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1. 2D-Tasks for Cognitive Rehabilitation

Author: Hernández, R. Caballero, Moreno, J. M. Martínez, Molina, A. García, Celma, S. Ferrer, Sánchez, J. Solana, Carrión, R. Sánchez, Casado, E. Fernández, Rodríguez, R. Pérez, Pulido, A. Gómez, Tafalla, C. Anglès, Taladriz, C. Cáceres, Bergada, M. Ferré, Rovira, T. Roig, López, P. García, Muñoz, J. M. Tormos, Aguilera, E. J. Gómez, Magjarevic, Ratko, editor, and Jobbágy, Ákos, editor
Published: 2012
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2. Sudden cardiac death in heart failure. A 20 years perspective from a Mediterranean cohort

Author: P Codina Verdaguer, E Zamora, W C Levy, M Domingo, E Santiago-Vacas, G Cediel, J Santesmases, M Ruiz-Cueto, C Diez-Quevedo, T Roig, M I Troya, D Casquete, A Sarrias, J Lupon, and A Bayes-Genis
Subjects: Cardiology and Cardiovascular Medicine
Abstract: Background Although sudden cardiac death (SCD) has progressively decreased in the last decade, it remains an important cause of death in patients with heart failure (HF). Differences based on clinical management and regional characteristics might be important. Purpose To assess the prevalence of SCD along 20 years of study in HF outpatients of different aetiologies managed in a multidisciplinary HF Clinic, and compare this prevalence with the expected proportional occurrence according to the acknowledged Seattle Proportional Risk Model (SPRM) score. Methods In a prospective observational registry of real-life HF outpatients, modes of death were classified as SCD (any unexpected death, witnessed or not, of a previously stable patient with no evidence of worsening HF or any other known cause of death) and non-SCD (progression of HF, acute myocardial infarction, stroke, procedural, other cardiovascular causes and non-cardiovascular). Results From August 2001 to May 2021, 2772 outpatients with known cause of death and with SPRM score available were included. Out of them, 1351 (48.7%) died during a median follow-up of 3.8 years [IQR 1.6–7.8], up to 20 years. Observed prevalence of SCD in the 1351 dead patients was 13.6% while predicted SPRM prevalence was 39.6%. Annual SPRM predicted SCD mortality rate was 3.0% while observed SCD annual mortality rate was 1.3%. Figure 1 depicts cumulative incidence of causes of death through the study period. A lower prevalence of SCD was observed in every quintile of SPRM risk (Figure 2). This lower prevalence of SCD was observed independently of left ventricular ejection fraction group, ischemic or non-ischaemic aetiology and implantable cardiac defibrillator (ICD). Although the baseline SPRM predicted risk of SCD showed a significant decreasing trend (p=0.005) along the periods of admission at the Unit, the lower observed prevalence of SCD was seen in all periods of admission. Conclusions The prevalence of SCD through a perspective of 20 years in a Mediterranean HF outpatient cohort managed in a multidisciplinary HF Clinic was significantly lower than that expected according to the SPRM independently of degree of predicted risk, ischaemic aetiology, period of admission and implanted ICD. Regional lifestyle and dietary habits may have an impact on the lower rate of SCD in this Mediterranean cohort, and deserve further in-depth analyses. Funding Acknowledgement Type of funding sources: None.
Published: 2022
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3. How to screen frailty in outpatients with heart failure: multimodality assessment vs. the Vulnerable Elderly Survey 13 (VES-13) scale

Author: T Roig, B Gonzalez, Y Lopez, C Rivas, A Arderiu, A Pulido, E Crespo, P Velayos, V Diaz, M Altabella, D Bares, E Barcelo, M Domingo, J Lupon, and A Bayes-Genis
Subjects: Cardiology and Cardiovascular Medicine
Abstract: Background During two decades we have been screening fragility in outpatients with heart failure (HF) with a multimodality assessment using several geriatric scales, showing that frailty or fragility is frequent in HF patients, even in young patients, and we demonstrated that this identified fragility played an important prognostic role. Frailty is a medical syndrome with multiple causes and contributors that increases outpatients' vulnerability so a minimal stress can cause functional impairment, with a major risk of dependency, even death. Frailty can be reversible or attenuated by interventions. Nowadays several specific scales for fragility or frailty detection are widely available. One of them, the Vulnerable Elderly Survey 13 (VES-13) has scarcely been used in HF. Purpose To assess the prevalence of fragility in an outpatient HF Clinic at first visit using both the VES-13 scale and a multimodality assessment that includes Barthel index, OARS scale, Pfeiffer test, and abbreviated Yesavage Geriatric Depression Scale of 4 items (GDS), and compare the two approaches Methods Nurses fulfilled the scales with the patients at their first visit. An scoring ≥3 in the VES-13 scale and the presence of one of the predefined criteria in the multimodality assessment (Barthel 3±1, depending on educational level; one positive depression response in abbreviated GDS; and age >85 years or nobody to turn to for help) were considered to have fragility for the purpose of the study. Results From March 2021 to December 2021, 136 patients were evaluated with the two fragility screening modalities (mean age 68.8±10.8 years, 64% men, 46% from ischaemic aetiology, 65.4%/27.9% in NYHA class II/III, LVEF 39.5% ± 13.4). VES-13 identified 51 (37.5%) patients with fragility, while the multimodality assessment detected 45 (33.6%) patients. Barthel index and depressive symptoms in the GDS were the most altered items (19 and 20 patients respectively) in the multimodality assessment. Concordance between VES-13 and multimodality assessment was 83.8%, but Cohen's Kappa was 0.65, not reaching the suitable level of 0.70. Conclusions VES-13 was capable of identifying a higher number of patients with fragility at first visit in the routine screening performed in an outpatient HF clinic, than the multimodality assessment used in the last decades. Follow-up of patients and further analysis will allow evaluating which of these two approaches adds more value for outcomes prediction. Funding Acknowledgement Type of funding sources: None.
Published: 2022
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4. 2D-Tasks for Cognitive Rehabilitation

Author: Hernández, R. Caballero, primary, Moreno, J. M. Martínez, additional, Molina, A. García, additional, Celma, S. Ferrer, additional, Sánchez, J. Solana, additional, Carrión, R. Sánchez, additional, Casado, E. Fernández, additional, Rodríguez, R. Pérez, additional, Pulido, A. Gómez, additional, Tafalla, C. Anglès, additional, Taladriz, C. Cáceres, additional, Bergada, M. Ferré, additional, Rovira, T. Roig, additional, López, P. García, additional, Muñoz, J. M. Tormos, additional, and Aguilera, E. J. Gómez, additional
Published: 2011
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5. Rehabilitación cognitiva en daño cerebral adquirido: variables que median en la respuesta al tratamiento

Author: A. Enseñat-Cantallops, Josep Maria Tormos, T. Roig-Rovira, R. López-Blázquez, Rocío Sánchez-Carrión, Alberto García-Molina, and Alejandro García-Rudolph
Subjects: Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation
Abstract: Resumen Objetivo Identificar que variables se relacionaban con la respuesta a un programa de rehabilitacion cognitiva en una poblacion de pacientes con dano cerebral adquirido. Material y metodos En este estudio retrospectivo participaron 528 pacientes con dano cerebral adquirido que recibieron rehabilitacion cognitiva en nuestro centro entre febrero de 2008 y enero de 2013. Mediante analisis de regresion logistica se analizo la respuesta al tratamiento (variable dependiente). La respuesta al tratamiento se calculo a partir de las diferencias entre las exploraciones neuropsicologicas pre- y post-tratamiento para las variables atencion, memoria y funciones ejecutivas. Resultados La edad en el momento de la lesion (OR = 0,97; 95% CI: 0,96-0,98) y el lugar donde se realizo el tratamiento (OR = 0,45; 95% CI: 0,27-0,73) se asociaron positivamente con una mejor respuesta al tratamiento para el indice atencional. En el caso del indice mnesico fueron la edad (OR = 0,98; 95% CI: 0,96-0,99), etiologia (OR = 0,63; 95% CI: 0,39-1) y lugar de realizacion del tratamiento (OR = 0,48; 95% CI: 0,29-0,79); tales variables tambien resultaron significativas para el indice ejecutivo. Conclusiones Los resultados sugieren que parte de las diferencias interindividuales observadas en la respuesta al tratamiento cognitivo en pacientes con dano cerebral adquirido podrian ser explicadas por las variables edad, etiologia y lugar de realizacion del tratamiento.
Published: 2015
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6. Síndrome post-polio, quejas cognitivas y exploración neuropsicológica

Author: E. Portell, A. García-Molina, and T. Roig-Rovira
Subjects: Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation
Abstract: Resumen Objetivo Estudiar el rendimiento psicometrico de una muestra de pacientes afectados por el sindrome post-polio que manifiestan quejas cognitivas. Pacientes y metodo La muestra estaba formada por 37 pacientes (17 hombres) con sindrome post-polio atendidos en consulta externa de Neuropsicologia. La edad media en el momento de la exploracion neuropsicologica era de 55 anos (DE: 4,58 anos). El 59,5% recibia tratamiento farmacologico por la presencia de sintomatologia ansioso-depresiva. Los resultados obtenidos por los pacientes en la exploracion neuropsicologica fueron comparados con los baremos normativos a fin de identificar el porcentaje de pacientes con puntuaciones patologicas para cada uno de los test aplicados. Resultados Los pacientes presentaban puntuaciones patologicas en todos los test neuropsicologicos; siendo especialmente relevante el porcentaje de puntuaciones indicativas de alteracion cognitiva en los test que valoraban velocidad de procesamiento cognitivo, aprendizaje verbal, fluencia verbal fonemica y flexibilidad cognitiva. No se observaron diferencias estadisticamente significativas en el rendimiento de los pacientes en funcion de la presencia o ausencia de sintomatologia ansioso-depresiva. Conclusiones Los pacientes afectados de sindrome post-polio que manifiestan quejas cognitivas presentan un rendimiento psicometrico inferior al de la poblacion general.
Published: 2015
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7. Heminegligencia espacial secundaria a traumatismo craneoencefálico

Author: T. Roig-Rovira, Juan García-Fernández, Celeste Aparicio-López, and Alberto García-Molina
Subjects: 03 medical and health sciences, 0302 clinical medicine, 05 social sciences, Clinical Neurology, 0501 psychology and cognitive sciences, Neurology (clinical), Psychology, 030217 neurology & neurosurgery, 050105 experimental psychology
Published: 2016
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8. Hemispatial neglect secondary to a traumatic brain injury

Author: Juan García-Fernández, Celeste Aparicio-López, Alberto García-Molina, and T. Roig-Rovira
Subjects: medicine.medical_specialty, Traumatic brain injury, 05 social sciences, 050109 social psychology, Hemispatial neglect, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, 0501 psychology and cognitive sciences, medicine.symptom, Psychology, 030217 neurology & neurosurgery
Published: 2016
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9. Alteraciones conductuales e integración comunitaria en el traumatismo craneoencefálico moderado y grave

Author: Montserrat Bernabeu, Alberto García-Molina, and T. Roig-Rovira
Subjects: Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation
Abstract: Resumen Introduccion Clinicos e investigadores argumentan que los cambios conductuales asociados al traumatismo craneoencefalico (TCE) tienen un impacto devastador en la calidad de vida del afectado. El objetivo de este estudio es examinar la relacion entre las alteraciones conductuales y la integracion comunitaria despues de un TCE moderado o grave. Material y metodos En este estudio retrospectivo participaron 90 personas con un TCE moderado o grave (rango de edad: 16–66 anos; edad media: 29,7 anos; DE: 14,7). El nivel de integracion en la comunidad se valoro mediante el Community Integration Questionnaire y la presencia de alteraciones conductuales se valoro mediante un cuestionario creado ad hoc para la situacion objeto de estudio. En funcion de las puntuaciones obtenidas en el cuestionario conductual los sujetos fueron divididos en dos grupos: pacientes con alteraciones conductuales (n=56) y pacientes sin alteraciones conductuales (n=34). Resultados La prueba de Mann-Whitney revelo diferencias significativas entre ambos grupos en el nivel de integracion comunitaria (p=0,002); los sujetos con alteraciones conductuales mostraron puntuaciones sensiblemente inferiores en el Community Integration Questionnaire . Conclusiones Los resultados muestran la existencia de una relacion entre la presencia de alteraciones conductuales y el nivel de integracion comunitaria tras un TCE moderado o grave. Sin embargo, la direccionalidad de esta relacion es confusa, limitando asi nuestra capacidad para efectuar inferencias causales. Son necesarios futuros estudios que permitan entender la naturaleza de esta relacion.
Published: 2010
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10. La integración en la comunidad como medida de resultado de la neurorrehabilitación en el traumatismo craneoencefálico

