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[WEB SITE] Nootropics: Types, safety, and risks of smart drugs

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Nootropics, or “smart drugs,” are a class of substances that can boost brain performance. They are sometimes called cognition enhancers or memory enhancing substances.

Prescription nootropics are medications that have stimulant effects. They can counteract the symptoms of medical conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy, or Alzheimer’s disease.

Nonprescription substances that can enhance brain performance or focus — such as caffeine and creatine — are also considered nootropics. They do not treat diseases but may have some effects on thinking, memory, or other mental functions.

This article looks at prescription and nonprescription smart drugs, including their uses, side effects, and safety warnings.

Prescription nootropics

a woman taking nootropics at her desk.

A person may take a nootropic to treat ADHD, narcolepsy, or dementia.

Prescription nootropics include:

  • modafinil (Provigil), a stimulant that addresses the sudden drowsiness of narcolepsy
  • Adderall, which contains amphetamines to treat ADHD
  • methylphenidate (Ritalin), a stimulant that can manage symptoms of narcolepsy and ADHD
  • memantine (Axura), which treats symptoms of Alzheimer’s disease

While these can be effective in treating specific medical conditions, a person should not take them without a prescription.

Like any prescription medications, they carry risks of side effects and interactions, and a person should only take them under a doctor’s care.

Common side effects of prescription nootropics include:

Some evidence suggests that people who use prescription nootropics to improve brain function have a higher risk of impulsive behaviors, such as risky sexual practices.

Healthcare providers should work closely with people taking prescription nootropics to manage any side effects and monitor their condition.

Over-the-counter nootropics

The term “nootropic” can also refer to natural or synthetic supplements that boost mental performance. The following sections discuss nootropics that do not require a prescription.

Caffeine

Many people consume beverages that contain caffeine, such as coffee or tea, because of their stimulant effects. Studies suggest that caffeine is safe for most people in moderate amounts.

Having a regular cup of coffee or tea may be a good way to boost mental focus. However, extreme amounts of caffeine may not be safe.

The Food and Drug Administration (FDA) recommend that people consume no more than 400 milligrams (mg) of caffeine a day. This is the amount in 4–5 cups of coffee.

Caffeine pills and powders can contain extremely high amounts of the stimulant. Taking them can lead to a caffeine overdose and even death, in rare cases.

Women who are pregnant or may become pregnant may need to limit or avoid caffeine intake. Studies have found that consuming 4 or more servings of caffeine a day is linked to a higher risk of pregnancy loss.

L-theanine

L-theanine is an amino acid that occurs in black and green teas. People can also take l-theanine supplements.

A 2016 review reported that l-theanine may increase alpha waves in the brain. Alpha waves may contribute to a relaxed yet alert mental state.

L-theanine may work well when paired with caffeine. Some evidence suggests that this combination helps boost cognitive performance and alertness. Anyone looking to consume l-theanine in tea should keep the FDA’s caffeine guidelines in mind.

There are no dosage guidelines for l-theanine, but many supplements recommend taking 100–400 mg per day.

Omega-3 fatty acids

person at desk holding omega 3 supplements in palm

Studies have shown that omega-3 fatty acids are important to fight against brain aging.

These polyunsaturated fats are found in fatty fish and fish oil supplements. This type of fat is important for brain health, and a person must get it from their diet.

Omega-3s help build membranes around the body’s cells, including the neurons. These fats are important for repairing and renewing brain cells.

A 2015 review found that omega-3 fatty acids protect against brain aging. Other research has concluded that omega-3s are important for brain and nervous system function.

However, a large analysis found “no benefit for cognitive function with omega‐3 [polyunsaturated fatty acids] supplementation among cognitively healthy older people.” The authors recommend further long term studies.

A person can get omega-3 supplements in various forms, including fish oil, krill oil, and algal oil.

These supplements carry a low risk of side effects when a person takes them as directed, but they may interact with medications that affect blood clotting. Ask a doctor before taking them.

Racetams

Racetams are synthetic compounds that can affect neurotransmitters in the brain. Some nootropic racetams include:

  • piracetam
  • pramiracetam
  • phenylpiracetam
  • aniracetam

A study conducted in rats suggests that piracetam may have neuroprotective effects.

