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Neurorehabilitation in brain tumours: evidences and suggestions for spreading of knowledge and research implementation
Blog, Brain Injury, Rehabilitation, Research

#NPsychPick of the Month: More evidence that early neurorehabilitation can improve the quality of life for brain tumour patients

Neurorehabilitation in brain tumours: evidences and suggestions for spreading of knowledge and research implementation via Current Opinion in Oncology.

Bartolo, M., Intiso, D., & Zucchella, C. (2023). Neurorehabilitation in brain tumours: evidences and suggestions for spreading of knowledge and research implementation. Current opinion in oncology, 35(6), 543–549.

Summary:

Drawing from the article “Neurorehabilitation in brain tumours: evidences and suggestions for spreading of knowledge and research implementation” by Bartolo, Intiso, and Zucchella, this review highlights the critical role of neurorehabilitation in addressing the sensory-motor and cognitive challenges caused by brain tumours and their treatments.

Key Takeaways:

  • Early evaluation through a multidisciplinary approach identifies diverse functional impairments.
  • Tailored rehabilitation programs address physical, cognitive, psychological, and social aspects, improving recovery and participation.
  • Collaborative care helps patients rebuild their lives and enhances their overall quality of life.

🚀 The Way Forward:

There’s a growing need to promote awareness of rehabilitation among neuro-oncologists and to drive high-quality research in this field.

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Efficacy of an Intensive Exposure Intervention for Individuals With Persistent Concussion Symptoms Following Concussion: A Concurrent Multiple Baseline Single-Case Experimental Design (SCED) Study.
Blog, Brain Injury, Concussion, NPsychPick, Rehabilitation, Research, Symptoms

#NPsychPick of the Month: Efficacy of an Intensive Exposure Intervention for Individuals With Persistent Concussion Symptoms Following Concussion: A Concurrent Multiple Baseline Single-Case Experimental Design Study

Efficacy of an Intensive Exposure Intervention for Individuals With Persistent Concussion Symptoms Following Concussion: A Concurrent Multiple Baseline Single-Case Experimental Design (SCED) Study.

King, Skye MSc; Stapert, Sven Z. PhD; Winkens, Ieke PhD; van der Naalt, Joukje PhD, MD; van Heugten, Caroline M. PhD; Rijkeboer, Marleen M. PhD

#NPsychPick of the Month

Abstract

Objective:

After a concussion, 1 in 3 patients report persistent symptoms and experience long-term consequences interfering with daily functioning, known as persistent concussion symptoms (PCS). Evidence suggests PCS is (partly) maintained by anxious thoughts about brain functioning, recovery, and experienced symptoms, leading to avoidance behaviors, which may prevent patients from meeting life demands. We aimed to investigate the efficacy of a newly developed intensive exposure intervention for individuals with PCS after concussion aimed to tackle avoidance behavior.

Setting:

Participants took part in the intervention at the Maastricht University faculty.

Participants:

Four participants who experienced PCS after concussion partook in the exploratory study. Participants’ age ranged between 20 and 32 (mean = 26.5, SD = 5.9) years, with an average length of time after the concussion of 9.8 months.

Design:

A concurrent multiple-baseline single-case design was conducted. The baseline period (A phase) length was randomly determined across participants (3, 4, 5, or 6 weeks). The exposure intervention (B phase) was conducted by psychologists over a 4-week period and consisted of 3 stages: exploration (2 sessions), active exposure (12 sessions conducted over 1 week), and 2 booster sessions.

Main Measures:

Participants answered daily questions on a visual analog scale related to symptom experience, satisfaction with daily functioning, and degree of avoidance of feared activities. Additional outcomes included symptom severity, catastrophizing, fear of mental activity, anxiety, depression, and societal participation.

Results:

Tau-U yielded significant effects (P < .05) for all participants on all measures when comparing baseline and intervention phases. The pooled standardized mean difference was high for all measures (symptom experience = 0.93, satisfaction of daily functioning = 1.86, and activity avoidance = −2.05).

Conclusions:

The results show efficacy of the newly developed intensive exposure treatment for PCS after concussion, which is based on the fear avoidance model. Replication in a larger heterogeneous sample is warranted and needed.

