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Nauta IM, van Dam M, Bertens D, Kessels RPC, Fasotti L, Uitdehaag BMJ, Speckens AEM, de Jong BA. Improved quality of life and psychological symptoms following mindfulness and cognitive rehabilitation in multiple sclerosis and their mediating role for cognition: a randomized controlled trial. J Neurol 2024:10.1007/s00415-024-12327-y. [PMID: 38653820 DOI: 10.1007/s00415-024-12327-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) frequently gives rise to depressive and anxiety symptoms, but these are often undertreated. This study investigated the effect of mindfulness-based cognitive therapy (MBCT) and cognitive rehabilitation therapy (CRT) on psychological outcomes and quality of life (QoL), and whether they mediate treatment effects on MS-related cognitive problems. METHODS This randomized controlled trial included MS patients with cognitive complaints (n = 99) and compared MBCT (n = 32) and CRT (n = 32) to enhanced treatment as usual (n = 35). Baseline, post-treatment and 6-months follow-up assessments included patient-reported outcome measures (PROMS) and cognitive outcomes (self-reported and neuropsychological assessment). PROMS concerned psychological symptoms, well-being, QoL, and daily life function. Linear mixed models indicated intervention effects on PROMS and mediation effects of PROMS on cognitive outcomes. RESULTS MBCT positively affected depressive symptoms (Cohen's d (d) = -0.46), fatigue (d = -0.39), brooding (d = -0.34), mindfulness skills (d = 0.49), and mental QoL (d = -0.73) at post-treatment. Effects on mindfulness skills remained significant 6 months later (d = 0.42). CRT positively affected depressive symptoms (d = -0.46), mindfulness skills (d = 0.37), and mental QoL (d = -0.45) at post-treatment, but not at 6-month follow-up. No effects on anxiety, well-being, self-compassion, physical QoL, and daily life function were found. Treatment effects on self-reported, but not objective, cognition were mediated by psychological symptoms and mindfulness skills. CONCLUSIONS MBCT and CRT reduced a wide array of psychological symptoms and improved mental QoL. These improvements seemed to impact self-reported cognitive problems after both treatments, whereas objective cognitive improvements after MBCT seemed independent of improvement in psychological symptoms. Future studies should investigate long-term sustainability of these beneficial effects. TRIAL REGISTRATION The trial was prospectively registered in the Dutch Trial registry on 31 May 2017 (NL6285; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6459 ).
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Affiliation(s)
- Ilse M Nauta
- Department of Neurology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Maureen van Dam
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands.
| | - Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
- Vincent Van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - Bernard M J Uitdehaag
- Department of Neurology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brigit A de Jong
- Department of Neurology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
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Nauta IM, Kessels RPC, Bertens D, Stam CJ, Strijbis EEM, Hillebrand A, Fasotti L, Uitdehaag BMJ, Hulst HE, Speckens AEM, Schoonheim MM, de Jong BA. Neurophysiological brain function predicts response to cognitive rehabilitation and mindfulness in multiple sclerosis: a randomized trial. J Neurol 2024; 271:1649-1662. [PMID: 38278979 DOI: 10.1007/s00415-024-12183-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/30/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Cognitive treatment response varies highly in people with multiple sclerosis (PwMS). Identification of mechanisms is essential for predicting response. OBJECTIVES This study aimed to investigate whether brain network function predicts response to cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT). METHODS PwMS with cognitive complaints completed CRT, MBCT, or enhanced treatment as usual (ETAU) and performed three measurements (baseline, post-treatment, 6-month follow-up). Baseline magnetoencephalography (MEG) measures were used to predict treatment effects on cognitive complaints, personalized cognitive goals, and information processing speed (IPS) using mixed models (secondary analysis REMIND-MS study). RESULTS We included 105 PwMS (96 included in prediction analyses; 32 CRT, 31 MBCT, 33 ETAU), and 56 healthy controls with baseline MEG. MEG did not predict reductions in complaints. Higher connectivity predicted better goal achievement after MBCT (p = 0.010) and CRT (p = 0.018). Lower gamma power (p = 0.006) and higher connectivity (p = 0.020) predicted larger IPS benefits after MBCT. These MEG predictors indicated worse brain function compared to healthy controls (p < 0.05). CONCLUSIONS Brain network function predicted better cognitive goal achievement after MBCT and CRT, and IPS improvements after MBCT. PwMS with neuronal slowing and hyperconnectivity were most prone to show treatment response, making network function a promising tool for personalized treatment recommendations. TRIAL REGISTRATION The REMIND-MS study was prospectively registered in the Dutch Trial registry (NL6285; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6459 ).
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Affiliation(s)
- Ilse M Nauta
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
- Vincent Van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - Cornelis J Stam
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- MEG Center, Clinical Neurophysiology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Eva E M Strijbis
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Arjan Hillebrand
- MEG Center, Clinical Neurophysiology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - Bernard M J Uitdehaag
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Menno M Schoonheim
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Brigit A de Jong
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
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Abelmann AC, Kessels RPC, Brazil IA, Fasotti L, Bertens D. Game-supported cognitive strategy training for slowed information processing speed after acquired brain injury: study protocol for a randomised controlled trial. BMJ Open 2023; 13:e067108. [PMID: 37734890 PMCID: PMC10514599 DOI: 10.1136/bmjopen-2022-067108] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 08/24/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION Many individuals with acquired brain injury tend to experience problems with slowed information processing speed (IPS). A potentially beneficial and cost-effective supplement for cognitive rehabilitation of impaired IPS may be the implementation of serious gaming that focuses on compensatory learning as part of cognitive training. However, most digital platforms used during cognitive rehabilitation focus on restoring cognitive function and evidence for skill transfer from digital practice to everyday life is lacking. This study aims to investigate the efficacy of a game-supported cognitive strategy training. The training combines a well-validated time pressure management cognitive strategy training, targeting slowed IPS, with a novel game and a mobile application. The game-supported training focuses on the generalisation of strategy-use to untrained tasks in everyday life. METHODS AND ANALYSIS The study is designed as a randomised controlled trial in which the experimental group (Karman Line - Tempo module: an 8-week game-supported cognitive strategy training) will be compared with an active control group (CogniPlus training: an 8-week computerised cognitive function training). Data from 60 individuals with acquired brain injury (30 per group, ages between 16 and 75) will be collected at baseline (T0), post-treatment (T1) and at 3-month follow-up (T2). The primary outcome measure is an objective assessment of compensatory strategy use in an untrained experimental task. The secondary outcome is the attainment of trained and untrained treatment goals assessed by goal attainment scaling. Pre-training and post-training data will be analysed using a 2×2 repeated measure analysis of variance. ETHICS AND DISSEMINATION This study has been approved by the medical review ethics committee CMO Region Arnhem and Nijmegen (NL74818.091.20) and is registered in the Netherlands Trial Register. Research findings will be published in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER NL9437; The Netherlands Trial Register.
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Affiliation(s)
- Amy C Abelmann
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
| | - Roy P C Kessels
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
| | - Inti A Brazil
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Division Diagnostics, Pompestichting Langdurige Forensisch Psychiatrische Zorg, Nijmegen, The Netherlands
| | - Luciano Fasotti
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
| | - Dirk Bertens
- Neuropsychology and Rehabilitation Psychology, Radboud University Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Research and Innovation, Klimmendaal, Arnhem, The Netherlands
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Van Heugten CM, Bertens D, Fasotti L. Can We Successfully Improve Attentional Impairments After Brain Injury With Computer-Based Interventions? Letter to the Editor on "Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014". Arch Phys Med Rehabil 2022; 103:2065. [PMID: 35777469 DOI: 10.1016/j.apmr.2022.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Caroline M Van Heugten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, the Netherlands
| | - Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Klimmendaal Rehabilitation Center, Arnhem, the Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Klimmendaal Rehabilitation Center, Arnhem, the Netherlands
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Valentini F, Fabio V, Boccia M, Tanzilli A, Iannetti M, Cinelli MC, De Angelis C, Fasotti L, Formisano R, Guariglia C, Ciurli MP. Two Ecological Tools for Testing Slowness of Information Processing in Italian Patients with Moderate-to-Severe Traumatic Brain Injury. Arch Clin Neuropsychol 2021; 37:677-691. [PMID: 34718376 DOI: 10.1093/arclin/acab085] [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] [Received: 10/26/2020] [Revised: 05/12/2021] [Accepted: 09/24/2021] [Indexed: 11/12/2022] Open
Abstract
Slowness of Information Processing (SIP) is frequently experienced after traumatic brain injury (TBI); however, the impact of SIP on everyday functioning may be underestimated by standard neuropsychological tests. OBJECTIVE we aimed to adapt two ecological instruments assessing SIP in Italian patients with moderate-to-severe TBI, as formerly proposed by Winkens and colleagues for persons with stroke, testing also its possible relation with other neuropsychological processes and functional outcomes. METHOD we performed an observational study on 37 patients with moderate-to-severe TBI and 35 demographically matched healthy controls, who underwent the Mental Slowness Observation Test (MSOT) and the Mental Slowness Questionnaire (MSQ), which had been adapted through a pilot study on independent sample of participants; extensive neuropsychological and functional evaluations were performed as well. RESULTS We found good clinical and psychometric properties of the Italian adaptation of the MSOT and MSQ; also, performance on MSOT significantly correlated with executive functions. Moreover, patients with TBI are significantly slower and less accurate than healthy controls on the MSOT, in particular in tasks with time limits. Even if the subjective feeling of SIP does not differ between patients and controls, we found a significant correlation between MSQ and MSOT. Finally, the performances on the MSOT correlated with measures of functional outcome and community integration. CONCLUSIONS the results support the use of the MSOT and the MSQ to measure SIP in an ecological fashion in patients with TBI, so that specific treatments for persons with acquired brain injury can be prescribed.
