1
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Nardo T, Berry J, Barker D, Assareh H, Lunn J, Sedwell A, Batchelor J, Shakeshaft A, Kelly PJ, Sarrami P, Russell S, James M. Cognitive remediation in residential substance use treatment: A randomized stepped-wedge trial. Neuropsychol Rehabil 2024:1-26. [PMID: 38358110 DOI: 10.1080/09602011.2024.2314879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/09/2023] [Indexed: 02/16/2024]
Abstract
ABSTRACTExecutive dysfunction is common in individuals with substance use disorder (SUD) and presents a barrier to treatment engagement. The study aimed to investigate the effectiveness of cognitive remediation (CR) for improving executive functioning and treatment retention in patients with SUD, using a stepped-wedge cluster randomized controlled trial. The sample included 527 adults enrolled across ten residential SUD treatment providers in NSW, Australia. The intervention consisted of 12 hours of CR delivered over six weeks in a group format. The comparator was treatment-as-usual (TAU). Primary outcomes included self-reported executive functioning and proportion of treatment completed (PoTC), measured as the number of days in treatment divided by the planned treatment duration. Intention-to-treat analysis did not find significant differences for self-reported executive functioning (mean difference = -2.49, 95%CI [-5.07, 0.09], p = .059) or PoTC (adjusted mean ratio = 1.09, 95%CI [0.88, 1.36], p = .442). Due to high dropout from the intention-to-treat sample (56%) a post-hoc analysis was conducted using a per-protocol approach, in which CR was associated with improved self-reported executive functioning (mean difference = -3.33, 95%CI [-6.10, -0.57], p = .019) and improved likelihood of treatment graduation (adjusted odds ratio = 2.43, 95%CI [1.43, 4.11], p < .001). More research is required to develop a CR approach that results in service-wide treatment effectiveness.
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Affiliation(s)
- Talia Nardo
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
- Advanced Neuropsychological Treatment Services, Strathfield South, NSW, Australia
| | - Jamie Berry
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
- Advanced Neuropsychological Treatment Services, Strathfield South, NSW, Australia
| | - Daniel Barker
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Hassan Assareh
- Agency for Clinical Innovation, St Leonards, NSW, Australia
| | - Jo Lunn
- We Help Ourselves, Rozelle, NSW, Australia
- Faculty of Arts, Social Sciences and Humanities, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | | | - Jennifer Batchelor
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Peter J Kelly
- Faculty of Arts, Social Sciences and Humanities, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Pooria Sarrami
- Agency for Clinical Innovation, St Leonards, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, Australia
| | - Skye Russell
- Agency for Clinical Innovation, St Leonards, NSW, Australia
| | - Megan James
- Agency for Clinical Innovation, St Leonards, NSW, Australia
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2
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Moshel ML, Warburton WA, Batchelor J, Bennett JM, Ko KY. Neuropsychological Deficits in Disordered Screen Use Behaviours: A Systematic Review and Meta-analysis. Neuropsychol Rev 2023:10.1007/s11065-023-09612-4. [PMID: 37695451 DOI: 10.1007/s11065-023-09612-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/01/2023] [Indexed: 09/12/2023]
Abstract
Over the last few decades, excessive and disordered screen use has become more prevalent, prompting investigations into its associated consequences. The extent to which disordered screen use behaviours impact neuropsychological functioning has been reportedly mixed and at times inconsistent. This review sought to synthesise the literature and estimate the magnitude of overall cognitive impairment across a wide range of disordered screen use behaviours. We also sought to determine the cognitive domains most impacted, and whether the observed impairments were moderated by the classification of screen-related behaviours (i.e., Internet or gaming) or the format of cognitive test administration (i.e., paper-and-pencil or computerised). A systematic search of databases (Embase, PsycINFO, MEDLINE) identified 43 cross-sectional articles that assessed neuropsychological performance in disordered screen use populations, 34 of which were included in the meta-analysis. A random-effects meta-analysis revealed significant small/medium (g = .38) cognitive deficits for individuals with disordered screen use behaviours relative to controls. The most affected cognitive domain with a significant medium effect size (g = .50) was attention and focus followed by a significant reduction in executive functioning (g = .31). The classification of disordered screen use behaviours into Internet or gaming categories or the format of cognitive testing did not moderate these deficits. Additionally, excluding disordered social media use in an exploratory analysis had little effect on the observed outcomes. This study highlights a number of methodological considerations that may have contributed to disparate findings and shows that disordered screen use can significantly impact cognitive performance. Recommendations for future research are also discussed. Data for this study can be found at https://osf.io/upeha/ .
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Affiliation(s)
- Michoel L Moshel
- School of Psychological Sciences, Macquarie University, Sydney, Australia.
| | - Wayne A Warburton
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Jennifer Batchelor
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Joanne M Bennett
- School of Behavioural and Health Sciences, Australian Catholic University, Sydney, Australia
| | - Katherine Y Ko
- School of Psychological Sciences, Macquarie University, Sydney, Australia
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3
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Vujic A, Mowszowski L, Meares S, Batchelor J, Naismith SL. Not all mentally stimulating activities are alike: insights from a 4-factor model and implications for late-life cognition. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2023; 30:822-836. [PMID: 35775824 DOI: 10.1080/13825585.2022.2094878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
It is not yet known which specific qualities of cognitively stimulating activities are most likely to enhance cognitive reserve in older adults. Taking an inductive approach to this problem, we asked 504 older adults with subjective and/or cognitive impairment to complete the Cognitively Stimulating Activities Questionnaire (CSA-Q). Exploratory factor analysis identified a 4-factor structure within a split-half sample, after which confirmatory factor analysis cross-validated the model. Retaining 12 CSA-Q items, the 4 factors were dubbed CSA-Processing, CSA-Challenging, CSA-Connecting and CSA-Socializing. Resulting factor weights were analyzed relative to cognitive reserve proxies and neuropsychological domains. All factors except CSA-Challenging were positively linked to cognitive reserve. Neuropsychologically, CSA-Challenging was modestly and positively correlated with processing speed and executive function, while CSA-Processing was positively correlated with executive function. CSA-Socializing had a small positive correlation with processing speed. Our findings offer new insights into late-life stimulating activities, laying the groundwork for longitudinal and intervention studies.
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Affiliation(s)
- Adam Vujic
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
| | - Susanne Meares
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Jennifer Batchelor
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
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4
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Denny JW, Brown RJ, Head MG, Batchelor J, Dickinson AS. Allocation of funding into blast injury-related research and blast traumatic brain injury between 2000 and 2019: analysis of global investments from public and philanthropic funders. BMJ Mil Health 2023; 169:127-132. [PMID: 33243763 PMCID: PMC10176327 DOI: 10.1136/bmjmilitary-2020-001655] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION There is little systematic tracking or detailed analysis of investments in research and development for blast injury to support decision-making around research future funding. METHODS This study examined global investments into blast injury-related research from public and philanthropic funders across 2000-2019. Research databases were searched using keywords, and open data were extracted from funder websites. Data collected included study title, abstract, award amount, funder and year. Individual awards were categorised to compare amounts invested into different blast injuries, the scientific approaches taken and analysis of research investment into blast traumatic brain injury (TBI). RESULTS A total of 806 awards were identified into blast injury-related research globally, equating to US$902.1 million (m, £565.9m GBP). There was a general increase in year-on-year investment between 2003 and 2009 followed by a consistent decline in annual funding since 2010. Pre-clinical research received $671.3 m (74.4%) of investment. Brain-related injury research received $427.7 m (47.4%), orthopaedic injury $138.6 m (15.4%), eye injury $63.7 m (7.0%) and ear injury $60.5m (6.7%). Blast TBI research received a total investment of $384.3 m, representing 42.6% of all blast injury-related research. The U.S. Department of Defense funded $719.3 m (80%). CONCLUSIONS Investment data suggest that blast TBI research has received greater funding than other blast injury health areas. The funding pattern observed can be seen as reactive, driven by the response to the War on Terror, the rising profile of blast TBI and congressionally mandated research.
