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Objective: COVID-19 lockdowns in 2020 limited activities of daily life. Data on the impact on healthcare systems is ambiguous. So far no data has been published for pediatric neurosurgery in Germany. We present the results of a big data approach. Method(s): We obtained anonymous data from the nationwide database of hospital statistics (German Federal Statistical Office, www. desta tis. de) in August 2022. For the age group <18 years in 2016- 2020, the following diagnoses (ICD-10 code) were analysed: Intracranial injury (S06), malignant (C71), benign (D33) and unspecified (D43) neoplasia, abuse (T74), violent attack (Y09) and, for comparison, forearm fracture (S52). The following operations (OPS code) were chosen: Operation of the central nervous system (CNS, 5-01- 05), excision of intracranial lesion (5-015), shunt insertion (5-023), shunt revision (5-024), plastic operations of the spinal cord (5-036) and, for comparison, overall number of operations (OPS-5), spondylodesis (5-836) and functional neurosurgery (5-028) at all ages. Result(s): The number of operations declined from 17.23 million in 2019 to 15.82 million in 2020 (8.2%). CNS operations declined by 5%. Shunt insertion declined by 8.1%, revision by 5.1% and spinal cord operations by 6.6%, whereas excisions of intracranial lesions increased by 1.7%. Spondylodesis and functional operations both decreased by 11.9%. The hospitalisations for intracranial neoplasia declined by 8.8% compared to previous years. The number of inpatients with intracranial injury declined by 16%. Violent attack was also documented less often (-13.2%), but child abuse increased by 3.3%. Forearm fractures declined by 5.6%. Conclusion(s): The COVID-19 lockdown in 2020 lead to reduction of operations. Neuro-oncological operations were not affected. Intracranial injury even declined by 16%, reflecting limited activities and mobility. An increase in documented child abuse by 3.3% compared to the average of previous years was observed. These results help understand the impact of pandemics and political decisions and guide future decision-making.
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SARS-CoV-2 which first was observed in Wuhan region, China in December 2019 is affected many organs, such as central nervous system. We describe a case of a 57-year-old male patient, in hospital with the loss of consciousness, in the form of lack of verbal and visual communication. He got a seizure attack for about 3 minutes in the form of generalized tonic-clonic seizure (GTS) and admitted to the neurological department and was intubated. Since, the patient was not aware, awake, did not obey, corneal reflexes test was positive and his pupils were isochoric and reactive therefore, the primary diagnosis was cerebrovascular accident (CVA). On the second day after admission, although the brain computed tomography (CT) did not show brain lesion, but chest X-ray (CXR) revealed lung involvement. In addition, on third day the RT-PCR test for coronavirus RNA in and the cerebrospinal fluid and nasopharyngeal swap done and the result was positive for both of them. Therefore, treatment for the covid-19 was started. Result(s): Since, the treatment for the covid-19 was started with Atazanavir, Clindamycin and ceftriaxone, ten days after hospitalization, the lung involvement and general condition of patient got better and after two weeks he was released from the hospital. Conclusion(s): GTS should be considered as a neurological outcome of COVID-19 and medications against the coronavirus, such as Atazanavir, Clindamycin and ceftriaxone can recover the neurological deficits in these patients.Copyright© 2020, TMU Press.
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The SARS-CoV-2 virus caused an unprecedented pandemic around the globe, infecting 36.5 million people and causing the death of over 1 million in the United States of America alone. COVID-19 patients demonstrated respiratory symptoms, cardiovascular complications, and neurologic symptoms, which in most severe cases included encephalopathy and encephalitis. Hypoxia and the uncontrolled proliferation of cytokines are commonly recognized to cause encephalopathy, while the retrograde trans-synaptic spread of the virus is thought to cause encephalitis in SARS-CoV-2-induced pathogenesis. Although recent research revealed some mechanisms explaining the development of neurologic symptoms, it still remains unclear whether interactions between these mechanisms exist. This review focuses on the discussion and analysis of previously reported hypotheses of SARS-CoV-2-induced encephalopathy and encephalitis and looks into possible overlaps between the pathogenesis of both neurological outcomes of the disease. Promising therapeutic approaches to prevent and treat SARS-CoV-2-induced neurological complications are also covered. More studies are needed to further investigate the dominant mechanism of pathogenesis for developing more effective preventative measures in COVID-19 cases with the neurologic presentation.
