| 1. |
- Blomgren, Charlotte, et al.
(author)
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Long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors-Impact of cognitive dysfunction, emotional problems and fatigue.
- 2019
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 14:5
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Journal article (peer-reviewed)abstract
- With an upward trend in the number of people who return home to independent living after stroke, the ability to perform more complex activities is becoming an increasingly important long-term outcome after stroke. Although associations between Instrumental Activities of Daily Living (IADL) and cognitive dysfunction, emotional problems, and fatigue have been reported, less is known about the long-term impact of these stroke consequences on the performance of everyday activities in young and middle-aged stroke survivors.To explore the impact of cognitive dysfunction, emotional problems, and fatigue on long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors.Data on stroke survivors, aged 18-69 at index stroke, were collected from the Sahlgrenska Academy Study on Ischaemic Stroke. IADL outcome was assessed using the Frenchay Activities Index (FAI), and the impact of chosen variables was assessed using Spearman´s rank-order correlation and logistic regression.Seven years after index stroke, 296 stroke survivors (median age of 64) were included in this study. Cognitive dysfunction showed the strongest correlations with FAI outcome and independently explained worse outcome on FAI summary score and the domain of work/leisure activities. Fatigue was independently explanatory of worse outcome on FAI summary score and domestic chores, while depressive symptoms independently explained worse outcome on work/leisure activities. In a subgroup with only those participants who had no or minimal residual neurological deficits at follow-up (NIHSS score 0), cognitive dysfunction independently explained worse outcome on FAI summary score and work/leisure activities. Depressive symptoms independently explained worse outcome on FAI summary score and domestic chores.Our results show that in young and middle-aged stroke survivors, cognitive dysfunction, depressive symptoms, and fatigue negatively impact performance of IADL even at seven years post stroke onset. Further, we have shown that an impact of both cognitive dysfunction and depressive symptoms can be found also among stroke survivors with mild or no remaining neurological deficits.
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| 2. |
- Broeren, Jurgen, et al.
(author)
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Virtual rehabilitation after stroke.
- 2008
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In: Studies in health technology and informatics. - 0926-9630 .- 1879-8365. ; 136, s. 77-82
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Journal article (peer-reviewed)abstract
- The purpose of this project was to investigate the effects of Virtual Reality technology and haptics for stroke rehabilitation. Twenty-nine stroke subjects, 17 women, and 12 men aged 44-85 years, participated in three different studies. All participants responded favorable to the use of the VR activity station. A change of attitude took place after the subjects were exposed to playing computer games. The general experience with the VR application approach suggests that this treatment concept is promising in stroke rehabilitation, with a wide range of applicability.
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| 3. |
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| 4. |
- Gerafi, Joel, et al.
(author)
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Neglect and aphasia in the acute phase as predictors of functional outcome 7 years after ischemic stroke
- 2017
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In: European Journal of Neurology. - : Wiley. - 1351-5101 .- 1468-1331. ; 24:11, s. 1407-1415
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Journal article (peer-reviewed)abstract
- © 2017 EAN Background and purpose: Visuospatial inattention (VSI) and language impairment (LI) are often present early after stroke and associations with an unfavorable short-term functional outcome have been reported. The purpose of this study was to investigate whether a screening of VSI and LI as indicators of cortical symptoms early after stroke could predict long-term functional outcomes. Methods: A consecutive cohort of 375 patients with ischemic stroke was assessed for the occurrence of VSI at a median of 7 days after admission (interquartile range, 1–5 days) using the Star Cancellation Test and for LI (within the first 7 days) with the language item in the Scandinavian Stroke Scale. Seven years later, functional outcomes were assessed by the modified Rankin scale and Frenchay Activities Index in 235 survivors without recurrent stroke. Relationships between baseline predictors and functional outcome at 7 years were analyzed with bivariate correlations and multiple categorical regressions with optimal scaling. Results: The regression model significantly explained variance in the modified Rankin scale (R 2 = 0.435, P < 0.001) and identified VSI (P = 0.001) and neurological deficits (P < 0.001; Scandinavian Stroke Scale score without the language item) as the significant independent predictors. The model for Frenchay Activities Index was also significant (R 2 = 0.269, P < 0.001) with VSI (P = 0.035) and neurological deficits (P < 0.001) as significant independent predictors. Conclusions: Visuospatial inattention at acute stroke has an independent impact on long-term functional outcomes. Early recognition may enable targeted rehabilitative interventions.
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| 5. |
- Andersson-Roswall, Lena, 1965, et al.
(author)
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Cognitive outcome 10 years after temporal lobe epilepsy surgery: a prospective controlled study
- 2010
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In: Neurology. - 0028-3878. ; 74:24, s. 1977-1985
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Journal article (peer-reviewed)abstract
- Objective: To explore late effects of temporal lobe resection (TLR) for epilepsy on general cognitive level and memory. Methods: Fifty-one patients who had undergone TLR (23 in the speech-dominant temporal lobe [DTL] and 28 in the nondominant temporal lobe [NDTL]) were assessed preoperatively and 2 and 10 years postoperatively. Twenty-three healthy controls were assessed at baseline and at corresponding intervals. A battery of standardized tests for assessment of general cognitive level and memory was analyzed using a linear mixed model of between-subjects treatment effect and within-subject time effect. Results: The main result was cognitive stability from 2 to 10 years after TLR. The DTL group had declined in verbal memory at the 10-year follow-up compared to the NDTL group and to the controls. However, this decline was detected already 2 years postoperatively, with no further decline from 2 to 10 years. The memory decline was not related to seizure outcome or AED treatment. The NDTL group showed less improvement in performance IQ (PIQ) at the 10-year follow-up compared to the controls. The most important correlate to inferior PIQ scores was continuing seizures, which was more frequent in the NDTL group. Conclusions: In this study, the main finding was cognitive stability from 2 to 10 years after temporal lobe resection. There was no further decline in verbal memory from 2 to 10 years after surgery, lending no support to the notion of an ongoing progressive decline in verbal memory after temporal lobe resection. The verbal memory course was not dependent on seizure outcome or antiepileptic drug treatment.
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| 6. |
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| 7. |
- Andersson-Roswall, Lena, 1965, et al.
