Chronic white matter changes detected using diffusion tensor imaging following adult traumatic brain injury and their relationship to cognition.

White matter (WM) changes detected using diffusion tensor imaging (DTI) are reportedly related to cognitive outcomes following traumatic brain injury (TBI), but much existing research is underpowered or has only examined general outcomes, rather than cognitive functioning. A large sample of adults who had sustained mild, moderate or severe TBIs seven months prior ( = 165) and a control group ( = 106) underwent DTI and cognitive testing. Fractional anisotropy and mean diffusivity were calculated for 5 regions (corpus callosum: genu, body, splenium; fornix; superior longitudinal fasciculus) that recent meta-analyses identified as being affected by TBI and related to cognition following TBI.

A fixel-based analysis of micro- and macro-structural changes to white matter following adult traumatic brain injury.

Diffusion tensor imaging is often used to assess white matter (WM) changes following traumatic brain injury (TBI), but is limited in voxels that contain multiple fibre tracts. Fixel-based analysis (FBA) addresses this limitation by using a novel method of analysing high angular resolution diffusion-weighted imaging (HARDI) data. FBA examines three aspects of each fibre tract within a voxel: tissue micro-structure (fibre density [FD]), tissue macro-structure (fibre-bundle cross section [FC]) and a combined measure of both (FD and fibre-bundle cross section [FDC]).

Motivational interviewing to promote health outcomes and behaviour change in multiple sclerosis: a systematic review.

Objective: To examine the evidence for motivational interviewing when used to assist individuals with multiple sclerosis manage their healthcare.

Data Sources: The Cochrane, Embase, PsycINFO and PubMed databases were searched for studies published between 1983 and December 2019. The reference lists of included studies were additionally examined and Scopus citation searches conducted.

Preliminary Screening Recommendations for Patients at Risk of Depression and/or Anxiety more than 1 year Poststroke.

Goal: Depression and anxiety are important complications of stroke but are underdiagnosed in community settings. The current study identified which patients were at increased risk of developing either disorder more than1 year poststroke to assist in targeted screening.

Methods: Crosssectional survey of 147 adults who had a stroke more than 1 year ago were recruited from stroke advocacy/support groups and an outpatient register.

Stroke survivor attitudes toward, and motivations for, considering experimental stem cell treatments.

Interest in stem cell treatments is increasing among some patient groups, but it is unclear whether this holds true for stroke survivors. This study examined stroke survivor attitudes toward stem cell treatments and identified a number of variables that may increase the likelihood that patients will consider these treatments. Adult stroke survivors ( = 183) were recruited (stroke advocacy/support groups, outpatient register) for a cross-sectional study.

Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: a meta-analysis.

Diffusion tensor imaging quantifies the asymmetry (fractional anisotropy; FA) and amount of water diffusion (mean diffusivity/apparent diffusion coefficient; MD/ADC) and has been used to assess white matter damage following traumatic brain injury (TBI). In healthy brains, diffusion is constrained by the organization of axons, resulting in high FA and low MD/ADC. Following a TBI, diffusion may be altered; however the exact nature of these changes has yet to be determined.

Waiting for multidisciplinary chronic pain services: A prospective study over 2.5 years.

Despite many patients waiting more than 2 years for treatment at publicly funded multidisciplinary chronic pain services, waitlist studies rarely examine beyond 6 months. We investigated psychological adjustment and health-care utilisation of individuals ( = 339) waiting ≤30 months for appointments at an Australian tertiary pain unit. Outcomes were relatively stable during the first 6 months, but long-term deteriorations in pain-related interference, distress and pain acceptance were evident, albeit with sex differences.

Does a Brief Educational Session Produce Positive Change for Individuals Waiting for Tertiary Chronic Pain Services?

Objectives: To examine: 1) whether a single brief pre-clinic educational session improved the well-being and quality of life of individuals entering the wait-list for a tertiary chronic pain (CP) service; and 2) the impact of waiting for services on these outcomes.

Methods: Participants were 346 adults, with basic English skills and non-urgent triage codes, who were recruited on referral to a tertiary Australian metropolitan CP unit. Participants were randomized across two conditions: "treatment as usual" (normal wait-list) and "experimental" (normal wait-list plus a 3-hour CP educational session).

