Neuropsychological Rehabilitation最新文献

Background: Recent research has shown the effectiveness of computerized therapy in the treatment of anomia in patients with aphasia. Multisensory stimulation, the use of various types of aids for lexical access, and immediate feedback favor this type of therapy. In the present study, the Computer-assisted Anomia Rehabilitation Program (CARP2) was applied.Aims: This study was designed to verify the efficacy of CARP2 in naming, to analyze the changes in terms of correct responses and types of errors according to the type of anomia, and to verify whether changes were generalized to the processes and skills involved in naming.Methods & Procedures: Ten people with aphasia were treated for 25 weeks; four had lexical anomia, two phonological anomia, and four semantic anomia. Neuropsychological assessment was conducted pre- and post-treatment.Outcomes & Results: The patients increased their effectiveness in naming, reducing, or modifying the type of error. Generalization effect of benefits is predominant.Conclusions: The study's findings suggest the potential efficacy of the CARP2 program. This therapy might be beneficial across anomia types, although generalization of treatment gains appears somewhat restricted in the case of semantic anomia.

Apathy is a recognized neuropsychiatric syndrome in individuals with traumatic brain injury (TBI) with far-reaching consequences, including reduced independence, meaningful activities and quality of life. However, previous studies have reported variable prevalence rates and no meta-analysis has synthesized prevalence findings and identified moderators of apathy in clinical populations. We conducted a pre-registered meta-analysis (PROSPERO CRD42024552306), searching three databases (MEDLINE, EMBASE, and APA PsycInfo) for primary studies assessing apathy in individuals with TBI. 18 studies met inclusion criteria, and data were extracted for meta-analysis to estimate the pooled prevalence of apathy. Subgroup analyses and meta-regressions explored the influence of potential moderating factors including demographic characteristics, injury-related factors, and methods of apathy assessment. The meta-analysis found the prevalence of apathy following TBI to be 37.6% [95% CI 28.5-47.2%]. Key moderators included cause of injury, TBI severity, sex and population type. Specifically, transport accidents were associated with higher apathy prevalence, while mild TBI, male sex, and veteran status were associated with lower apathy prevalence. Apathy is a prevalent and significant symptom following TBI, affecting over one-third of individuals in the reviewed studies. These findings highlight the need for increased clinical focus on apathy as an important aspect of TBI recovery.

Belonging to a minority ethnic background affects access to health and social care services. The sparse research available has been one of the factors limiting our understanding of this problem. Within the UK, there appear to be no published data around referral patterns of ethnic minority groups for inpatient neurorehabilitation following a brain injury. This study used Freedom of Information (FOI) requests to obtain data around rehabilitation referral patterns across England. Of the 42 Integrated Care Boards (ICB) approached, 35 responded. Data on ethnicity of the population served was provided in 30 (71%) cases. Information on referrals to inpatient neurorehabilitation was provided by 23 (66%) of the respondents, but a breakdown of the ethnicity of the referrals was only available for seven ICB's (30%), and the largest category of ethnicity on record was "unknown", or "undeclared." There are barriers to the capture and reporting of ethnic information, particularly for minority groups, but uncertainty as to whether this stems from patients' choice or reluctance in disclosing this, or from the minimum data capture requirements within services, or both. The absence of these data prevents the development of improvement strategies to audit and mitigate drivers of inequality.

Rehabilitation during community integration after acquired brain injury (ABI) focuses on supporting individuals to make sense of and manage injury-related changes in the context of occupational engagement. To improve understanding of the role of rehabilitation in facilitating early adjustment to ABI, the study aimed to understand individuals' rehabilitation priorities and expectations at hospital discharge and experiences at 3-months post-discharge. Semi-structured interviews were conducted with adults with ABI at discharge (n = 28) and 3-months post-discharge (n = 24) from a brain injury rehabilitation unit in Queensland, Australia. Data were thematically analysed using the Framework Method. Analysis identified an overarching theme of "Supporting self-continuity," comprising three interrelated themes. "Life's getting back on track" represented individuals' priority to access ongoing contextualized rehabilitation, enabling resumption of valued activities and roles. "My life on pause" reflected uncertainty about post-discharge processes for resuming occupations and feeling restricted by limitations and support gaps. "Collaborative fit: Matching my needs″, depicting the alignment between individual's mindset and expectations of life after ABI and personalization of rehabilitation services, and was central to self-continuity. Following discharge, collaborative fit between people with ABI and support systems is central to supporting self-continuity through enabling engagement in activities and roles important to self-identity.

Cognitive symptoms are common after mild traumatic brain injury (mTBI) and can interfere with return to work. Factors underlying these symptoms are poorly understood. This prospective observational study explored relationships between illness perceptions, coping style, and cognitive symptom reporting in mTBI, including when controlling for sex and psychological distress. Individuals with mTBI (n = 70) and trauma controls (n = 42) were assessed 6-10 weeks post-injury. Measures included the Brief-COPE, the Illness Perceptions Questionnaire-Revised (IPQ-R), and subjective cognitive and post-concussion symptom scales. Six of the nine IPQ-R subscales showed robust bivariate correlations with cognitive symptoms in the mTBI group (|r| = .24-.55). Illness perceptions contributed to cognitive symptom reporting over and above the effects of sex and psychological distress (F(2,64) = 4.12, p = .021); significant, robust independent predictors were psychological distress (β = .344, p = .003), and IPQ-Consequences (β = .276, p = .025). Relationships with general post-concussion symptoms, and in trauma controls, were also explored. This research demonstrates that illness perceptions have important relationships with cognitive symptoms after mTBI, which persist when controlling for pre-established predictors of these symptoms. This indicates that illness perceptions are a unique predictor of cognitive symptoms after mTBI and suggests that, alongside psychological distress, these perceptions may be a useful target for intervention in individuals with prolonged recovery.