(author)
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Verbal cognition and attention deficits do not explain the verbal memory decline associated with pharmacoresistant partial epilepsy
- 2007
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In: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050. ; 11:3, s. 413-420
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore whether change in verbal memory with time in patients with epilepsy is influenced by performance on tasks assessing verbal cognition or attention/processing speed. Thirty-six patients and twenty-five healthy controls were tested twice with median retest intervals of 4.8 and 3.1 years, respectively. Aspects of verbal memory, verbal cognition, and attention/processing speed were assessed. Decline in one verbal memory variable (Cronholm–Molander Memory Test Paired Associates—Delayed Recall) was the strongest correlate of epilepsy. The second strongest correlate was a decrease in one attention/processing speed variable (Digit Symbol). The relationship between decline in verbal memory and epilepsy was not influenced by the decline in attention/processing speed, and the results did not support the notion that limited mental reserves as reflected in impaired verbal cognition or attention/processing speed can explain the relationship between verbal memory and epilepsy.
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| 8. |
- Andersson-Roswall, L, et al.
(author)
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Verbal memory decline and adverse effects on cognition in adult patients with pharmacoresistant partial epilepsy: A longitudinal controlled study of 36 patients
- 2004
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In: Epilepsy & Behavior. ; 5:5, s. 677-686
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Journal article (peer-reviewed)abstract
- The aim of this study was to delineate possible longitudinal cognitive changes in adult patients with a long history of pharmacoresistant partial epilepsy. Thirty-six patients and thirty healthy controls were investigated at baseline. A reassessment was conducted, with median test intervals of 4.8 years for the patients and 3.1 years for controls. A standardized battery was used for assessment of general cognitive level and memory. At baseline, patients performed at a significantly lower level on general cognition, immediate recall of pairs of associated words, and retention of learned words and visuospatial stimuli, compared with controls. Analyses of change over time in the patients disclosed significant verbal memory decline in retention of pairs of associated words. Group comparisons of change over time revealed adverse effects in the performance aspect of general cognition on the patients. Also, group comparisons indicated impaired performance across time for the patients in retention of pairs of associated words and retention of visuospatial stimuli. The adverse effect on memory and general cognition in this patient group over the period was clear-cut when compared with the longitudinal changes in an adequate control group.
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| 9. |
- Andersson-Roswall, Lena, 1965, et al.
(author)
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Verbal memory decline is less frequent at 10 years than at 2 years after temporal lobe surgery for epilepsy
- 2012
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In: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050. ; 24:4, s. 462-467
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Journal article (peer-reviewed)abstract
- We investigated individual short-and long-term verbal memory changes after temporal lobe resection for epilepsy. Fifty-one patients (23 operated on the speech-dominant temporal lobe, DTL and 28 on the non-dominant temporal lobe, NDTL) were tested on learning/immediate recall and delayed recall of word-list and word-pairs preoperatively, 2 years postoperatively and 10 years postoperatively. Changes were defined using reliable change indices of 23 healthy controls assessed at corresponding intervals. Fewer patients had reliable declines at 10 years than at 2 years (DTL: 13-35% vs 35-44%; NDTL: 0-4% vs 7-21%). Four DTL patients (17%) had reliable declines in >= 2 tests at 10-year follow-up. More NDTL patients had improvement at 10 years than at 2 years (18-30% vs 4-22%). The only risk factor for decline both short and long term was DTL resection. In conclusion, most patients had stable verbal memory postoperatively. A few DTL patients had a lasting decline at long-term follow-up, but more patients showed partial recovery, especially in the NDTL group. (C) 2012 Elsevier Inc. All rights reserved.
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| 10. |
- Andreasson, Björn, et al.
(author)
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The measurement of venous haematocrit in patients with polycythaemia vera.
- 1999
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In: Journal of internal medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 246:3, s. 293-7
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Journal article (peer-reviewed)abstract
- OBJECTIVE: In clinical practice, patients with polycythaemia vera (PV) are monitored by measurement of venous packed cell volume (PCV). However, whereas treatment recommendations are still based upon studies in which the results were obtained with the centrifuged microhaematocrit, currently in most instances automated blood cell counters are used to calculate PCV. In a group of patients with polycythaemia we therefore compared the results obtained by the microhaematocrit method with PCV calculated by haematology analysers. DESIGN: The study was carried out on a prospective basis. Duplicate venous blood samples were collected. The centrifuged microhaemotocrit was obtained by using an IEC Micro-MB Centrifuge. Depending on different routine methods used in the participating hospitals, the blood cell counter PCV was calculated using Coulter STKS, Bayer Technicon H2 or H3. SETTING: Patients were included from four Swedish university hospitals: Akademiska (Uppsala), Huddinge and Karolinska (Stockholm) and Sahlgrenska (Göteborg). SUBJECTS: Seventy-four patients with PV and 10 patients with secondary polycythaemia were included and a total of 150 duplicate blood samples were analysed from these subjects. RESULTS: In the 150 measurements the mean blood cell counter calculated PCV was 0.448 +/- 0.037; the mean for centrifuged microhaematocrit was 0.467 +/- 0. 037 and the difference between means was highly significant (P = 6.8 x 10-25). The means for centrifuged haematocrit and calculated PCV differed significantly in the groups of PV patients treated with phlebotomy only, hydroxyurea or radiophosphorous (P < 0.0001, respectively). In PV patients treated with alpha-interferon and in patients with secondary polycythaemia the difference in means did not reach statistical significance (P = 0.07 and P = 0.13, respectively). The groups of patients with MCV <80 fL and >/=80 fL both presented significant differences between means for calculated PCV and centrifuged haematocrit. CONCLUSIONS: If PV patients are monitored with blood cell counter calculated PCV it appears that the therapeutic goal should be to maintain the calculated PCV below 0.43, provided the local differences in calculated PCV and centrifuged haematocrit are of the same magnitude as in this study.
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| 11. |
- Brandberg, M, et al.
(author)
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A comparative study of simple and interference reaction times in men and women
- 2018
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In: Conference program The 13th Nordic Meeting in Neuropsychology Stockholm, 2018.
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Conference paper (other academic/artistic)abstract
- Introduction: studies on reaction time (RT) indicate faster reactions for men than women. However, when comparing samples across decades, this difference seems to decrease. The aim of this study was to explore reaction times in a large contemporary sample of adult males and females (age range = 15-82). Methods: simple reaction time and interference reaction time (a go/no go reaction task) were measured with the Vienna Reaction Apparatus (Wiener Reaktionstest, Schuhfried), RT, version S1 and S2 for simple reaction time and version S3 and S4 for interference reaction time. Results Men responded faster on the interference reaction task, S3 (M=441,57, SD=80,86) than women (M=461,53, SD=91,53). This difference was significant,t(3,7) = p<0,001 and represent a small sized effect, d= .21. There were no significant differences regarding simple reaction time (S1 and S2) or on the other interference task (S4). In regards to intraindividual variability there was a significant difference, t(3.1), p=.002, d=.21, with less variability in males (M=65.99) as compared to females (M=70,45) on S3. Conclusions: when comparing groups, men performed slightly faster on one of the interference tasks. However, there were no significant differences on the other measures. This result is consistent with previous studies indicating a decrease in differences on reaction times, comparing men and women. Grant support: Skaraborg Research and Development Council, Research Fund at Skaraborg Hospital and The Swedish Stroke Association.
