Variables predictoras de la duración de la amnesia postraumática tras un traumatismo craneoencefálico / Predictors of the duration of post-traumatic amnesia following traumatic brain injury

Introducción: La duración de la amnesia postraumática (APT) ayuda a estimar el nivel de recuperación tras un traumatismo craneoencefálico (TCE). Sin embargo, apenas se dispone de información sobre qué variables sociodemográficas y clínicas influyen en su duración. Este estudio pretende identificarlas y crear un modelo predictivo que permita estimar el tiempo que un paciente tarda en emerger de la APT. Pacientes y métodos: La muestra estaba formada por 40 pacientes adultos en APT ingresados en un centro neurorrehabilitador. El 89,7% había sufrido un TCE grave; el 10,3% restante, un TCE moderado. Su estado cognitivo se valoró mediante el Galveston Orientation and Amnesia Test (GOAT) –escala que permite determinar en qué momento se puede considerar que un paciente emerge de la APT–. Resultados: Se encontró una ecuación de regresión (F = 8,511; p < 0,001; R2 = 0,415), en la que las siguientes variables (clasificadas por su orden de importancia) explicaron el 41,5% de la variabilidad observada en la duración de la APT: a) GOAT administrado a la llegada al centro neurorrehabilitador; b) años de formación reglada del paciente; y c) días que estuvo en APT antes de ingresar en el centro neurorrehabilitador. La ecuación de regresión derivada fue la siguiente: 104,284 + (–0,708 × GOAT-inicial) + (–4,124 × años formación reglada) + (0,219 × APT-hospital agudos). Conclusiones: El tiempo que un paciente tarda en emerger de la APT está condicionado por la puntuación que obtiene en el primer GOAT administrado al ingresar en el centro neurorrehabilitador, el nivel de estudios, y los días que permanece en APT entre el momento del TCE y el ingreso en el centro neurorrehabilitador.(AU)

Introduction: The duration of post-traumatic amnesia (PTA) helps estimate the level of recovery following traumatic brain injury (TBI). Yet, little information is available about which sociodemographic and clinical variables influence its duration. This study aims to identify them and create a predictive model that makes it possible to estimate the time it takes for a patient to emerge from PTA. Patients and methods: The sample consisted of 40 adult patients with PTA admitted to a neurorehabilitation centre. A total of 89.7% had suffered a severe TBI, whereas the remaining 10.3% had had a moderate TBI. Cognitive status was assessed using the Galveston Orientation and Amnesia Test (GOAT) – a scale for determining at what point a patient can be considered to be emerging from PTA. Results: A regression equation was found (F = 8.511; p < 0.001; R2 = 0.415), in which the following variables (ranked in order of importance) explained 41.5% of the variability observed in the duration of PTA: a) GOAT administered on arrival at the neurorehabilitation centre; b) years of formal education of the patient; and c) days with PTA prior to admission to the neurorehabilitation centre. The equation derived was as follows: 104.284 + (–0.708 × GOAT-initial) + (–4.124 × years formal education) + (0.219 × hospital acute-APT). Conclusions: The time it takes for a patient to emerge from PTA is conditioned by the score obtained in the first GOAT administered on admission to the neurorehabilitation centre, their level of education, and the number of days elapsed with PTA between occurrence of the TBI and admission to the neurorehabilitation centre.(AU)

Rehabilitation of social cognition impairment after traumatic brain injury: a systematic review.

INTRODUCTION: Many studies have described the presence of difficulty processing and generating social behaviour in patients who have suffered a traumatic brain injury (TBI). These difficulties in social cognition (SC) deteriorate personal relationships in the family, at work, or in the community. However, therapeutic programmes aiming to improve SC continue to be an outstanding issue in clinical practice. We performed a systematic review of the existing literature on the recovery of SC in patients with TBI, assessing the methodological quality of the included studies and the therapeutic effectiveness of the rehabilitation strategies used. DEVELOPMENT: We performed a bibliographic search of papers published before June 2018 in the Medline/PubMed, Google Scholar, PsycINFO, and ClinicalTrials.gov databases. Of the 198 potentially relevant articles, 10 met our eligibility criteria. Two of the authors independently and blindly assessed the methodological quality of these studies using the PEDro scale. CONCLUSIONS: The articles included in this systematic review essentially studied the effect of different interventions aimed at the rehabilitation of SC in patients with chronic TBIs. The analysis showed adequate methodological quality and an acceptable level of evidence. Future research should analyse the effect of these interventions in patients with TBIs in the sub- and post-acute phases.