One review states that “Some of the studies suggested there may be some benefit from piracetam, but, overall, the evidence is not consistent or positive enough to support its use for dementia or cognitive impairment.” Confirming this will require more research.

There is no set dosage for racetams, so a person should follow instructions and consult a healthcare provider. Overall, studies have no found adverse effects of taking racetams as directed.

Ginkgo biloba

Ginkgo biloba is a tree native to China, Japan, and Korea. Its leaves are available as an herbal supplement.

2016 study found that gingko biloba is “potentially beneficial” for improving brain function, but confirming this will require more research.

Ginkgo biloba may help with dementia symptoms, according to one review, which reported the effects occurring in people who took more than 200 mg per day for at least 5 months.

However, the review’s authors note that more research is needed. Also, with prescription nootropics available, ginkgo biloba may not be the most safe or effective option.

Panax ginseng

Panax ginseng is a perennial shrub that grows in China and parts of Siberia. People use its roots for medicinal purposes.

People should not confuse Panax ginseng with other types of ginseng, such as Siberian or American varieties. These are different plants with different uses.

2018 review reports that Panax ginseng may help prevent certain brain diseases, including Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease. It also may help with brain recovery after a stroke.

Panax ginseng interacts with many medications, so consult a doctor before taking it. A typical dosage for mental function is 100–600 mg once or twice a day.

Rhodiola

Some evidence suggests that Rhodiola rosea L., also known as rhodiola or roseroot, can help with cognitive ability.

One review reported that rhodiola may have neuroprotective effects and may help treat neurodegenerative diseases.

Another review found that rhodiola helped regulate neurotransmitters in the brain, having a positive effect on mood.

Rhodiola capsules have varying strengths. Usually, a person takes a capsule once or twice daily.

Creatine

Creatine is an amino acid, which is a building block of protein. This supplement is popular among athletes because it may help improve exercise performance. It may also have some effects on mental ability.

A 2018 review found that taking creatine appears to help with short term memory and reasoning. Whether it helps the brain in other ways is unclear.

The International Society of Sports Nutrition report that creatine supplementation of up to 30 grams per day is safe for healthy people to take for 5 years.

Another 2018 review notes that there has been limited research into whether this supplement is safe and effective for adolescent athletes.

Do nootropics work?

Some small studies show that some nootropic supplements can affect the brain. But there is a lack of evidence from large, controlled studies to show that some of these supplements consistently work and are completely safe.

Because of the lack of research, experts cannot say with certainty that over-the-counter nootropics improve thinking or brain function — or that everyone can safely use them.

For example, one report on cognitive enhancers found that there is not enough evidence to indicate that they are safe and effective for healthy people. The researchers also point to ethical concerns.

However, there is evidence that omega-3 fatty acids can benefit the brain and overall health. In addition, caffeine can improve mental focus in the short term.

Notes on the safety of nootropics

doctor and patient in office discussing adrenal cancer

A person should talk to a doctor about any interactions supplements may have with existing medications.

Also, some supplements may not contain what their labels say. A study of rhodiola products, for example, found that some contain contaminants or other ingredients not listed on the label.

For this reason, it is important to only purchase supplements from reputable companies that undergo independent testing.

BUYING NOOTROPICSA prescription is necessary for some nootropics, such as Provigil and Adderall. Over-the-counter nootropics are available in some supermarkets and drug stores, or people can choose between brands online:

Not all of these supplements are recommended by healthcare providers and some may interact with medications. Always speak to a doctor before trying a supplement.

Summary

Many doctors agree that the best way to boost brain function is to get adequate sleep, exercise regularly, eat a healthy diet, and manage stress.

For people who want to boost their cognitive function, nootropic supplements may help, in some cases. Anyone interested in trying a nootropic should consult a healthcare professional about the best options.