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Affiliation(s)
- Federica Valentini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Valentina Fabio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Antonio Tanzilli
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy.,Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Manuela Iannetti
- Neurorehabilitation 2 and Post-coma Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Maria Cristina Cinelli
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Carmela De Angelis
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Luciano Fasotti
- Rehabilitation Medical Centre Groot Klimmendaal, 6813 Arnhem, The Netherlands.,Donders Institute for Brain, Cognition, and Behaviour, Radboud University, 6525 Nijmegen, The Netherlands
| | - Rita Formisano
- Neurorehabilitation 2 and Post-coma Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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Nauta IM, Bertens D, van Dam M, Huiskamp M, Driessen S, Geurts J, Uitdehaag B, Fasotti L, Hulst HE, de Jong BA, Klein M. Performance validity in outpatients with multiple sclerosis and cognitive complaints. Mult Scler 2021; 28:642-653. [PMID: 34212754 PMCID: PMC8961248 DOI: 10.1177/13524585211025780] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suboptimal performance during neuropsychological assessment renders cognitive test results invalid. However, suboptimal performance has rarely been investigated in multiple sclerosis (MS). OBJECTIVES To investigate potential underlying mechanisms of suboptimal performance in MS. METHODS Performance validity testing, neuropsychological assessments, neuroimaging, and questionnaires were analyzed in 99 MS outpatients with cognitive complaints. Based on performance validity testing patients were classified as valid or invalid performers, and based on neuropsychological test results as cognitively impaired or preserved. Group comparisons and correlational analyses were performed on demographics, patient-reported, and disease-related outcomes. RESULTS Twenty percent displayed invalid performance. Invalid and valid performers did not differ regarding demographic, patient-reported, and disease-related outcomes. Disease severity of invalid and valid performers with cognitive impairment was comparable, but worse than cognitively preserved valid performers. Lower performance validity scores related to lower cognitive functioning, lower education, being male, and higher disability levels (p < 0.05). CONCLUSION Suboptimal performance frequently occurs in patients with MS and cognitive complaints. In both clinical practice and in cognitive research, suboptimal performance should be considered in the interpretation of cognitive outcomes. Identification of factors that differentiate between suboptimal and optimal performers with cognitive impairment needs further exploration.
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Affiliation(s)
- I M Nauta
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - D Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands/Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - M van Dam
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - M Huiskamp
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - S Driessen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jjg Geurts
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Bmj Uitdehaag
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - L Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands/Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - H E Hulst
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - B A de Jong
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - M Klein
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Palmisano S, Fasotti L, Bertens D. Neurobehavioral Initiation and Motivation Problems After Acquired Brain Injury. Front Neurol 2020; 11:23. [PMID: 32153486 PMCID: PMC7049782 DOI: 10.3389/fneur.2020.00023] [Citation(s) in RCA: 5] [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: 07/13/2019] [Accepted: 01/08/2020] [Indexed: 12/11/2022] Open
Abstract
Motivation is a primary and permanent source of human behavior and adaptation. Motivational deficits, along with deficiencies in initiation, frequently occur in individuals with acquired brain injury (ABI). These neurobehavioral problems are associated with consequences at the participation level: patients are reluctant to engage in rehabilitation, and their subsequent social reintegration is often at risk. The same problems may also become a heavy burden for the families of individuals with ABI. In the present paper, we will critically review both the current definitions and the instruments used to measure motivational disorders following ABI. We will also describe the neural system underlying motivation and its impairments. What emerges is the need to develop specific rehabilitative treatments, still absent at the moment, with the ultimate aim of ensuring a better quality of life for both the patients and their proxies.
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Affiliation(s)
- Simona Palmisano
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Rehabilitation Center Klimmendaal, Arnhem, Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Rehabilitation Center Klimmendaal, Arnhem, Netherlands
| | - Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Rehabilitation Center Klimmendaal, Arnhem, Netherlands
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Kootker JA, van Heugten CM, Kral B, Rasquin SM, Geurts AC, Fasotti L. Caregivers' effects of augmented cognitive-behavioural therapy for post-stroke depressive symptoms in patients: secondary analyses to a randomized controlled trial. Clin Rehabil 2019; 33:1056-1065. [PMID: 30841744 DOI: 10.1177/0269215519833013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/17/2022]
Abstract
OBJECTIVE To investigate the concomitant effects of two patient-directed interventions for post-stroke depressive symptoms on caregivers' well-being. DESIGN Secondary analyses of the results of a randomized controlled trial. SUBJECTS Fifty caregivers of stroke patients receiving outpatient rehabilitation. INTERVENTIONS Stroke patients and their caregivers were randomly allocated to either cognitive-behavioural therapy augmented with movement or occupational therapy ( n = 23) or computerized cognitive training ( n = 27) to alleviate depressive symptoms in patients. MAIN MEASURES Emotional burden (Involvement Evaluation Questionnaire), practical burden (Caregiver Strain Index), mental health (General Health Questionnaire) and emotional complaints (Hospital Anxiety and Depression Scale). RESULTS Caregivers of patients who received cognitive-behavioural therapy reported significantly higher mental health levels (mean difference (MD) = 1.78, 95% confidence interval (CI) = 0.43-3.13, P = 0.01) and less worrying about patients' well-being (MD = 1.9, 95% CI = 0.56-3.24, P < 0.01). In addition, there were positive time effects on the Involvement Evaluation Questionnaire for Brain Injury, particularly the subscales Worrying, Supervision and Tension. CONCLUSION The results suggest that augmented cognitive-behavioural therapy aimed at improving patients' emotional, behavioural and social functioning positively affects some aspects of caregivers' well-being.
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Affiliation(s)
- Joyce A Kootker
- 1 Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caroline M van Heugten
- 2 Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.,3 Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Bart Kral
- 4 Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Sascha Mc Rasquin
- 5 Adelante Rehabilitation Center, Hoensbroek, The Netherlands.,6 Department of Rehabilitation Medicine, CAPHRI, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alexander C Geurts
- 1 Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.,4 Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Luciano Fasotti
- 7 Klimmendaal, Rehabilitation Center, Arnhem, The Netherlands.,8 Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
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Westerhof-Evers HJ, Visser-Keizer AC, Fasotti L, Spikman JM. Social cognition and emotion regulation: a multifaceted treatment (T-ScEmo) for patients with traumatic brain injury. Clin Rehabil 2019; 33:820-833. [PMID: 30798631 PMCID: PMC6482595 DOI: 10.1177/0269215519829803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Indexed: 01/04/2023]
Abstract
BACKGROUND Many patients with moderate to severe traumatic brain injury have deficits in social cognition. Social cognition refers to the ability to perceive, interpret, and act upon social information. Few studies have investigated the effectiveness of treatment for impairments of social cognition in patients with traumatic brain injury. Moreover, these studies have targeted only a single aspect of the problem. They all reported improvements, but evidence for transfer of learned skills to daily life was scarce. We evaluated a multifaceted treatment protocol for poor social cognition and emotion regulation impairments (called T-ScEmo) in patients with traumatic brain injury and found evidence for transfer to participation and quality of life. PURPOSE In the current paper, we describe the theoretical underpinning, the design, and the content of our treatment of social cognition and emotion regulation (T-ScEmo). THEORY INTO PRACTICE The multifaceted treatment that we describe is aimed at improving social cognition, regulation of social behavior and participation in everyday life. Some of the methods taught were already evidence-based and derived from existing studies. They were combined, modified, or extended with newly developed material. PROTOCOL DESIGN T-ScEmo consists of 20 one-hour individual sessions and incorporates three modules: (1) emotion perception, (2) perspective taking and theory of mind, and (3) regulation of social behavior. It includes goal-setting, psycho-education, function training, compensatory strategy training, self-monitoring, role-play with participation of a significant other, and homework assignments. RECOMMENDATIONS It is strongly recommended to offer all three modules, as they build upon each other. However, therapists can vary the time spent per module, in line with the patients' individual needs and goals. In future, development of e-learning modules and virtual reality sessions might shorten the treatment.