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Affiliation(s)
- J W Denny
- Bioengineering Science Research Group, School of Engineering, University of Southampton, Southampton, UK
| | - R J Brown
- Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - M G Head
- Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - J Batchelor
- Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - A S Dickinson
- Bioengineering Science Research Group, School of Engineering, University of Southampton, Southampton, UK
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Fronzoni F, Rio EK, Girdwood MA, Castricum AA, Batchelor J. Fifteen minutes of high intensity running can impair performance on concussion testing; Implications for on-field diagnosis in sport. J Sci Med Sport 2022; 25:968-972. [DOI: 10.1016/j.jsams.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 09/11/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
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6
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Lees B, Earls NE, Meares S, Batchelor J, Oxenham V, Rae CD, Jugé L, Cysique LA. Diffusion Tensor Imaging in Sport-Related Concussion: A Systematic Review Using an a priori Quality Rating System. J Neurotrauma 2021; 38:3032-3046. [PMID: 34309410 DOI: 10.1089/neu.2021.0154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Diffusion tensor imaging (DTI) of brain white matter (WM) may be useful for characterizing the nature and degree of brain injury after sport-related concussion (SRC) and assist in establishing objective diagnostic and prognostic biomarkers. This study aimed to conduct a systematic review using an a priori quality rating strategy to determine the most consistent DTI-WM changes post-SRC. Articles published in English (until June 2020) were retrieved by standard research engine and gray literature searches (N = 4932), using PRISMA guidelines. Eligible studies were non-interventional naturalistic original studies that conducted DTI within 6 months of SRC in current athletes from all levels of play, types of sports, and sex. A total of 29 articles were included in the review, and after quality appraisal by two raters, data from 10 studies were extracted after being identified as high quality. High-quality studies showed widespread moderate-to-large WM differences when SRC samples were compared to controls during the acute to early chronic stage (days to weeks) post-SRC, including both increased and decreased fractional anisotropy and axial diffusivity and decreased mean diffusivity and radial diffusivity. WM differences remained stable in the chronic stage (2-6 months post-SRC). DTI metrics were commonly associated with SRC symptom severity, although standardized SRC diagnostics would improve future research. This indicates that microstructural recovery is often incomplete at return to play and may lag behind clinically assessed recovery measures. Future work should explore interindividual trajectories to improve understanding of the heterogeneous and dynamic WM patterns post-SRC.
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Affiliation(s)
- Briana Lees
- The Matilda Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola E Earls
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Susanne Meares
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Jennifer Batchelor
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Vincent Oxenham
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Randwick, New South Wales, Australia.,Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Caroline D Rae
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical Sciences, UNSW Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Lauriane Jugé
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical Sciences, UNSW Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Lucette A Cysique
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,St. Vincent's Hospital Applied Medical Research Centre, Peter Duncan Neuroscience, Sydney, New South Wales, Australia.,School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
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7
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Miezah D, Porter M, Rossi A, Kazzi C, Batchelor J, Reeve J. Cognitive profile of young children with Williams syndrome. J Intellect Disabil Res 2021; 65:784-794. [PMID: 34096129 DOI: 10.1111/jir.12860] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/18/2021] [Accepted: 05/09/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is very little research on the cognitive profile of young children with Williams syndrome (WS). METHOD The present study utilised the Differential Ability Scales - Second Edition to examine the early cognitive abilities of 22 young children with WS (aged 3.98 to 7.70 years, 10 male and 12 female participants). RESULTS Overall, IQ ranged from 38 (severely impaired) to 81.00 (low average). Consistent with Mervis et al. who looked at an older sample, over half (59.08%) of our young WS sample showed a significant and abnormal weakness in spatial ability relative to verbal ability. Moreover, 81.82% showed a significant and clinically unusual weakness in spatial ability relative to nonverbal reasoning ability. At the subtest level, only 4.55% of our sample showed a significant strength in naming vocabulary compared with verbal comprehension, while 13.64% showed a significant weakness in naming vocabulary relative to verbal comprehension. CONCLUSIONS The results of the present study show cognitive heterogeneity, consistent with the literature on older children and adults with WS. There were variable levels of intellect and variable patterns of cognitive strength and weakness across both index and subtest scores. Findings highlight the need for individual assessment and management of young children with WS but also indicate that for the majority of WS individuals spatial skills are indeed an area of significant and abnormal weakness and should be a focus for early intervention.
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Affiliation(s)
- D Miezah
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - M Porter
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - A Rossi
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - C Kazzi
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - J Batchelor
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
| | - J Reeve
- Psychology Department, Macquarie University, Sydney, New South Wales, Australia
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8
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Vujic A, Mowszowski L, Meares S, Duffy S, Batchelor J, Naismith SL. Engagement in cognitively stimulating activities in individuals with Mild Cognitive Impairment: relationships with neuropsychological domains and hippocampal volume. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2021; 29:1000-1021. [PMID: 34330189 DOI: 10.1080/13825585.2021.1955822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Late-life participation in cognitively stimulating activities is thought to contribute to an individual's cognitive reserve and thus protect against cognitive decline, yet its association with clinical markers of neurodegeneration is not well established. To investigate, we developed a 13-item self-report "cognitively stimulating activities" questionnaire (CSA-Q), which was completed by a community sample of 269 older adults (>50 years) at risk of dementia. Participants met criteria for Mild Cognitive Impairment (MCI) and were classified as amnestic (aMCI; n = 93) or non-amnestic (naMCI; n = 176). Weighted CSA-Q dimensions were calculated for activity intensity, mental engagement and social engagement via a panel of 23 inter-raters. The CSA-Q mean and its dimensions were examined in relation to: (a) demographics (age, sex), (b) cognitive reserve proxies (years of education, premorbid IQ), (c) neuropsychological markers across cognitive domains of executive function, processing speed, learning, and memory storage, and (d) neuroimaging markers (left and right hippocampal volume). Analyses were conducted for all MCI, as well as for aMCI and naMCI sub-types. The CSA-Q was found to have concurrent validity with cognitive reserve proxies. Among all MCI, the CSA-Q dimensions of intensity and mental engagement had moderate associations with left hippocampal volume, but not with neuropsychological performance. For naMCI, the CSA-Q had moderate associations with left hippocampal volume, and small associations with aspects of executive functioning and processing speed. No equivalent associations emerged for the aMCI subtype. Our findings show that the CSA-Q may be particularly useful for older adults with non-amnestic cognitive deficits.
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Affiliation(s)
- Adam Vujic
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Department of Science, School of Psychology, University of Sydney, Sydney, Australia
| | - Susanne Meares
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Shantel Duffy
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Charles Perkins Centre, University of Sydney, Australia.,Faculty of Health Sciences, Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Jennifer Batchelor
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Australia.,Department of Science, School of Psychology, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Australia
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9
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Eleftheriadou V, Atkar R, Batchelor J, McDonald B, Novakovic L, Patel JV, Ravenscroft J, Rush E, Shah D, Shah R, Shaw L, Thompson AR, Hashme M, Exton LS, Mohd Mustapa MF, Manounah L. British Association of Dermatologists guidelines for the management of people with vitiligo 2021. Br J Dermatol 2021; 186:18-29. [PMID: 34160061 DOI: 10.1111/bjd.20596] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 11/29/2022]
Affiliation(s)
- V Eleftheriadou
- Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, B15 2TH, UK
| | - R Atkar
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - J Batchelor
- Centre for Evidence Based Dermatology, University of Nottingham, Nottingham, NG7 2NR, UK
| | - B McDonald
- The Royal London Hospital, Whitechapel Road, Whitechapel, London, E1 1FR, UK
| | - L Novakovic
- Queen Elizabeth Hospital, Department of Dermatology, Lewisham and Greenwich NHS Trust, London, SE18 4QH, UK.,St John's Institute of Dermatology, Department of Photodermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, UK
| | | | | | - E Rush
- Patient representative.,Vitiligo Support UK, London, UK
| | - D Shah
- Amersham Hospital, Amersham, HP7 0JD, UK
| | - R Shah
- Central & North West London NHS Trust, London, NW1 2PL, UK.,British Psychological Society, Leicester, LE1 7DR, UK
| | - L Shaw
- Bristol Royal Infirmary, Bristol, BS2 8HW, UK
| | - A R Thompson
- British Psychological Society, Leicester, LE1 7DR, UK.,South Wales Clinical Psychology Training, Cardiff University, Cardiff, CF10 3AT, UK
| | - M Hashme
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
| | - L S Exton
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
| | - M F Mohd Mustapa
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
| | - L Manounah
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
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10
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Pienmunne J, Batchelor J, De Wit B, Sowman P. Rates of false positive outcomes on the A-WPTAS picture items in a sample of non-concussed athletes. Brain Inj 2021; 35:783-787. [PMID: 33971108 DOI: 10.1080/02699052.2021.1911000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Accurate diagnosis of sports related concussion ensures that athletes are removed from play if concussed and prevents incorrect removal when a concussion has not occurred. Although various screening tools are currently in use, there is no gold standard measure with which to diagnose sports related concussion.Objective: The current study aimed to investigate the diagnostic accuracy of the Abbreviated Westmead Post Traumatic Amnesia Scale (A-WPTAS) picture task, a neurocognitive measure used to assess mild traumatic brain injury. The incidence of false positive classifications and the potential confounding effect of exercise on scores on the A-WPTAS picture items were examined.Methods: The study included an athlete group comprising 33 players and a control group comprising 37 subjects. The A-WPTAS picture task was completed on three testing occasions, separated by three week intervals.Results: Results revealed that the A-WPTAS picture task was highly accurate (>95%) in correctly classifying participants with no concussion across all three testing occasions. There was no significant difference between the two groups in relation to false positive outcomes on any testing occasion, suggesting that exercise was not a confounding factor.Conclusions: Findings provide preliminary evidence to support the use of the A-WPTAS picture task in a sporting context.
