Daniela Ramos Usuga, Diego Rivera, Bridget Xia, Carmen I Carrión, Gloria M Morel Valdés, Oswaldo Moreno, Miriam J Rodriguez, Denise Krch, Wongthipa Wongserbchart, Christin I Drago, Patricia García, Patricia M Rivera, Laiene Olabarrieta-Landa, Paul B Perrin, Juan Carlos Arango-Lasprilla
Background: Normative data for Spanish-speaking populations, particularly Hispanics in the U.S., is notably scarce.
Objective: This study aims to establish normative data for executive function tests (Modified Wisconsin Card Sorting Test and Stroop Color and Word Test) among Spanish-speaking Hispanics in the U.S.
Methods: We assessed 245 individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin) and employed Bayesian regression to estimate norms, considering various sociodemographic factors influencing performance.
Results: The posterior distribution suggests a high probability that age impacts SCWT performance, with older adults likely to show greater declines, particularly among those with high proficiency in Spanish. The posterior distribution suggests a stronger effect of age on M-WCST performance among individuals with longer U.S. residency. Educational attainment demonstrates a robust positive impact on M-WCST outcomes, with lower levels of education associated with a higher probability of increased errors. An interaction between education and Spanish proficiency was observed, influencing SCWT scores differently across proficiency levels. Sex and acculturation levels interact to affect SCWT performance, with distinct patterns observed between men and women. This suggests that the impact of acculturation on cognitive test performance may vary by gender.
Conclusion: Establishing culturally sensitive normative data can enhance accurate identification of executive dysfunction and reduce misdiagnosis risks. This study underscores the importance of considering sociocultural factors including acculturation and language proficiency in neuropsychological assessments to better serve diverse populations.
{"title":"Executive function tests: Normative data for Spanish-speaking adults in the United States.","authors":"Daniela Ramos Usuga, Diego Rivera, Bridget Xia, Carmen I Carrión, Gloria M Morel Valdés, Oswaldo Moreno, Miriam J Rodriguez, Denise Krch, Wongthipa Wongserbchart, Christin I Drago, Patricia García, Patricia M Rivera, Laiene Olabarrieta-Landa, Paul B Perrin, Juan Carlos Arango-Lasprilla","doi":"10.3233/NRE-240088","DOIUrl":"https://doi.org/10.3233/NRE-240088","url":null,"abstract":"<p><strong>Background: </strong>Normative data for Spanish-speaking populations, particularly Hispanics in the U.S., is notably scarce.</p><p><strong>Objective: </strong>This study aims to establish normative data for executive function tests (Modified Wisconsin Card Sorting Test and Stroop Color and Word Test) among Spanish-speaking Hispanics in the U.S.</p><p><strong>Methods: </strong>We assessed 245 individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin) and employed Bayesian regression to estimate norms, considering various sociodemographic factors influencing performance.</p><p><strong>Results: </strong>The posterior distribution suggests a high probability that age impacts SCWT performance, with older adults likely to show greater declines, particularly among those with high proficiency in Spanish. The posterior distribution suggests a stronger effect of age on M-WCST performance among individuals with longer U.S. residency. Educational attainment demonstrates a robust positive impact on M-WCST outcomes, with lower levels of education associated with a higher probability of increased errors. An interaction between education and Spanish proficiency was observed, influencing SCWT scores differently across proficiency levels. Sex and acculturation levels interact to affect SCWT performance, with distinct patterns observed between men and women. This suggests that the impact of acculturation on cognitive test performance may vary by gender.</p><p><strong>Conclusion: </strong>Establishing culturally sensitive normative data can enhance accurate identification of executive dysfunction and reduce misdiagnosis risks. This study underscores the importance of considering sociocultural factors including acculturation and language proficiency in neuropsychological assessments to better serve diverse populations.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela Ramos Usuga, Lindsay E Ayearst, Diego Rivera, Denise Krch, Paul B Perrin, Carmen I Carrión, Gloria M Morel Valdés, Delly Loro, Miriam J Rodriguez, Geovani Munoz, Christin I Drago, Patricia García, Patricia M Rivera, Juan Carlos Arango-Lasprilla
Background: The Test of Memory Malingering (TOMM) is a widely used performance validity measure that is available in both English and Spanish. The Spanish version, however, has historically lacked normative data from samples that are representative of the U.S. Hispanic/Spanish speaking population.
Objective: The aim of the current study was to collect normative data on the update TOMM 2 for Hispanic individuals residing in the U.S.
Methods: Normative data on the TOMM 2 was collected across 9 sites from different regions of the U.S. The total sample consisted of n = 188 cognitively healthy adults aged 18 and over with no current or prior history of neurological or psychiatric disorder. Descriptive analyses were performed on total raw scores.