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Affiliation(s)
- Herma J Westerhof-Evers
- 1 Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.,2 Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annemarie C Visser-Keizer
- 2 Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Luciano Fasotti
- 3 Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,4 Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - Jacoba M Spikman
- 1 Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.,5 Department of Neuropsychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Westerhof- Evers HJ, Fasotti L, van der Naalt J, Spikman JM. Participation after traumatic brain injury: the surplus value of social cognition tests beyond measures for executive functioning and dysexecutive behavior in a statistical prediction model. Brain Inj 2018; 33:78-86. [DOI: 10.1080/02699052.2018.1531303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Herma J. Westerhof- Evers
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Joukje van der Naalt
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jacoba M. Spikman
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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11
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Emmanouel A, Kontrafouri E, Nikolaos P, Kessels RPC, Fasotti L. Incorporation of a working memory strategy in GMT to facilitate serial-order behaviour in brain-injured patients. Neuropsychol Rehabil 2018; 30:888-914. [PMID: 30272538 DOI: 10.1080/09602011.2018.1517369] [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: 10/28/2022]
Abstract
Goal Management Training (GMT) is an effective method for improving disorganised behaviour in multistep real-life tasks after brain damage. In the present study we incorporated Working Memory Training (WMT) in GMT to explore their combined efficacy in facilitating the serial-order maintenance of the steps that had to be learned. GMT+WMT was compared to a control WMT designed for other purposes. For this purpose 18 brain-injured patients (aged 20-54), who were at least 4 months post-onset, were randomly assigned to either the GMT+WMT or the WMT treatment. Inclusion was based on a baseline score of less than six correct steps on each of two multistep everyday tasks. Alternative versions of these tasks were used as primary outcome tasks. Pre-treatment and post-treatment comparisons of scores on these primary tasks and on several secondary neuropsychological measures were collected. The results show that post-treatment the GMT+WMT group performed significantly better than the WMT group on the primary outcome measures and on several ecologically valid executive tests that demanded a step-by-step maintenance of multiple actions. Time effects were found for both groups on the secondary measures. Other measures showed no significant differences. We conclude that our results support the efficacy of the combined GMT+WMT in facilitating performance in everyday multistep tasks.
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Affiliation(s)
- Anna Emmanouel
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.,Department of Psychology, City College, International Faculty of the University of Sheffield, Thessaloniki, Greece
| | - Ellisavet Kontrafouri
- MSc International Medicine, Management of Health Crises, Medical School of Athens, Athens, Greece
| | - Psarras Nikolaos
- Neurosurgical Department, General Hospital of Papanikolaou, Thessaloniki, Greece.,Neurosurgical Department, Clinic of Saint Loukas, Thessaloniki, Greece
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands.,Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.,Rehabilitation Center Klimmendaal, Arnhem, The Netherlands
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12
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Nauta IM, Balk LJ, Sonder JM, Hulst HE, Uitdehaag BM, Fasotti L, de Jong BA. The clinical value of the patient-reported multiple sclerosis neuropsychological screening questionnaire. Mult Scler 2018; 25:1543-1546. [PMID: 29775164 PMCID: PMC6753646 DOI: 10.1177/1352458518777295] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Indexed: 11/16/2022]
Abstract
Background: Cognitive problems are difficult to identify in patients with multiple
sclerosis (MS). Objective: To investigate the clinical applicability of the patient-reported MS
Neuropsychological Screening Questionnaire (MSNQ-P). Methods: Cut-off scores were determined to differentiate between cognitively impaired
(n = 90), mildly cognitively impaired
(n = 115), and cognitively preserved
(n = 147) MS patients using receiver operating
characteristic analyses. Results: We could not define specific and sensitive cut-off scores.
Higher scores (≥27) did indicate cognitive impairment. Among patients with a
higher education, lower scores (<12) indicated intact cognition. Conclusion: Certain scores can indicate intact or impaired cognitive function. Still,
MSNQ-P scores should be interpreted with caution.
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Affiliation(s)
- Ilse M Nauta
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Lisanne J Balk
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Judith M Sonder
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Bernard Mj Uitdehaag
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Klimmendaal Rehabilitation Center, Arnhem, The Netherlands
| | - Brigit A de Jong
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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13
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Affiliation(s)
- Nikita L. Frankenmolen
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Rehabilitation Centre Klimmendaal, Arnhem, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Rehabilitation Centre Klimmendaal, Arnhem, The Netherlands
| | - Roy P.C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Nijmegen, The Netherlands
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14
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Nauta IM, Speckens AEM, Kessels RPC, Geurts JJG, de Groot V, Uitdehaag BMJ, Fasotti L, de Jong BA. Cognitive rehabilitation and mindfulness in multiple sclerosis (REMIND-MS): a study protocol for a randomised controlled trial. BMC Neurol 2017; 17:201. [PMID: 29162058 PMCID: PMC5698960 DOI: 10.1186/s12883-017-0979-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 07/13/2017] [Accepted: 11/12/2017] [Indexed: 11/29/2022] Open
Abstract
Background Cognitive problems frequently occur in patients with multiple sclerosis (MS) and profoundly affect their quality of life. So far, the best cognitive treatment options for MS patients are a matter of debate. Therefore, this study aims to investigate the effectiveness of two promising non-pharmacological treatments: cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT). Furthermore, this study aims to gain additional knowledge about the aetiology of cognitive problems among MS patients, since this may help to develop and guide effective cognitive treatments. Methods/design In a dual-centre, single-blind randomised controlled trial (RCT), 120 MS patients will be randomised into one of three parallel groups: CRT, MBCT or enhanced treatment as usual (ETAU). Both CRT and MBCT consist of a structured 9-week program. ETAU consists of one appointment with an MS specialist nurse. Measurements will be performed at baseline, post-intervention and 6 months after the interventions. The primary outcome measure is the level of subjective cognitive complaints. Secondary outcome measures are objective cognitive function, functional brain network measures (using magnetoencephalography), psychological symptoms, well-being, quality of life and daily life functioning. Discussion To our knowledge, this will be the first RCT that investigates the effect of MBCT on cognitive function among MS patients. In addition, studying the effect of CRT on cognitive function may provide direction to the contradictory evidence that is currently available. This study will also provide information on changes in functional brain networks in relation to cognitive function. To conclude, this study may help to understand and treat cognitive problems among MS patients. Trial registration This trial was prospectively registered at the Dutch Trial Registration (number NTR6459, registered on 31 May 2017).
