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Donders J, Ramos A. Correlates of performance on the Child and Adolescent Memory Profile (ChAMP) in a mixed pediatric sample. Child Neuropsychol 2024:1-12. [PMID: 38817122 DOI: 10.1080/09297049.2024.2361123] [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: 02/20/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Abstract
This study aimed to determine some of the factors that influence performance on a comprehensive test of verbal and visual memory in children, the Child and Adolescent Memory Profile (ChAMP) in a mixed clinical sample (n = 178; 56% male, 67% White, median age 12 years). We used hierarchical linear regression analyses with ChAMP standard scores as the dependent variable, and parental education as well as Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) factor index scores as the independent variables. WISC-V Processing Speed and (to a lesser extent) Working Memory were statistically significant predictors of most ChAMP Index scores. In addition, WISC-V Verbal Comprehension contributed to the model for ChAMP Verbal Memory, and WISC-V Visual Spatial to the model for ChAMP Visual Memory. In each case better performance on the WISC-V was predictive of higher scores on the ChAMP, with large effect sizes. WISC-V variables also mediated the positive effect of parental education on ChAMP scores. We conclude that clinicians should consider performance on measures of speed of processing, working memory, language and visual-spatial skills as potential influences on ChAMP results that may suggest a specific memory deficit.
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Affiliation(s)
- Jacobus Donders
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Ashlee Ramos
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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2
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Larson KR, Demers LA, Holding EZ, Williams CN, Hall TA. Variability Across Caregiver and Performance-Based Measures of Executive Functioning in an Acute Pediatric Neurocritical Care Population. Neurotrauma Rep 2023; 4:97-106. [PMID: 36895819 PMCID: PMC9989517 DOI: 10.1089/neur.2022.0083] [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: 03/05/2023] Open
Abstract
Youth admitted to the pediatric intensive care unit (PICU) for traumatic brain injury (TBI) commonly struggle with long-term residual effects in the domains of physical, cognitive, emotional, and psychosocial/family functioning. In the cognitive domain, executive functioning (EF) deficits are often observed. The Behavior Rating Inventory of Executive Functioning, Second Edition (BRIEF-2) is a parent/caregiver-completed measure that is regularly utilized to assess caregivers' perspectives of daily EF abilities. Using parent/caregiver-completed measures like the BRIEF-2 in isolation as outcome measures for capturing symptom presence and severity might be problematic given that caregiver ratings are vulnerable to influence from external factors. As such, this study aimed to investigate the association between the BRIEF-2 and performance-based measures of EF in youth during the acute recovery period post-PICU admission for TBI. A secondary aim was to explore associations among potential confounding factors, including family-level distress, injury severity, and the impact of pre-existing neurodevelopmental conditions. Participants included 65 youths, 8-19 years of age, admitted to the PICU for TBI, who survived hospital discharge and were referred for follow-up care. Non-significant correlations were found between BRIEF-2 outcomes and performance-based measures of EF. Measures of injury severity were strongly correlated with scores from performance-based EF measures, but not BRIEF-2. Parent/caregiver-reported measures of their own health-related quality of life were related to caregiver responses on the BRIEF-2. Results demonstrate the differences captured by performance-based versus caregiver-report measures of EF, and also highlight the importance of considering other morbidities related to PICU admission.
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Affiliation(s)
- Kera R Larson
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Lauren A Demers
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.,Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, Oregon, USA
| | - Emily Z Holding
- Developmental Medical Center, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Cydni N Williams
- Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.,Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, Oregon, USA
| | - Trevor A Hall
- Division of Pediatric Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.,Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, Oregon, USA
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Bailey A, Chenoweth T, Fisher Z, Joannides M, Watters S, Mazzucchelli J, Taylor S, Harris C. Identifying Suitable Cognitive Assessments for Children and Adolescents with Acquired Brain Injury for use by Occupational Therapists in Acute and Subacute Hospital Contexts: A Scoping Review. Dev Neurorehabil 2022; 25:485-500. [PMID: 35850609 DOI: 10.1080/17518423.2022.2099031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To appraise the literature evaluating psychometric properties and clinical utility of cognitive assessments available for use by occupational therapists in acute and subacute hospital contexts with children aged 4-18 years diagnosed with an acquired brain injury. METHODS Scoping review. Assessments and associated studies were evaluated for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy. RESULTS Forty-one studies evaluated 49 different assessments and reported on assessment psychometrics (n = 40), clinical utility (n = 1) and five reported on both. Fourteen assessments with the strongest psychometric properties and clinical utility were shortlisted. CONCLUSION A gold standard assessment was not identified. Instead, a shortlist of functional, performance-based, technology-based, and self-report assessments were identified as relevant for the setting and population, but requiring further investigation. Future development of a cognitive assessment in partnership with therapists working in tertiary pediatric settings will ensure optimal clinical utility and validity.
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Affiliation(s)
- Ashleigh Bailey
- School of Allied Health, Curtin University, Perth, Australia
| | | | - Zoe Fisher
- School of Allied Health, Curtin University, Perth, Australia
| | | | - Samantha Watters
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
| | - Jodie Mazzucchelli
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
| | - Susan Taylor
- School of Allied Health, Curtin University, Perth, Australia.,Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Australia
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Sleep and Executive Functioning in Pediatric Traumatic Brain Injury Survivors after Critical Care. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050748. [PMID: 35626925 PMCID: PMC9139390 DOI: 10.3390/children9050748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 11/17/2022]
Abstract
Over 50,000 children are hospitalized annually for traumatic brain injury (TBI) and face long-term cognitive morbidity. Over 50% develop sleep/wake disturbances (SWDs) that can affect brain development and healing. We hypothesized SWDs would portend worse executive function outcomes in children aged 3−18 years with TBI 1−3 months after hospital discharge. SWDs were defined using the Sleep Disturbances Scale for Children (t-scores ≥ 60). Outcomes included the Global Executive Composite (GEC, t-score) from the Behavior Rating Inventory of Executive Function, Second and Preschool Editions, and multiple objective executive function assessments combined through Principal Components Analysis into a Neurocognitive Index (NCI, z-score). Multiple linear regression evaluated associations between SWDs and executive function outcomes, controlling for covariates. Among 131 children, 68% had clinically significant SWDs, which were associated with significantly worse median scores on the GEC (56 vs. 45) and NCI (−0.02 vs. 0.42; both p < 0.05). When controlling for baseline characteristics and injury severity in multivariable analyses, SWDs were associated with worse GEC (β-coefficient = 7.8; 95% Confidence Interval = 2.5, 13.1), and worse NCI (β-coefficient = −0.4; 95% Confidence Interval = −0.8, −0.04). SWDs in children with TBI are associated with worse executive function outcomes after hospital discharge, and may serve as modifiable targets to improve outcomes.
