Predictors and indicators of disability and quality of life 4 years after a severe traumatic brain injury. A Structural Equation Modelling analysis from the PariS-TBI study

ObjectiveTo assess the predictors and indicators of disability and quality of life four years after a severe traumatic brain injury (TBI), using a Structural Equation Modelling (SEM). SEM is a multivariate approach permitting to take into account the complex inter-relationships between individual predictors, in order to disentangle factors which have a direct or indirect relationship with the dependant variable.MethodsThe Paris-TBI study is a longitudinal inception cohort study of 504 patients with severe TBI in the Parisian area [1]. Among 245 survivors, 147 patients were assessed four years post-injury. Two outcome measures were analysed separately using SEM: the Glasgow Outcome Scale-extended (GOS-E) [2], which is a global measure of disability after TBI, and the QOLIBRI, a disease-specific measure of quality of life after TBI [3]. Four groups of variable were entered in the model: demographics; injury severity; psychological and cognitive impairments; somatic impairments.ResultsThe GOS-E was directly significantly related to all four groups of variables (age, gender, severity of injury, psycho-cognitive and somatic impairments). Education duration had an indirect effect, mediated by psycho-cognitive impairments. In contrast, the QOLIBRI was only directly predicted by psycho-cognitive impairments. Age and somatic impairments had an indirect influence on the QOLIBRI, via psycho-cognitive impairments.Discussion/ConclusionDisability and quality of life were directly influenced by different factors. While disability appeared to result from an interaction of a wide range of factors, including demographics, injury severity, psycho-cognitive and somatic deficiencies, quality of life was solely directly related to psycho-cognitive factors. Other factors, such as age and somatic impairments only had an indirect effect

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

Assessing Negative Attributions After Brain Injury With the Ambiguous Intentions Hostility Questionnaire

OBJECTIVES: (1) To explore the construct validity of the Ambiguous Intentions Hostility Questionnaire (AIHQ) in participants with traumatic brain injury (TBI) (ie, confirm negative attributions are associated with anger and aggression); and (2) use the AIHQ to examine negative attribution differences between participants with and without TBI. SETTING: Two rehabilitation hospitals. PARTICIPANTS: Eighty-five adults with TBI and 86 healthy controls (HCs). DESIGN: Cross-sectional survey. MAIN MEASURES: The AIHQ, a measure of negative attributions (intent, hostility, and blame), anger, and aggressive responses to hypothetical scenarios. RESULTS: Attributions were significantly correlated with anticipated anger and aggressive responses to AIHQ scenarios. Compared with HCs, participants with TBI reported stronger negative attributions (P ≤ .001), anger (P = .021), and aggressive responses (P = .002) to the scenarios. CONCLUSION: Negative attributions were associated with anger and aggression responses, demonstrating construct validity of the AIHQ in the TBI population. Participants with TBI judged others' behaviors more severely than HCs, similar to prior research using a different attribution measure. The AIHQ has promise as a practical instrument for assessing negative attributions after TBI

Visual Behavior, Pupil Dilation, and Ability to Identify Emotions From Facial Expressions After Stroke