Results: Participants obtained a mean score of 48.15 (SD = 2.81) on trial 1 of the TOMM 2, 49.86 (SD = 0.487) on trial 2, and 49.84 (SD = 0.509) on the recognition trial. Scores are provided for traditional cutoff scores as well as some popular cutoffs reported in the literature. Item level analyses were conducted as well as evaluation of performance based on a variety of demographics.
Conclusion: When compared to the English-speaking normative sample used for the original TOMM, this sample demonstrated better performance on the TOMM 2 indicating better cultural appropriateness of the items. This is the first study conducted that provides culturally appropriate descriptive norms for use with Spanish speakers living in the U.S.
{"title":"A preliminary examination of the TOMM2 in a sample of Spanish speakers in the United States.","authors":"Daniela Ramos Usuga, Lindsay E Ayearst, Diego Rivera, Denise Krch, Paul B Perrin, Carmen I Carrión, Gloria M Morel Valdés, Delly Loro, Miriam J Rodriguez, Geovani Munoz, Christin I Drago, Patricia García, Patricia M Rivera, Juan Carlos Arango-Lasprilla","doi":"10.3233/NRE-240085","DOIUrl":"https://doi.org/10.3233/NRE-240085","url":null,"abstract":"<p><strong>Background: </strong>The Test of Memory Malingering (TOMM) is a widely used performance validity measure that is available in both English and Spanish. The Spanish version, however, has historically lacked normative data from samples that are representative of the U.S. Hispanic/Spanish speaking population.</p><p><strong>Objective: </strong>The aim of the current study was to collect normative data on the update TOMM 2 for Hispanic individuals residing in the U.S.</p><p><strong>Methods: </strong>Normative data on the TOMM 2 was collected across 9 sites from different regions of the U.S. The total sample consisted of n = 188 cognitively healthy adults aged 18 and over with no current or prior history of neurological or psychiatric disorder. Descriptive analyses were performed on total raw scores.</p><p><strong>Results: </strong>Participants obtained a mean score of 48.15 (SD = 2.81) on trial 1 of the TOMM 2, 49.86 (SD = 0.487) on trial 2, and 49.84 (SD = 0.509) on the recognition trial. Scores are provided for traditional cutoff scores as well as some popular cutoffs reported in the literature. Item level analyses were conducted as well as evaluation of performance based on a variety of demographics.</p><p><strong>Conclusion: </strong>When compared to the English-speaking normative sample used for the original TOMM, this sample demonstrated better performance on the TOMM 2 indicating better cultural appropriateness of the items. This is the first study conducted that provides culturally appropriate descriptive norms for use with Spanish speakers living in the U.S.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda Gano, Joanne Gold, Rosemay A Remigio-Baker, Katrina Monti
Background: Concussion, also known as mild traumatic brain injury (mTBI), is a condition with unique ties to military service. Service members (SMs) are inherently at a higher risk for concussive injuries due to the intense physical training environment and combat operational tempo required to serve. The Traumatic Brain Injury Center of Excellence (TBICoE) is the US Department of Defense authority on this condition and provides a thorough approach to management of concussion and associated symptom sequela.
Objectives: This article seeks to review the TBICoE approach to the management and rehabilitation of military SMs with mTBI, and highlight resources available to military medical providers.
Methods: The authors reviewed evidence and TBICoE resources to provide this comprehensive overview of the TBICoE approach to management and rehabilitation of concussion in military SMs.
Results: A progressive return to activity protocol in conjunction with symptom-guided management of common post-concussive sequelae, including headache, vestibular and oculomotor issues, sleep dysfunction, cognitive rehabilitation, and behavioral health comorbidities are essential for concussion management in the acute, post-acute and chronic phases of injury.
Conclusion: The TBICoE approach to the rehabilitation of military SMs is comprehensive, and includes initial management with a stepwise return to duty protocol and an objective return to duty screening. The mainstays of treatment for SMs with post-acute and chronic post-concussion symptoms are headache management, vestibular and oculomotor rehabilitation, sleep interventions, cognitive rehabilitation, and early intervention for behavioral health comorbidities. These evidence-based strategies may be applied in the treatment of SMs in the US and internationally.