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Evaluating the feasibility and efficacy of the Amsterdam memory and attention training for children (Amat-c) following acquired brain injury (ABI): protocol for a pilot study with online clinician support. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Background:
Attention and memory deficits are common following paediatric acquired brain injury (ABI). However, there are few evidence-based interventions to improve these domains and benefit the everyday life of children post-injury. The Amsterdam Memory and Attention Training for children (Amat-c) has been translated from Dutch to English and shown to improve attention and memory skills in children following ABI. This protocol describes a study to expand accessibility of the program by using online, clinician-supported delivery with children post-ABI.
Method/design:
The study is a randomized controlled trial. Participants will be 40 children aged 8–16 a minimum of one-year post-ABI. Participants in the treatment group will complete 18 weekly sessions of the Amat-c program with weekly online clinician support. Participants in the active-control group will be administered ABI psychoeducation via a booklet for parents, with weekly online clinician contact. Attention and memory will be assessed at three time points up to six months post-intervention.
Results:
Analysis will be repeated measures multivariate planned comparisons; using the Statistical Package for the Social Sciences (IBM SPSS Statistics) General Linear Model procedure will compare pre- and post-intervention and six-month follow-up outcomes.
Discussion:
If shown efficacious in improving attention and memory, our team will then take a key role in implementing Amat-c into clinical care.
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Shi AC, Rohlwink U, Scafidi S, Kannan S. Microglial Metabolism After Pediatric Traumatic Brain Injury - Overlooked Bystanders or Active Participants? Front Neurol 2021; 11:626999. [PMID: 33569038 PMCID: PMC7868439 DOI: 10.3389/fneur.2020.626999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022] Open
Abstract
Microglia play an integral role in brain development but are also crucial for repair and recovery after traumatic brain injury (TBI). TBI induces an intense innate immune response in the immature, developing brain that is associated with acute and chronic changes in microglial function. These changes contribute to long-lasting consequences on development, neurologic function, and behavior. Although alterations in glucose metabolism are well-described after TBI, the bulk of the data is focused on metabolic alterations in astrocytes and neurons. To date, the interplay between alterations in intracellular metabolic pathways in microglia and the innate immune response in the brain following an injury is not well-studied. In this review, we broadly discuss the microglial responses after TBI. In addition, we highlight reported metabolic alterations in microglia and macrophages, and provide perspective on how changes in glucose, fatty acid, and amino acid metabolism can influence and modulate the microglial phenotype and response to injury.
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Affiliation(s)
- Aria C Shi
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ursula Rohlwink
- Neuroscience Institute and Division of Neurosurgery, University of Cape Town, Cape Town, South Africa.,The Francis Crick Institute, London, United Kingdom
| | - Susanna Scafidi
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sujatha Kannan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Abstract
OBJECTIVE There is limited understanding of the cognitive profiles of Spanish-speaking children with Attention-Deficit/Hyperactivity Disorder (ADHD). The current study investigated the cognitive cluster profiles of Puerto Rican Spanish-speaking children with ADHD using the Wechsler Intelligence Scales for Children-Fourth Edition Spanish (WISC-IV Spanish) Index scores and examined the association between cognitive cluster profiles with other potentially relevant factors. METHOD Hierarchical cluster analysis was used to identify WISC-IV clusters in a sample of 165 Puerto Rican children who had a primary diagnosis of ADHD. To examine the validity of the ADHD clusters, analysis of variances and chi-square analyses were conducted to compare the clusters across sociodemographics (e.g., age and education), type of ADHD diagnosis (ADHD subtype, Learning Disorder comorbidity), and academic achievement. RESULTS Clusters were differentiated by level and pattern of performance. A five-cluster solution was identified as optimal that included (C1) multiple cognitive deficits, (C2) processing speed deficits, (C3) generally average performance, (C4) perceptual reasoning strengths, and (C5) working memory deficits. Among the five clusters, the profile with multiple cognitive deficits was characterized by poorer performance on the four WISC-IV Spanish Indexes and was associated with adverse sociodemographic characteristics. CONCLUSIONS Results illustrate that there is substantial heterogeneity in cognitive abilities of Puerto Rican Spanish-speaking children with ADHD, and this heterogeneity is associated with a number of relevant outcomes.
