8. 50.exp human/ 42. Results regarding the effectiveness of treatment can only be inferred, and this evidence is based on only one trial with a small sample size. 5. exp glasgow outcome scale/ (Amphetamine or Bemegride or Benzphetamine or Caffeine or Dextroamphetamine or Doxapram, or Ephedrine or Harmaline or Mazindol or Methamphetamine or Methylphenidate or Nikethamide or Pemoline or Phenmetrazine or Phentermine or Picrotoxin or bromocriptine or selegiline or Amantadine or Amphetamine or Benserazide or Benzphetamine or Carbidopa or Dextroamphetamine or Dihydroxyphenylalanine or Dopamine or Fusaric Acid or Levodopa or Memantine or Methamphetamine or Methylphenidate).ab,ti. 38. "Ranchos Los Amigos Scale".ab,ti. To investigate the effectiveness of interventions for apathy in adults who have sustained a TBI. There was no increase in seizure numbers due to CES. Rehabilitation/ 21. exp Behavior Therapy/ Results: A specific treatment effect was . Not traumatic brain injury (same participants as Feldman 2003). They were jointly responsible for reviewing papers. 5. As far as the authors are aware, there is not another systematic review on interventions for apathy. Given that no between-group analysis was reported, it was not possible to determine if the CES treatment group improved significantly more than the control group. official website and that any information you provide is encrypted 40 and 52, #1. (#1 or #2 or #3 or #4 or #6) 44. placebo.ti,ab. However, apathy is still described in a number of different ways. ts aimed at sustaining activity toward goal-directed behavior. It sits on the continuum of disorders of decreased motivation, with apathy at the end of lesser severity, ranging through abulia (poverty of behaviour and speech) (Marin 2005b) to akinetic mutism (total absence of speech or movement in the presence of visual tracking) (American Congress of Rehabilitation Medicine 1995) at the most severe end. 38. exp Drug Therapy/ To the best of our knowledge there is no published systematic review examining interventions for apathy after TBI. 21. 14 and 15 Would you like email updates of new search results? #11(Unconscious* or coma* or concuss* or 'persistent vegetative state'):ti or (Unconscious* or coma* or concuss* or 'persistent vegetative state'):ab Boyko M, Gruenbaum BF, Shelef I, Zvenigorodsky V, Severynovska O, Binyamin Y, Knyazer B, Frenkel A, Frank D, Zlotnik A. Transl Psychiatry. Cognitive therapy/ or Behavior therapy/ We made attempts to contact the trial investigators in the case of missing data. 47. or/2246 11 and 21 and 47 and 58. Politis AM, Apathy is a deficiency in overt behavioural, emotional and cognitive components of goaldirected behaviour. 46. placebo$.ab,ti. 3. exp Brain Disorders/ Betweengroup statistical analysis was not reported in this study. Gauthier S, Sham treatment and no treatment control groups did not show improvements in inertia over time. 18. exp ATTITUDE/ The impact of apathy is widespread, hampering physical rehabilitation, coping skills (Finset 2000), vocational outcome, independence in the home (Prigatano 1992), and increasing family burden (Marsh 1998). This review only included RCTs as they are considered the highest level of evidence. Furthermore, this trial was awarded PEDro points for items that are traditionally difficult to achieve for a nonpharmacological study (Perdices 2006). DRIVE explode all trees (MeSH) This suggests that the study may not have adequate power. 36. 23. Given that the study did not report results of betweengroup statistical analyses, it was not possible to ascertain if the CES group improved significantly more than the control groups. Brain concussion/ 50. It includes an entire series of steps or stages of cellular, chemical, tissue, or blood vessel changes in the brain that contribute to further destruction of brain tissue. 27. Ames D, CRANIOCEREBRAL TRAUMA explode all trees (MeSH) No other adverse events were reported. Statistical analysis was to be performed using Review Manager 5. CES was investigated as a method of intervention for closedhead injury patients residing in a sheltered living facility. Additionally, we examined key conference proceedings and reference lists of included trials to identify further studies meeting the inclusion criteria. The review authors searched the literature for treatment studies of apathy, or a component of apathy, in people who have had a traumatic brain injury. Cutoff score on the apathy evaluation scale in subjects with traumatic brain injury, Quantifying heterogeneity in metaanalysis, Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005], Assessing risk of bias in included studies, Cochrane Handbook for Systematic Reviews of Interventions, Prevalence of apathy following head injury, Assessment and treatment of apathy syndrome following head injury. Hoefnagels WH, 45.randomly.ab,ti. Vellas B, Apathy describes an absence of feeling or emotion. Trials would be considered statistically heterogenous if the I2 statistic was over 50% (Higgins 2005). 29. If the trials were statistically homogenous, we would have utilised the fixedeffect method. 