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Affiliation(s)
- Joel Pienmunne
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | | | - Bianca De Wit
- Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia
| | - Paul Sowman
- Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia
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11
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Nardo T, Batchelor J, Berry J, Francis H, Jafar D, Borchard T. Cognitive Remediation as an Adjunct Treatment for Substance Use Disorders: A Systematic Review. Neuropsychol Rev 2021; 32:161-191. [PMID: 33871785 DOI: 10.1007/s11065-021-09506-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 04/06/2021] [Indexed: 11/28/2022]
Abstract
Substance use disorders are associated with diverse neuropsychological impairments, with deficits in memory and executive functioning commonly observed. Cognitive remediation has been shown to be effective in other populations with cognitive impairments in these domains, including those with psychiatric disorders and acquired brain injuries, and it has been hypothesised to be similarly effective for those in treatment for substance use disorders. We aimed to systematically review the evidence for cognitive remediation interventions administered as an adjunct treatment to substance use rehabilitation. Studies were included if participants were receiving substance use treatment, if improving cognitive functioning was the main focus of the intervention and if they used an experimental design with a control condition receiving treatment-as-usual or an active control intervention. Two independent reviewers agreed on the final selection of 32 studies, encompassing cognitive remediation for working memory, memory, executive functioning and general cognition. Significant differences between intervention and control groups for cognitive test results and treatment outcomes were extracted and compared across treatment approaches. The review found considerable heterogeneity across studies, including in the types of interventions, the nature of participants and the outcome measures used. Further, a lack of quality studies with sufficient power meant that limited conclusions could be drawn, highlighting a need for further replication and research. However, findings indicate that cognitive remediation remains a promising potential avenue for improving cognition and treatment outcomes for those in treatment for substance use disorders. Protocol submitted prospectively to PROSPERO 30.09.2019, CRD42020150978.
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Affiliation(s)
- Talia Nardo
- Macquarie University, North Ryde, NSW, 2109, Australia.
| | | | - Jamie Berry
- Macquarie University, North Ryde, NSW, 2109, Australia.,Advanced Neuropsychological Treatment Services, Strathfield South, NSW, 2136, Australia
| | | | - Deyyan Jafar
- Macquarie University, North Ryde, NSW, 2109, Australia
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12
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Berry J, Shores EA, Nardo T, Sedwell A, Lunn J, Marceau EM, Wesseling A, Zucco M, Sugden-Lingard S, Borchard T, Batchelor J. Brief executive-function assessment tool: A new cognitive impairment screening tool for alcohol and other drug services. Appl Neuropsychol Adult 2021; 29:1511-1521. [PMID: 33831338 DOI: 10.1080/23279095.2021.1895791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Accurate screening for cognitive impairment in alcohol and other drug (AOD) services would help to identify individuals who may need supports to obtain the greatest benefit from substance use disorder (SUD) treatment. At present there is no screening measure that has been developed specifically to detect cognitive impairment in a SUD population. This study examines the psychometric properties of the Brief Executive-function Assessment Tool (BEAT), which was specifically designed for this purpose. This study involving 501 individuals with SUD and 145 normal control participants established internal consistency (n = 646; 0.734), interrater (n = 60; 0.994), and test-retest reliability (n = 177; 0.845), and construct (all correlations p ≤ 0.05), and criterion (n = 467; ANCOVA p < 0.001) validity. Test operating characteristics (n = 500; 87% sensitivity, 71% specificity, 21% PPP, and 99% NPP) were also established relative to an independent criterion variable made up of three established performance-based neuropsychological tests. Findings support the reliability and validity of the BEAT as a screening measure of executive function impairment with high sensitivity and a low rate of false negatives.
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Affiliation(s)
- J Berry
- Advanced Neuropsychological Treatment Services, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - E A Shores
- Advanced Neuropsychological Treatment Services, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - T Nardo
- Advanced Neuropsychological Treatment Services, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - A Sedwell
- Agency for Clinical Innovation, Sydney, Australia
| | - J Lunn
- We Help Ourselves, Sydney, Australia
| | - E M Marceau
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - A Wesseling
- Department of Psychology, Macquarie University, Sydney, Australia
| | - M Zucco
- Department of Psychology, Macquarie University, Sydney, Australia
| | - S Sugden-Lingard
- Advanced Neuropsychological Treatment Services, Sydney, Australia
| | - T Borchard
- Advanced Neuropsychological Treatment Services, Sydney, Australia
| | - J Batchelor
- Department of Psychology, Macquarie University, Sydney, Australia
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13
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Pearce AJ, Kidgell DJ, Tommerdahl MA, Frazer AK, Rist B, Mobbs R, Batchelor J, Buckland ME. Chronic Neurophysiological Effects of Repeated Head Trauma in Retired Australian Male Sport Athletes. Front Neurol 2021; 12:633320. [PMID: 33767661 PMCID: PMC7985524 DOI: 10.3389/fneur.2021.633320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/17/2021] [Indexed: 12/16/2022] Open
Abstract
Aim: This study investigated the somatosensory and corticomotor physiology of retired contact sport athletes with a history of repeated concussion/subconcussion head trauma. Methods: Retired male athletes with a history of playing contact sports and repeated head trauma (n = 122) were divided into two groups: those who expressed concerns regarding their mental and cognitive health (“symptomatic”: n = 83), and those who did not express any ongoing concerns (“asymptomatic”: n = 39). Both groups were compared to age-matched male controls (n = 50) with no history of concussions or participation in contact sports, an absence of self-reported cognitive, or mood impairments. Transcranial magnetic stimulation (TMS) and vibrotactile stimulation were used to assess corticomotor and somatosensory pathways respectively. TMS and vibrotactile stimulation were correlated to self-reported responses using the Fatigue and Related Symptom Survey. Linear regression was used to associate concussion history with TMS, somatosensory variables. Results: Significant differences were found in symptom survey scores between all groups (p < 0.001). TMS showed significant differences between the “symptomatic” and control groups for intracortical inhibition and paired pulse TMS measures. Somatosensory measures showed significant differences for reaction time (p < 0.01) and reaction time variability (p < 0.01) between the “symptomatic” group to the “asymptomatic” and control groups. For other somatosensory measures, the “symptomatic” measures showed differences to the “control” group. Correlations showed significant associations between severity of symptom reporting with TMS and somatosensory measure, and regression revealed the number of concussions reported was shown to have significant relationships to increased intracortical inhibition and poorer somatosensory performance. Conclusion: This study shows that retired contact sport athletes expressing chronic symptoms showed significant pathophysiology compared to those with no ongoing concerns and non-concussed controls. Further, there is a linear dose-response relationship between number of reported concussions and abnormal neurophysiology. Neurophysiological assessments such as TMS and somatosensory measures represent useful and objective biomarkers to assess cortical impairments and progression of neuropsychological impairment in individuals with a history of repeated head trauma.
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Affiliation(s)
- Alan J Pearce
- College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
| | - Dawson J Kidgell
- Department of Physiotherapy, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, VIC, Australia
| | - Mark A Tommerdahl
- Department of Biomedical Engineering, University of North Carolina, Chappell Hill, NC, United States.,Cortical Metrics, Carrboro, NC, United States
| | - Ashlyn K Frazer
- Department of Physiotherapy, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, VIC, Australia
| | - Billymo Rist
- College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
| | - Rowena Mobbs
- Department of Neurology, Macquarie University Hospital, Macquarie University, Sydney, NSW, Australia
| | | | - Michael E Buckland
- Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Brain and Mind Centre, University Sydney, Camperdown, NSW, Australia
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14
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Berry J, Shores EA, Lunn J, Sedwell A, Nardo T, Wesseling A, Batchelor J. The Alcohol and Drug Cognitive Enhancement (ACE) Screening Tool: A simple and brief questionnaire to screen for cognitive impairment in substance use disorder treatment services. Appl Neuropsychol Adult 2021; 29:1450-1457. [PMID: 33646853 DOI: 10.1080/23279095.2021.1888727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The objective of this study was to determine the test-retest reliability; construct and criterion validity; and test operating characteristics of a newly developed cognitive impairment risk factor screening instrument, the Alcohol and Drug Cognitive Enhancement (ACE) Screening Tool. Participants in the validation study were 129 adults with substance use disorder (SUD) enrolled in residential SUD treatment services and 209 normal controls. Test and retest data were available for 36 participants with SUD and 40 normal control individuals on the ACE Screening Tool. Test-retest reliability was excellent (ICC = 0.97). The ACE Screening Tool was significantly correlated with the Montreal Cognitive Assessment (MoCA), Behavior Rating Inventory of Executive Functioning-Adult Version (BRIEF-A), Test of Premorbid Functioning (TOPF) and Five Point Test, establishing construct validity. Criterion validity was established using a ternary severity variable constructed using results obtained on the MoCA and BRIEF-A. Test operating characteristics analysis showed 93% sensitivity, 46% specificity, 33% positive predictive power, and 96% negative predictive power using a cut-score of >3. Those high levels of sensitivity and negative predictive power indicated that the tool would likely detect cognitive impairment when present and should therefore be considered suitable as an initial screening tool for cognitive impairment in individuals attending SUD services.
