Executive functions profiles in traumatic brain injury adults: Implications for rehabilitation studies

Zimmermann, Nicolle; Pereira, Natalie; Hermes-Pereira, Andressa; Holz, Maila Rossato; Joanette, Yves; Fonseca, Róchele Paz

doi:10.3109/02699052.2015.1015613

Cited by 17 publications

(12 citation statements)

References 51 publications

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“…There was also no significant influence of working memory or executive function ability on overall BGT performance, which is in keeping with some previous studies (e.g., Bechara et al, 1998; Turnbull et al, 2005). It is worth noting that there was also no significant difference between the survivors of TBI and controls on these measures which, although inconsistent with some studies of neurocognitive performance following TBI (e.g., Dunning, Westgate, & Adlam, 2016; Zimmermann et al, 2015), is consistent with findings reported in patients with anterior VMPfC (i.e., poorer emotion-based decision making relative to controls but intact working memory, Bechara et al, 1998).…”

Section: Discussionmentioning

confidence: 53%

The Bangor Gambling Task: Characterising the Performance of Survivors of Traumatic Brain Injury

et al. 2017

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The Bangor Gambling Task (BGT, Bowman & Turnbull, 2004) is a simple test of emotion-based decision making, with contingencies varying across five blocks of 20 trials. This is the first study to characterise BGT performance in survivors of traumatic brain injury (TBI) relative to healthy controls. The study also aimed to explore sub-groups (cluster analysis), and identify predictors of task performance (multiple regression). Thirty survivors of TBI and thirty-nine controls completed the BGT and measures of processing speed, pre-morbid IQ, working memory, and executive function. Results showed that survivors of TBI made more gamble choices than controls (total BGT score), although the groups did not significantly differ when using a cut-off score for ‘impaired’ performance. Unexpectedly, the groups did not significantly differ in their performance across the blocks; however, the cluster analysis revealed three subgroups (with survivors of TBI and controls represented in each cluster). Findings also indicated that only age and group were significant predictors of overall BGT performance. In conclusion, the study findings are consistent with an individual difference account of emotion-based decision making, and a number of issues need to be addressed prior to recommending the clinical use of the BGT.

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Section: Discussionmentioning

confidence: 53%

The Bangor Gambling Task: Characterising the Performance of Survivors of Traumatic Brain Injury

et al. 2017

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“…An epidemic that affects mainly the young damages a country's future. 9 From 11 studies, 1,5,6,8,[10][11][12][13][14][15][16] car accidents were involved in 43% of TBI, as compared with motorbike (30%) and pedestrian (27%). Of the six studies 1,6,11,12,14,15 (n = 1,753) including a pedal bicycles category, car dropped slightly to 40%, while motorbike and pedestrian were both associated with 23% of TBI and pedal bike was related in 14% of TBI.…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology of Traumatic Brain Injury Due to Traffic Accidents in Latin America: A Narrative Review

Dunne¹,

Quiñones-Ossa

Still

et al. 2020

JNRP

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Objective Traumatic brain injuries (TBIs) are devastating injuries and represent a major cause of morbidity and mortality worldwide. Traffic accidents are one of the main causes, especially in low- and middle-income countries. The epidemiology of TBI due to road traffic in Latin America is not clearly documented. Methods A narrative review was conducted using PubMed, SCOPUS, and Google Scholar, looking for TBI studies in Latin America published between 2000 and 2018. Seventeen studies were found that met the inclusion and exclusion criteria. Results It was found that TBI due to road traffic accidents (RTAs) is more frequent in males between the ages of 15 and 35 years, and patients in motor vehicles accounted for most cases, followed by pedestrians, motorcyclists, and cyclists. Conclusion Road traffic accidents is a common cause of TBI in Latin America. More studies and registries are needed to properly document the epidemiological profiles of TBI related to RTAs.

