Cognitive Impairment and Mood States after Spinal Cord Injury

Abstract

Spinal cord injury (SCI) is believed to be associated with high rates of cognitive impairment, which can result in complications in recovery. This study concerned two groups of adults with SCI. The first sample involved 150 participants with SCI who were assessed once for cognitive capacity with comparisons made with 45 able-bodied adults. Sample 2 were drawn from Sample 1, and included 88 participants with SCI who were prospectively assessed for mood states (anxiety, depressive mood, and fatigue) and pain intensity at three time periods: at admission to SCI rehabilitation, at discharge, and 6 months after transition into the community. Results showed that the SCI sample had significantly lower cognitive performance than the able-bodied control group. Further, almost 29% of the adults with SCI had lowered cognitive performance believed to be indicative of cognitive impairment. The risk of an adult with SCI having cognitive impairment was almost 13 times that of someone without an SCI. Results from Sample 2 revealed that the development of negative mood states was a significant problem in those with cognitive impairment after they transitioned into the community, a time when personal resources are severely challenged. Findings suggest all adults with SCI admitted to rehabilitation should receive a cognitive screen, and that rehabilitation strategies should then be guided by the cognitive performance of the person. Special attention should also be given to improving skills of those with cognitive impairment before they transition into the community, so as to reduce risk of comorbid mental health problems.

Cognitive impairment in HTLV-1-associated myelopathy, proviral load and inflammatory markers

“…Cross-sectional studies had already detected a high frequency of cognitive impairment in patients with HAM/TSP (Gascón et al, 2017), suggesting that these alterations are an important clinical manifestation associated with myelopathy or even among asymptomatic carriers of HTLV (Craig et al, 2017). Patients presenting traumatic spinal cord injury showed 29% of impaired cognitive performance (Gascón et al, 2017), which may be related to multiple factors, such as inflammation, disability adjustment, depressive mood and medications.…”

Cognitive performance of people with traumatic spinal cord injury: a cross-sectional study comparing people with subacute and chronic injuries

“…Recently, it has been reported that the risk of an adult with SCI having cognitive impairment is nearly 13 times higher than that of someone without a SCI [18]. Moreover, the development of negative mood states was a significant problem in those patients with cognitive impairment after the first rehabilitation period [18].…”

“…Most of the studies on the cognitive functions in people with SCI have been limited to the subacute stage (a few months after the injury). Cognitive dysfunction after SCI might be progressive due to several factors such as the cumulative effects of neuroactive drugs, brain inflammation, psychological factors, etc [18][19][20].…”

A Cognitive Behavioural Therapy Pain Management Programme for Neuropathic Pain Post Spinal Cord Injury: A Feasibility Study Including the Clinician and Patient Perspectives

“…Although increased pressure and administrative burden related to the programme was reported by clinicians in this current study, the clinical benefit was recognised. Clinicians highlighted that dual expertise was required both in pain science and SCI in CBT-PMP delivery to address the highly complex nature of SCI NP management which can be compounded by other secondary health complications including spasticity, pressure ulcers and low mood [52][53][54]. An Australian survey reported that 81% of health care professionals providing care for SCI patients in the community feel inadequately resourced to manage SCI pain, due to a lack of training, knowledge and specialist access [55].…”