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There is an urgent global need for accessible, usable, effective and scalable skills training and support programs for carers of people with dementia, particularly in LMICs. WHO's iSupport is filling this gap by providing such a program, accessible for translation and cultural adaptation worldwide. First steps have been undertaken to support the systematic and culturally fair translation and adaptation of the program in several countries. However, while web-based or online programs for dementia carers such as iSupport seem to be promising, the scaling of these programs remains challenging and is a common issue for digital health solutions. In fact, the findings of a first efficacy study from India highlight the need to understand carers' individual situation better and tailor support programs even more to their specific needs. Going forward, iSupport could be improved by adding a mobile phone application to offer more flexibility to users, including an interactive or moderated chat function or more audio-visual materials to the online program to increase its appeal. To assist carers who wish to use more traditional ways of learning, WHO has released the iSupport hardcopy manual, which presents the entire iSupport content in book format. Further robust cultural adaptations and high-quality research investigating the effectiveness of iSupport across different settings and for different groups of carers are required. Finally, in the context of the ongoing COVID-19 pandemic, digital support services such as iSupport are more important than ever and present a real opportunity to build back better, which will help to reach the global target set by WHO that 75% of countries will provide support and training programs for carers and families of people with dementia by 2025. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background: Although increasing evidence confirms neuropsychiatric manifestations associated mainly with severe COVID-19 infection, long-term neuropsychiatric dysfunction (recently characterized as part of "long COVID-19" syndrome) has been frequently observed after mild infection. Method(s): We performed a broad translational investigation, employing brain imaging and cognitive tests in 81 living COVID-19 patients (mildly infected individuals) as well as flow cytometry, respirometry, microscopy, proteomics, and metabolomics in postmortem brain samples, and in preclinical in vitro and ex vivo models. Result(s): We observed orbitofrontal cortical atrophy, neurocognitive impairment, excessive fatigue and anxiety symptoms in living individuals. Postmortem brain tissue from 26 individuals who died of COVID-19 revealed histopathological signs of brain damage. Five individuals out of the 26 exhibited foci of SARS- CoV-2 infection and replication, particularly in astrocytes. Supporting the hypothesis of astrocyte infection, neural stem cell-derived human astrocytes in vitro are susceptible to SARS-CoV-2 infection through a non-canonical mechanism that involves spike-NRP1 interaction. SARS-CoV-2-infected astrocytes manifested changes in energy metabolism and in key proteins and metabolites used to fuel neurons, as well as in the biogenesis of neurotransmitters. Moreover, human astrocyte infection elicits a secretory phenotype that significantly reduces neuronal viability. Conclusion(s): Our data support the model in which COVID-19 alter cortical thickness, promoting psychiatric symptoms. In addition, SARS-CoV-2 is able to reach the brain, infects astrocytes, and consequently, leads to neuronal death or dysfunction. These deregulated processes could contribute to the structural and functional alterations seen in the brains of COVID-19 patients. Funding Source: Sao Paulo Research Foundation (FAPESP) Keywords: COVID-19, Anxiety, Astrocytes, Multi-omics, Brain Magnetic Resonance Imaging (MRI)Copyright © 2023
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Background Management of patients with multiple sclerosis (MS) and evidence of disease activity during treatment with cladribine tablets represents a challenging point. Objectives To report a patient with highly active multiple sclerosis (HAMS) who has been early switched from cladribine to alemtuzumab owing to tumultuous clinical and radiological activity Methods A single retrospective case report. Results. Treatment with alemtuzumab has led to a complete suppression of disease activity without any evidence of infections or acquired autoimmune diseases. Conclusion Our report suggests that an early switch from cladribine to alemtuzumab, may be safe and efficacious in selected HAMS cases.Copyright © 2022 The Authors
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Introduction: Although many studies have demonstrated the existing neurological symptoms in COVID-19 patients, the mechanisms are not clear until now. This study aimed to figure out the critical molecular and immune infiltration situations in the brain of elderly COVID-19 patients. Methods: GSE188847 was used for the differential analysis, WGCNA, and immune infiltration analysis. We also performed GO, KEGG, GSEA, and GSVA for the enrich analysis. Results: 266 DEGs, obtained from the brain samples of COVID-19 and non-COVID-19 patients whose ages were over 70 years old, were identified. GO and KEGG analysis revealed the enrichment in synapse and neuroactive ligand-receptor interaction in COVID-19 patients. Further analysis found that asthma and immune system signal pathways were significant changes based on GSEA and GSVA. Immune infiltration analysis demonstrated the imbalance of CD8+ T cells, neutrophils, and HLA. The MEpurple module genes were the most significantly different relative to COVID-19. Finally, RPS29, S100A10, and TIMP1 were the critical genes attributed to the progress of brain damage. Conclusion: RPS29, S100A10, and TIMP1 were the critical genes in the brain pathology of COVID-19 in elderly patients. Our research has revealed a new mechanism and a potential therapeutic target.
