Mindfulness Matters: TheImpact of Mindfulness Based Stress Reduction on Post-Stroke Cognition
正念很重要:基于正念的减压对中风后认知的影响
基本信息
- 批准号:10040512
- 负责人:
- 金额:$ 46.04万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-09-01 至 2023-08-31
- 项目状态:已结题
- 来源:
- 关键词:AffectAftercareAnalysis of CovarianceAnxietyAreaAttentionAttention ConcentrationAwarenessBrainBrain imagingCerebrumChronic DiseaseChronic PhaseClient satisfactionClinicCognitionCognition DisordersCognitiveControl GroupsDataDecision MakingDiabetes MellitusDiffuseElderlyElectroencephalographyEnrollmentEnvironmentExecutive DysfunctionExhibitsFatigueFunctional ImagingFunctional disorderFusiform gyrusHome environmentImaging DeviceImpaired cognitionImpairmentIndividualInfarctionInterventionLanguage DisordersLifeLocationMagnetoencephalographyMeasuresMeditationMental DepressionMigraineMindfulness TrainingMinorMood DisordersMoodsMorbidity - disease rateNatural HistoryNeuronsOlder PopulationOutcomeParticipantPatientsPatternPerceptionPerformancePhasePopulationProcessQuality of lifeRandomizedRecoveryRecovery of FunctionRegulationRehabilitation therapyResolutionRestRetirementSeriesSocial EnvironmentSocietiesStrokeSupport GroupsTestingTherapeuticThrombectomyTimeTraumatic Brain InjuryTreatment EffectivenessUnited States National Institutes of HealthVisualWorkYogaactive lifestyleaffective disturbanceanxiety treatmentbasechronic strokecognitive functioncognitive taskcognitive testingcohorteffective therapyexecutive functionfrontal lobefunctional statusgroup interventionimprovedindexingmindfulnessmindfulness-based stress reductionmotor deficitmultitaskneuroimagingneurophysiologynovelpost interventionpost strokepost stroke cognitive impairmentpost stroke depressionpreventprocessing speedprofessional atmosphererecruitstroke outcomestroke patientstroke recoverytooltreatment effect
项目摘要
PROJECT SUMMARY
Thrombectomy has significantly improved stroke outcomes. Nearly 80% of our clinic population now present
with small strokes and low NIH Stroke Scale (NIHSS) scores. However, despite “good recoveries”, greater than
40% endorse significant problems with concentration, attention, executive function, processing speed, and
mood during the subacute phase of recovery. This dysfunction prohibits individuals from fully reintegrating into
their prior home and workplace environments and can result in early retirement or loss of independence,
particularly in the older population. Some degree of recovery is observed by 6 months, but it is often
incomplete or too late to reverse prior life-altering decisions. The impaired executive function and processing
speed appear to occur independent of stroke size, location, or co-existing depression.
Magnetoencephalography (MEG) is a functional imaging tool able to evaluate neurophysiologic processes in
real time similar to EEG, but with better spatial resolution. Our prior work with MEG suggests that cerebral
activation patterns are not only slowed and more dispersed during task completion in individuals with minor
stroke compared to controls, but that there is abnormal activity in the frontal lobes, even at rest. Unfortunately,
many patients do not qualify for rehabilitation and there is little data regarding effective treatment options to
hasten or augment recovery.
Mindfulness training may provide an attractive therapeutic option. A combination of meditation, body
awareness, and yoga, Mindfulness Based Stress Reduction (MBSR) is an active process thought to engage
the frontal lobes. MBSR has been shown to improve anxiety and depression in patients with chronic disease
states like migraine and diabetes, and has also been evaluated in a small series of patients with chronic stroke
and traumatic brain injury demonstrating improved performance during tasks of executive function.
We propose to study the effect of MBSR in the early phase of stroke recovery to determine if this intervention
can help to prevent post-stroke morbidity. A cohort of 40 patients (NIHSS <8, mRS 0-2) will be enrolled.
Twenty will be randomized to a standard 8 week course of MBSR, while the control group will instead
participate in a weekly Stroke Support Group (SSG). Depression, cognition, patient perception of recovery, and
degree of re-integration into prior environments will be evaluated pre- and post-intervention to determine the
impact of mindfulness training on subacute post-stroke depression (Aim 3) and cognition (Aim 2). All
participants will undergo neuroimaging using MEG pre- and post-intervention to determine the
neurophysiologic effect of treatment (Aim 1).
Patients with minor stroke have tremendous potential to return to their prior level of function; however, many
fail to return to work or successfully reintegrate into society. MBSR would provide a novel, non-pharmacologic
treatment that is likely to be effective by targeting areas of abnormality confirmed by neuroimaging studies.
项目总结
血栓切除术显著改善了中风的预后。我们现在有近80%的诊所人员在场
中风小,NIH卒中量表(NIHSS)得分低。然而,尽管出现了“良好的复苏”,
40%的人认为注意力、注意力、执行功能、处理速度以及
在亚急性恢复期的情绪。这种功能障碍使个体无法完全重新融入
他们以前的家庭和工作环境,并可能导致提前退休或丧失独立性,
特别是在老年人口中。某些程度的恢复需要6个月才能观察到,但通常是
不完整或为时已晚,无法扭转之前改变生活的决定。执行功能和加工能力受损
速度似乎与卒中大小、位置或共存的抑郁无关。
脑磁图(MEG)是一种功能成像工具,能够评估脑梗塞的神经生理过程。
实时与脑电相似,但空间分辨率更高。我们之前对梅格的研究表明,大脑
患有次要疾病的个体在任务完成期间激活模式不仅变慢,而且更加分散
中风与对照组相比,但额叶活动异常,即使在休息时也是如此。不幸的是,
许多患者没有资格接受康复治疗,关于有效的治疗方案的数据也很少
加速或增强复苏。
正念训练可能会提供一种有吸引力的治疗选择。冥想、身体的结合
意识,和瑜伽,基于正念的减压(MBSR)是一个积极的过程,被认为是参与
额叶。MBSR已被证明可以改善慢性病患者的焦虑和抑郁
偏头痛和糖尿病等状态,也在一小部分慢性中风患者中进行了评估
以及创伤性脑损伤,表现出执行功能任务中表现的改善。
我们建议研究MBSR在卒中康复早期阶段的作用,以确定这种干预是否
有助于预防中风后的发病率。将纳入40名患者的队列(NIHSS<;8,MRS 0-2)。
20人将随机接受标准的8周MBSR疗程,而对照组将改为
参加每周一次的中风支持小组(SSG)。抑郁、认知、患者对康复的感知,以及
将在干预前和干预后评估重新融入先前环境的程度,以确定
正念训练对亚急性卒中后抑郁的影响(目标3)和认知(目标2)。全
参与者将在干预前后接受脑磁图的神经成像,以确定
治疗的神经生理学效应(目标1)。
轻微中风的患者有巨大的潜力恢复到他们以前的功能水平;然而,许多
未能重返工作岗位或成功重新融入社会。MBSR将提供一种新的、非药理的
通过针对神经成像研究证实的异常区域进行可能有效的治疗。
项目成果
期刊论文数量(0)
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Elisabeth Breese Marsh其他文献
Elisabeth Breese Marsh的其他文献
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{{ truncateString('Elisabeth Breese Marsh', 18)}}的其他基金
Digital Biomarkers for Vascular Cognitive Decline in Patients with Minor Stroke
轻微中风患者血管认知下降的数字生物标志物
- 批准号:
10525918 - 财政年份:2022
- 资助金额:
$ 46.04万 - 项目类别:
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