ORCID Profile
0000-0001-8957-8594
Current Organisation
University of Adelaide
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Publisher: Informa UK Limited
Date: 04-1999
DOI: 10.1076/JCEN.21.2.200.930
Abstract: This study compared the emotional functioning and cognitive abilities (i.e., verbal fluency, executive functioning, memory, and attention) of 27 patients with mild traumatic brain injury (MTBI) to that of 27 controls. With the exception of verbal fluency, the cognitive abilities of the MTBI group appeared to be intact. Emotional functioning was assessed using the Neuropsychology Behavior and Affect Profile (NBAP), a revised version of the Neurobehavioural Rating Scale and the Headley Court Psychosocial Rating Scale. The NBAP demonstrated good internal reliability, criterion validity, and construct validity. The MTBI group showed significantly higher levels of post injury depression than controls on the NBAP. Pre injury levels of depression in the MTBI group were also higher than the controls but both the patient reports and those of family members confirmed an increase in depression following MTBI.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.AAP.2012.06.028
Abstract: Motor vehicle crashes involving rural drivers aged 75 years and over are more than twice as likely to result in a serious or fatal injury as those involving their urban counterparts. The current study examined some of the reasons for this using a database of police-reported crashes (2004-2008) to identify the environmental (lighting, road and weather conditions, road layout, road surface, speed limit), driver (driver error, crash type), and vehicle (vehicle age) factors that are associated with the crashes of older rural drivers. It also determined whether these same factors are associated with an increased likelihood of serious or fatal injury in younger drivers for whom frailty does not contribute to the resulting injury severity. A number of environmental (i.e., un ided, unsealed, curved and inclined roads, and areas with a speed limit of 100km/h or greater) and driver (i.e., collision with a fixed object and rolling over) factors were more frequent in the crashes of older rural drivers and additionally associated with increased injury severity in younger drivers. Moreover, when these environmental factors were entered into a logistic regression model to predict whether older drivers who were involved in crashes did or did not sustain a serious or fatal injury, it was found that each factor independently increased the likelihood of a serious or fatal injury. Changes, such as the provision of ided and sealed roads, greater protection from fixed roadside objects, and reduced speed limits, appear to be indicated in order to improve the safety of the rural driving environment for drivers of all ages. Additionally, older rural drivers should be encouraged to reduce their exposure to these risky circumstances.
Publisher: American Psychological Association (APA)
Date: 2014
DOI: 10.1037/NEU0000025
Abstract: The purpose of this study was to examine the relationship between subjective and objective assessments of memory and attention in people with chronic fatigue syndrome (CFS), using tests that have previously detected deficits in CFS s les and measures of potential confounds. Fifty people with CFS and 50 healthy controls were compared on subjective (memory and attention symptom severity, Cognitive Failures Questionnaire, Everyday Attention Questionnaires) and objective (California Verbal Learning Test, Rey-Osterreith Complex Figure Test, Paced Auditory Serial Addition Test, Stroop task) measures of memory and attention. Fatigue, sleep, depression, and anxiety were also assessed. The CFS group reported experiencing more cognitive problems than the controls, but the two groups did not differ on the cognitive tests. Scores on the subjective and objective measures were not correlated in either group. Depression was positively correlated with increased severity of cognitive problems in both the CFS and control groups. There is little evidence for a relationship between subjective and objective measures of cognitive functioning for both people with CFS and healthy controls, which suggests that they may be capturing different constructs. Problems with memory and attention in everyday life are a significant part of CFS. Depression appears to be related to subjective problems but does not fully explain them.
Publisher: Cambridge University Press (CUP)
Date: 05-01-2010
DOI: 10.1017/S0033291709992054
Abstract: Cognitive problems are commonly reported in persons with chronic fatigue syndrome (CFS) and are one of the most disabling symptoms of this condition. A number of cognitive deficits have been identified, although the findings are inconsistent and hindered by methodological differences. The current study therefore conducted a meta-analysis of research examining cognitive functioning in persons with CFS in order to identify the pattern and magnitude of any deficits that are associated with this condition. A comprehensive search of the PubMed and PsycINFO databases for studies that examined cognitive functioning in CFS between 1988 and 2008 identified 50 eligible studies. Weighted Cohen's d effect sizes, 95% confidence intervals and fail-safe N s were calculated for each cognitive score. Evidence of cognitive deficits in persons with CFS was found primarily in the domains of attention, memory and reaction time. Deficits were not apparent on tests of fine motor speed, vocabulary, reasoning and global functioning. Persons with CFS demonstrate moderate to large impairments in simple and complex information processing speed and in tasks requiring working memory over a sustained period of time.
Publisher: American Psychological Association (APA)
Date: 2016
DOI: 10.1037/NEU0000221
Abstract: Anxiety following a traumatic brain injury (TBI) is a common problem however, disparate prevalence estimates limit the clinical utility of research. The purpose of the current study was to examine how differences in methodological variables and s le characteristics impact on the prevalence of anxiety. Data from 41 studies that examined either the prevalence of generalized anxiety disorder (GAD) diagnoses or clinically significant "cases" of self-reported anxiety following adult, nonpenetrating TBI were analyzed, and the impact of diagnostic criteria, measure, postinjury interval and injury severity was evaluated. Overall, 11% of people were diagnosed with GAD and 37% reported clinically significant levels of anxiety following TBI. Prevalence estimates varied for different diagnostic criteria (range: 2%-19%), interview schedules (range: 2%-28%), and self-report measures (range: 36%-50%). GAD and "cases" of anxiety were most prevalent 2 to 5 years postinjury. The rates of GAD increased with injury severity (mild: 11%, severe 15%), but "cases" decreased (mild: 53%, severe: 38%), although neither difference was significant. Anxiety is common after a TBI and ongoing monitoring and treatment should be provided. Methodological and s le characteristics should be clear and well-defined, as differences across studies (e.g., how anxiety is conceptualized, which measure is used, time since injury, injury severity) impact prevalence rates.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.NEUBIOREV.2015.06.001
Abstract: Brain/biological (BR) and cognitive/neural reserve (CR) have increasingly been used to explain some of the variability that occurs as a consequence of normal ageing and neurological injuries or disease. However, research evaluating the impact of reserve on outcomes after adult traumatic brain injury (TBI) has yet to be quantitatively reviewed. This meta-analysis consolidated data from 90 studies (published prior to 2015) that either examined the relationship between measures of BR (genetics, age, sex) or CR (education, premorbid IQ) and outcomes after TBI or compared the outcomes of groups with high and low reserve. The evidence for genetic sources of reserve was limited and often contrary to prediction. APOE ∈4 status has been studied most, but did not have a consistent or sizeable impact on outcomes. The majority of studies found that younger age was associated with better outcomes, however most failed to adjust for normal age-related changes in cognitive performance that are independent of a TBI. This finding was reversed (older adults had better outcomes) in the small number of studies that provided age-adjusted scores although it remains unclear whether differences in the cause and severity of injuries that are sustained by younger and older adults contributed to this finding. Despite being more likely to sustain a TBI, males have comparable outcomes to females. Overall, as is the case in the general population, higher levels of education and pre-morbid IQ are both associated with better outcomes.
Publisher: Future Medicine Ltd
Date: 10-2016
Abstract: Aims: To evaluate the safety and efficacy of cell therapies administered acutely/sub-acutely after stroke. Methods: Five databases were searched for studies examining the safety/efficacy of cell therapies administered ≤90 days post-stroke. Reporting quality and adherence to research guidelines were evaluated. Safety and efficacy were assessed using risk ratios ooled incidence rates and Hedge's g, respectively. Results: 11 therapies (N studies = 28) were trialed: reporting quality was high, but adherence to guidelines low. Serious adverse events were observed following five treatments six improved outcomes. There was a trend toward larger treatment effects in non-blinded studies, younger participants, and higher dosages. Conclusion: Although a number of therapies appear effective, many studies did not control for normal recovery (standard-care). Long-term safety also needs to be established.
