Cognitive-functional Evaluation of Anosognosia

NCT ID: NCT03712839

Last Updated: 2023-05-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

48 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-10-18

Study Completion Date

2022-06-30

Brief Summary

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Acquired brain damage patients usually show severe cognitive deficit that alter their performance on every day life activities. Some of them suffer anosognosia and they are not aware of their own limitations. This situation increases disability by producing a large number of unsafe behaviours, caregivers burn-out and impede rehabilitation by affecting patients desire to follow treatment instructions. From disciplines like Neuropsychology, Cognitive Neuroscience or Occupational Therapy, it is considered a crucial issue to investigate the cognitive and neural mechanisms responsible of anosognosia, as well as to increase our knowledge about the most efficient treatments to deal with this phenomenon. The main general objective of this project is to generate and validate a detailed cognitive assessment protocol within the context of ADL to evaluate the different cognitive components of consciousness proposed on the Toglia and Kirk´s model: 1) Offline componente: metacognitive knowledge and 2) Online component: emergent awareness, self-regulation, anticipatory awareness, self-evaluation and updating processes).

Detailed Description

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The proposed protocol is composed by two ecological tools: The Cog-Awareness ADL Scale (ADL scale of metacognitive knowledge) and the Basic and Instrumental ADL performance based test (Awareness ADL), to identify the presence of cognitive deficits and anosognosia in patients with ABI always within the context of everyday life activities. One first specific aim is to test the convergent validity of the two proposed ecological tools with other traditional and validated measures usually used to assess similar cognitive processes and components of self-awareness. The second specific objective is to investigate the external validity of the ecological tools, by testing whether they are able to discriminate between acquired brain damage patients with and without anosognosia and a group of neurologically healthy participants on every component.

After conducting a literature review of the subject we found that this would be the first protocol developed to identify all these components in the same study.

Conditions

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Anosognosia Brain Damage

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Acquired Brain Injury group with anosognosia

People with presence of an acquired brain damage and cognitive deficits relative to executive functions and memory. To determine the presence of anosognosia, patients must present an overestimation value of their capacities greater than 5 (\>5) in the discrepancy index on the Patient Competency Rating Scale (PCRS) (Prigatano et al., 1998).

Cognitive-functional evaluation

Intervention Type OTHER

The participants will be evaluated with a set of tools within the context of meaningful ADL.

Acquired Brain Injury group without anosognosia

People with presence of an acquired brain damage and cognitive deficits relative to executive functions and memory. These patients must present a score of \< 5 on the PCRS Scale.

Cognitive-functional evaluation

Intervention Type OTHER

The participants will be evaluated with a set of tools within the context of meaningful ADL.

Control group

Healthy participants matched in age, gender and educational level with the others two groups.

Cognitive-functional evaluation

Intervention Type OTHER

The participants will be evaluated with a set of tools within the context of meaningful ADL.

Interventions

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Cognitive-functional evaluation

The participants will be evaluated with a set of tools within the context of meaningful ADL.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Presence of an acquired brain damage objectively observed with medical reports.
* Cognitive deficits relative to executive functions and/or memory evaluated by the team of professionals who recruit participants in the hospital.

Exclusion Criteria

* Presence of a serious visuoperceptual deficit that makes it difficult to complete the ADL tasks, evaluated by the team of professionals who recruit participants in the hospital.
* Presence of an understanding deficit (aphasia) evaluated by the team of professionals who recruit participants in the hospital.
* Presence of spatial neglect evaluated with line cancellation and line bisection tests.
* Presence of motor deficits in both upper limbs that impedes to complete the ADL tasks.
* Total score in MMSE\<18
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Universidad de Granada

OTHER

Sponsor Role collaborator

María Rodríguez Bailón

OTHER

Sponsor Role lead

Responsible Party

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María Rodríguez Bailón

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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María Jesús Funes-Molina, Professor

Role: PRINCIPAL_INVESTIGATOR

Facultad de Psicología (Departamento de Psicología Experimental) - Campus de Cartuja s/n, Granada, 18071

References

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Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189-98. doi: 10.1016/0022-3956(75)90026-6. No abstract available.