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Blog, Brain Injury, Research, Therapy

#NPsychPick of the Month: Mood Tracker: A Randomized Controlled Trial of a Self-Monitoring Intervention for Emotional Distress After Traumatic Brain Injury

Mood Tracker: A Randomized Controlled Trial of a Self-Monitoring Intervention for Emotional Distress After Traumatic Brain Injury.

Sherer, Mark PhD; Juengst, Shannon PhD; Sander, Angelle M. PhD; Leon-Novelo, Luis PhD; Liu, Xiangyi MS; Bogaards, Jay MA; Chua, Wilma BBA; Tran, Kim MA

#NPsychPick of the Month

Abstract

Objective:

Persons with traumatic brain injury (TBI) frequently experience emotional distress (ED) manifested in anxiety and depression. However, they may not access mental health services due to external (eg, access, transportation, and cost) or internal (eg, stigma and discomfort with traditional counseling) barriers. Based on substantial literature indicating that self-monitoring can ameliorate several health conditions, we conducted a randomized, parallel group, wait-list control (WLC) trial of a self-monitoring intervention to decrease ED after TBI.

Setting:

Community in the southwestern United States.

Participants:

Persons with medically documented complicated mild, moderate, and severe TBI.

Design:

About 127 participants were randomized in blocks of 6 to an active treatment (AT) group, wherein they completed multiple assessments of ED each week over a 6-week period via a smartphone app, or a WLC group in a parallel group, controlled trial. Participants received weekly support calls to promote self-monitoring of ED using ecological momentary assessment.

Main Measures:

ED (Patient Health Questionnaire—9 and Generalized Anxiety Disorder—7), Satisfaction with Life Scale, and Participation Assessment with Recombined Tools—Objective.

Results:

Analysis of the primary study outcome at 6 weeks after initiation of treatment for the AT group did not demonstrate that self-monitoring was effective in decreasing ED as compared to the WLC group. Brief support calls made weekly to promote compliance with self-monitoring were effective in achieving the target number of self-assessments. About 80% of support calls lasted less than 5 minutes. Greater ED was associated with lower life satisfaction and lower participation indicating the importance of addressing ED in persons with TBI.

Conclusion:

Additional work is needed to develop nontraditional interventions to circumvent barriers that prevent persons with TBI from accessing care for ED. Brief support calls may be an effective, low-cost intervention to improve compliance with self-monitoring or self-management interventions.

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Psychedelic-assisted Psychotherapy in 3-D: Acceptance, Connectedness, and Defensiveness
Blog, Psychedelic, Research, Therapy

#NPsychPick of the Month: Psychedelic-assisted Psychotherapy in 3-D: Acceptance, Connectedness, and Defensiveness: Neuropsychoanalysis: Vol 25, No 2.

Psychedelic-assisted Psychotherapy in 3-D: Acceptance, Connectedness, and Defensiveness.

Lawrence Fischman.

#NPsychPick of the Month

Abstract

As psychiatry weighs a move from a categorical to a dimensionally-based classification system, clinical research and treatment paradigms may shift towards identifying which dimensions of mental health can improve treatment outcomes across a broad range of diagnostic categories. Psychedelic-assisted psychotherapy, which is currently in clinical trials for a wide range of conditions from PTSD to tobacco dependency, holds promise for just such a dimensional approach to treatment. Anecdotal reports and qualitative studies have hinted at its potential for decreasing defensiveness and increasing feelings of acceptance and connectedness. In this theoretical paper, I draw upon ideas and research with psychedelics, infant observation, social psychology, and psychoanalysis to explain why psychedelic-assisted psychotherapy is especially well-suited for addressing these dimensions of mental health. Because studies already support the use of psychedelic-assisted psychotherapy in one dimensionally-based application – the treatment of existential anxiety in patients with cancer – I begin with a look at psychological models of defensiveness in relation to the fear of death. I then use the models of Winnicott, Stern, Carhart-Harris/Friston and others to discuss the experiences of awe, omnipotence, and creativity within ordinary and psychedelic states, and touch on a fourth dimension of mental health, authenticity. I suggest psychedelic-assisted psychotherapy may be viewed as a transitional space ideally suited for working through experiences of disconnection through the process of illusion-disillusionment, allowing gradual acceptance. I conclude with a summary of how acceptance, connectedness, and defensiveness are related to each other and to one’s sense of self.