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Affiliation(s)
- Jamie Berry
- Department of Psychology, Macquarie University, Sydney, Australia.,Advanced Neuropsychological Treatment Services, Sydney, Australia
| | - E Arthur Shores
- Department of Psychology, Macquarie University, Sydney, Australia.,Advanced Neuropsychological Treatment Services, Sydney, Australia
| | - Jo Lunn
- We Help Ourselves, Sydney, Australia
| | | | - Talia Nardo
- Department of Psychology, Macquarie University, Sydney, Australia.,Advanced Neuropsychological Treatment Services, Sydney, Australia
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15
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Miezah D, Porter M, Batchelor J, Boulton K, Campos Veloso G. Cognitive abilities in Williams syndrome. Res Dev Disabil 2020; 104:103701. [PMID: 32554266 DOI: 10.1016/j.ridd.2020.103701] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 04/28/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
The current study utilized a comprehensive neuropsychological test battery to investigate cognitive abilities in a sample of 49 WS individuals (25 male) aged 6-39 years. Age effects were also investigated by splitting the sample into child and adult groups. Cognitive heterogeneity was found on the Woodcock Johnson III Tests of Cognitive Abilities, Australian Adaptation (WJ-III COG) (Woodcock, McGrew, & Mather, 2001), with cognitive abilities ranging from profoundly impaired to superior and individualized profiles of strength and weakness varying considerably. Overall, findings supported previous research showing strengths in auditory processing and phonemic awareness. The weakest performance, on average, was in processing speed, attention, delayed associative learning and executive functioning capabilities. Visual-spatial functioning was not a weakness overall, neither was nonverbal reasoning. Chronological age did not relate significantly to cognitive abilities. Findings highlight the need for individual assessment and management of WS individuals.
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Affiliation(s)
- Daniel Miezah
- Psychology Department, Macquarie University, Sydney, Australia
| | - Melanie Porter
- Psychology Department, Macquarie University, Sydney, Australia.
| | | | - Kelsie Boulton
- Psychology Department, Macquarie University, Sydney, Australia
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16
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Pearce AJ, Sy J, Lee M, Harding A, Mobbs R, Batchelor J, Suter CM, Buckland ME. Chronic traumatic encephalopathy in a former Australian rules football player diagnosed with Alzheimer's disease. Acta Neuropathol Commun 2020; 8:23. [PMID: 32098626 PMCID: PMC7043040 DOI: 10.1186/s40478-020-0895-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 02/05/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Alan J Pearce
- College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Joanne Sy
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - Maggie Lee
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
- Brain & Mind Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Antony Harding
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
- Brain & Mind Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Rowena Mobbs
- Brain & Mind Centre, University of Sydney, Camperdown, NSW, 2006, Australia
- Macquarie University, Macquarie Park, NSW, 2109, Australia
| | | | - Catherine M Suter
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - Michael E Buckland
- Department of Neuropathology, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia.
- Brain & Mind Centre, University of Sydney, Camperdown, NSW, 2006, Australia.
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17
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Kirtschig G, Lo S, Batchelor J. Pragmatic trials: lab meets bedside. Br J Dermatol 2019; 181:431-433. [PMID: 31475345 DOI: 10.1111/bjd.17889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G Kirtschig
- Department of Dermatology, University of Marburg, Germany.,Medbase Frauenfeld, santémed Gesundheitszentren AG, Frauenfeld, Switzerland
| | - S Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia.,Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - J Batchelor
- Centre of Evidence Based Dermatology, University of Nottingham, Lenton Lane, Nottingham, NG7 2NR, U.K
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18
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Chen NYC, Batchelor J. Length of post-traumatic amnesia and its prediction of neuropsychological outcome following severe to extremely severe traumatic brain injury in a litigating sample. Brain Inj 2019; 33:1087-1096. [PMID: 31046471 DOI: 10.1080/02699052.2019.1610797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Primary Objective: The aim of the current study was to examine the relationship between duration of post-traumatic amnesia (PTA) and neuropsychological outcome at one or more years following severe to extremely severe traumatic brain injury (TBI) in a litigating sample. Research Design: Retrospective study design, using data collected from 2010 to 2017. Methods and Procedures: Data from 41 cases obtained from a private medicolegal neuropsychological database was examined. The database comprised information pertaining to TBI etiology, TBI severity parameters, demographic variables, neuropsychological test results and scores on psychological questionnaires. PTA duration was examined as a continuous variable. All cases that demonstrated non-credible effort were excluded. Main Outcomes and Results: Continuous PTA duration was not found to be a significant predictor of cognitive impairment across domains of verbal intellect, non-verbal intellect, working memory, information processing speed, immediate memory, delayed memory, and executive functioning. Conclusions: The predictive relationship between duration of PTA and cognitive impairment that has been reported in non-litigating populations did not exist in a litigating TBI sample. Findings illustrate the importance of investigating the relationships between injury variables and cognitive outcome in a population undergoing litigation, to provide better understanding of outcome in this subgroup of patients with TBI.
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19
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O’Brien S, Metcalf K, Batchelor J. An examination of the heterogeneity of cognitive outcome following severe to extremely severe traumatic brain injury. Clin Neuropsychol 2019; 34:120-139. [DOI: 10.1080/13854046.2019.1598501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sarah O’Brien
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kasey Metcalf
- Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia
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20
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McKinnon AC, Hickie IB, Scott J, Duffy SL, Norrie L, Terpening Z, Grunstein RR, Lagopoulos J, Batchelor J, Lewis SJG, Shine JM, Naismith SL. Current sleep disturbance in older people with a lifetime history of depression is associated with increased connectivity in the Default Mode Network. J Affect Disord 2018; 229:85-94. [PMID: 29306697 DOI: 10.1016/j.jad.2017.12.052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 09/13/2017] [Accepted: 12/27/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND The present study investigated Default Mode Network (DMN) functional connectivity in subjects with a lifetime history of major depression, comparing those with and without current sleep disturbance. Controls were included to assess DMN abnormalities specific to depression. METHODS A total of 93 adults aged 50 years and over were recruited from the Healthy Brain Ageing Clinic at the Brain and Mind Centre, Sydney, Australia. The sample comprised two groups, including 22 controls and 71 participants with a lifetime history of DSM-IV major depression (with depressive episode current or remitted). 52 of those with a lifetime history of depression also met criteria for Mild Cognitive Impairment (MCI). Participants underwent resting-state fMRI along with comprehensive psychiatric, neuropsychological, and medical assessment. Subjective sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI). Sleep disturbance was defined as a PSQI score > 5. A total of 68% (n = 48) of cases with a lifetime history of depression met criteria for sleep-disturbance. DMN functional connectivity was assessed via ROI-to-ROI analyses. RESULTS Relative to controls, those with lifetime major depression demonstrated significantly increased functional connectivity between the ventromedial prefrontal cortex and the temporal pole. Within the depression group (n = 48), those with current sleep disturbance had significantly increased connectivity between the anterior medial prefrontal cortex and both the parahippocampal cortex and the hippocampal formation, relative to those without sleep disturbance (n = 23). These results were present after controlling for MCI diagnosis. CONCLUSIONS Current sleep disturbance together with depression is associated with distinct abnormalities in DMN functioning incorporating regions responsible for self-reflection and declarative memory processes. Impaired sleep is associated with increased connectivity between these regions. Future studies may augment these findings with complementary imaging techniques including cortical thickness and diffusion tensor imaging, as well as high density electroencephalogram recording.