Publisher: Mary Ann Liebert Inc
Date: 04-2014
Publisher: S. Karger AG
Date: 2008
DOI: 10.1159/000121948
Publisher: SAGE Publications
Date: 09-1992
DOI: 10.3109/00048679209072074
Abstract: This study describes the prevalence of emotional and behavioural problems in the offspring of parents who are members of the Obsessive-Compulsive Neurosis Support Group in South Australia. The results suggest that the offspring of adults with obsessive-compulsive disorder do not have more problems than other children and adolescents in the community. The study also highlights potential benefits of collaborative research conducted by research groups and self-help organisations.
Publisher: Informa UK Limited
Date: 04-2005
DOI: 10.1080/02699050400005028
Abstract: To examine prospective and declarative memory problems following moderate and severe traumatic brain injury (TBI) and the relationship between prospective memory (PM) and declarative memory and PM and other cognitive functions. The performance of persons who suffered a TBI (n = 25) was compared with that of a demographically matched control group (n = 25). Measures of time- and event-based PM, visual and verbal declarative memory, attention and executive functioning were administered to both groups. The group with a TBI performed more poorly on event- and time-based PM, verbal declarative memory, certain aspects of attention and executive functioning. The correlations between the measures of PM, declarative memory and the other cognitive tests were all non-significant. Problems with declarative memory, attention, and executive functioning do not adequately account for poorer PM performance following a TBI, suggesting that PM should also be assessed following TBI.
Publisher: American Psychological Association (APA)
Date: 03-2013
DOI: 10.1037/A0032084
Abstract: To examine cognitive deficits in people with chronic fatigue syndrome (CFS) and their relationship to psychological status, CFS symptoms, and everyday functioning. The current study compared the cognitive performance (reaction time, attention, memory, motor functioning, verbal abilities, and visuospatial abilities) of a s le with CFS (n = 50) with that of a s le of healthy controls (n = 50), all of whom had demonstrated high levels of effort and an intention to perform well, and examined the extent to which psychological status, CFS symptoms, and everyday functioning were related to cognitive performance. The CFS group showed impaired information processing speed (reaction time), relative to the controls, but comparable performance on tests of attention, memory, motor functioning, verbal ability, and visuospatial ability. Moreover, information processing speed was not related to psychiatric status, depression, anxiety, the number or severity of CFS symptoms, fatigue, sleep quality, or everyday functioning. A slowing in information processing speed appears to be the main cognitive deficit seen in persons with CFS whose performance on effort tests is not compromised. Importantly, this slowing does not appear to be the consequence of other CFS-related variables, such as depression and fatigue, or motor speed.
Publisher: Elsevier BV
Date: 05-2995
DOI: 10.1016/J.GENHOSPPSYCH.2015.02.004
Abstract: Delirium is common in older adults following total joint replacement (TJR) of the hip and knee. However, reports of the incidence of delirium vary widely, limiting their usefulness. The current meta-analysis therefore examined (1) the incidence of delirium in older patients who underwent TJR and (2) whether these rates vary according to the (a) joint (hip/knee replacement), (b) inclusion/exclusion of patients who underwent simultaneous bilateral surgery, (c) inclusion/exclusion of patients with preexisting cognitive impairments, (d) type of anesthesia (regional/general), (e) method/frequency of assessment, and (f) postoperative interval. Data from 24 studies (2,895 patients) that measured postsurgical delirium following TJR were analyzed. Mean weighted proportions were calculated using a random-effects model to assess the overall incidence of delirium and whether the rate varied according to the aforementioned variables. Overall, 17% of patients who underwent TJR developed delirium during hospital admission. In idual estimates varied from 0% to 82%, but this variability was not adequately explained by the variables that were examined. Delirium is relatively common following TJR however, it remains unclear why in idual estimates vary so widely. Health professionals working with these patients should remain alert to the presentation, diagnosis and management of delirium to optimize postsurgical outcomes.
Publisher: American Psychological Association (APA)
Date: 2009
DOI: 10.1037/A0015384
Abstract: Differentiating between Alzheimer's disease (AD) and vascular dementia (VaD) remains difficult but important if existing pharmacological treatments are to provide symptomatic relief in the case of AD or to alter disease progression in the case of VaD. Cognitive assessments play an important role in aiding diagnosis, despite a lack of clear evidence defining the cognitive abilities and tests that best distinguish between the two types of dementia. The current study therefore completed a meta-analysis of research comparing the cognitive abilities of persons diagnosed with AD and VaD. A comprehensive search was undertaken of the PubMed and PsychInfo databases, with 81 studies being eligible for inclusion. Weighted Cohen's d effect sizes, percentage overlap statistics, fail-safe Ns, and confidence intervals were calculated for all cognitive tests. Of the tests that were examined by more than one study, there was one test of perception and one test of verbal memory that showed large and significant group differences. There were an additional 12 tests that may prove useful. However, all cognitive tests were limited in their ability to discriminate between AD and VaD, suggesting that they should be used cautiously and only in conjunction with other information (imaging, medical history) when diagnosing patients.
Publisher: Oxford University Press (OUP)
Date: 06-2015
DOI: 10.1111/PME.12723
Abstract: To document staffing (medical, nursing, allied health [AH], administrative) in Australian multidisciplinary persistent pain services and relate them to clinical activity levels. Of the 68 adult outpatient persistent pain services approached (Dec'08-Jan'10), 45 agreed to participate, received over 100 referrals/year, and met the contemporaneous International Association for the Study of Pain criteria for Level 1 or 2 multidisciplinary services. Structured interviews with Clinical Directors collected quantitative data regarding staff resources (disciplines, amount), services provided, funding models, and activity levels. Compared with Level 2 clinics, Level 1 centers reported higher annual demand (referrals), clinical activity (patient numbers) and absolute numbers of medical, nursing and administrative staff, but comparable numbers of AH staff. When staffing was assessed against activity levels, medical and nursing resources were consistent across services, but Level 1 clinics had relatively fewer AH and administrative staff. Metropolitan and rural services reported comparable activity levels and discipline-specific staff ratios (except occupational therapy). The mean annual AH staffing for pain management group programs was 0.03 full-time equivalent staff per patient. Reasonable consistency was demonstrated in the range and mix of most disciplines employed, suggesting they represented workable clinical structures. The greater number of medical and nursing staff within Level 1 clinics may indicate a lower multidisciplinary focus, but this needs further exploration. As the first multidisciplinary staffing data for persistent pain clinics, this provides critical information for designing and implementing clinical services. Mapping against clinical outcomes to demonstrate the impact of staffing patterns on safe and efficacious treatment delivery is required.
Publisher: Cambridge University Press (CUP)
Date: 16-09-2022
DOI: 10.1017/S1355617722000479
Abstract: Cognitive impairment affects older adults’ capacity to live independently and make lifestyle decisions (lifestyle decision-making capacity LS-DMC). Cognitive screens and clinical interviews are often used to assess people’s need for living-supports prior to conducting comprehensive LS-DMC assessments in busy clinical settings. This study investigated whether the QuickSort – a brief new cognitive screen – provides efficient and accurate information regarding patients’ LS-DMC when initially interviewed. This is an observational and diagnostic accuracy study of older inpatients (≥60 years) consecutively referred for neuropsychological assessment of LS-DMC ( n = 124). The resources required by inpatients with questionable LS-DMC were quantified (length of hospital stay, living-supports). QuickSort scores, patient background information, and two common cognitive screens were used to differentiate between older inpatients ( n = 124) who lacked (64%)/did not-lack (36%) LS-DMC. Hospitalizations averaged 49 days, with 62% of inpatients being readmitted within one year. The QuickSort differentiated between those lacking/not-lacking LS-DMC better than two common cognitive screens and patient information. The likelihood that inpatients lacked LS-DMC increased by a factor of 65.26 for QuickSort scores and reduced by a factor of 0.32 for scores ≥13. Modeling revealed that the post-test likelihood of lacking LS-DMC increased to 99% (scores ) and reduced to 30% (scores ≥ 13) in settings where many inpatients lack LS-DMC. Older adult inpatients with questionable LS-DMC have a high risk of extended hospitalization and readmission. The QuickSort provides time-efficient and sensitive information regarding patients’ LS-DMC, making it a viable alternative to longer cognitive screens that are used at the initial interview stage.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.NEUBIOREV.2014.07.007
Abstract: Depression is one of the most frequently reported psychological problems following TBI, however prevalence estimates vary widely. Methodological and s ling differences may explain some of this variability, but it is not known to what extent. Data from 99 studies examining the prevalence of clinically diagnosed depression (MDD/dysthymia) and self-reports of depression (clinically significant cases or depression scale scores) following adult, non-penetrating TBI were analysed, taking into consideration diagnostic criteria, measure, post-injury interval, and injury severity. Overall, 27% of people were diagnosed with MDD/dysthymia following TBI and 38% reported clinically significant levels of depression when assessed with self-report scales. Estimates of MDD/dysthymia varied according to diagnostic criteria (ICD-10: 14% DSM-IV: 25% DSM-III: 47%) and injury severity (mild: 16% severe: 30%). When self-report measures were used, the prevalence of clinically significant cases of depression differed between scales (HADS: 32% CES-D: 48%) method of administration (phone: 26% mail 46%), post-injury interval (range: 33-42%), and injury severity (mild: 64% severe: 39%). Depression is very common after TBI and has the potential to impact on recovery and quality of life. However, the diagnostic criteria, measure, time post-injury and injury severity, all impact on prevalence rates and must therefore be considered for benchmarking purposes.