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| 12. |
- Brandberg, Martin, 1972, et al.
(author)
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A comparative study on simple and interference reaction times in women and men.
- 2018
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In: Conference program, The 13th Nordic Meeting in Neuropsychology, Stockholm, 2018.
-
Conference paper (other academic/artistic)abstract
- Introduction: studies on reaction time (RT) indicate faster reactions for men than women. However, when comparing samples across decades, this difference seems to decrease. The aim of this study was to explore reaction times in a large contemporary sample of adult males and females (age range = 15-82). Methods: Simple reaction time and interference reaction time (a go/no go reaction task) were measured with the Vienna Reaction Apparatus (Wiener Reaktionstest, Schuhfried), RT, version S1 and S2 for simple reaction time and version S3 and S4 for interference reaction time. Results: men responded faster on the interference reaction task, S3 (M=441,57, SD=80,86) than women (M=461,53, SD=91,53). This difference was significant, t(3,7) = p<0,001 and represent a small sized effect, d = .21. There were no significant differences regarding simple reaction time (S1 and S2) or on the other interference task (S4). In regards to intraindividual variability there was a significant difference, t(3.1), p =.002, d =.21, with less variability in males (M =65.99) as compared to females (M=70,45) on S3. Conclusions: when comparing groups, men performed slightly faster on one of the interference tasks. However, there were no significant differences on the other measures. This result is consistent with previous studies indicating a decrease in differences on reaction times, comparing men and women.
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| 13. |
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| 14. |
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| 15. |
- Broeren, Jurgen, et al.
(author)
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Neglect assessment as an application of virtual reality.
- 2007
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In: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 116:3, s. 157-63
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Journal article (peer-reviewed)abstract
- OBJECTIVE: In this study a cancellation task in a virtual environment was applied to describe the pattern of search and the kinematics of hand movements in eight patients with right hemisphere stroke. METHODS: Four of these patients had visual neglect and four had recovered clinically from initial symptoms of neglect. The performance of the patients was compared with that of a control group consisting of eight subjects with no history of neurological deficits. RESULTS: Patients with neglect as well as patients clinically recovered from neglect showed aberrant search performance in the virtual reality (VR) task, such as mixed search pattern, repeated target pressures and deviating hand movements. The results indicate that in patients with a right hemispheric stroke, this VR application can provide an additional tool for assessment that can identify small variations otherwise not detectable with standard paper-and-pencil tests. CONCLUSION: VR technology seems to be well suited for the assessment of visually guided manual exploration in space.
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| 16. |
- Brännmark, Cecilia, et al.
(author)
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FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke
- 2023
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In: Bmj Open. - 2044-6055. ; 13:5
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Journal article (peer-reviewed)abstract
- ntroduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusion started early 2018 and we aim to enrol minimum 500 patients. Neurological and cognitive impairments across multiple domains are assessed using validated clinical assessment methods, advanced neuroimaging is performed and blood samples for biomarker measuring (protein, RNA and DNA) at inclusion and follow-up visits at 3 months, 6 months, 1 year, 2 years and 5 years poststroke. At baseline and at each follow-up visit, we also register clinical variables known to influence outcomes such as prestroke functioning, stroke severity, acute interventions, rehabilitation, other treatments, socioeconomic status, infections (including COVID-19) and other comorbidities. Recurrent stroke and other major vascular events are identified continuously in national registers. Ethics and dissemination FIND composes a unique stroke cohort with detailed phenotyping, repetitive assessments of outcomes across multiple neurological and cognitive domains and patient-reported outcomes as well as blood and imaging biomarker profiling. Ethical approval for the FIND study has been obtained from the Regional Ethics Review Board in Gothenburg and the Swedish Ethics Review Board. The results of this exploratory study will provide novel data on the time course of recovery and biomarkers after stroke. The description of this protocol will inform the stroke research community of our ongoing study and facilitate comparisons with other data sets.
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| 17. |
- Bunketorp Käll, Lina, 1975, et al.
(author)
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Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke A Randomized Controlled Trial
- 2017
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In: Stroke. - : Ovid Technologies (Wolters Kluwer Health). - 0039-2499 .- 1524-4628. ; 48:7, s. 1916-1924
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Journal article (peer-reviewed)abstract
- Background and Purpose-Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke. Methods-Participants were assigned to rhythm-and-music therapy, horse-riding therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3-and6-month follow-up. Results-One hundred twenty-three participants were assigned to rhythm-and-music therapy (n=41), horse-riding therapy (n=41), or control (n=41). Post-intervention, the perception of stroke recovery ( mean change from baseline on a scale ranging from 1 to 100) was higher among rhythm-and-music therapy (5.2 [95% confidence interval, 0.79-9.61]) and horse-riding therapy participants (9.8 [95% confidence interval, 6.00-13.66]), compared with controls (-0.5 [-3.20 to 2.28]); P=0.001 (1-way ANOVA). The improvements were sustained in both intervention groups 6 months later, and corresponding gains were observed for the secondary outcomes. Conclusions-Multimodal interventions can improve long-term perception of recovery, as well as balance, gait, grip strength, and working memory in a mixed population of individuals in late phase after stroke.
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| 18. |
- Bunketorp Käll, Lina, 1975, et al.
(author)
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Motor Function in the Late Phase After Stroke: Stroke Survivors' Perspective
- 2020
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In: Annals of Rehabilitation Medicine-Arm. - : Korean Academy of Rehabilitation Medicine. - 2234-0645 .- 2234-0653. ; 44:5, s. 362-369
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Journal article (peer-reviewed)abstract
- Objective To examine the association between observer-assessed functional status and perceived recovery in the late phase after stroke. The study also aimed to determine whether observer-assessed functional improvements as a result of horse-riding therapy (H-RT) are related to enhanced perception of stroke recovery. Methods This is a descriptive correlational study using data derived from a three-armed randomized controlled trial in which 123 individuals were enrolled, among whom 43 received H-RT for 12 weeks. The measures included the Modified Motor Assessment Scale, Berg Balance Scale, Timed Up and Go, timed 10-m walk, and perceived recovery from stroke indicated by item #9 in the Stroke Impact Scale (version 2.0). Spearman rank order correlation (r(s)) was used in the analyses. Results There were moderate to strong positive or negative correlations between all four observer-assessed motor variables and participants' ratings of perceived late-phase stroke recovery at trial entrance, ranging from r(s)=-0.49 to r(s)=0.54 (p<0.001). The results of the correlational analyses of variable changes showed that, after the end of the H-RT intervention, both self-selected and fast gait speed improvement were significantly correlated with increments in self-rated stroke recovery (4=-0.41, p=0.01 and r(s)=-0.38, p=0.02, respectively). Conclusion This study provided data supporting the association between individual ratings of self-perceived recovery after stroke and observer-assessed individual motor function. The results further demonstrate that enhancement in perceived stroke recovery after completing the intervention was associated with objectively measured gains in both self-selected and fast gait speed.
