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Using Technology to Overcome Impairments of Mental Functions
Published in Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth, Neuropsychological Rehabilitation, 2017
Brian O'Neill, Matthew Jamieson, Rachel Goodwin
Disorientation to brain injury status and rationale for treatment is a common difficulty after brain injury. One study explored the use of scripted orientation videos with five people who demonstrated a lack of insight and disorientation at three months post-injury. The videos were viewed daily, where significant others gave information on current setting and rehabilitation goals (where they were and why) and reassurance as to their safety and their identity within the family group. This significantly increased orientation scores on the Galveston Orientation and Amnesia Test (GOAT) in three of five participants. When an extended GOAT, including six insight questions, was used four of the five subjects showed significant improvements (Brown et al., 2013). Therefore using family orientation videos may effectively address difficulties with awareness.
Diffusion tensor imaging findings and neuropsychological performance in adults with TBI across the spectrum of severity in the chronic-phase
Published in Brain Injury, 2021
Katherine L. Zane, Jeffrey D. Gfeller, P. Tyler Roskos, Jeff Stout, Tony W. Buchanan, Thomas M. Malone, Richard Bucholz
Participants with a TBI were divided into two groups: mild versus moderate or severe TBI. Injury severity criteria were based on the Defense and Veterans Affairs Consensus Definition of Traumatic Brain Injury (23), as follows: Mild [normal structural imaging, loss of consciousness (LOC) <30 min, post-traumatic amnesia/confusion (PTA) <1 day, initial Glasgow Coma Scale (GCS) = 13–15]; moderate [normal or abnormal structural imaging, LOC = 30 min to 24 hours, PTA = 1–7 days, initial GCS = 9–12]; or severe [normal or abnormal structural imaging, LOC > 24 hours, PTA > 7 days, initial GCS < 9]. All participants with a TBI were ≥4-month post-injury and none exhibited significant confusion at the time of the study (e.g., Galveston Orientation and Amnesia Test ≥75). For the moderate to severe group, 11 of 24 participants who completed MRI scans showed abnormal findings (e.g., mild volume loss, encephalomalacia, chronic contusions, gliosis).
Return to work after severe traumatic brain injury: a national study with a one-year follow-up of neurocognitive and behavioural outcomes
Published in Neuropsychological Rehabilitation, 2020
Solrun Sigurdardottir, Nada Andelic, Eike Wehling, Audny Anke, Toril Skandsen, Oyvor Oistensen Holthe, Unn Sollid Manskow, Cecilie Roe
One-hundred four individuals attended neuropsychological assessments at the one-year follow-up (see Figure 1). Exclusion criteria for attending this assessment were if the patient did not master the Norwegian language or had a Galveston Orientation and Amnesia Test (GOAT) score lower than 75 at the one-year follow-up (Levin, O’Donnell, & Grossman, 1979), which applied to 10 individuals. Another 22 individuals did not wish to participate in the neuropsychological assessment, and seven were unable to attend the follow-up. No significant differences were found between individuals who completed the neuropsychological assessment (n = 104) and those who did not (n = 39) regarding age, gender, education, length of stay in intensive care, Rotterdam CT scores, AIS head and ISS scores (all p > .07).
Cognitive rehabilitation after severe acquired brain injury: current evidence and future directions
Published in Neuropsychological Rehabilitation, 2018
Rosaria De Luca, Rocco Salvatore Calabrò, Placido Bramanti
In the acute phase, the Glasgow Coma Scale (GCS), the most commonly used system for classifying TBI severity, grades a person’s level of consciousness on a scale of 3–15, based on verbal, motor, and eye-opening reactions to stimuli. In severe TBI (GCS score < 8) the cognitive deficits are pervasive, with the most profound impairments in the domains of attention, working memory, learning, and executive functions (Dikmen et al., 2009; Jannett & Bond, 1975; Millis et al., 2001). Thus, a proper neuropsychological assessment is needed in all the patients suffering from SABI, although it may be “time-consuming” and requires special expertise to administer and interpret the tests (Cristofori & Levin, 2015; Iaccarino, Bhatnagar, & Zafonte, 2015). In TBI, neuropsychological assessment (using specific tools, including the Halstead-Reitan Neuropsychological Battery) (Lezak, 1995) is often performed during hospitalisation. The Galveston Orientation and Amnesia Test (GOAT) is a repeatable test, investigating post-traumatic amnesia and helping to predict TBI outcome (Levin, O’Donnell, & Grossman, 1979). Since frontal lobe dysfunction is frequent post-TBI, the Wisconsin Card Sorting Test (WCST), Category Test and Stroop Tests should also be used (Lezak, Howieson, & Loring, 2004; Lezak, Howieson, Bigler, & Tranel, 2012).