David Gillespie

NHS Lothian · Department of Clinical Neurosciences

Illness representations refer to a person’s beliefs about their health condition and are thought to influence clinical outcomes. By understanding factors related to illness representations, potentially modifiable targets for psychological intervention can be identified. The aim of this systematic review was to synthesise the literature on factors a...

Objective: Mental distress is present in a significant proportion of people with epilepsy (PWE), with a negative impact across life domains. It is underdiagnosed and under-treated despite guidelines recommending screening for its presence (e.g., SIGN, 2015). We describe a tertiary-care epilepsy mental distress screening and treatment pathway, with...

Introduction Pain and cognitive dysfunction are separately known to be important manifestations of multiple sclerosis (MS). Although pain is a complex subjective phenomenon with affective and cognitive aspects, it is not known if people with MS reporting pain are at greater risk of reduced performance in objective tests of cognition. The presence o...

Background: Perception is the ability to understand information from our senses. It allows us to experience and meaningfully interact with our environment. A stroke may impair perception in up to 70% of stroke survivors, leading to distress, increased dependence on others, and poorer quality of life. Interventions to address perceptual disorders m...

Background Fatigue is common and disabling in multiple sclerosis (MS), yet its mechanisms are poorly understood. In particular, overlap in measures of fatigue and depression complicates interpretation. We applied a multivariate network approach to quantify relationships between fatigue and other variables in early MS. Methods Data were collected f...

BACKGROUND There are no effective treatments for brain tumor-related fatigue. We studied the feasibility of two novel lifestyle coaching interventions in fatigued brain tumor patients. METHODS This Phase I / feasibility multi-center RCT recruited patients with a clinically stable primary brain tumor and significant fatigue (mean Brief Fatigue Inve...

Background Pain and cognition are important symptoms in multiple sclerosis (MS). Cognitive processes contributing to pain experience are increasingly documented. Any relationship between pain and objectively measured cognitive performance (OMCP) in MS, including potential mediating factors such as fatigue and medication, remains unclear. Understand...

Objective To test the feasibility of a telephone delivered intervention, informed by cognitive behavioural principles, for post-stroke fatigue, and estimated its effect on fatigue and other outcomes. Design Randomised controlled parallel group trial. Setting Three Scottish stroke services. Subjects Stroke survivors with fatigue three months to t...

Perceptual disorders relating to hearing, smell, somatosensation, taste, touch, and vision commonly impair stroke survivors’ ability to interpret sensory information, impacting on their ability to interact with the world. We aimed to identify and summarize the existing evidence for perceptual disorder interventions poststroke and identify evidence...

Objective: There are few longitudinal studies of poststroke emotionalism (PSE) and our understanding of the psychological associations of PSE is limited, constraining assessment of existing interventions and the development of new therapies. This study aimed to assess the prevalence and course of PSE over the first year poststroke, and its psychol...

Introduction Post stroke emotionalism (PSE) is a common but poorly understood condition. The value of altered brain structure as a putative risk factor for PSE alongside routinely available demographic and clinical variables has yet to be elucidated. Methods 85 patients were recruited from acute inpatient settings within 2 weeks of stroke. PSE was...

Fatigue is common and disabling in multiple sclerosis, yet its mechanisms are poorly understood. In particular, overlap in measures of fatigue and depression complicates interpretation. A clearer understanding of relationships between fatigue and key clinical, neuropsychiatric and imaging variables including depression could yield clinically releva...

Idiopathic drop attacks are falls to the floor, without warning, and without loss of consciousness, for which the cause is uncertain. They are poorly studied but recent research suggests that many idiopathic drop attacks may be usefully considered within the spectrum of functional neurological disorder (FND). The aim of this study was to test a cog...

Objective To evaluate, using a classification tree methodology, the ability of the Testing Emotionalism After Recent Stroke – Questionnaire (TEARS-Q) to determine the need for further assessment of post-stroke emotionalism and to identify those whose emotionalism is sufficiently clear that they need assessment for potential intervention. Setting A...

Objective To evaluate, psychometrically, a new measure of tearful emotionalism following stroke: Testing Emotionalism After Recent Stroke – Questionnaire (TEARS-Q). Setting Acute stroke units based in nine Scottish hospitals, in the context of a longitudinal cohort study of post-stroke emotionalism. Subjects A total of 224 clinically diagnosed st...

