Browsing by Author "Brooks, Brian L."
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- ItemOpen AccessAdvancing Concussion Assessment in Pediatrics (A-CAP): a prospective, concurrent cohort, longitudinal study of mild traumatic brain injury in children: protocol study(BMJ, 2017-07-01) Yeates, Keith O.; Beauchamp, Miriam; Craig, William; Doan, Quynh; Zemek, Roger; Bjornson, Bruce H.; Gravel, Jocelyn; Mikrogianakis, Angelo; Goodyear, Bradley; Abdeen, Nishard; Beaulieu, Christian; Dehaes, Mathieu; Deschenes, Sylvain; Harris, Ashley D.; Lebel, Catherine; Lamont, Ryan; Williamson, Tyler; Barlow, Karen M.; Bernier, Francois; Brooks, Brian L.; Emery, Carolyn; Freedman, Stephen B.; Kowalski, Kristina; Mrklas, Kelly; Tomfohr-Madsen, Lianne; Schneider, Kathryn J.Introduction Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI. Methods and analysis A-CAP is a prospective, longitudinal cohort study of children aged 8.00-16.99 years with either mTBI or OI, recruited during acute emergency department (ED) visits at five sites from the Pediatric Emergency Research Canada network. Injury information is collected in the ED; follow-up assessments at 10 days and 3 and 6 months postinjury measure a variety of neurobiological and psychosocial markers, covariates/confounders and outcomes. Weekly postconcussive symptom ratings are obtained electronically. Recruitment began in September 2016 and will occur for approximately 24 months. Analyses will test the major hypotheses that neurobiological and psychosocial markers can: (1) differentiate mTBI from OI and (2) predict outcomes of mTBI. Models initially will focus within domains (eg, genes, imaging biomarkers, psychosocial markers), followed by multivariable modelling across domains. The planned sample size (700 mTBI, 300 OI) provides adequate statistical power and allows for internal cross-validation of some analyses. Ethics and dissemination The ethics boards at all participating institutions have approved the study and all participants and their parents will provide informed consent or assent. Dissemination will follow an integrated knowledge translation plan, with study findings presented at scientific conferences and in multiple manuscripts in peer-reviewed journals.
- ItemOpen AccessAn examination of the communicative linguistic abilities of children adopted from Romanian orphanages(2001) Brooks, Brian L.; Graham, Susan
- ItemOpen AccessAssessing Spatial Orientation Skills in Athletes After Sustaining a Concussion: A Pilot Study(2019-07-03) McFarlane, Liam Heath; Iaria, Giuseppe; Yeates, Keith Owen; Schneider, Kathryn J.; Brooks, Brian L.As a pilot study I investigated whether suffering a sport-related concussion (SRC) affected adolescent hockey participants’ abilities to form and use cognitive maps. To assess cognitive map formation and use a modified version of the Spatial Configuration Task (m-SCT), a computerized tool that has been shown to quantitatively measure an individual’s ability to form and use cognitive maps (Burles, 2014), was administered to a group of 18 adolescent hockey participants suffering from a SRC and a group of 19 adolescent controls with similar age, sex, handedness and no reported history of concussion. Using age as a covariate, an ANCOVA revealed a significant difference between athletes’ with a concussion (M = 42.61, SD = 7.22) m-SCT performances when compared to healthy controls’ (M = 48.32, SD = 8.27; F(1,34) = 5.82, p = .021, d ̂ = -0.72). As a group, adolescent participants with concussion performed significantly worse than the control group. There was no significant difference between groups average response time and no significant correlation between m-SCT performance and athlete reported symptoms on the Sport Concussion Assessment Tool, version 5 (SCAT5). However, a post hoc one-tailed Pearson’s partial correlations analysis revealed that participants with a concussion, as an independent group, show a positive relationship between average response time and performance on the m-SCT (r(15) = .51, p = .038). A discussion is provided and focuses on implications of the observed groups difference in performances on the m-SCT, the study’s limitations and recommendations for future studies wishing to investigate cognitive map formation in adolescents’ athletes with concussion. Additionally, this study also provides preliminary results showing that the Spatial Configuration Task may be modified in difficulty when assessing cognitive map formation in adolescents and children.