Publisher: American Psychological Association (APA)
Date: 2011
DOI: 10.1037/A0022249
Abstract: The delivery of mental health services by telephone, referred to as telecounseling, has the potential to improve the health outcomes of adults with an acquired physical disability in a cost-effective way. However, the efficacy of this form of treatment requires further evaluation before it is used on a larger scale. This meta-analysis provides a critical and quantitative evaluation of the impact of telephone-administered psychological interventions on the psychosocial functioning of adults with an acquired physical disability caused by spinal cord injury, limb utation, severe burn injury, stroke, or multiple sclerosis. A comprehensive search of eight electronic databases identified eight studies (N = 658 participants) that compared treatment efficacy to that of matched control groups. Differences in the psychosocial outcomes of treatment and control participants were examined using Cohen's d effect sizes. Fail-safe Ns and 95% confidence intervals were used to evaluate the significance of these results. Significant improvements in coping skills and strategies (overall d = 0.57), community integration (overall d = 0.45), and depression (overall d = 0.44) were observed immediately after telecounseling, with modest improvements in quality of life maintained at 12 months post-intervention (overall d = 0.37). The results suggest that telecounseling is an effective treatment modality for adults adjusting to a physical disability however, further trials are needed to establish the long term psychosocial benefits.
Publisher: Informa UK Limited
Date: 10-2013
DOI: 10.1080/13803395.2013.824554
Abstract: Neuropsychological assessments of outcome after traumatic brain injury (TBI) are often unrelated to self-reported problems after TBI. The current study cluster-analyzed the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) subtest scores from mild, moderate, and severe TBI (n=220) and orthopedic injury control (n=95) groups, to determine whether specific cognitive profiles are related to people's perceived outcomes after TBI. A two-stage cluster analysis produced 4- and 6-cluster solutions, with the 6-cluster solution better capturing subtle variations in cognitive functioning. The 6 clusters differed in the levels and profiles of cognitive performance, self-reported recovery, and education and injury severity. The findings suggest that subtle cognitive impairments after TBI should be interpreted in conjunction with patient's self-reported problems.
Publisher: Informa UK Limited
Date: 08-1998
DOI: 10.1076/JCEN.20.4.548.1476
Abstract: This study examined the effects of weight loss and nutritional status on the cognitive performance of patients with anorexia nervosa. The intellectual, memory, attentional, verbal fluency and visuospatial abilities of 34 females with anorexia were compared to that of 31 normal weight-for-height females. Group differences in anxiety and depression were found but neither variable was related to the cognitive performance of patients with anorexia. Moreover, nutritional status and weight loss bore little relationship to the cognitive scores of the patient group. Overall, patients with anorexia were found to be deficient in their ability to recall meaningful prose and visuospatial information. The failure to find many cognitive deficits in this s le may reflect the fact that few patients with anorexia exhibited frank nutritional deficiencies.
Publisher: SAGE Publications
Date: 11-05-2011
Publisher: Informa UK Limited
Date: 07-08-2015
DOI: 10.1080/13607863.2015.1072801
Abstract: Patients usually experience good physical recovery after total joint replacement (TJR) however, it is unclear whether mood also improves. The current meta-analysis examined changes in depression and anxiety following TJR in older (≥50 years) patients in order to address this gap in the literature. Data from 26 studies (4045 TJR, 55 controls) that assessed depression and/or anxiety pre- and post-surgery in TJR patients, with or without a control group, were analyzed. Prevalence rates and Cohen's d effect sizes were used to evaluate changes in the prevalence and severity of depression/anxiety, respectively. Approximately 23% of TJR patients had clinically significant levels of depression prior to surgery, which decreased to 13% one year later. The prevalence of anxiety could not be evaluated due to the limited available data. TJR patients did not show any clinically meaningful reductions in symptoms of depression or anxiety, following surgery. Compared to controls, there was no difference in symptom progression over time although only one study examined this. TJR patients appear to have higher rates of clinically significant symptoms of depression before and after surgery, compared to the general population, however more research with adequate control groups is needed to confirm this. Only a modest improvement in the severity of depression and anxiety symptoms was noted post-surgery. However, existing research is limited preventing definite conclusions regarding the impact of TJR on mood.
Publisher: Informa UK Limited
Date: 17-11-2014
Publisher: S. Karger AG
Date: 2007
DOI: 10.1159/000104787
Abstract: i Background: /i Bereavement is often associated with increased levels of depression, anxiety, and stress. The question of whether grief is associated with cognitive deficits in older adults remains largely unanswered. Although Xavier and coworkers (see text) found preliminary evidence that grief, in the absence of depression, impacted on memory in a s le of the oldest-old in Brazil, the impact of bereavement on cognitive functioning, independent of the effects of mood, has not been adequately examined. i Objective: /i To replicate and expand on the work of Xavier and colleagues to examine whether there is an association between bereavement due to spousal loss and performance in a range of cognitive functioning domains in older adults, independent of the effects of depression, stress, and anxiety. i Methods: /i S les of bereaved (n = 25) and non-bereaved (n = 25) participants, who were aged between 65 and 80 years and who were matched for age, gender, education, premorbid intellectual functioning, and general cognitive ability, were compared on a battery of tests designed to assess attention, verbal fluency, memory, and visuospatial ability. Depression, anxiety, and stress were also assessed, as were the presence of complicated grief and the adequacy of social support in the bereaved group. Cognitive tests that differed between the groups and correlated with depression, stress, or anxiety were analyzed using hierarchical multiple regression. i Results: /i The bereaved groups were more depressed, anxious, and stressed, and performed more poorly on tests assessing attention, information-processing speed, and verbal fluency. With the exception of the attentional switching task, the cognitive measures on which the groups differed were correlated with mood. When mood was controlled statistically, the group differences in these cognitive tests disappeared. Twenty-eight percent of the bereaved group met the criteria for a diagnosis of complicated grief. This subgroup was younger than the other bereaved participants and had higher levels of stress. i Conclusion: /i The evidence suggests that grief associated with death of a spouse has limited associations with cognition beyond those that would be expected to occur as a result of depression, anxiety, and stress.
Publisher: Elsevier BV
Date: 1992
DOI: 10.1016/0891-4222(92)90020-7
Abstract: This study evaluates the reliability of seven measures, selected to assess the social-cognitive variables hypothesized by Greenspan to define social intelligence. Responses from 75, 30 and 20 adolescents with mental retardation were used to assess each test's internal, interrater, and test-retest reliabilities, respectively. Interrater reliability coefficients were high to very high (.76 to .98), internal reliabilities were moderate to very high (.66 to .90), and test-retest reliabilities were moderate to high (.54 to .74). Internal and test-retest reliability coefficients compared favourably with those reported for the subtests of the Revised Wechsler Intelligence Scale for Children.
