Post-flight confusion: does flying affect the brain? BJPsych Intern, Feb, 2020
This paper describes a condition termed post-flight confusion using anecdotal and clinical observations.
Get In Touch With Us
0207 164 6821
This paper describes a condition termed post-flight confusion using anecdotal and clinical observations.
Specialist rehabilitation proved highly cost-efficient for severely disabled patients with TBI.
Neuropsychological assessment can improve both diagnostic classification and prediction of long-term daily-life outcomes in patients across the lifespan.
Psychological resilience plays an important role in recovery from concussion, and this relationship may be mediated by anxiety and depressive symptoms.
Structural and functional connectivity changes in response to short-term neurofeedback training with motor imagery
T.Marins, E.C. Rodrigues, T.Bortolini, Bruno Melo, J.Molla, F.Tovar-Molla. Available online 18 March 2019. In Press, Corrected Proof. NeuroImage
https://doi.org/10.1016/j.neuroimage.2019.03.027
Abstract
Recent findings have been challenging current understanding of how fast the human brain change its structural and functional connections in response to training. One powerful way to deepen the inner workings of human brain plasticity is using neurofeedback (NFB) by fMRI, a technique that allows self-induced brain plasticity by means of modulating brain activity in real time. In the present randomized, double-blind and sham-controlled study, we use NFB to train healthy individuals to reinforce brain patterns related to motor execution while performing a motor imagery task, with no overt movement. After 1 h of NFB training, participants displayed increased fractional anisotropy (FA) in the sensorimotor segment of corpus callosum and increased functional connectivity of the sensorimotor resting state network. Increased functional connectivity was also observed in the default mode network. These results were not observed in the control group, which was trained with sham feedback. To our knowledge, this is the first demonstration of white matter FA changes following a very short training schedule (<1 h). Our results suggest that NFB by fMRI can be an interesting tool to explore dynamic aspects of brain plasticity and open new venues for investigating brain plasticity in healthy individuals and in neurological conditions.
Effects of animal-assisted therapy on social behaviour in patients with acquired brain injury: a randomised controlled trial.
Karin Hediger, Stefan Thommen, Cora Wagner, Jens Gaab & Margret Hund-Georgiadis. Nature: Scientific Reports, volume 9, Published: 09 April 2019.
https://www.nature.com/articles/s41598-019-42280-0
Abstract
Animal-assisted therapy (AAT) is increasingly used to address impaired social competence in patients with acquired brain injury. However, the efficacy of AAT has not been tested in these patients. We used a randomised, controlled within subject trial to determine the effects of AAT on social competence in patients undergoing stationary neurorehabilitation. Participants received both AAT sessions and paralleled conventional therapy sessions. The patients’ social behaviour was systematically coded on the basis of video recordings of therapy sessions. Moreover, mood, treatment motivation and satisfaction was measured during each therapy session. We analysed 222 AAT and 219 control sessions of 19 patients with linear mixed models. Patients showed a significantly higher amount of social behaviour during AAT. Furthermore, patients’ positive emotions, verbal and non-verbal communication, mood, treatment motivation and satisfaction were increased in the presence of an animal. Neutral emotions were reduced but no effect was found regarding negative emotions. Our results show that AAT increases aspects of social competence and leads to higher emotional involvement of patients with acquired brain injury, reflected in higher social engagement, motivation and satisfaction during a therapeutic session.
In summary, CCR5 is a translational target for neural repair in stroke and TBI and the first reported gene associated with enhanced recovery in human stroke.
Helmet use in preventing acute concussive symptoms in recreational vehicle related head trauma
Marco Daverio, Franz E Babl, Ruth Barker, Dario Gregori, Liviana Da Dalt & Silvia Bressan
Pages 335-341, Brain Injury. Published online: 22 Jan 2018
https://doi.org/10.1080/02699052.2018.1426107
ABSTRACT
Objectives: Helmets use has proved effective in reducing head trauma (HT) severity in children riding non-motorised recreational vehicles. Scant data are available on their role in reducing concussive symptoms in children with HT while riding non-motorised recreational vehicles such as bicycles, push scooters and skateboards (BSS). We aimed to investigate whether helmet use is associated with a reduction in acute concussive symptoms in children with BSS-related-HT.
Methods: Prospective study of children <18 years who presented with a BSS related-HT between April 2011 and January 2014 at a tertiary Paediatric Emergency Department (ED).
Results: We included 190 patients. Median age 9.4 years (IQR 4.8–13.8). 66% were riding a bicycle, 23% a push scooter, and 11% a skateboard. 62% were wearing a helmet and 62% had at least one concussive symptom. Multivariate logistic regression analysis adjusting for age, gender, and type of vehicle showed that patients without a helmet presented more likely with headache (adjusted odds-ratio (aOR) 2.54, 95% CI 1.27–5.06), vomiting (aOR 2.16, 95% CI 1.00–4.66), abnormal behaviour (aOR 2.34, 95% CI 1.08–5.06), or the presence of at least one concussive symptom (aOR 2.39, 95% CI 1.20–4.80).