 

via Nootropics: Types, safety, and risks of smart drugs

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[BOOK] Virtual Reality for Psychological and Neurocognitive Interventions

Virtual Reality for Psychological and Neurocognitive Interventions

  • Albert “Skip” Rizzo
  • Stéphane Bouchard

Part of the Virtual Reality Technologies for Health and Clinical Applications book series (VRTHCA)

Table of contents

Search within book

  1. Front Matter

    Pages i-xii

  1. William S. Ryan, Jessica Cornick, Jim Blascovich, Jeremy N. Bailenson
    Pages 15-46
  2. Berenice Serrano, Cristina Botella, Brenda K. Wiederhold, Rosa M. Baños
    Pages 47-84
  3. Melissa Peskin, Brittany Mello, Judith Cukor, Megan Olden, JoAnn Difede
    Pages 85-102
  4. Stéphane Bouchard, Mylène Laforest, Pedro Gamito, Georgina Cardenas-Lopez
    Pages 103-130
  5. Patrick S. Bordnick, Micki Washburn
    Pages 131-161
  6. Giuseppe Riva, José Gutiérrez-Maldonado, Antonios Dakanalis, Marta Ferrer-García
    Pages 163-193
  7. Hunter G. Hoffman, Walter J. Meyer III, Sydney A. Drever, Maryam Soltani, Barbara Atzori, Rocio Herrero et al.
    Pages 195-208
  8. Dominique Trottier, Mathieu Goyette, Massil Benbouriche, Patrice Renaud, Joanne-Lucine Rouleau, Stéphane Bouchard
    Pages 209-225
  9. Thomas D. Parsons, Albert “Skip” Rizzo
    Pages 247-265
  10. P. J. Standen, David J. Brown
    Pages 267-287
  11. Roos Pot-Kolder, Wim Veling, Willem-Paul Brinkman, Mark van der Gaag
    Pages 289-305
  12. Pierre Nolin, Jérémy Besnard, Philippe Allain, Frédéric Banville
    Pages 307-326
  13. Lindsay A. Yazzolino, Erin C. Connors, Gabriella V. Hirsch, Jaime Sánchez, Lotfi B. Merabet
    Pages 361-385
  14. Thomas Talbot, Albert “Skip” Rizzo
    Pages 387-405
  15. Back Matter

    Pages 407-415

About this book

Introduction

This exciting collection tours virtual reality in both its current therapeutic forms and its potential to transform a wide range of medical and mental health-related fields. Extensive findings track the contributions of VR devices, systems, and methods to accurate assessment, evidence-based and client-centered treatment methods, and—as described in a stimulating discussion of virtual patient technologies—innovative clinical training. Immersive digital technologies are shown enhancing opportunities for patients to react to situations, therapists to process patients’ physiological responses, and scientists to have greater control over test conditions and access to results. Expert coverage details leading-edge applications of VR across a broad spectrum of psychological and neurocognitive conditions, including:

  • Treating anxiety disorders and PTSD.
  • Treating developmental and learning disorders, including Autism Spectrum Disorder,
  • Assessment of and rehabilitation from stroke and traumatic brain injuries.
  • Assessment and treatment of substance abuse.
  • Assessment of deviant sexual interests.
  • Treating obsessive-compulsive and related disorders.
  • Augmenting learning skills for blind persons.

Readable and relevant, Virtual Reality for Psychological and Neurocognitive Interventions is an essential idea book for neuropsychologists, rehabilitation specialists (including physical, speech, vocational, and occupational therapists), and neurologists. Researchers across the behavioral and social sciences will find it a roadmap toward new and emerging areas of study.

via Virtual Reality for Psychological and Neurocognitive Interventions | SpringerLink

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[ARTICLE] Mirror Therapy Using Gesture Recognition for Upper Limb Function, Neck Discomfort, and Quality of Life After Chronic Stroke: A Single-Blind Randomized Controlled Trial – Full Text

Abstract

Background

Mirror therapy for stroke patients was reported to be effective in improving upper-extremity motor function and daily life activity performance. In addition, game-based virtual reality can be realized using a gesture recognition (GR) device, and various tasks can be presented. Therefore, this study investigated changes in upper-extremity motor function, quality of life, and neck discomfort when using a GR device for mirror therapy to observe the upper extremities reflected in the mirror.

Material/Methods

A total of 36 subjects with chronic stroke were randomly divided into 3 groups: GR mirror therapy (n=12), conventional mirror therapy (n=12), and control (n=12) groups. The GR therapy group performed 3D motion input device-based mirror therapy, the conventional mirror therapy group underwent general mirror therapy, and the control group underwent sham therapy. Each group underwent 15 (30 min/d) intervention sessions (3 d/wk for 5 weeks). All subjects were assessed by manual function test, neck discomfort score, and Short-Form 8 in pre- and post-test.

