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Purpose: Sensory hypersensitivity is a frequently reported complaint after acquired brain injury (ABI). This study explores patients’ perceptions of sensory hypersensitivity following ABI and its impact on everyday life. Materials and Methods: Semi-structured interviews were conducted with 18 patients with ABI (stroke, brain tumour, TBI) who reported complaints of sensory hypersensitivity. Interview data were analysed using qualitative thematic analysis. Results: Six themes emerged from the data: (1) definition of sensory hypersensitivity, relating to individual perceptions of sensory hypersensitivity; (2) type of sensory stimuli, relating to the variety of stimuli that patients may be sensitive to; (3) course, relating to changes in sensory hypersensitivity following ABI; (4) fatigue, relating to its association with sensory hypersensitivity; (5) consequences of sensory hypersensitivity, relating to the physical, social and emotional impact of sensory hypersensitivity on patients’ lives; and (6) coping strategies, relating to behaviours used to cope with sensory hypersensitivity. Conclusions: Sensory hypersensitivity can have a major impact on patients’ physical well-being, return to work and (social) participation after ABI. Characteristics of sensory hypersensitivity vary between patients with ABI. To develop treatments for sensory hypersensitivity, future studies should focus on cognitive (e.g., filtering information) and psychological factors (e.g., coping) in relation to sensory hypersensitivity.

Introduction: The purpose of this study was to map subtypes in Parkinson's disease with respect to motor, cognitive and neuropsychiatric symptoms, assess the possible relation between these symptoms, and assess their longitudinal disease trajectory. Methods: Data from 341 idiopathic Parkinson’s disease patients were used to perform a Hierarchical Cluster Analysis (HCA). We included measurements of motor, cognitive and neuropsychiatric symptoms. A Linear Discriminant Analysis (LDA) was performed to determine which constructs could best differentiate the clusters and a repeated measures ANOVA was used to assess the development of symptoms over a period of two years. Results: The HCA revealed six clusters: (A) a cluster with low motor symptoms and high REM sleep behavior disorder ( age M: 61.6); (B) a neuropsychiatrically and cognitively impaired cluster with rapidly worsening REM sleep behavior disorder (age M: 66.3); (C) a cluster with severe motor dysfunction and below average but stable cognition and neuropsychiatry (age M: 68.1); (D) a cluster with overall average functioning without RBD symptoms (age M: 65.9); (E) a young aged overall unimpaired cluster (age M: 58.0); and (F) an old-aged cluster with severe overall impairments (age M: 68.6). The LDA revealed that cognitive symptoms could best discriminate the clusters. Conclusion: We differentiated six cluster (A-E). The mean age in clusters A and E were relatively similar, as is the case for clusters B, C, D, and F. We found a distinction between these two cluster groups based on disease onset and severity of symptoms. The clusters were further distinguishable on specific cognitive, motor and neuropsychiatric symptoms. Future research should focus on determining whether the distinction we found is based on different underlying neuropathology or other factors, like medication effectiveness.

Current changes in health and health centers require efficient neuropsychological assessment. This thesis evaluates whether reduction in assessment time of neuropsychological evaluation can be accomplished by using abbreviated test versions. Abbreviated forms of frequently used neuropsychological tests were selected from literature or developed. Multiple methods were used to examine not only their psychometric quality, but also to compare their diagnostic quality with the original tests. The results showed that some abbreviated forms can replace original tests in neuropsychological evaluation for diagnostic purposes. However, other abbreviated forms should not even be used as screening instruments. Although the use of abbreviated forms can definitely contribute to efficient neuropsychological assessment, it is important that the quality of these forms is examined carefully.

Objectives: The current study was aimed at investigating working memory (WM) functioning in glioma patients undergoing awake brain surgery. Three main purposes were addressed: 1) to test the validity of the digit span as a WM test for intraoperative purposes, 2) to examine the relationship between WM and overall cognitive functioning, and 3) to evaluate the effect of intraoperative WM testing on postoperative WM functioning. Methods: A validation study was carried out in 20 healthy participants to examine the validity of the digit span, which is a feasible WM task for awake brain surgery. Subsequently, a multiple regression analysis was performed to evaluate the relationship between WM and overall cognitive functioning in a clinical sample of 81 glioma patients undergoing awake brain surgery. In addition, differences in pre- and postoperative WM performance were examined. Patients who were intraoperatively tested for WM were compared to patients who were not. Results: Validity of the digit span backward was supported. In the patient sample, no significant relationship between WM and overall cognitive functioning was demonstrated. No decline in WM performance was found following awake brain surgery, independent of intraoperative WM testing. Conclusion: The current study suggests that WM performance is a not a reliable predictor of overall cognitive functioning in glioma patients. Furthermore, it suggests that WM functioning remains stable after intraoperative cognitive monitoring. However, it is not yet possible to provide solid conclusions on the protective value of intraoperative WM testing, since heterogeneity in the group of glioma patients may have masked differences between subgroups. The main implication of these results is that WM testing is not necessarily beneficial for all patients undergoing awake brain surgery, but when an individual patient is at risk for WM impairment, the digit span backward is a valid task for intraoperative purposes.