背景:脑震荡又称轻度脑损伤(mTBI),是一种与服兵役有特殊关系的疾病。由于服役所需的高强度体能训练环境和作战行动节奏,军人(SMs)受到脑震荡伤害的风险本身就较高。创伤性脑损伤卓越中心(TBICoE)是美国国防部在此方面的权威机构,为脑震荡及相关症状后遗症的治疗提供了全面的方法:本文旨在回顾 TBICoE 对患有 mTBI 的军事 SM 的管理和康复方法,并重点介绍可供军事医疗提供者使用的资源:作者回顾了相关证据和 TBICoE 的资源,全面概述了 TBICoE 管理和康复军队 SM 脑震荡的方法:循序渐进的恢复活动方案与以症状为导向的常见脑震荡后遗症(包括头痛、前庭和眼部运动问题、睡眠功能障碍、认知康复和行为健康合并症)管理相结合,对于急性、急性后和慢性损伤阶段的脑震荡管理至关重要:TBICoE 对军队 SM 的康复治疗方法是全面的,包括通过逐步重返工作岗位方案和客观的重返工作岗位筛查进行初始管理。对有急性和慢性脑震荡后症状的工作人员的主要治疗方法是头痛管理、前庭和眼部运动康复、睡眠干预、认知康复和行为健康合并症的早期干预。在美国和国际上,这些循证策略可用于治疗脑震荡后遗症。
{"title":"TBICoE approach to concussion rehabilitation in service members and veterans.","authors":"Amanda Gano, Joanne Gold, Rosemay A Remigio-Baker, Katrina Monti","doi":"10.3233/NRE-230269","DOIUrl":"https://doi.org/10.3233/NRE-230269","url":null,"abstract":"<p><strong>Background: </strong>Concussion, also known as mild traumatic brain injury (mTBI), is a condition with unique ties to military service. Service members (SMs) are inherently at a higher risk for concussive injuries due to the intense physical training environment and combat operational tempo required to serve. The Traumatic Brain Injury Center of Excellence (TBICoE) is the US Department of Defense authority on this condition and provides a thorough approach to management of concussion and associated symptom sequela.</p><p><strong>Objectives: </strong>This article seeks to review the TBICoE approach to the management and rehabilitation of military SMs with mTBI, and highlight resources available to military medical providers.</p><p><strong>Methods: </strong>The authors reviewed evidence and TBICoE resources to provide this comprehensive overview of the TBICoE approach to management and rehabilitation of concussion in military SMs.</p><p><strong>Results: </strong>A progressive return to activity protocol in conjunction with symptom-guided management of common post-concussive sequelae, including headache, vestibular and oculomotor issues, sleep dysfunction, cognitive rehabilitation, and behavioral health comorbidities are essential for concussion management in the acute, post-acute and chronic phases of injury.</p><p><strong>Conclusion: </strong>The TBICoE approach to the rehabilitation of military SMs is comprehensive, and includes initial management with a stepwise return to duty protocol and an objective return to duty screening. The mainstays of treatment for SMs with post-acute and chronic post-concussion symptoms are headache management, vestibular and oculomotor rehabilitation, sleep interventions, cognitive rehabilitation, and early intervention for behavioral health comorbidities. These evidence-based strategies may be applied in the treatment of SMs in the US and internationally.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laiene Olabarrieta-Landa, Diego Rivera, Bridget Xia, Oswaldo Moreno, Daniela Ramos Usuga, Gloria M Morel Valdés, Enrique Lopez, Miriam J Rodriguez, Carmen I Carrión, Anthony H Lequerica, Christin I Drago, Patricia García, Patricia M Rivera, Paul B Perrin, Juan Carlos Arango-Lasprilla
Background: Linguistic deficits are common across neurological and neurodegenerative disorders. Currently there are limited neuropsychological norms available for Spanish-speaking adults residing in the U.S.
Objective: To generate norms for two verbal fluency tests and the Boston Naming Test (BNT) in a Spanish-speaking population in the U.S., with adjustments for demographic and cultural variables.
Methods: The sample consisted of 245 adults from the U.S. Participants completed phonological and semantic verbal fluency tests and the BNT. A standardized two-step statistical procedure was used.
Results: For the phoneme F, interactions between Spanish proficiency, age, and education arose. Better performance on phonemes A, S, and M was related to education. Spanish proficiency, acculturation, and time in the U.S. were associated with the phonemes S, A, P, M, and R. An age by education interaction was found for phonemes M and R. The FAS and PMR triads were related to age, sex, time in U.S., and Spanish proficiency. For the semantic verbal fluency tests, an interaction between education and Spanish proficiency arose. For the BNT, test scores were related to education, and significant interactions were also found based on education's interaction with Spanish proficiency and acculturation.
Conclusion: This study highlights the importance of accounting for sociodemographic and acculturative factors when developing normative data for verbal fluency tests and the BNT for dominant Spanish-speaking adults in the U.S. These sociodemographically-adjusted norms will help improve accuracy of diagnosis and interpretation of linguistic test performance in Spanish speakers living in the U.S.