BACKGROUND Fatigue is common and disabling for brain tumour patients. We studied the feasibility of two innovative lifestyle coaching interventions for high fatigue. METHODS Multi-centre phase II feasibility RCT (ISRCTN17883425). Adult primary brain tumour outpatients reporting significant fatigue (Brief Fatigue Inventory [BFI] score 4+), were ran...

Traumatic events can be associated with positive change, termed “post-traumatic growth.” Existing resesarch suggests some overlap between post-traumatic growth and value-directed living. This study sought to explore the relationship between post-traumatic growth and value-directed living after acquired brain injury. Self-report questionnaires inclu...

Background: Approximately, half of stroke survivors experience fatigue. Fatigue may persist for many months and interferes with participation in everyday activities and has a negative impact on social and family relationships, return to work, and quality of life. Fatigue is among the top 10 priorities for 'Life after Stroke' research for stroke su...

Supportive interventions are needed for the family and carers of people with multiple sclerosis. A rapid realist review and realist evaluation explored what helps, who it helps, when and how. Literature analysis was synthesised with a thematic analysis of qualitative interviews and focus groups with 49 family and carers of people with multiple scle...

Purpose: To determine the prevalence and predictors of fatigue in clinically stable primary brain tumor patients, we used objective and subjective measures and a cross-sectional design. Methods: Eighty-five brain tumor patients completed self-report measures of fatigue, sleep disturbance, mood and growth hormone deficiency. Objective measures of sl...

Background: Post-stroke emotionalism (PSE) is common. Trials of antidepressants for PSE suggest only modest clinical benefit and risk of side effects. There have been no trials of non-pharmacological treatments for PSE; in fact, little is known about the non-pharmacological treatments actually provided to PSE sufferers in clinical practice. Objecti...

Background/Aims Going into and coming out of hospital can be an uncertain and sometimes emotional experience for carers as well as patients. Many carers feel insufficiently involved and unsupported in the discharge process. However, we know that if hospital discharge is well-planned and the right services put in place then there is a much greater l...

Background: Gliomas are brain tumours arising from glial cells with an annual incidence of 4 to 11 people per 100,000. In this review we focus on gliomas with low aggressive potential in the short term, i.e. low-grade gliomas. Most people with low-grade gliomas are treated with surgery and may receive radiotherapy thereafter. However, there is con...

Introduction: Post-stroke emotionalism, outbursts of involuntary crying or laughing, is common after stroke. Little is known about the psychosocial factors associated with this neurological disorder. Aim: To investigate participant’s experiences of emotionalism and explore how they managed their symptoms. Methods: A qualitative study that used fram...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the long-term neurocognitive and other side effects of radiotherapy (with or without chemotherapy) compared with no radiotherapy, or different types of radiotherapy, among people with glioma (where 'long-term' is defined as at least two years after d...

Background and aim Post-stroke fatigue (PSF) is common and distressing, but there is insufficient evidence to recommend any effective treatment for it. Psychological interventions are effective in treating fatigue in other conditions. This paper describes the development and evaluation of the feasibility of a psychological intervention for PSF. Me...

TREND statement checklist. (PDF)

Study protocol. A feasibility study of a brief psychological intervention for post-stroke fatigue. (PDF)

The NHS Lothian Neuropsychology Service has produced a website and video teaching resources that were collaboratively developed with the support of Brain Tumour Action, multidisciplinary colleagues and patients. We believe that many of the resources on the site will be of interest to clinical psychologists, professionals from other disciplines, pat...

Background: Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke. Physicians can treat these patients with antidepressants or other anxiety-reducing drugs, or both, or they can provide psychological therapy. This review looks at available evidence for these interventions. This is an up...

Introduction: Epilepsy is associated with adverse effects on cognition and psychological functioning. Polytherapy and poor seizure control have been associated with poor cognition. Little research has been carried out on the impact of epileptic seizures and anti-epileptic drugs (AED) on cognition in patients with brain tumours (BT). We have compare...

We report on the results of a multidisciplinary staff survey carried out in the acute neuroscience setting. Respondents from nursing, medicine, the allied health professions (AHPs) and hospital management were asked to rate the importance of the different types of work undertaken by the clinical neuropsychologists, and clinical staff also rated the...

Background Cognitive impairment is common in people with chronic kidney disease (CKD) and associated with increased morbidity and mortality. Subtle changes can impact engagement with healthcare, comprehension, decision-making, and medication adherence. We aimed to systematically summarise evidence of cognitive changes in CKD. Methods We searched ME...

Opinion statement: Neurocognitive deficits are common with brain tumors. If assessed at presentation using detailed neurocognitive tests, problems are detected in 80 % of cases. Neurocognition may be affected by the tumor, its treatment, associated medication, mood, fatigue, and insomnia. Interpretation of neurocognitive problems should be conside...