[Predictors of the duration of post-traumatic amnesia following traumatic brain injury]. / Variables predictoras de la duración de la amnesia postraumática tras un traumatismo craneoencefálico.

INTRODUCTION: The duration of post-traumatic amnesia (PTA) helps estimate the level of recovery following traumatic brain injury (TBI). Yet, little information is available about which sociodemographic and clinical variables influence its duration. This study aims to identify them and create a predictive model that makes it possible to estimate the time it takes for a patient to emerge from PTA. PATIENTS AND METHODS: The sample consisted of 40 adult patients with PTA admitted to a neurorehabilitation centre. A total of 89.7% had suffered a severe TBI, whereas the remaining 10.3% had had a moderate TBI. Cognitive status was assessed using the Galveston Orientation and Amnesia Test (GOAT) - a scale for determining at what point a patient can be considered to be emerging from PTA. RESULTS: A regression equation was found (F = 8.511; p < 0.001; R2 = 0.415), in which the following variables (ranked in order of importance) explained 41.5% of the variability observed in the duration of PTA: a) GOAT administered on arrival at the neurorehabilitation centre; b) years of formal education of the patient; and c) days with PTA prior to admission to the neurorehabilitation centre. The equation derived was as follows: 104.284 + (-0.708 x GOAT-initial) + (-4.124 x years formal education) + (0.219 x hospital acute-APT). CONCLUSIONS: The time it takes for a patient to emerge from PTA is conditioned by the score obtained in the first GOAT administered on admission to the neurorehabilitation centre, their level of education, and the number of days elapsed with PTA between occurrence of the TBI and admission to the neurorehabilitation centre.

TITLE: Variables predictoras de la duración de la amnesia postraumática tras un traumatismo craneoencefálico.Introducción. La duración de la amnesia postraumática (APT) ayuda a estimar el nivel de recuperación tras un traumatismo craneoencefálico (TCE). Sin embargo, apenas se dispone de información sobre qué variables sociodemográficas y clínicas influyen en su duración. Este estudio pretende identificarlas y crear un modelo predictivo que permita estimar el tiempo que un paciente tarda en emerger de la APT. Pacientes y métodos. La muestra estaba formada por 40 pacientes adultos en APT ingresados en un centro neurorrehabilitador. El 89,7% había sufrido un TCE grave; el 10,3% restante, un TCE moderado. Su estado cognitivo se valoró mediante el Galveston Orientation and Amnesia Test (GOAT) ­escala que permite determinar en qué momento se puede considerar que un paciente emerge de la APT­. Resultados. Se encontró una ecuación de regresión (F = 8,511; p menor de 0,001; R2 = 0,415), en la que las siguientes variables (clasificadas por su orden de importancia) explicaron el 41,5% de la variabilidad observada en la duración de la APT: a) GOAT administrado a la llegada al centro neurorrehabilitador; b) años de formación reglada del paciente; y c) días que estuvo en APT antes de ingresar en el centro neurorrehabilitador. La ecuación de regresión derivada fue la siguiente: 104,284 + (­0,708 × GOAT-inicial) + (­4,124 × años formación reglada) + (0,219 × APT-hospital agudos). Conclusiones. El tiempo que un paciente tarda en emerger de la APT está condicionado por la puntuación que obtiene en el primer GOAT administrado al ingresar en el centro neurorrehabilitador, el nivel de estudios, y los días que permanece en APT entre el momento del TCE y el ingreso en el centro neurorrehabilitador.