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Blog, Brain Injury, mental health, Neuropsychological, NPsychPick, NPsychTeamResearch, Research

#NPsychPick of the Month: Developing an understanding of the Frontal Lobe Paradox through clinical group discussions. Copstick, Sue Turnbull, Lorraine Bobbie Tibbles, Jennifer Ashworth, Sarah Swanepoel, Henk J. Kinch, Julianne Moffitt, Jenna. The Neuropsychologist November 2023 via NPsych

The Neuropsychologist 16

Developing an understanding of the Frontal Lobe Paradox through clinical group discussions.

Copstick, Sue Turnbull, Lorraine Bobbie Tibbles, Jennifer Ashworth, Sarah Swanepoel, Henk J. Kinch, Julianne Moffitt, Jenna.

#NPsychPick of the Month

Abstract

This discussion paper presents reflections from a group of clinical, forensic and neuropsychologists on their clinical caseloads in brain injury rehabilitation services at Cygnet Healthcare. These services specialise in working with people with coexisting mental health or behavioural difficulties where the work involves frequent staff discussions on interpreting an individual’s behaviour, considering its functions and whether it is part of an involuntary neuro-psychological disorder related to their brain injury, specifically the Frontal Lobe Paradox. Through consideration of six patients, the cognitive mechanisms that may relate to, or underlie apparent Frontal Lobe Paradox were highlighted. Several additional reasons were found to explain why people might show this paradox, including testing conditions, slowed processing, reduced attention, disinhibition, self-monitoring problems, and premorbid difficulties. The authors also discuss interventions, which could be used to support these individuals, with the aim of broadening clinical understanding and discussion surrounding the causes of, and treatment approaches for individuals presenting with potential Frontal Lobe Paradox.

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HCPC registered psychologists with expertise and experience in neurorehabilitation. We offer services such as neuropsychological assessment NPsych
Blog, Diagnosis, Health, Memory, NPsychPick, Rehabilitation, Research, Trauma

#NPsychPick of the Month: Applying EMDR therapy with clients who have impaired cognitive abilities, EMDR Therapy Quarterly, Summer 2023

Neuro EMDR: Applying EMDR therapy with clients who have impaired cognitive abilities

Author: Dr Jonathan Hutchins Simon Proudlock

EMDR therapy has been shown to be highly effective and time efficient in addressing trauma memories in both adults and children. However, there are questions about how EMDR can be effective with adults who have experienced a brain injury or are experiencing other cognitive difficulties. This article summarises some of the recent research within the area and proposes adaptations to the standard protocol that can be made to make best use of EMDR therapy in this population.

Introduction

Within the UK in 2019-2020 there were 356,669 UK admissions to hospital with acquired brain injury (ABI), or any brain injury that has occurred after birth including traumatic brain injury (TBI), stroke or brain tumours, which is a 12% increase since 2005-2006 (Headway, 2023). In 2019, there were approximately 977 TBI admissions per day to UK hospitals, one every 90 seconds. The diagnostic criteria for TBI on the DSM V states that there must be an “impact to the head or other mechanisms of rapid movement or displacement of the brain within the skull with one or more of the following: loss of consciousness, posttraumatic amnesia, disorientation and confusion, neurological signs such as neuroimaging demonstrating injury or a worsening of a pre-existing seizure disorder” (American Psychiatric Association, 2013).

Click here to go to the full article…

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ABI, Blog, NeuropsychReport, NPsychPick, NPsychTeamResearch, Publications, Research

#NPsychTeamResearch – Impact of Covid-19 lockdown for people with brain injury in the UK. Carlacci De Mattia, Campbell, Parrett. The Neuropsychologist April 2023 via NPsych

The Neuropsychologist 15: 40-51

Impact of Covid-19 lockdown on the mood, behaviour, and social activities of people with brain injury in the UK: Results of a survey of brain injury professionals’ reports

De Mattia, Lucilla Carlacci

Campbell, Tomás

Parrett, Neil

#NPsychTeamResearch

 