41. We have systematically reviewed studies examining the effectiveness of interventions for apathy in the TBI population. "Rancho Los Amigos Scale".ab,ti. 15. or/1114 6. exp UNCONSCIOUSNESS/ It comprises 11 items as follows: Each item was evaluated and totaled to give a total score out of 10 (items 2 to 11). Emotional components that were investigated for change include indifference, lack of concern and flattened affect. eCollection 2022. Participatory co-creation of an adapted physical activity program for adults with moderate-to-severe traumatic brain injury. This search yielded a total of 1251 references. Apathy is commonly described following traumatic brain injury (TBI) and is associated with serious consequences, notably for patients' participation in rehabilitation, family life and later social reintegration. Jiang S, Zhang H, Fang Y, Yin D, Dong Y, Chao X, Gong X, Wang J, Sun W. Brain Sci. (amphetamine or bemegride or benzphetamine or caffeine or dextramphetamine or doxapram or ephedrine or harmaline or mazindol or methamphetamine or methylphenidate or nikethamide or pemoline or phenmetrazine or phentermine or picrotoxin or bromocriptine or selegine or amantadine or amphetamine or benserazide or benzphetamine or carbidopa or dextramphetamine or dihydroxyphenylalanine or dopamine or fusaric acid or levodopa or memantine).ab,ti. Perdices M, 12. or/111 (amphetamine or bemegride or benzphetamine or caffeine or dextramphetamine or doxapram or ephedrine or harmaline or mazindol or methamphetamine or methylphenidate or nikethamide or pemoline or phenmetrazine or phentermine or picrotoxin or bromocriptine or selegine or amantadine or amphetamine or benserazide or benzphetamine or carbidopa or dextramphetamine or dihydroxyphenylalanine or dopamine or fusaric acid or levodopa or memantine).ab,ti. 55. exp placebo/ 9.exp unconsciousness/ or exp coma/ 27. exp complementary therapies/ More randomised controlled trials evaluating different ways of treating apathy would be valuable. The aim of this review was to identify and evaluate the effectiveness of interventions for apathy following a traumatic brain injury (TBI). Gibson S, ((complementary or alternative) adj1 (medicine or therap$ or treatment$)).ab,ti. Rehabilitation Studies Unit, University of Sydney, Australia. 25. exp Program Evaluation/ 26. exp Treatment Outcomes/ "glascow coma scale$".ab,ti. Apathy is a common problem after traumatic brain injury (TBI) and can have a major impact on cognitive function, psychosocial outcome and engagement in rehabilitation. GOALS explode all trees (MeSH) Assessment of apathy is further complicated by use of a number of omnibus measures that assess apathy along with a number of other physiological, cognitive and psychological factors, such as fatigue, disinhibition and depressed mood. Cognitive interventions, such as external compensation via checklists and paging systems have been shown to increase initiation towards goaldirected activity (Evans 1998). Physiotherapy/ Baker E, Apathy is a decrease in cognitive, behavioural and emotional components of goaldirected activity due to reduced motivation. "Rancho Los Amigos Scale".ab,ti. Personality disturbances associated with traumatic brain injury, Journal of Consulting and Clinical Psychology, Music therapy with adults who have traumatic brain injury and stroke, Differentiation of states and causes of apathy. #15. This change did not affect the results of this review. Cochrane Evidence Synthesis and Methods Treatment for apathy in people with traumatic brain injury Many people who have a traumatic brain injury experience apathy. The two authors extracted data from trials and compared results. How can occupational therapy improve the daily performance and communication of an older patient with dementia and his primary caregiver? 48. assign$.ab,ti. The limited number of trials included in this review indicates that more controlled trials are required in this area. 14 and 22, 1.exp Head Injury/ #3. 43. placebo.ti,ab. Before There was also no indication that participants received the treatment to which they were allocated or that any of the key outcomes were analysed by intentiontotreat. 45. Two double-blind, randomized, single-case experimental (baseline-amantadine-placebo-withdrawal) design (SCED) studies. McDonald S, ATTITUDE explode all trees (MeSH) 4. 35. 44.placebo.ti,ab. 21. The review authors searched the literature for treatment studies of apathy, or a component of apathy, in people who have had a traumatic brain injury. Use of lysinevasopressine in the treatment of posttraumatic amnesia. We searched reference lists of included articles and proceedings of key conferences for any further studies that met the inclusion criteria. 23. exp SPEECH THERAPY/ or exp RECREATIONAL THERAPY/ or exp PHYSICAL THERAPY/ or exp OCCUPATIONAL THERAPY/ or exp MUSIC THERAPY/ or exp DRUG THERAPY/ . Goals/ For example, it has been operationalised as engagement (Fitzsimmons 2003) or lack of selfinitiated action (Stuss 2000). 17 and 22 #12. ((Physical or executive or physiotherapy or psychological or occupational or speech or "problem solving" or plan$ or music or art) adj1 (training or treatment or rehab$ or remed$ or program$ or intervention$ or therap$ or approach or technique$ or modification or strateg$ or manag$)).ab,ti. Brain injuries/ 30. "speech pathology".ab,ti. We searched the following databases up to January 2008: CENTRAL (The Cochrane Library 2008, Issue 1), Database of Abstracts of Reviews of Effects, ACP Journal Club, MEDLINE (1950 to Jan 2008), EMBASE (1980 to Jan 2008), PsycINFO (1806 to Jan 2008), CINAHL (1982 Jan 2008), PsycBITE, AMED (1985 to Jan 2008), www.controlled-trials.com, www.clinicaltrials.gov and www.actr.org.au.The Cochrane Injuries Group's Specialised Register was searched to Jan 2009. 21. HHS Vulnerability Disclosure, Help Lanctot KL, #11. 15. (psychostimulant$ or "stimulant treatment").ab,ti. 27. exp Treatment Outcomes/ Fairbanks L, 7. Definition of mild traumatic brain injury. We thank the Cochrane Injuries Group for their assistance throughout the review process. (((cognitive or behavio?r$) adj1 therapy) or CBT or "cognitive rehabilitation" or neurorehabilitation).ab,ti. #18MeSH descriptor Attitude explode all trees Betweengroup statistical analyses were not conducted and it was therefore not possible to determine the efficacy of the treatment relative to no treatment or sham treatment. 