[EN] Social cognition is the innate human ability to interpret the emotional state of others from contextual verbal and non-verbal information, and to self-regulate accordingly. Facial expressions are one of the most relevant sources of non-verbal communication, and their interpretation has been extensively investigated in the literature, using both behavioral and physiological measures, such as those derived from visual activity and visual responses. The decoding of facial expressions of emotion is performed by conscious and unconscious cognitive processes that involve a complex brain network that can be damaged after cerebrovascular accidents. A diminished ability to identify facial expressions of emotion has been reported after stroke, which has traditionally been attributed to impaired emotional processing. While this can be true, an alteration in visual behavior after brain injury could also negatively contribute to this ability. This study investigated the accuracy, distribution of responses, visual behavior, and pupil dilation of individuals with stroke while identifying emotional facial expressions. Our results corroborated impaired performance after stroke and exhibited decreased attention to the eyes, evidenced by a diminished time and number of fixations made in this area in comparison to healthy subjects and comparable pupil dilation. The differences in visual behavior reached statistical significance in some emotions when comparing individuals with stroke with impaired performance with healthy subjects, but not when individuals post-stroke with comparable performance were considered. The performance dependence of visual behavior, although not determinant, might indicate that altered visual behavior could be a negatively contributing factor for emotion recognition from facial expressions.This study was funded by Conselleria de Educacion, Cultura y Deporte of Generalitat Valenciana of Spain (Project SEJI/2019/017), and Universitat Politecnica de Valencia (Grant PAID-10-18).Maza, A.; Moliner, B.; Ferri, J.; Llorens Rodríguez, R. (2020). Visual Behavior, Pupil Dilation, and Ability to Identify Emotions From Facial Expressions After Stroke. Frontiers in Neurology. 10:1-12. https://doi.org/10.3389/fneur.2019.01415S11210Nijsse, B., Spikman, J. M., Visser-Meily, J. M. A., de Kort, P. L. M., & van Heugten, C. M. (2019). Social cognition impairments are associated with behavioural changes in the long term after stroke. PLOS ONE, 14(3), e0213725. doi:10.1371/journal.pone.0213725Feldman, R. S., White, J. B., & Lobato, D. (1982). Social Skills and Nonverbal Behavior. 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K., Guerra-Carrillo, B., Miller Singley, A. T., & Bunge, S. A. (2017). Beyond eye gaze: What else can eyetracking reveal about cognition and cognitive development? Developmental Cognitive Neuroscience, 25, 69-91. doi:10.1016/j.dcn.2016.11.001Ariel, R., & Castel, A. D. (2013). Eyes wide open: enhanced pupil dilation when selectively studying important information. Experimental Brain Research, 232(1), 337-344. doi:10.1007/s00221-013-3744-5Zekveld, A. A., & Kramer, S. E. (2014). Cognitive processing load across a wide range of listening conditions: Insights from pupillometry. Psychophysiology, 51(3), 277-284. doi:10.1111/psyp.12151De Gee, J. W., Knapen, T., & Donner, T. H. (2014). Decision-related pupil dilation reflects upcoming choice and individual bias. Proceedings of the National Academy of Sciences, 111(5), E618-E625. doi:10.1073/pnas.1317557111Bradley, M. M., Miccoli, L., Escrig, M. A., & Lang, P. J. (2008). The pupil as a measure of emotional arousal and autonomic activation. Psychophysiology, 45(4), 602-607. doi:10.1111/j.1469-8986.2008.00654.xDuque, A., Sanchez, A., & Vazquez, C. (2014). Gaze-fixation and pupil dilation in the processing of emotional faces: The role of rumination. Cognition and Emotion, 28(8), 1347-1366. doi:10.1080/02699931.2014.881327Lanata, A., Armato, A., Valenza, G., & Scilingo, E. P. (2011). Eye tracking and pupil size variation as response to affective stimuli: a preliminary study. Proceedings of the 5th International ICST Conference on Pervasive Computing Technologies for Healthcare. doi:10.4108/icst.pervasivehealth.2011.246056Peinkhofer, C., Knudsen, G. M., Moretti, R., & Kondziella, D. (2019). Cortical modulation of pupillary function: systematic review. PeerJ, 7, e6882. doi:10.7717/peerj.6882Grill-Spector, K., Knouf, N., & Kanwisher, N. (2004). The fusiform face area subserves face perception, not generic within-category identification. Nature Neuroscience, 7(5), 555-562. doi:10.1038/nn1224Ferretti, V., & Papaleo, F. (2018). Understanding others: emotion recognition abilities in humans and other animals. Genes, Brain and Behavior, e12544. doi:10.1111/gbb.12544Sergerie, K., Chochol, C., & Armony, J. L. (2008). The role of the amygdala in emotional processing: A quantitative meta-analysis of functional neuroimaging studies. Neuroscience & Biobehavioral Reviews, 32(4), 811-830. doi:10.1016/j.neubiorev.2007.12.002Rapcsak, S. Z., Galper, S. R., Comer, J. F., Reminger, S. L., Nielsen, L., Kaszniak, A. W., … Cohen, R. A. (2000). Fear recognition deficits after focal