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1- Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Rofeideh Rehabilitation Hospital, Tehran, Iran.
2- Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Rofeideh Rehabilitation Hospital, Tehran, Iran. ,fahimi1970@yahoo.com
3- Clinical Research Development Center, Rofeideh Rehabilitation Hospital, Department of Clinical Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Bachelor of Nursing, Young Researchers and Elite Club, Islamic Azad University, Semnan, Iran.
2- Department of Occupational Therapy, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Rofeideh Rehabilitation Hospital, Tehran, Iran. ,
3- Clinical Research Development Center, Rofeideh Rehabilitation Hospital, Department of Clinical Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Bachelor of Nursing, Young Researchers and Elite Club, Islamic Azad University, Semnan, Iran.
Abstract: (203 Views)
Background: Spinal cord injury is a devastating event that can result in a range of physical and psychological consequences. One of the relatively under recognized complications associated with spinal cord injury is cognitive dysfunction. The purpose of this study was to review the “Mechanism of cognitive dysfunction” and “Assessment tools in detection of cognitive impairment” in adult with SCI without traumatic brain injury.
Methods:
To conduct this scoping review, Pub med, OT seeker, Cinahel, PsycInfo, Cochran library, Scopus, ProQuest, Medline, Magi ran, Web of Science and Google Scholar were searched from 2013 to 2024, using the spinal cord injury, adult, cognitive disorder, cognitive domains, assessment, evaluation, test, keywords.
Result: totally 14cross sectional and a cohort study were included 771 adults with spinal cord injury, two review studies and a systematic review study were found. In these studies, the prevalence of cognitive impairment in adult with spinal cord injury was reported as 30-60%. The cognitive impairment mechanisms in adult with SCI were related to many factors such as: decrease in the expression of dopamine receptors, chronic inflammatory changes in the thalamus , hippocampus, and cerebral cortex, cardiovascular dysfunction (impaired in decentralized cardiovascular autonomic control, shifts in inhibitory processes, hypoxia, anoxia), autonomic dysfunction, obstructive sleep apnea, alcohol abuse, certain drugs, psychological(emotional distress, high anxiety), and somatic complaints. Furthermore concentration, attention, working memory, visuospatial perception, processing speed was reported as the most cognitive domains which damaged after SCI. The Beck Depression Inventory, Wechsler Adult Intelligence Scale, Mini-Mental State Examination, Neuropsychiatry Unit Cognitive Assessment Tool, Edinburgh Cognitive and Behavioral ALS Screen, and Stroop were the most commonly tools for detect these impairments.
Conclusion: Cognitive impairment after SCI is a multi-mechanism event. We categorized them in three levels: central nerves system impairments, cardiovascular dysfunctions, and mental health problems. However, there is no specialized tool for accurate screen or detect the cognitive impairment after SCI, clinicians should be attuned to the presence of the disorders, ensure timely diagnosis, and design appropriated cognitive rehabilitation plans and intervention
Methods:
To conduct this scoping review, Pub med, OT seeker, Cinahel, PsycInfo, Cochran library, Scopus, ProQuest, Medline, Magi ran, Web of Science and Google Scholar were searched from 2013 to 2024, using the spinal cord injury, adult, cognitive disorder, cognitive domains, assessment, evaluation, test, keywords.
Result: totally 14cross sectional and a cohort study were included 771 adults with spinal cord injury, two review studies and a systematic review study were found. In these studies, the prevalence of cognitive impairment in adult with spinal cord injury was reported as 30-60%. The cognitive impairment mechanisms in adult with SCI were related to many factors such as: decrease in the expression of dopamine receptors, chronic inflammatory changes in the thalamus , hippocampus, and cerebral cortex, cardiovascular dysfunction (impaired in decentralized cardiovascular autonomic control, shifts in inhibitory processes, hypoxia, anoxia), autonomic dysfunction, obstructive sleep apnea, alcohol abuse, certain drugs, psychological(emotional distress, high anxiety), and somatic complaints. Furthermore concentration, attention, working memory, visuospatial perception, processing speed was reported as the most cognitive domains which damaged after SCI. The Beck Depression Inventory, Wechsler Adult Intelligence Scale, Mini-Mental State Examination, Neuropsychiatry Unit Cognitive Assessment Tool, Edinburgh Cognitive and Behavioral ALS Screen, and Stroop were the most commonly tools for detect these impairments.
Conclusion: Cognitive impairment after SCI is a multi-mechanism event. We categorized them in three levels: central nerves system impairments, cardiovascular dysfunctions, and mental health problems. However, there is no specialized tool for accurate screen or detect the cognitive impairment after SCI, clinicians should be attuned to the presence of the disorders, ensure timely diagnosis, and design appropriated cognitive rehabilitation plans and intervention
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