Anoxia-Hypoxia in Forensic Neuropsychological Assessment: Cognitive Impact of Pulmonary Injuries, Respiratory Distress, Cerebral Blood Hypoperfusion, and Major Surgeries

Schultz, Izabela Z.; Sepehry, Amir Ali; Greer, Sarah C.

doi:10.1007/s12207-018-9319-9

Cited by 10 publications

(6 citation statements)

References 164 publications

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“…Survivors of severe COVID-19 are more likely to have a history of hypoxia and resulting acquired brain injury. These have also been associated with both cognitive and psychiatric impairments (Schultz et al, 2018) and progressive brain deterioration more than a decade after the original injury (Tobe, 2012). Both persistent neurocognitive deficits and declining mental health have been observed in ARDS survivors two years after hospital discharge (Hopkins et al, 2005), and cognitive impairment has been associated with worse health-related quality of life and greater disability status in ARDS survivors (Rothenh€ ausler et al, 2001).…”

Section: The Intersection Between Ptsd and Neurocognitive Functioning In Covid-19mentioning

confidence: 99%

Post-traumatic stress disorder: A differential diagnostic consideration for COVID-19 survivors

Kaseda

Levine

2020

The Clinical Neuropsychologist

143

116

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Objective: SARS-CoV-2 infection and its oft-associated illness COVID-19 may lead to neuropsychological deficits, either through direct mechanisms (i.e., neurovirulance) or indirect mechanisms, most notably complications caused by the virus (e.g., stroke) or medical procedures (e.g., intubation). The history of past human coronavirus outbreaks resulting in similar health emergencies suggests there will be a substantial prevalence of post-traumatic stress disorder (PTSD) among COVID-19 survivors. To prepare neuropsychologists for the difficult task of differentiating PTSD-related from neuropathology-related deficits in the oncoming wave of COVID-19 survivors, we integrate research across a spectrum of related areas. Methods: Several areas of literature were reviewed: psychiatric, neurologic, and neuropathological outcomes of SARS and MERS patients; neurological outcomes in COVID-19 survivors; PTSD associated with procedures common to COVID-19 patients; and differentiating neuropsychological deficits due to PTSD from those due to acquired brain injuries in other patient groups. Conclusions: Heightened risk of PTSD occurred in MERS and SARS survivors. While data concerning COVID-19 is lacking, PTSD is known to occur in patient groups who undergo similar hospital courses, including ICU survivors, patients who are intubated and mechanically ventilated, and those that experience delirium. Research with patients who develop PTSD in the context of mild traumatic brain injury further suggests that PTSD may account for some or all of a patient's subjective cognitive complaints and neuropsychological test performance. Recommendations are provided for assessing PTSD in the context of COVID-19.

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Section: The Intersection Between Ptsd and Neurocognitive Functioning In Covid-19mentioning

confidence: 99%

Post-traumatic stress disorder: A differential diagnostic consideration for COVID-19 survivors

Kaseda

Levine

2020

The Clinical Neuropsychologist

143

116

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“…The cause of persistent cognitive symptoms in SARS survivors is not fully understood, but the evidence is highly suggestive of hypoxemia, or hypoxia-induced brain injury. Hypoxic injury has been shown to affect such cognitive domains as attention and vigilance, memory, and executive functions (see Schultz et al, 2018 for a review). Tests of sustained attention and memory are particularly sensitive to hypoxia, and there is a dose-dependent relationship between hypoxia and cognitive deficits (Stuss, Peterkin, Guzman, Guzman, & Troyer, 1997).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, considering that one of the critical symptoms of SARS is hypoxemia, its effects may be similar to other hypoxic disorders. Complex attention (sustained, divided, and concentration during interference), mental processing speed, memory, and executive functioning is the most commonly impaired cognitive domains in several hypoxic disorders (see Schultz, Sepehry, & Greer, 2018 for a review), including sleep apnea (Sforza & Roche, 2012;Stranks & Crowe, 2016), chronic obstructive pulmonary disease (Riordan, Stika, Goldberg, & Drzewiecki, 2020;Schou, Østergaard, Rasmussen, Rydahl-Hansen, & Phanareth, 2012;Thakur et al, 2010), hypoxia due to stroke or heart attack (Kim, 2016), and other acute respiratory diseases such as acute respiratory distress syndrome (ARDS; Riordan et al, 2020;Mikkelsen et al, 2012) and hantavirus pulmonary syndrome (HPS; Hopkins, Larson-Lohr, Weaver, & Bigler, 1998). Furthermore, there is a complex relationship between the severity of hypoxia and cognition.…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive Outcome Following Recovery from Severe Acute Respiratory Syndrome – Coronavirus-1 (SARS-CoV-1)

