Clinical and demographic predictors of symptoms of depression and anxiety in patients with spinal cord injury

Hara, Ana Clara Portela; Aching, Nicole C; Marques, Lucas Murrins; Fregni, Felipe; Battisttella, Linamara R; Simis, Marcel

doi:10.1038/s41393-022-00831-9

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…The primary predictor of depression was the presence of anxiety, and SCI-related factors were not significant. Finally, characteristics of the Functional Independence Measure (FIM) and cognitive aspects of the MoCA scale were found to be the main predictors of depressive symptoms ( 68 ).A significant correlation was found between lower depressive symptoms and greater general self-efficacy and meaning in life. Through appraisal and coping strategies, it was observed that there were significant direct effects on higher life satisfaction and significant negative effects in individuals with depressive symptoms.The effect of general self-efficacy on depressive symptoms was fully mediated by appraisal and coping strategies ( 69 ).…”

Section: Resultsmentioning

confidence: 99%

Cognitive, behavioral and psychiatric symptoms in patients with spinal cord injury: a scoping review

Calderone,

Cardile,

De Luca

et al. 2024

Front. Psychiatry

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Spinal Cord Injury (SCI) is a condition where the spinal cord is damaged and experiences partial or complete loss of motor and/or sensory function, which is typically less than normal. After SCI, patients may exhibit more severe psychiatric symptoms and experience cognitive impairments, including reduced speed and attention processing capacity, as well as difficulties with executive function and episodic memory retention. Among the behavioral and psychiatric symptoms, depression, anxiety, substance use disorder, and posttraumatic stress disorder are the most common. This review aims to investigate the cognitive, behavioral, or psychiatric symptoms of the patient with SCI and their influence on the rehabilitation process. Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases. Studies published between 2013-2023 were selected. This review has been registered on OSF (n) 3KB2U. We have found that patients with SCI are at high risk of cognitive impairment and experience a wide range of difficulties, including tasks based on processing speed and executive function. This clinical population may experience adjustment disorders with depression and anxiety, as well as other psychiatric symptoms such as fatigue, stress, and suicidal ideation. This review has demonstrated that SCI patients may experience psychiatric symptoms and cognitive impairments that affect their functioning. At the same time, these patients may be more prone to various adjustment and mood disorders. Moreover, these two aspects may interact with each other, causing a range of symptoms, increasing the risk of hospitalization, and delaying the rehabilitation process.

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Section: Resultsmentioning

confidence: 99%

Cognitive, behavioral and psychiatric symptoms in patients with spinal cord injury: a scoping review

Calderone,

Cardile,

De Luca

et al. 2024

Front. Psychiatry

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“…Specifically, this association that greater emotional impairment is associated with a significant reduction in Alpha activity, strengthens the relationship between functional and emotional impairment in stroke 34 and it also adds to the discussion regarding the association between impaired motor cortex activity and symptoms of depression in several neurological/psychiatric patients. [35][36][37]…”

Section: Depressionmentioning

confidence: 99%

Resting-state EEG as Biomarker of Maladaptive Motor Function and Depressive Profile in Stroke Patients

Marques,

Barbosa,

Gianlorenço

et al. 2024

Clin EEG Neurosci

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Objective: Investigate the relationship between resting-state EEG-measured brain oscillations and clinical and demographic measures in Stroke patients. Methods: We performed a cross-sectional analysis of a cohort study (DEFINE cohort), Stroke arm, with 85 patients, considering demographic, clinical, and stroke characteristics. Resting-state EEG relative power from delta, theta, alpha, and beta oscillations were measured from the central region. Multivariate regression models were used for both affected and non-affected hemispheres. Results: Motor function was negatively associated with Delta and Theta oscillations, while positively associated with Alpha oscillations (both hemispheres). Similarly, cognition levels measured were negatively associated with Delta activity. Depression levels were negatively associated with Alpha activity specifically in the affected hemisphere, while positively associated with Beta activity in both hemispheres. Regarding pain measures, no significant association was observed, while CPM measure showed a positive association with Alpha activity in the non-affected hemisphere. Finally, we found that theta/alpha ratio was negatively associated with motor function and CPM scores. Conclusion: The results lead us to propose a framework for brain oscillations in stroke, whereas Delta and Beta would represent disrupted mal-adaptive brain plasticity and Theta and Alpha would represent compensatory and functional brain oscillations for motor and sensory deficits in stroke, respectively.

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“…Vulnerability to depression and anxiety has also been linked to less favorable functional outcomes. 124-126 Recovery is thus a broad concept with multiple intrinsic and extrinsic contributing factors.…”

Section: Other Predictors Of Patient Recovery After Scimentioning

confidence: 99%

Development of a Systems Medicine Approach to Spinal Cord Injury

Guest

Kelly-Hedrick

Williamson

et al. 2023

Journal of Neurotrauma

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Traumatic spinal cord injury (SCI) causes a sudden onset multi-system disease, permanently altering homeostasis with multiple complications. Consequences include aberrant neuronal circuits, multiple organ system dysfunctions, and chronic phenotypes such as neuropathic pain and metabolic syndrome. Reductionist approaches are used to classify SCI patients based on residual neurological function. Still, recovery varies due to interacting variables, including individual biology, comorbidities, complications, therapeutic side effects, and socioeconomic influences for which data integration methods are lacking. Infections, pressure sores, and heterotopic ossification are known recovery modifiers. However, the molecular pathobiology of the disease-modifying factors altering the neurological recovery-chronic syndrome trajectory is mainly unknown, with significant data gaps between intensive early treatment and chronic phases. Changes in organ function such as gut dysbiosis, adrenal dysregulation, fatty liver, muscle loss, and autonomic dysregulation disrupt homeostasis, generating progression-driving allostatic load. Interactions between interdependent systems produce emergent effects, such as resilience, that preclude single mechanism interpretations. Due to many interacting variables in individuals, substantiating the effects of treatments to improve neurological outcomes is difficult. Acute injury outcome predictors, including blood and cerebrospinal fluid biomarkers, neuroimaging signal changes, and autonomic system abnormalities, often do not predict chronic SCI syndrome phenotypes. In systems medicine, network analysis of bioinformatics data is used to derive molecular control modules. To better understand the evolution from acute SCI to chronic SCI multi-system states, we propose a topological phenotype framework integrating bioinformatics, physiological data, and allostatic load tested against accepted established recovery metrics. This form of correlational phenotyping may reveal critical nodal points for intervention to improve recovery trajectories. This study examines the limitations of current classifications of SCI and how these can evolve through systems medicine.

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Clinical and demographic predictors of symptoms of depression and anxiety in patients with spinal cord injury

Cited by 6 publications

References 36 publications

Cognitive, behavioral and psychiatric symptoms in patients with spinal cord injury: a scoping review

Cognitive, behavioral and psychiatric symptoms in patients with spinal cord injury: a scoping review

Resting-state EEG as Biomarker of Maladaptive Motor Function and Depressive Profile in Stroke Patients

Development of a Systems Medicine Approach to Spinal Cord Injury

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