Author: A. Enseñat-Cantallops, Montserrat Bernabeu, Rocío Sánchez-Carrión, M. Yuguero, T. Roig-Rovira, and Alberto García-Molina
Subjects: Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation
Abstract: Resumen Introduccion Los traumatismos craneoencefalicos (TCE) afectan principalmente a personas jovenes, ocasionando alteraciones fisicas, cognitivas, conductuales y socials que pueden limitar al sujeto en sus actividades incluso anos despues de la lesion. El objetivo ultimo de la neurorrehabilitacion es ayudar al paciente con TCE a reducir el impacto de las condiciones discapacitantes, facilitando que logre niveles optimos de funcionalidad. El objetivo de este estudio es describir el nivel de integracion comunitaria en pacientes con TCE moderado o grave entre 2 y 5 anos despues del traumatismo. Pacientes y metodos La muestra estaba formada por 73 pacientes con TCE moderado o grave (edad media: 30,7 [desviacion estandar: 13,7 anos]). La integracion comunitaria se valoro entre 2 y 5 anos despues del tratamiento neurorrehabilitador utilizando una adaptacion del Community Integration Questionnaire. Resultados El 66,5 % de los pacientes eran independientes para las actividades basicas de la vida diaria, el 76,7 % participaban en actividades de ocio y un 38,7 % volvieron a trabajar despues del TCE. Conclusiones Los pacientes con TCE pueden mostrar, anos despues de la lesion, limitaciones en su reintegracion social y laboral. Si bien en neurorrehabilitacion la reinsercion laboral del paciente es utilizada ampliamente como medida de los resultados del tratamiento, es necesario incorporar otras variables como el nivel de integracion comunitaria.
Published: 2008
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11. Assessing a cognitive rehabilitation environment based on interactive video and eye-tracking technologies

Author: Javier Solana, Enrique J. Gómez, T. Roig, J M Tormos, R Sanchez-Carrion, Patricia Sánchez-González, J Lopez, and J. M. Martínez-Moreno
Subjects: Telecomunicaciones, Multimedia, Interactive video, 05 social sciences, 050301 education, computer.software_genre, 03 medical and health sciences, 0302 clinical medicine, Eye tracking, Cognitive rehabilitation therapy, Psychology, 0503 education, computer, 030217 neurology & neurosurgery
Abstract: This paper presents an study design to assess the effectiveness of a new cognitive rehabilitation environment based on interactive video and advanced monitoring technologies.
Published: 2015

12. Modelling ecological cognitive rehabilitation therapies for building virtual environments in brain injury

Author: J. M. Martínez-Moreno, Enrique J. Gómez, P. Sánchez-González, T. Roig, M. Luna, and J. M. Tormos
Subjects: 030506 rehabilitation, Activities of daily living, Psychometrics, Interactive video, Ecological validity, medicine.medical_treatment, Applied psychology, Psychological intervention, Poison control, Health Informatics, 03 medical and health sciences, User-Computer Interface, 0302 clinical medicine, Cognition, Health Information Management, Nursing, Neuropsychology, Activities of Daily Living, Medicine, Humans, Computer Simulation, Cognitive rehabilitation therapy, Advanced and Specialized Nursing, Telecomunicaciones, Rehabilitation, business.industry, Neurological Rehabilitation, Equipment Design, Models, Theoretical, Telemedicine, 3. Good health, Spain, Brain Injuries, Therapy, Computer-Assisted, Quality of Life, Virtual rehabilitation, 0305 other medical science, business, 030217 neurology & neurosurgery, Software
Abstract: SummaryBackground: Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients’ quality of life. Cognitive rehabilitation aims to promote patients’ skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine. Objectives: To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments. Methods: The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation. Results: An ADL case study (’buying bread’) is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures. Conclusions: The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current work is devoted to designing more experiments in order to present more evidence about its values.
Published: 2015

13. Neuroanatomic-based detection algorithm for automatic labeling of brain structures in brain injury

Author: Alvaro Pascual-Leone, T. Roig, A. García-Molina, Montserrat Bernabeu, J. M. Tormos, L. M. González, César Cáceres, M. Luna, Francisco Gayá, and Enrique J. Gómez
Subjects: 030506 rehabilitation, Telecomunicaciones, Relation (database), Computer science, Medicina, medicine.disease, Functional disorder, 03 medical and health sciences, 0302 clinical medicine, Neuroimaging, Feature (computer vision), medicine, 0305 other medical science, Algorithm, 030217 neurology & neurosurgery, Neurorehabilitation
Abstract: The number and grade of injured neuroanatomic structures and the type of injury determine the degree of impairment after a brain injury event and the recovery options of the patient. However, the body of knowledge and clinical intervention guides are basically focused on functional disorder and they still do not take into account the location of injuries. The prognostic value of location information is not known in detail either. This paper proposes a feature-based detection algorithm, named Neuroanatomic-Based Detection Algorithm (NBDA), based on SURF (Speeded Up Robust Feature) to label anatomical brain structures on cortical and sub-cortical areas. Themain goal is to register injured neuroanatomic structures to generate a database containing patient’s structural impairment profile. This kind of information permits to establish a relation with functional disorders and the prognostic evolution during neurorehabilitation procedures.
Published: 2014