Rehabilitación de la cognición social en el traumatismo craneoencefálico: una revisión sistemática / Rehabilitation of social cognition impairment after traumatic brain injury: A systematic review

Introducción: Múltiples estudios han descrito la presencia de dificultades para procesar y generar conductas de tipo social en pacientes que han sufrido un traumatismo craneoencefálico (TCE). Tales dificultades, englobadas bajo el término genérico de cognición social (CS), provocan un deterioro en las relaciones personales, tanto a nivel familiar como laboral o comunitario. No obstante, los programas terapéuticos dirigidos a la mejora de la CS continúan siendo una asignatura pendiente en la práctica clínica. El objetivo de este trabajo es realizar una revisión sistemática de la literatura existente sobre rehabilitación de la CS en pacientes con TCE, valorar su calidad metodológica y la efectividad terapéutica de las estrategias rehabilitadoras empleadas.DesarrolloSe realizó una búsqueda bibliográfica hasta junio de 2018 en las bases de datos Medline/PubMed, Google Scholar, PsycInfo y ClinicalTrials.gov. De los 198 artículos potencialmente interesantes, 10 cumplieron los criterios de elegibilidad. Dos de los autores evaluaron, de forma independiente y ciega, la calidad metodológica de los estudios incluidos en la revisión mediante la escala PEDro.ConclusionesLos artículos incluidos en esta revisión sistemática han estudiado esencialmente el efecto de diferentes intervenciones dirigidas a la rehabilitación de la CS en pacientes con TCEs en fase crónica. El análisis muestra que su calidad metodológica es adecuada y que el nivel de evidencia es aceptable. Se constata la necesidad de analizar el efecto de estas intervenciones en pacientes con TCE en fases subaguda y postaguda. (AU)

Introduction: Many studies have described the presence of difficulty processing and generating social behaviour in patients who have suffered a traumatic brain injury (TBI). These difficulties in social cognition (SC) deteriorate personal relationships in the family, at work, or in the community. However, therapeutic programmes aiming to improve SC continue to be an outstanding issue in clinical practice. We performed a systematic review of the existing literature on the recovery of SC in patients with TBI, assessing the methodological quality of the included studies and the therapeutic effectiveness of the rehabilitation strategies used.DevelopmentWe performed a bibliographic search of papers published before June 2018 in the Medline/PubMed, Google Scholar, PsycINFO, and ClinicalTrials.gov databases. Of the 198 potentially relevant articles, 10 met our eligibility criteria. Two of the authors independently and blindly assessed the methodological quality of these studies using the PEDro scale.ConclusionsThe articles included in this systematic review essentially studied the effect of different interventions aimed at the rehabilitation of SC in patients with chronic TBIs. The analysis showed adequate methodological quality and an acceptable level of evidence. Future research should analyse the effect of these interventions in patients with TBIs in the sub- and post-acute phases. (AU)

Neuropsychological rehabilitation for post-COVID-19 syndrome: results of a clinical programme and six-month follow up.

INTRODUCTION: Patients with post-COVID-19 syndrome may present cognitive and emotional symptomatology. This study aims to analyse the results of an outpatient neuropsychological intervention programme for post-COVID-19 syndrome. METHOD: In June 2020 Institut Guttmann started an outpatient post-COVID-19 neurorehabilitation programme, including respiratory therapy, physiotherapy, and neuropsychological rehabilitation. Before and after the programme, the cognitive-emotional state of all participants is assessed. Six months after treatment, a follow-up assessment is administered (which includes a collection of information on various aspects of daily life). RESULTS: The sample analysed consisted of 123 patients (mean age: 51 years, SD: 12.41). Seventy-four per cent (n = 91) had cognitive impairment and underwent cognitive treatment (experimental group); the remaining 26% (n = 32) constituted the control group. After the intervention, the experimental group improved in working memory, verbal memory (learning, recall and recognition), verbal fluency and anxious-depressive symptomatology. The control group showed changes in immediate memory, verbal memory (learning and recognition) and depressive symptomatology, although the effect size in the latter two was smaller than in the experimental group. Six months after treatment, 44.9% of the patients were unable to perform their pre-COVID-19 work activity, and 81.2% reported difficulties in their activities of daily living. CONCLUSIONS: Neuropsychological rehabilitation is an effective tool to treat the cognitive-emotional deficits present in post-COVID-19 syndrome. However, months after the end of treatment, not all patients recover their pre-COVID-19 functional level.