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Ramos-Usuga D, Benito-Sánchez I, Pérez-Delgadillo P, Valdivia-Tangarife R, Villaseñor-Cabrera T, Olabarrieta-Landa L, Arango-Lasprilla J. Trajectories of neuropsychological functioning in Mexican children with traumatic brain injury over the first year after injury. NeuroRehabilitation 2019; 45:295-309. [DOI: 10.3233/nre-192834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- D. Ramos-Usuga
- Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - I. Benito-Sánchez
- Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
- BioCruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - P. Pérez-Delgadillo
- Rusk Rehabilitation at New York University Langone Health, New York, NY, USA
| | | | - T. Villaseñor-Cabrera
- Department of Psychology, University of Guadalajara, Guadalajara, Mexico
- Department of Neurosciences, University of Guadalajara, Guadalajara, Mexico
| | - L. Olabarrieta-Landa
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, Spain
| | - J.C. Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute, Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
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McKay E, Richmond S, Kirk H, Anderson V, Catroppa C, Cornish K. Training attention in children with acquired brain injury: a study protocol of a randomised controlled trial of the TALI attention training programme. BMJ Open 2019; 9:e032619. [PMID: 31806614 PMCID: PMC6924822 DOI: 10.1136/bmjopen-2019-032619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Childhood inattention has been linked with poor academic outcomes, and increased lifetime social, occupational and psychiatric morbidity. Children with an acquired brain injury (ABI) are particularly susceptible to attention deficits and may benefit from interventions aimed at enhancing attention. The primary objective of this study is to evaluate the short-term efficacy of the TALI Train programme, compared with a placebo, on the outcome of attention in children with ABI. METHODS AND ANALYSIS The study is a parallel, double-blind, randomised controlled trial. Participants will consist of 80 children with a diagnosis of ABI aged 4-9 years 11 months. Participants will be randomly allocated to either (1) TALI Train (intervention group), an adaptive game-based attention training programme, or (2) a non-adaptive placebo programme (control group). Both programmes are delivered on a touchscreen tablet, and children complete five 20 min sessions per week for a 5-week period at home. Assessment of selective, sustained and executive attention (primary outcomes), and behavioural attention, working memory, social skills and mathematics ability (secondary outcomes) will occur at baseline, post-training, and at 3-month and 6-month follow-up to assess immediate and long-term efficacy of TALI Train compared with placebo. Assessments will be completed at the Royal Children's Hospital in Melbourne, Australia. All assessments and analyses will be undertaken by researchers blinded to group membership. Latent growth curve modelling will be employed to examine primary and secondary outcomes. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Royal Children's Hospital Human Research Ethics Committee (HREC) (38132) and the Monash University HREC (17446). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities. TRIAL REGISTRATION NUMBER ACTRN12619000511134.
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Affiliation(s)
- Erin McKay
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
| | - Sally Richmond
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
| | - Hannah Kirk
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Psychology Service, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
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10
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Lecci L, Williams M, Taravath S, Frank HG, Dugan K, Page R, Keith J. Validation of a Concussion Screening Battery for Use in Medical Settings: Predicting Centers for Disease Control Concussion Symptoms in Children and Adolescents. Arch Clin Neuropsychol 2019; 35:265-274. [DOI: 10.1093/arclin/acz041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/15/2019] [Accepted: 07/18/2019] [Indexed: 02/02/2023] Open
Abstract
Abstract
Objective
Effective screening for concussion is increasingly important, and medical professionals play a critical role in diagnostic and return-to-play decisions. However, few well-validated measures are available to assist in those decisions. This study aims to determine whether previously validated measures assessing neurocognitive and neurobehavioral abilities can predict Centers for Disease Control (CDC) concussion symptom endorsement in a sample of child or youth athletes.
Method
Participants were 113 individuals, aged 6–17, representing 29 consecutive cases undergoing a post-concussion evaluation by a pediatric neurologist and 84 consecutive cases completing standardized baseline assessments (i.e., not being evaluated as a follow-up to a concussion). All participants completed the same standardized battery of tests comprised of the Connors’ Continuous Performance Test (CPT 3), the Balance Error Scoring System (BESS), and the NIH 4-Meter Gait Test as well as completing a checklist of CDC concussion symptoms.
Results
Regression analyses indicate that the screening battery explained 33% of the variance (d = 1.4) in concussion symptom endorsement, after controlling for age. The neurocognitive test alone (CPT 3) accounts for 21.5% of the variance (d = 1.05) in symptoms after controlling for age, and the neurobehavioral measures (BESS and NIH 4-Meter Gait) then account for an additional 11.5% variance (accounting for 18.6% variance, d = .96, when entered first). These effect sizes are considered large to very large and reflect a marked increase in predictive validity relative to existing measures commonly used in concussion assessments.
Conclusions
A relatively brief screening battery can function in medical settings to predict significant and substantial variability in CDC concussion symptoms in a pediatric sample.
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Affiliation(s)
- Len Lecci
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC 28403, USA
| | - Mark Williams
- Internal Medicine, New Hanover Regional Medical Center, Wilmington, NC 28403, USA
| | - Sasidharan Taravath
- Pediatric Neurology, New Hanover Regional Medical Center, Wilmington, NC 28403, USA
| | - Harrison G Frank
- Frank Institute for Health and Wellness, Wilmington, NC 28403, USA
| | - Kelly Dugan
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC 28403, USA
| | - Ryan Page
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC 28403, USA
| | - Julian Keith
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC 28403, USA
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Ringdahl EN, Becker ML, Hussey JE, Thaler NS, Vogel SJ, Cross C, Mayfield J, Allen DN. Executive Function Profiles in Pediatric Traumatic Brain Injury. Dev Neuropsychol 2018; 44:172-188. [PMID: 30590952 DOI: 10.1080/87565641.2018.1557190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Traumatic brain injury (TBI) results in heterogeneous patterns of neuropsychological impairment. This study investigated heterogeneity in executive function (EF) using the Comprehensive Trail Making Test (CTMT) to evaluate 121 children and adolescents with TBI and 121 matched normal controls. The TBI group performed approximately two standard deviations below controls. Cluster analyses indicated that a three-cluster solution best classified the TBI group and a four-cluster solution best classified controls. Greater impairment in EF was associated with lower intellectual, achievement, and neuropsychological test performance in the TBI group. Results suggest that EF deficits reflected in CTMT performance may be useful for classifying severity of TBI.