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Affiliation(s)
- Ilse M Nauta
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Vincent de Groot
- Department of Rehabilitation Medicine, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Bernard M J Uitdehaag
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.,Klimmendaal Rehabilitation Center, PO Box 9044, 6800 CG, Arnhem, the Netherlands
| | - Brigit A de Jong
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
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15
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El Haj M, Raffard S, Fasotti L, Allain P. Destination memory in social interaction: better memory for older than for younger destinations in normal aging? Memory 2017; 26:610-618. [DOI: 10.1080/09658211.2017.1387665] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mohamad El Haj
- SCALab – Sciences Cognitives et Sciences Affectives, UMR 9193, CHU Lille, CNRS, University of Lille, Lille, France
- Centre Hospitalier de Tourcoing, Unité de Gériatrie, Tourcoing, France
| | - Stéphane Raffard
- Epsylon Laboratory, EA 4556, University Montpellier III, Montpellier, France
- University Department of Adult Psychiatry, CHRU Montpellier, Montpellier, France
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Philippe Allain
- Centre National de Référence pour les Maladies Neurogénétiques de l’Adulte, Département de Neurologie, Centre Hospitalier Universitaire d’Angers, Angers, France
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), LUNAM Université, Université d’Angers, Angers, France
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16
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Kootker JA, Rasquin SM, Lem FC, van Heugten CM, Fasotti L, Geurts AC. Augmented Cognitive Behavioral Therapy for Poststroke Depressive Symptoms: A Randomized Controlled Trial. Arch Phys Med Rehabil 2017; 98:687-694. [DOI: 10.1016/j.apmr.2016.10.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
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17
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Frankenmolen NL, Altgassen M, Kessels R, de Waal MM, Hindriksen JA, Verhoeven B, Fasotti L, Scheres A, Kessels RPC, Oosterman JM. Intelligence moderates the benefits of strategy instructions on memory performance: an adult-lifespan examination. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2016; 24:45-61. [PMID: 27141830 DOI: 10.1080/13825585.2016.1171289] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Whether older adults can compensate for their associative memory deficit by using memory strategies efficiently might depend on their general cognitive abilities. This study examined the moderating role of an IQ estimate on the beneficial effects of strategy instructions. A total of 142 participants (aged 18-85 years) received either intentional learning or strategy ("sentence generation") instructions during encoding of word pairs. Whereas young adults with a lower IQ benefited from strategy instructions, those with a higher IQ did not, presumably because they already use strategies spontaneously. Older adults showed the opposite effect: following strategy instructions, older adults with a higher IQ showed a strong increase in memory performance (approximately achieving the level of younger adults), whereas older adults with a lower IQ did not, suggesting that they have difficulties implementing the provided strategies. These results highlight the importance of the role of IQ in compensating for the aging-related memory decline.
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Affiliation(s)
- Nikita L Frankenmolen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,b Rehabilitation Centre Klimmendaal , Arnhem , The Netherlands
| | - Mareike Altgassen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Renée Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Marleen M de Waal
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Julie-Anne Hindriksen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Barbara Verhoeven
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Luciano Fasotti
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,b Rehabilitation Centre Klimmendaal , Arnhem , The Netherlands
| | - Anouk Scheres
- c Developmental Psychology, Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands
| | - Roy P C Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,d Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands
| | - Joukje M Oosterman
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
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18
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Abstract
Forty-two patients with spinal cord lesions were asked to fill out the Amsterdam Mood Questionnaire in order to ascertain whether this group of patients with reduced sensorimotor capacities would show a deviant pattern of moods. An overall reduction in mood state levels had to be expected for these patients on the basis of various emotion theories, and various theories about the psychological consequences of severe handicaps. The various mood state levels for these patients did not differ from those for the norm group, with the exception of the mood state 'fatigued'. It is concluded that spinal cord lesions do not affect mood states in a direct way. Success or failure in coping with the lesion-induced handicap does, however, effect mood state levels. Failure in coping is related to depression and an accentuation of negative moods, whereas successful coping is related to lack of depression and an accentuation of positive moods. The results of this study indicate that the theories mentioned need reconsideration as do the therapeutic strategies based upon them.
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Affiliation(s)
- B. Bermond
- Department of Experimental Psychology, University of Amsterdam
| | - J. Schuerman
- Institute for Rehabilitation Research, Hoensbroek
| | | | - L. Fasotti
- Institute for Rehabilitation Research, Hoensbroek
| | - J. Elshout
- Department of Experimental Psychology, University of Amsterdam
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19
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Bertens D, Kessels RP, Boelen DH, Fasotti L. Transfer effects of errorless Goal Management Training on cognitive function and quality of life in brain-injured persons. NeuroRehabilitation 2016; 38:79-84. [DOI: 10.3233/nre-151298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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)
- Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Outpatient Neuropsychiatry Center Thalamus, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands
| | - Roy P.C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Medical Psychology, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Danielle H.E. Boelen
- Outpatient Neuropsychiatry Center Thalamus, Institution for Integrated Mental Health Care Pro Persona, Nijmegen, The Netherlands
- Rehabilitation Medical Centre Groot Klimmendaal, Arnhem, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Rehabilitation Medical Centre Groot Klimmendaal, Arnhem, The Netherlands
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20
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Bertens D, Fasotti L, Boelen DH, Kessels RP. Moderators, Mediators, and Nonspecific Predictors of Treatment Outcome in an Intervention for Everyday Task Improvement in Persons With Executive Deficits After Brain Injury. Arch Phys Med Rehabil 2016; 97:97-103. [DOI: 10.1016/j.apmr.2015.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/20/2015] [Accepted: 07/27/2015] [Indexed: 12/21/2022]
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21
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Bertens D, Fasotti L, Egger JIM, Boelen DHE, Kessels RPC. Reliability of an Adapted Version of the Modified Six Elements Test as a Measure of Executive Function. Appl Neuropsychol Adult 2015; 23:35-42. [PMID: 26111243 DOI: 10.1080/23279095.2015.1012258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Modified Six Elements Test (MSET) is used to examine executive deficits-more specifically, planning deficits. This study investigates the reliability of an adapted version of the MSET and proposes a novel scoring method. Two parallel versions of the adapted MSET were administered in 60 healthy participants in a counterbalanced order. Test-retest and parallel-form reliability were examined using intraclass correlation coefficients, Bland-Altman analyses, standard errors of measurement, and smallest real differences, representing clinically relevant changes over time. Moreover, the ecological validity of the adapted MSET was evaluated using the Executive Function Index, a self-rating questionnaire measuring everyday executive performance. No systematic differences between the test occasions were present, and the adapted MSET including the proposed scoring method was capable of detecting real clinical changes. Intraclass correlations for the test-retest and parallel-form reliability were modest, and the variability between the test scores was high. The nonsignificant correlations with the Executive Function Index did not confirm the previously established ecological validity of the MSET. We show that both parallel versions of the test are clinically equivalent and can be used to measure executive function over the course of time without task-specific learning effects.
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Affiliation(s)
- Dirk Bertens
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Luciano Fasotti
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,b Rehabilitation Medical Centre Groot Klimmendaal , Arnhem , The Netherlands
| | - Jos I M Egger
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,c Centre of Excellence for Neuropsychiatry , Vincent van Gogh Institute for Psychiatry , Venray , The Netherlands.,d Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands.,e Pompe Institute for Forensic Psychiatry , Pro Persona , Nijmegen , The Netherlands
| | - Danielle H E Boelen
- b Rehabilitation Medical Centre Groot Klimmendaal , Arnhem , The Netherlands.,f Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands
| | - Roy P C Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,f Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands.,g Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders , Vincent van Gogh Institute for Psychiatry , Venray , The Netherlands
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22
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El Haj M, Fasotti L, Allain P. Directed forgetting of source memory in normal aging and Alzheimer's disease. Aging Clin Exp Res 2015; 27:329-36. [PMID: 25365949 DOI: 10.1007/s40520-014-0276-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 10/11/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Using the source directed forgetting method, the present paper investigated whether older adults and Alzheimer's disease (AD) patients were able to inhibit source information. METHODS Younger adults, older adults and AD participants were presented with two sets of six items each: Set1 and Set2. Each item was presented by one of two sources: an experimenter black- or white-gloved hand. After the presentation of the Set1 items, participants were instructed either to forget or to continue remembering the source of the items. Afterward, all participants were presented with the Set2 items, and were asked to remember their source. Finally, subjects were exposed to the Set1 and Set2 items, and were asked to recall, for each item, its original source presentation (i.e., the experimenter black- or white-gloved hand). RESULTS In comparison with younger adults, older adults and AD participants showed no differences in remembering the source of the Set1 and Set2 items. In other words, they failed to inhibit the source information. DISCUSSION AND CONCLUSION Our outcomes are discussed in terms of retrieval inhibition deficits and changes in adaptive nature of memory in normal aging and AD.
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Affiliation(s)
- Mohamad El Haj
- Research Unit on Cognitive and Affective Sciences (URECA EA1059 & UMR SCALAB), Department of Psychology, University of North of France, Lille, France,
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23
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24
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Vlagsma TT, Koerts J, Fasotti L, Tucha O, van Laar T, Dijkstra H, Spikman JM. Parkinson's patients' executive profile and goals they set for improvement: Why is cognitive rehabilitation not common practice? Neuropsychol Rehabil 2015; 26:216-35. [PMID: 25693688 DOI: 10.1080/09602011.2015.1013138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 01/10/2023]
Abstract
Impairments in executive functions (EF) are the core cognitive impairment in patients with Parkinson's disease (PD). Surprisingly, cognitive rehabilitation is not routinely offered to patients with PD. However, in patients with acquired brain injury (ABI), cognitive rehabilitation, in particular strategic executive training, is common practice and has been shown to be effective. In this study, we determined whether PD patients have different needs and aims with regard to strategic executive training than ABI patients, and whether possible differences might be a reason for not offering this kind of cognitive rehabilitation programme to patients with PD. Patients' needs and aims were operationalised by individually set goals, which were classified into domains of EF and daily life. In addition, patients with PD and ABI were compared on their cognitive, in particular EF, profile. Overall, PD patients' goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account.