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Affiliation(s)
- Andrew C McKinnon
- Healthy Brain Ageing Program, Australia; Department of Psychology, Macquarie University, Australia
| | | | - Jan Scott
- Healthy Brain Ageing Program, Australia
| | - Shantel L Duffy
- Healthy Brain Ageing Program, Australia; Central Clinical School, Faculty of Medicine, The University of Sydney, Australia
| | | | | | | | - Jim Lagopoulos
- Healthy Brain Ageing Program, Australia; Sunshine Coast Mind and Neuroscience - Thompson Institute, University of The Sunshine Coast, QLD, Australia
| | | | | | | | - Sharon L Naismith
- Healthy Brain Ageing Program, Australia; School of Psychology, Australia; Charles Perkins Centre and Brain and Mind Centre, The University of Sydney, Australia.
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21
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García-Doval I, Albrecht J, Flohr C, Batchelor J, Ingram JR. Optimizing case reports and case series: guidance on how to improve quality. Br J Dermatol 2018; 178:1257-1262. [PMID: 29451697 DOI: 10.1111/bjd.16467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 12/16/2022]
Abstract
Case reports and case series remain an important part of journals and are often first to document medical breakthroughs. This article reviews their characteristics, aims and limitations. It provides information on how to increase the validity of the bedside decision-making process that these studies report, using tools such as validated outcomes and split-body or n-of-1 trials. A section describing tools to improve writing of case reports and case series provides suggestions for detailed reporting and good evaluation of novelty, validity and relevance. It includes general and British Journal of Dermatology-specific guidance.
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Affiliation(s)
- I García-Doval
- Research Unit, Fundación Piel Sana AEDV Madrid, Ferraz 100, 1° izda, 28008, Madrid, Spain.,Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Meixoeiro sn, 36200, Vigo, Spain
| | - J Albrecht
- Division of Dermatology, Department of Medicine, J.H. Stroger Jr Hospital of Cook County, 1900 West Polk Street, Chicago, IL, 60612, U.S.A
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - J Batchelor
- Centre of Evidence Based Dermatology, King's Meadow Campus, University of Nottingham, Nottingham, U.K
| | - J R Ingram
- Department of Dermatology & Wound Healing, Division of Infection and Immunity, Cardiff University, University Hospital of Wales, 3rd Floor Glamorgan House, Heath Park, Cardiff, CF14 4XN, U.K
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22
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Wake EV, Batchelor J, Lawton S, Thomas KS, Harrison EF, Cowdell FC. The views of children and young people on the use of silk garments for the treatment of eczema: a nested qualitative study within the CLOTHing for the relief of Eczema Symptoms (CLOTHES) randomized controlled trial. Br J Dermatol 2018; 178:183-190. [PMID: 28856661 PMCID: PMC6487959 DOI: 10.1111/bjd.15909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2017] [Indexed: 11/28/2022]
Abstract
Background Many children suffer with skin diseases but to date most dermatological research has been done ‘on’ rather than ‘with’ children; in this study we actively sought the experiences of children and young people. Atopic eczema (AE) is a chronic, itchy, inflammatory skin condition that affects around 20% of children and can impact on the health and wellbeing of children and their families. The role of specialist clothing in the management of AE is poorly understood. Objectives The aim of this study, which was nested in a randomized controlled trial, was to qualitatively examine child participants’ experiences of using silk garments for the treatment of AE. Methods Eighteen children aged 5–15 years, who took part in the CLOTHing for the relief of Eczema Symptoms (CLOTHES) trial, participated in age‐appropriate individual interviews or focus groups. Results Thematic analysis generated four themes directly related to the silk garments: (i) expectations of the garments; (ii) wearing the garments; (iii) asking if the garments helped; and (iv) thoughts about the garments. The conclusions from this nested qualitative study are that there was some limited improvement in eczema for some children but that the hoped‐for ‘miracle cure’ did not transpire. A mixed picture of knowledge, beliefs and experiences of using the silk garments emerged. Conclusions Engaging children in the evaluation of the garments provided first‐hand nuanced insights that enhanced understanding of the CLOTHES study as a whole. This nested study demonstrates that children can and indeed want to be engaged in dermatological research in meaningful ways that add to our understanding of treatment options. What's already known about this topic? Eczema affects around 20% of children and can have a detrimental effect on the child and their family. Adherence with topical treatments is often poor and can lead to treatment failure. Although children are often end‐users of eczema treatments, they are rarely engaged in research involving these products beyond completing questionnaires.
What does this study add? Children and young people can be meaningfully engaged in dermatology research and add new dimensions of understanding that would not be gained by proxy data. Children told us about their expectations of the garments and their views once they had worn them. The added value of child data lies in enhancing understanding of reasons for adherence and nonadherence, in facilitating interpretation of the trial results, and in ensuring selected objective outcome measures include factors important to children.
What are the clinical implications of the work? This study illustrates the need to communicate effectively with children and young people to ascertain their thoughts and beliefs about treatment regimens and assess the likelihood of adherence.
Linked Comment: Teasdale. Br J Dermatol 2018; 178:25–26. Plain language summary available online Respond to this article
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Affiliation(s)
- E V Wake
- Faculty of Health and Social Care, University of Hull, Hull, U.K
| | - J Batchelor
- Centre of Evidence Based Dermatology, The University of Nottingham, Nottingham, U.K
| | - S Lawton
- Dermatology Department, The Rotherham NHS Foundation Trust, Rotherham, U.K
| | - K S Thomas
- Centre of Evidence Based Dermatology, The University of Nottingham, Nottingham, U.K
| | - E F Harrison
- Nottingham Clinical Trials Unit, The University of Nottingham, Nottingham, U.K
| | - F C Cowdell
- Faculty of Health Education and Life Sciences, Birmingham City University, Birmingham, U.K
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23
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Wake E, Batchelor J, Lawton S, Thomas K, Harrison, E, Cowdell F. 儿童和青少年对穿着丝绸服装治疗湿疹的观点:缓解湿疹症状的服装随机对照试验范畴内的巢式定性研究. Br J Dermatol 2018. [DOI: 10.1111/bjd.16183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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24
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Wake E, Batchelor J, Lawton S, Thomas K, Harrison E, Cowdell F. The views of children and young people on the use of silk garments for the treatment of eczema: a nested qualitative study within the CLOTHing for the relief of Eczema Symptoms (CLOTHES) randomized controlled trial. Br J Dermatol 2018. [DOI: 10.1111/bjd.16177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Ridley N, Batchelor J, Draper B, Demirkol A, Lintzeris N, Withall A. Cognitive screening in substance users: Diagnostic accuracies of the Mini-Mental State Examination, Addenbrooke's Cognitive Examination-Revised, and Montreal Cognitive Assessment. J Clin Exp Neuropsychol 2017; 40:107-122. [PMID: 28436744 DOI: 10.1080/13803395.2017.1316970] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Despite the considerable prevalence of cognitive impairment in substance-using populations, there has been little investigation of the utility of cognitive screening measures within this context. In the present study the accuracy of three cognitive screening measures in this population was examined-the Mini-Mental State Examination (MMSE), the Addenbrooke's Cognitive Examination-Revised (ACE-R), and the Montreal Cognitive Assessment (MoCA). METHOD A sample of 30 treatment-seeking substance users and 20 healthy individuals living in the community were administered the screening measures and a neuropsychological battery (NPB). Agreement of classification of cognitive impairment by the screening measures and NPB was examined. RESULTS Results indicated that the ACE-R and MoCA had good discriminative ability in detection of cognitive impairment, with areas under the receiver-operating characteristic (ROC) curve of .85 (95% confidence interval, CI [.75. .94] and .84 (95% CI [.71, .93]) respectively. The MMSE had fair discriminative ability (.78, 95% CI [.65, .93]). The optimal cut-score for the ACE-R was 93 (impairment = score of 92 or less), at which it correctly classified 89% of individuals as cognitively impaired or intact, while the optimal cut-score for the MoCA was <26 or <27 depending on preference for either specificity or sensitivity. The optimal cut-score for the MMSE was <29; however, this had low sensitivity despite good specificity. CONCLUSIONS These findings suggest that the MoCA and ACE-R are both valid and time-efficient screening tools to detect cognitive impairment in the context of substance use.