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.NEUROIMAGE.2016.01.056
Abstract: Identifying diffuse axonal injury (DAI) in patients with traumatic brain injury (TBI) presenting with normal appearing radiological MRI presents a significant challenge. Neuroimaging methods such as diffusion MRI and probabilistic tractography, which probe the connectivity of neural networks, show significant promise. We present a machine learning approach to classify TBI participants primarily with mild traumatic brain injury (mTBI) based on altered structural connectivity patterns derived through the network based statistical analysis of structural connectomes generated from TBI and age-matched control groups. In this approach, higher order diffusion models were used to map white matter connections between 116 cortical and subcortical regions. Tracts between these regions were generated using probabilistic tracking and mean fractional anisotropy (FA) measures along these connections were encoded in the connectivity matrices. Network-based statistical analysis of the connectivity matrices was performed to identify the network differences between a representative subset of the two groups. The affected network connections provided the feature vectors for principal component analysis and subsequent classification by random forest. The validity of the approach was tested using data acquired from a total of 179 TBI patients and 146 controls participants. The analysis revealed altered connectivity within a number of intra- and inter-hemispheric white matter pathways associated with DAI, in consensus with existing literature. A mean classification accuracy of 68.16%±1.81% and mean sensitivity of 80.0%±2.36% were achieved in correctly classifying the TBI patients evaluated on the subset of the participants that was not used for the statistical analysis, in a 10-fold cross-validation framework. These results highlight the potential for statistical machine learning approaches applied to structural connectomes to identify patients with diffusive axonal injury.
Publisher: The Haworth Press
Date: 04-10-2006
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2010
Publisher: IEEE
Date: 04-2016
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.ARTH.2013.06.007
Abstract: This meta-analysis consolidated the research on postoperative cognitive dysfunction (POCD) following total joint arthroplasty (TJA). Data from 17 studies that assessed cognition pre- and post-surgery in TJA patients alone (15 studies) or matched TJA and control groups (2 studies) were analysed. Results were grouped by cognitive domain (memory, attention, language, speed, general cognition) and follow-up interval (pre-discharge, 3-6 months post-surgery). The TJA data revealed small declines in reaction time and general cognition pre-discharge, but no evidence of decline 3-6 months post-surgery. Very limited TJA and Control data indicated no group differences in the changes to performance over time however, the TJA group was cognitively compromised pre- and post-surgery compared to Controls. Further appropriately controlled research is required to clarify whether POCD commonly occurs after TJA.
Publisher: Elsevier BV
Date: 03-1996
Publisher: Cambridge University Press (CUP)
Date: 08-2009
DOI: 10.1017/S1041610209009119
Abstract: Background: Older drivers are at a higher risk of being involved in a motor vehicle accident. However, on-road assessments of all older drivers are impractical, highlighting the need to screen for potentially unsafe drivers. This study undertook a meta-analysis of research examining the cognitive predictors of driving ability in older drivers in order to provide an evidence-based method for screening drivers. Methods: Comprehensive searches were undertaken of the PubMed, PsycINFO, CINAHL, and Health-Source Nursing electronic databases between 1980 and 2007 in order to identify studies that examined cognitive differences between drivers aged over 55 years who either passed or failed a driving assessment. Twenty-one studies were eligible for inclusion. Weighted Cohen's d effect sizes, percentage overlap statistics, Fail-safe Ns and 95% CIs were calculated for all cognitive tests. Results: The best predictors of on-road driving were the Ergovision and Useful Field of View (UFOV) tests, a complex RT task, Paper Folding task, Dot Counting, WMS Visual Reproduction, and Computerized Visual Attention Task. Simulator driving performance was best predicted by the Benton Line Orientation Task, Clock Drawing, a Driver Scanning task, the UFOV, WAIS Picture Arrangement and MMSE. Finally, the Trail Making Test, Stroop, UFOV, WAIS Block Design, and Automated Psychophysical Test were good predictors of driving problems. Conclusions: There are a variety of tests that appear suitable for screening older drivers, the exact choice of which depends on the “gold standard” for determining driving ability (on-road driving, driving simulator, driving problems) and whether a computerized or paper-and-pencil task is required.
Publisher: Cambridge University Press (CUP)
Date: 03-2004
DOI: 10.1017/S1355617704102117
Abstract: Neuroradiological and neuropathological investigations have found evidence of diffuse brain damage in the frontal and temporal lobes, corpus callosum, and fornices in patients who have sustained a mild traumatic brain injury (TBI). However, neuropsychological assessments of these patients do not typically target many of the subtle information processing deficits that may arise from diffuse damage involving the frontotemporal regions of the brain as well as white matter pathology, including the corpus callosum. Consequently, we have a limited understanding of the deficits that may be attributable to temporary or permanent disruptions to these functional pathways. This study assessed a group of mild TBI patients ( N = 40) and a matched control group ( N = 40) on a number of standard neuropsychological tests of selective and sustained attention, verbal and non-verbal fluency, and verbal memory. In addition, reaction time (RT) tasks, requiring both the inter- and intra-hemispheric processing of visual and tactile information, were used to assess the functional integrity of the tracts that are likely to be affected by diffuse damage. In the 1st month after sustaining their injury, the mild TBI group demonstrated deficits in attention, non-verbal fluency, and verbal memory. They also demonstrated slower visual and tactile RTs, with the visual RTs of mild TBI patients being more affected by increased task difficulty and the need to transfer information across the corpus callosum, than did their matched controls. ( JINS , 2004, 10 , 286–297.)
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.NEUROIMAGE.2010.01.020
Abstract: There is a growing interest in understanding alterations to the interhemispheric transfer of information as a result of brain injury and neurological disease. To facilitate research, we have developed a fully automated method for the accurate extraction of commissural pathways (corpus callosum (CC) and anterior commissure (AC)) and functional parcellation of the CC using a high angular resolution diffusion imaging (HARDI) based probabilistic tractography approach that is applicable to clinical populations. The CC was ided into 33 functional isions based on its connections to cortical parcellations derived from in idual structural images in 8 healthy participants. Probabilistic CC population maps acquired at two different b-values (1000 s mm(-2) and 3000 s mm(-2)) are presented. Topography of the CC was consistent with histology reports. We show that HARDI data acquired at a higher b-value reveals more callosal-temporal connections than low b-value data. With respect to intra-subject precision, data acquired using a higher b-value show superior reproducibility of the delineated CC area on the midsagittal plane (MSP), as well as the total number of callosal streamlines and the number of clustered callosal streamlines. The AC was delineated in all 8 participants using high b-value HARDI tractography. Cortical projections of the AC were analysed and are in agreement with known anatomy. We conclude that, while data acquired at a lower b-value may be used, this is associated with a loss in quality, both in the delineation of commissural pathways and, potentially, the reproducibility of results over time.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2009
Publisher: Elsevier BV
Date: 08-2012
DOI: 10.1016/J.SLEEP.2012.04.006
Abstract: Sleep is often disrupted following a traumatic brain injury (TBI), which may compromise recovery and quality of life. Prevalence rates vary widely, reflecting differences in the criteria and measures that are used to assess sleep, as well as s le differences. This meta-analysis examined the prevalence of general and specific, and formally and informally diagnosed, sleep disturbances following TBI in order to establish the nature and extent of these sequelae and their potential impact on recovery. Data from 21 studies, which assessed (1) sleep disturbances, regardless of type or severity, (2) diagnosed sleep disorders, and (3) specific sleep problems following TBI, were analyzed and compared to data for the general population. Overall, 50% of people suffered from some form of sleep disturbance after a TBI and 25-29% had a diagnosed sleep disorder (insomnia, hypersomnia, apnea) - rates that are much higher than those seen in the general population. They were also two to four times more likely to experience problems with sleep maintenance and efficiency, nightmares, excessive sleepiness, early awakenings, and sleep walking. Sleep disturbances are very common after TBI and have the potential to seriously undermine patient rehabilitation, recovery, and outcomes making it important to routinely screen for such problems in order to assess both treatment needs and their potential impact on recovery and outcome.
Publisher: Informa UK Limited
Date: 03-1995
Publisher: SAGE Publications
Date: 14-12-2011
Abstract: While rates of mild cognitive impairment (MCI) are relatively high in populations with cardiovascular diseases and risk factors, screening tests for MCI have not been evaluated in this patient group. This study investigated the sensitivity and specificity of the Montreal Cognitive Assessment (MoCA) tool for detecting MCI in 110 patients (mean age 67.9 + 11.7 years 60% female) recruited from hospital cardiovascular outpatient clinics. Mean MoCA performance was relatively low (22.8 + 3.8) in this group, with 72.1% of participants scoring below the recommended cutoff for cognitive impairment ( ). The presence of MCI was determined using the Neuropsychological Assessment Battery Screening Module (NAB-SM). Both amnestic MCI and multiple-domain MCI were identified. The optimum MoCA cutoff for detecting MCI in this group was . At this cutoff, the MoCA’s sensitivity for detecting amnestic MCI was 100% and for multiple-domain MCI it was 83.3%. Specificity rates for amnestic MCI and multiple-domain MCI were 50.0% and 52% respectively. The poor specificity of the MoCA suggests that it will have limited value as a screening test for MCI in settings where the overall prevalence of MCI is low.