14. Fourth meeting of the European Neurological Society 25–29 June 1994 Barcelona, Spain

Author: H. Hattig, C. Delli Pizzi, M. C. Addonizio, Michelle Davis, A. R. Giovagnoli, L. Florensa, M. Roth, J. de Kruijk, Francisco Lacruz, Ph. Dewailly, A. Toygar, C. Avendano, P.P. De Deyn, J. F. Hurtevent, F. Lomeila, T. W. Wong, Gordon T. Plant, M. Bud, H. J. Willison, DH Miller, D. W. Langdon, R. Cioni, J. Servan, A. Kaygisiz, E. Racadot, D. B. Schens, E. Picciola, L. Falip, C. Bouchard, J. Jotova, A. Jorge-Santamaria, P. Misra, A. Dufour, C. P. Panagopoulos, A. Venneri, B. Sredni, B. Angelard, M. Janelidze, M. Carreno, J. Obenberger, J. Pouget, H. W. Moser, R. Kaufmann, J. A. Molina, D. Linden, A. Martin Urda, E. Uvestad, A. Krone, J. P. Cochin, J. Mallecourt, A. Cambon-Thomsen, K. Violleau, P. Osschmann, A. M. Durocher, E. Bussaglia, D. M. Danielle, H. Efendi, C. Van Broeckhoven, K. G. Jordan, W. Rautenberg, C. Iniguez, J. M. Delgado, Graham Watson, M. Lawden, Gareth J. Barker, K. Stiasny, James T. Becker, G. Campanella, E. Peghi, A. Poli, A. Haddad, T. Yamawaki, Giacomo P. Comi, S. Sotgiu, B. Ersmark, A. Pomes, M. Ziegler, P. Ferrante, P. Ruppi, H. KuÇukoglu, R. Bouton, U. K. Rinne, P. Vieregge, M. Dary, P. Giunti, Peter J. Goadsby, S. Jung, E. Secor, A. Steinberg, N. Vila, M. A. Hernandez, M. Cursi, A. Enqelhardt, A. Engelhardt, J. Veitch, F. Di Silverio, F. Arnaud, B. Neundörfer, R. Brucher, Dominique Caparros-Lefebvre, B. Meyer, Marianne Dieterich, M. H. Snidaro, R. Gomez, R. Cerbo, M. Ragno, J. M. Vance, S. Nemni, A. Caliskan, F. Barros, I. Velcheva, D. Ceballos-Baumann, V. Barak, A. Avila, N. Antonova, F. Resche, S. Pappata, L. Varela, S. R. Silveira Santos, A. Cammarota, L. Naccache, Y. Nara, E. Tournier-Lasserves, R. Mobner, T. Chase, A. Ensenyat, J. Ulrich, G. Giegerich, M. Rother, M. Revilla, N. Nitschke, K. Honczarenko, E. Basart Tarrats, J. Blin, B. Jacob, J. Santamaria, S. Knezevic, J. L. Castillo, M. Antem, J. Colomer, O. Busse, Didier Hannequin, S. Carrier, J. B. Ruidavets, C. Rozman, J. Bogoussslavsky, J. Pascual Calvet, E. Monros, J. M. Polo, M. Zucconl, Javier Muruzabal, R. R. Allen, R. Rivolta, K. Haugaard, A. Nespolo, K. Hoang-Xuang, G. Bussone, T. Avramidis, E. Corsini, Christiana Franke, T. Vinogradova, H. Boot, K. Vestergaard, G. H. Jansen, N. Argentino, M. Raltzig, W. Linssen, Mark B. Pepys, P. Roblot, L. Lauritzen, E. Fainardi, D. Morin, T. X. Arbizu Urdiain, J. Wollenhaupt, S. Bostantjopoulou, G. Pavesi, A. D. Forman, Giovanni Fabbrini, D. Jean, J. J. Archelos, M. I. Blanchs, M. Del Gobbo, Anna Carla Turconi, Ch. Derouesné, Elio Scarpini, A. Visbeck, P. Castejon, J. P. Renou, F. Mounier-Vehier, G. Potagas, Ch. Duyckaerts, A. Filla, R. Schneider, G. Ronen, K. Nagata, J. P. Vedel, A. Henneberg, G. van Melle, C. Baratti, H. Knott, M. C. Prevett, A. Bes, B. Metin, Jos V. Reempts, L. Martorell, Mefkure Eraksoy, H. O. Handwerker, D. S. Younger, O. Oktem, D. Frongillo, C. Soriano-Soriano, L. Niehaus, F. Zipp, A. Tartaro, S Newman, R. H. Browne, P. Davous, R. Sanchez, M. Muros, M. E. Kornhuber, A. Lavarone, M. Mohr, M. R. Garcia, S. Russell, H. Kellar-Wood, M. R. Tola, B. Ostermeyer, Ch. Tzekov, K. Sartor, E. B. Ringelstein, P. P. Gazzaniga, Paul Krack, H. Fidaner, H. Rico, T. Dbaiss, F. Alameda, E. Torchiana, L. Rumbach, I. Charques, J. M. Bogaard, C. D. Frith, L. J. Rappelle, R. Brenner, A. Joutel, K. Fuxe, G. HÄcker, M. J. Blaser, J. Valls-SolÇ, G. Ulm, M. Alberdi, A. Bock, F. W. Bertelsmann, U. Wieshmann, J. Visa, J. R. Lupski, D. D'Amico, L. M. P. Ramos, A. A. Vanderbark, R. Horn, M. Warmuth, Dietmar Kühne, Mark S. Palmer, C. Ehrenheim, E. Canga, S. Viola, O. Scarpino, P. Naldi, R. Almeida, A. A. Raymond, J. Gamez, Stephan Arnold, A. DiGiovanni, J. Dalmau, C. C. Chari, H. F. Beer, J. C. Koetsier, J. Iriarte, E. Yunis, J. Casadevall, E. Le Guern, E. Stenager, S. R. Benbadis, J. M. Warter, F. Burklin, I. Theodorou, L. Johannesen, G. A. Graveland, X. Leclerc, I. Vecchio, L. Ozelius, G. Nicoletti, R. K. Gherardi, E. Esperet, M. L. Delodovici, F. Cattin, F. Paiau, Giorgio Sacilotto, C. A. J. Broere, D. Chavdarov, J. P. Willmer, C. H. Hawkes, Th. Naegele, E. Ellie, E. Dartigues, M. J. Guardiola, S. Hesse, Z. Levic, Marco Rovaris, P. Saugeir-Veber, B. A. Yaqub, H. F. Durwen, R. Larumbe, J. Ballabrina, M. Sendtner, J. Röther, M. Horstink, C. Kluglein, M.P. Montesi, H. Apaydin, J. Montoya, E. Waubant, Ch. Verellen-Dunoulin, A. Nicolai, J. Lopez-Delval, R. Lemon, G. Cantinho, E. Granieri, A. Zeviani, Wolfgang H. Oertel, U. Ficola, V. Di Piero, V. Fragola, K. Sabev, M. V. Guitera, I. Turki, F. Bolgert, P. Ingrand, J. M. Gobernado, L. M. E. Grimaldi, S. Baybas, B. Eymard, Y. Rolland, Y. Robitaille, Ta. Pampols, P. J. Koehler, A. Carroacedo, J. Vilchez, S. Di Vittorio, I. R. Rise, T. Nagy, M. Kuffner, E. Palazzini, A. Ott, J. Pruim, T. X. Arbizu, E. Manetti, C. Cervera, S. Felber, G. Gursoy, J. Scholz, G. A. Buscaino, M. S. Chen, A. Pascual, J. Hazan, J. U. Gajda, J. G. Cea, G. Bottini, G. Damalik, F. Le Doze, G. Bonaldi, J. M. Hew, C. Messina, A. M. Kennedy, J. M. Carney, N. M. F. Murray, M. Parent, M. Koepp, V. Dimova, D. De Leo, K. Jellinger, G. Salemi, S. Mientus, M. L. Hansen, F. Mazzucchelli, J. Vieth, M. Mauri, E. Bartels, L. Johannsen, C. Humphreys, J. Emile, D. N. Landon, E. Kansu, R. Sanchez-Pernaute, Rsj Frackowiak, M. Gonzalez Torres, L. Oller, C. Machedo, J. Kother, M. Billiard, H. Durak, T. Schindler, A. Frank, A. Uncini, A. Sbriccoli, C. Farinas, D. W. Paty, N. Fast, A. T. Zangaladze, A. Kerkhofs, J. M. Pino Garcia, I. De la Fuente, B. Marini, L. Gomez, I. Rubio, Alessandra Bardoni, C. Brodie, P. Acin, U. Sliwka, S. A. Hawkins, S. Tardieu, F. Vitullo, J. M. Pereira Monteino, R. Gagliardi, T. Jezewski, A. Cano, T. Lempert, F. Abad Alegria, G. Rotondo, D. Ince, C. Martinez Parra, Y. Huang, H. Luders, Y. Steinvil, F. G. A. Van Der Meche, R. Bianchi, A. Sanchez, T. Sevilla, J. M. Ketelslegers, A. Domzal-Stryga, M. Pandolfo, M. O. Josse, K. W. Neff, I. Blanco, G. W. Bruyn, O. W. Witte, J. L. Thibault, G. Andersen, J. Pariset, A. Marcone, R. J. M. 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Garcia de Yebenes, N. K. Olsen, P. Hitzenberger, S. Einius, Aj Thompson, Ch. J. Vecht, T. Crepin-Leblond, Klaus L. Leenders, A. Di Muzio, L. Georgieva, René Spiegel, K. Sabey, D. Ménégalli, J. Meulstee, U. Liszka, P. Giral, C. Sunol, J. M. Espadaler, A. D. Crockar, K. Varli, G. Giraud, P. J. Hülser, A. Benazzouz, A. Reggio, M. Salvatore, K. Genc, M. Kushnir, S. Barbieri, J. Ph. Azulay, M. Gianelli, N. Bathien, A. AlMemar, F. Hentati, I. Ragueneau, F. Chiarotti, R. C. F. Smits, A. K. Asbury, F. Lacruz, B. Muller, Alan J. Thompson, Gordon Smith, K. Schmidt, C. Daems Monpeun, Juergen Weber, A. Arboix, G. R. Fink, A. M. Cobo, M. Ait Kaci Ahmed, E. Gencheva, Israel-Biet, G. Schlaug, P. De Jonghe, Philip Scheltens, K. Toyka, P. Gonzalez-Porque, A. Cila, J. M. Fernandez, P. Augustin, J. Siclia, S. Medaglini, D. E. Ziogas, A. Feve, L. Kater, G. J. E. Rinkel, D. Leppert, Rüdiger J. Seitz, S. Ried, C. Turc-Carel, G. Smeyers, F. Godinho, M. Czygan, M. Rijntjes, E. Aversa, M. Frigo, Leif Østergaard, J. L. Munoz Blanco, A. Cruz-Matinez, J. De Reuck, C. Theillet, T. Barroso, V. Oikonen, Florence Lebert, M. Kilinc, C. Cordon-Cardon, G. Stoll, E. Thiery, F. Pulcinelli, J. Solski, M. Schmiegelow, L. J. Polman, P. Fernandez-Calle, C. Wikkelso, M. Ben Hamida, M. Laska, E. Kott, W. Sulkowski, C. Lucas, N. M. Bornstein, D. Schmitz, M. W. Lammers, A. de Louw, R. J. S. Wise, P. A. van Darn, C. Antozzi, P. Villanueva, P. H. E. Hilkens, C. Constantin, W. Ricart, A. Wolf, M. Gamba, P. Maguire, Alessandro Padovani, B. M. Patten, Marie Sarazin, H. Ackermann, L. Durelli, S. Timsit, Sebastian Jander, B. W. Scheithauer, G. Demir, J. P. Neau, P. Barbanti, A. Brand, N. AraÇ, V. Fischer-Gagnepain, R. Marchioli, G. Serratrice, C. Maugard-Louboutin, G. T. Spencer, D. Lücke, G. Mainardi, K. Harmant Van Rijckevorsel, G. B. Creel, R. Manzanares, Francesco Fortunato, A. May, J. Workman, K. Johkura, E. Fernandez, Carlo Colosimo, L. Calliauw, L. Bet, Félix F. Cruz-Sánchez, M. Dhib, H. Meinardi, F. Carrara, J. Kuehnen, C. Peiro, H. Lassmann, K. Skovgaard Olsen, A. McDonald, L. Sciulli, A. Cobo, A. Monticelli, B. Conrad, J. Bagunya, J. Benitez, V. Desnizza, B. Dupont, O. Delrieu, D. Moraes, J. J. Heimans, F. Garcia Rio, M. Matsumto, A. Fernandez, R. Nermni, R. Chalmers, M. J. Marchau, F. Aguado, P. Velupillai, P. J. Martin, P. Tassan, V. Demarin, A. Engelien, T. Gerriets, Comar, J. L. Carrasco, J. P. Pruvo, A. Lopez de Munain, D. Pavitt, J. Alarcon, Chris H. Polman, B. Guldin, N. Yeni, Hartmut Brückmann, N. Wilczak, H. Szwed, R. Causaran, G. Kyriazis, M. E. Westarp, M. Gasparini, N. Pecora, J. M. Roda, E. Lang, V. Scaioli, David R. Fish, D. Caputo, O. Gratzl, R. Mercelis, A. Perretti, G. Steimetz, I. Link, C. Rigoletto, A. Catafau, G. Lucotte, M. Buti, G. Fagiolari, A. Piqueras, C. Godinot, J. C. Meurice, Erodriguez J. Dominigo, F. Lionnet, H. Grzelec, David J. Brooks, P. M. G. Munro, F. X. Weilbach, M. Maiwald, W. Split, B. Widjaja-Cramer, V. Ozturk, J. Colas, E. Brizioli, J. Calleja, L. Publio, M. Desi, R. Soffietti, P. Cortinovis-Tourniaire, E. F. Gonano, G. Cavaletti, S. Uselli, K. Westerlind, H. Betuel, C. O. Dhiver, H. Guggenheim, M. Hamon, R. Fazio, P. Lehikoinen, A. Esser, B. Sadzot, G. Fink, Angelo Antonini, D. Bendahan, V. Di Carlo, G. Galardi, A. F. Boller, M. Aksenova, Del Fiore, V. de la Sayette, H. Chabriat, A. Nicoletti, A. Dilouya, M. L. Harpin, E. Rouillet, J. Stam, A. Wolters, M. R. Delgado, Eduardo Tolosa, G. Said, A. J. Lees, L. Rinaldi, A. Schulze-Bonhage, MA Ron, C. Lefebvre, E. W. Radü, R. Alvarez, M. L. Bots, P. Reganati, S. Palazzi, A. Poggi, N. J. Scolding, V. Sazdovitch, T. Moreau, E. Maes, M. A. Estelies, P. Petkova, Jose-Felix Marti-Masso, G De La Meilleure, N. Mullatti, M. Rodegher, N. C. Notermans, T. A. T. Warner, S. Aktan, J. P. Louboutin, L. Volpe, C. Scheidt, W. Aust, C. M. Wiles, U. Schneider, S. K. Braekken, W. R. Willems, K. Usuku, Peter M. Rothwell, C. Talamon, M. L. Sacchetti, A. Codina, M. H. Marion, A. Santoro, J. Roda, A. Bordoni, D. J. Taylor, S. Ertas, H. H. Emmen, J. Vichez, V. BesanÇon, R. E. Passingham, M. L. Malosio, A. Vérier, M. Bamberg, A. W. Hansen, E. Mostacero, G. Gaudriault, Marie Vidailhet, B. Birebent, K. Strijckmans, F. Giannini, T. Kammer, I. Araujo, J. Nowicki, E. Nikolov, A. Hutzelmann, R. Gherardi, J. Verroust, L. Austoni, A. Scheller, A. Vazquez, S. Matheron, H. Holthausen, J. M. Gerard, M. Bataillard, S. Dethy, V. H. Patterson, V. Ivanez, N. P. Hirsch, F. Ozer, M. Sutter, C. Jacomet, M. Mora, Bruno Colombo, A. Sarropoulos, T. H. Papapetropoulos, M. Schwarz, D. S. Dinner, N. Acarin, B. Iandolo, J. O. Riis, P. R. J. Barnes, F. Taroni, J. Kazenwadel, L. Torre, A. Lugaresi, I. L. Henriques, S. Pauli, S. Alfonso, Pedro Quesada, A. S. T. Planting, J. M. Castilla, Thomas Gasser, M. Van der Linden, A. Alfaro, E. Nobile-Orazio, G. Popova, W. Vaalburg, F. G. A. van der Mech, L. Williams, F. Medina, J. P. Vernant, J. Yaouanq, B. Storch-Hagenlocher, A. Potemkowski, R. Riva, M. H. Mahagne, M. Ozturk, Ve. Drory, N. Konic, C. Jungreis, A. Pou Serradell, J. L. Gauvrit, G. J. Chelune, S. Hermandez, T. Dingus, L. Hewer, Ch. Koch, M. N. Metz-Lutz, G. Parlato, M. Sinaki, Charles Pierrot-Deseilligny, H. C. Diener, J. Broeckx, J. Weill-Fulazza, M. L. Villar, M. Rizzo, O. Ganslandt, C. Duran, N. A. Fletcher, G. Di Giovacchino, Susan T. Iannaccone, C. Kolig, N. Fabre, H. A. Crockard, Rita Bella, M. Tazir, E. Papagiannuli, K. Overgaard, Emma Ciafaloni, I. Lorenzetti, F. Viader, P. A. H. Millac, I. Montiel, L. H. Visser, M. Palomar, P. L. Murgia, H. Pedersen, Rafael Blesa, S. Seddigh, W. O. Renier, I. Lemahieu, H. M. L. Jansen, L. Rosin, J. Galofre, K. Mattos, M. Pondal, G. M. Hadjigeorgiou, D. Francis, L. Cantin, D. Stegeman, M. Rango, A. B. M. F. Karim, S. Schraff, B. Castellotti, I. Iriarte, E. Laborde, T. J. Tjan, R. Mutani, D. Toni, B. Bergaasco, J. G. Young, C. Klotzsch, A. Zincone, X. Ducrocq, M. Uchuya, O. J. Kolar, A. Quattrone, T. Bauermann, Nereo Bresolin, J. Vallée, B. C. Jacobs, A. Campos, Werner Poewe, J. A. Villanueva, A. W. Kornhuber, A. Malafosse, E. Diez-Tejedor, G. Jungreia, M. J. A. Puchner, A. Komiyama, O. Saribas, V. Volpini, L. Geremia, S. Bressi, A. Nibbio, Timothy E. Bates, T. z. Tzonev, E. Ideman, G. A. Damlacik, G. Martino, G. Crepaldi, T. Martino, Kjell Någren, E. Idiman, D. Samuel, J. M. Perez Trullen, Y. van der Graaf, J. O. Thorell, M. J. M. Dupuis, E. Sieber, R. D'Alessandro, C. Cazzaniga, J. Faiss, A. Tanguy, A. Schick, I. Hoksergen, A. Cardozo, R. Shakarishvili, G. K. Wennlng, J. L. Marti-Vilalta, J. Weissenbach, I. L. Simone, Amalia C. Bruni, Darius J. Adams, C. Weiller, A. Pietrangeli, F. Croria, C. Vigo-Pelfrey, Patricia Limousin, A. Ducros, G. Conti, O. Lindvall, E. Richter, M. Zuffi, A. Nappo, T. Riise, J. Wijdenes, M. J. Fernandez, J. Rosell, P. Vermersh, S. Servidei, M. S. C. Verdugo, F. Gouttiere, W. Solbach, M. Malbezin, I. S. Watanabe, A. Tumac, W. I. McDonald, D. A. Butterfield, P. P. Costa, F. deRino, F. Bamonti, J. M. Cesar, C. H. Lahoz, I. Mosely, M. Starck, M. H. Lemaitre, K. M. Stephan, S. Tex, R. Bokonjic, I. Mollee, L. Pastena, M. Gutierrez, F. Boiler, M. C. Martinez-Para, M. Velicogna, O. Obuz, A. Grinspan, M. Guarino, L. M. Cartier, E. Ruiz, D. Gambi, S. Messina, M. Villa, Michael G. Hanna, J. Valk, Leone Pascual, M. Clanet, Z. Argov, B. Ryniewicz, E. Magni, B. Berlanga, K. S. Wong, C. Gellera, C. Prevost, F. Gonzalez-Huix, R. Petraroli, J. E. G. Benedikz, I. Kojder, C. Bommelaer, L. Perusse, M. R. Bangioanni, Guy M. McKhann, A. Molina, C. Fresquet, E. Sindern, Florence Pasquier, M. J. Rosas, M. Altieri, O. Simoncini, M. Koutroumanidis, C. A. F. Tulleken, M. Dary-Auriol, S. Oueslati, H. Kruyer, I. Nishisho, C. R. Horning, A. Vital, G. V. Czettritz, J. Ph. Neau, B. Mihout, A. Ameri, M. Francis, S. Quasthoff, D. Taussig, S. Blunt, P. Valentin, C. Y. Gao, O. Heinzlef, H. d'Allens, C. Coudero, M. Erfas, G. Borghero, P. J. Modrego Pardo, M. C. Patrosso, N. L. Gershfeld, P. A. J. M. Boon, O. Sabouraud, M. Lara, J. Svennevig, G. L. Lenzi, A. Barrio, H. Villaroya, JosÇ M. Manubens, O. Boespflug-Tanguy, M. Carreras, D. A. Costiga, J. P. Breux, S. Lynn, C. Oliveras Ley, A. G. Herbaut, J. Nos, C. Tornali, Y. A. Hekster, J. L. Chopard, J. M. Manubens, P. Chemouilli, A. Jovicic, F. Dworzak, S. Smirne, S. E. Soudain, B. Gallano, D. Lubach, G. Masullo, G. Izquierdo, A. Pascual Leone Pascual, A. Sessa, V. Freitas, O. Crambes, L. Ouss, G. W. Van Dijk, P. Marchettini, P. Confalonieri, M. Donaghy, A. Munnich, M. Corbo, and M. E. L. van der Burg
Subjects: Neurology, business.industry, Media studies, Library science, Medicine, Neurology (clinical), business
Published: 1994
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15. ¿Deterioro cognitivo progresivo en el síndrome post-polio?