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Affiliation(s)
- Erik N Ringdahl
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Megan L Becker
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Julia E Hussey
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | | | - Sally J Vogel
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Chad Cross
- b School of Medicine and School of Community Health Sciences , University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | | | - Daniel N Allen
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
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Holdnack JA, Iverson GL, Silverberg ND, Tulsky DS, Heinemann AW. NIH toolbox cognition tests following traumatic brain injury: Frequency of low scores. Rehabil Psychol 2018; 62:474-484. [PMID: 29265868 DOI: 10.1037/rep0000145] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVE To apply multivariate base rate analyses to the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) to facilitate the identification of cognitive impairment in individuals with traumatic brain injury (TBI). Research Method/Design: In a multisite cross-sectional design, 158 participants who sustained a complicated mild or moderate TBI (n = 74) or severe TBI (n = 84) at least 1 year earlier were administered the NIHTB-CB. The NIHTB-CB is comprised of 2 crystallized cognition tests (reflecting premorbid ability) and 5 fluid cognition tests, measuring processing speed, memory, and executive functioning. Base rates for obtaining 0 to 5 low fluid cognition scores were calculated across a range of cutoffs for defining a low test score (≤25th to 5th percentiles). Base rates of low scores in the TBI sample were compared to the NIHTB-CB normative sample using diagnostic accuracy statistics. RESULTS The proportion of the TBI sample obtaining low scores decreased as the cutoff for defining a low score decreased. Individuals with lower premorbid cognitive ability, as measured by NIHTB-CB Crystallized Composite score, tended to produce more low scores on the NIHTB-CB fluid cognition tests, even when using fully demographically adjusted scores. Certain patterns of low scores were associated with TBI (defined as likelihood ratio >2.0), whereas others were nonspecific, occurring almost as often in participants without TBI. CONCLUSIONS/IMPLICATIONS Premorbid ability stratified base rate tables provided in this article can guide researchers and clinicians in the interpretation of NIHTB-CB performance in adults with TBI. (PsycINFO Database Record
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Affiliation(s)
- James A Holdnack
- The Center for Health Assessment Research and Translation, University of Delaware
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School
| | - Noah D Silverberg
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of British Columbia
| | - David S Tulsky
- The Center for Health Assessment Research and Translation, Departments of Physical Therapy, Psychological and Brain Sciences, University of Delaware
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Dvorak E, van Heugten C. A summary on the effectiveness of the Amsterdam memory and attention training for children (Amat-c) in children with brain injury. Brain Inj 2017; 32:18-28. [PMID: 29115862 DOI: 10.1080/02699052.2017.1367961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To summarise the current research on the effectiveness of the Amsterdam Memory and Attention Training for Children (Amat-c). METHODS A literature search was conducted to find articles published about the Amat-c, using PubMed, psychINFO, and PsychBITE databases. Relevant search terms included Amat-c, attention and memory, and childhood ABI. RESULTS Our literature search identified 7 articles that described 5 separate studies including 61 children in total (mostly TBI). Only one study had a control group. All results indicated positive effects on memory and attention, although in three of the studies, these results were not statistically tested. Positive results were generally maintained six months follow up. CONCLUSIONS This review showed that the Amat-c is effective for treating attention and memory disturbances in children with ABI. However, evidence is limited and training material is outdated. We suggest that the Amat-c should be digitised and implemented in a school setting and further evaluated.
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Affiliation(s)
- Elizabeth Dvorak
- a Department of Neuropsychology & Psychopharmacology , Maastricht University , Maastricht , the Netherlands
| | - Caroline van Heugten
- a Department of Neuropsychology & Psychopharmacology , Maastricht University , Maastricht , the Netherlands.,b School for mental health and neuroscience , Maastricht University Medical Center , Maastricht , the Netherlands
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Validity of Accelerometry to Measure Physical Activity Intensity in Children With an Acquired Brain Injury. Pediatr Phys Ther 2017; 29:322-329. [PMID: 28953176 DOI: 10.1097/pep.0000000000000439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the validity of the ActiGraph accelerometer (AG) to differentiate between standardized, physical activity tasks using oxygen consumption ((Equation is included in full-text article.)O2) as the criterion measure in children and adolescents with an acquired brain injury; to determine vector magnitude activity intensity cut-points; to compare performance of cut-points to previously published cut-points. METHODS Twenty-seven children performed standardized walking and stepping activities wearing a portable indirect calorimeter, AG, and heart rate monitor. Differences in (Equation is included in full-text article.)O2 and AG vector magnitude activity counts were measured during activities. Receiver operating characteristic curves were determined for intensity cut-points. RESULTS (Equation is included in full-text article.)O2 and AG activity counts significantly increased as walking speed increased. Discrimination of the newly derived cut-points was excellent and demonstrated greater agreement compared with the previously published cut-points. CONCLUSION Output from accelerometers can differentiate physical activity intensity in children with an acquired brain injury. Future studies can apply these cut-points to evaluate physical activity performance.
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Baque E, Barber L, Sakzewski L, Boyd RN. Reproducibility in measuring physical activity in children and adolescents with an acquired brain injury. Brain Inj 2016; 30:1692-1698. [DOI: 10.1080/02699052.2016.1201594] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Emmah Baque
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Roslyn N. Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
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Yang LY, Huang CC, Chiu WT, Huang LT, Lo WC, Wang JY. Association of traumatic brain injury in childhood and attention-deficit/hyperactivity disorder: a population-based study. Pediatr Res 2016; 80:356-62. [PMID: 27064246 DOI: 10.1038/pr.2016.85] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/08/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND We evaluated the risk of attention-deficit hyperactivity disorder (ADHD) following childhood traumatic brain injury (TBI). METHODS Using Taiwan's National Health Insurance Research Database, we included 10,416 newly diagnosed TBI children (aged ≤12 y) between 2001 and 2002 and 41,664 children without TBI, who were frequency matched by sex, age, and year of the index medical service with each TBI child, as controls. Children who had been diagnosed with ADHD prior to their medical service index were excluded. Each individual was followed for 9 y to identify ADHD diagnosis. We also compared the ADHD risk in children who were treated for fractures but not TBI as sensitivity analysis. RESULTS During the 9-y follow-up period, children with TBI had a higher ADHD risk (adjusted hazard ratio (AHR) = 1.32, 95% confidence interval (CI) = 1.19, 1.45) than did those without TBI. Furthermore, children with mild and severe TBI had higher AHRs for ADHD than did those without TBI (AHR = 1.30; 95% CI = 1.10, 1.53; and AHR = 1.37; 95% CI = 1.22, 1.55). However, no significant association was observed between fractures and ADHD. CONCLUSION TBI in childhood is associated with a greater likelihood of developing ADHD.