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Affiliation(s)
- T T Vlagsma
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands
| | - J Koerts
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands
| | - L Fasotti
- b Donders Institute for Brain, Cognition and Behaviour , Radboud University Nijmegen , Nijmegen , The Netherlands.,c Rehabilitation Medical Centre Groot Klimmendaal , Arnhem , The Netherlands
| | - O Tucha
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands
| | - T van Laar
- d Department of Neurology , University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands
| | - H Dijkstra
- e Department of Medical Psychology , Medical Centre Nij Smellinghe , Drachten , The Netherlands
| | - J M Spikman
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands.,d Department of Neurology , University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands
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25
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Bertens D, Frankenmolen N, Boelen DHE, Kessels RPC, Fasotti L. Validity of an Adapted Scoring Method for a Modified Six Elements Test in Individuals with Brain Injury. Arch Clin Neuropsychol 2014; 30:122-9. [DOI: 10.1093/arclin/acu093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Kootker JA, Rasquin SMC, Smits P, Geurts AC, van Heugten CM, Fasotti L. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol. Clin Rehabil 2014; 29:833-43. [DOI: 10.1177/0269215514559987] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/26/2014] [Indexed: 11/15/2022]
Abstract
Aim: Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. Method of protocol development: This intervention was based on cognitive behavioural therapy principles and was shown feasible in a pilot study. In order to meet the specific needs of stroke patients (concerning both sensori-motor, cognitive, and behavioural problems), we incorporated motivational interviewing, grief resolution, and psycho-education. We emphasised for each session to take into account the cognitive deficits of the patients (i.e. be concrete, accessible, structured, specific, and repeat information). Moreover, we augmented the psychologist-administered therapy with the contribution of an occupational or movement therapist aimed at facilitating patients’ goal-setting and attainment. The intervention consisted of 12 one-hour sessions with a psychologist and three or four one-hour sessions with an occupational or movement therapist. Currently, the effectiveness of the intervention is evaluated in a randomised controlled trial. Discussion: The proposed psychological treatment protocol is innovative, as it applies cognitive behavioural therapy in a stroke-specific manner; moreover, it supports goal attainment by incorporating occupational or movement therapy sessions.
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Affiliation(s)
- Joyce A Kootker
- Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Sascha MC Rasquin
- Adelante Rehabilitation Foundation Limburg, Hoensbroek, The Netherlands
- CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter Smits
- Rehabilitation Centre, St. Maartenskliniek, Nijmegen, The Netherlands
| | - Alexander C Geurts
- Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Caroline M van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
- Rehabilitation Medical Centre Groot Klimmendaal, Siza Support and Rehabilitation, Arnhem, The Netherlands
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27
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El Haj M, Caillaud M, Verny C, Fasotti L, Allain P. Destination and source memory in Huntington's disease. J Neuropsychol 2014; 10:77-89. [DOI: 10.1111/jnp.12057] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/08/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Mohamad El Haj
- Research Unit on Cognitive and Affective Sciences; Department of Psychology; University of North of France; Lille France
| | - Marie Caillaud
- UNAM University; Psychology Laboratory (EA 4638); University of Nantes and Angers; France
| | - Christophe Verny
- UMR CNRS 6214; Inserm U1083; University of Angers; France
- Neurology Department; CHU of Angers; France
| | - Luciano Fasotti
- Donders Institute for Brain; Cognition and Behaviour; Radboud University Nijmegen; the Netherlands
| | - Philippe Allain
- UNAM University; Psychology Laboratory (EA 4638); University of Nantes and Angers; France
- Neurology Department; CHU of Angers; France
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28
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Abstract
BACKGROUND Huntington's disease (HD) is characterized by episodic memory deterioration. OBJECTIVE Our paper investigates the cognitive mechanisms that might underlie this decline. To this aim, we tested two executive hypotheses, the binding and the inhibition hypotheses. METHODS Fifteen HD patients (Mean Cytosine-Adenine-Guanine repeats = 44.93, SD = 2.82), and eighteen controls matched for age, gender and education were assessed with a neuropsychological battery tapping episodic memory and several executive functions, including binding and inhibition. RESULTS Episodic decline in patients with HD was only related to binding performance. CONCLUSIONS Our study shows that HD patients suffer from a perturbation of the associative or integrative mechanisms responsible for the combination of different memory features into complex episodic representations. Damage to frontal-hippocampal circuitry in HD is likely to be responsible for this impairment.
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Affiliation(s)
- Mohamad El Haj
- LUNAM Université, Laboratoire de Psychologie des Pays de la Loire, Université de Nantes et Angers, France Neuropsychology and Auditory Cognition, Department of Psychology, University of Lille, France Laboratoire Epsylon, EA 4556, Université Paul-Valery, Montpellier III, France
| | - Marie Caillaud
- LUNAM Université, Laboratoire de Psychologie des Pays de la Loire, Université de Nantes et Angers, France Neuropsychology and Auditory Cognition, Department of Psychology, University of Lille, France
| | - Luciano Fasotti
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Rehabilitation Medical Centre Groot Klimmendaal, SIZA Support and Rehabilitation, Arnhem, The Netherlands
| | - Christophe Verny
- Centre Mémoire de Ressources et de Recherches, CHU Angers, France
| | - Philippe Allain
- LUNAM Université, Laboratoire de Psychologie des Pays de la Loire, Université de Nantes et Angers, France Centre Mémoire de Ressources et de Recherches, CHU Angers, France
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29
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Emmanouel A, Mouza E, Kessels RPC, Fasotti L. Validity of the Dysexecutive Questionnaire (DEX). Ratings by patients with brain injury and their therapists. Brain Inj 2014; 28:1581-9. [DOI: 10.3109/02699052.2014.942371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Anna Emmanouel
- Donders Institute for Brain, Cognition and Behaviour, Radboud University NijmegenThe Netherlands
| | - Eirini Mouza
- Rehabilitation Center ‘Anagennisi’, Nea Redestos
Oik. Filothei, ThessalonikiGreece
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University NijmegenThe Netherlands
- Department of Medical Psychology, Radboud University Medical Center
NijmegenThe Netherlands
- Vincent van Gogh Institute for Psychiatry
VenrayThe Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University NijmegenThe Netherlands
- Rehabilitation Medical Centre Groot Klimmendaal
ArnhemThe Netherlands
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30
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Emmanouel A, Kessels RPC, Mouza E, Fasotti L. Sensitivity, specificity and predictive value of the BADS to anterior executive dysfunction. Neuropsychol Rehabil 2013; 24:1-25. [PMID: 24354937 DOI: 10.1080/09602011.2013.863731] [Citation(s) in RCA: 9] [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] [Indexed: 10/25/2022]
Abstract
In this study we investigated the validity of the BADS subtests to adequately discriminate anterior lesions (AL) from posterior lesions (PL). Therefore, we compared the performances of 30 AL patients, 22 PL patients and 29 healthy controls (HC) on the BADS subtests. Seven standard executive test variables were also examined. Our multiple comparisons showed that the BADS Zoo Map-Part 1 was not indicative for AL, whereas Rule Shifting, Action Programme, Key Search, Zoo Map-total score, and BADS-total score were found to be sensitive to AL. More importantly, the Modified Six Element Test (MSET), and the Zoo Map-Part 2 were highly specific for AL. In both BADS subtests AL patients performed significantly worse than either the PL or the HC groups, whereas no significant differences on the same variables were found between PL and HC individuals. Further logistic regression analysis revealed that the BADSMSET was the best predictor for distinguishing AL from PL patients, correctly classifying 78.8% of the patients. These results suggest that the BADSMSET is an accurate screening tool for the detection of anterior pathology. Poor performance on this BADS subtest is a significant indicator of executive dysfunctioning after anterior brain damage.