Author: A. García-Molina and T. Roig-Rovira
Subjects: business.industry, Rehabilitation, Medicine, Physical Therapy, Sports Therapy and Rehabilitation, business
Published: 2015
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16. A computational model to simulate groundwater seepage risk in support of geotechnical investigations of levee and dam projects

Author: Yuill, Brendan T.; Roig-Silva, Carla, United States. Army. Corps of Engineers. Fort Worth District, Yuill, Brendan T.; Roig-Silva, Carla, and United States. Army. Corps of Engineers. Fort Worth District
Abstract: ERDC/GSL TR-13-5 A Computational Model to Simulate Groundwater Seepage Risk in Support of Geotechnical Investigations of Levee and Dam Projects Geotechnical and Structures Laboratory Brendan T. Yuill and Carla M. Roig-Silva March 2013 Approved for public release; distribution is unlimited. The US Army Engineer Research and Development Center (ERDC) solves the nation’s toughest engineering and environmental challenges. ERDC develops innovative solutions in civil and military engineering, geospatial sciences, water resources, and environmental sciences for the Army, the Department of Defense, civilian agencies, and our nation’s public good. Find out more at www.erdc.usace.army.mil. To search for other technical reports published by ERDC, visit the ERDC online library at http://acwc.sdp.sirsi.net/client/default. ERDC/GSL TR-13-5 March 2013 A Computational Model to Simulate Groundwater Seepage Risk in Support of Geotechnical Investigations of Levee and Dam Projects Brendan T. Yuill and Carla M. Roig-Silva Geotechnical and Structures Laboratory US Army Engineer Research and Development Center 3909 Halls Ferry Road Vicksburg, MS 39180-6199 Final report Approved for public release; distribution is unlimited. Prepared for US Army Corps of Engineers, Fort Worth District 809 Taylor Street 4A01 Fort Worth, TX 76102 ERDC/GSL TR-13-5 ii Abstract The amount and distribution of coarse-grained sediment relative to fine-grained sediment within a floodplain influences the floodplain’s geo-technical properties, including the potential for groundwater seepage. Seepage is a primary driver of levee and dam failure, and understanding it is of paramount concern to water resource engineers and managers. This report documents the results of a computational modeling study that simulated alluvial floodplain construction by using simple geomorphic process-imitating rules. The model aggrades an alluvial floodplain, creating floodplain architecture by differentiating between sediment deposited by
Published: 2013

17. Intracavernous pharmacotherapy for management of erectile dysfunction in multiple sclerosis patients

Author: J, Vidal, L, Curcoll, T, Roig, and J, Bagunyá
Subjects: Adult, Male, Multiple Sclerosis, Penile Erection, Parasympatholytics, Self Administration, Middle Aged, Severity of Illness Index, Injections, Sexual Dysfunction, Physiological, Papaverine, Humans, Hypoglycemic Agents, Insulin
Abstract: Intracavernous self-injection of vasoactive drugs is a well accepted therapy for the management of erectile dysfunction in neurogenic disorders. We present the results of a self-injection program in seven MS patients who were admitted in Institut Guttmann of Barcelona and who presented with an insufficient erection. All patients showed an excellent erectile response and had penile rigidity sufficient for sexual intercourse during acceptable time, with minimal complications. A patient reported improvement of erectile capacity so as not to need another cavernously injection for 2-3 months.
Published: 1995

18. [Craniocerebral injury:neuropsychological and behavioral aspects. Rehabilitation]

Author: T, Roig Rovira and M, Juncadella Puig
Subjects: Adult, Male, Cognitive Behavioral Therapy, Brain Injuries, Humans, Female, Neuropsychological Tests, Cognition Disorders
Published: 1994

19. Double luminal and vascular perfusion of chicken jejunum: studies on 3-O-methyl-D-glucose absorption

Author: T. Roig, E. Fernández, María Pilar Vinardell, and J. Ruberté
Subjects: Male, Physiology, Phloretin, Enterocyte, Clinical Biochemistry, Lumen (anatomy), Biology, Intestinal absorption, Jejunum, chemistry.chemical_compound, Theophylline, Physiology (medical), medicine, Pressure, Animals, Methylglucosides, Small intestine, Perfusion, Microscopy, Electron, medicine.anatomical_structure, Phlorhizin, Biochemistry, chemistry, Intestinal Absorption, Biophysics, Microscopy, Electron, Scanning, 3-O-Methylglucose, Chickens, medicine.drug
Abstract: The aims of the present study were: (1) to set up a procedure for simultaneous vascular and luminal perfusion of the chicken jejunum; (2) to assess the transport capacity of the tissue under such conditions, and (3) to study the effects of phloretin and theophylline, given through the vascular perfusate, on 3-O-methyl-D-glucose intestinal transport. The perfusion procedure described allowed the control of intestinal and vascular inflow rates and perfusion pressures so that these parameters could be adjusted to physiological values. A perfluorochemical emulsion was used as oxygen carrier for the vascular perfusate. The absorptive function of the perfused tissue was assessed by means of its ability to transport 3-O-methyl-D-glucose. Furthermore, ultrastructure preservation was evaluated by scanning and transmission electron microscopy. Results indicate that the perfused tissue kept its transport capacity and morphology intact throughout the 120-min experimental period. Moreover, no hypersecretion was observed as indicated by the constancy of perfusate volumes and perfusion pressures. Phloretin (1 mM) or theophylline (10 mM) added to the vascular perfusate markedly reduced the transfer of 3-O-methyl-D-glucose from the enterocyte to the vascular fluid without affecting the uptake from the lumen. Our results suggest that this preparation may be used as an alternative tool for the study of intestinal absorption processes in avian species, particularly when complete examination is required of the efflux of substrates from the intestinal lumen to the vascular fluid.
Published: 1993

20. Intestinal perfusion in vivo for the study of absorptive processes

Author: María Pilar Vinardell and T. Roig
Subjects: Pathology, medicine.medical_specialty, Intestinal perfusion, General Medicine, Absorption (skin), Biology, Intestinal absorption, Intestines, Perfusion, Intestinal Absorption, In vivo, medicine, Animals
Abstract: 1. 1. Intestinal absorption can be studied by in vitro and in vivo techniques. Among the in vivo ones, intestinal perfusion is the one more employed. 2. 2. Intestinal perfusion could be performed by a simple perfusion of an intestinal segment or by a double perfusion of the intestine and the vascular bed simultaneously. 3. 3. The double perfusion has the advantage of measuring the substrate appearance in the vascular circuit. 4. 4. In this review we compare the different techniques described in the literature, paying attention to their advantages. 5. 5. The best method is the one that maintains the animal alive throughout the experiment, because it provides information about intestinal absorption under conditions similar to the natural ones.
Published: 1991

21. Afasias Adquiridas en La Infancia

Author: Por J. Peña Casanova, L. Barraquer Bordas, and T. Roig Rovira
Subjects: Speech and Hearing, LPN and LVN
Abstract: RESUMEN Los autores revisan las manifestaciones clinicas de las afasias infantiles, insistiendo en sus caracteristicas fundamentales: reduccion de la expresion, trastornos articulatorios, rareza de parafasias, ausencia de logorrea, relativa preservacion de la comprension (esta estaria afectada en un tercio de los casos) y buen pronostico. A continuacion exponen los problemas, planteados por los datos que indican la muy temprana especializacion funcional del hemisferio izquierdo en el lenguaje, la rapida recuperacion de la funcion verbal en la afasia infantil, la presencia de afasia por lesion derecha, muy especialmente en edades anteriores a los cinco anos, y discuten los conceptos «periodo critico» y «reorganizacion funcional».
Published: 1983
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22. Psychotriae Cubenses Novae (Rubiaceae)

Author: J. Acuña and J. T. Roig
Subjects: Plant ecology, Rubiaceae, Botany, Plant physiology, Plant Science, Biology, biology.organism_classification, Ecology, Evolution, Behavior and Systematics
Published: 1962
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23. Geriatric syndromes and functions in older adults with COVID-19 hospitalized in sub-acute care: a multicenter study.