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Affiliation(s)
- Ling-Yu Yang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan.,Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Ta Chiu
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Li-Tung Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - Wei-Cheng Lo
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jia-Yi Wang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Gorman S, Barnes MA, Swank PR, Prasad M, Cox CS, Ewing-Cobbs L. Does processing speed mediate the effect of pediatric traumatic brain injury on working memory? Neuropsychology 2016; 30:263-73. [PMID: 26214659 PMCID: PMC4729671 DOI: 10.1037/neu0000214] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Processing speed (PS) and working memory (WM), core abilities that support learning, are vulnerable to disruption following traumatic brain injury (TBI). Developmental increases in WM are related to age-related changes in PS. The purpose of this study was to investigate whether WM deficits in children with TBI are mediated by PS. METHOD The performance of children with complicated mild, moderate, and severe TBI (n = 77) was examined relative to an orthopedic injury (n = 30) and a healthy comparison group (n = 40) an average of 4 years after injury (range 8 months to 12 years). Coding was utilized as a measure of PS, while the WM measures included complex verbal and visual-spatial span tasks with parallel processing requirements. Mediation analysis examined whether TBI might have an indirect effect on WM through PS. RESULTS Children in the TBI group performed more poorly than the combined comparison groups on coding and visual-spatial WM. Verbal WM scores were lower in TBI and the healthy comparison relative to the orthopedic group. TBI severity group differences were found on coding, but not WM measures. The relation between coding and both the WM tasks was similar. Bootstrap regression analyses suggested that PS, as measured by coding, might partially mediate the effect of group performance on WM. CONCLUSIONS TBI disrupts core PS and WM abilities that scaffold more complex abilities. Importantly, slowed PS was associated with WM deficits commonly identified following pediatric TBI. Implications of our findings regarding the relation between PS and WM may suggest interventions for children and adolescents following TBI.
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Affiliation(s)
- Stephanie Gorman
- Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston
| | - Marcia A Barnes
- Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston
| | - Paul R Swank
- School of Public Health, University of Texas Health Science Center at Houston
| | - Mary Prasad
- Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston
| | - Charles S Cox
- Department of Pediatric Surgery, University of Texas Health Sciences Center at Houston
| | - Linda Ewing-Cobbs
- Department of Pediatrics and Children's Learning Institute, University of Texas Health Science Center at Houston
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Phillips NL, Parry L, Mandalis A, Lah S. [Formula: see text]Working memory outcomes following traumatic brain injury in children: A systematic review with meta-analysis. Child Neuropsychol 2015; 23:26-66. [PMID: 26397711 DOI: 10.1080/09297049.2015.1085500] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The aim of this review is to systematically examine the literature concerning multicomponent working memory (WM)-comprising a central executive (CE), two storage components (phonological loop, PL and visuo-spatial sketchpad, VSSP), and episodic buffer (EB)-in pediatric traumatic brain injury (TBI). Electronic searches were conducted of MEDLINE, PsychINFO and EMBASE up to October 2014 with the inclusion criteria of children and adolescents with TBI, and quantitative methods to assess at least one component of WM. Meta-analytic procedures calculated pooled effect sizes for WM outcomes. Of the studies examined, 27 met the inclusion criteria. Children with TBI exhibited deficits in the CE and PL, but not in the VSSP, and no study could be found which examined the EB. Qualitative analysis found that greater TBI severity was associated with poorer CE functioning in five out of nine studies. Differences in patterns of brain activation were evident in four out of five fMRI studies that examined WM in TBI children and controls. Deficits in CE were associated with poorer mathematical skills in the only study that examined relations between WM and academic deficits. Notwithstanding the heterogeneity of the studies reviewed, TBI places children at risk of WM deficits. Moreover, this meta-analysis suggests that various components of WM have differential vulnerability to pediatric TBI, with significant deficits found in the CE and PL, but not in the VSSP (although the VSSP has rarely been examined to date). Future studies should be theoretically driven, employ tasks assessing all components of the WM model and examine the functional ramifications (including academic outcomes) of WM deficits in this population.