Reference Type BACKGROUND
PMID: 1202204 (View on PubMed)

Giovannetti T, Libon DJ, Hart T. Awareness of naturalistic action errors in dementia. J Int Neuropsychol Soc. 2002 Jul;8(5):633-44. doi: 10.1017/s135561770280131x.

Reference Type BACKGROUND
PMID: 12164673 (View on PubMed)

Prigatano GP, Bruna O, Mataro M, Munoz JM, Fernandez S, Junque C. Initial disturbances of consciousness and resultant impaired awareness in Spanish patients with traumatic brain injury. J Head Trauma Rehabil. 1998 Oct;13(5):29-38. doi: 10.1097/00001199-199810000-00005.

Reference Type BACKGROUND
PMID: 9753533 (View on PubMed)

Forde EM, Humphreys GW, Remoundou M. Disordered knowledge of action order in action disorganisation syndrome. Neurocase. 2004 Feb;10(1):19-28. doi: 10.1080/13554790490960459.

Reference Type BACKGROUND
PMID: 15849156 (View on PubMed)

Schmidt J, Fleming J, Ownsworth T, Lannin NA. Video feedback on functional task performance improves self-awareness after traumatic brain injury: a randomized controlled trial. Neurorehabil Neural Repair. 2013 May;27(4):316-24. doi: 10.1177/1545968312469838. Epub 2012 Dec 27.

Reference Type BACKGROUND
PMID: 23270921 (View on PubMed)

Rodriguez-Bailon M, Montoro-Membila N, Garcia-Moran T, Arnedo-Montoro ML, Funes Molina MJ. Preliminary cognitive scale of basic and instrumental activities of daily living for dementia and mild cognitive impairment. J Clin Exp Neuropsychol. 2015;37(4):339-53. doi: 10.1080/13803395.2015.1013022. Epub 2015 Mar 25.

Reference Type BACKGROUND
PMID: 25805061 (View on PubMed)

Forde EM, Humphreys GW. Dissociations in routine behaviour across patients and everyday tasks. Neurocase. 2002;8(1-2):151-67. doi: 10.1093/neucas/8.1.151.

Reference Type BACKGROUND
PMID: 11997493 (View on PubMed)

Sirigu A, Zalla T, Pillon B, Grafman J, Agid Y, Dubois B. Selective impairments in managerial knowledge following pre-frontal cortex damage. Cortex. 1995 Jun;31(2):301-16. doi: 10.1016/s0010-9452(13)80364-4.

Reference Type BACKGROUND
PMID: 7555008 (View on PubMed)

Sirigu A, Zalla T, Pillon B, Grafman J, Agid Y, Dubois B. Encoding of sequence and boundaries of scripts following prefrontal lesions. Cortex. 1996 Jun;32(2):297-310. doi: 10.1016/s0010-9452(96)80052-9.

Reference Type BACKGROUND
PMID: 8800616 (View on PubMed)

Torralva T, Roca M, Gleichgerrcht E, Lopez P, Manes F. INECO Frontal Screening (IFS): a brief, sensitive, and specific tool to assess executive functions in dementia. J Int Neuropsychol Soc. 2009 Sep;15(5):777-86. doi: 10.1017/S1355617709990415. Epub 2009 Jul 28.

Reference Type BACKGROUND
PMID: 19635178 (View on PubMed)

Toglia J, Kirk U. Understanding awareness deficits following brain injury. NeuroRehabilitation. 2000;15(1):57-70.

Reference Type BACKGROUND
PMID: 11455082 (View on PubMed)

Merchan-Baeza JA, Rodriguez-Bailon M, Ricchetti G, Navarro-Egido A, Funes MJ. Awareness of cognitive abilities in the execution of activities of daily living after acquired brain injury: an evaluation protocol. BMJ Open. 2020 Oct 26;10(10):e037542. doi: 10.1136/bmjopen-2020-037542.

Reference Type DERIVED
PMID: 33109646 (View on PubMed)

Other Identifiers

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PSI2016-80331-P

Identifier Type: -

Identifier Source: org_study_id

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