Publisher: Informa UK Limited
Date: 26-02-2018
DOI: 10.1080/09297049.2018.1441821
Abstract: Neurodevelopmental delays are known to occur in children with metopic synostosis, but it is presently unclear whether the cognitive, behavioral and psychological outcomes of children with metopic synostosis differ to those of their healthy peers. This meta-analysis consolidated data from 17 studies (published prior to August 2017) that examined the cognitive, behavioral and psychological outcomes of children (n = 666 aged ≤19 yrs) with metopic synostosis. Hedges'g (g
Publisher: SAGE Publications
Date: 05-2012
DOI: 10.1597/10-143
Abstract: To examine the psychosocial functioning of adults with congenital craniofacial conditions relative to normative data. Single s le cross-sectional design. The Australian Craniofacial Unit, Women's and Children's Hospital, Adelaide, which is one of the main craniofacial treatment centers in Australia. Adults ( N = 93) with congenital craniofacial conditions (excluding cleft lip alate) who were treated in the Australian Craniofacial Unit. All participants completed self-report scales assessing health-related quality of life (SF-36) life satisfaction, anxiety, and depression (HADS) self-esteem (Rosenberg) appearance-related concerns perceived social support and social anxiety. Overall, participants were very similar in psychosocial function to the general population. However, adults with craniofacial conditions were less likely to be married and have children (females), were more likely to be receiving a disability pension, and reported more appearance-related concerns and less social support from friends. They also reported more limitations in both their social activities, due to physical or emotional problems, and usual role activities, because of emotional problems, as well as poorer mental health. These results give cause to be very positive about the long-term outcomes of children who are undergoing treatment for craniofacial conditions, while also identifying specific areas that interventions could target.
Publisher: SAGE Publications
Date: 03-07-2013
Abstract: To investigate the short- and medium-term efficacy of counselling services provided remotely by telephone, video or internet, in managing mental health outcomes following spinal cord injury. A search of electronic databases, critical reviews and published meta-analyses was conducted. Seven independent studies ( N = 272 participants) met the inclusion criteria. The majority of these studies utilized telephone-based counselling, with limited research examining psychological interventions delivered by videoconferencing ( N study = 1) or online ( N study = 1). There is some evidence that telecounselling can significantly improve an in idual’s management of common comorbidities following spinal cord injury, including pain and sleep difficulties ( d = 0.45). Medium-term treatment effects were difficult to evaluate, with very few studies providing these data, although participants have reported gains in quality of life 12 months after treatment ( d = 0.88). The main clinical advantages are time efficiency and consumer satisfaction. The results highlight the need for further evidence, particularly randomized controlled trials, to establish the benefits and clinical viability of telecounselling.
Publisher: Elsevier BV
Date: 03-2011
DOI: 10.1016/J.NEUROIMAGE.2010.12.010
Abstract: Magnetic resonance diffusion tractography provides a powerful tool for the assessment of white matter architecture in vivo. Quantitative tractography metrics, such as streamline length, have successfully been used in the study of brain pathology. To date, these studies have relied on a priori knowledge of which tracts are affected by injury or pathology and manual delineation of regions of interest (ROIs) for use as waypoints in tractography. This limits the analyses to specific tracts under investigation and relies on the accurate and consistent placement of ROIs. We present a fully automated technique for the voxel-wise analysis of streamline length within the entire brain, the Average Pathlength Map (APM). We highlight the precision and reproducibility of voxel-wise average streamline length over time, and assess normal variability of pathlength values in a cohort of 43 healthy participants. Additionally, we demonstrate the utility of this approach by performing voxel-wise comparison between pathlength values obtained from a patient with a severe traumatic brain injury (TBI, Glasgow Coma Scale Score=7) and those from control participants. Our analysis shows that voxel-wise average pathlength values are comparable to fractional anisotropy (FA) in terms of reproducibility and variability. For the TBI patient, we observed a significant reduction in streamline pathlength in the genu of the corpus callosum and its projections into the frontal lobe. This study demonstrates that the average pathlength map can be used for voxel-based analysis of a quantitative tractography metric within the whole brain, removing both the dependence on a priori knowledge of affected pathways and time-consuming manual delineation of ROIs.
Publisher: Elsevier BV
Date: 09-2006
DOI: 10.1016/J.AAP.2006.04.016
Abstract: Although it is known that older drivers limit their driving, it is not known whether this self-regulation is related to actual driving ability. A s le of 104 older drivers, aged between 60 and 92, completed a questionnaire about driving habits and attitudes. Ninety of these drivers also completed a structured on-road driving test. A measure of self-regulation was derived from drivers' self-reported avoidance of difficult driving situations. The on-road driving test involved a standard assessment used to determine fitness to drive. Driving test scores for the study were based on the number of errors committed in the driving tests, with weightings given according to the seriousness of the errors. The most commonly avoided difficult driving situations, according to responses on the questionnaire, were parallel parking and driving at night in the rain, while the least avoided situation was driving alone. Poorer performance on the driving test was not related to overall avoidance of difficult driving situations. Stronger relationships were found between driving ability and avoidance of specific difficult driving situations. These specific driving situations were the ones in which the drivers had low confidence and that the drivers were most able to avoid if they wished to.
Publisher: Informa UK Limited
Date: 12-2006
DOI: 10.1080/13854040500246935
Abstract: Green, Rohling, Lees-Haley, and Allen (2001) suggested that scores on a test of "effort," the Word Memory Test (WMT), explains more variance in outcome after brain injury than does injury severity. As a consequence, Green and colleagues recommend using the WMT to control for sub-optimal effort in neuropsychological evaluations and group research. We re-examine the evidence for their conclusions and argue that identifying a larger proportion of explained variance is not in itself evidence of validity unless the premise to be proven is already assumed, namely, that the test is a valid measure of effort. Instead, the crux of Green and colleagues claim for the validity of the WMT implies an interaction between effort and injury severity on outcome scores, although the specific interaction has not been tested in their previous research. We failed to find any evidence for this interaction in a s le of 100 Australian litigants. We conclude that our data do not support the view that effort, as measured by the WMT, interacts with injury severity to suppress cognition after brain injury.
Publisher: Informa UK Limited
Date: 27-09-2016
DOI: 10.1080/13803395.2016.1233940
Abstract: Whether total joint replacement (TJR) patients are susceptible to postoperative cognitive dysfunction (POCD) remains unclear due to inconsistencies in research methodologies. Moreover, cognitive reserve may moderate the development of POCD after TJR, but has not been investigated in this context. The current study investigated POCD after TJR, and its relationship with cognitive reserve, using a more rigorous methodology than has previously been utilized. Fifty-three older adults (aged 50+) scheduled for TJR were assessed pre and post surgery (6 months). Forty-five healthy controls matched for age, gender, and premorbid IQ were re-assessed after an equivalent interval. Cognition, cognitive reserve, and physical and mental health were all measured. Standardized regression-based methods were used to assess cognitive changes, while controlling for the confounding effect of repeated cognitive testing. TJR patients only demonstrated a significant decline in Trail Making Test Part B (TMT B) performance, compared to controls. Cognitive reserve only predicted change in TMT B scores among a subset of TJR patients. Specifically, patients who showed the most improvement pre to post surgery had significantly higher reserve than those who showed the greatest decline. The current study provides limited evidence of POCD after TJR when examined using a rigorous methodology, which controlled for practice effects. Cognitive reserve only predicted performance within a subset of the TJR s le. However, the role of reserve in more cognitively compromised patients remains to be determined.