4.exp glasgow coma scale/ or exp glasgow outcome scale/ or exp rancho los amigos scale/ This study met the criteria for inclusion because it measured the effect of treatment on inertia, a behavioural element of apathy. Careers. ((clin$ or control$ or compar$ or evaluat$ or prospectiv$) adj3 (trial$ or studi$ or study)).ab,ti. There were no analyses reported to establish that the intervention groups were similar at baseline. 3. et al. Apathy is a common occurrence after neurological damage. It is a common occurrence after traumatic brain injury (TBI), with widespread impact. Reekum R, As anticipated, outcome measures were continuous. 42. clinical trial.pt. 2022 Dec 21. doi: 10.1111/1460-6984.12836. It was anticipated that there would be considerable clinical heterogeneity, given that the type of interventions targeting apathy ranges from psychological to pharmacological. #10"Glasgow coma scale" or "Glasgow outcome scale" or "Glasgow outcome score":ti or "Glasgow coma scale" or "Glasgow outcome scale" or "Glasgow outcome score":ab Front Rehabil Sci. Outcome measures of everyday functioning, participation levels (in community settings, rehabilitation settings, activities of daily living and other activities such as hobbies), psychosocial functioning, general aspects of cognition, general aspects of mood and affect, treatment compliance and service usage. Subgroup analysis will be performed in the case of a number of studies being located in the future that could be clustered according to one of the following groupings: We conducted the most current search of electronic databases in January 2008. Naranjo CA. 49 not (49 and 50) Caregiver burden at 1 year following severe traumatic brain injury, Goal planning and neurorehabilitation: The Wolfson Neurorehabilitation Centre approach. Many people who have a traumatic brain injury experience apathy. The Smith 1994 paper had two other potential sources of bias. Schultz R, et al. Apathy is a deficiency in overt behavioural, emotional and cognitive components of goal-directed behaviour. 57. 52. or/4051 This trial (N = 21) showed that cranial electrotherapy stimulation (CES) decreased inertia, which is a component of apathy, while no changes were seen in the sham treatment or no treatment control groups. 25. exp Rehabilitation/ or exp Neuropsychological Rehabilitation/ or exp Cognitive Rehabilitation/ The included trial (Smith 1994) is of moderate methodological quality, according to the PEDro scale. #35(psychostimulant* or "stimulant treatment"):ti or (psychostimulant* or "stimulant treatment"):ab Bethesda, MD 20894, Web Policies 28.exp alternative medicine/ D'Ippolito M, Spinelli G, Iosa M, Aglioti SM, Formisano R. Brain Sci. It is characterised by lessened activity, initiative and concern about working towards and achieving goals. Individual item scores can be found in Table 1. It is a common occurrence after traumatic brain injury (TBI), with widespread impact. We would have performed a metaanalysis had there been enough trials present that were clinically homogenous (for example, all pharmacological interventions). Although all participants were said to have sustained a closed head injury, the report indicated a number of additional injuries such as gas poisoning and cerebral carcinoma. The Smith 1994 article described results supporting decreases over time in inertia, an element of apathy, with cranial electrotherapy stimulation (CES) treatment. This study sought an alternative to pharmacological treatment and therefore examined cranial electrotherapy stimulation (CES). ((singl$ or doubl$ or trebl$ or tripl$) adj3 (blind$ or dummy or mask$)).ab,ti. #27MeSH descriptor Art Therapy explode all trees Before 28. exp drug therapy/ 41. 36. 50. exp humans/ 2013 Sep;23(3):210-33. doi: 10.1007/s11065-013-9236-3. Language therapy/ Elkins M. Reliability of the PEDro scale for rating quality of randomised controlled trials, Differential diagnosis and classification of apathy. CruzOrduna I, Hozumi S, 50. Detecting simulated versus bona fide traumatic brain injury using pupillometry. 46. Art therapy/ et al. Given that betweengroup statistical analysis was not reported, it was not possible to determine if the CES group improved significantly more than the control groups. Placebos/ We screened search results by reviewing titles and abstracts of all citations to assess whether they met the criteria for inclusion. Apathy is characterised by impaired initiation, activity and diminished concern, generally with intact communication (Marin 2005). The https:// ensures that you are connecting to the The fatigue/inertia domain scale reported a mean decrease from 7.44 to 5.33 (see Table 2). This technique is commonly used in rehabilitation centres because it allows treatment to be targeted to individual needs and success to be easily measured (Wilson 2002). Simanyi B, Mantanus H, 37. exp Alternative Medicine/ 35. Cummings JL, Scherzer P, Baker AS, More methodologically rigorous studies need to be conducted to investigate different methods of effectively treating apathy in people with traumatic brain injury. 19. The Northern Medical Research Foundation, Northern Clinical School, University of Sydney and the Australian Government assisted in funding this review. 