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Affiliation(s)
- Nicole Ridley
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia
| | - Jennifer Batchelor
- b Department of Psychology , Macquarie University , North Ryde , NSW , Australia
| | - Brian Draper
- c School of Psychiatry, Faculty of Medicine , UNSW Australia , NSW , Sydney , Australia.,d Academic Department for Old Age Psychiatry , Prince of Wales Hospital , Randwick , NSW , Australia
| | - Apo Demirkol
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,e School of Public Health & Community Medicine, Faculty of Medicine , UNSW Australia , Sydney , NSW , Australia
| | - Nicholas Lintzeris
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,f Discipline of Addiction Medicine, Central Clinical School , Sydney Medical School, The University of Sydney , Sydney , NSW , Australia
| | - Adrienne Withall
- e School of Public Health & Community Medicine, Faculty of Medicine , UNSW Australia , Sydney , NSW , Australia
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26
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McKinnon AC, Duffy SL, Cross NE, Terpening Z, Grunstein RR, Lagopoulos J, Batchelor J, Hickie IB, Lewis SJ, Shine JM, Naismith SL. Functional Connectivity in the Default Mode Network is Reduced in Association with Nocturnal Awakening in Mild Cognitive Impairment. J Alzheimers Dis 2017; 56:1373-1384. [DOI: 10.3233/jad-160922] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrew C. McKinnon
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- Department of Psychology, Macquarie University, Sydney NSW, Australia
| | - Shantel L. Duffy
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- Charles Perkins Centre and Brain and Mind Centre, The University of Sydney, Camperdown NSW, Australia
| | - Nathan E. Cross
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- Woolcock Institute of Medical Research, Glebe NSW, Australia
| | - Zoe Terpening
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | | | - Jim Lagopoulos
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | | | - Ian B. Hickie
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | - Simon J.G. Lewis
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | - James M. Shine
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | - Sharon L. Naismith
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- School of Psychology, The University of Sydney, Camperdown NSW, Australia
- Charles Perkins Centre and Brain and Mind Centre, The University of Sydney, Camperdown NSW, Australia
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27
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McKinnon AC, Lagopoulos J, Terpening Z, Grunstein R, Hickie IB, Batchelor J, Lewis SJG, Duffy SL, Shine JM, Naismith SL. P1‐281: Sleep Disturbance in Mild Cognitive Impairment is Associated With Alterations in The Brain's Default Mode Network. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Andrew C. McKinnon
- Macquarie UniversitySydneyAustralia
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
| | - Jim Lagopoulos
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
| | - Zoe Terpening
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
| | - Ron Grunstein
- Woolcock Institute of Medical ResearchSydneyAustralia
| | - Ian B. Hickie
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
| | | | - Simon JG. Lewis
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
| | - Shantel L. Duffy
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
- Charles Perkins Centre, University of SydneySydneyAustralia
- Brain & Mind Research Centre, University of SydneySydneyAustralia
| | - James M. Shine
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
| | - Sharon L. Naismith
- Healthy Brain Ageing Program, University of SydneySydneyAustralia
- Charles Perkins Centre, University of SydneySydneyAustralia
- Brain & Mind Research Centre, University of SydneySydneyAustralia
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McKinnon AC, Lagopoulos J, Terpening Z, Grunstein R, Hickie IB, Batchelor J, Lewis SJG, Duffy S, Shine JM, Naismith SL. Sleep disturbance in mild cognitive impairment is associated with alterations in the brain’s default mode network. Behav Neurosci 2016; 130:305-15. [DOI: 10.1037/bne0000137] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Samimi M, Albrecht J, Batchelor J, Matin RN. Clinical trials in the BJD: how to publish, what to publish and where to publish. Br J Dermatol 2016; 174:947-8. [PMID: 27206351 DOI: 10.1111/bjd.14533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Samimi
- Department of Dermatology, University Hospital of Tours, University Francois Rabelais, Tours, France. .,ISP 1282 INRA-University of Tours, Tours, France.
| | - J Albrecht
- Division of Dermatology, Department of Medicine, J.H. Stroger Jr Hospital of Cook County, 1900 West Polk Street, Chicago, IL, 60612, U.S.A.,Department of Dermatology, Rush University Medical Center, 1900 West Polk Street, Chicago, IL, 60612, U.S.A
| | - J Batchelor
- Centre of Evidence Based Dermatology, King's Meadow Campus, Lenton Lane, Nottingham, NG7 2NR, U.K
| | - R N Matin
- Department of Dermatology, Churchill Hospital, Oxford, OX3 7LE, U.K
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Affiliation(s)
- J Batchelor
- Centre of Evidence Based Dermatology, King's Meadow Campus, University of Nottingham, Lenton Lane, Nottingham, NG7 2NR, U.K.
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Massey JS, Meares S, Batchelor J, Bryant RA. An exploratory study of the association of acute posttraumatic stress, depression, and pain to cognitive functioning in mild traumatic brain injury. Neuropsychology 2015; 29:530-42. [PMID: 25822464 DOI: 10.1037/neu0000192] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Few studies have examined whether psychological distress and pain affect cognitive functioning in the acute to subacute phase (up to 30 days postinjury) following mild traumatic brain injury (mTBI). The current study explored whether acute posttraumatic stress, depression, and pain were associated with performance on a task of selective and sustained attention completed under conditions of increasing cognitive demands (standard, auditory distraction, and dual-task), and on tests of working memory, memory, processing speed, reaction time (RT), and verbal fluency. METHOD At a mean of 2.87 days (SD = 2.32) postinjury, 50 adult mTBI participants, consecutive admissions to a Level 1 trauma hospital, completed neuropsychological tests and self-report measures of acute posttraumatic stress, depression, and pain. A series of canonical correlation analyses was used to explore the relationships of a common set of psychological variables to various sets of neuropsychological variables. RESULTS Significant results were found on the task of selective and sustained attention. Strong relationships were found between psychological variables and speed (r(c) = .56, p = .02) and psychological variables and accuracy (r(c) = .68, p = .002). Pain and acute posttraumatic stress were associated with higher speed scores (reflecting more correctly marked targets) under standard conditions. Acute posttraumatic stress was associated with lower accuracy scores across all task conditions. Moderate but nonsignificant associations were found between psychological variables and most cognitive tasks. CONCLUSIONS Acute posttraumatic stress and pain show strong associations with selective and sustained attention following mTBI.
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Meares S, Shores EA, Smyth T, Batchelor J, Murphy M, Vukasovic M. Identifying posttraumatic amnesia in individuals with a Glasgow Coma Scale of 15 after mild traumatic brain injury. Arch Phys Med Rehabil 2015; 96:956-9. [PMID: 25576643 DOI: 10.1016/j.apmr.2014.12.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 12/19/2014] [Accepted: 12/31/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To examine the utility of the Abbreviated Westmead Post-traumatic Amnesia Scale, which includes the Glasgow Coma Scale (GCS) and 3 picture cards used to measure amnesia, in identifying the presence or absence of posttraumatic amnesia in individuals with mild traumatic brain injury (mTBI). DESIGN Prospective study using data from the Abbreviated Westmead Post-traumatic Amnesia Scale. SETTING Trauma hospital. PARTICIPANTS Individuals with possible mTBI who presented between April and September 2011 (N=252; age range, 18-65y; mean age, 37.4±13.9y; 77% men). INTERVENTION Administration of the Abbreviated Westmead Post-traumatic Amnesia Scale. MAIN OUTCOME MEASURES GCS and Abbreviated Westmead Post-traumatic Amnesia Scale pass/fail rates. RESULTS Of the individuals, 169 (mean age, 35.1±13.6y; 77% men) received the scale. A pass/fail performance was achieved a median 121 minutes (interquartile range, 89-205min) after triage. Of the 45 who failed, 31 (69%) had a GCS score of 15. The likelihood of failing was associated with being older (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.06; P<.05), having consumed alcohol (OR, 3.09; 95% CI, 1.42-6.74; P<.01), and the scale being administered closer to the time of the injury (OR, 0.99; 95% CI, 0.99-1.00; P<.05). Nineteen (42%) of those who failed had consumed alcohol, 11 had a GCS score of 15, and 8 had a GCS score of 14. CONCLUSIONS A GCS score of 15 does not always signify return to normative cognitive function. Individuals with a GCS score of 15 who are acutely cognitively impaired are at risk of not being accurately identified. The addition of an amnesia score to the GCS in the Abbreviated Westmead Post-traumatic Amnesia Scale will assist in making a diagnosis of mTBI.
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Affiliation(s)
- Susanne Meares
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia; Department of Rehabilitation Medicine, Westmead Hospital, Westmead, NSW, Australia.
| | - E Arthur Shores
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Tracy Smyth
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia; Department of Emergency Services, Westmead Hospital, Westmead, NSW, Australia
| | - Jennifer Batchelor
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Margaret Murphy
- Department of Emergency Services, Westmead Hospital, Westmead, NSW, Australia
| | - Matthew Vukasovic
- Department of Emergency Services, Westmead Hospital, Westmead, NSW, Australia
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Abstract
Wilson's Disease (WD) (also known as hepatolenticular degeneration) is a rare inherited autosomal recessive disorder of abnormal copper metabolism, with an estimated prevalence of approximately 1 in 30,000. The clinical features associated with WD are highly varied. However, subtypes generally reflect neurological, hepatic, and psychiatric symptoms. The present case study reports two brothers with a recent diagnosis of WD. Neurological symptoms and cognitive deficits were exhibited in one brother (BL) in the form of extrapyramidal features, while the other brother (AL) only exhibited hepatic symptoms. Extensive neuropsychological testing was conducted on both siblings to compare cognitive profiles. Results for BL indicated significantly impaired motor functioning and information processing speed, which impacted him significantly at school. Aspects of executive dysfunction were also apparent in addition to reduced visual and verbal memory, working memory, and attention. Results for AL revealed evidence of verbal memory difficulties and aspects of executive dysfunction. Comparison is made of the distinct and common cognitive characteristics of the cases presented in terms of implications for early intervention and management of cognitive difficulties.