Pinnock

Rich

Vasquez

et al. 2021

J Int Neuropsychol Soc

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Objective: Severe acute respiratory syndrome (SARS) is a highly contagious viral respiratory illness associated with hypoxia and dyspnea. Many of those who contracted and recovered from SARS during the 2002–2003 outbreak reported persistent physical, psychological, and cognitive difficulties. Here, we investigated the residual influences of SARS on cognition for a subset of healthcare professionals who recovered and were referred for neuropsychological evaluation through their workplace insurance. Method: Twenty-eight healthcare professionals were evaluated on neuropsychological and mood functioning approximately 1.5 years post-recovery from a severe respiratory illness. Test scores were compared with age-matched normative data, and correlations were examined between mood, self-report memory scales, subjective complaints (e.g., poor concentration, pain, fatigue), illness severity (i.e., length of hospitalization, oxygen use during hospital stay), and cognitive performance. Results: Participants performed within age expectations on the majority of cognitive measures including overall memory ability. Although processing speed was generally within normal limits, 43% showed significant speed–accuracy trade-offs favoring accuracy over maintaining speed. Deficits were observed on measures of complex attention, such as working memory and the ability to sustain attention under conditions of distraction. Participants endorsed poorer memory ability than same-age peers on a meta-memory measure and mild to moderate depression and anxiety symptoms. Objective test performance was largely uncorrelated with self-reports, mood, or illness severity, except for moderate correlations between complex attention and participants’ subjective ratings of Everyday Task-Oriented Memory. Conclusions: These findings demonstrate specific long-term cognitive deficits associated with SARS and provide further evidence of the cognitive effects of hypoxic illnesses.

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“…The important assumption is related to cerebral anoxia and/or hypoxia; as the brain requires a constant and abundant blood supply for oxygen and other nutrients, and any effect of the blood supply can have an impact on cerebral functions, including cognitive functions [41,42]. It has been proposed that soft tissue injuries or fractures could lead to suboptimal oxygen delivery to the brain [43,44]. Soft tissue injuries or fractures result in increased blood flow in the injured area as an emergency response to the injury, and this condition will continue during subsequent repair and regeneration period which might cause suboptimal oxygen delivery to the brain [45].…”

Section: Possible Explanations Of the Underlying Mechanismsmentioning

confidence: 99%

Is there an association between traumatic peripheral lesions and cognitive impairments in adults? A scoping review

Zhang¹,

Tse²,

Li³

et al. 2023

areh

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The aim of this scoping review was to critically review and synthesize the evidence investigating the relationship between traumatic peripheral lesions and cognitive impairments.Five electronic databases (Medline, Cinahl, Psycinfo, Embase, and Cochrane Library) were searched from inception using the two key concepts "cognition" and "trauma". An additional manual search was conducted. Articles included were written in English, included an assessment of cognition, study participants experienced any acute peripheral lesion or physical trauma and were between 18 and 65 years. Articles were screened for eligibility by two independent reviewers. Disagreements were resolved by discussion or consensus with a third author.A total of 11573 records were identified, of which 10 met the inclusion criteria. Whiplash injury, brachial plexus injury, soft tissue injury around the cervical spine, and fracture were found to be associated with cognitive impairments. The earliest cognitive assessment time point was 1-month post injuries, while the latest counterpart was 444 months. Cognition was assessed using 20 unique instruments, targeting 9 distinct cognitive domains.There is an overall positive association between traumatic peripheral lesions and cognitive impairments. Therefore, further longitudinal research is needed to monitor the changes in cognitive functions post physical trauma.

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Anoxia-Hypoxia in Forensic Neuropsychological Assessment: Cognitive Impact of Pulmonary Injuries, Respiratory Distress, Cerebral Blood Hypoperfusion, and Major Surgeries

Cited by 10 publications

References 164 publications

Post-traumatic stress disorder: A differential diagnostic consideration for COVID-19 survivors

Post-traumatic stress disorder: A differential diagnostic consideration for COVID-19 survivors

Neurocognitive Outcome Following Recovery from Severe Acute Respiratory Syndrome – Coronavirus-1 (SARS-CoV-1)

Is there an association between traumatic peripheral lesions and cognitive impairments in adults? A scoping review

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