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| 19. |
- Engman, Elisabeth, 1942, et al.
(author)
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Serial cognitive change patterns across time after temporal lobe resection for epilepsy
- 2006
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In: Epilepsy Behav. - : Elsevier BV. - 1525-5050. ; 8:4, s. 765-72
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Journal article (peer-reviewed)abstract
- Longitudinal cognitive outcome with respect to general cognitive status and memory at the group and individual levels was studied 10 years after temporal lobe resection for epilepsy. Twenty-five patients who had undergone a medium-term follow-up (T2, median = 2.7 years) also underwent a long-term follow-up (T3, median = 9.8 years). At the group level, there was a significant increment across time, partly due to practice, in IQ (P value from 0.049 to <0.0001) but not in memory variables. On the basis of the normative interval of reassessed matched controls, the analysis at the individual level of change from baseline to T2 disclosed decrements in 12-29% of the patients and increments in 8-21%. These proportions diminished at T3 (0-12 and 0-16%) and the dominating pattern of Performance IQ and verbal memory was a return toward baseline. These findings make the interpretation of an initial (T2) postoperative increment or decrement more problematic and underline the need for a comprehensive evaluation across time, including both at the group and individual levels.
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| 20. |
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| 21. |
- Gerafi, Joel, et al.
(author)
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The presence and prediction of lateralized inattention 7 years post-stroke
- 2020
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 141:5, s. 423-430
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Journal article (peer-reviewed)abstract
- Objective Lateralized inattention is a typical sign of neglect and related to poor functional outcome. Knowledge of the long-term course of this phenomenon is limited. The purpose of this study was to investigate presence and predictors for signs of lateralized inattention 7 years after stroke. Methods From a cohort of acute ischemic stroke patients, aged 18-69 years (n = 297), a consecutive series of 188 survivors without recurrent stroke at follow-up 7 years later were included. Within the first week after stroke onset, stroke severity was assessed according to the Scandinavian Stroke Scale. Target omissions, asymmetry of omissions, and perceptual speed according to Star- and Letter Cancellation Tests were also assessed. Presence of lateralized inattention at the 7-year follow-up was investigated with the Star- and Letter Cancellation Tests and with the neglect item in the National Institutes of Health Stroke Scale. Results At the follow-up, 22 (11.7%) participants had lateralized inattention and the multivariable regression showed that independent significant baseline predictors were total omissions in target cancellations (P < .001) and inferior baseline performance on visual processing speed (P = .008). Conclusion About one of ten individuals exhibited signs of lateralized inattention 7 years after stroke. Baseline performance in perceptual processing speed and target omissions independently predicted presence of late signs of lateralized inattention. This is the first time processing speed is recognized as a significant predictor of lateralized inattention several years after the stroke incidence, indicating that the longitudinal course of processing speed following stroke is a critical subject for future research.
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| 22. |
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| 23. |
- Hedner, Thomas, 1949, et al.
(author)
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Nabumetone: therapeutic use and safety profile in the management of osteoarthritis and rheumatoid arthritis.
- 2004
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In: Drugs. - : Springer Science and Business Media LLC. - 0012-6667. ; 64:20
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Research review (peer-reviewed)abstract
- Nabumetone is a nonsteroidal anti-inflammatory prodrug, which exerts its pharmacological effects via the metabolite 6-methoxy-2-naphthylacetic acid (6-MNA). Nabumetone itself is non-acidic and, following absorption, it undergoes extensive first-pass metabolism to form the main circulating active metabolite (6-MNA) which is a much more potent inhibitor of preferentially cyclo-oxygenase (COX)-2. The three major metabolic pathways of nabumetone are O-demethylation, reduction of the ketone to an alcohol, and an oxidative cleavage of the side-chain occurs to yield acetic acid derivatives. Essentially no unchanged nabumetone and < 1% of the major 6-MNA metabolite are excreted unchanged in the urine from which 80% of the dose can be recovered and another 10% in faeces. Nabumetone is clinically used mainly for the management of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) to reduce pain and inflammation. The clinical efficacy of nabumetone has also been evaluated in patients with ankylosing spondylitis, soft tissue injuries and juvenile RA. The optimum oral dosage of nabumetone for OA patients is 1 g once daily, which is well tolerated. The therapeutic response is superior to placebo and similar to nonselective COX inhibitors. In RA patients, nabumetone 1 g at bedtime is optimal, but an additional 0.5-1 g can be administered in the morning for patients with persistent symptoms. In RA, nabumetone has shown a comparable clinical efficacy to aspirin (acetylsalicylic acid), diclofenac, piroxicam, ibuprofen and naproxen. Clinical trials and a decade of worldwide safety data and long-term postmarketing surveillance studies show that nabumetone is generally well tolerated. The most frequent adverse effects are those commonly seen with COX inhibitors, which include diarrhoea, dyspepsia, headache, abdominal pain and nausea. In common with other COX inhibitors, nabumetone may increase the risk of GI perforations, ulcerations and bleedings (PUBs). However, several studies show a low incidence of PUBs, and on a par with the numbers reported from studies with COX-2 selective inhibitors and considerably lower than for nonselective COX inhibitors. This has been attributed mainly to the non-acidic chemical properties of nabumetone but also to its COX-1/COX-2 inhibitor profile. Through its metabolite 6-MNA, nabumetone has a dose-related effect on platelet aggregation, but no effect on bleeding time in clinical studies. Furthermore, several short-term studies have shown little to no effect on renal function. Compared with COX-2 selective inhibitors, nabumetone exhibits similar anti-inflammatory and analgesic properties in patients with arthritis and there is no evidence of excess GI or other forms of complications to date.
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| 24. |
- Hofgren, Caisa, 1952, et al.