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Affiliation(s)
- Deborah Arguedas
- a Department of Psychology , Macquarie University , Sydney NSW 2109 , Australia
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Nott MT, Baguley IJ, Heriseanu R, Weber G, Middleton JW, Meares S, Batchelor J, Jones A, Boyle CL, Chilko S. Effects of concomitant spinal cord injury and brain injury on medical and functional outcomes and community participation. Top Spinal Cord Inj Rehabil 2014; 20:225-35. [PMID: 25484568 DOI: 10.1310/sci2003-225] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND There are limited data on the interactions between concomitant spinal cord injury (SCI) and traumatic brain injury (TBI) in terms of medical, psychological, functional, and community outcomes. OBJECTIVE To investigate the hypothesis that in addition to SCI-associated sensory-motor impairments, people with dual diagnosis would experience additional TBI-associated cognitive impairments that would have a negative impact on community reintegration. METHODS Cross-sectional, case-matched study comparing a consecutive sample of participants with dual diagnosis (n = 30) to an SCI group (n = 30) and TBI group (n = 30). Participants who were on average 3.6 years postrehabilitation discharge were interviewed using a battery of standardized outcome measures. RESULTS Length of rehabilitation stay was significantly longer in SCI and dual diagnosis participants. Fatigue, pain, sexual dysfunction, depression, and sleep disturbances were frequently reported by all groups. Similar levels of anxiety and depression were reported by participants in all groups, however TBI participants reported higher stress levels. All groups achieved mean FIM scores > 100. The dual diagnosis and SCI groups received more daily care and support than TBI participants. Similar levels of community reintegration were achieved by all groups with a high level of productive engagement in work, study, or volunteer activities. CONCLUSIONS The findings of this study do not support the hypotheses. Postrehabilitation functioning was better than anticipated in adults with dual diagnosis. The contribution of rehabilitation factors, such as longer admission time to develop compensatory techniques and strategies for adaptation in the community, may have contributed to these positive findings.
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Affiliation(s)
- Melissa T Nott
- School of Community Health, Charles Sturt University , Albury, NSW , Australia
| | - Ian J Baguley
- Brain Injury Rehabilitation Service , Westmead Hospital, Sydney, NSW , Australia
| | - Roxana Heriseanu
- Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Sydney, NSW , Australia
| | - Gerard Weber
- Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Sydney, NSW , Australia
| | | | - Sue Meares
- Department of Psychology, Macquarie University , Sydney, NSW , Australia
| | - Jennifer Batchelor
- Department of Psychology, Macquarie University , Sydney, NSW , Australia
| | - Andrew Jones
- Concord Centre for Mental Health, Concord Hospital , Sydney, NSW , Australia
| | - Claire L Boyle
- Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Sydney, NSW , Australia
| | - Stephanie Chilko
- Occupational Therapy Department, Balmain Hospital , Sydney, NSW , Australia
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Sigmundsdottir L, Tchan MC, Knopman AA, Menzies GC, Batchelor J, Sillence DO. Cognitive and psychological functioning in Fabry disease. Arch Clin Neuropsychol 2014; 29:642-50. [PMID: 25319043 PMCID: PMC4263929 DOI: 10.1093/arclin/acu047] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2014] [Indexed: 11/12/2022] Open
Abstract
Fabry disease is an X-linked lysosomal storage disorder which can result in renal, cardiac, and cerebrovascular disease. Patients are at increased risk of stroke and neuroimaging studies note cerebrovascular pathology. This study provides a cognitive profile of a cohort of individuals with Fabry disease and investigates the impact of pain, age, renal, cardiac, and cerebrovascular functioning on cognition and psychological functioning. Seventeen Fabry patients (12 males) with ages ranging 25 to 60 years (M = 46.6+11.8), and 15 age-matched healthy controls (M = 46.2+12.7) were administered a comprehensive neuropsychological battery. Fabry males demonstrated slower speed of information processing, reduced performance on measures of executive functions (verbal generation, reasoning, problem solving, perseveration), were more likely to show clinically significant reductions, and were more likely to report symptoms of anxiety and depression. Conversely, Fabry females performed at a similar level to controls. Correlational analyses indicated a link between cognitive and clinical measures of disease severity.
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Affiliation(s)
| | - Michel C Tchan
- Department of Genetic Medicine, Westmead Hospital and Discipline of Genetic Medicine, Sydney Medical School, Sydney, Australia
| | - Alex A Knopman
- Department of Medical Psychology, Westmead Hospital, Sydney, Australia
| | - Graham C Menzies
- Department of Medical Psychology, Westmead Hospital, Sydney, Australia
| | | | - David O Sillence
- Department of Genetic Medicine, Westmead Hospital and Discipline of Genetic Medicine, Sydney Medical School, Sydney, Australia
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Gillis I, Wilhelm K, Batchelor J, Burke D. Information processing speed remains low in school teachers a decade after recovery from depression. Int J Geriatr Psychiatry 2014; 29:1098-100. [PMID: 25256311 DOI: 10.1002/gps.4162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Inika Gillis
- Faces in the Street, Urban Mental Health and Wellbeing Research Institute, St Vincent's Hospital, Sydney, Australia
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McKinnon A, Terpening Z, Hickie IB, Batchelor J, Grunstein R, Lewis SJG, Naismith SL. Prevalence and predictors of poor sleep quality in mild cognitive impairment. J Geriatr Psychiatry Neurol 2014; 27:204-11. [PMID: 24687189 DOI: 10.1177/0891988714527516] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To investigate the prevalence of and contributors to poor sleep quality in patients with mild cognitive impairment (MCI). METHODS Data were collected for 158 patients meeting the criteria for MCI. Measures included the Pittsburgh Sleep Quality Index, Geriatric Depression Scale, and Mini-Mental State Examination. Demographic, lifestyle, medication, and substance use data were also collected. RESULTS A total of 63% of patients with MCI demonstrated sleep disturbance, a significantly higher rate than that of the controls (44%; chi-square = 8.77; P = .003). Depressive symptoms, cognition, antidepressant usage, alcohol consumption, age, and education were identified as significant predictors of self-reported sleep quality in patients with MCI (R(2) = .327, F 6,145 = 11.729, P < .0001). CONCLUSIONS Sleep disturbance occurs in around two-thirds of patients with MCI. Interventions addressing depression, cognition, and substance and medication use may improve sleep quality in MCI.
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Affiliation(s)
- Andrew McKinnon
- Healthy Brain Ageing Clinic, The University of Sydney, Camperdown, NSW, Australia Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Zoe Terpening
- Healthy Brain Ageing Clinic, The University of Sydney, Camperdown, NSW, Australia
| | - Ian B Hickie
- Healthy Brain Ageing Clinic, The University of Sydney, Camperdown, NSW, Australia
| | - Jennifer Batchelor
- Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Ron Grunstein
- Woolcock Institute of Medical Research, NSW, Australia
| | - Simon J G Lewis
- Healthy Brain Ageing Clinic, The University of Sydney, Camperdown, NSW, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Clinic, The University of Sydney, Camperdown, NSW, Australia
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Barhon LI, Batchelor J, Meares S, Chekaluk E, Shores EA. A Comparison of the Degree of Effort Involved in the TOMM and the ACS Word Choice Test Using a Dual-Task Paradigm. Applied Neuropsychology: Adult 2014; 22:114-23. [DOI: 10.1080/23279095.2013.863775] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mowszowski L, Hermens DF, Diamond K, Norrie L, Cockayne N, Ward PB, Hickie IB, Lewis SJ, Batchelor J, Naismith SL. Cognitive Training Enhances Pre-Attentive Neurophysiological Responses in Older Adults ‘At Risk’ of Dementia. ACTA ACUST UNITED AC 2014; 41:1095-108. [DOI: 10.3233/jad-131985] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Loren Mowszowski
- Healthy Brain Ageing Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
- Department of Psychology, Macquarie University, NSW, Australia
| | - Daniel F. Hermens
- Clinical Research Unit, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
| | - Keri Diamond
- Healthy Brain Ageing Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
| | - Louisa Norrie
- Healthy Brain Ageing Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
| | - Nicole Cockayne
- Healthy Brain Ageing Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
| | - Philip B. Ward
- School of Psychiatry, University of New South Wales, NSW, Australia
| | - Ian B. Hickie
- Healthy Brain Ageing Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
| | - Simon J.G. Lewis
- Healthy Brain Ageing Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
| | | | - Sharon L. Naismith
- Healthy Brain Ageing Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia
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Kamminga J, Cysique LA, Lu G, Batchelor J, Brew BJ. Validity of cognitive screens for HIV-associated neurocognitive disorder: a systematic review and an informed screen selection guide. Curr HIV/AIDS Rep 2014; 10:342-55. [PMID: 24072534 PMCID: PMC3851699 DOI: 10.1007/s11904-013-0176-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Various screening tools have been proposed to identify HIV-Associated Neurocognitive Disorder (HAND). However, there has been no systematic review of their strengths and weaknesses in detecting HAND when compared to gold standard neuropsychological testing. Thirty-five studies assessing HAND screens that were conducted in the era of combination antiretroviral therapy were retrieved using standard search procedures. Of those, 19 (54 %) compared their screen to standard neuropsychological testing. Studies were characterised by a wide variation in criterion validity primarily due to non-standard definition of neurocognitive impairment, and to the demographic and clinical heterogeneity of samples. Assessment of construct validity was lacking, and longitudinal useability was not established. To address these limitations, the current review proposed a summary of the most sensitive and specific studies (>70 %), as well as providing explicit caution regarding their weaknesses, and recommendations for their use in HIV primary care settings.