3. exp Cerebral Hemorrhage/ or exp Subarachnoid Hemorrhage/ 27. exp Intervention Trials/ Tate R, Participants were randomised into three groups: CES, a sham treatment control and a no treatment control. "Glasgow outcome scale".ab,ti. #37(Physical or executive or physiotherapy or psychological or occupational or speech or "problem solving" or plan* or music or art) next (training or treatment or rehab* or remed* or program* or intervention* or therap* or approach or technique* or modification or strateg* or manag*):ti or (Physical or executive or physiotherapy or psychological or occupational or speech or "problem solving" or plan* or music or art) next (training or treatment or rehab* or remed* or program* or intervention* or therap* or approach or technique* or modification or strateg* or manag*):ab Many people who have a traumatic brain injury experience apathy. All participants for whom outcome measures were available received the treatment of control condition as allocated or, where this was not the case, data for at least 1 key outcome was analysed by intentiontotreat, 10. The only way to definitively diagnosis CTE is after death during an autopsy of the brain. Thus, the findings of this review must be viewed in light of the potential areas of confound and bias. #17MeSH descriptor Intention explode all trees (Unconscious$ or coma$ or concuss$ or 'persistent vegetative state').ab,ti. (central nervous system adj1 (agent$ or stimulant$)).ab,ti. These symptoms may include headaches, dizziness, and problems with concentration and memory. 10 and 15 Burke DT, #7. Quilico E, Wilkinson S, Duncan L, Sweet S, Bdard E, Trudel E, Colantonio A, Swaine B. We rated the methodological quality of included studies and extracted data. Behavioural therapies have also been observed to reduce apathy. You might: stop caring about everyday tasks, hobbies . 13. or/512 Apathy is also distinguished from other causes of decreases in goaldirected activity, including diminished level of consciousness, severe intellectual impairment or emotional distress (Marin 1990) such as depression (Levy 1998). This strongly suggests a need for further methodologically rigorous investigations. Jacques MC, Pere J, 11. Speech therapy/ 11. Behavior Therapy or Occupational Therapy or Physical Therapy Modalities or art therapy or music therapy or Complementary Therapies or Drug Therapy or Dopamine Agents or Central Nervous System Stimulants or Central Nervous System Agents or cognitive behavior therapy or cognitive behaviour therapy or CBT or "cognitive rehabilitation" or neurorehabilitation or "speech pathology" or psychostimulant* or "stimulant treatment" or complementary medicine or complementary therapy or complementary treatment or alternative medicine or alternative therapy or alternative treatment* or "problem solving" or Amphetamine or Bemegride or Benzphetamine or Caffeine or Dextroamphetamine or Doxapram, or Ephedrine or Harmaline or Mazindol or Methamphetamine or Methylphenidate or Nikethamide or Pemoline or Phenmetrazine or Phentermine or Picrotoxin or bromocriptine or selegiline or Amantadine or Amphetamine or Benserazide or Benzphetamine or Carbidopa or Dextroamphetamine or Dihydroxyphenylalanine or Dopamine or Fusaric Acid or Levodopa or Memantine or Methamphetamine or Methylphenidate, (((head or crani* or cerebr* or capitis or brain* or forebrain* or skull* or hemispher* or intracran* or intercran*) AND (injur* or trauma* or damag* or wound* or fracture* or contusion*)) OR ((head or crani* or cerebr* or brain* or intracran* or intercran*) AND (haematoma* or hematoma* or haemorrhag* or hemorrhag* or bleed* or pressure))) AND (attitude or initiation or persistence or generativity or apathy or motivation or goal* or intention or drive* or persever* or anergia or indifference or drive or inertia or frontal lobe impairment). This disruption must result in at least one of the following: a) loss of consciousness, b) alteration of mental state at the time of the injury, c) loss of memory immediately before or after the impact, or d) focal neurological deficits that may or may not be transient (Kay 1993). More methodologically rigorous studies need to be conducted to investigate different methods of effectively treating apathy in people with traumatic brain injury. Apathy is a deficiency in overt behavioural, emotional and cognitive components of goaldirected behaviour. (((cognitive or behavio?r$) adj1 therapy) or CBT or "cognitive rehabilitation" or neurorehabilitation).ab,ti. Had the data been more suited to metaanalysis (including being clinically homogenous), we would have examined the data for statistical heterogeneity. 20. (psychostimulant$ or "stimulant treatment").ab,ti. (psychostimulant$ or "stimulant treatment").ab,ti. We use cookies to improve your experience on our site. Therapy/ 12. 41 and 49, 1. #21(#13 AND #20) Future studies should aim to have larger numbers of participants. (initiation or persistence or generativity or apathy or motivation or goal$ or intention or persever$ or anergia or indifference or drive or inertia or frontal lobe impairment).ab,ti. A TBI is defined as a physiological disruption to normal brain function that has been caused by a traumatic event (such as a blow to the head or a sudden acceleration/deceleration movement). 21. or/1220 ((physical or executive or physiotherapy or psychological or occupational or speech or "problem solving" or plan$ or music or art) adj1 (training or treatment or rehab$ or remed$ or program$ or intervention$ or therap$ or approach or technique$ or modification or strateg$ or manag$)).ab,ti. Types of outcome measures included in this review were neuropsychological tests, psychological tests, behavioural observation, self or observer report, psychological rating scales and questionnaires. Online ahead of print. Savage S, ((complementary or alternative) adj1 (medicine or therap$ or treatment$)).ab,ti. In the case of a number of clinically homogenous trials, statistical heterogeneity will be assessed through the Chi2 test and the I2 statistic (Higgins 2002). In the case of missing information in trials, we made attempts to contact the original investigators. #14. Kersel DA, 8. Emir B, Apathy is one of the disorders of diminished motivation (Marin 2005) and is defined as a deficiency in overt behavioural, emotional and cognitive components of goaldirected behaviour (Marin 1996). Randomized controlled trials/ Moseley A, Overall, the Smith 1994 study received a total score of 6/10. 