Publisher: Informa UK Limited
Date: 08-2001
DOI: 10.1076/CLIN.15.3.405.10279
Abstract: The Test of Everyday Attention (TEA) was designed to address some of the limitations of established measures of attention. However, very few studies have examined its clinical utility. A group of 35 patients who had sustained a severe TBI were compared with 35 age- and education-matched controls on the TEA, Stroop, SDMT, WMS-R Digit Span, Ruff 2s and 7s Selective Attention Test, and PASAT. Of the TEA subtests, only the Map and Telephone Search subtests of the TEA produced significant differences between the two groups, suggesting a deficit in visual selective attention following TBI. Principal components analysis revealed a four-component / factor structure of attention, largely consistent with previous studies. A logistic regression found that the TEA Map Search and Modified Colour-Word subtest of the Stroop were best able to discriminate between the TBI and control groups. When the TBI group was ided into Early ( 2 years post injury) groups, there was an additional deficit on the Lottery (sustained attention) subtest in the Early TBI group, indicating that there is some recovery in attentional function beyond 1 year post injury.
Publisher: SAGE Publications
Date: 07-02-2011
Abstract: Pharmacological treatments have been widely investigated in pre-clinical animal trials to evaluate their usefulness in reducing cognitive, behavioural and motor problems after traumatic brain injury (TBI). However, the relative efficacy of these agents has yet to be evaluated, making it difficult to assess the strength of evidence for their use in a clinical population. A meta-analytic review of research (1980–2009) was therefore conducted to examine the impact of pharmacological treatments administered to adult male rodents after experimental TBI on cognitive, behavioural, and motor outcome. The PubMed and PsycInfo databases were searched using 35 terms. Weighted Cohen’s d effect sizes, percent overlap, Fail-Safe N statistics and confidence intervals were calculated for each treatment. In total, 91 treatments were evaluated in 223 pre-clinical trials, comprising 5988 rodents. Treatments that were investigated by multiple studies and showed large and significant treatment effects were of greatest interest. Of the 16 treatments that were efficacious, six improved cognition, 10 improved motor function and no treatment improved behaviour (depression/anxiety, aggression, zoosocial behaviour). Treatment benefits were found across a range of TBI models. Drug dosage and treatment interval impacted on treatment effects.
Publisher: Mary Ann Liebert Inc
Date: 10-2011
Abstract: Traumatic brain injury (TBI) often causes raised intracranial pressure (ICP), with >50% of all TBI- related deaths being associated with this increase in ICP. To date, there is no effective pharmacological treatment for TBI, partly because widely used animal models of TBI may not replicate many of the pathophysiological responses observed in humans, and particularly the ICP response. Generally, rodents are the animal of choice in neurotrauma research, and edema formation has been demonstrated in rat models however, few studies in rats have specifically explored the effects of TBI on ICP. The aim of the current study was to investigate the ICP response of rats in two different, focal and diffuse, injury models of TBI. Adult male Sprague-Dawley rats were subjected to brain trauma by either lateral fluid percussion or impact-acceleration induced injury, in the presence or absence of secondary hypoxia. ICP, mean arterial blood pressure (MABP), and cerebral perfusion pressure (CPP) were monitored for 4 h after TBI. TBI alone or coupled with hypoxia did not result in any significant increase of ICP in rats unless there was an intracranial hemorrhage. At all other times, changes in CPP were the result of changes in MABP and not ICP. Our results suggest that rats may be able to compensate for the intracranial expansion associated with cerebral edema after TBI, and that they only develop a consistent post-traumatic increase in ICP in the presence of a mass lesion. Therefore, they are an inappropriate model for the investigation of ICP changes after TBI, and for the development of therapies targeting ICP.
Publisher: Informa UK Limited
Date: 08-0022
DOI: 10.1080/13803395.2012.668176
Abstract: The current study examined the potential contribution of suboptimal effort to the cognitive deficits that are associated with Chronic Fatigue Syndrome (CFS) using the Validity Indicator Profile (VIP). Unlike most tests of effort, the VIP distinguishes between intentional and unintentional poor performance and does not assess cognitive functions that are affected by CFS, thereby reducing the risk of mistakenly attributing genuinely poor performance to reduced effort. The VIP was administered to 54 persons with CFS and 54 matched healthy community controls, and performance categorized into 1 of 4 response styles (valid: compliant invalid: suppressed, irrelevant, inconsistent), based on the level of effort expended (high or low) and the intention to perform well or not. VIP performance was classified as valid for the majority of participants (CFS and controls), indicating high levels of effort and an intention to perform well. Three participants in the CFS group and four in the control group showed low levels of effort but an intention to do well (invalid: inconsistent). No participant performed in a manner indicative of an intent to perform poorly (invalid: suppressed, inconsistent). These findings suggest that poor effort is unlikely to contribute to cognitive test performance of persons with CFS.
Publisher: Elsevier
Date: 1990
Publisher: American Psychological Association (APA)
Date: 2007
DOI: 10.1037/0894-4105.21.2.212
Abstract: Deficits in attention are frequently reported following severe traumatic brain injury (TBI). However, methodological differences make it difficult to reconcile inconsistencies in the research findings in order to undertake an evidence-based assessment of attention. The current study therefore undertook a meta-analytic review of research examining attention following severe TBI. A search of the PsycINFO and PubMed databases spanning the years 1980 to 2005 was undertaken with 24 search terms. Detailed inclusion and exclusion criteria were used to screen all articles, leaving 41 studies that were included in the current meta-analysis. Weighted Cohen's d effect sizes, percentage overlap statistics, and confidence intervals were calculated for the different tests of attention. Fail-safe Ns were additionally calculated to address the bias introduced by the tendency to publish significant results. Large and significant deficits were found in specific measures of information-processing speed, attention span, focused/selective attention, sustained attention, and supervisory attentional control following severe TBI. Finally, age, education, and postinjury interval were not significantly related to these deficits in attention.
Publisher: SAGE Publications
Date: 07-2013
DOI: 10.1597/11-105
Abstract: Adults with craniofacial conditions experience more psychosocial problems than adults in the general population, but little is known about the factors that render a person more or less susceptible to these problems. Guided by research on adults with other conditions that affect appearance, this study examined predictors of psychosocial outcome in adults with craniofacial conditions. Single-s le cross-sectional design. The Australian Craniofacial Unit, Women's and Children's Hospital, Adelaide, one of the main craniofacial treatment centers in Australia. Adults (N = 93 36.9% of the potential s le) with congenital craniofacial conditions (excluding cleft lip and/or cleft palate) who were treated in the Australian Craniofacial Unit. All participants completed measures assessing anxiety, depression, and quality of life (Hospital Anxiety and Depression Scale, Short-Form Health Survey) and variables predicted to affect these outcomes (SF-36 Health Survey - Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, Cleft Satisfaction Profile, Brief Fear of Negative Evaluation Scale, Derriford Appearance Scale). Multiple regression analyses revealed that anxiety was predicted by social support, self-esteem, and fear of negative evaluation, while depression was predicted by self-esteem and social support. Physical quality of life was not predicted by any of the measures. Satisfaction with appearance, gender, age, and education were not related to outcome. Interventions designed to increase perceived social support and self-esteem and reduce fear of negative evaluation appear to be indicated and may assist in establishing a causal relationship between these variables.
Publisher: Oxford University Press (OUP)
Date: 26-03-2012
Abstract: To provide a meta-analysis of research that has examined the cognitive functioning of children and adults with cleft lip (CL), cleft palate (CP), and cleft lip and palate (CLP). Data from 29 studies, which compared persons with a cleft to a control group on tests of cognitive functioning, were analyzed. The data were obtained from 1,546 persons with cleft and 279,805 controls. Participants with a cleft performed significantly worse on 7 cognitive domains. However, the only moderate and significant deficit, which was based on nonheterogeneous study findings and not subject to publication bias, was in the language domain. CL, CP, and CLP were all associated with cognitive impairments, although the profiles for the groups differed. Cross-sectional studies suggest that persons with clefts experience poorer cognitive functioning across a range of domains, although large-scale longitudinal studies are needed to more definitively differentiate outcomes by cleft type.
Publisher: SAGE Publications
Date: 26-10-2011
Abstract: This meta-analysis evaluated the impact of cognitive behavior therapy (CBT) on the psychological adjustment of adults with spinal cord injury (SCI). A comprehensive search of six electronic databases identified 10 studies (424 participants) that met the inclusion criteria. Pre- and post-data for participants who received CBT were pooled and analyzed. Large and significant group differences were noted for measures of assertiveness, coping, self-efficacy, depression and quality of life. These data suggest that CBT has a significant positive impact on short-term psychological outcomes following SCI. However, further research is needed to establish the long-term benefits.