(author)
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Cognitive screen and employment long-term after infratentorial stroke
- 2022
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 145:5, s. 610-618
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Journal article (peer-reviewed)abstract
- Objectives: Motor problems are well-described neurological deficits that occur commonly after an infratentorial ischemic stroke. However, the brain stem and cerebellum are also part of the neural interconnections responsible for cognition, emotions, and behavioral responses. We lack studies on long-term cognitive outcomes and patient employment after an infratentorial stroke. In the present study, we described and compared long-term poststroke cognitive outcomes and employment between patients that experienced infratentorial and supratentorial ischemic strokes. Materials and Methods: We included consecutive patients that experienced an acute ischemic stroke at <= 58 years of age. Patients were classified according to the stroke location. At seven years poststroke, surviving participants were assessed for neurological deficits (National Institutes of Health Stroke Scale [NIHSS]), functional outcome (modified Rankin Scale [mRS]), cognitive function Barrow Neurological Institute Screen (BNIS), and employment. Results: Among 141 participants, 25 (18%) had infratentorial and 116 (82%) had supratentorial strokes. At the 7-year poststroke follow-up, there was no significant difference in BNIS total scores; with a median of 43 (IQR 40.5-46) and 41 (IQR 38-46) in the infratentorial and supratentorial groups, respectively. This result indicated that cognitive dysfunction occurred frequently in both groups. Similar employment rates were observed in the infratentorial (48%) and supratentorial (55%) groups. Both groups had a median NIHSS score of 0 and a median mRS score of 2 at the 7-year follow-up. Conclusion: Patients who survived an infratentorial or supratentorial ischemic stroke had similar rates of long-term cognitive dysfunction and difficulties in returning and/or remaining at work.
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| 25. |
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| 26. |
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Klinisk neuropsykologi
- 2023
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Editorial collection (other academic/artistic)abstract
- Klinisk neuropsykologi är en grundbok om sambandet mellan beteende och hjärnans funktioner. Denna tredje reviderade och utökade upplaga innehåller ett flertal nyskrivna och helt nytillkomna kapitel, såsom Läkemedel och kognition, Digital testning, Symptom- och prestationsvaliditet samt ett kapitel om hjärntrötthet, Kognitiv fatigue. Del I inleds med Teorier och modeller för de viktigaste funktionsområdena, som uppmärksamhet, emotioner, språk, minne, spatial förmåga och exekutiva funktioner. I del II beskrivs Utredning och diagnostik. Här finns anvisningar för undersökning och bedömning med såväl traditionella som digitala psykologiska test samt ett nytt kapitel om den kliniska användningen av tekniker för att avbilda hjärnans struktur och funktion. I det nyskrivna kapitlet om Lurias teori och bedömningsmetod kopplas dessa till modern neurovetenskap. Del III, Skador och störningar, beskriver de kognitiva följderna av de vanligaste somatiska tillstånden, medan del IV ägnas åt Neuropsykiatriska tillstånd. Här finns ett helt nytt kapitel om Utvecklingsrelaterade funktionsnedsättningar. Del V, Behandling och åtgärder, är betydligt utökad, och innehåller ett kapitel där utvecklingen och evidensläget inom Kognitiv rehabilitering beskrivs. Klinisk neuropsykologi vänder sig till alla som behöver kunskaper om hjärnan och beteendet; främst blivande psykologer, studenter och yrkesverksamma inom hälso- och sjukvård, skola och i olika typer av omsorgsverksamhet.
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| 27. |
- Krabbe, D., et al.
(author)
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Executive function and attention in patients with stress-related exhaustion: perceived fatigue and effect of distraction
- 2017
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In: Stress-the International Journal on the Biology of Stress. - : Informa UK Limited. - 1025-3890. ; 20:4, s. 333-340
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Journal article (peer-reviewed)abstract
- Cognitive impairment has frequently been shown in patients who seek medical care for stress-related mental health problems. This study aims to extend the current knowledge of cognitive impairments in these patients by focusing on perceived fatigue and effects of distraction during cognitive testing. Executive function and attention were tested in a group of patients with stress-related exhaustion (n=25) and compared with healthy controls (n=25). Perceived fatigue was measured before, during and after the test session, and some of the tests were administered with and without standardized auditory distraction. Executive function and complex attention performance were poorer among the patients compared to controls. Interestingly, their performance was not significantly affected by auditory distraction but, in contrast to the controls, they reported a clear-cut increase in mental tiredness, during and after the test session. Thus, patients with stress-related exhaustion manage to perform during distraction but this was achieved at a great cost. These findings are discussed in terms of a possible tendency to adopt a high-effort approach despite cognitive impairments and the likelihood that such an approach will require increased levels of effort, which can result in increased fatigue. We tentatively conclude that increased fatigue during cognitive tasks is a challenge for patients with stress-related exhaustion and plausibly of major importance when returning to work demanding high cognitive performance.
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| 28. |
- Lindén, Thomas, 1962, et al.
(author)
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Visual neglect and cognitive impairment in elderly patients late after stroke.
- 2005
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In: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 111:3, s. 163-8
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To investigate the prevalence of visual neglect and its relationship to cognitive impairment and dementia in elderly stroke patients 20 months after stroke. METHODS: Of 243 stroke patients aged 70-91 years, 149 underwent neuropsychiatric testing, 138 with the Star Cancellation Test for visual neglect. RESULTS: Fifteen per cent (n = 21) had visual neglect, 9% (n = 12) severe and 9% (n = 12) lateralized. Cognitive impairments were twice as common in patients with neglect as in patients without it and threefold more common when the neglect was severe. Neglect was related to apraxia, impaired visual field, and a previous stroke. Severe neglect was related to dementia, amnesia and impaired visual field. CONCLUSIONS: Chronic neglect is common after stroke in elderly patients. So are cognitive impairments, especially in those with neglect. This calls for high alertness to impairments in spatial attention when treating patients with dementia and other cognitive impairments.
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| 29. |
- Ljunggren, Sofia, et al.
(author)
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Cognitive outcome two years after frontal lobe resection for epilepsy - A prospective longitudinal study
- 2015
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In: Seizure-European Journal of Epilepsy. - : Elsevier BV. - 1059-1311. ; 30, s. 50-56
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Journal article (peer-reviewed)abstract
- Purpose: To investigate cognitive outcomes after frontal lobe resection (FLR) for epilepsy in a consecutive single centre series. Methods: Neuropsychological examinations were performed prior to and two years (mean test interval 2.5 years) after surgery in 30 consecutive patients who underwent FLR. Cognitive outcome was evaluated with particular consideration to the site of surgery (lateral, premotor/SMA [supplementary motor area], mesial/orbital). Cognitive domains assessed were speed, language, memory, attention, executive functions and intelligence. 25 healthy controls were assessed at corresponding time points (mean test interval 3.0 years). Analyses were made both at group and individual levels. Results: At baseline the patients performed below controls in variables depending on speed, executive functions, global and verbal intelligence. Two years after surgery, the analyses at the subgroup level indicated that the lateral resection group had less improvement than the controls in global intelligence, FSIQ (p = .037). However, at the individual level, the majority of the change scores (74-100%) were classified as within the normal range for all but one variable. The exception was the variable "Comprehension" (measuring verbal reasoning ability) with reliable declines in 44% (8/18) of the patients. This pattern of decline was observed in the lateral (4/7 patients) and premotor/SMA (4/7 patients) resection groups. Seizure outcome and side of surgery did not influence these results. Conclusion: The main finding was cognitive stability at group level two years after FLR. A reliable decline in verbal reasoning ability was rather common at an individual level, but only in the lateral and premotor/SMA resection groups. The lateral resection group also had less improvement than the controls in global intelligence. (C) 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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| 30. |
- Ljunggren, Sofia, et al.