Conclusions: In children presenting to the ED following a wheeled BSS-related HT helmet use was associated with less acute concussive symptoms.
ABBREVIATIONS: aOR, adjusted odds ratio; APHIRST, Australasian Paediatric Head Injury Rules Study; BSS, bicycles, push scooters and skateboards; CI, confidence interval; CT, computed tomography; ED, emergency department; HT, head trauma; IQR, interquartile range; OR, odds ratio; RCH, Royal Children’s Hospital; RV, recreational vehicle.
Risk of Posttraumatic Stress Disorder and Major Depression in Civilian Patients After Mild Traumatic Brain Injury A TRACK-TBI Study.
Stein, Sonia Jain, Giacino et al. JAMA Psychiatry. 2019; 76(3):249-258.
https://doi.org/10.1001/jamapsychiatry.2018.4288
Published online: January 30, 2019
Importance Traumatic brain injury (TBI) has been associated with adverse mental health outcomes, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), but little is known about factors that modify risk for these psychiatric sequelae, particularly in the civilian sector.
Objective To ascertain prevalence of and risk factors for PTSD and MDD among patients evaluated in the emergency department for mild TBI (mTBI).
Design, Setting, and Participants Prospective longitudinal cohort study (February 2014 to May 2018). Posttraumatic stress disorder and MDD symptoms were assessed using the PTSD Checklist for DSM-5 and the Patient Health Questionnaire-9 Item. Risk factors evaluated included preinjury and injury characteristics. Propensity score weights-adjusted multivariable logistic regression models were performed to assess associations with PTSD and MDD. A total of 1155 patients with mTBI (Glasgow Coma Scale score, 13-15) and 230 patients with nonhead orthopedic trauma injuries 17 years and older seen in 11 US hospitals with level 1 trauma centers were included in this study.
Main Outcomes and Measures Probable PTSD (PTSD Checklist for DSM-5 score, ≥33) and MDD (Patient Health Questionnaire-9 Item score, ≥15) at 3, 6, and 12 months postinjury.
Results Participants were 1155 patients (752 men [65.1%]; mean [SD] age, 40.5 [17.2] years) with mTBI and 230 patients (155 men [67.4%]; mean [SD] age, 40.4 [15.6] years) with nonhead orthopedic trauma injuries. Weights-adjusted prevalence of PTSD and/or MDD in the mTBI vs orthopedic trauma comparison groups at 3 months was 20.0% (SE, 1.4%) vs 8.7% (SE, 2.2%) (P < .001) and at 6 months was 21.2% (SE, 1.5%) vs 12.1% (SE, 3.2%) (P = .03). Risk factors for probable PTSD at 6 months after mTBI included less education (adjusted odds ratio, 0.89; 95% CI, 0.82-0.97 per year), being black (adjusted odds ratio, 5.11; 95% CI, 2.89-9.05), self-reported psychiatric history (adjusted odds ratio, 3.57; 95% CI, 2.09-6.09), and injury resulting from assault or other violence (adjusted odds ratio, 3.43; 95% CI, 1.56-7.54). Risk factors for probable MDD after mTBI were similar with the exception that cause of injury was not associated with increased risk.
Conclusions and Relevance After mTBI, some individuals, on the basis of education, race/ethnicity, history of mental health problems, and cause of injury were at substantially increased risk of PTSD and/or MDD. These findings should influence recognition of at-risk individuals and inform efforts at surveillance, follow-up, and intervention.
Sport-related Concussion Clinical Profiles: Clinical Characteristics, Targeted Treatments, and Preliminary Evidence.
Kontos, Sufrinko, Sandel, Emami, Collins. Curr Sports Med Rep. 2019 Mar;18(3):82-92.
www.doi.org/10.1249/JSR.0000000000000573
Abstract
Sport-related concussion (SRC) is a heterogeneous injury that involves varied symptoms and impairment that presents a significant clinical challenge to sports medicine professionals.
In response to this challenge, clinical researchers have proposed clinical profiles or subtype models for assessing and treating athletes with SRC. One such model emphasizes five concussion clinical profiles including cognitive/fatigue, vestibular, ocular, migraine, and anxiety/mood. Sleep is a common modifier that co-occurs across these clinical profiles. A combination of medical history, risk factors, injury information, clinical characteristics, and assessment outcomes can inform each clinical profile.
Preliminary data involving 236 patients from a concussion specialty clinic indicate that the migraine (26%) and anxiety/mood (24%) profiles are the most common, with vestibular and ocular profiles combined representing more than one third (35%) of clinical profiles.
Findings also support several relationships among different clinical profiles including vestibular and migraine, suggesting that many athletes present with multiple clinical profiles. Targeted, active treatments for each profile are discussed.
0207 164 6821
7 Ducketts Mead, Roydon, Essex, UK
Company Name: Npsych Limited. Company Number: 07119496, Place of Registration: England and Wales. Registered Office: 7 Ducketts Mead, Roydon, Essex, CM19 5EG
Copyright All Rights Reserved © 2022 │ Privacy Policy │ Disclaimer │ NPsych Limited │ Designed by The Look Blog Agency