Publisher: Informa UK Limited
Date: 08-01-2010
DOI: 10.1080/13803390903427414
Abstract: The differential diagnosis of Alzheimer's disease (AD) and frontotemporal dementia (FTD) remains a difficult clinical issue. A recent meta-analysis by Hutchinson and Mathias (2007) found that many cognitive tests do not adequately differentiate between these types of dementia. However, their study did not examine the ability of neurobehavioral scales to distinguish between AD and FTD. The data from 33 studies, published between January 1994 and December 2008, examining the neurobehavioral symptoms of persons with AD (N = 2,305) and FTD (N = 971) were therefore analyzed. Weighted Cohen's d effect sizes, percentage overlap statistics, confidence intervals, and fail-safe Ns were calculated for each scale. The most discriminating measures were the Schedules for Clinical Assessment in Neuropsychiatry and the Scale for Emotional Blunting. The Middelheim Frontality Score and the Frontal Behavior Inventory also had excellent discriminative ability, surpassing the cognitive tests examined previously. Numerous other scales additionally showed large and significant differences between the AD and FTD groups, highlighting the importance of assessing neurobehavioral symptoms in this context. While these latter measures may be useful in providing a clinical profile of patients with dementia, greater overlap in the scores of patients with AD and FTD limits their usefulness in the context of differential diagnosis.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.NEUROIMAGE.2012.07.022
Abstract: Diffusion MR images are prone to artefacts caused by head movement and cardiac pulsation. Previous techniques for the automated voxel-wise detection of signal intensity outliers have relied on the fit of the diffusion tensor to the data (RESTORE). However, the diffusion tensor cannot appropriately model more than a single fibre population, which may lead to inaccuracies when identifying outlier voxels in crossing fibre regions, particularly when high b-values are used to obtain increased angular contrast. HOMOR (higher order model outlier rejection) was developed to overcome this limitation and is introduced in this study. HOMOR is closely related to RESTORE, but employs a higher order model capable of resolving multiple fibre populations within a voxel. Using high b-value (b=3000 s/mm2) diffusion data from a population of 90 healthy participants, as well as simulations, HOMOR was found to identify a decreased number of outlier voxels compared to RESTORE primarily within areas of crossing, bending and fanning fibres. At lower b-values, however, RESTORE and HOMOR give similar results, which is demonstrated using diffusion data acquired at b=1000 s/mm2 in a mixed cohort. This study demonstrates that, although RESTORE is suitable for low b-value data, HOMOR is better suited for high b-value data.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2008
Publisher: Elsevier BV
Date: 1992
DOI: 10.1016/0891-4222(92)90019-3
Abstract: Study 1 assessed the construct validity of Greenspan's 1979 and 1981 models of adaptive and social intelligence. Seventy-five adolescents with mental retardation completed four measures of conceptual intelligence, a general measure of adaptive behavior (practical intelligence), and seven measures of social intelligence. A factor analysis of all measures yielded three factors that were obliquely rotated and labelled Practical-Interpersonal Competence (defined by a subset of social intelligence and adaptive behavior measures). Verbal Intelligence, and Accuracy of Inference. An analysis of the seven measures of social intelligence found no evidence to support the hierarchical organization of variables that is proposed in Greenspan's model of social intelligence. The criterion validity of the Practical-Interpersonal Competence construct identified in this study was then assessed in Study 2 (N = 20). Factor scores were calculated from nine measures that were selected to represent the Practical-Interpersonal Competence, Verbal Intelligence, and Accuracy of Inference factors, and correlated with three criterion measures of practical and interpersonal competence. Two of the three criterion measures validated both the Practical-Interpersonal Competence and Verbal Intelligence Factor scores but did not discriminate between the two. The criterion validity of the Practical-Interpersonal Competence construct, therefore, has yet to be established.
Publisher: Wiley
Date: 07-05-2010
DOI: 10.1002/GPS.2431
Abstract: The depression-executive dysfunction (DED) model predicts that cognitive impairment, particularly executive dysfunction, is associated with poor response to antidepressant medication. A meta-analysis was undertaken to assess the evidence for this hypothesis. The PsycInfo and PubMed databases were searched to identify studies that examined response to antidepressant treatment in relation to pre-treatment cognitive performance. Systematic screening yielded 17 eligible publications, providing data for 1269 in iduals. Ninety cognitive tests and subtests were used by these studies 30 were used by more than one study. Weighted mean Cohen's d effect sizes, 95% confidence intervals and Fail Safe Ns were calculated for these 30 tests. Five cognitive tests provided good discrimination (d(w) > 0.5) between patients who ultimately responded to antidepressant medication and those who failed to respond. One was a test of executive function but the remainder assessed other cognitive domains. Due to the small number of studies the influence of methodological factors, such as participant age and treatment duration, could not be statistically examined. However, a supplementary analysis restricted to nine studies where SSRIs were the only class of antidepressant revealed a similar pattern of results. Performance on selected tests of executive function and non-executive cognitive functions is associated with response to anti-depressant medication in some populations. The available evidence does not provide strong support for the DED model.
Publisher: BMJ
Date: 09-2007
Publisher: Springer Science and Business Media LLC
Date: 24-10-2009
DOI: 10.1007/S00221-008-1604-5
Abstract: We investigated the relationship between the morphology of the corpus callosum (CC) and IQ in a healthy s le of in iduals in their late teens and early twenties. The relationship between the area of the CC, measured at the midline, and IQ showed regional differences. We observed that a higher estimated performance IQ was associated with smaller area in the posterior regions of the CC, a finding that differs from a positive association previously observed in a somewhat older adult s le. In contrast, higher estimated verbal IQ was associated with decreased fractional anisotropy of the genu, an anterior portion of the CC. Age effects were also observed such that older age was associated with larger CC area. Our results suggest that CC morphology is related to cognitive performance, which may have implications for clinical populations in whom CC morphology is atypical.
Publisher: Informa UK Limited
Date: 12-06-2013
DOI: 10.3109/02699052.2013.793398
Abstract: Community (CC) or orthopaedic/injury (OC) control groups are typically used to evaluate the consequences of traumatic brain injuries (TBIs). Whereas CCs match for demographic variables and are readily available, OCs may additionally control for other pre- and post-injury variables but are more costly to recruit. Together, they enable an evaluation of brain- vs general-injury effects. However, the comparability of these two groups and the increase in control over confounding variables when OCs are used has rarely been examined. The current study compared s les of CCs (n = 71) and OCs (n = 69), aged between 18-80, on a range of demographic (age, gender, education, socio-economic status), background (medical history, handedness), psychosocial (alcohol use, fatigue, pain, depression, social support, community integration, 'post-concussion' symptoms) and cognitive (motor and processing speed, memory, intellectual ability) variables. The two groups were comparable on all variables, except alcohol use, with the OC group having higher levels of alcohol consumption. However, alcohol use did not correlate with any other variable, including commonly used measures of outcome following TBI. The current findings suggest that an orthopaedic injury control group does not have any clear advantages over a carefully recruited community control group.
Publisher: Informa UK Limited
Date: 02-04-2016
Publisher: American Psychological Association (APA)
Date: 2008
DOI: 10.1037/0894-4105.22.3.341
Abstract: Several studies have examined corpus callosum (CC) morphology in children and adolescents with attention deficit hyperactivity disorder (ADHD). A meta-analysis of atypical brain morphology in children and adolescents with ADHD by Valera, Faraone, Murray, and Seidman (2006) reported a reduction in the splenium of the CC in this group compared with healthy controls. This meta-analysis undertook a more detailed examination of callosal morphology by also considering comorbid conditions and gender differences. The data from 13 studies were analyzed. Consistent with Valera et al. (2006), the splenium was smaller in children and adolescents with ADHD than in healthy controls. However, this result appears to be the result of a smaller splenium in females with ADHD. In addition, boys exhibited a smaller rostral body. There were no significant differences in CC measurements of studies that included ADHD s les with comorbid conditions. However, comorbidities were not consistently reported, making it difficult to accurately evaluate the impact of comorbidity on CC size. Additional research is needed to investigate whether gender differences reflect different ADHD subtypes. In addition, it is not known if these CC differences persist into adulthood.