背景:语言障碍是神经系统和神经退行性疾病中的常见病。目前,针对居住在美国的讲西班牙语的成年人的神经心理学标准非常有限:目的:根据人口统计学和文化变量进行调整,为美国讲西班牙语的人群制定两种语言流利性测试和波士顿命名测试(BNT)的标准:样本由 245 名美国成年人组成,参加者完成了语音和语义语言流利性测试以及波士顿命名测试。研究采用了标准化的两步统计程序:就音素 F 而言,西班牙语水平、年龄和教育程度之间存在交互作用。在音素 A、S 和 M 方面的较佳表现与教育程度有关。西班牙语水平、文化程度和在美国的时间与音素 S、A、P、M 和 R 有关,而音素 M 和 R 则存在年龄与教育之间的交互作用。在语义语言流畅性测试中,教育程度和西班牙语水平之间存在交互作用。就 BNT 而言,测试分数与教育程度有关,教育程度与西班牙语水平和文化适应度之间也存在显著的交互作用:本研究强调了在为美国主要讲西班牙语的成年人制定语言流利性测试和 BNT 常模数据时考虑社会人口学和文化适应因素的重要性。
{"title":"Normative data for verbal fluency and naming tests in Spanish-speaking adults in the United States.","authors":"Laiene Olabarrieta-Landa, Diego Rivera, Bridget Xia, Oswaldo Moreno, Daniela Ramos Usuga, Gloria M Morel Valdés, Enrique Lopez, Miriam J Rodriguez, Carmen I Carrión, Anthony H Lequerica, Christin I Drago, Patricia García, Patricia M Rivera, Paul B Perrin, Juan Carlos Arango-Lasprilla","doi":"10.3233/NRE-240087","DOIUrl":"https://doi.org/10.3233/NRE-240087","url":null,"abstract":"<p><strong>Background: </strong>Linguistic deficits are common across neurological and neurodegenerative disorders. Currently there are limited neuropsychological norms available for Spanish-speaking adults residing in the U.S.</p><p><strong>Objective: </strong>To generate norms for two verbal fluency tests and the Boston Naming Test (BNT) in a Spanish-speaking population in the U.S., with adjustments for demographic and cultural variables.</p><p><strong>Methods: </strong>The sample consisted of 245 adults from the U.S. Participants completed phonological and semantic verbal fluency tests and the BNT. A standardized two-step statistical procedure was used.</p><p><strong>Results: </strong>For the phoneme F, interactions between Spanish proficiency, age, and education arose. Better performance on phonemes A, S, and M was related to education. Spanish proficiency, acculturation, and time in the U.S. were associated with the phonemes S, A, P, M, and R. An age by education interaction was found for phonemes M and R. The FAS and PMR triads were related to age, sex, time in U.S., and Spanish proficiency. For the semantic verbal fluency tests, an interaction between education and Spanish proficiency arose. For the BNT, test scores were related to education, and significant interactions were also found based on education's interaction with Spanish proficiency and acculturation.</p><p><strong>Conclusion: </strong>This study highlights the importance of accounting for sociodemographic and acculturative factors when developing normative data for verbal fluency tests and the BNT for dominant Spanish-speaking adults in the U.S. These sociodemographically-adjusted norms will help improve accuracy of diagnosis and interpretation of linguistic test performance in Spanish speakers living in the U.S.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul Olowoyo, Olabode Oguntiloye, Luqman Ogunjimi, Olaleye Adeniji, Segun Atolani, Olumuyiwa Ariyo, Mayowa Owolabi
Background: The prevalence of epilepsy is highest in the Central Africa subregion most especially in rural settlements. This is further compounded by a high prevalence of treatment gap, from poor drug adherence, and poor road network. One approach to overcoming this burden is to leverage Video-based Directly Observed Therapy (ViDOT) use for stable patients living with epilepsy, harnessing the advancement in mHealth technologies, and widespread adoption of smartphones. ViDOT is a form of telemedicine that is a smartphone-based, treatment approach for monitoring and evaluating remote patients.
Objective: We performed a narrative review of the existing literature using electronic databases from PubMed and Google Scholar to identify relevant publications related to ViDOT and chronic diseases, in particular epilepsy.
Methods: The selected articles were assessed for relevance, and key findings were synthesized to provide an overview of the role of ViDOT in addressing the challenges of drug adherence in epilepsy.
Results: The review shows that poor drug adherence is a major risk for poor outcomes in patients living with epilepsy. ViDOT has the potential to significantly contribute to improved drug adherence in patients living with epilepsy. Other benefits of ViDOT include the elimination of prolonged waiting times, improvement in access to specialized care, eradication of self-induced stigma and discrimination, diminishing neurologists' workload, and cost-effectiveness. Challenges include poor network coverage and unstable internet service.
Conclusion: Giving a brief psychoeducation about epilepsy, anti-epileptic drug (AED) side effects, and the importance of sticking with the recommended drug use can improve AED adherence and epilepsy outcomes. Information dissemination through ViDOT to people with epilepsy and their caregivers at large is important to promote a healthy life.