Cell therapies administered in the chronic phase after stroke: a meta-analysis examining safety and efficacy.

Aim: To assess the safety and efficacy of cell therapies for chronic stroke.

Methodology: Five databases were searched for treatments administered >90 days post-stroke. Reporting quality, adherence to research guidelines, treatment safety (risk ratios/pooled incidence rates) and neurological/functional efficacy (Hedge's g) were all evaluated.

Traumatic brain injury and alcohol/substance abuse: A Bayesian meta-analysis comparing the outcomes of people with and without a history of abuse.

Alcohol and substance (drugs and/or alcohol) abuse are major risk factors for traumatic brain injury (TBI); however, it remains unclear whether outcomes differ for those with and without a history of preinjury abuse. A meta-analysis was performed to examine this issue. The PubMed, Embase, and PsycINFO databases were searched for research that compared the neuroradiological, cognitive, or psychological outcomes of adults with and without a documented history of alcohol and/or substance abuse who sustained nonpenetrating TBIs.

Safety and efficacy of cell therapies administered in the acute and subacute stages after stroke: a meta-analysis.

Aims: To evaluate the safety and efficacy of cell therapies administered acutely/sub-acutely after stroke.

Methods: Five databases were searched for studies examining the safety/efficacy of cell therapies administered ≤90 days post-stroke. Reporting quality and adherence to research guidelines were evaluated.

Relationship Between Diffusion Tensor Imaging (DTI) Findings and Cognition Following Pediatric TBI: A Meta-Analytic Review.

This study meta-analyzed research examining relationships between diffusion tensor imaging and cognition following pediatric traumatic brain injury (TBI). Data from 14 studies that correlated fractional anisotropy (FA) or apparent diffusion coefficient/mean diffusivity with cognition were analyzed. Short-term (<4 weeks post-TBI) findings were inconsistent, but, in the medium to long term, FA values for numerous large white matter tracts and the whole brain were related to cognition.

Statistical machine learning to identify traumatic brain injury (TBI) from structural disconnections of white matter networks.

Identifying diffuse axonal injury (DAI) in patients with traumatic brain injury (TBI) presenting with normal appearing radiological MRI presents a significant challenge. Neuroimaging methods such as diffusion MRI and probabilistic tractography, which probe the connectivity of neural networks, show significant promise. We present a machine learning approach to classify TBI participants primarily with mild traumatic brain injury (mTBI) based on altered structural connectivity patterns derived through the network based statistical analysis of structural connectomes generated from TBI and age-matched control groups.

Contribution of brain or biological reserve and cognitive or neural reserve to outcome after TBI: A meta-analysis (prior to 2015).

Brain/biological (BR) and cognitive/neural reserve (CR) have increasingly been used to explain some of the variability that occurs as a consequence of normal ageing and neurological injuries or disease. However, research evaluating the impact of reserve on outcomes after adult traumatic brain injury (TBI) has yet to be quantitatively reviewed. This meta-analysis consolidated data from 90 studies (published prior to 2015) that either examined the relationship between measures of BR (genetics, age, sex) or CR (education, premorbid IQ) and outcomes after TBI or compared the outcomes of groups with high and low reserve.

Psychological functioning of people living with chronic pain: a meta-analytic review.

Objectives: Chronic pain (CP; >3 months) is a common condition that is associated with significant psychological problems. Many people with CP do not fit into discrete diagnostic categories, limiting the applicability of research that is specific to a particular pain diagnosis. This meta-analysis synthesized the large extant literature from a general CP, rather than diagnosis-specific, perspective to systematically identify and compare the psychological problems most commonly associated with CP.

An analysis of multidisciplinary staffing levels and clinical activity in Australian tertiary persistent pain services.

Objective: To document staffing (medical, nursing, allied health [AH], administrative) in Australian multidisciplinary persistent pain services and relate them to clinical activity levels.

Methods: Of the 68 adult outpatient persistent pain services approached (Dec'08-Jan'10), 45 agreed to participate, received over 100 referrals/year, and met the contemporaneous International Association for the Study of Pain criteria for Level 1 or 2 multidisciplinary services. Structured interviews with Clinical Directors collected quantitative data regarding staff resources (disciplines, amount), services provided, funding models, and activity levels.

