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- Björkdahl, Ann, 1959-, et al.
(författare)
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Decline in cognitive function due to diffuse axonal injury does not necessarily imply a corresponding decline in ability to perform activities
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:10, s. 1006-1015
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The study explored the direction of change (decline vs. improvement) after diffuse axonal injury (DAI) in the domains of the ICF: body structure, body function, and activity.Methods: Thirteen patients with DAI were assessed by using diffusion tensor imaging (DTI) to measure body structure, the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) to measure body function, and the Assessment of Motor and Process Skills (AMPS) to measure activity. The DTI, BNIS, and AMPS were applied at the acute phase (A1), and at 6 and 12 months post-injury (A2 and A3). Visual and statistical analyses were conducted to explore time-dependent changes in the ICF domains.Results: Improvements were observed for most patients in all ICF domains from injury until six months. Thereafter, the results diverged, with half of the subjects showing a decline in DTI and BNIS scores between A2–A3, and all but one of the patients exhibiting identical or better A2–A3 AMPS process skill scores.Conclusions: From 6 to 12 months post-injury, some patients underwent an ongoing degenerative process, causing a decline in cognitive function. The same decline was not observed in the activity measure, which might be explained by the use of compensatory strategies.Implications for rehabilitationIn rehabilitation it is essential to be aware that in some cases with TBI, an ongoing degenerative process in the white matter can be expected, causing an adverse late effect on cognitive function.The cognitive decline, caused by DAI, does not necessarily mean a concurrent decrease in activity performance, possibly explained by the use of compensatory strategies. This suggests that, after the post-acute phase, rehabilitation offering strategy training may be beneficial to enhance every-day functioning.Strategy use requires awareness, which imply the need to assess level of awareness in order to guide rehabilitation.
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- Esbjörnsson, Eva, et al.
(författare)
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Cognitive impact of traumatic axonal injury (TAI) and return to work
- 2013
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Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 27:5, s. 521-528
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Axonal injury (AI) after traumatic brain injury (TBI) is often overlooked as an explanation Methods: The sample included 17 patients younger than 65 years old, however one died. In the acute Results: After 1 year, all patients still showed cognitive dysfunction. A recovery had been noted at 6
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- Hofgren, Caisa, 1952, et al.
(författare)
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A comparison between two screening instruments for cognitive function; the Mini-Mental State Examination (MMSE) and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS).
- 2009
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Ingår i: 5th World Congress of the International Society of Physical and Rehabilitation Medicine (ISPRM), Istanbul, Turkey.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To compare two methods for brief assessment of cognitive functions in a neurorehabilitation setting. The Mini Mental State Examination (MMSE) is a well-known instrument for a brief, structured assessment of cognitive function. A more recent instrument, the Barrow Neurological Institute Screen for Higher Cerebral Functions was constructed to cover a broad range of cognitive functions including aspects of affect and awareness. Materials&Methods: 52 patients with neurological diagnosis (stroke, traumatic brain injury, anoxic brain injury, Parkinson´s disease) were assessed with the MMSE and the BNIS. Concordance of the scales was assessed with Goodman-Kruskal´s gamma and scale structure (parallel reliability) was explored with Rank Transformable Pattern of Agreement (RTPA). A linking to the ICF at item-level was performed. Results: 36 men and 16 women (median age 52 years) were recruited. Median number of days between admittance to hospital and screening was 47 (MMSE) and 51 (BNIS). Concordance between the two instruments was good with a gamma coefficient of 0.724 (p=0.0005). RTPA identified different width of the scale steps showing that BNIS discriminated between the subjects that reached the high end of the MMSE scale and MMSE discriminated somewhat better between individuals with lower scores. The MMSE covered 12 ICF categories on Body function and 14 on Activities and Participation. BNIS covered 18 categories on Body functions and 16 on Activities and Participation. Conclusion: The concordance between MMSE and BNIS was good but the scales are not completely interchangeable. The BNIS differentiated those who reached the ceiling on MMSE. More ICF categories on Body function were assessed with the BNIS which might explain this.
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| 10. |
- Hofgren, Caisa, 1952, et al.
(författare)
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Application and validation of the Barrow Neurological Institute Screen for higher cerebral functions in a control population and in patient groups commonly seen in neurorehabilitation.
- 2007
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 39:7, s. 547-53
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine whether the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) can differentiate brain-dysfunctional patients from controls. DESIGN: A case-control study. SUBJECTS: A total of 92 controls and 120 patients from a neuro-rehabilitation clinic with a diagnosis of: right and left hemisphere stroke, traumatic brain injury, Parkinson's disease or anoxic brain damage. METHODS: The BNIS has a maximum total score of 50 points, < 47 indicates cognitive dysfunction. Group comparisons and exploration of variables influencing the BNIS total score were made. RESULTS: A significant difference was found between the control group and the total patient group for the BNIS total score and for the subscales (p < 0.0005). Sensitivity was 88% and specificity 78%. Presence of disease and educational level had the greatest influence on the results of the BNIS. Patients with Parkinson's disease were shown to be the least cognitively affected and those with anoxic brain damage the most affected. CONCLUSION: The BNIS has potential value as a screening instrument for cognitive functions and is sufficiently sensitive to differentiate brain-dysfunctional patients from a control population. It appears to be applicable in a neurological rehabilitation setting, and can be used early in the process, giving a baseline cognitive functional level.
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