(author)
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Decision-making under ambiguity after frontal lobe resection for epilepsy
- 2023
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In: Epilepsy and Behavior. - 1525-5050 .- 1525-5069. ; 142
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Journal article (peer-reviewed)abstract
- Purpose: Decision-making is crucial to daily life and can impact our society as well as economic conditions. Although the frontal lobes have been identified as important for decision-making, this capacity has only been studied to a limited extent in frontal lobe epilepsy and not at all after frontal lobe resection (FLR) for epilepsy. This study aimed to explore decision-making under ambiguity after FLR for epilepsy. Methods: Fourteen patients having undergone FLR for epilepsy completed the Iowa Gambling Task (IGT) which is a widely used tool to measure decision-making under ambiguity. Iowa Gambling Task scores included in the analysis were: total net score, separate scores from five blocks across the test, and a change score (last block of IGT minus first block). A group of healthy controls (n = 30) was used as a comparison. Associations between IGT and standardized neuropsychological methods for assessment of executive functions, self-rating questionnaires of mental health, fatigue, and behavior linked to frontal lobe dysfunction were also investigated. Results: The patient group performed inferior to controls at the final block of the IGT (p =.001). A group difference in IGT change scores was found (p =.005), reflecting the absence of a positive change in performance over time for the FLR group compared to the control group. Correlations with tests of executive functions as well as self-rating scales were mainly statistically nonsignificant. Conclusions: This study shows that patients having undergone FLR for epilepsy have difficulties with decision-making under ambiguity. The performance illustrated a failure to learn throughout the task. Executive as well as emotional deficits may impact decision-making processes in this patient group and need to be considered in further studies. Prospective studies with larger cohorts are needed.
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| 31. |
- Ljunggren, Sofia, et al.
(author)
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Predicting verbal memory decline following temporal lobe resection for epilepsy
- 2019
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 140:5, s. 312-319
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Journal article (peer-reviewed)abstract
- Objectives The aim of the study was to develop a prediction model for verbal memory decline after temporal lobe resection (TLR) for epilepsy. The model will be used in the preoperative counselling of patients to give individualized information about risk for verbal memory decline. Materials and Methods A sample of 110 consecutive patients who underwent TLR for epilepsy at Sahlgrenska University Hospital between 1987 and 2011 constituted the basis for the prediction model. They had all gone through a formal neuropsychological assessment before surgery and 2 years after. Penalized regression and 20 x 10-fold cross-validation were used in order to build a reliable model for predicting individual risks. Results The final model included four predictors: side of surgery; inclusion or not of the hippocampus in the resection; preoperative verbal memory function; and presence/absence of focal to bilateral tonic-clonic seizures (TCS) the last year prior to the presurgical investigation. The impact of a history of TCS is a new finding which we interpret as a sign of a more widespread network disease which influences neuropsychological function and the cognitive reserve. The model correctly identified 82% of patients with post-operative decline in verbal memory, and the overall accuracy was 70%-85% depending on choice of risk thresholds. Conclusions The model makes it possible to provide patients with individualized prediction regarding the risk of verbal memory decline following TLR. This will help them make more informed decisions regarding treatment, and it will also enable the epilepsy surgery team to prepare them better for the rehabilitation process.
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| 32. |
- Pedersen, Annie, 1981, et al.
(author)
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Fatigue 7 years post-stroke: Predictors and correlated features
- 2022
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 146:3, s. 295-303
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Journal article (peer-reviewed)abstract
- Background Post-stroke fatigue (PSF) is common with great impact on quality of life. We explored predictive and cross-sectionally correlated features in the long term after ischemic stroke. Methods This study comprises 430 participants of the prospective Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS), aged 18-69 years at index stroke. Information on acute stroke severity and cardiovascular risk factors was collected at index stroke. After 7 years, PSF was assessed by the Daily Fatigue Impact Scale (D-FIS). Cognitive, neurological, and functional outcomes, and symptoms of depression and anxiety, pain, insomnia, and physical activity were also assessed. Associations between baseline variables and PSF were analyzed by ordinal regression. Correlations between PSF and cross-sectionally assessed variables, and between PSF and baseline variables, were analyzed with Spearman's or point-biserial correlation for the whole sample and in sex-stratified analyses. Results At 7 years post-stroke, 80% of the participants reported some impact of fatigue. Female sex and stroke severity were independently associated with PSF, whereas no associations were detected with baseline cardiovascular risk factors. In cross-sectional analyses at 7 years, we found correlations between PSF and poor functional, neurological, and cognitive outcomes, as well as depressive symptoms, anxiety, insomnia, pain, and low physical activity (p < .001 throughout). The correlation with insomnia was stronger in women than in men (two-way ANOVA interaction test, p = .03). Conclusions Our findings confirm that PSF is common in the long term after ischemic stroke and show a complex interplay with sex and several other outcomes. Future studies should address causal relationships and interventions towards fatigue and coexisting features.
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| 33. |
- Pedersen, Annie, 1981, et al.
(author)
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Fibrinogen concentrations predict long-term cognitive outcome in young ischemic stroke patients
- 2018
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In: Research and Practice in Thrombosis and Haemostasis. - : Elsevier BV. - 2475-0379. ; 2:2, s. 339-346
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Journal article (peer-reviewed)abstract
- Background: Cognitive impairment is frequent after stroke, and young patients may live with this consequence for a long time. Predictors of cognitive outcomes after stroke represent a current gap of knowledge. Objectives: To investigate levels of three hemostatic biomarkers as predictors of long-term cognitive function after stroke. Methods: This longitudinal study included consecutively recruited patients with ischemic stroke at 18-69 years (n = 268). Blood was collected 3 months after index stroke and analyzed for plasma concentrations of fibrinogen, von Willebrand factor (VWF) and tissue-type plasminogen activator (t-PA) antigen. Cognitive function 7 years after index stroke was assessed by the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS). Participants with stroke <50 years of age were also examined by the Trail Making Test A and B (n = 41). Associations between biomarker concentrations and cognitive scales were assessed in the whole group and in participants with stroke <50 years of age. Results: The hemostatic biomarkers fibrinogen, VWF and t-PA, were all correlated to total BNIS score, but these associations did not withstand adjustment for confounding factors in the whole group. However, in patients <50 years, we found an independent association between fibrinogen concentrations and total BNIS score (beta(std) = -.27, 95% confidence interval [CI], -0.47 to -0.07) and to performance on the Trail Making Test A (beta(std) = 31, 95% CI, 0.03-0.58). No such association was seen for the Trail Making Test B. Conclusion: High convalescent fibrinogen concentrations were associated with worse long-term cognitive outcomes in ischemic stroke <50 years of age. We propose further investigations of fibrinogen in relation to cognitive function in stroke in the young.