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“…Cluster analysis has been extensively applied in the study of TBI in the last 30 years [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Nevertheless, we have identified several common limitations such as the number of TBI patients that were clustered (<100 in many studies), the clustering approaches (only hierarchical clustering and k-means and not discussing other possible techniques), the specific implementation of such techniques (most of them restricted to only commercial products), as well as the lack of relation between the obtained clusters and rehabilitation tasks.…”

Section: Clustering In Tbimentioning

confidence: 99%

“…We have worked with public GNU libraries, as opposed to the state-of-the-art publications presented in Table A1, wherein most techniques were implemented using commercial packages [15][16][17][18][20][21][22][23][25][26][27][29][30][31]. Previous research presented in Table A1 applied clustering techniques in a batch mode as desktop applications.…”

Section: Comparison With Prior Workmentioning

confidence: 99%

Personalized Web-Based Cognitive Rehabilitation Treatments for Patients with Traumatic Brain Injury: Cluster Analysis (Preprint)

García-Rudolph¹,

García-Molina²,

Opisso³

et al. 2019

Preprint

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BACKGROUND Traumatic Brain Injury (TBI) is a leading cause of disability worldwide. TBI patients are characterized by a wide heterogeneity, one of the most significant barriers to effective therapeutic interventions. Cluster analysis (CA) to identify homogeneous subgroups based on performance in neuropsychological baseline tests has been extensively applied in state-of-the-art. Nevertheless, most analyzed samples are rarely larger than n = 100, different CA approaches and cluster validity indices (CVI) have been scarcely compared and not applied in web-based rehabilitation treatments. OBJECTIVE 1) Apply state-of-the-art CVIs to different cluster strategies: hierarchical, partitional and model based. 2) Apply combined strategies of dimensionality reduction by means of principal components analysis and random forests and perform stability assessment to the final profiles 3) Characterize the identified profiles by means of demographic and clinically relevant variables 4) Study the external validity of the obtained clusters considering three relevant aspects of TBI rehabilitation: Glasgow Coma Scale (GCS), functional independence measure (FIM) and executions of web-based cognitive tasks. METHODS Different cluster strategies were executed with mclust, factoextra and cluster R packages. For combined strategies we used the factominer and random forest R packages. Stability analysis was performed with fpc R package. Between groups comparisons for external validation were performed using T-test, chi-square test or Mann-Whitney U test as appropriate. The period under study is August 2008 to July 2019 RESULTS We analyzed 574 adult (mostly severe) TBI patients undergoing web-based rehabilitation. We identified and characterized 3 clusters with strong internal validation: 1) moderate attentional impairment and moderate disexecutive syndrome with mild memory impairment and normal spatio-temporal perception being 66% highly educated (P<.05) 2) severe disexecutive syndrome with severe attentional and memory impairments and normal spatio-temporal perception being 49.2% highly educated (P<.05) 3) very severe cognitive impairment, being 45.2% highly educated (P<.05). We externally validated them with severity of injury (P<.006), and functional independence assessments: cognitive (P< .001), motor(P<.001) and total(P<.001). We mapped 151,763 web based cognitive rehabilitation tasks performed by the 574 participants during the whole period (all cognitive functions) to the 3 obtained clusters (P<.001) and confirmed the identified patterns. Stability analysis indicates that Cluster 1 and 2 were respectively rated as 0.6 and 0.75 therefore they are indeed measuring a pattern and Cluster 3 was rated as highly stable. CONCLUSIONS CA in web-based cognitive rehabilitation treatments allows for ii)identifying and characterizing strong patterns of response to neuropsychological tests, iii) externally validating the obtained clusters using important aspects of TBI rehabilitation (severity or functional independence in daily activities) iv) tailoring cognitive web based tasks executed in the web platform to the identified profiles providing clinicians a tool for treatments’ personalization not addressed in previous traditional CA. iv) extension of a similar approach to other medical conditions CLINICALTRIAL

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Executive functions profiles in traumatic brain injury adults: Implications for rehabilitation studies

Abstract: The first cluster replicated findings of previous studies on TBI EF profiles. IT is suggested that TBI rehabilitation studies of EF must select participants by their EF profile rather than for clinical or demographical variables.

Cited by 17 publications

References 51 publications

The Bangor Gambling Task: Characterising the Performance of Survivors of Traumatic Brain Injury

The Bangor Gambling Task: Characterising the Performance of Survivors of Traumatic Brain Injury

The Epidemiology of Traumatic Brain Injury Due to Traffic Accidents in Latin America: A Narrative Review

Personalized Web-Based Cognitive Rehabilitation Treatments for Patients with Traumatic Brain Injury: Cluster Analysis (Preprint)

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