Cognitive functioning in people with chronic fatigue syndrome: a comparison between subjective and objective measures.

Objective: The purpose of this study was to examine the relationship between subjective and objective assessments of memory and attention in people with chronic fatigue syndrome (CFS), using tests that have previously detected deficits in CFS samples and measures of potential confounds.

Method: Fifty people with CFS and 50 healthy controls were compared on subjective (memory and attention symptom severity, Cognitive Failures Questionnaire, Everyday Attention Questionnaires) and objective (California Verbal Learning Test, Rey-Osterreith Complex Figure Test, Paced Auditory Serial Addition Test, Stroop task) measures of memory and attention. Fatigue, sleep, depression, and anxiety were also assessed.

Contribution of psychological trauma to outcomes after traumatic brain injury: assaults versus sporting injuries.

Clinical research into outcomes after traumatic brain injury (TBI) frequently combines injuries that have been sustained through different causes (e.g., car accidents, assaults, and falls), the effect of which is not well understood.

Wechsler Adult Intelligence Scale-Third Edition profiles and their relationship to self-reported outcome following traumatic brain injury.

Neuropsychological assessments of outcome after traumatic brain injury (TBI) are often unrelated to self-reported problems after TBI. The current study cluster-analyzed the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) subtest scores from mild, moderate, and severe TBI (n=220) and orthopedic injury control (n=95) groups, to determine whether specific cognitive profiles are related to people's perceived outcomes after TBI. A two-stage cluster analysis produced 4- and 6-cluster solutions, with the 6-cluster solution better capturing subtle variations in cognitive functioning.

Postoperative cognitive dysfunction after total joint arthroplasty in the elderly: a meta-analysis.

This meta-analysis consolidated the research on postoperative cognitive dysfunction (POCD) following total joint arthroplasty (TJA). Data from 17 studies that assessed cognition pre- and post-surgery in TJA patients alone (15 studies) or matched TJA and control groups (2 studies) were analysed. Results were grouped by cognitive domain (memory, attention, language, speed, general cognition) and follow-up interval (pre-discharge, 3-6 months post-surgery).

Applications of telecounselling in spinal cord injury rehabilitation: a systematic review with effect sizes.

Objective: To investigate the short- and medium-term efficacy of counselling services provided remotely by telephone, video or internet, in managing mental health outcomes following spinal cord injury.

Data Sources: A search of electronic databases, critical reviews and published meta-analyses was conducted.

Review Methods: Seven independent studies (N = 272 participants) met the inclusion criteria.

Cognitive deficits in chronic fatigue syndrome and their relationship to psychological status, symptomatology, and everyday functioning.

Objective: To examine cognitive deficits in people with chronic fatigue syndrome (CFS) and their relationship to psychological status, CFS symptoms, and everyday functioning.

Method: The current study compared the cognitive performance (reaction time, attention, memory, motor functioning, verbal abilities, and visuospatial abilities) of a sample with CFS (n = 50) with that of a sample of healthy controls (n = 50), all of whom had demonstrated high levels of effort and an intention to perform well, and examined the extent to which psychological status, CFS symptoms, and everyday functioning were related to cognitive performance.

Results: The CFS group showed impaired information processing speed (reaction time), relative to the controls, but comparable performance on tests of attention, memory, motor functioning, verbal ability, and visuospatial ability.

HOMOR: higher order model outlier rejection for high b-value MR diffusion data.

Diffusion MR images are prone to artefacts caused by head movement and cardiac pulsation. Previous techniques for the automated voxel-wise detection of signal intensity outliers have relied on the fit of the diffusion tensor to the data (RESTORE). However, the diffusion tensor cannot appropriately model more than a single fibre population, which may lead to inaccuracies when identifying outlier voxels in crossing fibre regions, particularly when high b-values are used to obtain increased angular contrast.

Effectiveness of telephone counseling in managing psychological outcomes after spinal cord injury: a preliminary study.

Objective: To determine whether an individualized counseling intervention delivered by telephone-telecounseling-feasibly improves the emotional adjustment of adults with a newly acquired spinal cord injury (SCI).

Design: Randomized controlled trial.

Setting: Spinal injuries unit of a rehabilitation center.