- ItemOpen AccessAn examination of communicative interactions of children from Romanian orphanages and their adoptive mothers(Canadian Psychological Association : Canadian Journal of Behavioural Science, 2014-01) Graham, Susan; Nilsen, Elizabeth S.; Mah, Janet W. T.; Morison, Sara J.; MacLean, Kim; Fisher, Lianne; Brooks, Brian L.; Ames, Elinor WardwellBefore adoption to Canada, children from Romanian orphanages experienced conditions of global deprivation. In this study, we examined the communicative interactions of 4-year-old children adopted from Romania with their adoptive mothers and those of age-matched Canadian-born children. In general, children who had spent more than 8 months in a Romanian orphanage (later adoptees; n = 27) did not differ in the types of communicative intents produced in unstructured interactions from their earlier-adopted peers (n = 21). Later adoptees did produce more acknowledgment utterances, fewer praise utterances, and more requests than the Canadian-born children (n = 27). Mothers of later-adopted children adopted from Romanian orphanages used more frequent regulatory language than mothers of earlier-adopted or Canadian-born children. Mothers’ increased regulation of their child’s activity through language was related to their child’s attachment style and attention difficulties, which significantly differed between the child groups. The results demonstrate that children’s characteristics can influence caregivers’ communicative behaviours. Importantly, results suggest that children from adverse conditions adopted into healthier environments do not show long-term differences in pragmatic or social language usage.
- ItemEmbargoInjury Setting and Social Support as Moderators of the Effects of Pediatric Concussion on Post-Concussive Symptoms(2020-09-16) Chadwick, Leah; Yeates, Keith Owen; Emery, Carolyn A.; Brooks, Brian L.; Madigan, Sheri L.Concussions are a pressing public health concern. Concussions often result in physical, cognitive, and emotional problems, known as post-concussive symptoms (PCS). Although most children recover from concussions without complication, a subset are hindered by persistent PCS that reduce their quality of life. Previous research tends to differentiate between sport-and-recreation-related and non-sport-related concussions because there may be differences between these settings that affect concussion outcomes. Social support, the perceived or actual support a person receives from their community and social networks, is known to protect against detrimental consequences of health problems. However, little research has examined the effect of social support on PCS after concussion. Social support may foster recovery, particularly for children with sport-related concussions, who are often isolated from their teams during recovery, resulting in feelings of loneliness and isolation. This study aimed to identify the effects of social support on PCS in children after sport-related versus non-sport-related concussion. Participants were children/adolescents aged 8-16 years with either concussion or orthopedic injury who were recruited during Emergency Department visits at five sites across Canada. Injury information was collected in the Emergency Department, social support was measured at 10 days, and PCS were measured at 10 days, 3 months, and 6 months post-injury. Linear multi-level modelling analysis was used to examine injury group (concussion versus orthopedic injury), injury setting (sport-related versus non-sport-related), and social support as predictors of PCS over time. The analyses found that social support predicted lower ratings of cognitive PCS, but regardless of the type of injury. However, injury setting did have a specific moderating effect on recovery from concussion, such that concussions in non-sport-related settings were associated with higher cognitive PCS relative to orthopedic injuries and concussions occurring in sport-related settings. We did not find any significant effects of social support or injury setting on somatic PCS, which suggests that trajectories of somatic and cognitive PCS after concussion may be associated with different risk factors.
- ItemOpen AccessParent and family impact of raising a child with perinatal stroke(BioMed Central, 2014-07-14) Bemister, Taryn B.; Brooks, Brian L.; Dyck, Richard H.; Kirton, Adam
- ItemOpen AccessPossible Lingering Effects of Multiple Past Concussions(2012-02-26) Iverson, Grant L.; Echemendia, Ruben J.; LaMarre, Amanda K.; Brooks, Brian L.; Gaetz, Michael B.Background. The literature on lingering or “cumulative” effects of multiple concussions is mixed. The purpose of this study was to examine whether athletes with a history of three or more concussions perform more poorly on neuropsychological testing or report more subjective symptoms during a baseline, preseason evaluation. Hypothesis. Athletes reporting three or more past concussions would perform more poorly on preseason neurocognitive testing. Study Design. Case-control study. Methods. An archival database including 786 male athletes who underwent preseason testing with a computerized battery (ImPACT) was used to select the participants. Twenty-six athletes, between the ages of 17 and 22 with a history of three or more concussions, were identified. Athletes with no history of concussion were matched, in a case-control fashion, on age, education, self-reported ADHD, school, sport, and, when possible, playing position and self-reported academic problems. Results. The two groups were compared on the four neuropsychological composite scores from ImPACT using multivariate analysis of variance followed by univariate ANOVAs. MANOVA revealed no overall significant effect. Exploratory ANOVAs were conducted using Verbal Memory, Visual Memory, Reaction Time, Processing Speed, and Postconcussion Scale composite scores as dependent variables. There was a significant effect for only the Verbal Memory composite. Conclusions. Although inconclusive, the results suggest that some athletes with multiple concussions could have lingering memory deficits.