Subject(s)
Asthma , Brain Injuries , COVID-19 , Aged , Humans , COVID-19/genetics , Brain , Genes, RegulatorABSTRACT
Background: In the context of aphasia rehabilitation, there is a perceived need for interventions with a reduced linguistic demand targeting well-being. Mind-body and creative arts approaches are holistic and person-centred approaches, primarily relying on means other than verbal exchanges and promoting self-regulation strategies. Aim(s): This mixed-method systematic review aimed to evaluate the availability, feasibility and effectiveness of mind-body and creative arts therapies in promoting well-being for people with aphasia. Eight databases were searched using subject headings and keywords. Full-text screening, critical appraisal and data extraction were conducted independently by two reviewers. A segregated synthesis approach was used (i.e., Revised Effect Direction Plot technique and Thematic Synthesis approach). Findings are presented in a narrative and visual form. Main Contribution: Twenty-two studies were included (Mind-body: n = 11;Creative arts: n = 11). Heterogeneity of study design and quality, intervention type, procedures and dosage, outcomes, and level of offered communication support were identified. Improvements were noted across a wide range of well-being outcomes with more consistent positive results for anxiety and communication. One hundred and twenty-eight findings were extracted and synthesised in three broad themes: positive impact on self, empowering multifaceted experience, and relevance of needs-centred adjustments. Conclusion(s): Provisional findings about the benefits of mind-body and creative arts interventions on aspects of well-being for some individuals with aphasia were identified. However, findings are complex and need to be interpreted cautiously. Facilitators and barriers to these therapies are highlighted with related recommendations for practice. This review poses a demand for further research in the field, implementing rigorous methodology and aphasia-specific support to facilitate inclusion and engagement.Copyright © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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The mobile application RehaGoal app is presented for people with acquired and congenital brain damage who have difficulties with complex planning tasks. The development of the RehaGoal app was based on the Goal Management Training approach, which focuses on breaking down an overarching goal into sub-goals and manageable steps to achieve them. So far, this approach has been paper-based, which makes it difficult to transfer to everyday life. Therefore, the RehaGoal app, which can be used on various digital devices such as smartphones, smartwatches, etc., was developed. Our target group often has additional limitations, which is why the RehaGoal app has a barrierfree design, voice output, visual display options, a user-dependent display, simple menu navigation and an authoring system. We illustrate the possible applications of the RehaGoal app with patients in outpatient neuropsychological rehabilitation, during vocational reintegration and during lockdown due to COVID-19.Copyright © Hippocampus Verlag 2023.
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Many people with intellectual disability, particularly those with Down syndrome, are at increased risk for Alzheimer's disease. Recent findings suggest that while onset may be at an earlier age and more rapid in early dementia stages, there is often a long late stage where decisions about end-of-life care and dying well must be supported. For the individual and caregivers, later stages of dementia can be complicated by lack of understanding and preparedness by both generic palliative care and intellectual disability services. The COVID-19 pandemic has posed significant challenges for staff and family, and many have struggled with moral distress as they feel forced to act in a manner contrary to their own care beliefs. Three case studies with reflective questions about caring for people with Down syndrome and dementia are offered, one from the COVID-19 period. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Background: There have been reports of demyelinating syndromes in association with COVID-19 and to a much lesser extent COVID 19 vaccines. The association between demyelination and vaccines, in general, remains controversial. We review a presentation of fulminant demyelination, and discuss antecedent COVID-19 vaccination, the formulation of a broader differential diagnosis and ultimately the pathologic diagnosis. Case presentation: An 80-year-old woman presented with seizure, encephalopathy, quadriparesis and ultimately expired. She received a SARS-CoV-2 vaccine one day prior. Imaging revealed contrast enhancing cerebral lesions, longitudinally extensive transverse myelitis. CSF was markedly inflammatory. Pathologic examination of the CNS lesions revealed demyelination and inflammation beyond white matter, not restricted to a perivenular distribution. Conclusion(s): This case depicts a seemingly fulminant course of a diffuse demyelinating syndrome characterized clinicopathologically as Marburg's variant of multiple sclerosis. There are several unique aspects of this case including the extremely rapid course, the unusual evolution of CSF abnormalities, with hypoglycorrhachia and markedly elevated protein. The proximity to vaccination is a pertinent association to document, though we cannot unequivocally prove causation.Copyright © 2022 The Authors
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A 20-year-old patient was presented with subacute onset of headache, nausea and vomiting. Testing of nasal/oropharyngeal swabs indicated the presence of SARS-CoV-2 RNA, and later the antibodies to this virus were found. The treatment in the hospital for Coronavirus 19 Disease (COVID-19) provided only temporary relief, and the patient then was referred to the Regional Stroke Center (RSC) to exclude a subarachnoid hemorrhage. RSC neurologists drew attention to multiple skin nevi in the patient. Brain MRI demonstrated abnormal T1 hyperintensity in the brain leptomeninges, with leptomeningeal contrast enhancement as well as hyperintensity in amygdala regions on T1 weighted images, bilaterally. The anomaly of the Dandy-Walker malformation complex was also revealed. Cerebrospinal fluid (CSF) analysis showed elevated protein (0.52 g/L), low lymphocytosis (lymphocytes, 6 in mm3), and decreased glucose (1.8 mmol/L). Neurocutaneous melanocytosis (NCM) was diagnosed, which neurological manifestation was probably triggered by COVID-19. The patient's vision gradually progressively worsened. In 2.5 months after the clinical manifestation of NCM, fundoscopy revealed optic discs atrophy (despite the absence of previous edema), and repeated CSF analysis showed atypical cells with characteristics corresponding to melanoma. Malignant transformation of cerebral melanocytosis was suspected, and the patient was referred to an oncological dispensary for further therapy. In the presented literature review, special attention is paid to the issues of neuroimaging, cytological and immunocytochemical diagnostics of NCM.Copyright © Russian Neurological Journal. All rights reserved.