[Use of immersive virtual reality for cognitive rehabilitation of patients with brain injury]. / Uso de la realidad virtual inmersiva en la rehabilitación cognitiva de pacientes con daño cerebral. Revisión sistemática.

INTRODUCTION: Virtual reality (VR) is a therapeutic tool that is widely used in the cognitive rehabilitation of brain-damaged patients. Depending on the degree of immersiveness, a distinction can be made between non-immersive, semi-immersive and immersive VR. Studies assessing the utility of VR have focused on the non-immersive and semi-immersive modes. Little evidence is available on the effectiveness of immersive VR. AIM: To describe the characteristics, methodological quality and main results of studies that have applied immersive VR programmes in the cognitive rehabilitation of brain-damaged patients. MATERIALS AND METHODS: Following the PRISMA guidelines, a bibliographic search was conducted for studies published in the PubMed and PsycINFO databases. The methodological quality of the articles that met the selection criteria was assessed using the PEDro scale. RESULTS: After applying the inclusion and exclusion criteria, of the 369 articles of potential interest, five met the eligibility criteria. One of them was a randomised clinical trial (with acceptable/good methodological quality). Three were studies with pre- and post-treatment measures and one was a single case study, all four of them displaying poor methodological quality. CONCLUSIONS: According to the results obtained, there is no evidence of the effectiveness or utility of immersive VR in cognitive rehabilitation in brain-damaged patients. This finding is explained by the lack of studies with a methodological design that allows for the generation of quality evidence rather than because the results obtained in the articles analysed are negative or inconclusive.

TITLE: Uso de la realidad virtual inmersiva en la rehabilitación cognitiva de pacientes con daño cerebral. Revisión sistemática.Introducción. La realidad virtual (RV) es una herramienta terapéutica ampliamente utilizada en la rehabilitación cognitiva de pacientes con daño cerebral. En función de su grado de inmersividad, se puede diferenciar entre RV no inmersiva, semiinmersiva e inmersiva. Los estudios que valoran la utilidad de la RV se han centrado en las modalidades no inmersiva y semiinmersiva. Apenas se dispone de evidencias sobre la eficacia de la RV inmersiva. Objetivo. Describir las características, la calidad metodológica y los principales resultados de los estudios que han aplicado programas de RV inmersiva en la rehabilitación cognitiva de pacientes con daño cerebral. Materiales y métodos. Siguiendo las directrices PRISMA, se realizó una búsqueda bibliográfica de los trabajos publicados en las bases de datos PubMed y PsycINFO. La calidad metodológica de los artículos que cumplían los criterios de selección se evaluó mediante la escala PEDro. Resultados. Tras aplicar los criterios de inclusión y exclusión, de los 369 artículos potencialmente interesantes, cinco cumplieron los criterios de elegibilidad. Uno de ellos era un ensayo clínico aleatorizado (con una calidad metodológica aceptable/buena). Tres correspondían a estudios con medidas pre- y postratamiento y uno a un estudio de caso único, los cuatro con una calidad metodológica pobre. Conclusiones. De acuerdo con los resultados obtenidos, no hay evidencias de la eficacia ni de la utilidad de la RV inmersiva en la rehabilitación cognitiva en pacientes con daño cerebral. Este hallazgo se explica por la falta de estudios con un diseño metodológico que permita generar evidencias de calidad y no porque los resultados obtenidos en los artículos analizados sean negativos o no concluyentes.