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Affiliation(s)
- Jody Kamminga
- St Vincent's Clinical School, St. Vincent's Hospital Applied Medical Research Centre, The University of New South Wales, Sydney, Australia,
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Lane TA, Moore DM, Batchelor J, Brew BJ, Cysique LA. Facial emotional processing in HIV infection: relation to neurocognitive and neuropsychiatric status. Neuropsychology 2012; 26:713-22. [PMID: 22984798 DOI: 10.1037/a0029964] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To examine facial emotional processing in HIV+ individuals and its relation to neurocognitive performance, neuropsychiatric symptomatology and immune status. METHOD Participants included 85 HIV+ individuals (83 males, 2 females) and 25 age-comparable HIV- individuals (22 males, 3 females). Participants underwent The University of Pennsylvania computerized neuropsychological facial emotion test battery, standardized neuropsychological testing, neurobehavioral questionnaires, a semistructured psychiatric interview, and an assessment of independence in activities of daily living. RESULTS Relative to HIV- controls, HIV+ individuals showed a mild difference for recognition of sadness (p = .02, d = 0.43), discrimination of happiness (p = .02, d = 0.52), and speed of recognition for fear (p = .04, d = 0.37). HIV+ individuals with HIV-associated neurocognitive disorder (HAND; 20%) had abnormal emotional facial recognition (p = .04; d = .59), and slower recognition of negative facial expressions (p < .01; d = .63-.83), as well as poorer discrimination of happy facial expressions (p < .003, d = .83). Apathy, depression, reduced independence in activities of daily living, and HIV biomarkers were not associated with reduced facial emotion recognition in the HIV+ group. CONCLUSIONS Clinically stable HIV+ individuals show a mild level of emotional processing reduction that is dissociated from neuropsychiatric complaints. Individuals with HAND showed moderate to large emotional processing abnormalities, particularly for the timely recognition of negative expressions (fear, sadness, and anger). These findings warrant a more comprehensive and dynamic evaluation of emotional processing in HIV infection and an investigation of the integrity of the fronto-basal-amygdala circuits.
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Affiliation(s)
- Tammy A Lane
- Psychology Department, Macquarie University, Sydney, Australia
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Gardner A, Shores EA, Batchelor J, Honan CA. Diagnostic Efficiency of ImPACT and CogSport in Concussed Rugby Union Players Who Have Not Undergone Baseline Neurocognitive Testing. Applied Neuropsychology: Adult 2012; 19:90-7. [DOI: 10.1080/09084282.2011.643945] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Andrew Gardner
- a Department of Psychology , Macquarie University , New South Wales , Australia
| | - E. Arthur Shores
- a Department of Psychology , Macquarie University , New South Wales , Australia
| | - Jennifer Batchelor
- a Department of Psychology , Macquarie University , New South Wales , Australia
| | - Cynthia A. Honan
- a Department of Psychology , Macquarie University , New South Wales , Australia
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Affiliation(s)
- A Yaakub
- Department of Dermatology, Queen's Medical Centre, Nottingham, UK.
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Abstract
AbstractAssessment of posttraumatic amnesia (PTA) in young children remains problematic. This article details a version of the Westmead PTA Scale, which was adapted for use with children aged 4 and 5 years, and an evaluation of this scale with typically developing children. The Westmead PTA Scale for Children (WPTAS-C) comprises 2 orientation and 4 memory questions, including 2 items involving remembering pictures of familiar objects. Participants included 55 preschool and kindergarten children aged 4 and 5 years. The scale was administered for 4 consecutive days. Ninety-three per cent of the children achieved a score of 6 out 6 for the final 3 days of the 4-day test period. It is concluded that the WPTAS-C is an appropriate measure of orientation and continuous memory in 4- and 5-year-old typically developing children. Validation of the scale in clinical populations is recommended.
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Meares S, Shores EA, Taylor AJ, Lammél A, Batchelor J. Validation of the Abbreviated Westmead Post-traumatic Amnesia Scale: a brief measure to identify acute cognitive impairment in mild traumatic brain injury. Brain Inj 2011; 25:1198-205. [PMID: 21902551 DOI: 10.3109/02699052.2011.608213] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To validate the use of the Abbreviated Westmead Post-traumatic Amnesia Scale (A-WPTAS) in the assessment of acute cognitive impairment in mild traumatic brain injury (mTBI). METHODS Data previously collected from 82 mTBI and 88 control participants using the Revised Westmead Post-traumatic Amnesia Scale (R-WPTAS) was converted to A-WPTAS scores and pass/fail classifications were calculated for both scales. RESULTS The proportion of failures on the R-WPTAS and the A-WPTAS did not differ and a similar number of mTBIs were classified on each. For mTBIs the relationship between the independent memory test and a pass/fail classification was the same for both scales. Bivariate logistic regressions revealed that mTBIs, relative to controls, were around 8 times more likely to fail the assessment (R-WPTAS: 95% CI: 3.70-18.87; A-WPTAS: 95% CI: 3.70-20.14). As verbal learning improved the likelihood of failure was reduced. Greater education was associated with a decreased likelihood of failure. The relationship between education and a fail performance was not sustained when education was adjusted for the effect of age, prior mTBI, blood alcohol level, injury status, verbal learning, and morphine administration. CONCLUSIONS The A-WPTAS is a valid measure. The A-WPTAS may reduce the risk of failing to classify patients with mTBI by identifying and documenting acute cognitive impairment.
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Affiliation(s)
- Susanne Meares
- Department of Psychology, Macquarie University, Sydney, Australia
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Eleftheriadou V, Whitton ME, Gawkrodger DJ, Batchelor J, Corne J, Lamb B, Ersser S, Ravenscroft J, Thomas KS. Future research into the treatment of vitiligo: where should our priorities lie? Results of the vitiligo priority setting partnership. Br J Dermatol 2011; 164:530-6. [PMID: 21128908 PMCID: PMC3084501 DOI: 10.1111/j.1365-2133.2010.10160.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vitiligo is the most frequent depigmentation disorder of the skin and is cosmetically and psychologically devastating. A recently updated Cochrane systematic review 'Interventions for vitiligo' showed that the research evidence for treatment of vitiligo is poor, making it difficult to make firm recommendations for clinical practice. OBJECTIVES To stimulate and steer future research in the field of vitiligo treatment, by identifying the 10 most important research areas for patients and clinicians. METHODS A vitiligo priority setting partnership was established including patients, healthcare professionals and researchers with an interest in vitiligo. Vitiligo treatment uncertainties were gathered from patients and clinicians, and then prioritized in a transparent process, using a methodology advocated by the James Lind Alliance. RESULTS In total, 660 treatment uncertainties were submitted by 461 participants. These were reduced to a list of the 23 most popular topics through an online/paper voting process. The 23 were then prioritized at a face-to-face workshop in London. The final list of the top 10 treatment uncertainties included interventions such as systemic immunosuppressants, topical treatments, light therapy, melanocyte-stimulating hormone analogues, gene therapy, and the impact of psychological interventions on the quality of life of patients with vitiligo. CONCLUSIONS The top 10 research areas for the treatment of vitiligo provide guidance for researchers and funding bodies, to ensure that future research answers questions that are important both to clinicians and to patients.
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Affiliation(s)
- V Eleftheriadou
- Centre of Evidence Based Dermatology, University of Nottingham, UK
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