Results

Upper-extremity function, depression, and quality of life in the GR mirror therapy group were significantly better than in the control group. The changes of neck discomfort in the conventional mirror therapy and control groups were significantly greater than in the GR mirror therapy group.

Conclusions

We found that GR device-based mirror therapy is an intervention that improves upper-extremity function, neck discomfort, and quality of life in patients with chronic stroke.

Background

In patients with acute stroke that occurred >6 months previously, 85% have upper-limb disorders, and 55% to 75% have upper-limb disorders []. The upper-limb movement function is decreased due to weakening of upper-limb muscles, which is primarily caused by changes in the central nervous system and secondarily by weakness due to inactivity and reduced activity [,].

Activities of daily living are limited due to body dysfunction, and most stroke patients have limited social interaction; these disorders reduce the quality of life []. In addition, stroke patients may experience depression due to reduced motivation []. Depression results in loss of interest and joy, anxiety, fear, hostility, sadness, and anger, which negatively affect functional recovery and rehabilitation in stroke patients [].

Constraint-induced movement therapy, action observation training, and mirror therapy have been recently studied as therapies for upper-extremity motor function []. These interventions are used to increase the use of paralyzed limbs to overcome disuse syndromes, observe and imitate movement, and change the neural network involved in movement. Providing various tasks in upper-extremity rehabilitation is necessary and virtual reality is used as a method for providing various tasks [,].

Interventions using virtual reality require cognitive factors, such as judgment and memory, as the task progresses. It can use visual and auditory stimuli, and can induce interest and motivation, helping stroke patients to be mentally stable and motivated []. Gesture recognition (GR) is a topic that studies the reading of these movements using algorithms. These GR algorithms mainly focus on the movement of arm, hands, eyes, legs, and other body parts. The main idea is to capture body movements using capture devices and send the acquired data to a computer []. A remarkable example is shown in physical rehabilitation, where the low-cost hardware and algorithms accomplish outstanding results in therapy of patients with mobility issues. A 3D motion input device is required for upper-body rehabilitation in virtual reality. The Leap motion controller, a GR input device, has been recently released, which monitors hand and finger movements and reflects them on the monitor []. In addition, game-based virtual reality can be realized using a GR device, and various tasks can be presented.

Mirror therapy has been used as a therapeutic intervention for phantom pain in amputees. The painful and paralyzed body parts are covered with a mirror. The mirror is placed in the center of the body, and the movement of the paralyzed body is viewed through the mirror. The patient has a visual illusion that the paralyzed side is normally moving []. Mirror therapy for stroke patients was reported to be effective in upper-extremity motor function and daily life activity performance []. However, conventional mirror therapy methods require high concentration and can become tedious, making active participation difficult []. In addition, conventional mirror therapy differs from the actual situation wherein a mirror positioned at the center of the body should be viewed with the head sideways. Because patients are in a suboptimal posture, they may have neck discomfort after mirror therapy. The body has muscle strength disproportion when maintaining poor posture for a long time. This results in inadequate tension on adjacent muscles and joints, resulting in movement restriction, reduced flexibility, pain, and changes in bone and soft tissue [].

This study investigated the effect on upper-extremity motor function, quality of life, and neck discomfort by using GR device mirror therapy in patients with chronic stroke, and evaluated the efficacy of this technique.

[…]

 

Continue —>  Mirror Therapy Using Gesture Recognition for Upper Limb Function, Neck Discomfort, and Quality of Life After Chronic Stroke: A Single-Blind Randomized Controlled Trial

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Figure 2
(A) Gesture recognition mirror therapy group, (B) Conventional mirror therapy, (C) Control group.