Uso de la realidad virtual inmersiva en la rehabilitación cognitiva de pacientes con daño cerebral. Revisión sistemática / Use of immersive virtual reality for cognitive rehabilitation of patients with brain injury

Introducción: La realidad virtual (RV) es una herramienta terapéutica ampliamente utilizada en la rehabilitación cognitiva de pacientes con daño cerebral. En función de su grado de inmersividad, se puede diferenciar entre RV no inmersiva, semiinmersiva e inmersiva. Los estudios que valoran la utilidad de la RV se han centrado en las modalidades no inmersiva y semiinmersiva. Apenas se dispone de evidencias sobre la eficacia de la RV inmersiva. Objetivo: Describir las características, la calidad metodológica y los principales resultados de los estudios que han aplicado programas de RV inmersiva en la rehabilitación cognitiva de pacientes con daño cerebral. Materiales y métodos: Siguiendo las directrices PRISMA, se realizó una búsqueda bibliográfica de los trabajos publicados en las bases de datos PubMed y PsycINFO. La calidad metodológica de los artículos que cumplían los criterios de selección se evaluó mediante la escala PEDro. Resultados: Tras aplicar los criterios de inclusión y exclusión, de los 369 artículos potencialmente interesantes, cinco cumplieron los criterios de elegibilidad. Uno de ellos era un ensayo clínico aleatorizado (con una calidad metodológica aceptable/buena). Tres correspondían a estudios con medidas pre- y postratamiento y uno a un estudio de caso único, los cuatro con una calidad metodológica pobre. Conclusiones: De acuerdo con los resultados obtenidos, no hay evidencias de la eficacia ni de la utilidad de la RV inmersiva en la rehabilitación cognitiva en pacientes con daño cerebral. Este hallazgo se explica por la falta de estudios con un diseño metodológico que permita generar evidencias de calidad y no porque los resultados obtenidos en los artículos analizados sean negativos o no concluyentes.(AU)

Introduction: Virtual reality (VR) is a therapeutic tool that is widely used in the cognitive rehabilitation of brain-damaged patients. Depending on the degree of immersiveness, a distinction can be made between non-immersive, semi-immersive and immersive VR. Studies assessing the utility of VR have focused on the non-immersive and semi-immersive modes. Little evidence is available on the effectiveness of immersive VR. Aim: To describe the characteristics, methodological quality and main results of studies that have applied immersive VR programmes in the cognitive rehabilitation of brain-damaged patients. Materials and methods: Following the PRISMA guidelines, a bibliographic search was conducted for studies published in the PubMed and PsycINFO databases. The methodological quality of the articles that met the selection criteria was assessed using the PEDro scale. Results: After applying the inclusion and exclusion criteria, of the 369 articles of potential interest, five met the eligibility criteria. One of them was a randomised clinical trial (with acceptable/good methodological quality). Three were studies with pre- and post-treatment measures and one was a single case study, all four of them displaying poor methodological quality. Conclusions: According to the results obtained, there is no evidence of the effectiveness or utility of immersive VR in cognitive rehabilitation in brain-damaged patients. This finding is explained by the lack of studies with a methodological design that allows for the generation of quality evidence rather than because the results obtained in the articles analysed are negative or inconclusive.(AU)

Computerized social cognitive training in the subacute phase after traumatic brain injury: A quasi-randomized controlled trial.

OBJECTIVES: To assess the usefulness of a computerized tasks module designed for the rehabilitation of social cognition (SC) in acquired brain injury. METHODS: Quasi-randomized controlled trial (ClinicalTrials.gov:NCT03479970) involving 45 patients with moderate-severe traumatic brain injury (TBI) in a subacute inpatient rehabilitation hospital. The experimental group (n = 28) received treatment with a computerized SC module in combination with a non-SC module. The control group (n = 26) only received a treatment with non-SC module. RESULTS: Intragroup comparisons showed that the experimental group had better results for all SC measures, except for International Affective Picture System (IAPS). The control group improved for Facial Expressions of cEmotion-Stimuli and Tests (FEEST) and Moving Shapes Paradigm (MSP), showing no changes with respect to pretreatment in IAPS, MSP and Reading the Mind in the Eyes Test (RMET). Intergroup comparisons did not present differences between the two groups for pretreatment measures. Post-treatment comparison showed that the experimental group obtained better results for RMET than the control group. CONCLUSION: The computerized SC module was useful for the rehabilitation of SC in patients with moderate-severe TBI in the subacute phase. The group that received combined rehabilitative treatment (SC + non-SC) obtained better results for SC than the group that received treatment intended only for non-SC.