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Affiliation(s)
- Anna Emmanouel
- a Rehabilitation Centre "Anagennisi" , Nea Redestos , Oik. Filothei, Thessaloniki , Greece
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31
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Abstract
Visuospatial neglect due to right hemisphere damage, usually a stroke, is a major cause of disability, impairing the ability to perform a whole range of everyday life activities. Conventional and long-established methods for the rehabilitation of neglect like visual scanning training, optokinetic stimulation, or limb activation training have produced positive results, with varying degrees of generalization to (un)trained tasks, lasting from several minutes up to various months after training. Nevertheless, some promising novel approaches to the remediation of left visuospatial neglect have emerged in the last decade. These new therapy methods can be broadly classified into four categories. First, non-invasive brain stimulation techniques by means of transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS), after a period of mainly diagnostic utilization, are increasingly applied as neurorehabilitative tools. Second, two classes of drugs, dopaminergic and noradrenergic, have been investigated for their potential effectiveness in rehabilitating neglect. Third, prism adaptation treatment has been shown to improve several neglect symptoms consistently, sometimes during longer periods of time. Finally, virtual reality technologies hold new opportunities for the development of effective training techniques for neglect. They provide realistic, rich, and highly controllable training environments. In this paper the degree of effectiveness and the evidence gathered to support the therapeutic claims of these new approaches is reviewed and discussed. The conclusion is that for all these approaches there still is insufficient unbiased evidence to support their effectiveness. Further neglect rehabilitation research should focus on the maintenance of therapy results over time, on a more functional evaluation of treatment effects, on the design and execution of true replication studies and on the exploration of optimal combinations of treatments.
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Affiliation(s)
- Luciano Fasotti
- Rehabilitation Medical Centre Groot Klimmendaal, SIZA Support and Rehabilitation , Arnhem , Netherlands ; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen , Nijmegen , Netherlands
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El Haj M, Moroni C, Samson S, Fasotti L, Allain P. Prospective and retrospective time perception are related to mental time travel: Evidence from Alzheimer’s disease. Brain Cogn 2013; 83:45-51. [DOI: 10.1016/j.bandc.2013.06.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/20/2013] [Accepted: 06/21/2013] [Indexed: 11/15/2022]
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Spikman JM, Boelen DHE, Pijnenborg GHM, Timmerman ME, van der Naalt J, Fasotti L. Who benefits from treatment for executive dysfunction after brain injury? Negative effects of emotion recognition deficits. Neuropsychol Rehabil 2013; 23:824-45. [PMID: 23964996 DOI: 10.1080/09602011.2013.826138] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Deficits in emotion recognition, a crucial aspect of social cognition, are common after serious brain injury, as are executive deficits. Since social cognition and executive function are considered to be separate constructs, our first aim was to examine the presence of emotion recognition problems in brain injury patients with dysexecutive problems. We studied 65 brain injury patients of mixed aetiology participating in a randomised controlled trial evaluating the effects of a multifaceted treatment for executive dysfunction (Spikman, Boelen, Lamberts, Brouwer, & Fasotti, 2010 ) and 84 matched controls with a test for emotion recognition. Results showed that, in patients with acquired brain injury exhibiting executive deficits, emotion recognition deficits are also present. Male patients are more impaired than female patients, irrespective of aetiology. Our second aim was to investigate whether emotion recognition problems negatively predict the results of the treatment programme. Pre-treatment emotion recognition performance significantly predicted resumption of roles in daily life (Role Resumption List; RRL) and performance on an ecologically valid test for everyday executive functioning (Executive Secretarial Task; EST) post-treatment and, in addition, interfered negatively with treatment condition. Moreover, worse pre-treatment emotion recognition skills affect the learning of compensatory strategies for executive dysfunction negatively, whereas pre-treatment dysexecutive deficits do not.
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Affiliation(s)
- Jacoba M Spikman
- a Department of Clinical and Developmental Neuropsychology , University of Groningen (RUG) , The Netherlands
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34
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van Kessel ME, Geurts ACH, Brouwer WH, Fasotti L. Visual Scanning Training for Neglect after Stroke with and without a Computerized Lane Tracking Dual Task. Front Hum Neurosci 2013; 7:358. [PMID: 23847519 PMCID: PMC3707289 DOI: 10.3389/fnhum.2013.00358] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 02/28/2013] [Accepted: 06/21/2013] [Indexed: 11/13/2022] Open
Abstract
Neglect patients typically fail to explore the contralesional half-space. During visual scanning training, these patients learn to consciously pay attention to contralesional target stimuli. It has been suggested that combining scanning training with methods addressing non-spatial attention might enhance training results. In the present study, a dual task training component was added to a visual scanning training (i.e., Training di Scanning Visuospaziale – TSVS; Pizzamiglio et al., 1990). Twenty-nine subacute right hemisphere stroke patients were semi-randomly assigned to an experimental (N = 14) or a control group (N = 15). Patients received 30 training sessions during 6 weeks. TSVS consisted of four standardized tasks (digit detection, reading/copying, copying drawings, and figure description). Moreover, a driving simulator task was integrated in the training procedure. Control patients practiced a single lane tracking task for 2 days a week during 6 weeks. The experimental group was administered the same training schedule, but in weeks 4–6 of the training, the TSVS digit detection task was combined with lane tracking on the same projection screen, so as to create a dual task (computerized visual reaction time task designed for training). Various neglect tests and driving simulator tasks were administered before and after training. No significant group and interaction effects were found that might reflect additional positive effects of dual task training. Significant improvements after training were observed in both groups taken together on most assessment tasks. Ameliorations were generally not correlated to post-onset time, but spontaneous recovery, test–retest variability, and learning effects could not be ruled out completely, since these were not controlled for. Future research might focus on increasing the amount of dual task training, the implementation of progressive difficulty levels in driving simulator tasks, and further exploration of relationships between dual task training and daily functioning.
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Affiliation(s)
- M E van Kessel
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen , Nijmegen , Netherlands ; Medisch Spectrum Twente Hospital Group , Enschede , Netherlands
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35
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Bertens D, Fasotti L, Boelen DHE, Kessels RPC. A randomized controlled trial on errorless learning in goal management training: study rationale and protocol. BMC Neurol 2013; 13:64. [PMID: 23786651 PMCID: PMC3693893 DOI: 10.1186/1471-2377-13-64] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [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] [Received: 04/25/2013] [Accepted: 06/19/2013] [Indexed: 11/24/2022] Open
Abstract
Background Many brain-injured patients referred for outpatient rehabilitation have executive deficits, notably difficulties with planning, problem-solving and goal directed behaviour. Goal Management Training (GMT) has proven to be an efficacious cognitive treatment for these problems. GMT entails learning and applying an algorithm, in which daily tasks are subdivided into multiple steps. Main aim of the present study is to examine whether using an errorless learning approach (preventing the occurrence of errors during the acquisition phase of learning) contributes to the efficacy of Goal Management Training in the performance of complex daily tasks. Methods/Design The study is a double blind randomized controlled trial, in which the efficacy of Goal Management Training with an errorless learning approach will be compared with conventional Goal Management Training, based on trial and error learning. In both conditions 32 patients with acquired brain injury of mixed etiology will be examined. Main outcome measure will be the performance on two individually chosen everyday-tasks before and after treatment, using a standardized observation scale and goal attainment scaling. Discussion This is the first study that introduces errorless learning in Goal Management Training. It is expected that the GMT-errorless learning approach will improve the execution of complex daily tasks in brain-injured patients with executive deficits. The study can contribute to a better treatment of executive deficits in cognitive rehabilitation. Trial registration (Dutch Trial Register):
http://NTR3567
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Affiliation(s)
- Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.
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36
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van Kessel ME, van Nes IJW, Geurts ACH, Brouwer WH, Fasotti L. Visuospatial asymmetry in dual-task performance after subacute stroke. J Neuropsychol 2012; 7:72-90. [DOI: 10.1111/j.1748-6653.2012.02036.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 06/11/2012] [Accepted: 09/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | - Ilse J. W. van Nes
- Sint Maartenskliniek Research; Development and Education; Nijmegen; The Netherlands
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37
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Roy A, Barbarot S, Roulin JL, Charbonnier V, Fasotti L, Stalder JF, Le Gall D. Is executive function specifically impaired in children with neurofibromatosis type 1? A neuropsychological investigation of cognitive flexibility. Appl Neuropsychol Child 2012; 3:94-102. [PMID: 24716868 DOI: 10.1080/21622965.2012.704185] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Our study investigated spontaneous versus reactive cognitive flexibility in children with neurofibromatosis type 1 (NF1) and their comorbidity with attention-deficit hyperactivity disorder (ADHD). Thirty children with NF1 aged 7 to 12 years old were compared to 60 healthy controls matched by age, gender, and parental education. On the basis of Eslinger and Grattan's definition ( 1993 ), spontaneous shifting was assessed using fluency tests, whereas reactive flexibility was measured by a child adaptation of the Modified Card-Sorting Test and the Brixton Test. IQ and basic skills were taken into account as confounding variables that might influence executive measures. NF1 children performed below the level of healthy children on both reactive flexibility tasks, even when intelligence and basic skills were partialled out, but ADHD symptomatology was not found to adversely affect the performance of patients. Our findings support the hypothesis of a specific executive impairment in NF1, uncovering a dissociation between (impaired) reactive flexibility and (preserved) spontaneous shifting, with no impact of ADHD on executive performance.