Publisher: Informa UK Limited
Date: 05-11-2018
DOI: 10.1080/02699052.2018.1540794
Abstract: To provide a qualitative examination of the service and support needs of children who have had a mild traumatic brain injury (mTBI), and their parents, in order to improve clinical services. Semi-structured interviews were conducted with 9 children (8-12 years M = 10.6 years, SD = 0.8) and their parents (n = 9) 29-55 days (M = 34 days SD = 9.3) after presenting to an Australian Paediatric Emergency Department (PED) for mTBI. Children's post-concussive symptoms (PCS) were additionally measured using the Post-Concussive Symptom Inventory (PCSI). Audio recordings were transcribed, and a thematic analysis was conducted. Post-injury needs were reflected in four main themes: Communication Family Burden Continuity of Care and Social and Community Support. These themes reflected children's and parents' needs for information, emotional/social/community support, and follow-up care. Both the children's and parents' needs, and the extent to which they were met, appeared to be related to the severity and duration of the child's PCS. Dedicated pediatric mTBI follow-up services that build on family's resources and meet their in idual needs for information, emotional support, and referral may assist in optimizing post-injury outcomes.
Publisher: Wiley
Date: 11-2007
Publisher: Wiley
Date: 13-03-2015
DOI: 10.1111/BJC.12078
Abstract: Chronic pain (CP >3 months) is a common condition that is associated with significant psychological problems. Many people with CP do not fit into discrete diagnostic categories, limiting the applicability of research that is specific to a particular pain diagnosis. This meta-analysis synthesized the large extant literature from a general CP, rather than diagnosis-specific, perspective to systematically identify and compare the psychological problems most commonly associated with CP. Four databases were searched from inception to December 2013 (PsychINFO, The Cochrane Library, Scopus, and PubMed) for studies comparing the psychological functioning of adults with CP to healthy controls. Data from 110 studies were meta-analysed and Cohen's d effect sizes calculated. The CP group reported experiencing significant problems in a range of psychological domains (depression, anxiety, somatization, anger/hostility, self-efficacy, self-esteem and general emotional functioning), with the largest effects observed for pain anxiety/concern and somatization followed by anxiety and self-efficacy and then depression, anger/hostility, self-esteem and general emotional functioning. This study demonstrates, for the first time, that in iduals with CP are more likely to experience physically focussed psychological problems than other psychological problems and that, unlike self-efficacy, fear of pain is intrinsically tied to the CP experience. This challenges the prevailing view that, for in iduals with CP, problems with depression are either equal to, or greater than, problems with anxiety, thereby providing important information to guide therapeutic targets. Positive clinical implications: This is the first time that the CP literature has been synthesized from a general perspective to examine psychological functioning in the presence of CP and provide practical recommendations for assessment and therapy. In iduals with CP were most likely to experience psychological problems in physically focussed areas - namely pain anxiety/concern and somatization. Although fear of pain was intrinsically tied to the CP experience, self-efficacy was not. CP was more strongly associated with anxiety than with depression. Limitations The study focuses on the general CP literature, adults and research-utilizing self-report measures. Meta-analyses are limited by the empirical literature on which they are based.
Publisher: Wiley
Date: 30-01-2020
DOI: 10.1002/HBM.24939
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2011
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.APMR.2012.06.002
Abstract: To determine whether an in idualized counseling intervention delivered by telephone-telecounseling-feasibly improves the emotional adjustment of adults with a newly acquired spinal cord injury (SCI). Randomized controlled trial. Spinal injuries unit of a rehabilitation center. Adults (N=40) aged 18 or older, who were recently discharged home from inpatient spinal rehabilitation, were randomly assigned to a telecounseling treatment or standard-care control group. All participants had recently received psychological treatment as inpatients in order to help assist them in adjusting to their disability. Referral to the inpatient psychology service was therefore a key indicator of participants' baseline distress levels and, consequently, their need for counseling support postdischarge. Seven telecounseling sessions were delivered over a 12-week period by a single psychologist (D.D.). Pre- and postintervention data, plus a 3-month follow-up assessment, were compared with that of an SCI control group who received standard care. Psychosocial outcome was measured using the following: Depression Anxiety Stress Scale-21 Mini International Neuropsychiatric Interview Spinal Cord Lesion Emotional Wellbeing and Coping Strategies Questionnaires and the Multidimensional Measure of Social Support. Cost-effectiveness and clinical feasibility were also evaluated. Telecounseling participants reported clinical improvements in depression and anxiety and aspects of SCI coping immediately postintervention. However, these treatment gains were not statistically significant. Additionally, treatment effects were minimal at 3-month follow-up. Delivery related outcomes, including participation rate and cost analyses, were all positive. The results suggest that continued psychological services for in iduals reporting distress during their inpatient rehabilitation is important and that such services can be delivered by telephone cost-effectively and efficiently. However, the long-term benefits of telecounseling, once ceased, were not demonstrated.
Publisher: Informa UK Limited
Date: 09-2016
DOI: 10.1080/09602011.2016.1224190
Abstract: Although a known risk factor for traumatic brain injury (TBI), alcohol has been found to both promote and protect against secondary brain damage. However, it is presently unclear whether the cognitive, psychological and medical/functional outcomes of adults who have consumed alcohol prior to sustaining a TBI differ from those who have not. This meta-analysis examined the outcomes of groups that differed in terms of their day-of-injury (DOI) blood alcohol levels (BALs) by comparing positive with zero BAL (BAL
Publisher: Springer Science and Business Media LLC
Date: 22-12-2010
DOI: 10.1038/SC.2009.161
Abstract: A repeated measures, non-randomised controlled trial. To examine the effectiveness of in idualised cognitive behaviour therapy (CBT) on the psychological adjustment of patients undergoing rehabilitation for newly acquired spinal cord injury. South Australian Spinal Cord Injury Service, H stead Rehabilitation Centre, South Australia, Australia. Eleven participants received in idual CBT as part of their spinal rehabilitation. Self-reported levels of depression, anxiety and stress were assessed before the intervention, at week 12 of rehabilitation and at 3 months post-discharge, using the depression, anxiety and stress scales (DASS-21). Functional independence was also assessed, using the Functional Independence Measure (FIM). Responses were compared with 13 participants, closely matched on demographic and injury variables, who received standard psychological care (that is, assessment and monitoring only). Depression scores for treatment participants showed a significant time effect, with worsening symptoms reported at three-month follow-up, after CBT was discontinued. In contrast, the DASS-21 scores of standard care participants remained at subclinical levels throughout the study. Clinical improvements in symptoms of anxiety and stress were also reported by the treatment group as inpatient therapy progressed. Targeted, in idualised psychological treatment contributed to short-term, meaningful improvements in emotional outcomes for in iduals reporting psychological morbidity after recent spinal injury. The results also highlight the need for ongoing access to specialised, psychological services post-discharge. Replication of these results with a larger s le is required before definitive conclusions can be drawn.
Publisher: Informa UK Limited
Date: 08-09-2020
Publisher: Informa UK Limited
Date: 17-01-2007
Publisher: Informa UK Limited
Date: 06-2001
DOI: 10.1076/JCEN.23.3.386.1190
Abstract: Attentional problems have frequently been identified following traumatic brain injuries (TBIs) using both clinical assessments and self-report measures. Unfortunately, most measures of attention do not enable us to determine the underlying basis of these attentional deficits. One exception is Posner's Covert Orienting of Attention Task (COAT), which is designed to identify some of the fundamental mental operations underlying attention. This study sought to determine whether the COAT task could identify discrete attentional deficits following TBI beyond those caused by reduced speed of information processing. Thirty five patients who had sustained a severe TBI were compared to 35 age-matched controls. Results revealed that, although the reaction times of the patients with TBI were significantly slower than the controls, there were no differences between the two groups in terms of their ability to disengage, move, and engage their attention. The introduction of a secondary (language) task produced no significant difference between the two groups on the COAT task. However, there was a significant difference between the two groups on the language-based task, suggesting a deficit in auditory-verbal attention under dual task conditions.
No related grants have been discovered for Jane Mathias.