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| 34. |
- Redfors, Petra, et al.
(author)
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The Barrow Neurological Institute Screen for Higher Cerebral Functions in Cognitive Screening after Stroke
- 2014
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In: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1052-3057. ; 23:2, s. 349-355
-
Journal article (peer-reviewed)abstract
- The objective of this study was to evaluate the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) in screening for cognitive dysfunction at longterm follow-up after stroke in young and middle-aged patients. Within the Sahlgrenska Academy Study on Ischemic Stroke Outcome, the BNIS and the Mini-Mental State Examination (MMSE) were administered to 295 consecutive surviving patients seven years after ischemic stroke. All participants were less than 70 years at index stroke. BNIS score less than 47 and an MMSE score less than 29 were chosen to indicate cognitive dysfunction. Two hundred eighty-one (95%) patients completed both tests. The 2 test scores were moderately correlated, and both tests correlated to disability as measured by the modified Rankin Scale. The distribution of the MMSE score was skewed toward the top scores, with a marked ceiling effect, whereas the BNIS score was more normally distributed. Most BNIS subscales showed mean performance around the mid of the scale without ceiling effects. Both tests identified a large proportion of the subjects as cognitive impaired, however, with a substantially larger proportion for the BNIS (89%) compared with the MMSE (65%). We conclude that the BNIS may be a useful screening instrument for cognitive dysfunction after ischemic stroke and that a large proportion of young and middle-aged ischemic stroke survivors showed signs of cognitive dysfunction long after index stroke. Further validations of BNIS against formal neuropsychological testing and studies of the determinants and consequences of long-term cognitive outcome in this patient group are warranted.
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| 35. |
- Samuelsson, Hans, 1955, et al.
(author)
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Cognitive function is an important determinant of employment amongst young ischaemic stroke survivors with good physical recovery
- 2021
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In: European Journal of Neurology. - : Wiley. - 1351-5101 .- 1468-1331. ; 28:11, s. 3692-3701
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Journal article (peer-reviewed)abstract
- Background and purpose This cross-sectional cohort study aims at investigating young ischaemic stroke survivors with good physical recovery 7 years post-stroke in order to analyze the relation between late cognitive ability and employment. Methods Consecutive ischaemic stroke survivors participating in the Sahlgrenska Academy Study on Ischemic Stroke, <55 years of age at stroke onset, and with no or minimal persisting neurological deficits corresponding to a score <= 2 on the National Institutes of Health Stroke Scale at long-term follow-up 7 years post-stroke were included. At this follow-up, the participants were assessed with respect to general cognitive function, processing speed, executive functions, cardiovascular risk factors, self-reported employment, cognitive difficulties, fatigue, depressive symptoms, anxiety and physical function. Results Seven years post-stroke 112/142 (79%) had part-time or full-time work and 30/142 (21%) had full-time disability pension or sick leave. Compared to those with full-time disability pension or sick leave, participants with current employment demonstrated significantly better performance with respect to general cognitive function and processing speed, and significantly lower self-ratings for cognitive difficulties, physical limitations, fatigue and depressed mood. Multivariable logistic regression selected self-rated memory (odds ratio [OR] 2.61, 95% confidence interval [CI] 1.61-4.21), processing speed (OR 3.50, 95% CI 1.67-7.33) and self-rated communication skills (OR 3.46, 95% CI 1.75-6.85) as most important correlates (area under the curve 0.83-0.87) of having current employment. Conclusion This study indicates that cognitive dysfunction is an important contributor to long-term work disability amongst young stroke survivors with good physical recovery.
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| 36. |
- Samuelsson, Hans, 1955
(author)
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Medvetenhet och medvetna upplevelser : Awareness and conscious experiences
- 2006
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In: Inre och yttre världar. - Lund : Lund: Studentlitteratur. - 9144033583 ; , s. 47-62
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Book chapter (other academic/artistic)abstract
- This chapter concerns visual awareness, awareness of self-initiated movements, and self-awareness. Neuropsychological symptoms after brain damage and patients’ experiences of these symptoms are described in order to illustrate possible mechanisms behind visual awareness and self-awareness. The relationship between attentional mechanisms and visual awareness is discussed in the light of symptoms of visuospatial neglect after right hemisphere stroke. Systems for conscious experience of willed action are considered in the light of symptoms of anosognosia after damage to the right hemisphere. Finally, symptoms after damage to the medial and ventromedial frontal lobe are discussed and compared to the concept of self-awareness.
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| 37. |
- Samuelsson, Hans, 1955
(author)
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Right hemisphere disturbances: Neglect and awareness
- 2005
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In: Invited paper presented at the 13th Nordic Meeting on Cerebrovascular Diseases, Göteborg, Sweden.
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Conference paper (peer-reviewed)abstract
- One of the more central issues in cognitive neuroscience is the relationship be-tween attentional mechanisms and visual awareness. Processing in the primary visual cortex is necessary for conscious visual perception. Damage to this area leads to a visual field cut. However, activation simply of this area and of classical ventral pathways is not sufficient for obtaining visual awareness. Resent results show that a more extensive attentional network is implicated in this process. Conscious visual perception is associated with parallel increase in activity in pa-rietal and dorsolateral prefrontal areas areas that are involved in orientation of selective visuospatial attention. Enhanced interactions between this frontoparie-tal attentional network and visual cortex may subserve both visual attention and visual awareness. On the basis of resent research on perceptual awareness and visual attention, there are good reasons to presume a close relationship between attentional impairments and deficient awareness of visual impairments exhibited by patients showing visual neglect. This lecture will discuss the awareness and experience of impaired visual attention and of a visual field deficit in patients with visuospatial neglect. Studies on the relationship between visual awareness and attention in patients with neglect will also be reviewed
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| 38. |
- Samuelsson, Tove, et al.
