Remote Neuropsychological Assessment of Patients With Neurological Disorders and Injuries
Traumatic Brain InjuryStroke4 moreFor the last decades, many aspects of human life have been altered by digital technology. For health care, this have opened a possibility for patients who have difficulties travelling a long distance to a hospital to meet with their health care providers over different digital platforms. With an increased digital literacy, and an aging population often living in the countryside, far from hospitals or other health care settings, an increasing need for digitalization of meetings between patients and health care personnel is inevitable. However, neuropsychological assessment is one sort of health care not possible to directly transfer into digital form. These evaluations are most often performed with well validated tests, only to be used in a paper-pencil form with a specially trained psychologist during physical meetings. The aim of this project is to investigate whether a newly developed digital neuropsychological test battery can be used to perform remote assessments of cognitive function in patients with neurological injuries and impairments. To this date, there are no such test batteries available in the Swedish language. Mindmore (www.mindmore.com) is a test system developed in Sweden, performing neuropsychological tests on a tablet, but still with the psychologist present in the room. This system is now evolving into offering the possibility for the patient to perform the test in their own home, using their own computer or tablet. The aim of the present research project is to validate this latter system (Mindmore Distance), using the following research questions: Are the tests in Mindmore Distance equivalent to traditional neuropsychological tests in patients with traumatic brain injury, stroke, multiple sclerosis, Parkinson's Disease, epilepsy, and brain tumor? Can the results from Mindmore Distance be transferred into neuropsychological profiles that can be used in diagnostics for specific patient groups? How do the patients experience undergoing a neuropsychological evaluation on their own compared to traditional neuropsychological assessment in a physical meeting with a psychologist?
InMotion - Telehealth Delivered Exercise Promotion to Treat Major Depression After TBI
TBI (Traumatic Brain Injury)Depressive Disorder4 moreThe purpose of this randomized controlled trial is to evaluate whether the InMotion intervention, delivered via telehealth (using a HIPAA-compliant video platform or phone), which uses evidence-based behavioral and motivational counseling to increase daily physical activity, is an effective treatment for Major Depressive Disorder (MDD) for people who are at least one year out from sustaining a traumatic brain injury (TBI). The first aim is to compare the efficacy of the InMotion intervention to the waitlist control (WLC) condition on measures of depression severity and associated conditions in under-active adults with TBI and MDD. For the second aim the investigators plan to identify possible moderators of exercise treatment effects. The third aim will examine possible mediators of treatment outcome. In addition, the weekly dose of exercise, the extent to which exercise generates positive affect, and engagement in enjoyable or meaningful aspects of life will be explored.
Neutral Versus Liberal fLuId In Traumatic Brain Injury: a Randomised Controlled Trial
Traumatic Brain InjuryFluid Overload2 moreFeasibility and safety of targeting neutral vs liberal fluid balance in traumatic brain injured patients: a phase II randomized controlled trial
Intermediate Normal Versus High Normal Oxygen Levels in the Emergency Department for Severe Traumatic...
Traumatic Brain InjuryAcute Respiratory Failure2 moreDespite almost universal usage of supplemental oxygen therapy in patients presenting in the emergency department with traumatic brain injury (TBI), optimal oxygen levels are unclear. The investigators propose a pilot multi-center randomized controlled trial to test the hypothesis that maintaining intermediate normal as opposed to high normal oxygen levels in patients presenting in the emergency department with TBI is feasible, and to obtain preliminary data on the efficacy of the two approaches to oxygen therapy. The aim is that the investigators produce pilot data, which could inform the design of potential subsequent larger clinical trials.
Depth Electrode Detection of Cortical Spreading Depolarization After Traumatic Brain Injury
TBI (Traumatic Brain Injury)Preliminary evaluation of depth electrode recording and novel algorithms to determine Cortical Spreading Depolarization's (CSD) following traumatic brain injury (TBI) requiring neurosurgical intervention.
Antiseizure Medication in Seizure Networks at Early Acute Brain Injury
Brain InjuriesAcute11 moreThe goal of this clinical trial is to explore the effect of FDA-approved antiseizure drugs in the brain connectivity patterns of severe acute brain injury patients with suppression of consciousness. The main questions it aims to answer are: Does the antiseizure medication reduce the functional connectivity of seizure networks, as identified by resting state functional MRI (rs-fMRI), within this specific target population? What is the prevalence of seizure networks in patients from the target population, both with EEG suggestive and not suggestive of epileptogenic activity? Participants will have a rs-fMRI and those with seizure networks will receive treatment with two antiseizure medications and a post-treatment rs-fMRI. Researchers will compare the pretreatment and post-treatment rs-fMRIs to see if there are changes in the participant's functional connectivity including seizure networks and typical resting state networks.
Assess the Clinical Effectiveness in AI Prioritising CT Heads
TraumaBrain8 moreNon-Contrast Computed Tomography (NCCT) of the head is the most common imaging method used to assess patients attending the Emergency Department (ED) with a wide range of significant neurological presentations including trauma, stroke, seizure and reduced consciousness. Rapid review of the images supports clinical decision-making including treatment and onward referral. Radiologists, those reporting scans, often have significant backlogs and are unable to prioritise abnormal images of patients with time critical abnormalities. Similarly, identification of normal scans would support patient turnover in ED with significant waits and pressure on resources. To address this problem, Qure.AI has worked to develop the market approved qER algorithm, which is a software program that can analyse CT head to identify presence of abnormalities supporting workflow prioritisation. This study will trial the software in 4 NHS hospitals across the UK to evaluate the ability of the software to reduce the turnaround time of reporting scans with abnormalities that need to be prioritised.
Allopregnanolone in Chronic Complex Traumatic Brain Injury
Traumatic Brain Injury (TBI)This study will determine if allopregnanolone (ALLO) improves depression and pain symptoms in patients who have a history of mild traumatic brain injury (TBI) [primary endpoints]. The investigators will also determine if ALLO improves functional outcome [secondary endpoint]. Participants in this study will receive an intravenous infusion of either ALLO or placebo. Behavioral assessments will be conducted during the infusion and at several time points post-infusion.
Traumatic Brain Injury Associated Radiological DVT Incidence and Significance Study
Traumatic Brain InjuryDeep Vein Thrombosis2 moreWhilst deep vein thrombosis (DVT) is common following traumatic brain injury (TBI), optimal timing and safety of pharmacological prophylaxis is uncertain. Paradoxically the harm associated with the occurrence of is also unclear. This study is an observational pilot that aims to define the incidence of proximal DVT in patients with moderate to severe TBI. It seeks prospectively to determine if there is an association between DVT and outcome. It also seeks to explore possible associations between the occurrence of DVT and the incidence of lung injury and/or ventilator associated pneumonia.
Quality of Life in Traumatic Brain Injury Patients
All Adult Patients Admitted to theHMPIT ICU for Management of Head TraumaThe aim of this study is to describe the quality of life of CT patients in our study, at least 6 months after the occurrence of the trauma. This assessment is related to the patient's degree of sequelae, using the GOSE scale.