Social and nonsocial cognition: Are they linked? A study on patients with moderate-to-severe traumatic brain injury.

OBJECTIVES: The first aim was to study the relationship between Social Cognition (SC) and nonsocial Cognition (n-SC) measures in a group of patients with moderate or severe traumatic brain injury (TBI) to assess the dependence or independence of both types of cognition. The second aim was to explore the relationships between SC measures and generate a model based on the results of these relationships. METHODS AND PROCEDURES: Forty-three subacute patients with TBI were included in the study. They were administered a SC battery and n-SC battery. SC battery included the following measures: International Affective Picture System (IAPS); Facial Expressions of Emotion-Stimuli Test (FEEST); Moving Shapes Paradigm (MSP); Reading the Mind in the Eyes Test- Revised Version (RMET); Social Decision Making Task (SDMT). n-SC battery included Digit Span Forwards and Backwards; Trail Making Test (Part A); Rey's Auditory Verbal Learning Test; Letter-Number Sequencing; and verbal fluency test (PMR). RESULTS: FEEST, MSP and RMET were related to n-SC measures. The exploratory factor analysis shows a two-factor SC structure: Factor 1: Emotional recognition and mentalization (FEEST, MSP and RMET) and Factor 2: Acquisition and contextualization (IAPS and SDMT). CONCLUSION: The performance of subjects with moderate-to-severe TBI in the SC measures is related, at least partially, by the performance in the n-SC measures. Our SC model shows a two-factor structure characterized by a first factor that brings together SC measures that are highly related to n-SC domains and a second factor that brings together measures whose performance is not influenced by n-SC domains.

Intervención no farmacológica en la amnesia postraumática, una revisión sistemática / Non-pharmacological intervention in post-traumatic amnesia, a systematic review

Introducción: Las personas que sobreviven a un traumatismo craneoencefálico pueden presentar un estado transitorio de confusión y perturbación global del funcionamiento cognitivoconductual denominado amnesia postraumática. Objetivo: Describir las características, la calidad metodológica y los principales resultados de los estudios que han analizado el impacto de las intervenciones no farmacológicas en el tratamiento de los síntomas asociados a la amnesia postraumática. Pacientes y métodos: Siguiendo las directrices PRISMA, se realizó una búsqueda bibliográfica de los trabajos publicados en las bases de datos PubMed y PsycInfo durante los últimos 20 años (2000-2020). La calidad metodológica de los artículos se evaluó mediante la escala PEDro. Resultados: Tras aplicar los criterios de inclusión y exclusión, de los 1.036 artículos potencialmente interesantes, ocho cumplieron los criterios de elegibilidad; de estos, cuatro eran ensayos clínicos aleatorizados. Las intervenciones aplicadas se agruparon de la siguiente forma: reentrenamiento estructurado de las actividades de la vida diaria (cuatro estudios), programa de orientación a la realidad (dos estudios), sistema Perceive, Recall, Plan and Perform (un estudio) y aplicación terapéutica de la música (un estudio). Siete de los ocho artículos revisados mostraron resultados positivos o parcialmente positivos. Conclusiones: De acuerdo con los resultados obtenidos, hay indicios de que las intervenciones no farmacológicas tienen efectos positivos en la disminución de la sintomatología cognitivoconductual asociada a la amnesia postraumática.(AU)