{"title":"Video-Based Directly Observed Therapy (ViDOT) as a strategic tool to improve medication adherence in epilepsy: A narrative review.","authors":"Paul Olowoyo, Olabode Oguntiloye, Luqman Ogunjimi, Olaleye Adeniji, Segun Atolani, Olumuyiwa Ariyo, Mayowa Owolabi","doi":"10.3233/NRE-240080","DOIUrl":"https://doi.org/10.3233/NRE-240080","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of epilepsy is highest in the Central Africa subregion most especially in rural settlements. This is further compounded by a high prevalence of treatment gap, from poor drug adherence, and poor road network. One approach to overcoming this burden is to leverage Video-based Directly Observed Therapy (ViDOT) use for stable patients living with epilepsy, harnessing the advancement in mHealth technologies, and widespread adoption of smartphones. ViDOT is a form of telemedicine that is a smartphone-based, treatment approach for monitoring and evaluating remote patients.</p><p><strong>Objective: </strong>We performed a narrative review of the existing literature using electronic databases from PubMed and Google Scholar to identify relevant publications related to ViDOT and chronic diseases, in particular epilepsy.</p><p><strong>Methods: </strong>The selected articles were assessed for relevance, and key findings were synthesized to provide an overview of the role of ViDOT in addressing the challenges of drug adherence in epilepsy.</p><p><strong>Results: </strong>The review shows that poor drug adherence is a major risk for poor outcomes in patients living with epilepsy. ViDOT has the potential to significantly contribute to improved drug adherence in patients living with epilepsy. Other benefits of ViDOT include the elimination of prolonged waiting times, improvement in access to specialized care, eradication of self-induced stigma and discrimination, diminishing neurologists' workload, and cost-effectiveness. Challenges include poor network coverage and unstable internet service.</p><p><strong>Conclusion: </strong>Giving a brief psychoeducation about epilepsy, anti-epileptic drug (AED) side effects, and the importance of sticking with the recommended drug use can improve AED adherence and epilepsy outcomes. Information dissemination through ViDOT to people with epilepsy and their caregivers at large is important to promote a healthy life.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Mandibular reconstruction has historically been challenging due to the complex, highly functional, and esthetic nature of the anatomy. The most common etiologies of these defects requiring resection include trauma, benign tumors, and malignant pathology. Mandibular defects have been treated with little consideration for neural reconstruction, leaving patient's orally incompetent with associated social stigma. Although recent advances in reconstructive techniques improve oral rehabilitation, immediate inferior alveolar nerve (IAN) reconstruction has not been widely adapted.
Objective: Here-in we seek to discuss the innovations of neural reconstruction of large segment mandibular defects and associated IAN defects and present an example case performed at Naval Medical Center San Diego (NMCSD).
Methods: Pertinent literature discussing maxillofacial reconstruction and nerve repair using autogenous nerve harvest and allograft was queried from available online resources.
Results: Six patients have received immediate reconstruction of the IAN using processed nerve allograft over the past three years. All obtained sensation to S3 within six months of surgery.
Conclusion: IAN repair using nerve allografts in conjunction with free flap reconstruction for large mandibular defects is a viable treatment and should be the new paradigm in maxillofacial reconstruction as it provides substantial quantifiable and qualitative improvements in social, functional, and esthetic outcomes of care.
背景:由于下颌骨解剖结构复杂、功能性和美观性强,下颌骨重建历来具有挑战性。这些需要切除的缺损最常见的病因包括外伤、良性肿瘤和恶性病变。下颌骨缺损的治疗很少考虑神经重建,导致患者口腔功能不全,并因此在社会上留下污名。尽管最近的重建技术进步改善了口腔康复,但下牙槽神经(IAN)的即刻重建尚未被广泛采用。目的:在此,我们试图讨论下颌大段缺损及相关 IAN 缺损的神经重建的创新,并介绍一个在圣地亚哥海军医疗中心(NMCSD)实施的病例:方法: 我们从现有的在线资源中查询了讨论使用自体神经采集和异体移植进行颌面部重建和神经修复的相关文献:结果:在过去三年中,有六名患者接受了使用加工过的神经异体移植物进行的 IAN 即刻重建术。结果:在过去三年中,有六名患者接受了使用加工神经异体移植的 IAN 即刻重建手术,所有患者都在手术后六个月内获得了 S3 的感觉:使用神经异体移植修复 IAN 并结合游离皮瓣重建治疗大面积下颌缺损是一种可行的治疗方法,应该成为颌面部重建的新范例,因为它在社会、功能和美学护理效果方面提供了可量化和质化的实质性改善。
{"title":"Immediate inferior alveolar nerve reconstruction: Improving warfighter quality of life following mandibulectomy or traumatic avulsion of the mandible.","authors":"Dan P Ho, Michael Andersen, Daniel Hammer","doi":"10.3233/NRE-230253","DOIUrl":"https://doi.org/10.3233/NRE-230253","url":null,"abstract":"<p><strong>Background: </strong>Mandibular reconstruction has historically been challenging due to the complex, highly functional, and esthetic nature of the anatomy. The most common etiologies of these defects requiring resection include trauma, benign tumors, and malignant pathology. Mandibular defects have been treated with little consideration for neural reconstruction, leaving patient's orally incompetent with associated social stigma. Although recent advances in reconstructive techniques improve oral rehabilitation, immediate inferior alveolar nerve (IAN) reconstruction has not been widely adapted.</p><p><strong>Objective: </strong>Here-in we seek to discuss the innovations of neural reconstruction of large segment mandibular defects and associated IAN defects and present an example case performed at Naval Medical Center San Diego (NMCSD).</p><p><strong>Methods: </strong>Pertinent literature discussing maxillofacial reconstruction and nerve repair using autogenous nerve harvest and allograft was queried from available online resources.</p><p><strong>Results: </strong>Six patients have received immediate reconstruction of the IAN using processed nerve allograft over the past three years. All obtained sensation to S3 within six months of surgery.</p><p><strong>Conclusion: </strong>IAN repair using nerve allografts in conjunction with free flap reconstruction for large mandibular defects is a viable treatment and should be the new paradigm in maxillofacial reconstruction as it provides substantial quantifiable and qualitative improvements in social, functional, and esthetic outcomes of care.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremy Landvater, Sharon Kim, Keenan Caswell, Caroline Kwon, Emamoke Odafe, Grace Roe, Ananya Tripathi, Christian Vukovics, Johnathan Wang, Keith Ryan, Victoria Cocozza, Matthew Brock, Zahari Tchopev, Brionn Tonkin, Vincent Capaldi, Jacob Collen, Jennifer Creamer, Muna Irfan, Emerson Wickwire, Scott Williams, J Kent Werner
Background: Traumatic brain injury (TBI) is a hallmark of wartime injury and is related to numerous sleep wake disorders (SWD), which persist long term in veterans. Current knowledge gaps in pathophysiology have hindered advances in diagnosis and treatment.