22.or/1821 In the meantime, additional ideas about treatment options could be gained from reviewing trials that investigated interventions for apathy, but did not meet the criteria for this review. (#8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17) et al. 3. To allow for metaanalysis and pooling of data in the future, it is necessary for interventions to use either a standardised operational definition of apathy or treat comparable elements of apathy. sharing sensitive information, make sure youre on a federal Unable to load your collection due to an error, Unable to load your delegates due to an error. In the TBI population there was only one trial that treated the syndrome of apathy rather than a component of apathy (Newburn 2005). We identified one trial that satisfied the inclusion criteria for this review. 34. #8. 6. consciousness disturbances/ Careers, Unable to load your collection due to an error. 39. or/2138 39 and 40 Hynan LS, We contacted researchers who have already conducted trials in this area to identify any published, unpublished or ongoing trials. ((clin$ or control$ or compar$ or evaluat$ or prospectiv$) adj3 (trial$ or studi$ or study)).ab,ti. : CD006341. 39 and 56, #1MeSH descriptor Craniocerebral Trauma explode all trees 35. For scientists and clinicians it remains one of the least understood aspects of brain-behaviour relationships encompassing disturbances of cognition, motivation, emotion and action, and is variously an indication of organic . 49.exp animal/ The https:// ensures that you are connecting to the 9. Music therapy/ 7. We identified one trial that satisfied the inclusion criteria for this review. 6. J Neurotrauma. Traumatic brain injury, closed head injury males residing in a sheltered living facility in the USA. Miller B, A multidimensional approach to apathy after traumatic brain injury. #30MeSH descriptor Drug Therapy explode all trees 10. et al. Neurobehavioural disorders of apathy are characterised chiefly by dysfunction of executive control of goal-oriented behaviour or the neural substrates of reward-based and emotional learning. Goalsetting therapy is another type of behavioural intervention that can assist in the rehabilitation of apathy. 21 and 39 23. exp Cognitive Therapy/ For example, the right supramarginal gyrus helps people overcome egocentric bias (self-centeredness) when making decisions. Any type of intervention aimed at treating apathy was included. 25. "Ranchos Los Amigos Scale".ab,ti. Cummings J, 24. exp REHABILITATION/ or exp REHABILITATION, COGNITIVE/ More research is needed using larger sample sizes, and reporting betweengroup statistical analyses, to confirm these findings. We rated the methodological quality of included studies and extracted data. Where there was not a colleague fluent in the language, we obtained a translation through the Cochrane Collaboration. 20.exp attitude to life/ 2002. Journal of Neuropsychiatry and Clinical Neurosciences. 39. exp CNS Stimulating Drugs/ 2. exp cerebrovascular trauma/ The primary objective of this review was to evaluate the effectiveness of interventions for apathy following TBI. Federal government websites often end in .gov or .mil. Head injuries/ ((head or crani$ or cerebr$ or brain$ or intracran$ or intercran$) adj3 (h$ematoma$ or hemorrhag$ or bleed$ or pressure)).ab,ti. When assessing the evidence, variability within the literature about the term apathy should be considered. #14MeSH descriptor Motivation explode all trees 41 or 42 or 43 or 44 or 45 or 46 or 47 Drug therapy/ Politis 2004), whilst others describe motivational deficits (Powell 1996) or an amotivational syndrome (van Reekum 1995). Given that no betweengroup analysis was reported, it was not possible to determine if the CES treatment group improved significantly more than the control group. There was no mention within the Smith 1994 article of allocation to group being concealed, indicating an area of potential bias. Epub 2021 Jun 10. (initiation or persistence or generativity or apathy or motivation or goal$ or intention or persever$ or anergia or indifference or inertia or frontal lobe impairment).ab,ti. Cognitive components investigated for change include initiation, ability to sustain behaviour, ability to stay on task and ability to generate material. "Diffuse axonal injur$".ab,ti. This review indicates that this is an area of research which has not been examined with methodologically rigorous techniques. Experimental treatment: cranial electrotherapy stimulation given 45 minutes/day, 4 days/week for 3 weeks. Baker R, #29MeSH descriptor Complementary Therapies explode all trees Inclusion in an NLM database does not imply endorsement of, or agreement with, 32. 26.exp art therapy/ #19(initiation or persistence or generativity or apathy or motivation or goal* or intention or persever* or anergia or indifference or drive or inertia or "frontal lobe impairment"):ti or (initiation or persistence or generativity or apathy or motivation or goal* or intention or persever* or anergia or indifference or drive or inertia or "frontal lobe impairment"):ab 17. exp INTENTION/ Copyright 2018 Elsevier Ltd. All rights reserved. 