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[Clinimetrics] The Scandinavian Stroke Scale

Summary

The Scandinavian Stroke Scale (SSS) is a clinical measure of functional impairment and activity limitations in patients with acute stroke. It was first presented by the Copenhagen Stroke Study Group in 1985.1 The SSS consists of nine items measuring consciousness, eye movement, arm motor power, hand motor power, leg motor power, orientation, speech, facial palsy and gait.1 Each item is scored on an ordinal scale with two to five categories, with item scores ranging from 2 to 12. In the original scale, unconscious patients could not be scored, as the lowest category in this item read: reacts to verbal command, but is not fully conscious (score 2).1 However, a scale revision added the category unconscious (score 0).2 Thus, sum scores range from 0 to 58 in the edited version, with 0 indicating severe neurological deficits and 58 indicating no neurological deficits. The SSS includes items that are of functional significance to the patients and are easy to assess.1 Therefore, items such as dysarthria, visual field, sensation, and reflexes were omitted during scale development.1 The SSS can be administered in < 5 minutes by non-specialists (ie, physiotherapists and nurses).3 It is used worldwide and is available in multiple languages, including English,1 Danish4 and Portuguese.5

Reliability and validity: The internal consistency of items in the SSS is high (Cronbach’s α: 0.91).6 The interrater reliability of items is also good to excellent, with weighted Kappa coefficients ranging from 0.608 to 0.912.7 The items with the strongest agreement are gait (κ: 0.912) and speech (κ: 0.860), while the items with the poorest agreement are leg motor power (κ: 0.688) and facial palsy (κ: 0.608). It is also possible to obtain reliable SSS scores based on information from medical records when compared with face-to-face assessment, with excellent agreement (κ > 0.75) except for consciousness (κ: 0.71) and eye movements (κ: 0.58).8 The positive predictive value for the speech item is 0.55 (95% CI 0.23 to 0.83) when assessed by trained nurses compared to comprehensive assessments by speech and language therapists.9

Ninety-day SSS scores correlate with the National Institute of Health Stroke Scale (NIHSS) (r2 = 81.2%), Barthel Index (r2 = 72.3%) and modified Rankin Scale (r2 = 76.9%).10 However, interconversion models for SSS to NIHSS, accounting for age and gender, demonstrate that the relationship between SSS and NIHSS depends on the timing of measurement. In the acute phase, the adjusted r2 = 0.60 whereas 90 days after stroke the adjusted r2 = 0.80.11 The SSS predicts 1-week mortality3 and 3-month disability12 with the same accuracy as the NIHSS scale. The area under the ROC curve is 0.76 for 1-week mortality3 and 0.769 for 3-month disability.12 Using a cut-off score of 36, the SSS predicts 1-week mortality with a sensitivity of 0.83 and specificity of 0.633 and using a cut-off score > 42 predicts 3-month disability with a sensitivity of 69.5% and specificity of 82.2%.12

Commentary

The SSS is a common measure of stroke impairment in acute care settings (eg, in Denmark it is mandatory to administer the SSS to all hospitalised patients with acute stroke or transient ischaemic attack), and is used in clinical trials and observational studies as a measure of neurological deficit. To our knowledge, the SSS did not undergo testing of its clinimetric properties during its development. However, subsequent studies have provided some information on the reliability, validity and internal consistency. Although the SSS has some predictive validity, the values are likely to be optimistic, as the predictions were not externally validated.

In comparison with other commonly used scales such as NIHSS, the SSS assesses gait but does not include items measuring ataxia, neglect or sensation. This facilitates ease of use and administration by non-specialists but could miss useful information that may assist in determining appropriate management and potential prognosis. Low inter-rater reliability has been reported in the item facial palsy,7 likely due to the simplicity/ambiguity of the item, with categorisation as either present facial palsy or none/dubious facial palsy.1 Furthermore, the speech item in the SSS has low positive predictive value, resulting in patients without aphasia being scored as having aphasia.13

The SSS is an easy-to-use measure of functional limitations in patients with stroke, which may be useful for clinical and research purposes. Further research investigating the clinimetric and prognostic properties of the SSS is warranted.

References

via Clinimetrics: The Scandinavian Stroke Scale – ScienceDirect

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[WEB SITE] Turn Up the Walking Intensity to Spur Further Stroke Recovery

TreadmillPatient

 

High-intensity step training  that mimics real-world conditions may better improve walking ability in stroke survivors compared to traditional, low-impact training, according to new research published in the American Heart Association’s journal Stroke.

“People who suffer strokes often have difficulty walking and impaired balance. Rehabilitation after a stroke traditionally focuses on patients practicing low-intensity walking, usually only in a forward direction, which does not provide enough of a challenge to the nervous system to enable patients to negotiate real-world situations, such as uneven surfaces, stairs or changing direction,” says study author T. George Hornby, PhD, professor of physical medicine and rehabilitation at Indiana University School of Medicine in Indianapolis, in a media release from the American Heart Association.