Author: Morandi A, Gual N, Cesari M, Mota M, Buttò V, Gentile S, Balestreri G, Camussi A, Platto C, Roig T, de Andrés AM, Bellelli G, and Inzitari M
Subjects: Humans, Aged, Female, Male, Prospective Studies, Subacute Care, Pandemics, Syndrome, Geriatric Assessment, Frail Elderly, Frailty epidemiology, COVID-19 epidemiology, Delirium epidemiology
Abstract: Objective: Alternatives to conventional acute hospitalizations have been particularly useful during the COVID-19 pandemic. However, little is known on the management and outcomes of COVID-19 in older patient admitted to non-acute settings. The main aim of this study was to determine the effect of geriatrics syndromes on functional outcomes in older COVID-19 patients cared in sub-acute units., Methods: Prospective multicenter observational cohort study of patients aged 65 years and older with COVID-19, admitted to sub-acute units in Italy and Spain. Multivariable logistic regression models were used to test the association between geriatric syndromes and other clinical variables, and the functional status at discharge, defined by a Barthel Index > = 80., Results: A total of 158 patients were included in the study with a median age of 82 [Interquartile Range 81, 83]; of these 102 (65%) patients had a Barthel Index ≥ 80 at discharge. In the main multivariable logistic regression model a higher severity of frailty-measured with the Clinical Frailty Scale-(OR 0.30; CI 0.18-0.47), and the presence of delirium (OR 0.04; CI 0.00-0.35) at admission were associated with lower odds of a higher functional status at discharge. Other variables associated with lower functional status were female gender (OR 0.36; CI 0.13-0.96), and a higher number of comorbidities (OR 0.48; CI 0.26-0.82)., Conclusion: The study reports a relatively high prevalence of functional recovery for older COVID-19 patients admitted to sub-acute units. Additionally, it underlines the importance of targeting geriatrics syndromes, in particular frailty and delirium, for their possible effects on functional recovery., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Published: 2023
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24. Combination treatment in the rehabilitation of visuo-spatial neglect.

Author: Aparicio-López C, García-Molina A, García-Fernández J, López-Blázquez R, Enseñat-Cantallops A, Sánchez-Carrión R, Muriel V, Tormos JM, and Roig-Rovira T
Subjects: Adult, Aged, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Perceptual Disorders etiology, Stroke complications, Perceptual Disorders rehabilitation, Stroke Rehabilitation methods
Abstract: Background: Visuo-spatial neglect predicts longer hospitalization, poorer recovery of motor skills and greater functional limitation. The aim of the present study was to analyze whether the combined administration of computerized cognitive rehabilitation with right hemifield eye-patching in patients with left spatial neglect following a right hemisphere stroke is more effective than computerized cognitive rehabilitation applied in isolation., Method: Randomized clinical trial conducted in 28 patients. These were grouped into two experimental groups: single treatment group (ST) (n= 15) and combined treatment group (CT) (n= 13). All received an average of 15 one-hour sessions of computerized cognitive rehabilitation using the Guttmann, NeuroPersonalTrainer® telerehabilitation platform. Those patients in the TC group performed the sessions wearing a visual device with which the right hemifield of each eye was occluded., Results: Following treatment, both the ST and the TC group showed improvements in neuropsychological examination protocol although there were no differences pre- and post-treatment on the functional scale in either group. Likewise, no statistically significant differences were observed in intergroup comparison., Conclusions: The results from this study indicate that combination treatment is not more effective than rehabilitation applied in isolation.
Published: 2016
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25. Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury.

Author: Martínez-Moreno JM, Sánchez-González P, Luna M, Roig T, Tormos JM, and Gómez EJ
Subjects: Activities of Daily Living, Cognition, Computer Simulation, Equipment Design, Humans, Models, Theoretical, Neurological Rehabilitation methods, Neuropsychology methods, Psychometrics methods, Quality of Life, Software, Spain, Therapy, Computer-Assisted, User-Computer Interface, Brain Injuries rehabilitation, Telemedicine methods
Abstract: Background: Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine., Objectives: To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments., Methods: The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation., Results: An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures., Conclusions: The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current work is devoted to designing more experiments in order to present more evidence about its values.
Published: 2016
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26. [What is hidden behind the Baking Tray Task? Study of sensibility and specificity in right-hemispheric stroke patients].

Author: Garcia-Fernandez J, Garcia-Molina A, Aparicio-Lopez C, Sanchez-Carrion R, Ensenat A, Pena-Casanova J, and Roig-Rovira T
Subjects: Adult, Aged, Brain Ischemia complications, Dominance, Cerebral, Female, Humans, Male, Middle Aged, Perceptual Disorders etiology, Psychomotor Performance, Sensitivity and Specificity, Young Adult, Cerebral Hemorrhage complications, Neuropsychological Tests, Perceptual Disorders diagnosis
Abstract: Introduction: Tham and Tegner proposed the Baking Tray Task (BTT) as a fast simple assessment test for detecting spatial negligence. However, very few studies have examined its validity as a diagnostic test., Aim: To analyse the diagnostic validity of the BTT by measuring its specificity and sensitivity in a sample of subjects with right hemisphere strokes., Subjects and Methods: Forty-eight patients with right hemisphere vascular lesions were distributed in two groups (negligence group, n = 35; non-negligence group, n = 13) according to the scores obtained in a battery of visuospatial examination tests. The participants' performance on the BTT was compared with that of a healthy control group (n = 12)., Results: The results showed a high level of sensitivity of the BTT, but low specificity. The performance on the BTT of eight of the 13 members of the non-negligence group was suggestive of negligence., Conclusions: The BTT has proved to be a sensitive test for the detection of spatial negligence. Yet, based on its low specificity, its use alone as a single diagnostic test is not recommended.
Published: 2015

27. [Relationship between executive functioning and behaviour in children with cerebral palsy].

Author: Muriel V, Garcia-Molina A, Aparicio-Lopez C, Ensenat A, and Roig-Rovira T
Subjects: Adolescent, Child, Female, Humans, Male, Adaptation, Psychological, Cerebral Palsy physiopathology, Cerebral Palsy psychology, Executive Function
Abstract: Introduction: Cerebral palsy is defined as a group of developmental disorders of movement and posture that causes social and cognitive deficits, emotional, and behavior disturbances., Aim: To study the relationship between executive functioning and behavior in children with cerebral palsy from the answers given by parents and teachers on the Behavior Rating Inventory of Executive Function (BRIEF) and on the System Assessment Adaptive Behavior (ABAS-II)., Patients and Methods: The sample consisted on 46 children with CP with a mean age of 10.26 ± 2.95 years. Forty-four of the 46 children were distributed in Gross Motor Function Classification System (GMFCS) into level I (n = 16), level II (n = 3), level III (n = 11), level IV (n = 10) and level V (n = 4)., Results: The results showed a relationship between BRIEF and ABAS-II. Furthermore, discrepancies between the responses from parents and teachers, both in the ABAS-II and in the BRIEF, were obtained., Conclusions: We found a significant relationship between executive functioning in children with cerebral palsy and adaptive behavior. We found discrepancies in the answers given by parents and teachers. Finally, the data showed that the higher motor impairment increases difficulties at home.
Published: 2015

28. Geriatric Screening Tools to Select Older Adults Susceptible for Direct Transfer From the Emergency Department to Subacute Intermediate-Care Hospitalization.

Author: Inzitari M, Gual N, Roig T, Colprim D, Pérez-Bocanegra C, San-José A, and Jimenez X
Subjects: Aged, Aged, 80 and over, Chronic Disease epidemiology, Cohort Studies, Dementia epidemiology, Emergency Service, Hospital, Female, Hospital Mortality, Hospitalization, Humans, Male, Predictive Value of Tests, Pressure Ulcer epidemiology, Proportional Hazards Models, Spain epidemiology, Geriatric Assessment methods, Intermediate Care Facilities, Patient Discharge, Patient Transfer
Abstract: Objectives: Early transfer to intermediate-care hospitals, low-tech but with geriatric expertise, represents an alternative to conventional acute hospitalization for selected older adults visiting emergency departments (EDs). We evaluated if simple screening tools predict discharge destination in patients included in this pathway., Design, Setting, and Participants: Cohort study, including patients transferred from ED to the intermediate-care hospital Parc Sanitari Pere Virgili, Barcelona, during 14 months (2012-2013) for exacerbated chronic diseases., Measurements: At admission, we collected demographics, comprehensive geriatric assessment, and 3 screening tools (Identification of Seniors at Risk [ISAR], SilverCode, and Walter indicator)., Outcome: Discharge destination different from usual living situation (combined death and transfer to acute hospitals or long-term nursing care) versus return to previous situation (home or nursing home)., Results: Of 265 patients (mean age ± SD = 85.3 ± 7.5, 69% women, 58% with acute respiratory infections, 38% with dementia), 80.8% returned to previous living situation after 14.1 ± 6.5 days (mean ± SD). In multivariable Cox proportional hazard models, ISAR >3 points (hazard ratio [HR] 2.06, 95% confidence interval [95% CI] 1.16-3.66) and >1 pressure ulcers (HR 2.09, 95% CI 1.11-3.93), but also continuous ISAR, and, in subanalyses, Walter indicator, increased the risk of negative outcomes. Using ROC curves, ISAR showed the best prediction among other variables, although predictive value was poor (AUC = 0.62 (0.53-0.71) for ISAR >3 and AUC = 0.65 (0.57-0.74) for continuous ISAR). ISAR and SilverCode showed fair prediction of acute hospital readmissions., Conclusions: Among geriatric screening tools, ISAR was independently associated with discharge destination in older adults transferred from ED to intermediate care. Predictive validity was poor. Further research on selection of candidates for alternatives to conventional hospitalization is needed., (Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
Published: 2015
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29. [What happens after the accident? Psychosocial needs of people with traumatic brain injury and their families].

Author: Gifre M, Gil Á, Pla L, Roig T, and Monreal-Bosch P
Subjects: Adult, Aged, Brain Injuries, Traumatic etiology, Brain Injuries, Traumatic rehabilitation, Communication Disorders etiology, Communication Disorders psychology, Communication Disorders rehabilitation, Emotions, Family Characteristics, Female, Focus Groups, Humans, Male, Mental Disorders etiology, Mental Disorders psychology, Mental Disorders rehabilitation, Middle Aged, Psychological Distance, Quality of Life, Social Participation, Social Support, Accidents, Traffic psychology, Brain Injuries, Traumatic psychology
Abstract: Objective: To identify factors that people with a traumatic brain injury and their families perceived as helping to improve their quality of life., Methods: Three focus groups and five interviews were conducted with a total of 37 participants: 14 persons with traumatic brain injury and 23 caregivers. A content analysis was conducted. The constant comparative method was applied., Results: We detected five factors that improved the quality of life of persons with a traumatic brain and their families: 1) Informal support (family and friends); 2) formal support (counseling, employment, built and bureaucratic environment); 3) type of clinical characteristics; 4) social participation, and 5) social visibility., Conclusions: The needs expressed by our participants primarily focused on social and emotional factors. For persons with severe traumatic brain injury attempting to achieve the best possible community integration, a new semiology is required, not limited to medical care, but also involving social and psychological care tailored to the needs of each individual and family and their environment., (Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.)
Published: 2015
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30. [Neuropsychological deficits in alternating hemiplegia of childhood: a case study].

Author: Muriel V, Garcia-Molina A, Aparicio-Lopez C, Ensenat A, and Roig-Rovira T
Subjects: Attention, Child, Child Behavior Disorders etiology, Comprehension, Emotions, Female, Flunarizine therapeutic use, Hemiplegia diagnosis, Hemiplegia drug therapy, Humans, Memory Disorders etiology, Memory, Short-Term, Mental Processes, Neuroimaging, Neurologic Examination, Neuropsychological Tests, Psychomotor Performance, Severity of Illness Index, Speech Disorders etiology, Hemiplegia psychology
Abstract: Introduction: Alternating hemiplegic of childhood is a predominantly sporadic neurodevelopmental syndrome of uncertain etiology, characterized by alternating transient attacks of hemiplegia. Additional features include tonic fits, dystonic posturing, ocular motor abnormalities and deficits in cognitive functioning., Case Report: A girl of 7 years-old with alternating hemiplegic of childhood. The first symptoms debut at 17 months of age in the form of lower limb weakness, migraine, nystagmus and hemiplegic crisis alternating both hemibodies. We administrate the Wechsler Intelligence Scale for Children IV (WISC-IV), the Conners Continuous Performance Test II (CPT-II), the Conners scales for parents (CPRS-48) and teachers (CTRS-28) and the Behavior Rating Inventory Executive Function (BRIEF)., Conclusions: In our study we found deficits in sustained attention, reduced speed of information processing, and difficulties in understanding, speaking and working memory. In addition, parents and teachers reported behavioral disturbances, difficulties inhibition capability, in self-control and in regulating emotions.
Published: 2015

31. Cognitive rehabilitation with right hemifield eye-patching for patients with sub-acute stroke and visuo-spatial neglect: a randomized controlled trial.