Objective: We reviewed TBI SWD pathophysiology, comorbidities, diagnosis and treatment that have emerged over the past two decades.
Methods: We conducted a literature review of English language publications evaluating sleep disorders (obstructive sleep apnea, insomnia, hypersomnia, parasomnias, restless legs syndrome and periodic limb movement disorder) and TBI published since 2000. We excluded studies that were not specifically evaluating TBI populations.
Results: Highlighted areas of interest and knowledge gaps were identified in TBI pathophysiology and mechanisms of sleep disruption, a comparison of TBI SWD and post-traumatic stress disorder SWD. The role of TBI and glymphatic biomarkers and management strategies for TBI SWD will also be discussed.
Conclusion: Our understanding of the pathophysiologic underpinnings of TBI and sleep health, particularly at the basic science level, is limited. Developing an understanding of biomarkers, neuroimaging, and mixed-methods research in comorbid TBI SWD holds the greatest promise to advance our ability to diagnose and monitor response to therapy in this vulnerable population.
{"title":"Traumatic brain injury and sleep in military and veteran populations: A literature review.","authors":"Jeremy Landvater, Sharon Kim, Keenan Caswell, Caroline Kwon, Emamoke Odafe, Grace Roe, Ananya Tripathi, Christian Vukovics, Johnathan Wang, Keith Ryan, Victoria Cocozza, Matthew Brock, Zahari Tchopev, Brionn Tonkin, Vincent Capaldi, Jacob Collen, Jennifer Creamer, Muna Irfan, Emerson Wickwire, Scott Williams, J Kent Werner","doi":"10.3233/NRE-230380","DOIUrl":"https://doi.org/10.3233/NRE-230380","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a hallmark of wartime injury and is related to numerous sleep wake disorders (SWD), which persist long term in veterans. Current knowledge gaps in pathophysiology have hindered advances in diagnosis and treatment.</p><p><strong>Objective: </strong>We reviewed TBI SWD pathophysiology, comorbidities, diagnosis and treatment that have emerged over the past two decades.</p><p><strong>Methods: </strong>We conducted a literature review of English language publications evaluating sleep disorders (obstructive sleep apnea, insomnia, hypersomnia, parasomnias, restless legs syndrome and periodic limb movement disorder) and TBI published since 2000. We excluded studies that were not specifically evaluating TBI populations.</p><p><strong>Results: </strong>Highlighted areas of interest and knowledge gaps were identified in TBI pathophysiology and mechanisms of sleep disruption, a comparison of TBI SWD and post-traumatic stress disorder SWD. The role of TBI and glymphatic biomarkers and management strategies for TBI SWD will also be discussed.</p><p><strong>Conclusion: </strong>Our understanding of the pathophysiologic underpinnings of TBI and sleep health, particularly at the basic science level, is limited. Developing an understanding of biomarkers, neuroimaging, and mixed-methods research in comorbid TBI SWD holds the greatest promise to advance our ability to diagnose and monitor response to therapy in this vulnerable population.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141910029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Austin R Miller, Sarah L Martindale, Jared A Rowland, Samuel Walton, Tomer Talmy, William C Walker
Background: A significant factor for the high prevalence of traumatic brain injury (TBI) among U.S. service members is their exposure to explosive munitions leading to blast-related TBI. Our understanding of the specific clinical effects of mild TBI having a component of blast mechanism remains limited compared to pure blunt mechanisms.
Objective: The purpose of this review is to provide a synopsis of clinical research findings on the long-term effects of blast-related mild TBI derived to date from the Long-Term Impact of Military-Relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC).