- ItemOpen AccessPredictors of caregiver depression and family functioning after perinatal stroke(BioMed Central Pediatrics, 2015-07-15) Bemister, Taryn B.; Brooks, Brian L.; Dyck, Richard H.; Kirton, AdamBACKGROUND: Perinatal stroke is a leading cause of cerebral palsy and lifelong neurological morbidity. Studies on perinatal stroke outcomes are increasing, although examinations of its broader impact on parents and families have been limited. A recent study found that parents of children with moderate and severe outcomes have increased risk for psychosocial concerns, including depressive symptoms and poor family functioning. Other parents adapt remarkably well, but how this occurs is unknown. The primary aim of this study was to examine predictors of parent and family outcomes, namely caregiver depression and family functioning. The secondary aim was to explore potential mediators and moderators of the relationship between condition severity and parent and family outcomes. METHODS: Parents were recruited from a large, population-based perinatal stroke research cohort, and they completed measures assessing their demographics, social supports, stress levels, marital quality, feelings of guilt and blame, psychological well-being, and family functioning. Bivariate analyses compared these variables. Predictor variables, mediators, and moderators were chosen according to the strength of their relationship with the outcome variables (i.e., caregiver depression and family functioning) and theory. Hierarchical regression, mediator, and moderator analyses were conducted accordingly. RESULTS: A total of 103 parents participated in this study (76 mothers, 27 fathers; mean age of 39.2 years; mean child age of 7.46 years). Condition severity, anxiety, social support, and blame independently predicted caregiver depression while condition severity, stress levels, and marital quality independently predicted family functioning. Blame regarding the cause of their child's condition also mediated the relationship between condition severity and caregiver depression. CONCLUSIONS: Adverse parental outcomes can be predicted in perinatal stroke populations. Moreover, anxiety and stress management techniques, marital support, and psychoeducation regarding the unpreventable nature of perinatal stroke may be utilized in the future to enhance family outcomes.
- ItemOpen AccessThe Roles of Cognitive Reserve, Brain Reserve, and Psychological Resilience in Predicting Trajectories of Post-Concussive Symptoms in Children with Concussion and Orthopaedic Injury(2020-08-26) Laliberté Durish, Christianne; Yeates, Keith Owen; Brooks, Brian L.; Noel, MelanieStudy 1: Objective. The current scoping review collated published research examining cognitive and brain reserve, as well as psychological resilience, in the context of traumatic brain injury (TBI) to address the following aims: (1) identify constructs and associated tools measured as proxies of reserve and resilience, (2) explore construct validity and mechanisms of reserve and resilience, as related to TBI, (3) describe relationships among reserve and resilience in the context of TBI, and (4) identify outcomes of TBI predicted by reserve and resilience. Methods. Specific search criteria were entered into MEDLINE Ovid and PsycINFO Ovid databases to capture relevant original research studies from inception to April 2020. Search results underwent title and abstract screen, as well as full-text review, to identify original research studies that examined the roles of cognitive reserve, brain reserve, or psychological resilience in individuals with TBI. Results. A total of 47 articles met inclusion criteria and were included in the review. The majority of studies examined cognitive reserve or resilience, and only one study examined brain reserve. Cognitive reserve was primarily measured via estimated pre-morbid intelligence, education, or occupational attainment using a variety of measures; brain reserve was measured via total intracranial volume; and resilience was primarily measured via a variety of self-report measures capturing individual/psychological factors associated with resilience. Studies supported brain reserve as a static factor and cognitive reserve and resilience as dynamic factors, and indicated reserve and resilience to be protective factors in a variety of cognitive, psychological, and social outcomes associated with TBI. Conclusions. Results elucidate current