Author: Aparicio-López C, García-Molina A, García-Fernández J, Lopez-Blazquez R, Enseñat-Cantallops A, Sánchez-Carrión R, Muriel V, Tormos JM, and Roig-Rovira T
Subjects: Adult, Agnosia physiopathology, Agnosia psychology, Cognition, Cognition Disorders physiopathology, Cognition Disorders psychology, Female, Humans, Male, Middle Aged, Perceptual Disorders physiopathology, Perceptual Disorders psychology, Perceptual Disorders rehabilitation, Spain, Stroke physiopathology, Stroke psychology, Therapy, Computer-Assisted, Agnosia rehabilitation, Cognition Disorders rehabilitation, Stroke Rehabilitation
Abstract: Objective: To assess whether, following a right-hemisphere stroke, the combined administration of computer-based cognitive rehabilitation and right hemifield eye-patching in patients with visuo-spatial neglect is more effective than computer-based cognitive rehabilitation alone., Methods: Twelve patients were randomized into two treatment groups: a single treatment group (n = 7) and a combination treatment group (n = 5). In both cases, the treatment consisted of a mean number of 15 sessions, each lasting 1 hour. Visuo-spatial neglect was assessed using a specific exploration protocol (Bell Cancellation Test, Figure Copying of Odgen, Line Bisection, Baking Tray Task and Reading Task). The functional effects of the treatment were assessed using the Catherine Bergego Scale., Results: Significant between-group differences were observed when comparing the pre- and post-treatment scores for the Reading Task. No differences were observed in either group in the Catherine Bergego Scale administered at baseline and at the final intervention., Conclusion: The results obtained do not allow one to conclude that the combination treatment with cognitive rehabilitation and right hemifield eye-patching is more effective than cognitive rehabilitation alone. Although partial improvement in the performance of neuropsychological tests was observed, this improvement is not present at functional level.
Published: 2015
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32. Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer.

Author: Solana J, Cáceres C, García-Molina A, Opisso E, Roig T, Tormos JM, and Gómez EJ
Subjects: Adolescent, Adult, Brain Injuries diagnosis, Brain Injuries economics, Cognition Disorders diagnosis, Cognition Disorders economics, Cognitive Behavioral Therapy economics, Decision Support Systems, Clinical economics, Female, Health Care Costs statistics & numerical data, Humans, Male, Patient-Centered Care economics, Spain, Telemedicine economics, Therapy, Computer-Assisted, Treatment Outcome, User-Computer Interface, Young Adult, Brain Injuries rehabilitation, Cognition Disorders rehabilitation, Cognitive Behavioral Therapy methods, Decision Support Systems, Clinical organization & administration, Patient-Centered Care methods, Telemedicine methods
Abstract: Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines.
Published: 2015
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33. Cytomegalovirus and herpes simplex infections in mothers and newborns in a Havana maternity hospital.

Author: Festary A, Kourí V, Correa CB, Verdasquera D, Roig T, and Couret MP
Subjects: Cross-Sectional Studies, Cytomegalovirus Infections congenital, Female, Herpes Simplex congenital, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Infectious virology, Pregnancy Trimester, Third, Prevalence, Cytomegalovirus Infections epidemiology, Herpes Simplex epidemiology, Hospitals, Maternity statistics & numerical data, Infant, Newborn, Diseases epidemiology, Pregnancy Complications, Infectious epidemiology
Abstract: Introduction: Cytomegalovirus and herpes simplex virus are associated with congenital or perinatal infection, causing potential damage to the newborn., Objectives: Determine the prevalence of active or latent infection by cytomegalovirus and herpes simplex virus in a population of mothers, congenital infection by these agents in their infants, and association between prevalence of virus infection in mothers and in their newborns., Methods: A cross-sectional study was conducted from June to September 2012 in a population of 95 pregnant women admitted to the Dr Ramón González Coro University Maternity Hospital during the third trimester of pregnancy, and their infants (98). Patients were tested for antibodies specific to these viruses; vaginal swabs and urine from the women and serum and urine from the newborns were tested for viral genome. The Fisher exact test with 95% confidence interval was used for comparisons., Results: Of the women studied, 89.5% tested positive for cytomegalovirus and 83.2% for herpes simplex. Active infection from cytomegalovirus was detected in 16.7%, and from herpes simplex in 3.2%. Congenital cytomegalovirus infection was detected in 4.1% of newborns; no herpes simplex virus infection was found in this group. Two newborns of women with active cytomegalovirus infection were congenitally infected., Conclusions: Serology demonstrated that most of the women were immune to both viruses. Active cytomegalovirus infections are common in this population, and newborns of women with active cytomegalovirus infection during pregnancy are at increased risk of congenital infection.
Published: 2015
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34. [Cognitive stimulation in children with cerebral palsy].

Author: Muriel V, Garcia-Molina A, Aparicio-Lopez C, Ensenat A, and Roig-Rovira T
Subjects: Adolescent, Attention, Cerebral Palsy psychology, Cerebral Palsy rehabilitation, Child, Executive Function, Female, Hemiplegia rehabilitation, Humans, Intelligence Tests, Male, Memory, Motor Activity, Neuropsychological Tests, Quadriplegia rehabilitation, Severity of Illness Index, Surveys and Questionnaires, Cerebral Palsy therapy, Therapy, Computer-Assisted
Abstract: Introduction: Cerebral palsy is often accompanied by cognitive impairment affecting attention, visuoperception, executive functions and working memory. AIMS. To analyse the effect of cognitive stimulation treatment on the cognitive capabilities in children with cerebral palsy., Patients and Methods: Our sample consisted of 15 children with cerebral palsy, with a mean age of 8.80 ± 2.51 years, who were classified with the aid of the Gross Motor Function Classification System (GMFCS) on level I (n = 6), level II (n = 4), level III (n = 2) and level V (n = 3). Cognitive impairment was evaluated by means of the Wechsler Intelligence Scale for Children (WISC-IV) and the Continuous Performance Test (CPT-II). Both the questionnaires for parents and teachers from the Behavior Rating Inventory of Executive Function (BRIEF) and the Conners rating scales (CPRS-48 and CTRS-28) were administered. A cognitive stimulation programme was carried out at a rate of two hours a week for a total of eight weeks., Results: Statistically significant differences were observed after applying the cognitive stimulation treatment in the perceptive reasoning index of the WISC-IV. No differences were obtained on the Conners' and the BRIEF scores before and after the treatment. Neither were any differences found in the results on the WISC-IV according to sex or on the GMFCS., Conclusions: The cognitive performance of children with cerebral palsy improves after applying a cognitive rehabilitation programme.
Published: 2014

35. Intelligent Therapy Assistant (ITA) for cognitive rehabilitation in patients with acquired brain injury.

Author: Solana J, Cáceres C, García-Molina A, Chausa P, Opisso E, Roig-Rovira T, Menasalvas E, Tormos-Muñoz JM, and Gómez EJ
Subjects: Brain Injuries complications, Cognition Disorders etiology, Humans, Neuropsychology instrumentation, Software standards, Telemedicine instrumentation, Algorithms, Brain Injuries rehabilitation, Cognition Disorders rehabilitation, Neuropsychology methods, Telemedicine methods
Abstract: Background: This paper presents the design, development and first evaluation of an algorithm, named Intelligent Therapy Assistant (ITA), which automatically selects, configures and schedules rehabilitation tasks for patients with cognitive impairments after an episode of Acquired Brain Injury. The ITA is integrated in "Guttmann, Neuro Personal Trainer" (GNPT), a cognitive tele-rehabilitation platform that provides neuropsychological services., Methods: The ITA selects those tasks that are more suitable for the specific needs of each patient, considering previous experiences, and improving the personalization of the treatment. The system applies data mining techniques to cluster the patients according their cognitive impairment profile. Then, the algorithm rates every rehabilitation task, based on its cognitive structure and the clinical impact of executions done by similar patients. Finally, it configures the most suitable degree of difficulty, depending on the impairment of the patient and his/her evolution during the treatment., Results: The ITA has been evaluated during 18 months by 582 patients. In order to evaluate the effectiveness of the ITA, a comparison between the traditional manual planning procedure and the one presented in this paper has been done, taking into account: a) the selected tasks assigned to rehabilitation sessions; b) the difficulty level configured for the sessions; c) and the improvement of their cognitive capacities after completing treatment., Conclusions: The obtained results reveal that the rehabilitation treatment proposed by the ITA is as effective as the one performed manually by therapists, arising as a new powerful support tool for therapists. The obtained results make us conclude that the proposal done by the ITA is very close to the one done by therapists, so it is suitable for real treatments.
Published: 2014
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36. [Neuropsychotherapy in brain injury rehabilitation].

Author: García-Molina A, Roig-Rovira T, Enseñat-Cantallops A, and Sánchez-Carrión R
Subjects: Adaptation, Psychological, Affective Symptoms etiology, Affective Symptoms psychology, Affective Symptoms rehabilitation, Brain Damage, Chronic psychology, Brain Damage, Chronic rehabilitation, Brain Injuries psychology, Clinical Trials as Topic, Cognition Disorders etiology, Cognition Disorders psychology, Cognition Disorders rehabilitation, Grief, Humans, Neuropsychology, Quality of Life, Self Concept, Stress, Psychological, Stroke complications, Stroke psychology, Stroke Rehabilitation, Treatment Outcome, Uncertainty, Brain Injuries rehabilitation, Psychotherapy methods
Abstract: Introduction: Persons who have suffered brain damage can experience a wide range of cognitive, behavioural and emotional disorders. However, neuropsychological rehabilitation usually focuses, almost exclusively, on the cognitive deficits and pays very little attention to the emotional challenges associated with the psychological impact of the lesion. It is in this more personal side of brain damage where neuropsychotherapy can be of great aid to facilitate the process of acceptance and adaptation following a neurological lesion., Development: In this article, we describe the theoretical and conceptual aspects of psychotherapy oriented towards persons with brain damage, the implications of cognitive deficits in the practice of neuropsychotherapy and the evidence regarding its effectiveness., Conclusions: In the past, neuropsychotherapy was considered to be of little use in the rehabilitation of brain damage. Today, however, a growing number of professionals are acknowledging its importance in the management of the psychological/emotional suffering associated with brain damage. The aim of neuropsychological rehabilitation is not just to promote the recovery of the altered brain functions, but also to improve the individual's functional capacity, deal with his or her experiences of loss and help him or her to again find a meaning to life.
Published: 2014

37. Risk taking in hospitalized patients with acute and severe traumatic brain injury.

Author: Fecteau S, Levasseur-Moreau J, García-Molina A, Kumru H, Vergara RP, Bernabeu M, Roig T, Pascual-Leone A, and Tormos JM
Subjects: Adult, Analysis of Variance, Case-Control Studies, Choice Behavior, Female, Frontal Lobe physiopathology, Humans, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Time Factors, Young Adult, Brain Injuries rehabilitation, Hospitalization, Risk-Taking
Abstract: Rehabilitation can improve cognitive deficits observed in patients with traumatic brain injury (TBI). However, despite rehabilitation, the ability of making a choice often remains impaired. Risk taking is a daily activity involving numerous cognitive processes subserved by a complex neural network. In this work we investigated risk taking using the Balloon Analogue Risk Task (BART) in patients with acute TBI and healthy controls. We hypothesized that individuals with TBI will take less risk at the BART as compared to healthy individuals. We also predicted that within the TBI group factors such as the number of days since the injury, severity of the injury, and sites of the lesion will play a role in risk taking as assessed with the BART. Main findings revealed that participants with TBI displayed abnormally cautious risk taking at the BART as compared to healthy subjects. Moreover, healthy individuals showed increased risk taking throughout the task which is in line with previous work. However, individuals with TBI did not show this increased risk taking during the task. We also investigated the influence of three patients' characteristics on their performance at the BART: Number of days post injury, Severity of the head injury, and Status of the frontal lobe. Results indicate that performance at the BART was influenced by the number of days post injury and the status of the frontal lobe, but not by the severity of the head injury. Reported findings are encouraging for risk taking seems to naturally improve with time postinjury. They support the need of conducting longitudinal prospective studies to ultimately identify impaired and intact cognitive skills that should be trained postinjury.
Published: 2013
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38. White matter/gray matter contrast changes in chronic and diffuse traumatic brain injury.