Methods: Publications on blast-related mild TBI from LIMBIC-CENC and the LIMBIC-CENC prospective longitudinal study (PLS) cohort were reviewed and their findings summarized. Findings from the broader literature on blast-related mild TBI that evaluate similar outcomes are additionally reviewed for a perspective on the state of the literature.
Results: The most consistent and compelling evidence for long-term effects of blast-related TBI is for poorer psychological health, greater healthcare utilization and disability levels, neuroimaging impacts on brain structure and function, and greater headache impact on daily life. To date, evidence for chronic cognitive performance deficits from blast-related mild TBI is limited, but futher research including crucial longitudinal data is needed.
Conclusion: Commentary is provided on: how LIMBIC-CENC findings assimilate with the broader literature; ongoing research gaps alongside future research needs and priorities; how the scientific community can utilize the LIMBIC-CENC database for independent or collaborative research; and how the evidence from the clinical research should be assimilated into clinical practice.
{"title":"Blast-related mild TBI: LIMBIC-CENC focused review with implications commentary.","authors":"Austin R Miller, Sarah L Martindale, Jared A Rowland, Samuel Walton, Tomer Talmy, William C Walker","doi":"10.3233/NRE-230268","DOIUrl":"https://doi.org/10.3233/NRE-230268","url":null,"abstract":"<p><strong>Background: </strong>A significant factor for the high prevalence of traumatic brain injury (TBI) among U.S. service members is their exposure to explosive munitions leading to blast-related TBI. Our understanding of the specific clinical effects of mild TBI having a component of blast mechanism remains limited compared to pure blunt mechanisms.</p><p><strong>Objective: </strong>The purpose of this review is to provide a synopsis of clinical research findings on the long-term effects of blast-related mild TBI derived to date from the Long-Term Impact of Military-Relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC).</p><p><strong>Methods: </strong>Publications on blast-related mild TBI from LIMBIC-CENC and the LIMBIC-CENC prospective longitudinal study (PLS) cohort were reviewed and their findings summarized. Findings from the broader literature on blast-related mild TBI that evaluate similar outcomes are additionally reviewed for a perspective on the state of the literature.</p><p><strong>Results: </strong>The most consistent and compelling evidence for long-term effects of blast-related TBI is for poorer psychological health, greater healthcare utilization and disability levels, neuroimaging impacts on brain structure and function, and greater headache impact on daily life. To date, evidence for chronic cognitive performance deficits from blast-related mild TBI is limited, but futher research including crucial longitudinal data is needed.</p><p><strong>Conclusion: </strong>Commentary is provided on: how LIMBIC-CENC findings assimilate with the broader literature; ongoing research gaps alongside future research needs and priorities; how the scientific community can utilize the LIMBIC-CENC database for independent or collaborative research; and how the evidence from the clinical research should be assimilated into clinical practice.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul Olowoyo, Rajinder K Dhamija, Mayowa O Owolabi
Background: Telerehabilitation as a new subdiscipline of telehealth is the application of information technology to support and deliver rehabilitation services via two-way or multipoint interactive online telecommunication technology. This enables the therapist to optimize the timing, intensity, and duration of therapy which is often not possible within the constraints of face-to-face treatment protocols in current health systems.
Objective: To review the historical perspective and conceptual framework of telerehabilitation in neurological disorders.
Methods: A narrative review of the literature was performed for the historical perspective and a systematic review of the conceptual framework was performed using the PRISMA guidelines on chronic neurological disorders; multiple sclerosis, spinal cord injury, stroke, Parkinson's disease, cognitive impairment, and headaches. The search included articles from the past 20 years (2004 to 2024).
Results: Telerehabilitation dates back to the 1960s and early 1970s. Documented effective interventions were mostly on therapies for speech disorders. The conceptual framework consisted of three major components of telerehabilitation programmes including development, implementation, and evaluation. The COVID-19 pandemic suddenly made telerehabilitation come to the limelight because physical distancing became necessary. Out of the 110,000 articles downloaded, 43 met the inclusion criteria for review on the conceptual framework of telerehabilitation in relation to neurological disorders. The articles discussed multiple sclerosis (2), spinal cord disorders (1), stroke (17), Parkinson's disease (15), headaches (3), and cognitive disorders (5). All articles reviewed assessed the effectiveness of telemedicine except for the articles on multiple sclerosis and spinal cord disorders which examined the interphase between the technology and the end users.
Conclusion: The future of telerehabilitation looks promising with the subsequent integration of innovative tools and applications. This will require the adaption of technology, continuous capacity building, education, and training of healthcare professionals to ensure that they are adequately equipped with the necessary skills to provide quality virtual reality rehabilitation care.