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Affiliation(s)
- Arnaud Roy
- a Psychology Laboratory, LUNAM, Angers University , Angers , France
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38
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Allain P, Fasotti L, Roy A, Chauviré V, Etcharry-Bouyx F, Le Gall D. Script-event representation in patients with severe traumatic brain injury. Cortex 2012; 48:1155-64. [DOI: 10.1016/j.cortex.2011.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 11/29/2010] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
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Abstract
Source monitoring is the process of making judgments about the origin of memories. There are three categories of source monitoring: reality monitoring (discrimination between self- versus other-generated sources), external monitoring (discrimination between several external sources), and internal monitoring (discrimination between two types of self-generated sources). We investigated whether Alzheimer's Disease (AD) patients, when compared with young and older adults, are impaired at the same level on the three source monitoring categories. We designed three tasks, one for each source monitoring category. In the first task, aimed at reality monitoring, participants had to remember whether objects were previously placed in a bag by themselves or by the experimenter. In the second task, assessing external monitoring, participants had to remember whether the experimenter had previously placed objects in the bag with a black or white gloved hand. In the third task, measuring internal monitoring, participants had to remember whether they had previously placed or imagined themselves placing objects in the bag. Participants showed worse performances in the external and internal monitoring tasks, when compared with reality monitoring. The external monitoring deficit was even more pronounced in AD patients. Regression analyses showed that variation in the external monitoring performances was reliably predicted by inhibition. Our results emphasize the role of inhibitory processes in AD patients' source monitoring decline. The close relation between source and inhibitory decline in AD is interpreted in terms of a common neural base for both concepts.
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Affiliation(s)
- Mohamad El Haj
- LUNAM Université, Université d'Angers, Laboratoire de Psychologie des Pays de la Loire, France.
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40
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Kootker JA, Fasotti L, Rasquin SMC, van Heugten CM, Geurts ACH. The effectiveness of an augmented cognitive behavioural intervention for post-stroke depression with or without anxiety (PSDA): the Restore4Stroke-PSDA trial. BMC Neurol 2012; 12:51. [PMID: 22769041 PMCID: PMC3433315 DOI: 10.1186/1471-2377-12-51] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 07/07/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post-Stroke Depression with or without Anxiety (PSDA) is a common disorder in the chronic phase of stroke. Neuropsychiatric problems, such as PSDA, have a negative impact on social reintegration and quality of life. Currently, there is no evidence-based treatment available for reducing PSDA symptoms. In the recent literature on depression in the general population it has been shown that depression complaints can diminish by cognitive behavioural therapy (CBT). In the current study, the effectiveness of augmented, activation-based and individually tailored CBT on the reduction of depression and anxiety will be investigated in patients with PSDA. Additionally, the effects on various secondary outcome measures, such as quality of life, goal attainment and societal participation will be evaluated. This study is embedded in a consortium of 4 interrelated studies on quality of life after stroke (Restore4Stroke). METHODS/DESIGN A multi-centre, assessor-blind, randomized controlled trial is conducted. A sample of 106 PSDA patients, as assessed with the Hospital Anxiety and Depression Scale (HADS depression subscale >7), will be recruited and randomly allocated to either an experimental or a control group. The experimental intervention consists of an augmented CBT intervention. The intervention is based on CBT principles of recognizing, registering, and altering negative thoughts and cognitions so that mood, and emotional symptoms are improved. CBT is augmented with direct in-vivo activation offered by occupational or movement therapists. Patients in the control group will receive a computerized cognitive training intervention. Outcomes will be assessed at baseline, immediately post intervention, and at 6 and 12 months follow up. DISCUSSION This study is the first randomized clinical trial that evaluates the (maintenance of) effects of augmented CBT on post-stroke depression with or without anxiety symptoms. Together with three other projects, the Restore4Stroke PSDA trial will provide novel information about the (treatment of) emotional problems and quality of life after stroke. TRIAL REGISTRATION TRIAL REGISTRATION NUMBER Dutch Trial Register NTR2999.
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Affiliation(s)
- Joyce A Kootker
- Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
- Rehabilitation Medical Centre Groot Klimmendaal, Arnhem, The Netherlands
| | - Sascha MC Rasquin
- Adelante Rehabilitation Foundation Limburg, Limburg, The Netherlands
- Dept Rehabilitation, CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alexander CH Geurts
- Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Zedlitz AMEE, van Eijk M, Kessels RPC, Geurts ACH, Fasotti L. Poststroke Fatigue Is Still a Neglected Issue: Findings from an Internet-Based Study on the Need for Information and Treatment in The Netherlands. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/629589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective. To evaluate the need for information and treatment of poststroke fatigue (PSF) in community-dwelling patients with stroke in The Netherlands. Methods. Data were obtained from a Dutch internet-based questionnaire. The amount of information received about PSF, self-management and other treatment options, and the perceived need for treatment were scored. PSF was assessed with two Visual Numerical Scales of fatigue severity (VNSF), the Fatigue Severity Scale (FSS7), and by scoring the nature (physical versus mental) and onset time of PSF. Results. Data were available of 538 stroke survivors (mean age 52 years, 45% men, and mean time since onset 2.7 years). Severe fatigue (both VNSF items ≥7; 48%) and severe fatigue impact (FSS7 > 5; 68%) were frequent. Most participants (57%) experienced both physical and mental fatigue. Only 17% of the respondents indicated to have had received sufficient information about PSF and 7% about treatment options, whereas 56% expressed a substantial need for treatment. The need for treatment was moderately associated with fatigue severity and fatigue impact, whereas information status was not related to any demographical, fatigue, or stroke characteristic. Conclusions. PSF is a significant symptom after stroke requiring medical attention and treatment. The results of this survey indicate that patients do not receive adequate information on PSF.
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Affiliation(s)
- Aglaia M. E. E. Zedlitz
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE Nijmegen, The Netherlands
- Department of Clinical Neuropsychology, Leiden University, 2300 RB Leiden, The Netherlands
| | | | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands
| | - Alexander C. H. Geurts
- Department of Rehabilitation Medicine, Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE Nijmegen, The Netherlands
- Research, Development and Education, Sint Maartenskliniek, 6500 GM Nijmegen, The Netherlands
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Abstract
Background and Purpose—
Fatigue is a common, persistent consequence of stroke, and no evidence-based treatments are currently available to alleviate fatigue. A new treatment combining cognitive therapy (CO) with graded activity training (GRAT), called COGRAT, was developed to alleviate fatigue and fatigue-related symptoms. This study compared the effectiveness of the COGRAT intervention with a CO-only intervention after a 3-month qualification period without intervention.
Methods—
This randomized, controlled, assessor-blind clinical trial was conducted in 8 rehabilitation centers. Eighty-three stroke patients (>4 months after stroke) were randomly assigned to 12 weeks of CO or COGRAT after qualification. Seventy-three patients completed treatment and 68 were available at follow-up. Primary outcomes (Checklist Individual Strength–subscale Fatigue (CIS-f); self-observation list–fatigue (SOL-f)) and secondary outcomes (Hospital Anxiety and Depression Scale, Stroke-Adapted Sickness Impact Profile, SOL-pain, SOL-sleep-D, 6-minute walk test) were collected at baseline (before and after qualification period) and after treatment (immediate and 6-month follow-up).
Results—
The qualification period showed stable outcome measures. Both treatments showed significant beneficial effects on fatigue (CIS-f: η
p
2
=0.48,
P
<0.001) and other outcomes (except pain and anxiety) with intention-to-treat analyses. Gains for the COGRAT group exceeded those in the CO group on number of individuals showing clinical improvement on the CIS-f (≥8 points: 58% versus 24%) and on physical endurance (η
p
2
=0.20,
P
<0.001).
