Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis
IntroductionAmong patients with traumatic brain injury (TBI), postural instability often persists chronically with negative consequences such as higher fall risk. One explanation may be reduced executive function (EF) required to effectively process, interpret and combine, sensory information. In ot...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.906661/full |
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| author | Susanne M. van der Veen Susanne M. van der Veen Robert A. Perera Laura Manning-Franke Amma A. Agyemang Karen Skop Scott R. Sponheim Scott R. Sponheim Elisabeth A. Wilde Elisabeth A. Wilde Elisabeth A. Wilde Alexander Stamenkovic James S. Thomas William C. Walker William C. Walker |
| author_facet | Susanne M. van der Veen Susanne M. van der Veen Robert A. Perera Laura Manning-Franke Amma A. Agyemang Karen Skop Scott R. Sponheim Scott R. Sponheim Elisabeth A. Wilde Elisabeth A. Wilde Elisabeth A. Wilde Alexander Stamenkovic James S. Thomas William C. Walker William C. Walker |
| author_sort | Susanne M. van der Veen |
| collection | DOAJ |
| description | IntroductionAmong patients with traumatic brain injury (TBI), postural instability often persists chronically with negative consequences such as higher fall risk. One explanation may be reduced executive function (EF) required to effectively process, interpret and combine, sensory information. In other populations, a decline in higher cognitive functions are associated with a decline in walking and balance skills. Considering the link between EF decline and reduction in functional capacity, we investigated whether specific tests of executive function could predict balance function in a cohort of individuals with a history of chronic mild TBI (mTBI) and compared to individuals with a negative history of mTBI.MethodsSecondary analysis was performed on the local LIMBIC-CENC cohort (N = 338, 259 mTBI, mean 45 ± STD 10 age). Static balance was assessed with the sensory organization test (SOT). Hierarchical regression was used for each EF test outcome using the following blocks: (1) the number of TBIs sustained, age, and sex; (2) the separate Trail making test (TMT); (3) anti-saccade eye tracking items (error, latency, and accuracy); (4) Oddball distractor stimulus P300 and N200 at PZ and FZ response; and (5) Oddball target stimulus P300 and N200 at PZ and FZ response.ResultsThe full model with all predictors accounted for between 15.2% and 21.5% of the variability in the balance measures. The number of TBI's) showed a negative association with the SOT2 score (p = 0.002). Additionally, longer times to complete TMT part B were shown to be related to a worse SOT1 score (p = 0.038). EEG distractors had the most influence on the SOT3 score (p = 0.019). Lastly, the SOT-composite and SOT5 scores were shown to be associated with longer inhibition latencies and errors (anti-saccade latency and error, p = 0.026 and p = 0.043 respectively).ConclusionsThese findings show that integration and re-weighting of sensory input when vision is occluded or corrupted is most related to EF. This indicates that combat-exposed Veterans and Service Members have greater problems when they need to differentiate between cues when vision is not a reliable input. In sum, these findings suggest that EF could be important for interpreting sensory information to identify balance challenges in chronic mTBI. |
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| last_indexed | 2024-04-10T23:43:09Z |
| publishDate | 2023-01-01 |
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| spelling | doaj.art-ebbf3b98aa254e289fdbdfb7ce5d5acf2023-01-11T06:22:33ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-01-011310.3389/fneur.2022.906661906661Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysisSusanne M. van der Veen0Susanne M. van der Veen1Robert A. Perera2Laura Manning-Franke3Amma A. Agyemang4Karen Skop5Scott R. Sponheim6Scott R. Sponheim7Elisabeth A. Wilde8Elisabeth A. Wilde9Elisabeth A. Wilde10Alexander Stamenkovic11James S. Thomas12William C. Walker13William C. Walker14Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Biostatistics, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Physical Medicine and Rehabilitation Services, James A. Haley Veterans' Hospital, Tampa, FL, United StatesMinneapolis VA Health Care System, Veterans Affairs Medical Center, Minneapolis, MN, United StatesDepartment of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United StatesDepartment of Physical Medicine and Rehabilitation, Michael E. DeBakey VA Medical Center, Houston, TX, United StatesPhysical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, United StatesDepartment of Neurology, University of Utah, Salt Lake City, UT, United StatesDepartment of Physical Therapy, College of Health Professions, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Physical Therapy, College of Health Professions, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States0Richmond Veterans Affairs (VA) Medical Center, Central Virginia VA Health Care System, Richmond, VA, United StatesIntroductionAmong patients with traumatic brain injury (TBI), postural instability often persists chronically with negative consequences such as higher fall risk. One explanation may be reduced executive function (EF) required to effectively process, interpret and combine, sensory information. In other populations, a decline in higher cognitive functions are associated with a decline in walking and balance skills. Considering the link between EF decline and reduction in functional capacity, we investigated whether specific tests of executive function could predict balance function in a cohort of individuals with a history of chronic mild TBI (mTBI) and compared to individuals with a negative history of mTBI.MethodsSecondary analysis was performed on the local LIMBIC-CENC cohort (N = 338, 259 mTBI, mean 45 ± STD 10 age). Static balance was assessed with the sensory organization test (SOT). Hierarchical regression was used for each EF test outcome using the following blocks: (1) the number of TBIs sustained, age, and sex; (2) the separate Trail making test (TMT); (3) anti-saccade eye tracking items (error, latency, and accuracy); (4) Oddball distractor stimulus P300 and N200 at PZ and FZ response; and (5) Oddball target stimulus P300 and N200 at PZ and FZ response.ResultsThe full model with all predictors accounted for between 15.2% and 21.5% of the variability in the balance measures. The number of TBI's) showed a negative association with the SOT2 score (p = 0.002). Additionally, longer times to complete TMT part B were shown to be related to a worse SOT1 score (p = 0.038). EEG distractors had the most influence on the SOT3 score (p = 0.019). Lastly, the SOT-composite and SOT5 scores were shown to be associated with longer inhibition latencies and errors (anti-saccade latency and error, p = 0.026 and p = 0.043 respectively).ConclusionsThese findings show that integration and re-weighting of sensory input when vision is occluded or corrupted is most related to EF. This indicates that combat-exposed Veterans and Service Members have greater problems when they need to differentiate between cues when vision is not a reliable input. In sum, these findings suggest that EF could be important for interpreting sensory information to identify balance challenges in chronic mTBI.https://www.frontiersin.org/articles/10.3389/fneur.2022.906661/fullbalanceexecutive functiontraumatic brain injuryconcussiongaitcognition |
| spellingShingle | Susanne M. van der Veen Susanne M. van der Veen Robert A. Perera Laura Manning-Franke Amma A. Agyemang Karen Skop Scott R. Sponheim Scott R. Sponheim Elisabeth A. Wilde Elisabeth A. Wilde Elisabeth A. Wilde Alexander Stamenkovic James S. Thomas William C. Walker William C. Walker Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis Frontiers in Neurology balance executive function traumatic brain injury concussion gait cognition |
| title | Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis |
| title_full | Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis |
| title_fullStr | Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis |
| title_full_unstemmed | Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis |
| title_short | Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis |
| title_sort | executive function and relation to static balance metrics in chronic mild tbi a limbic cenc secondary analysis |
| topic | balance executive function traumatic brain injury concussion gait cognition |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.906661/full |
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