brain damage: A cautionary note. Neurology, 54(3), 575-575. doi:10.1212/wnl.54.3.575Radice-Neumann, D., Zupan, B., Tomita, M., & Willer, B. (2009). Training Emotional Processing in Persons With Brain Injury. Journal of Head Trauma Rehabilitation, 24(5), 313-323. doi:10.1097/htr.0b013e3181b09160Yuvaraj, R., Murugappan, M., Norlinah, M. I., Sundaraj, K., & Khairiyah, M. (2013). Review of Emotion Recognition in Stroke Patients. Dementia and Geriatric Cognitive Disorders, 36(3-4), 179-196. doi:10.1159/000353440Babbage, D. R., Yim, J., Zupan, B., Neumann, D., Tomita, M. R., & Willer, B. (2011). Meta-analysis of facial affect recognition difficulties after traumatic brain injury. Neuropsychology, 25(3), 277-285. doi:10.1037/a0021908Milders, M., Fuchs, S., & Crawford, J. R. (2003). Neuropsychological Impairments and Changes in Emotional and Social Behaviour Following Severe Traumatic Brain Injury. Journal of Clinical and Experimental Neuropsychology, 25(2), 157-172. doi:10.1076/jcen.25.2.157.13642Genova, H. M., Genualdi, A., Goverover, Y., Chiaravalloti, N. D., Marino, C., & Lengenfelder, J. (2016). An investigation of the impact of facial affect recognition impairments in moderate to severe TBI on fatigue, depression, and quality of life. Social Neuroscience, 12(3), 303-307. doi:10.1080/17470919.2016.1173584Rigon, A., Voss, M. W., Turkstra, L. S., Mutlu, B., & Duff, M. C. (2018). Different aspects of facial affect recognition impairment following traumatic brain injury: The role of perceptual and interpretative abilities. Journal of Clinical and Experimental Neuropsychology, 40(8), 805-819. doi:10.1080/13803395.2018.1437120Rosenberg, H., McDonald, S., Dethier, M., Kessels, R. P. C., & Westbrook, R. F. (2014). Facial Emotion Recognition Deficits following Moderate–Severe Traumatic Brain Injury (TBI): Re-examining the Valence Effect and the Role of Emotion Intensity. Journal of the International Neuropsychological Society, 20(10), 994-1003. doi:10.1017/s1355617714000940Lancelot, C., & Gilles, C. (2018). How does visual context influence recognition of facial emotion in people with traumatic brain injury? Brain Injury, 33(1), 4-11. doi:10.1080/02699052.2018.1531308McDonald, S. (2013). Impairments in Social Cognition Following Severe Traumatic Brain Injury. Journal of the International Neuropsychological Society, 19(3), 231-246. doi:10.1017/s1355617712001506Vallat-Azouvi, C., Azouvi, P., Le-Bornec, G., & Brunet-Gouet, E. (2018). Treatment of social cognition impairments in patients with traumatic brain injury: a critical review. Brain Injury, 33(1), 87-93. doi:10.1080/02699052.2018.1531309Godin, B., Oishi, K., Oishi, K., Davis, C., Gomez, Y., Trupe, L., … Tippett, D. (2018). Impaired Recognition of Emotional Faces after Stroke Involving Right Amygdala or Insula. Seminars in Speech and Language, 39(01), 087-100. doi:10.1055/s-0037-1608859Abbott, J. D., Cumming, G., Fidler, F., & Lindell, A. K. (2013). The perception of positive and negative facial expressions in unilateral brain-damaged patients: A meta-analysis. Laterality: Asymmetries of Body, Brain and Cognition, 18(4), 437-459. doi:10.1080/1357650x.2012.703206Abbott, J. D., Wijeratne, T., Hughes, A., Perre, D., & Lindell, A. K. (2014). The perception of positive and negative facial expressions by unilateral stroke patients. Brain and Cognition, 86, 42-54. doi:10.1016/j.bandc.2014.01.017Delazer, M., Sojer, M., Ellmerer, P., Boehme, C., & Benke, T. (2018). Eye-Tracking Provides a Sensitive Measure of Exploration Deficits After Acute Right MCA Stroke. Frontiers in Neurology, 9. doi:10.3389/fneur.2018.00359Lech, M., Kucewicz, M. T., & Czyżewski, A. (2019). Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries. Frontiers in Neurology, 10. doi:10.3389/fneur.2019.00006Spikman, J. M., Milders, M. V., Visser-Keizer, A. C., Westerhof-Evers, H. J., Herben-Dekker, M., & van der Naalt, J. (2013). Deficits in Facial Emotion Recognition Indicate Behavioral Changes and Impaired Self-Awareness after Moderate to Severe Traumatic Brain Injury. PLoS ONE, 8(6), e65581. doi:10.1371/journal.pone.0065581Knox, L., & Douglas, J. (2009). Long-term ability to interpret facial expression after traumatic brain injury and its relation to social integration. Brain and Cognition, 69(2), 442-449. doi:10.1016/j.bandc.2008.09.009Struchen, M. A., Clark, A. N., Sander, A. M., Mills, M. R., Evans, G., & Kurtz, D. (2008). Relation of executive functioning and social communication measures to functional outcomes following traumatic brain injury. NeuroRehabilitation, 23(2), 185-198. doi:10.3233/nre-2008-23208Ferro, J. M., Caeiro, L., & Santos, C. (2009). Poststroke Emotional and Behavior Impairment: A Narrative Review. Cerebrovascular Diseases, 27(1), 197-203. doi:10.1159/000200460Bortolon, C., Capdevielle, D., & Raffard, S. (2015). Face recognition in schizophrenia disorder: A comprehensive review of behavioral, neuroimaging and neurophysiological studies. Neuroscience & Biobehavioral Reviews, 53, 79-107. doi:10.1016/j.neubiorev.2015.03.006Harms, M. B., Martin, A., & Wallace, G. L. (2010). 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Frontiers in Neural Circuits, 12. doi:10.3389/fncir.2018.0002