Introduction: Survivors of traumatic brain injury may experience a transient state of confusion and global disturbance of cognitive-behavioural functioning called post-traumatic amnesia.Aim. To describe the characteristics, methodological quality and main results of studies that have analysed the impact of non-pharmacological interventions in the treatment of symptoms associated with post-traumatic amnesia. Patients and methods: Following the PRISMA guidelines, a literature search was carried out on papers published in the PubMed and PsycInfo databases over the last 20 years (2000-2020). The methodological quality of the articles was assessed using the PEDro scale. Results: After applying the inclusion and exclusion criteria, of the 1,036 potentially interesting articles, eight met the eligibility criteria, four of which were randomised clinical trials. The interventions applied were grouped as follows: structured retraining of activities of daily living (four studies), reality orientation programme (two studies), Perceive, Recall, Plan and Perform system (one study) and therapeutic application of music (one study). Seven of the eight articles reviewed showed positive or partially positive results. Conclusions: According to the results obtained, there is evidence that non-pharmacological interventions have positive effects on reducing the cognitive-behavioural signs and symptoms associated with post-traumatic amnesia.(AU)

[Non-pharmacological intervention in post-traumatic amnesia, a systematic review]. / Intervención no farmacológica en la amnesia postraumática, una revisión sistemática.

INTRODUCTION: Survivors of traumatic brain injury may experience a transient state of confusion and global disturbance of cognitive-behavioural functioning called post-traumatic amnesia. AIM: To describe the characteristics, methodological quality and main results of studies that have analysed the impact of non-pharmacological interventions in the treatment of symptoms associated with post-traumatic amnesia. PATIENTS AND METHODS: Following the PRISMA guidelines, a literature search was carried out on papers published in the PubMed and PsycInfo databases over the last 20 years (2000-2020). The methodological quality of the articles was assessed using the PEDro scale. RESULTS: After applying the inclusion and exclusion criteria, of the 1,036 potentially interesting articles, eight met the eligibility criteria, four of which were randomised clinical trials. The interventions applied were grouped as follows: structured retraining of activities of daily living (four studies), reality orientation programme (two studies), Perceive, Recall, Plan and Perform system (one study) and therapeutic application of music (one study). Seven of the eight articles reviewed showed positive or partially positive results. CONCLUSIONS: According to the results obtained, there is evidence that non-pharmacological interventions have positive effects on reducing the cognitive-behavioural signs and symptoms associated with post-traumatic amnesia.

TITLE: Intervención no farmacológica en la amnesia postraumática, una revisión sistemática.Introducción. Las personas que sobreviven a un traumatismo craneoencefálico pueden presentar un estado transitorio de confusión y perturbación global del funcionamiento cognitivoconductual denominado amnesia postraumática. Objetivo. Describir las características, la calidad metodológica y los principales resultados de los estudios que han analizado el impacto de las intervenciones no farmacológicas en el tratamiento de los síntomas asociados a la amnesia postraumática. Pacientes y métodos. Siguiendo las directrices PRISMA, se realizó una búsqueda bibliográfica de los trabajos publicados en las bases de datos PubMed y PsycInfo durante los últimos 20 años (2000-2020). La calidad metodológica de los artículos se evaluó mediante la escala PEDro. Resultados. Tras aplicar los criterios de inclusión y exclusión, de los 1.036 artículos potencialmente interesantes, ocho cumplieron los criterios de elegibilidad; de estos, cuatro eran ensayos clínicos aleatorizados. Las intervenciones aplicadas se agruparon de la siguiente forma: reentrenamiento estructurado de las actividades de la vida diaria (cuatro estudios), programa de orientación a la realidad (dos estudios), sistema Perceive, Recall, Plan and Perform (un estudio) y aplicación terapéutica de la música (un estudio). Siete de los ocho artículos revisados mostraron resultados positivos o parcialmente positivos. Conclusiones. De acuerdo con los resultados obtenidos, hay indicios de que las intervenciones no farmacológicas tienen efectos positivos en la disminución de la sintomatología cognitivoconductual asociada a la amnesia postraumática.

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Rehabilitation of social cognition impairment after traumatic brain injury: A systematic review. / Rehabilitación de la cognición social en el traumatismo craneoencefálico: una revisión sistemática.