Abstract

The Covid-19 related lockdown of March–June 2020 in the United Kingdom (UK) may have negatively affected mood and behaviour of people with brain injuries. Conversely, there may have been beneficial effects due to reduced demand on cognition and emotional regulation. In this online survey study, care coordinators (n=19) assessed the consequences of lockdown on 130 individuals with ABI (range 3–29 clients per care co-ordinator; 10–65years+; and mostly living in residential care). The majority of reports were of no change to mood, behaviour, or social functioning (105 ratings). However, respondents reported that 88 (68 per cent) clients presented with changes: 63 clients (48 per cent) had lower mood, higher distress, and agitation, and were less engaged in usual activities; while 25 clients (19 per cent) were reported to have improved. Moreover, 13/19 (68 per cent) of respondents reported increased vulnerabilities in their clients, and 5/19 (26 per cent) reported online exploitation, controlling behaviour from partner and financial scams. These data present a mixed picture of how the first national lockdown affected people with ABI.

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Brain Injury, eTechnologies, NPsychPick, Rehabilitation, Research

#NPsychPick of the Month: Use of smartphones and tablets after acquired brain injury to support cognition. Disabil. Rehabil.: Assist. Technol. April 2023

NPsych Pick of the Month: April 2023

Use of smartphones and tablets after acquired brain injury to support cognition

Journal: Disability and Rehabilitation: Assistive Technology, 2023

Authors: Simon Beaulieu-Bonneau and Laurie Dubois and Sarah-Jeanne Lafond-Desmarais and Seena Fortin and Gabrielle Forest-Dionne and Marie-Christine Ouellet and others.

Abstract

Objectives

To describe the use of mobile devices after acquired brain injury (ABI), from the perspectives of injured individuals and significant others, and to examine factors associated with mobile device use for cognition.

Methods

Cross-sectional study with 50 adults with moderate/severe traumatic brain injury or stroke (42% women; mean of 50.7 years old, 4.6 years post-ABI), and 24 significant others. Participants completed questionnaires on mobile technology, cognitive functioning and the impact of technology.

Results

Of 45/50 adults with ABI who owned a smartphone/tablet, 31% reported difficulties in using their device post-injury, 44% had received support, and 46% were interested in further training. Significant others reported motor/visual impairments and the fear of becoming dependent on technology as barriers for mobile device use, and 65% mentioned that their injured relative needed additional support. Mobile device use for cognition was common (64%), predicted in a regression model by lower subjective memory and more positive perception of the psychosocial impacts of technology, and also associated in univariate analyses with younger age, lower executive functioning, and greater use of memory strategies.

Conclusion

Using mobile devices for cognition is common post-ABI but remains challenging for a significant proportion. Developing training approaches may help supporting technology use.

  • IMPLICATIONS FOR REHABILITATION

  • Using mobile electronic devices (smartphones and tablets) is common after acquired brain injury (ABI) but is challenging for a significant proportion of individuals.

  • After the ABI, close to 50% of individuals receive support in using their mobile device, mostly from family members and friends, but rarely from rehabilitation clinicians or technology specialists.

  • In a sample of 50 adults with ABI, more frequent use of mobile devices to support cognition was associated with poorer subjective memory and executive functioning, greater use of memory strategies, more positive perception of the psychosocial impacts of technology, and younger age.

Click here to go to the article

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NPsychPick, Rehabilitation, Research, TBI

#NPsychTeamResearch: Objects with motor valence affect the visual processing of human body parts: Evidence from behavioural and ERP studies. Lucilla C De Mattia. Cortex, Aug, 2022 via NPsych

NPsych Pick of the Month, April 2021: The impact of Covid-19 and lockdown on the lives of people with traumatic brain injury: Do we need an increased focus on the assessment and enhancement of resilience? Campbell and Parrett. NPsych. The Neuropsychologist, 11, 2021.

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NPsychPick, Rehabilitation, Research, TBI

#NPsychTeamResearch: The impact of Covid-19 and lockdown on the lives of people with TBI. Campbell & Parrett. The Neuropsychologist 11, 2021 via NPsych

NPsych Pick of the Month, April 2021: The impact of Covid-19 and lockdown on the lives of people with traumatic brain injury: Do we need an increased focus on the assessment and enhancement of resilience? Campbell and Parrett. NPsych. The Neuropsychologist, 11, 2021.

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