(author)
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Development of strong and water resistant packaging materials from high yield pulps – fundamental aspects
- 2018
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In: IMPC 2018. - Trondheim, Norway.
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Conference paper (peer-reviewed)abstract
- This work is focused on fundamental aspects of the densification of paper sheets during hot-pressing under conditions where the lignin in the fibre walls is softened. In this study light microscope and scanning electron microscope (SEM) techniques were used to reveal the mechanisms in the fibre network structure within the paper sheets that arises due to densification and the impact of lignin. UV and staining methods and spectrometric observations of the ultrastructure of cross section of paper sheets and fibre surfaces will highlight the changes that occur in the fibre structures. This study improves the understanding of how fibres collapse and how internal fibre-fibre bonds in lignin-rich mechanical pulp affect the physical properties of the final paper sheet. To demonstrate this, paper sheets from five different pulps containing different concentration of natural lignin were produced. Handsheets of 150 g/m2 were prepared in a Rapid Köthen (RK) laboratory sheet former, where the sheets were press-dried at 100 kPa and ca 90oC to a dry content of 45-50% d.c. After 24 hours in room temperature the hand sheets were hot-pressed in a temperature interval from 20 – 200oC at a constant pressure in a cylinder-press at a speed of 1 m/min. The results show that remarkable improvements on paper sheets, based lignin-rich pulps, can be achieved in terms of increased tensile index (up to 85 kNm/kg), compression strength, SCT, (up to 38 kNm/kg) and wet strength (up to 10 kNm/kg), which depends on the densification of the fibre structure at high temperature and pressure in the load nip. It is concluded that this to a major extent is related to that the lignin rich fibres are compressed at high enough temperature to both softened and develop tacky surfaces so that the fibres are locked into their positions within the highly densified sheets. The SEM evaluation shows how the surface structure get dense at pressing at 200oC for the CTMP based paper sheets. The light microscopy studies of the sheet cross sections reveal how the fibres collapse in the case of CTMP based sheets while fibres from bleached kraft pulp based sheets are quite well collapsed already at room temperature.
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| 39. |
- Viken, Jo Inge, 1976, et al.
(author)
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Change across time in visuospatial search in patients with right hemisphere stroke
- 2007
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In: 9th Nordic Meeting in Neuropsychology. August 19-22, Göteborg, Sweden.
-
Conference paper (peer-reviewed)abstract
- Patients with a right hemisphere stroke often exhibit symptoms of aberrant visuospatial exploration such as visual inattention and disorganized search. These disturbances are complex and constitute several lateralized and non-lateralized impairments. Although individual symptoms of impaired visuospatial search have been examined in several studies, little is known about the change in these symptoms across time and about the relationships between the different symptoms. The participants in the current study were selected from a series of 411 patients included in the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) at Göteborg University. All patients with an acute ischemic stroke admitted to the stroke unit at the Sahlgrenska Univeristy hospital and with an age below 70 years were investigated during a period of 5 year. From these were a consecutive series of patients with a right hemisphere stroke selected for examination of impaired visuospatial search. The patients were tested at the post-acute stage (< 7 days after onset) and at a follow-up session (approximately 90 days after onset). Conventional cancellation tests and visual search tasks were used to assess the following components of impaired search: 1) lateralized inattention (omissions distributed asymmetrically across the test sheet), 2) non-lateralized inattention (omissions distributed equally across the test sheet), 3) ipsilesional bias in the start of visual search (a bias toward the right side of the test sheet when marking the first target), 4) slow processing speed on timed visual cancellation tasks. The results are described and discussed as follows: 1) the occurrence of the different symptoms at the post-acute stage, 2) the pattern of change in the symptoms between post-acute stage and follow-up, 3) the relationships between the acute symptoms and between the changes in the symptoms.
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| 40. |
- Viken, Jo Inge, 1976, et al.
(author)
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Ipsilesional bias and processing speed are important predictors of functional dependency in the neglect phenomenon after a right hemisphere stroke.
- 2014
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In: The Clinical neuropsychologist. - : Informa UK Limited. - 1744-4144 .- 1385-4046. ; 28:6, s. 974-93
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Journal article (peer-reviewed)abstract
- Visuospatial neglect (VSN) predicts unfavorable functional outcome in stroke patients. This study examined the relative importance of different core symptoms of VSN as predictors of functional dependency. A consecutive series of 105 right hemisphere stroke patients were tested early after stroke on three basic symptoms of VSN (omissions, asymmetry of omissions and ipsilesional bias of attention) and on two symptoms related to VSN (processing speed and repetitive target detections in visual search). Neurological deficits were also assessed. Functional outcome was measured 3 months and 2 years after stroke with the modified Rankin Scale. Univariate analyses revealed significant relationships with functional outcome for both core and related symptoms of VSN and for neurological deficits. Area under the curve statistics and stepwise logistic regressions showed that the most important predictors assessed early after stroke were presence of ipsilesional bias for dependency at 3 months and visual processing speed for dependency at 2 years after stroke. These results show that valuable prognostic information regarding dependency after right hemisphere stroke can be obtained by assessing fundamental sub-components of VSN early after stroke. The development of standardized clinical methods for investigation of sub-components, such as a right capture of attention and processing speed, is essential.
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| 41. |
- Viken, Jo Inge, 1976, et al.
(author)
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The prediction of functional dependency by lateralized and non-lateralized neglect in a large prospective stroke sample.
- 2012
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In: European journal of neurology : the official journal of the European Federation of Neurological Societies. - : Wiley. - 1468-1331. ; 19:1, s. 128-134
-
Journal article (peer-reviewed)abstract
- Background and purpose: Lateralized and non-lateralized impairments in visual attention have been identified as important components in patients with visuospatial neglect. This study investigated the course of these two phenomena across time in relation to neurological symptoms and functional outcome in a large consecutive and prospective stroke sample. Methods: A total of 375 consecutive stroke patients were divided into three groups (lateralized, non-lateralized or no visual inattention) acutely and 3months post-stroke using the star cancellation test. Neurological impairments, localization of brain damage, asymmetry in clinical symptoms and functional outcome were assessed. Possible group differences were analysed, and stepwise logistic regressions were performed to examine the relative importance of predictors of functional dependency. Results: Participants with acute lateralized inattention differed (P≤0.05) from the other two groups by more often exhibiting severe neurological symptoms, functional dependency and persisting visual inattention. The regression analyses selected acute lateralized inattention as an important and independent predictor of functional dependency following right hemisphere damage, but not following left hemisphere damage. Conclusions: The results emphasize the prognostic value of lateralized inattention and the importance of separating lateralized and non-lateralized symptoms of visual inattention at the commencement of rehabilitation.
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