Author: Palacios EM, Sala-Llonch R, Junque C, Roig T, Tormos JM, Bargallo N, and Vendrell P
Subjects: Adult, Brain Injuries complications, Brain Injuries psychology, Chronic Disease, Cognition Disorders etiology, Cognition Disorders psychology, Diffusion Tensor Imaging, Female, Glasgow Coma Scale, Humans, Image Processing, Computer-Assisted, Male, Neuropsychological Tests, Young Adult, Brain pathology, Brain Injuries pathology
Abstract: Signal-intensity contrast of T1-weighted magnetic resonance imaging scans has been associated with tissue integrity and reported as a sign of neurodegenerative changes in diseases such as Alzheimer's disease. After severe traumatic brain injury (TBI), progressive structural changes occur in white (WM) and gray matter (GM). In the current study, we assessed the signal-intensity contrast of GM and WM in patients with diffuse TBI in the chronic stage to (1) characterize the regional pattern of WM/GM changes in intensity contrast associated with traumatic axonal injury, (2) evaluate possible associations between this measure and diffusion tensor image (DTI)/fractional anisotropy (FA) for detecting WM damage, and (3) investigate the correlates of both measures with cognitive outcomes. Structural T1 scans were processed with FreeSurfer software to identify the boundary and calculate the WM/GM contrast maps. DTIs were processed with the FMRIB software library to obtain FA maps. The WM/GM contrast in TBI patients showed a pattern of reduction in almost all of the brain, except the visual and motor primary regions. Global FA values obtained from DTI correlated with the intensity contrast of all associative cerebral regions. WM/GM contrast correlated with memory functions, whereas FA global values correlated with tests measuring memory and mental processing speed. In conclusion, tissue-contrast intensity is a very sensitive measure for detecting structural brain damage in chronic, severe and diffuse TBI, but is less sensitive than FA for reflecting neuropsychological sequelae, such as impaired mental processing speed.
Published: 2013
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39. [Neuropsychological rehabilitation in wartime].

Author: García-Molina A and Roig-Rovira T
Subjects: Brain Damage, Chronic etiology, Brain Damage, Chronic history, Brain Damage, Chronic psychology, Brain Damage, Chronic rehabilitation, Brain Injuries psychology, Brain Injuries rehabilitation, Combat Disorders psychology, Combat Disorders rehabilitation, Europe, History, 20th Century, History, 21st Century, Humans, Israel, Military Personnel psychology, Russia, Spain, United States, World War I, World War II, Brain Injuries history, Combat Disorders history, Military Medicine history, Rehabilitation Centers history, Warfare
Abstract: Introduction: The decrease in the rate of mortality due to brain damage during the First World War resulted in a large number of veterans with neurological or neuropsychological sequelae. This situation, which was unknown up until then, called for the development of new therapeutic approaches to help them reach acceptable levels of autonomy., Development: This article reviews the relationship between neuropsychological rehabilitation and warfare, and describes the contributions made by different professionals in this field in the two great conflicts of the 20th century. The First World War was to mark the beginning of neuropsychological rehabilitation as we know it today. Some of the most outstanding contributions in that period were those made by Goldstein and Popplereuter in Germany or Franz in the United States. The Second World War was to consolidate this healthcare discipline, the leading figures at that time being Zangwill in England and Luria in the Soviet Union. Despite being of less importance, geopolitically speaking, the study also includes the Yom Kippur War, which exemplifies how warfare can stimulate the development of neuropsychological intervention programmes., Conclusions: Today's neuropsychological rehabilitation programmes are closely linked to the interventions used in wartime by Goldstein, Zangwill or Luria. The means employed may have changed, but the aims are still the same, i.e. to help people with brain damage manage to adapt to their new lives.
Published: 2013

40. [Geriatric assessment and factors associated with mortality in elderly patients with heart failure admitted to an acute geriatric unit].

Author: Roig T, Márquez MÁ, Hernández E, Pineda I, Sabartés O, Miralles R, and Inzitari M
Subjects: Aged, Aged, 80 and over, Female, Hospital Units, Hospitalization, Humans, Longitudinal Studies, Male, Risk Factors, Geriatric Assessment, Heart Failure mortality
Abstract: Introduction and Objectives: Heart failure (HF) is very prevalent in older adults, and is associated with a high mortality. The prediction of the outcome of HF and the identification of patients in advanced stages is difficult. The present work aims at identifying variables of the geriatric assessment and other clinical variables associated with an increased risk of death at one year in older adults with HF., Material and Methods: Prospective study of 101 patients (mean age, 85.9 ± 6.3 years, 81% women) admitted during 2006 to an Acute Geriatric Unit, with principal diagnosis of HF. We recorded: demographic data, predisposing heart disease, main trigger of exacerbation, comorbidity, number of prescriptions at discharge and specific treatment of HF, average length-of-stay, readmissions, and mortality at one year after discharge. Geriatric assessment included: disability in basic (Barthel index) and instrumental (Lawton index) activities of daily living, cognitive function (Pfeiffer test), comorbidity (Charlson index), and geriatric syndromes., Results: In a multivariable logistic regression model, previous disability (lower Barthel index) (OR [95%CI]=1.03 [1.01-1.06]; P=.040) and higher number of re-admissions (OR [95%CI]=3.53 [1.19-10.44]; P=.023) were associated with 1-year mortality. Female sex had a protective effect (OR [95%CI]=0.15 [0.04-0.59]; P=.007)., Conclusions: Disability in the basic activities of daily living and re-admissions were associated with increased 1-year mortality in older adults, whereas female sex was protective. If confirmed in further studies, these data could reinforce the need for a systematic comprehensive geriatric assessment in older adults with HF., (Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.)
Published: 2013
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41. Resting-state functional magnetic resonance imaging activity and connectivity and cognitive outcome in traumatic brain injury.

Author: Palacios EM, Sala-Llonch R, Junque C, Roig T, Tormos JM, Bargallo N, and Vendrell P
Subjects: Adult, Anisotropy, Brain Injuries physiopathology, Cerebral Cortex physiopathology, Diffuse Axonal Injury pathology, Diffuse Axonal Injury physiopathology, Diffusion Tensor Imaging instrumentation, Female, Frontal Lobe pathology, Frontal Lobe physiopathology, Gyrus Cinguli pathology, Gyrus Cinguli physiopathology, Humans, Magnetic Resonance Imaging instrumentation, Male, Nerve Net physiopathology, Neuropsychological Tests, Parietal Lobe pathology, Parietal Lobe physiopathology, Young Adult, Brain Injuries pathology, Cerebral Cortex pathology, Diffusion Tensor Imaging methods, Magnetic Resonance Imaging methods, Nerve Net pathology
Abstract: Importance: The study of brain activity and connectivity at rest provides a unique opportunity for the investigation of the brain substrates of cognitive outcome after traumatic axonal injury. This knowledge may contribute to improve clinical management and rehabilitation programs., Objective: To study functional magnetic resonance imaging abnormalities in signal amplitude and brain connectivity at rest and their relationship to cognitive outcome in patients with chronic and severe traumatic axonal injury., Design: Observational study., Setting: University of Barcelona and Hospital Clinic de Barcelona, Barcelona, and Institut Guttmann-Neurorehabilitation Hospital, Badalona, Spain., Participants: Twenty patients with traumatic brain injury (TBI) were studied, along with 17 matched healthy volunteers., Interventions: Resting-state functional magnetic resonance imaging and diffusion tensor imaging data were acquired. After exploring group differences in amplitude of low-frequency fluctuations (ALFF), we studied functional connectivity within the default mode network (DMN) by means of independent component analysis, followed by a dual regression approach and seed-based connectivity analyses. Finally, we performed probabilistic tractography between the frontal and posterior nodes of the DMN., Main Outcomes and Measures: Signal amplitude and functional connectivity during the resting state, tractography related to DMN, and the association between signal amplitudes and cognitive outcome., Results: Patients had greater ALFF in frontal regions, which was correlated with cognitive performance. Within the DMN, patients showed increased connectivity in the frontal lobes. Seed-based connectivity analyses revealed augmented connectivity within surrounding areas of the frontal and left parietal nodes of the DMN. Fractional anisotropy of the cingulate tract was correlated with increased connectivity of the frontal node of the DMN in patients with TBI., Conclusions and Relevance: Increased ALFF is related to better cognitive performance in chronic TBI. The loss of structural connectivity produced by damage to the cingulum tract explained the compensatory increases in functional connectivity within the frontal node of the DMN.
Published: 2013
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42. [Interindividual variability in recovery after traumatic brain injury: effect of cognitive reserve].

Author: García-Molina A, Enseñat-Cantallops A, Sánchez-Carrión R, Rodríguez P, Tormos JM, and Roig-Rovira T
Subjects: Achievement, Adult, Amnesia etiology, Amnesia psychology, Brain Damage, Chronic etiology, Brain Damage, Chronic psychology, Brain Damage, Chronic rehabilitation, Brain Injuries psychology, Educational Status, Female, Humans, Male, Mental Competency, Middle Aged, Occupations statistics & numerical data, Surveys and Questionnaires, Trauma Severity Indices, Young Adult, Brain Injuries rehabilitation, Recovery of Function
Abstract: Background and Objective: The aim of this study was to examine the effect of cognitive reserve in recovery after a moderate or severe traumatic brain injury (TBI). Different authors proposed that this construct might account for the mismatch between TBI severity, its clinical expression, and subsequent recovery., Patients and Method: Eighty-four patients who sustained moderate-to-severe TBI participated in the study. Participants were divided into a high cognitive reserve group (n=46) or low cognitive reserve group (n=38) based on premorbid educational and occupational attainment. Patient's functional status was examined with the Patient Competency Rating Scale (PCRS)., Results: There were no significant differences between groups in demographic and injury variables (sex, age, severity of injury, post-traumatic amnesia duration, and time since injury). The analysis revealed statistically significant differences between the 2 groups on the PCRS: The high cognitive reserve group scored better than the low cognitive reserve group., Conclusions: The results of this study suggest that cognitive reserve may mediate recovery after a moderate or severe TBI. Educational and occupational attainments provide a cognitive provision that would be associated with better functional status after injury., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)
Published: 2013
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43. Long-term declarative memory deficits in diffuse TBI: correlations with cortical thickness, white matter integrity and hippocampal volume.

Author: Palacios EM, Sala-Llonch R, Junque C, Fernandez-Espejo D, Roig T, Tormos JM, Bargallo N, and Vendrell P
Subjects: Adult, Atrophy complications, Atrophy pathology, Atrophy physiopathology, Brain Injuries complications, Brain Injuries pathology, Brain Mapping, Cerebral Cortex physiopathology, Diffusion Tensor Imaging, Female, Hippocampus physiopathology, Humans, Male, Memory physiology, Memory Disorders etiology, Memory Disorders pathology, Memory Disorders physiopathology, Neuropsychological Tests, Organ Size, Verbal Learning physiology, Brain Injuries psychology, Cerebral Cortex pathology, Hippocampus pathology, Memory Disorders psychology, Nerve Fibers, Myelinated pathology
Abstract: We investigated structural brain damage in subjects who had suffered severe and diffuse traumatic brain injury (TBI), and examined its relationship with declarative memory impairment. Cortical thickness, diffusion tensor imaging (DTI), and volumetric and shape data of the hippocampus were assessed in a group of 26 adults with severe TBI in the chronic stage and 22 healthy matched controls. Declarative memory was evaluated by Rey's Auditory Verbal Learning Test (RAVLT). TBI patients performed significantly worse than controls on all RAVLT measures. The group comparison for cortical thickness and DTI revealed a pattern of widespread atrophy in TBI patients. In the TBI group DTI measures correlated with cortical thickness in the prefrontal and parietal regions, including the precuneus. Declarative memory correlated with both cortical thickness and DTI measures. However, although hippocampal volume was significantly decreased in TBI patients, no correlations were found. Multiple regression analysis of all the structural measures revealed that decreases in Fractional anisotropy (FA) and thinning of the left parietal region were the best predictors of memory impairment. In conclusion, cortical thickness reductions in the left hemisphere and a lack of white matter integrity are the main contributors to long-term impairment in declarative memory among patients suffering from severe and diffuse TBI. In this study the hippocampus did not make a significant contribution to memory dysfunctions, suggesting that damage to this structure is compensated for by other regions, with the definitive sequelae being mainly explained by alterations in cortico-subcortical connectivity., (Copyright © 2012 Elsevier Ltd. All rights reserved.)
Published: 2013
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44. Cognitive neurorehabilitation based on interactive video technology.

