen Lane, Philadelphia, PA 19129, USA
| | - Benjamin A Abramoff
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania-Perelman School of Medicine, 1800 Lombard Street, Philadelphia, PA 19146, USA.
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Muderrisoglu AE, Becher KF, Madersbacher S, Michel MC. Cognitive and mood side effects of lower urinary tract medication. Expert Opin Drug Saf 2019; 18:915-923. [PMID: 31373245 DOI: 10.1080/14740338.2019.1652269] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Muscarinic receptor antagonists, 5α-reductase inhibitors and α1-adrenoceptor antagonists are frequently used drug classes for the treatment of lower urinary tract symptoms including those of overactive bladder syndrome and benign prostatic enlargement/benign prostatic obstruction. Areas covered: The authors review the evidence for adverse effects of these drug classes on cognitive function, mood and other functions of the central nervous system and discuss such effects against the evidence for mechanistic plausibility. Expert opinion: Muscarinic antagonists carry a risk for impaired cognition and other brain functions that differs quantitatively between compounds, being highest with oral formulations of oxybutynin. 5□-Reductase inhibitors can cause depressive symptoms even at low doses and starting several months after discontinuation of treatment. The evidence for α1-adrenoceptor antagonists and specifically tamsulosin to cause dementia is controversial and lacks mechanistic plausibility. We recommend that physicians treating patients with lower urinary tract symptoms carefully monitor mental status prior to prescribing and periodically thereafter.
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Affiliation(s)
- A Elif Muderrisoglu
- Dept. of Pharmacology, School of Pharmacy, Ankara University , Ankara , Turkey
| | - Klaus F Becher
- Dept. of Geriatrics and Early Rehabilitation, Helios Hanseklinikum Stralsund GmbH , Stralsund , Germany
| | - Stephan Madersbacher
- Dept. of Urology, Kaiser Franz Josef Spital, Sigmund Freud Private University , Vienna , Austria
| | - Martin C Michel
- Dept. of Pharmacology, Johannes Gutenberg University , Mainz , Germany
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Pacheco N, Mollayeva S, Jacob B, Colantonio A, Mollayeva T. Interventions and cognitive functioning in adults with traumatic spinal cord injuries: a systematic review and meta-analysis. Disabil Rehabil 2019; 43:903-919. [PMID: 31354083 DOI: 10.1080/09638288.2019.1644380] [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: 10/26/2022]
Abstract
AIM This research synthesized scientific evidence on the impact of interventions for adults with traumatic spinal cord injury on cognition, to understand if current intervention approaches are appropriate in light of the risk of post-injury cognitive impairments. METHOD Medline, Central, Embase, Scopus, PsycINFO and PubMed were searched for intervention in persons with SCI assessing cognition pre- and post-intervention. Study quality was completed using the National Institutes of Health quality assessment tools. Results were grouped by type of intervention. The meta-analysis involved calculation of pooled effect sizes for interventions utilizing the same cognitive measure. RESULTS Eleven studies of moderate quality discussed drug therapy, transcutaneous tibial nerve stimulation, diet modification and dietary supplements, and inpatient rehabilitation. Some aspects of cognition were negatively affected by drugs while diet modification and supplement use, and transcutaneous tibial nerve stimulation showed no evidence of a difference in cognitive scores when compared with no intervention. Inpatient rehabilitation revealed a small but beneficial effect, when results of seven studies were pooled. CONCLUSION Evidence on the effects of interventions on cognitive functioning in patients with traumatic spinal cord injury is sparse and inconclusive, so work in this area is timely. It is valuable to know not only which interventions are effective for improving cognition, but also how other commonly used interventions, intended to treat other injury sequela, can affect cognition. PROSPERO: CRD42018087238.Implications for rehabilitationHistorically, rehabilitation of patients with traumatic spinal cord injury has targeted physical impairments, with little attention to cognition; this research aimed to understand if current interventions are appropriate in light of the risk of patients' cognitive impairments. Evidence on the effects of drug therapy, diet and dietary supplements interventions on cognitive functioning in traumatic spinal cord injury is sparse and inconclusive.Combining multiple inpatient rehabilitation interventions shows a positive but heterogeneous effect on the cognitive functioning; interventions applied earlier show greater gains.A major challenge for clinicians is to select an outcome measure sensitive to change over time, and to relate the results to patients' change in cognitive abilities with intervention applicationResearch to understand the functional effect of spinal cord injury on the widely distributed networks of the central and autonomic nervous systems subserving cognition, is timely.
