Lawsuit and Traumatic Brain Injury: The Relationship Between Long-Lasting Sequelae and Financial Compensation in Litigants. Results From the PariS-TBI Study

Purpose: People with traumatic brain injury are frequently involved in a litigation because another person was at fault for causing the accident. A compensation amount will often be settled to compensate the victim for the past, present, future damages and losses suffered. We report descriptive data about the full and final personal compensation amount and investigated its association with patient's outcomes.Methods: We used a longitudinal prospective study of severe TBI patients injured in 2005–2007 (PariS-TBI). Questions regarding involvement in a litigation were asked concurrently with 4 and 8-year outcomes.Results: Among 160 participants assessed 4 and/or 8 years post-injury, a total of 67 persons declared being involved in a litigation, among which 38 people reported a compensation amount of a mean €292,653 (standard deviation = 436,334; interquartile 25–50–75 = 37,000–100,000–500,000; minimum = 1,500-maximum = 2,000,000). A higher compensation amount was associated with more severe disability and cognitive impairment in patients, and with more informal care time provided by caregivers. However, no significant association related to patient's gender, age, years of education, motor/balance impairment, return to work status, mood and related to caregiver's subjective burden was found.Conclusion: Financial compensation was related to victims' long-term severity of impairment, although some extreme cases with severe disability were granted very poor compensation

Sommeil, Fatigue, troubles du sommeil et troubles cognitifs.

International audienceDans ce livre réalisé sous l’égide de la Société de Neuropsychologie de Langue Française, les spécialistes détaillent les liens entre le sommeil, la fatigue, et les troubles cognitifs.Ils abordent notamment : la physiologie du sommeil, l’exploration et les principaux troubles cliniques ; l’effet des troubles du sommeil sur les fonctions psychologiques (mémoire, attention, etc.) ; les principales causes à l’origine des troubles du sommeil (apnées du sommeil, etc.) ; la fatigue cognitive physiologique ; les liens entre troubles du sommeil et pathologies neurologiques (Alzheimer, SEP, AVC) ; le développement du sommeil et ses troubles chez l’enfant ; les thérapies non médicamenteuses de la fatigue et des troubles du sommeil

La mémoire de travail et son évaluation.

International audienc

Evaluation etrééducation de la cognition sociale: spécificités pour les patients traumatisés crâniens.

International audienc

Rehabilitation of social cognition after traumatic brain injury.

International audienc

Potential for recovery between 4 and 8 years after a severe traumatic brain injury. Data from the PariS-TBI longitudinal study

International audienceBackground: Severe traumatic brain injury (TBI) is a leading cause of complex and persistent disability. Yet, long-term change in global functioning and determinants of this change remain unclear. Objectives: This study aimed to assess change in global functioning in the long-term after severe TBI and factors associated with the change. Methods: This was a prospective observational study of an inception cohort of adults with severe TBI in the Paris area (PariS-TBI). Outcome was assessed at 1, 4 and 8 years post-injury. For the included participants (n = 257), change in global outcome between 4 and 8 years was evaluated with the Glasgow Outcome Scale Extended (GOSE) score, and its association with pre-injury, injury-related and post-injury variables was tested with univariate and multivariable analyses. Results: More than half of the 73 participants evaluated at both 4 and 8 years showed global improvement (of at least one point) in GOSE score and an improvement in mood, executive function, and subjective complaints. On univariate analysis, none of the pre-injury, injury or post-injury variables were associated with GOSE score change between 4 and 8 years, except for GOSE score at 4 years (rho = −0.24, P = 0.04). On multivariable analysis, probability of increased GOSE score was associated with more years of education (odds ratio 1.18 [95% confidence interval 1.02–1.37], P = 0.03). The change in GOSE score was significantly correlated with change in Hospital Anxiety Depression Scale score between 4 and 8 years (rho = −0.42, P < 0.001). Conclusions: Most participants with severe TBI in the present sample showed a late improvement (4 to 8 years post-injury) in global functioning. Of the socio-demographic and injury-related factors, only more years of education was associated with improvement in global functioning. Decreased anxiety and depression symptoms were associated with improved global functioning. Targeting interventions to enhance resilience may be the most effective in the long-term after severe TBI

Homelessness and Research: Methodological Obstacles and Lessons Learned from a Psychological Study in Parisian Homeless Services

Homelessness, defined as a lack of appropriate, stable, and permanent housing, is a common issue in many societies and is linked to both structural and individual factors. These factors include psychological mechanisms and disorders which can trigger or worsen already precarious situations. In order for these factors to be taken into account in social rehabilitation programs, they need to be precisely described. However, at present, studies in this field are lacking in France. Despite homelessness being an issue across the country, few studies have evaluated the underlying psychological or neuropsychological mechanisms. More data are needed, not only to provide an accurate description of the situation in France, but also to ensure that foreign observations and interventions are relevant for application to the homeless population. In order to achieve this, more quantitative and qualitative data and investigative methodologies and studies are needed. Sharing experience and methods within the scientific community is one way to support further research, particularly in complex domains such as homelessness. At the moment, only a few such papers have been published. In this paper, we share our experiences from a research project that started in 2020 (currently unpublished) on the prevalence of cognitive disorders among homeless service users in Paris. We describe the exploratory phase of our project, obstacles encountered during the implementation of the study, including how we dealt with ethical issues, and data collection. We end the paper with recommendations for future psychological studies on homelessness

Rééducation de la mémoire de travail après un traumatisme crânien : liens entre cognition et IRM

National audienceINTRODUCTION: Des troubles de la mémoire de travail (MDT) persistent souvent à long terme après une lésion cérébrale acquise, et engendrent des difficultés en vie quotidienne (Azouvi et al., 2017). Contrairement à la littérature sur le sujet sain (Papa et al., 2020), il n’existe encore à ce jour que très peu d’études évaluant les corrélats cérébraux de la rééducation chez le patient cérébrolésé. L’objectif de cette étude est donc d’étudier les effets de la rééducation cognitive sur la plasticité cérébrale.METHODE: L’étude PLASTIM-MDTC est une étude en cas unique répétés sur des patients TC modéré à sévères. Après deux évaluations cognitives en ligne de base, les patients ont bénéficié d’une rééducation de la MDT pendant 3 mois (3/sem). L’efficacité de la rééducation à été évalué en post rééducation et après 3 mois. Une IRM multimodale est effectuée avant et après rééducation.RESULTATS PRELIMINAIRES : Les résultats montrent une efficacité de la rééducation sur le plan comportemental et une évolution du profil d’activation fonctionnel à l’IRM lors d’une tâche de n-back. Mais le profil d’évolution diffère d’un patient à l’autre, tant sur le plan cognitif qu’à l’IRMf. Nous présenterons ici quelques études de cas.DISCUSSION : Les résultats préliminaires de l’étude PLASTIM sont en accord avec ceux observés dans les études de cas répétées de Hubacher et al. (2015) sur des patients SEP et constituent une occasion d’étudier les interactions et complémentarités entre données cognitives et IRM, notamment en terme de perception de l’efficacité de la rééducation selon le type de donnée