Author: Martínez-Moreno JM, Solana J, Sánchez R, González S, Sánchez-González P, Gómez C, Morell M, Cáceres C, Roig T, Tormos JM, and Gómez EJ
Subjects: Cognition Disorders diagnosis, Humans, Activities of Daily Living, Biofeedback, Psychology methods, Cognition Disorders rehabilitation, Cognitive Behavioral Therapy methods, Therapy, Computer-Assisted methods, User-Computer Interface, Video Recording methods
Abstract: Cognitive impairment is the main cause of disability in developed societies. New interactive technologies help therapists in neurorehabilitation in order to increase patients' autonomy and quality of life. This work proposes Interactive Video (IV) as a technology to develop cognitive rehabilitation tasks based on Activities of Daily Living (ADL). ADL cognitive task has been developed and integrated with eye-tracking technology for task interaction and patients' performance monitoring.
Published: 2013

45. White matter integrity related to functional working memory networks in traumatic brain injury.

Author: Palacios EM, Sala-Llonch R, Junque C, Roig T, Tormos JM, Bargallo N, and Vendrell P
Subjects: Adult, Aged, Brain Mapping, Cross-Sectional Studies, Databases, Factual, Demography, Diffusion Tensor Imaging, Educational Status, Female, Functional Laterality physiology, Glasgow Coma Scale, Head Injuries, Closed pathology, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Neural Pathways pathology, Neuropsychological Tests, Principal Component Analysis, Recovery of Function, Sex Factors, Spain epidemiology, Brain pathology, Brain Injuries pathology, Brain Injuries psychology, Memory, Short-Term physiology, Nerve Net pathology
Abstract: Objective: This study explores the functional and structural patterns of connectivity underlying working memory impairment after severe traumatic axonal injury., Methods: We performed an fMRI n-back task and acquired diffusion tensor images (DTI) in a group of 19 chronic-stage patients with severe traumatic brain injury (TBI) and evidence of traumatic axonal injury and 19 matched healthy controls. We performed image analyses with FSL software and fMRI data were analyzed using probabilistic independent component analysis. Fractional anisotropy (FA) maps from DTI images were analyzed with FMRIB's Diffusion Toolbox., Results: We identified working memory and default mode networks. Global FA values correlated with both networks and FA whole-brain analysis revealed correlations in several tracts associated with the functional activation. Furthermore, working memory performance in the patient group correlated with the functional activation patterns and with the FA values of the associative fasciculi., Conclusion: Combining structural and functional neuroimaging data, we were able to describe structural white matter changes related to functional network alterations and to lower performance in working memory in chronic TBI.
Published: 2012
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46. Do traditional executive measures tell us anything about daily-life functioning after traumatic brain injury in Spanish-speaking individuals?

Author: García-Molina A, Tormos JM, Bernabeu M, Junqué C, and Roig-Rovira T
Subjects: Adolescent, Adult, Brain Injuries complications, Brain Injuries diagnosis, Brain Injuries physiopathology, Cognition Disorders diagnosis, Cognition Disorders etiology, Cognition Disorders physiopathology, Comprehension, Female, Glasgow Coma Scale, Humans, Language, Male, Middle Aged, Reproducibility of Results, Severity of Illness Index, Spain epidemiology, Young Adult, Activities of Daily Living, Brain Injuries psychology, Cognition Disorders psychology, Executive Function, Neuropsychological Tests
Abstract: Primary Objective: To examine the relationship between traditional executive function measures and everyday competence in Spanish-speaking individuals with moderate-to-severe traumatic brain injury (TBI)., Methods and Procedures: Thirty-two TBI patients (24 men, eight women) with an age range of 17-59 years (mean age = 30.73 years; SD = 13.34) were administered a battery of performance-based executive function measures. Such measures included the Trail Making Test part B, Wisconsin Card Sorting Test, Stroop Colour Word Interference Test, Controlled Oral Word Association Test and Letter-Number Sequencing. Behavioural manifestations of executive deficits were assessed by the Behaviour Rating Inventory of Executive Function-Adult version (BRIEF-A). Patient's everyday functioning was examined with the Patient Competency Rating Scale (PCRS)., Main Outcomes and Results: Traditional performance-based executive measures correlated significantly, although moderately, with the PCRS; this relationship was more significant in the Controlled Oral Word Association Test and Trail Making Test part B. A significant correlation was obtained between the BRIEF-A clinical scales and patient's everyday competence as measured by the PCRS., Conclusions: The current findings suggest that traditional performance-based executive measures reveal some degree of ecological validity or real-world relevance, providing relevant information for predicting everyday competence after moderate-to-severe TBI.
Published: 2012
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47. Fructose 1,6 biphosphate administration to rats prevents metabolic acidosis and oxidative stress induced by deep hypothermia and rewarming.

Author: Alva N, Carbonell T, Roig T, Bermúdez J, and Palomeque J
Subjects: Acidosis metabolism, Acidosis physiopathology, Animals, Nitric Oxide biosynthesis, Nitric Oxide metabolism, Rats, Rats, Sprague-Dawley, Time Factors, Vasodilation drug effects, Acidosis etiology, Acidosis prevention & control, Fructosediphosphates administration & dosage, Fructosediphosphates pharmacology, Hypothermia complications, Oxidative Stress drug effects, Rewarming adverse effects
Abstract: Fructose 1,6 biphosphate (F1,6BP) exerts a protective effect in several in vitro models of induced injury and in isolated organs; however, few studies have been performed using in vivo hypothermia. Here we studied the effects of deep hypothermia (21ºC) and rewarming in anaesthetised rats after F1,6BP administration (2 g/kg body weight). Acid-base and oxidative stress parameters (plasma malondialdehyde and glutathione, and erythrocyte antioxidant enzymes) were evaluated. Erythrocyte and leukocyte numbers in blood and plasma nitric oxide were also measured 3 h after F1,6BP administration in normothermia animals. In the absence of F1,6BP metabolic acidosis developed after rewarming. Oxidative stress was also evident after rewarming, as shown by a decrease in thiol groups and in erythrocyte superoxide dismutase, catalase and GSH-peroxidase, which corresponded to an increase in AST in rewarmed animals. These effects were reverted in rats treated with F1,6BP. Blood samples of F1,6BP-treated animals showed a significant increase in plasma nitric oxide 3 h after administration, coinciding with a significant rise in leukocyte number. F1,6BP protection may be due to the decrease in oxidative stress and to the preservation of the antioxidant pool. In addition, we propose that the reduction in extracellular acidosis may be due to improved tissue perfusion during rewarming and that nitric oxide may play a central role., (Copyright © 2011 Elsevier B.V. All rights reserved.)
Published: 2011
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48. Soft drinks consumption, diet quality and BMI in a Mediterranean population.

Author: Balcells E, Delgado-Noguera M, Pardo-Lozano R, Roig-González T, Renom A, González-Zobl G, Muñoz-Ortego J, Valiente-Hernández S, Pou-Chaubron M, and Schröder H
Subjects: Adult, Aged, Cross-Sectional Studies, Diet, Mediterranean statistics & numerical data, Female, Humans, Linear Models, Male, Middle Aged, Obesity epidemiology, Obesity etiology, Spain, Body Mass Index, Carbonated Beverages statistics & numerical data, Diet standards, Health Behavior, Sedentary Behavior
Abstract: Objectives: Evidence of the effects of soft drinks consumption on BMI and lifestyle in adult populations is mixed and quite limited. The aim of the present study was to determine the association of soft drinks consumption with BMI and lifestyle in a representative Mediterranean population., Design: Two independent, population-based, cross-sectional (2000 and 2005) studies. Dietary intake was assessed using a validated FFQ. Weight and height were measured., Setting: Girona, Spain., Subjects: Random sample of the 35- to 74-year-old population (3910 men and 4285 women)., Results: Less than half (41·7%) of the population consumed soft drinks; the mean consumption was 36·2 ml/d. The prevalence of sedentary lifestyle increased with the frequency of soft drinks consumption (P = 0·025). Daily soft drinks consumption significantly increased the risk of low adherence to the Mediterranean diet (OR = 0·57, 95% CI 0·44, 0·74 v. top tertile of Mediterranean diet score). Multiple linear regression analyses, controlled for potential confounders, revealed that an increment in soft drinks consumption of 100 ml was associated with a 0·21 kg/m² increase in BMI (P = 0·001). Only implausibly low reports of energy consumption showed a null association between soft drinks consumption and BMI., Conclusions: Soft drinks consumption was not embedded in a healthy diet context and was positively associated with BMI and sedentary lifestyle in this Mediterranean population.
Published: 2011
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49. Diffusion tensor imaging differences relate to memory deficits in diffuse traumatic brain injury.

Author: Palacios EM, Fernandez-Espejo D, Junque C, Sanchez-Carrion R, Roig T, Tormos JM, Bargallo N, and Vendrell P
Subjects: Adolescent, Adult, Anisotropy, Brain Injuries complications, Brain Mapping methods, Cross-Sectional Studies, Female, Humans, Male, Memory Disorders complications, Neuropsychological Tests, Brain Injuries pathology, Brain Injuries psychology, Diffusion Tensor Imaging methods, Memory Disorders pathology, Nerve Fibers, Myelinated pathology, Neural Pathways pathology
Abstract: Background: Memory is one of the most impaired functions after traumatic brain injury (TBI). We used diffusion tensor imaging (DTI) to determine the structural basis of memory deficit. We correlated fractional anisotropy (FA) of the fasciculi connecting the main cerebral regions that are involved in declarative and working memory functions., Methods: Fifteen patients with severe and diffuse TBI and sixteen healthy controls matched by age and years of education were scanned. The neuropsychological assessment included: Letter-number sequencing test (LNS), 2-back task, digit span (forwards and backwards) and the Rivermead profilet. DTI was analyzed by a tract-based spatial statics (TBSS) approach., Results: Whole brain DTI analysis showed a global decrease in FA values that correlated with the 2-back d-prime index, but not with the Rivermead profile. ROI analysis revealed positive correlations between working memory performance assessed by 2-back d-prime and superior longitudinal fasciculi, corpus callosum, arcuate fasciculi and fornix. Declarative memory assessed by the Rivermead profile scores correlated with the fornix and the corpus callosum., Conclusions: Diffuse TBI is associated with a general decrease of white matter integrity. Nevertheless deficits in specific memory domains are related to different patterns of white matter damage.
Published: 2011
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50. Combination of diffusion tensor and functional magnetic resonance imaging during recovery from the vegetative state.

Author: Fernández-Espejo D, Junque C, Cruse D, Bernabeu M, Roig-Rovira T, Fábregas N, Rivas E, and Mercader JM
Subjects: Brain Injuries complications, Brain Injuries physiopathology, Head Injuries, Closed complications, Head Injuries, Closed physiopathology, Humans, Male, Middle Aged, Neuropsychological Tests, Persistent Vegetative State etiology, Brain physiopathology, Diffusion Magnetic Resonance Imaging, Magnetic Resonance Imaging, Persistent Vegetative State physiopathology
Abstract: Background: The rate of recovery from the vegetative state (VS) is low. Currently, little is known of the mechanisms and cerebral changes that accompany those relatively rare cases of good recovery. Here, we combined functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) to study the evolution of one VS patient at one month post-ictus and again twelve months later when he had recovered consciousness., Methods: fMRI was used to investigate cortical responses to passive language stimulation as well as task-induced deactivations related to the default-mode network. DTI was used to assess the integrity of the global white matter and the arcuate fasciculus. We also performed a neuropsychological assessment at the time of the second MRI examination in order to characterize the profile of cognitive deficits., Results: fMRI analysis revealed anatomically appropriate activation to speech in both the first and the second scans but a reduced pattern of task-induced deactivations in the first scan. In the second scan, following the recovery of consciousness, this pattern became more similar to that classically described for the default-mode network. DTI analysis revealed relative preservation of the arcuate fasciculus and of the global normal-appearing white matter at both time points. The neuropsychological assessment revealed recovery of receptive linguistic functioning by 12-months post-ictus., Conclusions: These results suggest that the combination of different structural and functional imaging modalities may provide a powerful means for assessing the mechanisms involved in the recovery from the VS.
Published: 2010
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