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Affiliation(s)
- Natalie Lynette Phillips
- a School of Psychology , The University of Sydney , Sydney , New South Wales , Australia.,b ARC Centre of Excellence in Cognition and its Disorders , Sydney , New South Wales , Australia
| | - Louise Parry
- c Brain Injury Rehabilitation Program , Sydney Children's Hospital , Sydney , New South Wales , Australia.,d Department of Psychology , Sydney Children's Hospital , Sydney , New South Wales , Australia
| | - Anna Mandalis
- d Department of Psychology , Sydney Children's Hospital , Sydney , New South Wales , Australia
| | - Suncica Lah
- a School of Psychology , The University of Sydney , Sydney , New South Wales , Australia.,b ARC Centre of Excellence in Cognition and its Disorders , Sydney , New South Wales , Australia
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Chiou KS, Sandry J, Chiaravalloti ND. Cognitive contributions to differences in learning after moderate to severe traumatic brain injury. J Clin Exp Neuropsychol 2015; 37:1074-85. [DOI: 10.1080/13803395.2015.1078293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Catroppa C, Stone K, Hearps SJC, Soo C, Anderson V, Rosema S. Evaluation of an attention and memory intervention post-childhood acquired brain injury: Preliminary efficacy, immediate and 6 months post-intervention. Brain Inj 2015; 29:1317-24. [PMID: 26186037 DOI: 10.3109/02699052.2015.1043345] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Impairments in attention and memory are common sequelae following paediatric acquired brain injury (ABI). While it has been established that such impairments are long-term and, therefore, affect quality-of-life, there is a scarcity of evidence-based interventions to treat these difficulties. The current study aimed to pilot the efficacy of the Amsterdam Memory and Attention Training for Children (Amat-c: English version) using both neuropsychological and ecologically sensitive measures. It was expected that children with attention and memory difficulties post-ABI would show improved performance post-intervention on cognitive and ecological measures, with maintenance at 6 months post-intervention. METHODS AND PROCEDURES Ten children with an ABI, between the ages of 8-13 years at the time of recruitment were identified through audits of presentations to a metropolitan paediatric hospital. Each child underwent screening, the 18 week intervention programme, pre-intervention, immediate and 6 month post-intervention assessments. OUTCOMES/RESULTS Findings supported the hypothesis that children would show post-intervention (immediate and 6 month) improvement in areas of attention and memory, with generalization to everyday life. CONCLUSIONS/IMPLICATIONS Preliminary results provide support for the efficacy of the Amat-c post-childhood ABI. A larger study is needed to confirm these findings, as a reduction in attention and memory difficulties will enhance everyday functioning.
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Affiliation(s)
- Cathy Catroppa
- a Murdoch Children's Research Institute .,b Royal Children's Hospital , and.,c University of Melbourne , Parkville , Victoria , Australia
| | | | | | - Cheryl Soo
- a Murdoch Children's Research Institute .,c University of Melbourne , Parkville , Victoria , Australia
| | - Vicki Anderson
- a Murdoch Children's Research Institute .,b Royal Children's Hospital , and.,c University of Melbourne , Parkville , Victoria , Australia
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Raiker JS, Manning E, Herrington B, May AC, Haynes S, Graves PE, Karlson CW. Brief neurocognitive screening in youth with brain tumours: A preliminary investigation of the Lebby-Asbell Neurocognitive Screening Examination (LANSE). Brain Inj 2015; 29:1192-1198. [DOI: 10.3109/02699052.2015.1035331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Silberg T, Ahonniska-Assa J, Levav M, Eliyahu R, Peleg-Pilowsky T, Brezner A, Vakil E. The effect of age-at-testing on verbal memory among children following severe traumatic brain injury. Child Neuropsychol 2015; 22:600-17. [DOI: 10.1080/09297049.2015.1028348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kizony R, Tau S, Bar O, Engel Yeger B. Comparing memory and meta-memory abilities between children with acquired brain injury and healthy peers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1666-1673. [PMID: 24726285 DOI: 10.1016/j.ridd.2014.03.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/18/2014] [Accepted: 03/18/2014] [Indexed: 06/03/2023]
Abstract
This study compared visual memory and meta-memory abilities of children with ABI to that of healthy peers. Participants included 16 children (aged 13.55 ± 3.29 years) with moderate or severe ABI and 16 healthy children (aged 12.44 ± 3.24 years) with typical development. Children completed the Contextual Memory Test for Children (CMT-CH). The study group showed significantly lower immediate and delayed recall abilities. While the controls used the context for better memorizing, most of the children with ABI used rehearsals. In both groups better delayed recall correlated with the use of a more efficient strategy. Meta-memory should be an integral part of the assessment for children with ABI. Therapists should enhance child's self-awareness to his/her abilities and encourage the use of strategies (e.g. context) for memorizing in daily life.
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Affiliation(s)
- Rachel Kizony
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel; Department of Occupational Therapy, Sheba Medical Center, Tel Hashomer, Israel.
| | - Shoshi Tau
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel; Ministry of Education, Local Resource Center for Special Education Services, Raanana, Israel
| | - Orly Bar
- Pediatric Rehabilitation Department, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Batya Engel Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
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Thaler NS, O'Rourke JJ, Scott JG, Duff K, Mold J, Adams RL. Longitudinal stability of RBANS profiles in a geriatric community-dwelling sample. Clin Neuropsychol 2014; 28:269-80. [PMID: 24528211 DOI: 10.1080/13854046.2014.884243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This investigation is an extension of a previous study that identified four neurocognitive RBANS groups via cluster analysis in a geriatric community-dwelling sample of 699 individuals who were at least 65 years of age. Groups were examined longitudinally over a 2-year interval to establish if they exhibited marked score changes over three assessment periods. Dropout rates, onset of medical pathology, and self-reported functioning were tracked at each evaluation. Results confirmed that cluster scores were generally stable over time although the Low Immediate Memory group's Immediate Memory index score regressed upward toward the mean by the third assessment. Of interest, individuals in the Below Average group had substantial dropout between the first and third assessments. Results are interpreted through a clinical framework to explore how RBANS cluster profiles may have predictive value in general neurocognitive functioning over the observed time period and be potentially influenced by general health factors.