Background: Despite the profound impact of "brain fog" and/or cognitive impairment in relatively young people with Long COVID, no interventions with demonstrated efficacy are currently available. We conducted a pilot randomized controlled trial investigating the preliminary outcomes of a cognitive rehabilitation (CR) intervention adapted for persons with post-COVID cognitive impairment.

Methods: Participants were ≥18 years of age, English-speaking, had history of SARS-CoV-2, and had cognitive impairment on objective measures. Eligible participants were randomized to a 12-week CR intervention or a time - and attention-matched control arm. Objective and subjective cognitive functioning was assessed at pre - and within 2-weeks post-intervention, utilizing validated neuropsychological measures across multiple domains. We compared pre vs. post intervention changes in cognitive scores in intervention vs. control groups.

Results: The mean change in the intervention group compared to the controls in measures of processing speed, learning, memory, language, and of executive function did not reach the threshold for futility. In comparison to controls, the intervention group self-reported significant improvements in cognitive functioning.

Conclusions: We found that an adapted CR intervention for Long COVID may improve post-COVID cognitive impairment in comparison to a time - and attention-matched control group and should be evaluated in a larger trial.

Trial registration: ClinicalTrials.gov identifier: NCT05498493. Registered on 08/10/2022.

The Depression Intensity Scale Circles (DISCs) is a visual self-report depression screening tool that has been designed specifically for people with moderate-to-severe cognitive or communicative impairment. This scoping review aimed to systematically map research on the DISCs, drawing conclusions about its reliability, validity, and utilization in research and clinical practice. A literature search from 2004 - July 2024 was conducted using 9 databases. Thirty-six sources met inclusion criteria of mentioning "Depression Intensity Scale Circles" in their abstract or full text (15 published literature, 12 grey literature, and 9 social media posts). Only three sources formally studied the psychometric properties of the DISCs. Taken together, their results suggested that the DISCs has stronger predictive validity than reported in previous systematic reviews. While promising, these results should be interpreted cautiously due to the limited research available. Despite limited research, we found that the DISCs continues to be recommended and included into guidelines for depression screening, especially in in-patient stroke settings in the UK. The need for further research into the psychometric properties of the DISCs is identified. The trade-off in clinical settings between psychometric validity and clinical utility when working with individuals with cognitive and communication impairments is highlighted.

Research on social support following sport-related concussion (SRC) has largely been examined from the athlete perspective. This qualitative study explored social support interactions during recovery following SRC. We conducted semi-structured interviews with six athletes and 16 individuals who were identified as being part of the athletes' social support network (e.g., teammates, friends, or family members). All 22 participants in this study completed a timeline mapping activity, which allowed participants to share details about the athletes' SRC recovery, including the type and timing of support provided and received. Using thematic analysis, we found three themes. First, we found that social support was optimal when perceptions of social support were aligned (e.g., delivery and perceived impact on recovery). Second, we found several instances where challenges arose in the social support relationships, often stemming from incongruent perspectives (e.g., expectations and perceptions of support differed). Third, members of the support network described some of the barriers they faced when attempting to provide social support to athletes. Overall, these results add to the literature by demonstrating the good (aligned perspectives), the bad (incoherent perspectives), and the challenges with the social support relationships following SRC from the perspective of athletes and members of their support network.

To establish reliability and construct validity of a Norwegian version of the social cognition test, the Awareness of Social Inference Test (N-TASIT). Participants with traumatic brain injury (TBI; n = 101) and 50 matched healthy controls performed either a virtual reality (VR) or 2D version of N-TASIT at baseline and 16 weeks later. Reliability measures were test-retest reliability and internal consistency. Intraclass correlation (ICC) and Cronbach's alpha (α) were calculated for the overall sample and both groups separately. Construct validity was tested with known groups validity, convergent and discriminant validity. Known groups analysis was conducted for both versions separately and combined. Convergent and discriminant validity were determined by associations between N-TASIT and established measures of social cognition and with measures of cognition, emotional distress and fatigue. ICC for the total sample was 0.63 (95% CI 0.49-0.73), and α was 0.88, when presentation modes (VR and 2D) were combined. The healthy control group outperformed the TBI group in both presentation modes. Medium-to-large associations were found between N-TASIT performance and social cognitive measures, and mostly weak or no significant correlations with non-social domains. N-TASIT appears psychometrically sound and comparable to the original. The influence of presentation mode on performance remains unclear.

More research is needed on suicidal ideation (SI) and self-harm (SH) following moderate-severe traumatic brain injury (TBI). Previous studies have shown limited, inconsistent associations with demographic and injury factors and relied on diagnosis-specific analyses of psychiatric factors. This cross-sectional survey included 387 individuals with moderate-severe TBI and examined correlations between SI, SH, and 35 other variables, including a series of transdiagnostic internalizing symptom dimensions. In the previous two weeks, 21% of participants reported SI and 5% reported SH, both generally at mild levels. While demographic and injury factors showed minimal associations, SI and SH were significantly correlated with higher internalizing symptoms, greater disability, and lower life satisfaction. Elastic net regression was used to select the most important correlates, including core negative affect (e.g., depressed mood), post-traumatic intrusion, obsessive-compulsive, and low positive affect symptoms. While each significantly explained only a small amount of unique variance (<1-7%), their combination accounted for 50% and 31% of the variance in SI and SH, respectively. We identified a transdiagnostic profile that may help guide assessment and treatment of SI and SH in individuals with moderate-severe TBI. Future research should aim to distinguish SH with and without suicidal intent and incorporate a control group.