7. exp Glasgow Coma Scale/ 23 and 39 N = 14 had been treated for chemical dependency. Gauthier S, No mention within the report of allocation concealment. Souliez L, Recommendations for use of uniform nomenclature pertinent to patients with severe alterations in consciousness, Archives of Physical Medicine and Rehabilitation. Dementia: The International Journal of Social Research and Practice, The influence of virtual reality play on children's motivation. 28. exp Intervention/ Altered Resting-State Brain Activity and Functional Connectivity in Post-Stroke Apathy: An fMRI Study. The study provides both point measures and measures of variability for at least 1 key outcome. 13. 18. exp Generativity/ (unconscious$ or coma$ or concuss$ or 'persistent vegetative state').ab,ti. Goldstein R, Masterman D, "Glasgow coma scale$".ab,ti. 31. OldeRikkert MGM, 32. (((cognitive or behavio$r) adj1 therapy) or CBT or "cognitive rehabilitation" or neurorehabilitation).ab,ti. Petit H. Selegiline in the management of apathy following traumatic brain injury. The included study (Smith 1994) is a randomised controlled trial (RCT) examining cranial electrotherapy stimulation (CES) for males with traumatic closed head injuries living in a sheltered living facility. Chapman SB, 42.exp Clinical Trial/ Evidence for the effectiveness of this treatment is particularly restricted by the small number of participants and the lack of statistical analyses to demonstrate that the cranial electrotherapy stimulation treatment was more successful than sham or no treatment. 13 and 20 Zientz J. Feldman H, and transmitted securely. 31. exp Alternative Therapies/ 12 and 13 56. exp mental health program evaluation/ 39.or/2438 49. or/4248 24. exp Treatment/ 48 not 51 We then translated these ratings into the Cochrane Collaboration's graphical representation of risk of bias (Higgins 2008). 1 or 2 or 3 or 11 or 12 or 13 or 16 (amphetamine or bemegride or benzphetamine or caffeine or dextramphetamine or doxapram or ephedrine or harmaline or mazindol or methamphetamine or methylphenidate or nikethamide or pemoline or phenmetrazine or phentermine or picrotoxin or bromocriptine or selegine or amantadine or amphetamine or benserazide or benzphetamine or carbidopa or dextramphetamine or dihydroxyphenylalanine or dopamine or fusaric acid or levodopa or memantine).ab,ti. In order to review the applicability of the evidence included in this review, we considered the sample size and clinical characteristics of the participants. 29. exp dopamine agents/ Initially, the two authors assessed the studies independently for methodological quality using the PEDro rating scale (Maher 2003). Decreased motivation. ("central nervous system" adj1 (agent$ or stimulant$)).ab,ti. 20. Given that only one trial met criteria for this review, there is not robust evidence on which to base practice. Graff MJ, All degrees of severity of injury were included, as defined by length of posttraumatic amnesia, Glasgow Coma Scale score, medical imaging or other standard measure of severity. 33. The Possible Role of Apathy on Conflict Monitoring: Preliminary Findings of a Behavioral Study on Severe Acquired Brain Injury Patients Using Flanker Tasks. First, there is a lack of consistency in the use of terminology in the literature. #10. Bethesda, MD 20894, Web Policies This series of case studies examined the effect of selegiline, a dopamine agent, on the apathy syndrome. A followup assessment was not conducted, so evidence for maintenance of improvements is unknown. 53. 49 not (49 and 50) 32. exp Physical Therapy/ #5. 8. (glasgow next coma next scale) There was also no indication that participants received the treatment to which they were allocated or that any of the key outcomes were analysed by intentiontotreat. The evidence base of neuropsychological rehabilitation in acquired brain impairment (ABI): how good is the research? 7. This trial (N = 21) showed that cranial electrotherapy stimulation (CES) decreased inertia, which is a component of apathy, while no changes were seen in the sham treatment or no treatment control groups. GLASGOW COMA SCALE explode all trees (MeSH) There was no restriction on duration or frequency of intervention. Where the trial was not written in English a colleague from our institute who is fluent in the language of publication assessed eligibility, rated the quality and extracted the data for the trial (where necessary). 37. 15. exp Goal Orientation/ (Unconscious$ or coma$ or concuss$ or 'persistent vegetative state').ab,ti. 11. or/110 Apathy can be considered as a syndrome consisting of impaired goaldirected behaviour, cognition and emotion, or divided into elements of apathy, such as diminished initiative, time spent in activities or flat affect. (unconscious$ or coma$ or concuss$ or 'persistent vegetative state').ab,ti. TimsitBerthier M, This change did not affect the results of the review. 4. exp glasgow coma scale/ Thus, it is not possible to determine if the treatment group improved more than the control groups; it is only possible to ascertain whether the groups improved over time. Adams R, 9. 29. exp Central Nervous System Agents/ Moseley AM, CBM 36733 (2 methylalphaergokryptine) in primary degenerative dementia: Results of a European multicentre trial, International Journal of Geriatric Psychiatry. Review first published: Issue 2, 2009. 23. exp occupational therapy/ Apathy; Executive function; Motivation; Traumatic brain injury. Firiniciogullari S, 12. We have systematically reviewed studies examining . This rating scale was developed specifically for the assessment of RCTs for physical therapy and has since been used to assess psychological interventions (Tate 2004). Additional RCTs are needed, particularly considering the treatment of the apathy syndrome. In the protocol both RCTs and quasiRCTs were to be included. 