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Affiliation(s)
- Nicholas S Thaler
- a Department of Psychiatry and Biobehavioral Sciences , UCLA Semel Institute , Los Angeles , CA , USA
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25
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Limond J, Adlam AL, Cormack M. A Model for Pediatric Neurocognitive Interventions: Considering the Role of Development and Maturation in Rehabilitation Planning. Clin Neuropsychol 2014; 28:181-98. [DOI: 10.1080/13854046.2013.873083] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Thaler NS, Terranova J, Turner A, Mayfield J, Allen DN. A comparison of IQ and memory cluster solutions in moderate and severe pediatric traumatic brain injury. APPLIED NEUROPSYCHOLOGY. CHILD 2013; 4:20-30. [PMID: 24191845 DOI: 10.1080/21622965.2013.790820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Recent studies have examined heterogeneous neuropsychological outcomes in childhood traumatic brain injury (TBI) using cluster analysis. These studies have identified homogeneous subgroups based on tests of IQ, memory, and other cognitive abilities that show some degree of association with specific cognitive, emotional, and behavioral outcomes, and have demonstrated that the clusters derived for children with TBI are different from those observed in normal populations. However, the extent to which these subgroups are stable across abilities has not been examined, and this has significant implications for the generalizability and clinical utility of TBI clusters. The current study addressed this by comparing IQ and memory profiles of 137 children who sustained moderate-to-severe TBI. Cluster analysis of IQ and memory scores indicated that a four-cluster solution was optimal for the IQ scores and a five-cluster solution was optimal for the memory scores. Three clusters on each battery differed primarily by level of performance, while the others had pattern variations. Cross-plotting the clusters across respective IQ and memory test scores indicated that clusters defined by level were generally stable, while clusters defined by pattern differed. Notably, children with slower processing speed exhibited low-average to below-average performance on memory indexes. These results provide some support for the stability of previously identified memory and IQ clusters and provide information about the relationship between IQ and memory in children with TBI.
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Thaler NS, Linck JF, Heyanka DJ, Pastorek NJ, Miller B, Romesser J, Sim A, Allen DN. Heterogeneity in Trail Making Test performance in OEF/OIF/OND veterans with mild traumatic brain injury. Arch Clin Neuropsychol 2013; 28:798-807. [PMID: 24145667 DOI: 10.1093/arclin/act080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study used cluster analysis to examine variability in Trail Making Test (TMT) performance in a sample of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans referred for mild traumatic brain injury (mTBI). Three clusters were extracted, two of which were characterized by level of performance and the third with a unique performance pattern characterized by slow performance on the TMT B (Low B). Clusters did not differ on demographic or psychiatric variables. The Above Average cluster had better performance on measures of processing speed, working memory, and phonemic fluency compared with the Low B cluster. Results suggest that a subset of patients with mTBI perform poorly on TMT B, which subsequently predicts poorer cognitive functioning on several other neuropsychological measures. This subset may be vulnerable to cognitive changes in the context of mTBI and multiple comorbidities while a number of other patients remain cognitively unaffected under the same circumstances.
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Affiliation(s)
- Nicholas S Thaler
- Oklahoma City Department of Veteran Affairs Medical Center, Oklahoma City, OK, USA
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Harman-Smith YE, Mathias JL, Bowden SC, Rosenfeld JV, Bigler ED. Wechsler Adult Intelligence Scale–Third Edition profiles and their relationship to self-reported outcome following traumatic brain injury. J Clin Exp Neuropsychol 2013; 35:785-98. [DOI: 10.1080/13803395.2013.824554] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jonsson CA, Catroppa C, Godfrey C, Smedler AC, Anderson V. Cognitive recovery and development after traumatic brain injury in childhood: a person-oriented, longitudinal study. J Neurotrauma 2013; 30:76-83. [PMID: 23025803 DOI: 10.1089/neu.2012.2592] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Influence of childhood traumatic brain injury (TBI) on cognitive recovery and subsequent development is poorly understood. In this longitudinal study we used cluster analysis to explore acute stage individual profiles of injury age and cognition in 118 children with traumatic brain injury. Repeated measures of cognitive function were conducted at 30 months, indicating recovery, and 10 years post-injury, indicating development. Nine clusters were identified. Recovery was evident in three clusters, two of them with low functioning profiles. Developmental gains occurred for three clusters and an acute profile of higher freedom from distractibility (FFD) and lower processing speed (PS) was related to positive differences. One cluster, average low functioning and especially low verbal comprehension, demonstrated a slower development than peers. This suggests that developmental change after TBI in childhood takes place on a continuum, with both chance of long-term catching up, and risk of poor development. An acute profile of higher FFD and lower PS seemed to reflect injury consequences and were followed by developmental gains. These results challenge previous findings, and warrant further investigation.
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Thaler NS, Scott JG, Duff K, Mold J, Adams RL. RBANS Cluster Profiles in a Geriatric Community-Dwelling Sample. Clin Neuropsychol 2013; 27:794-807. [DOI: 10.1080/13854046.2013.783121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Aaro Jonsson C, Catroppa C, Godfrey C, Smedler AC, Anderson V. Individual profiles of predictors and their relations to 10 years outcome after childhood traumatic brain injury. Brain Inj 2013; 27:831-8. [PMID: 23789862 DOI: 10.3109/02699052.2013.775493] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Outcome after childhood traumatic brain injury (CTBI) is heterogeneous, with several predictors influencing long-term outcome. METHOD This exploratory study used person-oriented cluster analysis to investigate individual profiles of medical, psychological and social predictors and their relation to longitudinal development in a sample of 127 participants with mild, moderate and severe CTBI. Outcome of cognitive, adaptive and academic function was measured at 30 months and 10 years post-injury. RESULTS A nine-cluster solution, explaining 67% of the variance in the sample, resulted in two clusters with individuals with mostly mild injuries, five with mostly moderate injured individuals and two clusters with severely injured individuals. Best outcome at 10 years post-injury had a cluster with individuals with moderate injuries, young age at injury, average socioeconomic status (SES) and high pre-injury adaptive function. Worst outcome had a small cluster with severely injured individuals, young age at injury, average SES and average pre-injury adaptive function. CONCLUSIONS The findings suggest that pre-injury adaptive function is an influential predictor of outcome following moderate CTBI. Age at injury in the severe group appears to have increased influence over time, with younger age at injury associated with reduced outcome at 10 years after severe CTBI.