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Affiliation(s)
- Nicole Pacheco
- Faculty of Honours Life Sciences, McMaster University, Toronto, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Shirin Mollayeva
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Binu Jacob
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Angela Colantonio
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Faculty of Occupational Science and Occupational Therapy, University of Toronto, Canada
| | - Tatyana Mollayeva
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Faculty of Occupational Science and Occupational Therapy, University of Toronto, Canada
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Chiaravalloti ND, Weber E, Wylie G, Dyson-Hudson T, Wecht JM. Patterns of cognitive deficits in persons with spinal cord injury as compared with both age-matched and older individuals without spinal cord injury. J Spinal Cord Med 2018; 43:88-97. [PMID: 30508409 PMCID: PMC7006756 DOI: 10.1080/10790268.2018.1543103] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Context/Objective: Cognitive deficits can impact as many as 60% of individuals with spinal cord injury (SCI). In an effort to identify the nature of cognitive deficits in SCI, we examined neuropsychological test performance in individuals with SCI, age matched healthy controls and older healthy controls.Design: Participants completed a motor-free neuropsychological test battery assessing attention, working memory, information processing speed, new learning /memory and executive control.Setting: Outpatient rehabilitation research facility.Participants: Participants included 60 individuals with chronic spinal cord injury [SCI; 32 with paraplegia (T2-T12) and 28 with tetraplegia (C3-T1)], 30 age-matched healthy controls (AMHC; 30-40 years old) and 20 older healthy controls (OHC; 50-60 years old).Outcome Measures: Wechsler Intelligence Scale - 3rd edition (WAIS-III) Digit Span and Letter-Number Sequencing; Symbol Digit Modalities Test (SDMT) - oral version; California Verbal Learning Test-II; Paced Auditory Serial Addition Test (PASAT); Wechsler Abbreviated Scale of Intelligence (WASI); Delis-Kaplan Executive Function System; Verbal Fluency subtest.Results: Significant differences were noted between the SCI and AMHC groups on measures of information processing speed, new learning and memory, and verbal fluency. No significant differences were noted between the groups on tests of attention or working memory.Conclusion: The current study documented differences in specific realms of cognitive functioning between a chronic SCI sample and AMHC. Implications for cognitive rehabilitation and overall quality of life are discussed. Additional research is needed utilizing a more comprehensive battery of motor-free neuropsychological tests that avoid the confound of upper limb motor limitations on cognitive performance.
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Affiliation(s)
- Nancy D. Chiaravalloti
- Kessler Foundation, Traumatic Brain Injury Research, West Orange, New Jersey, USA,Kessler Foundation, Neuropsychology & Neuroscience Research, West Orange, New Jersey, USA,Department of Physical Medicine and Rehabilitation Medical School, Rutgers-NJ, Newark, New Jersey, USA,Correspondence to: Nancy D. Chiaravalloti, PhD, Kessler Foundation, 120 Eagle Rock Avenue, Suite 100, East Hanover, NJ 07936, (973) 324–8440.
| | - Erica Weber
- Kessler Foundation, Traumatic Brain Injury Research, West Orange, New Jersey, USA,Department of Physical Medicine and Rehabilitation Medical School, Rutgers-NJ, Newark, New Jersey, USA
| | - Glenn Wylie
- Kessler Foundation, Neuropsychology & Neuroscience Research, West Orange, New Jersey, USA,Department of Physical Medicine and Rehabilitation Medical School, Rutgers-NJ, Newark, New Jersey, USA,VA War Related Illness and Injury Study Center, East Orange, New Jersey, USA
| | - Trevor Dyson-Hudson
- Department of Physical Medicine and Rehabilitation Medical School, Rutgers-NJ, Newark, New Jersey, USA,Kessler Foundation, Spinal Cord Injury Research, West Orange, New Jersey, USA
| | - Jill M. Wecht
- VA RR&D National Center for the Medical Consequences of SCI, James J. Peters VAMC, Bronx, New York, USA,Department of Medicine and Rehabilitation Medicine, The Icahn School of Medicine, Mount Sinai, New York, New York, USA
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