The relationship between cognition and vocational training outcome in patients with acquired brain injury: Contribution of Machine Learning.

The aim of this study was to identify specific cognitive patterns related to long-term vocational training outcome. Records of twenty-eight patients who had benefited from a professional rehabilitation program were retrospectively processed. Screening through machine learning algorithms of patients' neuropsychological scores identified cognitive patterns related to both vocational training outcomes: succeeded or failed. These patterns were based on cognitive performance intervals even if the cognitive ability was not impaired. The cognitive pattern related to a successful vocational training included performance intervals on measures underlying verbal memory consolidation, visual memory incidental recall, problem solving and planning abilities. The cognitive pattern explaining failure of vocational training included performance intervals on tasks involving planning and problem solving abilities. From a comprehensive neuropsychological battery, memory and executive measures appeared to be the best attributes related to the vocational training outcome in patients with brain injury. Even with a cognitive functioning above the pathological cutoff, patients suffering from a brain injury could fail a vocational training. The attributes related to the vocational training outcome would be more a specific level of cognitive functioning rather than an interpretation of neuropsychological scores only based on a normal versus pathological distinction.

Is Multidimensional Fatigue Inventory (MFI-20) adequate to measure brain injury related fatigue?

BACKGROUND: Fatigue is a common symptom in patients with acquired brain injury (ABI) related disability while its multidimensionality has never been investigated, and specifically its relationship with patients' cognitive functioning. OBJECTIVE: This study aimed to evaluate the validity of the Multidimensional Fatigue Inventory (MFI-20) in patients living with ABI-related disability. METHODS: Four hundred twenty-six participants divided in three different groups (ABI-related disability, physical-related disability without an ABI, and healthy volunteers with no disability) were administered the French version of the Multidimensional Fatigue Inventory. We investigated the link between these fatigue measures and neuropsychological assessment in patients with ABI. Performance on this tool was compared according to the group and we calculated normative data for the Multidimensional Fatigue Inventory based on healthy volunteers' performance. RESULTS: In patients with ABI, fatigue measures significantly correlated with neuropsychological measures of attention, memory and executive functions. We found higher scores on Mental Fatigue and Reduced Activities dimensions in patients with ABI in comparison with the patients with physical disability (p < 0.05) and healthy controls (p < 0.01). CONCLUSIONS: The Multidimensional Fatigue Inventory appeared to be a sensitive tool to detect ABI-related fatigue, fatigue levels being higher than in patients with physical disability and in healthy volunteers. As fatigue appeared to be related to memory, executive and attentional functioning of patients with ABI-related disability who often face unemployment, its impact on vocational outcome following ABI should be further investigated.

Why evaluate one-week-delayed verbal recall in patients with severe traumatic brain injury?

PRIMARY OBJECTIVE: The aim of this study was to propose new measures to evaluate memory processes in patients with severe traumatic brain injury (TBI). In this purpose, we analyzed learning and consolidation processes depending on own patient's performance during a memory test. METHODS: One-week Free and Cued Selective Reminding Test - word version (1W-FCSRT-word), which special feature relies on a 30-min and a 1-week-delayed recall after encoding, was administered to a group of 43 patients with severe TBI (age range from 20 to 54 years) and a group of neurologically healthy volunteers matched for age and gender. RESULTS: Patients performed worse than healthy volunteers for the learning score. Their forgetting percentage was above healthy volunteers' performance and difference between the two groups increased with the delay from the learning phase. CONCLUSION: In patients with severe TBI, our results underlined an altered learning and an impairment of long-term consolidation. It is crucial to detect these deficits in the aim to highlight, with a better accuracy, these patients' memory complaints and to propose a better professional rehabilitation.

Extension to one week of verbal memory consolidation assessment.

OBJECTIVE: Although impairments of long-term recall affect everyday life, they may be missed by standard delayed recall tests, which typically assess the ability to retain new information within a few minutes, without encompassing the consolidation process. We adapted a verbal memory test to evaluate long-term memory consolidation in healthy volunteers. METHOD: A sample of 238 participants (M = 42.23 years old, SD = 16.45) was administered an adapted version of the French RL/RI-16 (Van der Linden & the members of GREMEM, 2004), the One-Week Free and Cued Selective Reminding Test-word version, in which special feature relies on a 30-min and a 1-week-delayed recall after encoding. We proposed normative data on 4 indicators, depending on participants' own performance during the test, to measure their encoding, storage and consolidation abilities, with a method using an ascendant step-by-step linear regression model and a percentile procedure. RESULTS: Results showed a better performance in women than in men for encoding and cueing scores (p < .01 and p < .05, respectively). We also highlighted an increase of the forgetting score according to the recall delay after encoding (30 min vs. 7 days; Z = 12.49, p < .001), the forgetting percentage 7 days after encoding being largely influenced by participants' age and gender (F[2, 236] = 248.1, p < .001; adjusted R2 = 67%). CONCLUSIONS: This study emphasized the role of demographic factors on long-term memory consolidation. The demographically adjusted normative data we provide for the One-Week Free and Cued Selective Reminding Test-word version make it a sensitive tool for long-term memory consolidation assessment in clinical and forensic practice. (PsycINFO Database Record