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Thaler NS, Bello DT, Etcoff LM. WISC-IV profiles are associated with differences in symptomatology and outcome in children with ADHD. J Atten Disord 2013; 17:291-301. [PMID: 22286109 DOI: 10.1177/1087054711428806] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The current study investigated the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) cluster profiles of children with ADHD to examine the association between IQ profiles and diagnostic frequency, symptomatology, and outcome in this population. METHOD Hierarchical cluster analysis was conducted on 189 children with a diagnosis of ADHD-inattentive (ADHD-I) and ADHD-combined (ADHD-C) subtypes. Clusters were then compared across symptom rating scale factor scores, behavioral rating scales, and achievement scores. RESULTS A five-cluster solution was extracted. One cluster was identified to have reduced processing speed relative to other WISC-IV indexes and significantly higher ratings of inattention and incidence of ADHD-I diagnosis. A second cluster had impairments in processing speed and working memory and was associated with impaired behavioral functioning. CONCLUSION Findings support a relationship between reduced processing speed and inattention and provide evidence that WISC-IV profiles may be helpful in predicting symptomatology and outcome in children with ADHD.
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Rackley C, Allen DN, Fuhrman LJ, Mayfield J. Generalizability of WISC-IV index and subtest score profiles in children with traumatic brain injury. Child Neuropsychol 2012; 18:512-9. [DOI: 10.1080/09297049.2011.628308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Yang Z, Yeo RA, Pena A, Ling JM, Klimaj S, Campbell R, Doezema D, Mayer AR. An FMRI study of auditory orienting and inhibition of return in pediatric mild traumatic brain injury. J Neurotrauma 2012; 29:2124-36. [PMID: 22533632 DOI: 10.1089/neu.2012.2395] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Studies in adult mild traumatic brain injury (mTBI) have shown that two key measures of attention, spatial reorienting and inhibition of return (IOR), are impaired during the first few weeks of injury. However, it is currently unknown whether similar deficits exist following pediatric mTBI. The current study used functional magnetic resonance imaging (fMRI) to investigate the effects of semi-acute mTBI (<3 weeks post-injury) on auditory orienting in 14 pediatric mTBI patients (age 13.50±1.83 years; education: 6.86±1.88 years), and 14 healthy controls (age 13.29±2.09 years; education: 7.21±2.08 years), matched for age and years of education. The results indicated that patients with mTBI showed subtle (i.e., moderate effect sizes) but non-significant deficits on formal neuropsychological testing and during IOR. In contrast, functional imaging results indicated that patients with mTBI demonstrated significantly decreased activation within the bilateral posterior cingulate gyrus, thalamus, basal ganglia, midbrain nuclei, and cerebellum. The spatial topography of hypoactivation was very similar to our previous study in adults, suggesting that subcortical structures may be particularly affected by the initial biomechanical forces in mTBI. Current results also suggest that fMRI may be a more sensitive tool for identifying semi-acute effects of mTBI than the procedures currently used in clinical practice, such as neuropsychological testing and structural scans. fMRI findings could potentially serve as a biomarker for measuring the subtle injury caused by mTBI, and documenting the course of recovery.
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Affiliation(s)
- Zhen Yang
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA
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Thaler NS, Mayfield J, Reynolds CR, Hadland C, Allen DN. Teacher-Reported Behavioral Disturbances in Children With Traumatic Brain Injury: An Examination of the BASC-2. APPLIED NEUROPSYCHOLOGY-CHILD 2012; 1:30-7. [DOI: 10.1080/21622965.2012.665776] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Southwick JS, Bigler ED, Froehlich A, DuBray MB, Alexander AL, Lange N, Lainhart JE. Memory functioning in children and adolescents with autism. Neuropsychology 2011; 25:702-710. [PMID: 21843004 PMCID: PMC3340415 DOI: 10.1037/a0024935] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Memory functioning in children and adolescents ages 5-19 with autism (n = 50) and typically developing controls (n = 36) was assessed using a clinical assessment battery, the Test of Memory and Learning (TOMAL). METHOD Participant groups were statistically comparable in age, nonverbal IQ, handedness, and head circumference, and were administered the TOMAL. RESULTS Test performance on the TOMAL demonstrated broad differences in memory functioning in the autism group, across multiple task formats, including verbal and nonverbal, immediate and delayed, attention and concentration, sequential recall, free recall, associative recall, and multiple-trial learning memory. All index and nearly all subtest differences remained significant even after comparing a subset of the autism group (n = 36) and controls that were matched for verbal IQ (p > .05). However, retention of previously remembered information after a delay was similar in autism and controls. CONCLUSIONS These findings indicate that performance on measures of episodic memory is broadly reduced in autism, and support the conclusion that information encoding and organization, possibly due to inefficient cognitive processing strategies, rather than storage and retrieval, are the primary factors that limit memory performance in autism.
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Affiliation(s)
| | - Erin D Bigler
- Department of Psychology and Neuroscience Center, Brigham Young University
| | | | - Molly B DuBray
- Interdepartmental Neuroscience Program, University of Utah
| | - Andrew L Alexander
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin
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Barney SJ, Allen DN, Thaler NS, Park BS, Strauss GP, Mayfield J. Neuropsychological and Behavioral Measures of Attention Assess Different Constructs in Children With Traumatic Brain Injury. Clin Neuropsychol 2011; 25:1145-57. [DOI: 10.1080/13854046.2011.595956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Thaler NS, Barney SJ, Reynolds CR, Mayfield J, Allen DN. Differential Sensitivity of TOMAL Subtests and Index Scores to Pediatric Traumatic Brain Injury. ACTA ACUST UNITED AC 2011; 18:168-78. [DOI: 10.1080/09084282.2011.595443] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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