INTRODUCTION: Many studies have described the presence of difficulty processing and generating social behaviour in patients who have suffered a traumatic brain injury (TBI). These difficulties in social cognition (SC) deteriorate personal relationships in the family, at work, or in the community. However, therapeutic programmes aiming to improve SC continue to be an outstanding issue in clinical practice. We performed a systematic review of the existing literature on the recovery of SC in patients with TBI, assessing the methodological quality of the included studies and the therapeutic effectiveness of the rehabilitation strategies used. DEVELOPMENT: We performed a bibliographic search of papers published before June 2018 in the Medline/PubMed, Google Scholar, PsycINFO, and ClinicalTrials.gov databases. Of the 198 potentially relevant articles, 10 met our eligibility criteria. Two of the authors independently and blindly assessed the methodological quality of these studies using the PEDro scale. CONCLUSIONS: The articles included in this systematic review essentially studied the effect of different interventions aimed at the rehabilitation of SC in patients with chronic TBIs. The analysis showed adequate methodological quality and an acceptable level of evidence. Future research should analyse the effect of these interventions in patients with TBIs in the sub- and post-acute phases.

¿Es posible potenciar la recuperación espontánea después de un ictus? Ensayo controlado aleatorizado con pacientes que presentan heminegligencia espacial / Can spontaneous neurological recovery of visuospatial neglect be maximised in patients with a right hemispheric stroke?

Introducción. Aproximadamente el 25-30% de los pacientes que presentan un ictus muestran signos de heminegligencia espacial. Los objetivos del presente trabajo fueron dos: 1) valorar cómo el tiempo transcurrido entre el ictus y el inicio de tratamiento repercute (o puede llegar a repercutir) en la mejora del paciente y 2) analizar la respuesta de los pacientes a dos tipos de tratamientos (tratamiento único: estimulación cognitiva informatizada vs. tratamiento combinado: estimulación cognitiva informatizada junto con la técnica del right hemifield eye-patching). Material y método. Ensayo clínico aleatorizado realizado con 31 pacientes. Dos grupos experimentales: grupo tratamiento único (n=18) y grupo tratamiento combinado (n=13). Cada grupo de tratamiento fue dividido en función del tiempo transcurrido entre el ictus y el inicio del tratamiento (≤ 12 semanas vs.>12 semanas). Todos ellos recibieron una media de 15 sesiones de rehabilitación cognitiva informatizada de una hora de duración mediante la plataforma de telerrehabilitación Guttmann, NeuroPersonalTrainer®, con la diferencia de que el grupo que recibió el tratamiento combinado ejecutó los ejercicios de rehabilitación con un dispositivo visual que llevaba el hemicampo derecho de cada ojo ocluido. Resultados. Los resultados obtenidos tras aplicar los tratamientos indican cambios a nivel intragrupal en los cuatro grupos; sin embargo, no se obtienen diferencias intergrupales. Conclusiones. Ni el tiempo transcurrido entre el ictus y el inicio del tratamiento, ni recibir un tratamiento combinado respecto a uno único, parecen ser variables concluyentes que influyan en la mejora de estos pacientes (AU)

Introduction. Approximately 25-30% of patients with stroke show signs of visuospatial neglect. The objectives of the present study were two-fold: 1) to assess how the time between stroke and the start of treatment impacts (or can impact) patient improvement, and 2) to analyse patient response to two treatments (single treatment: computerised cognitive stimulation vs. combination treatment: computerised cognitive stimulation with right hemifield eye-patching). Material and method. A randomised clinical trial was conducted in 31 patients. These were grouped into two experimental groups: a single treatment group (n=18) and a combined treatment group (n=13). Each treatment group was divided according to the period that elapsed between the stroke and the start of treatment (≤ 12 weeks vs.>12 weeks). All received an average of 15 one-hour sessions of computerised cognitive rehabilitation using the Guttmann, NeuroPersonalTrainer(R) telerehabilitation platform. Patients in the combined treatment group performed the sessions wearing a visual device that occluded the right hemifield of each eye. Results. The results obtained after application of these treatments indicated changes at the intragroup level in the four groups analysed. However, no between-group differences were found. Conclusions. Neither the time between the stroke and the beginning of treatment nor the type of treatment received are conclusive variables influencing improvement in these patients (AU)