How to make the economics profession socially useful? (A reaction to George Soros’ lectures and INET’s activities)

The profession of economics does not fulfill its social function to provide people a correct understanding of economic phenomena. In other words, the institution of economics does not work properly. George Soros makes this conclusion in his lectures at the Central European University (Soros, 2010). He sponsored the creation of the Institute for New Economic Thinking (INET) with the objective to change this situation in economics. However activities of the INET are not oriented to change the institution of economics and most of participants in its activities are mainstream economists. This short paper summarizes my ideas in what way it is necessary to change the institution of economics. First, in order to make the profession of economists socially useful, it is necessary to reconsider the methodology and history of economics. At present the former leads the profession in a wrong way and the latter to a great extent justifies this wrong way. Secondly, it is necessary to reform the institution of economics. I define the notion of institution in the following way: an institution is a set of formal and informal rules, and also beliefs, that stand behind these rules, that orient the behaviour of members of a certain community. The rules of the institution of economics relate to the community of university professors and students of economics. These rules provide a framework for developing curricula and syllabi, as well as for the organization of examinations. They define the procedures and directions of economic research, and the criteria for publication of articles in academic economic journals. These rules include formal and informal rules of functioning of professional organizations of economists, such as the American Economic Association. Beliefs that underlie the rules of functioning of the community of academic economists are expressed in different answers to such questions as: What does it mean to undertake economic research? What is the purpose of economic research? What should economists study? How should they carry out the study? In what form should the results of the study be presented? What does it mean to teach economics? What kind of economics should we teach? The answers to these questions, along with formal and informal rules of behaviour based on the answers, together constitute the institutional knowledge of professional economists. Candidates for admission to the profession acquire most of this knowledge during the preparation and defense of PhD dissertations that many do in the framework of post-graduate studies. If someone becomes a member of the profession and does not have this knowledge, or refuses to follow its instructions, then sooner or later she/he will be rejected by the profession. To reform the profession of economists means to reform the institution of economics, i.e. to change their rules and beliefs. I think that the only way for economics to become a socially useful science is the transformation of economics from a kind of applied mathematics (mainstream economics) or social philosophy (heterodox economics) to something similar to social anthropology with its ethnographic method justified in the framework of the constructivist discursive methodology. The methodology that I prone can be expressed very shortly in the following way. The social-economic regularities result from the fact that people behave according to certain socially-constructed rules, and these rules are explained, justified, and kept in mind by telling themselves and others some stories. Taking this statement into consideration, we must agree with the fact that for the identification of social-economic regularities, we must explore and analyse these stories. Modern economics does not study the discourses of economic actors and thereby deprive itself of the ability to understand and predict economic phenomena. The study of discourse is not a deviation from the academic standards which are built into natural sciences, but rather an approximation to it, since almost all social interactions are mediated by language

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.

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

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