“Our study suggests that stroke patients can perform higher-intensity walking exercises and more difficult tasks than previously thought possible. We need to move beyond traditional, low-intensity rehabilitation to challenge the nervous and cardiovascular systems so patients can improve function and perform better in the real world.”

Researchers evaluated 90 people, 18- to 85-years-old with weakness on one side of the body who had survived a stroke at least six months prior.

Participants received training of either high-intensity stepping performing variable, difficult tasks; high-intensity stepping performing only forward walking; or low-intensity stepping of variable tasks. Variable tasks included walking on uneven surfaces, up inclines and stairs, over randomly placed obstacles on a treadmill and across a balance beam.

The researchers observed the following, the release explains:

  • Survivors in both the high-intensity, variable training and high-intensity, forward walking groups walked faster and farther than the low-intensity, variable training group.
  • For all walking outcomes, 57% to 80% of participants in the high-intensity groups had important clinical gains, while only 9% to 31% of participants did so following low-intensity training.
  • High-intensity variable training also resulted in improved dynamic balance while walking and improved balance confidence.

Hornby notes that no serious adverse events occurred during the training sessions, suggesting stroke survivors can be pushed to higher-intensity walking with more variable tasks during rehabilitation.

“Rehabilitation that allows walking practice without challenging the nervous system doesn’t do enough to make a statistical or clinically significant difference in a patient’s recovery after a stroke,” Hornby suggests.

“We found that when stroke patients are pushed harder, they see greater changes in less time, which translates into more efficient rehabilitation services and improved mobility.”

Ultimately, their goal is to incorporate high-intensity variable step training into regular clinical rehabilitation protocols.

The study was small compared to larger, multicenter clinical trials. Hornby adds in the release that the next step would be to test high-intensity, variable step training in larger patient populations in a large, multicenter clinical trial.

[Source(s): American Heart Association, Science Daily]

 

via Turn Up the Walking Intensity to Spur Further Stroke Recovery – Rehab Managment

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[Infographic] Foods linked to better brainpower

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[Abstract] Cognitive Training in Young Patients With Traumatic Brain Injury: A Fixel-Based Analysis

Background. Traumatic brain injury (TBI) is associated with altered white matter organization and impaired cognitive functioning.

Objective. We aimed to investigate changes in white matter and cognitive functioning following computerized cognitive training.

Methods. Sixteen adolescents with moderate-to-severe TBI (age 15.6 ± 1.8 years, 1.2-4.6 years postinjury) completed the 8-week BrainGames program and diffusion weighted imaging (DWI) and cognitive assessment at time point 1 (before training) and time point 2 (after training). Sixteen healthy controls (HC) (age 15.6 ± 1.8 years) completed DWI assessment at time point 1 and cognitive assessment at time point 1 and 2. Fixel-based analyses were used to examine fractional anisotropy (FA), mean diffusivity (MD), and fiber cross-section (FC) on a whole brain level and in tracts of interest.

Results. Patients with TBI showed cognitive impairments and extensive areas with decreased FA and increased MD together with an increase in FC in the body of the corpus callosum and left superior longitudinal fasciculus (SLF) at time point 1. Patients improved significantly on the inhibition measure at time point 2, whereas the HC group remained unchanged. No training-induced changes were observed on the group level in diffusion metrics. Exploratory correlations were found between improvements on verbal working memory and reduced MD of the left SLF and between increased performance on an information processing speed task and increased FA of the right precentral gyrus.

Conclusions. Results are indicative of positive effects of BrainGames on cognitive functioning and provide preliminary evidence for neuroplasticity associated with cognitive improvements following cognitive intervention in TBI.

via Cognitive Training in Young Patients With Traumatic Brain Injury: A Fixel-Based Analysis – Helena Verhelst, Diana Giraldo, Catharine Vander Linden, Guy Vingerhoets, Ben Jeurissen, Karen Caeyenberghs,

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[BLOG POST] Clamming up about my brain injury stings relationships – Jumbledbrain

At times I’m just too tired to explain how I’m feeling. (You might have noticed I write less often than I used to and that’s one of the reasons for it.) Sometimes there is a storm of emotions inside me which I realise are irrational but I can’t quell them. So to avoid saying anything that I would later regret, I find myself clamming up. But my face rarely gets the memo and goes into full on sulky mode. I’m so bored of this brain injury, I wish I could direct my anger at it and evict it from my head. Sadly it doesn’t work like that though.

