Multidimensional review of cognitive impairment after spinal cord injury
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REVIEW ARTICLE
Multidimensional review of cognitive impairment after spinal cord injury Fang Li1 · Su Huo1 · Weiqun Song1 Received: 25 June 2020 / Accepted: 19 September 2020 © Belgian Neurological Society 2020
Abstract Cognitive impairment is highly prevalent in the population with spinal cord injury (SCI) and exerts a significant impact on functional independence and quality of life in this population. A number of neuroscientists have conducted preliminary investigations of cognitive deficits after SCI, but achieved marginally contradictory results due to some limitations such as the heterogeneity in the sample population, sample size, types of tests utilized, study design, and time since SCI. Therefore, this review mainly focuses on the characteristics, assessments, potential causality and treatment of cognitive impairment for better understanding such deficits in the SCI population. Keywords Spinal cord injury (SCI) · Cognitive impairment · Cognition
Introduction Spinal cord injury (SCI) occurs when the spinal cord is severely bruised, compressed, lacerated, or severed due to traumatic injury or disease [1]. It is common knowledge that up to 90% of all spinal cord injuries are of traumatic etiology. Among the most common causes of SCI are motor vehicle accidents, falls, work and recreation/sports activities, and violence [2, 3]. SCI is a major public health concern with a prevalence rate of 236–1298 per million people and an annual incidence rate of 9.2–246.0 per million people, creating a tremendous burden on patients, families, and health care providers [2]. Historically, research in the population with SCI has focused primarily on the associated physical limitations, as well as the majority of rehabilitation efforts target these physical deficits [4]. However, in recent years, technological advancements have dramatically improved the life span of SCI individuals, with up to 90% of patients now surviving past the first year of injury and nearly 50% surviving for 40 years post-injury [5]. This has led to the expansion of rehabilitation programs including gainful employment and * Weiqun Song [email protected] 1
reintegrating into the community rather than merely focusing on addressing physical impairments [5]. Consequently, cognitive functioning is a major concern in these expanded tasks. Indeed, SCI is believed to be associated with high rates of cognitive deficits which can lead to complications in recovery. Following SCI, cognitive deficits are reported in as much as 64% of individuals [5, 6]. The risk of an adult with SCI having cognitive deficits is nearly 13 times greater than is found in uninjured individuals [5, 7]. It has been reported that cognitive declines after SCI are diverse affecting various domains such as attention, concentration, abstract reasoning, verbal learning, new learning and memory (NLM), and processing speed (PS) [4, 8, 9]. These cognitive dysfunctions have a substantial negative impact on functional outcomes after SCI, with less functional gains during rehabilitation [4]. In
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