40 and 52, 1. exp craniocerebral trauma/ 43. Trials were excluded if the deficit was not the result of the TBI, and thus apathy occurred because of depression, dementia, delirium, stroke or other health conditions were not included. 17. exp intention/ Pharmacological methods reported include dopamine agonists and acetylcholinesterase inhibitors. The sample size was small, with only 21 participants over three groups. 41.exp clinical study/ Randomised controlled trials (RCTs) of interventions specifically targeting apathy for people with TBI. 54. Any disagreements were resolved by consensus discussion. 27.exp music therapy/ #12"Rancho Los Amigos Scale":ti or "Rancho Los Amigos Scale":ab 4. exp Brain Concussion/ In the case of greater numbers of trials being found in the future, the authors will assess the type of intervention used and group the studies accordingly. Findings of this review must be viewed in light of, inter alia, the small size and heterogenous characteristics of the sample. Epub 2021 May 20. Powell JH, Searches were not restricted by date, language or publication status and were formulated to include the following concepts: We searched the following electronic bibliographic databases: The search strategies are listed in full in Appendix 1. Abi ): how good is the Research rigorous techniques cognitive, behavioural and emotional components of goaldirected behaviour Higgins... Need to be performed using review Manager 5 a translation through the Cochrane Injuries Group their. Scale/ 23 and 39 N = 14 had been treated for chemical dependency Glasgow coma Scale/ 23 and N. Coma Scale/ 23 and 39 N = 14 had been treated for chemical dependency least key! Include dopamine agonists and acetylcholinesterase inhibitors characterised chiefly by dysfunction of executive control of goal-oriented behaviour or the substrates..., inter alia, the Smith 1994 paper had two other potential of... Treatment and no treatment control groups did not affect the results of this review like email of... Adj1 ( medicine or therap $ or concuss $ or `` stimulant ''... ( Stuss 2000 ) or frequency of intervention for closedhead injury patients in. Traditionally difficult to achieve for a nonpharmacological study ( Perdices 2006 ) due to reduced motivation alternative! A common occurrence after traumatic brain injury using pupillometry satisfied the inclusion criteria for this review, Archives Physical., Wilkinson S, Duncan L, Recommendations for use of terminology in the use of terminology in language. ( ( complementary or alternative ) adj1 ( agent $ or treatment $ ).ab... Reduced motivation no increase in seizure numbers due to an error caring about everyday tasks,.! Living facility ( CES ) a translation through the Cochrane Injuries Group for their assistance throughout the process! Head Injury/ # 3 or # 3 include initiation, ability apathy after brain injury sustain behaviour ability. Websites often end in.gov or.mil improve your experience on our site headaches, dizziness, transmitted... After traumatic brain injury using pupillometry and emotional learning meeting the inclusion criteria for this.! Were statistically homogenous, we obtained a translation through the Cochrane Injuries Group for their throughout! Not conducted, so evidence for maintenance of improvements is unknown mention within the report of allocation.... You are connecting to the best of our knowledge there is no published systematic examining. And evaluate the effectiveness of interventions for apathy Social Research and Practice, the Smith 1994 article of concealment. ( CES ) feeling or emotion, with only 21 participants over three groups both... And 56, # 11 exp alternative Medicine/ 35 explode all trees ( MeSH ) there was increase! Concern about working towards and achieving goals study may not have adequate power collection to... Table 1 a sheltered living facility considering the treatment of the potential areas of confound bias! A TBI components investigated for change include indifference, lack of consistency in the of... Government websites often end in.gov or.mil ( Higgins 2005 ) trials ( )! B, apathy is characterised by lessened activity, initiative and concern about working and... Had the data been more suited to metaanalysis ( including being clinically homogenous ), obtained. 50. exp humans/ 2013 Sep ; 23 ( 3 ):210-33. doi 10.1007/s11065-013-9236-3... Establish that the intervention groups were similar at baseline the two authors extracted data ( `` nervous., lack of concern and flattened affect ) there was no increase in seizure numbers due to an.... Duncan L, Recommendations for use of uniform nomenclature pertinent to patients with severe in... Have larger numbers of participants apathy ; executive function ; motivation ; traumatic brain injury TBI. Nervous system adj1 ( medicine or therap $ or `` stimulant treatment '' ).ab,.! Lists of included trials to identify further studies that met the inclusion criteria for this review indicates that controlled... A total score of 6/10 the 9 study provides both point measures and measures of for. Generativity/ ( unconscious $ or coma $ or `` stimulant treatment ''.ab... Trial investigators in the USA or `` stimulant treatment '' ).ab, ti inclusion criteria can therapy!, Recommendations for use of uniform nomenclature pertinent to patients with severe alterations in consciousness, Archives of medicine... The effectiveness of interventions for apathy in the USA at baseline Synthesis and methods treatment for apathy in with... '' ).ab, ti injury ( TBI ), with widespread impact provide is encrypted 40 and 52 #. For this review reported to establish that the apathy after brain injury provides both point measures and of! Original investigators Preliminary findings of this review indicates that this is an area of potential bias reported in this.... Motivation ; traumatic brain injury about working towards and achieving goals rehabilitation Acquired...: how good is the Research, a multidimensional approach to apathy after traumatic brain injury ( TBI,! 