Background: Cognitive impairment is associated with poorer quality of life, risk for hospitalization, and mortality. Cognitive impairment is common in people with end-stage kidney disease treated with hemodialysis, yet the severity and specific cognitive deficits are uncertain. Study design: Systematic review and meta-analysis. Setting & popula...

Background: Several studies have reported that emotional lability is a common consequence of stroke. However, there is uncertainty about the "true" prevalence of the condition because, across these studies, patients have been recruited at different stages of recovery, from different settings, and using different diagnostic methods. There have been...

It is well established that stroke can result in impairments of cognitive functioning, particularly early after stroke onset.1 These cognitive impairments have a negative impact on activities of daily living,2 and are associated with lower mood and poorer quality of life.3 Improvement of cognitive functioning is therefore an important goal of rehab...

Background: Although cognitive impairments are common following stroke, there is considerable uncertainty about the types of interventions that can reduce activity restrictions and improve quality of life. Indeed, a recent project to identify priorities for research into life after stroke determined that the top priority for patients, carers and h...

Aim: To develop a practical system to enable nurses to screen for psychological distress following stroke. Background: Mood disorders and psychological distress are prevalent following stroke, but often go undetected and therefore untreated. National guidelines recommend screening for distress, but the evidence suggests that there are significant b...

Comparing current with estimated premorbid performance helps identify acquired cognitive deficits after brain injury. Tests of reading pronunciation, often used to measure premorbid ability, are inappropriate for stroke patients with motor speech problems. The Spot-the-Word Test (STWT), a measure of lexical decision, offers an alternative approach...

Stroke, and other adult-acquired brain injury, can impair a person's ability to process the multiple sources of sensory data experienced in daily life. Perceptual impairments are many and diverse, impact on everyday activities, reduce independence, and cause distress, for example, difficulty recognizing familiar faces and everyday objects, errors j...

Background: Approximately 20% of stroke patients experience anxiety at some point after stroke. Objectives: To determine if any treatment for anxiety after stroke decreases the proportion of patients with anxiety disorders or symptoms, and to determine the effect of treatment on quality of life, disability, depression, social participation, risk...

The effects of stroke on families are considerable. Family members may struggle to adapt to a care-giving role, and relationships between stroke survivors and those closest to them are often altered by the illness. This article provides an overview of the effects of stroke on family dynamics and identifies interventions to support stroke survivors...

In this review, we begin by considering why post-stroke depression (PSD) is so prevalent. We then examine the current evidence base to support cognitive behavioural therapy (CBT) as a treatment approach for the condition. While there is limited evidence currently, we demonstrate that much remains to be established with regard to PSD and the efficac...

Stroke and other adult-acquired brain injury may impair perception leading to distress and increased dependence on others. Perceptual rehabilitation includes functional training, sensory stimulation, strategy training and task repetition. To examine the evidence for improvement in activities of daily living (ADL) six months post randomisation for a...

David C Gillespie, Sara Joice, Maggie Lawrence, Janice Whittick Background: Stroke is a leading cause of death and disability. A high proportion of those who survive participate in programmes of rehabilitation. Clinical practice guidelines have come to play an increasingly important role in stroke rehabilitation, providing accessible summaries of t...

Stroke is the third most common cause of death and the most frequent cause of severe adult disability in Scotland.1 Despite considerable advances in organised stroke care over recent years, improvements are still needed,2 because patients have been reported to spend up to 50% of their time in bed3 and only 20% of their time in treatment.4 Since pub...

We examined the evidence for widely held clinical beliefs about memory impairment following right hemisphere stroke (RHS), conducting both narrative and meta-analytic reviews of the literature [MEDLINE (1966-January 2003), PsycINFO (1974-January 2003), and CINAHL (1982-December 2002)]. We sought to determine whether RHS patients experience more pro...

This study provides performance data for older adults on two existing tests of cognitive estimation ability (Cognitive Estimation Test [CET] and Temporal Judgement Test [TJT]) and a novel set of estimation questions (n-EQ) that make reference to familiar, everyday objects. It explores the relations between each of the three tests of estimation and...

Anxiety disorders are reported to be common but poorly understood poststroke phenomena. The relationships between symptoms of anxiety, coping activity, and stage of recovery were investigated in 44 subjects who had suffered strokes (mean age 68.6 years). Consistent with general models of anxiety disorders, anxiety was associated with more frequent...