Conclusions—
A 12-week cognitive therapy program can alleviate persistent fatigue after stroke. The best results are obtained when cognitive therapy is augmented with graded activity training.
Clinical Trial Registration—
URL:
http://www.trialregister.nl
. Unique identifier: NTR2704.
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Affiliation(s)
- Aglaia M.E.E. Zedlitz
- From the Donders Centre for Cognition, Radboud University Nijmegen (A.M.E.E.Z., L.F.), Sint Maartenskliniek Research, Development, and Education (A.M.E.E.Z., L.F.), the Department of Linguistics, Radboud University Nijmegen (T.C.M.R.), and Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, Department of Rehabilitation (A.C.G.), Nijmegen, The Netherlands
| | - Toni C.M. Rietveld
- From the Donders Centre for Cognition, Radboud University Nijmegen (A.M.E.E.Z., L.F.), Sint Maartenskliniek Research, Development, and Education (A.M.E.E.Z., L.F.), the Department of Linguistics, Radboud University Nijmegen (T.C.M.R.), and Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, Department of Rehabilitation (A.C.G.), Nijmegen, The Netherlands
| | - Alexander C. Geurts
- From the Donders Centre for Cognition, Radboud University Nijmegen (A.M.E.E.Z., L.F.), Sint Maartenskliniek Research, Development, and Education (A.M.E.E.Z., L.F.), the Department of Linguistics, Radboud University Nijmegen (T.C.M.R.), and Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, Department of Rehabilitation (A.C.G.), Nijmegen, The Netherlands
| | - Luciano Fasotti
- From the Donders Centre for Cognition, Radboud University Nijmegen (A.M.E.E.Z., L.F.), Sint Maartenskliniek Research, Development, and Education (A.M.E.E.Z., L.F.), the Department of Linguistics, Radboud University Nijmegen (T.C.M.R.), and Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, Department of Rehabilitation (A.C.G.), Nijmegen, The Netherlands
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El Haj M, Fasotti L, Allain P. The involuntary nature of music-evoked autobiographical memories in Alzheimer’s disease. Conscious Cogn 2012; 21:238-46. [DOI: 10.1016/j.concog.2011.12.005] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 12/13/2011] [Accepted: 12/15/2011] [Indexed: 11/30/2022]
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Allain P, Havet-Thomassin V, Verny C, Gohier B, Lancelot C, Besnard J, Fasotti L, Le Gall D. Evidence for deficits on different components of theory of mind in Huntington's disease. Neuropsychology 2012; 25:741-51. [PMID: 21728429 DOI: 10.1037/a0024408] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [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 The main aim of this study was to investigate the effects of Huntington's disease (HD) on cognitive and affective Theory of Mind (ToM) abilities. The relation of ToM performance and executive functions was also examined. METHOD Eighteen HD patients, early in the course of the disease, and 18 healthy volunteers matched for age and educational levels, were given two tasks: a nonverbal cognitive ToM task assessing attribution of intentions to others and a revised version of the 'Reading the Mind in the Eyes' test, which is an affective ToM task assessing the understanding of other people's mental states from their eyes. Participants were also given various executive tests. RESULTS The two ToM tasks revealed a significant impairment of ToM abilities in HD patients. Executive functioning was impaired in the HD group and ToM performance on the attribution of intentions task was dependent on several executive processes. CONCLUSIONS Our results are consistent with the idea that both cognitive and affective aspects of ToM could be impaired in HD patients, indicating that cortico-subcortical circuits are underlying higher social functions such as ToM. The results are also consistent with the idea that only a few executive mechanisms regulate the ToM abilities we tested in this work. They also provide a basis for the understanding of the disorganized behavior and the breakdown of interpersonal relationships in daily life after HD.
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Affiliation(s)
- Philippe Allain
- Laboratory of Psychology and Department of Neurology, University Hospital of Angers, France.
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Winkens I, Van Heugten CM, Fasotti L, Wade DT. Treatment of mental slowness: How to evaluate treatment effects. A systematic review of outcome measures. Neuropsychol Rehabil 2011; 21:860-83. [DOI: 10.1080/09602011.2011.627267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Zedlitz AMEE, Visser-Meily AJMA, Schepers VP, Geurts ACH, Fasotti L. Patients with severe poststroke fatigue show a psychosocial profile comparable to patients with other chronic disease: implications for diagnosis and treatment. ISRN Neurol 2011; 2011:627081. [PMID: 22389826 PMCID: PMC3263554 DOI: 10.5402/2011/627081] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 09/17/2011] [Indexed: 11/23/2022]
Abstract
Objective. To obtain a psychosocial profile of patients with poststroke fatigue (PSF), which could aid in optimizing treatment strategies. Methods. Eighty-eight outpatients with severe PSF measured with the Checklist Individual Strength-fatigue subscale (CIS-f) and the Fatigue Severity Scale (FSS) were selected. Depression and anxiety, psychological distress, coping, social support, and self-efficacy of this group were compared to reference groups of healthy controls and patients with other chronic diseases. Associations between psychosocial characteristics and fatigue were calculated. Results. Compared to healthy controls, patients with PSF reported more psychological distress, less problem-focused coping, and more positive social support. Minor or no differences were found in comparison with other chronic patients. The CIS-f correlated with somatic complaints and the FSS with cognitive complaints. Conclusion. Patients with PSF show a psychosocial profile comparable to patients with other chronic disease. Implications for diagnosis and treatment are discussed.
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Affiliation(s)
- Aglaia M E E Zedlitz
- Donders Centre for Cognition, Radboud University Nijmegen, 6500 HE Nijmegen, The Netherlands
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Dechamps A, Marcel OR, Fasotti L, Robert P, Kessels R. P4‐216: Overview and preliminary results of the 3 LM‐AD study: Comparison of 3 Learning techniques in Alzheimer disease. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.2239] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dechamps A, Fasotti L, Jungheim J, Leone E, Dood E, Allioux A, Robert PH, Gervais X, Maubourguet N, Olde Rikkert MGM, Kessels RPC. Effects of different learning methods for instrumental activities of daily living in patients with Alzheimer's dementia: a pilot study. Am J Alzheimers Dis Other Demen 2011; 26:273-81. [PMID: 21502092 PMCID: PMC10845318 DOI: 10.1177/1533317511404394] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We examined whether errorless learning (EL) and learning by modeling (LM) were more advantageous than trial and error learning (TEL) in the acquisition of instrumental activities of daily living (IADL) in Alzheimer's dementia (AD) patients (n = 14). Using a counterbalanced within-subject design, participants performed 3 learning conditions. EL consisted of straightforward prompts before any action, LM focused on the modeling of each step of the tasks and standard TEL without cues was used as a control condition. The participants had to (re)learn 3 IADL. Repeated-measure analyses during learning and follow-up assessments were performed 1 and 3 weeks after learning. The LM and the EL procedures resulted in significantly better learning compared to TEL, with effect sizes (partial eta squared) of 0.42 and 0.35, respectively. This is the first controlled study to show that (re)learning of IADL is possible in patients with AD using an error-reduction approach.
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Affiliation(s)
- Arnaud Dechamps
- Department of Geriatrics and Alzheimer Centre Nijmegen, Radboud University Nijmegen Medical Centre, The Netherlands
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Allain P, Gaura V, Fasotti L, Chauviré V, Prundean A, Sherer-Gagou C, Bonneau D, Bachoud-Levi AC, Dubas F, Remy P, Le Gall D, Verny C. The neural substrates of script knowledge deficits as revealed by a PET study in Huntington's disease. Neuropsychologia 2011; 49:2673-84. [PMID: 21651921 DOI: 10.1016/j.neuropsychologia.2011.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 04/07/2011] [Accepted: 05/20/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Previous neuropsychological investigations have suggested that both the prefrontal cortex and the basal ganglia are involved in the management of script event knowledge required in planning behavior. METHODS This study was designated to map, the correlations between resting-state brain glucose utilization as measured by FDG-PET (positron emission tomography) and scores obtained by means of a series of script generation and script sorting tasks in 8 patients with early Huntington's disease. RESULTS These patients exhibited a selectively greater impairment for the organizational aspects of scripts compared to the semantic aspects of scripts. We showed significant negative correlations between the number of sequencing, boundary, perseverative and intrusion errors and the metabolism of several cortical regions, not only including frontal, but also posterior regions. CONCLUSION Our findings suggest that, within the fronto-striatal system, the cortical frontal regions are more crucial in script retrieval and script sequencing than the basal ganglia.
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