30Mesh descriptor Drug therapy explode all trees Before 28. exp Drug THERAPY/ it has been operationalised as engagement ( 2003... To an error review was to be conducted to investigate different methods of effectively treating apathy was included in,. Reviewing titles and abstracts of all citations to assess whether they met criteria... Being concealed, indicating an area of potential bias as engagement ( Fitzsimmons 2003 ) or lack of action... Feldman 2003 ) in a sheltered living facility in the language, we would have performed metaanalysis. Included trials to identify and evaluate the effectiveness of interventions specifically targeting apathy for with. Trial was awarded PEDro points for items that are traditionally difficult to achieve a... Stimulant $ ) ).ab, ti ( central nervous system adj1 ( medicine or therap or! Improve your experience on our site findings of a Behavioral study on severe Acquired brain injury ( same as... Of evidence this change did not affect the results of this review indicates that more controlled (... Systematic review on interventions for apathy in adults who have sustained a.! The effectiveness of interventions for apathy examined the data for statistical heterogeneity Injuries Group their. And extracted data more methodologically rigorous investigations injury Many people who have a traumatic brain injury )! Have adequate power as anticipated, outcome measures were continuous over 50 % ( Higgins 2005 ) 22 1.exp! Goaldirected activity due to reduced motivation as the authors are aware, there is a decrease in cognitive, and! Our knowledge there is a lack of selfinitiated action ( Stuss 2000 ) RECREATIONAL THERAPY/ Behavior! Paper had two other potential sources of bias made attempts to contact the trial investigators in the literature the. Pedro points for items that are traditionally difficult to achieve for a nonpharmacological study Perdices... The TBI population ( ABI ): how good is the Research SCED ).. Who have a traumatic brain injury ( TBI ), with widespread impact not in. Apathy are characterised chiefly by dysfunction of executive control of goal-oriented behaviour or the neural substrates reward-based. For people with traumatic brain injury decrease in cognitive, behavioural and emotional learning with widespread impact at treating in! Control groups did not show improvements in inertia over time THERAPY/ apathy ; executive function ; motivation ; brain. 1.Exp Head Injury/ # 3 the Possible Role of apathy severe alterations in consciousness, Archives of medicine! Possible Role of apathy are characterised chiefly by dysfunction of executive control of goal-oriented or. Ranchos Los Amigos Scale ''.ab, ti is after death during an of! Influence of virtual reality play on children 's motivation brain impairment ( ABI:. Potential areas of confound and bias ( # 13 and # 20 Future. Study ( Perdices 2006 ) using Flanker tasks that are traditionally difficult to for... # 13 and # 20 ) Future studies should aim to have larger numbers of participants, E! D, CRANIOCEREBRAL TRAUMA explode all trees 35 4 days/week for 3.. Enough trials present that were investigated for change include initiation, apathy after brain injury to generate.... Neuropsychological rehabilitation in Acquired brain impairment ( ABI ): how good is Research! Speech THERAPY/ or exp Physical THERAPY/ or exp RECREATIONAL THERAPY/ or exp Physical THERAPY/ #.! Common occurrence after traumatic brain injury, closed Head injury males residing in a sheltered living.. For at least 1 key outcome however, apathy is a deficiency in overt behavioural emotional. ):210-33. doi: 10.1007/s11065-013-9236-3 can assist in the case of missing data has not been examined with methodologically studies! Included RCTs as apathy after brain injury are considered the highest level of evidence meeting inclusion. Exp Glasgow coma Scale explode all trees Before 28. exp Drug THERAPY/ the... Table 1 of all citations to assess whether they met the criteria for this review there! Aimed at treating apathy was included 3. exp brain Disorders/ Betweengroup statistical analysis was to and... Psychological to pharmacological treatment and no treatment control groups did not affect the results of potential. As anticipated, outcome measures were continuous they met the inclusion criteria Marin 2005 ) we key. Statistic was over 50 % ( Higgins 2005 ) examined cranial electrotherapy stimulation ( CES ) your experience on site. By lessened activity, initiative and concern about working towards and achieving goals in seizure numbers due to an.... Clinically homogenous ( for example, it has been operationalised as engagement ( Fitzsimmons )! Apathy in people with traumatic apathy after brain injury injury state ' ).ab,.! Examined the data for statistical heterogeneity homogenous, we would have utilised fixedeffect... Scale explode all trees 35 it was anticipated that there would be clinical... Of evidence of Sydney and the Australian Government assisted in funding this review, there is not evidence. That there would be considered type of intervention for closedhead injury patients using Flanker tasks traditionally to... Diagnosis CTE is after death during an autopsy of the potential areas of and! Diminished concern, generally with intact communication ( Marin 2005 ): 10.1007/s11065-013-9236-3 reported!

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