{"title":"Telerehabilitation - historical perspectives and conceptual framework in reference to neurological disorders: A narrative review.","authors":"Paul Olowoyo, Rajinder K Dhamija, Mayowa O Owolabi","doi":"10.3233/NRE-240079","DOIUrl":"https://doi.org/10.3233/NRE-240079","url":null,"abstract":"<p><strong>Background: </strong>Telerehabilitation as a new subdiscipline of telehealth is the application of information technology to support and deliver rehabilitation services via two-way or multipoint interactive online telecommunication technology. This enables the therapist to optimize the timing, intensity, and duration of therapy which is often not possible within the constraints of face-to-face treatment protocols in current health systems.</p><p><strong>Objective: </strong>To review the historical perspective and conceptual framework of telerehabilitation in neurological disorders.</p><p><strong>Methods: </strong>A narrative review of the literature was performed for the historical perspective and a systematic review of the conceptual framework was performed using the PRISMA guidelines on chronic neurological disorders; multiple sclerosis, spinal cord injury, stroke, Parkinson's disease, cognitive impairment, and headaches. The search included articles from the past 20 years (2004 to 2024).</p><p><strong>Results: </strong>Telerehabilitation dates back to the 1960s and early 1970s. Documented effective interventions were mostly on therapies for speech disorders. The conceptual framework consisted of three major components of telerehabilitation programmes including development, implementation, and evaluation. The COVID-19 pandemic suddenly made telerehabilitation come to the limelight because physical distancing became necessary. Out of the 110,000 articles downloaded, 43 met the inclusion criteria for review on the conceptual framework of telerehabilitation in relation to neurological disorders. The articles discussed multiple sclerosis (2), spinal cord disorders (1), stroke (17), Parkinson's disease (15), headaches (3), and cognitive disorders (5). All articles reviewed assessed the effectiveness of telemedicine except for the articles on multiple sclerosis and spinal cord disorders which examined the interphase between the technology and the end users.</p><p><strong>Conclusion: </strong>The future of telerehabilitation looks promising with the subsequent integration of innovative tools and applications. This will require the adaption of technology, continuous capacity building, education, and training of healthcare professionals to ensure that they are adequately equipped with the necessary skills to provide quality virtual reality rehabilitation care.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: U.S. Special Operations Forces (SOF) are at increased risk of multiple mild traumatic brain injury (mmTBI). Testosterone was prescribed for several participants in a VA program designed to address sequelae of mmTBI for SOF.
Objective: To determine testosterone prevalence in the Palo Alto VA Intensive Evaluation and Treatment Program (IETP) and observe for association between testosterone and neurobehavioral outcomes.
Methods: A retrospective cohort study included patients in the Palo Alto VA IETP. Sociodemographic data, testosterone blood levels, and neurobehavioral outcomes were collected from medical records.
Results: 55 IETP participants were included: six were testosterone users; the rest were classified as non-users. Testosterone use in this population is 11%, higher than reported national averages in the U.S. Of the 6 testosterone users, 2 (33%) had a formal diagnosis of hypogonadism prior to initiation of testosterone. Neurobehavioral outcome scores between testosterone users and non-users failed to show statistically significant differences, except for the PROMIS pain score, which was higher in the testosterone user population.
Conclusion: The current study did not find an association between mmTBI, testosterone use, or testosterone level and neurobehavioral outcomes. This study highlights a need to further examine the relationship between hypogonadism, mmTBI, SOF culture around testosterone, and the effects of testosterone use in this population.
{"title":"Testosterone and neurobehavioral outcomes in special operations forces military with multiple mild traumatic brain injury.","authors":"Nathan Barnett, Milica Ljubic, Joyce Chung, Allison Capizzi","doi":"10.3233/NRE-230291","DOIUrl":"https://doi.org/10.3233/NRE-230291","url":null,"abstract":"<p><strong>Background: </strong>U.S. Special Operations Forces (SOF) are at increased risk of multiple mild traumatic brain injury (mmTBI). Testosterone was prescribed for several participants in a VA program designed to address sequelae of mmTBI for SOF.</p><p><strong>Objective: </strong>To determine testosterone prevalence in the Palo Alto VA Intensive Evaluation and Treatment Program (IETP) and observe for association between testosterone and neurobehavioral outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study included patients in the Palo Alto VA IETP. Sociodemographic data, testosterone blood levels, and neurobehavioral outcomes were collected from medical records.</p><p><strong>Results: </strong>55 IETP participants were included: six were testosterone users; the rest were classified as non-users. Testosterone use in this population is 11%, higher than reported national averages in the U.S. Of the 6 testosterone users, 2 (33%) had a formal diagnosis of hypogonadism prior to initiation of testosterone. Neurobehavioral outcome scores between testosterone users and non-users failed to show statistically significant differences, except for the PROMIS pain score, which was higher in the testosterone user population.</p><p><strong>Conclusion: </strong>The current study did not find an association between mmTBI, testosterone use, or testosterone level and neurobehavioral outcomes. This study highlights a need to further examine the relationship between hypogonadism, mmTBI, SOF culture around testosterone, and the effects of testosterone use in this population.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}