At the time clamming up feels like the lesser of two evils. But maybe it isn’t.

My silence carries more weight than I intend it to. All I’m doing it trying to contain my poisonous tongue. Some people go quiet for dramatic effect, waiting for someone to ask “What’s wrong, you’ve hardly said a word today?” I guarantee you, that when you are struggling with a brain injury there is no such thing as dramatic effect.

Even when I’m trying to be mindful, holding my tongue is the best I can do. I might be sulking about my partner James having to work so much, and having less time with him. As he is the only one bringing in a income, I know I can’t begrudge him for being so conscientious. In fact, I know he would like nothing more than being able to work less, or even take early retirement. But currently neither are an option. So I try to remind myself of this and empathise with his position. And it works, but not for my brain injury. It just keeps complaining and dragging me down.

How clamming up about my brain injury is not a good idea

How silence leaves too many unanswered questions.

My grumpiness is too obvious, and I know it makes James feel guilty. But he has nothing to feel guilty about. He has been truly amazing the entire time. Superman hasn’t got a patch on this guy. If the world had more people like him in it, people wouldn’t need heaven.

But he still doubts himself as he can read my face. So eventually I manage to spill, but I start with a disclaimer: “I know I’m being stupid, and here’s the reason why it’s stupid …..blah,blah,blah…. but I can’t help it. I’m upset about ….x,y,z….. because…..”

This really does help the situation, it’s just a shame it takes me so long to be in a position where I can do it. James is getting used to my behaviour, but he is only human (although he’s as close to an angel as you can get.) When I am clamming up, his mind is running a million miles an hour, thinking of all the things I might be annoyed about. I do feel bad for torturing him like this as he doesn’t deserve it. So here’s a shout out for all the carers who some how put up with the nonsense some of us survivors put them through.

clamming up after my brain injury isn't helpful.

I’m tired and I’ve run out of words again so I’m going to leave it there. I think you get the point, and I’m sure I’m not the only one who is going through this.

Other articles you may like:

Do you find yourself clamming up, or are you the opposite? If you say everything that is going on in your mind does it work out well for you?

via Clamming up about my brain injury stings relationships | Jumbledbrain

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[QUOTATION] Emotionally: I’m done. Mentally: I’m drained. Spiritually: I feel dead. Physically: I smile.

Relationships Quotes Top 337 Relationship Quotes And Sayings 72

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[Abstract + References] Design of Finger Exoskeleton Rehabilitation Robot Using the Flexible Joint and the MYO Armband

Abstract

High-risk diseases such as stroke can do great harm to human hands. Hand rehabilitation for stroke patients is a complex and necessary task. To achieve this goal, this paper introduces a hand exoskeleton equipment with flexible joints and EMG-base motion prediction. Experiment of the equipment includes kinematics analysis, EMG signal detection by MYO armband and motion prediction base on BP neural network. The result shows that the device can not only assists patient bending or extending fingers, but also perform six kinds of rehabilitation exercises with 92% accuracy for target motion recognition.

References

  1. 1.
    Ates, S., Haarman, C.J.W., Stienen, A.H.A.: SCRIPT passive orthosis: design of interactive hand and wrist exoskeleton for rehabilitation at home after stroke. Auton. Robots 41(3), 711–723 (2017)CrossRefGoogle Scholar
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    Wolf, S.L., Blanton, S., Baer, H., et al.: Repetitive task practice: a critical review of constraint-induced movement therapy in stroke. Neurologist 8(6), 325–338 (2002)Google Scholar
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    Diez, J.A., Catalan, J.M., Lledo, L.D., et al.: Multimodal robotic system for upper-limb rehabilitation in physical environment. Adv. Mech. Eng. 8(9), 8/9/1687814016670282 (2016)CrossRefGoogle Scholar
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    Sarac, M., Solazzi, M., Sotgiu, E., et al.: Design and kinematic optimization of a novel underactuated robotic hand exoskeleton. Meccanica 52, 749–761 (2017)MathSciNetCrossRefGoogle Scholar
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