understandings of the roles of reserve and resilience in the context of TBI, as well as identify knowledge gaps that remain to be addressed. The results may aid in guiding future research studies directed towards improving prognosis and treatment of TBI. Study 2: Objectives. The current study sought to examine the roles of psychological resilience, cognitive reserve, and brain reserve as predictors of and moderators of group differences in trajectories of post-concussive symptoms (PCS) among children with concussion and orthopaedic injury (OI). Methods. This study was completed as part of a larger parent study. A total of 465 children/adolescents, aged 8-17 years, and their caregivers were recruited prospectively from emergency departments across Canada after sustaining a concussion (n = 304) or OI (n = 161). Participants were followed for 6 months and were assessed at 3 time points: post-acute (i.e., approximately 10-days post-injury) and 3- and 6-months post-injury. Participants completed magnetic resonance imaging, which provided a measure of total brain volume (TBV), and a measure assessing psychological resilience during the post-acute assessment. Intelligence (estimated Full Scale IQ) was assessed during the 3-month assessment. Child- and parent-reported cognitive and somatic PCS were measured at all three time points. Linear mixed models were conducted to examine the effect of psychological resilience, IQ, and TBV as predictors and moderators of group differences in trajectories of PCS. Results. Primary analyses indicated that group, sex, age, retrospective ratings of pre-injury symptoms, and psychological resilience were predictive of individual differences in PCS; however, only group and pre-injury symptoms predicted changes in PCS across time and no moderation effects were found. Conclusions. Psychological resilience is an important predictor of PCS, regardless of injury type. However, cognitive reserve and brain reserve, which might be conceptualized as “neurological resilience”, may be less relevant in the context of minor injuries that have relatively little direct impact on neurological function. Results provide important implications for the implementation of resilience intervention efforts to help mitigate PCS and their negative consequences.
- ItemOpen AccessSleep Disturbances and Fatigue in Survivors of Pediatric Acute Lymphoblastic Leukemia and their Siblings(2019-08-19) Russell, Karleen Brooke; Tomfohr-Madsen, Lianne M.; Schulte, Fiona S. M.; Noel, Melanie; Brooks, Brian L.; Laing, Catherine M.Sleep disturbances and fatigue have been identified by patients with cancer as common and distressing. Conflicting evidence about the prevalence of these outcomes, however, exists for survivors of childhood cancers. Additionally, little is known about how the cancer trajectory might impact survivor siblings’ sleep and fatigue. The current study compared sleep and fatigue in survivors of acute lymphoblastic leukemia (ALL) (2-7 years off therapy) and their siblings to healthy control sibling dyads. We hypothesized that survivors would have less total sleep time (TST), greater wake after sleep onset (WASO), poorer sleep efficiency (SE), and higher ratings of fatigue than controls. Participants (survivors, n=45; survivor siblings, n=27; controls, n=45; control siblings, n=41; 58% male) aged 8-18 (m=11.64, SD=2.62) completed the PedsQL Multidimensional Fatigue Scale, a 7-day sleep diary, and 7-consecutive days of actigraphy. Parents (n=90) completed the Children’s Sleep Habits Questionnaire for each of their children. No between-group differences were found on measures of fatigue, sleep diaries, or actigraphy. Parents reported that survivor siblings had significantly poorer sleep habits than survivors or controls. For survivors, greater time off treatment and younger age at diagnosis were significantly related to poorer outcomes via actigraphy on TST, WASO, and SE, as well as sleep-onset latency (SOL) via sleep diaries. This research suggests that poorer sleep in later survivorship from childhood cancer may be related to late-effects, which may account for variability in these findings in the broader literature, and that siblings of survivors of childhood cancer may be at risk for sleep problems.
- ItemOpen AccessThe relationship between executive functioning and independent living skills in mild cognitive impairment and mild dementia(2005) Brooks, Brian L.; Scialfa, Charles T.