| 1. |
- Björkdahl, Ann, 1959-, et al.
(författare)
-
Decline in cognitive function due to diffuse axonal injury does not necessarily imply a corresponding decline in ability to perform activities
- 2016
-
Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:10, s. 1006-1015
-
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.
|
|
| 2. |
- Esbjörnsson, Eva, et al.
(författare)
-
Cognitive impact of traumatic axonal injury (TAI) and return to work
- 2013
-
Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 27:5, s. 521-528
-
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
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Viktorisson, Adam, et al.
(författare)
-
Prestroke physical activity is associated with admission haematoma volume and the clinical outcome of intracerebral haemorrhage.
- 2023
-
Ingår i: Stroke and vascular neurology. - 2059-8696. ; 8:6, s. 511-20
-
Tidskriftsartikel (refereegranskat)abstract
- Prestroke physical activity (PA) has been linked to improved outcomes after intracerebral haemorrhage (ICH), but its association with ICH volume is unknown. We aimed to investigate associations of prestroke PA with location-specific haematoma volume and the clinical outcome of ICH.All patients with primary ICH, admitted to three hospitals between 2014 and 2019, were included. Patients performing light PA ≥4 hour/week the year before stroke were considered physically active. Haematoma volumes were assessed from admission brain imaging. Adjusted associations were estimated using multivariate linear and logistic regression models. Haematoma volume was explored as mediator to the relationship between prestroke PA and mild stroke severity (0-4 points on the National Institutes of Health Stroke Scale), a good 1-week functional status (0-3 points on the modified Rankin Scale) and 90-day survival. Average direct effects (ADE) and average causal mediation effects (ACME) were computed.Of 686 primary ICH cases, 349 were deep, 240 lobar and 97 infratentorial. Prestroke PA predicted smaller haematoma volumes in deep ICH (β=-0.36, SE=0.09, p<0.001) and lobar ICH (β=-0.23, SE=0.09, p=0.016). Prestroke PA was also associated with mild stroke severity (OR 2.53, 95% CI 1.59 to 4.01), a good 1-week functional status (OR 2.12, 95% CI 1.37 to 3.30) and 90-day survival (OR 3.48, 95% CI 2.06 to 5.91). Haematoma volume partly mediated the relationships between PA and stroke severity (ADE 0.08, p=0.004; ACME 0.10, p<0.001), 1-week functional status (ADE 0.07, p=0.03; ACME 0.10, p<0.001) and 90-day survival (ADE 0.14, p<0.001; ACME 0.05, p<0.001).Light PA ≥4 hour/week prior to ICH was associated with smaller haematoma volumes in deep and lobar locations. Physically active patients with ICH had a higher likelihood of mild stroke, a good 1-week functional status and 90-day survival, in part mediated by smaller haematoma volumes on admission.
|
|