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A 20-year-old patient was presented with subacute onset of headache, nausea and vomiting. Testing of nasal/oropharyngeal swabs indicated the presence of SARS-CoV-2 RNA, and later the antibodies to this virus were found. The treatment in the hospital for Coronavirus 19 Disease (COVID-19) provided only temporary relief, and the patient then was referred to the Regional Stroke Center (RSC) to exclude a subarachnoid hemorrhage. RSC neurologists drew attention to multiple skin nevi in the patient. Brain MRI demonstrated abnormal T1 hyperintensity in the brain leptomeninges, with leptomeningeal contrast enhancement as well as hyperintensity in amygdala regions on T1 weighted images, bilaterally. The anomaly of the Dandy-Walker malformation complex was also revealed. Cerebrospinal fluid (CSF) analysis showed elevated protein (0.52 g/L), low lymphocytosis (lymphocytes, 6 in mm3), and decreased glucose (1.8 mmol/L). Neurocutaneous melanocytosis (NCM) was diagnosed, which neurological manifestation was probably triggered by COVID-19. The patient's vision gradually progressively worsened. In 2.5 months after the clinical manifestation of NCM, fundoscopy revealed optic discs atrophy (despite the absence of previous edema), and repeated CSF analysis showed atypical cells with characteristics corresponding to melanoma. Malignant transformation of cerebral melanocytosis was suspected, and the patient was referred to an oncological dispensary for further therapy. In the presented literature review, special attention is paid to the issues of neuroimaging, cytological and immunocytochemical diagnostics of NCM.Copyright © Russian Neurological Journal. All rights reserved.
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Objectives: The present study sought to investigate the experience of individuals living with their partner with an acquired brain injury (ABI) during the first lock down period of the COVID-19 pandemic. Method: Semi-structured interviews were conducted with seven partners of individuals who had sustained a range of ABIs. Interviews were transcribed verbatim and thematic analysis was carried out by two of the researchers exploring the unique narratives. Results: ABI occurs within a relational framework, which means that it has repercussions not only for the individual but also the entire family system. COVID-19 prevented family systems (living separately) from coming together which negatively impacted them;however, it also slowed life down, with many people working from home with flexible arrangements in place which participants found to be beneficial. Three main themes emerged from the interview data: partner focus, slowing down and support networks. The narratives identified the struggles of having to continue their partner's rehabilitation when face to face services could not visit the home, the importance of establishing routine, the positives of a slower paced life (due to COVID-19) that enabled them to build stronger relationships with their partners, and the difficulties of being separated from family and loved ones. Conclusion: This research suggests that it is imperative to consider individual experiences and choices. Some families benefited from reduced treatment and a slowed pace of life, whilst others may find this overwhelming and burdensome. The study makes recommendations for supporting couples after an ABI during the ongoing pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Purpose: The purpose of this study is to assess the effect of social isolation of minors with a parent or grandparent suffering from amyotrophic lateral sclerosis (ALS) and to determine whether the psychological support offered by an Italian no-profit association helped them to manage stress. Methodology: This study followed a qualitative research design. The participants responded to in-depth interviews that were processed with inductive thematic analysis. Findings: Five themes emerged: feedback on the psychological intervention;learning and changes after the intervention;discourses on illness and death in the family;experiences and difficulties during the lockdown and suggestions for other peers who might face the same situation. Social Implications: Psychological support is necessary for these minors, and it helped them to manage both the stress of living with ALS and the limitations of social relationships during the pandemic. It showed the importance of authentic and honest communication about illness and death that allowed minors to manage anxiety and fear. Positive reinterpretation of these experiences by transforming them into opportunities was also revealed. Originality: Studies on families with ALS patients are numerous, but studies on children of these patients are still rare, and no study has investigated the impact of the COVID-19 pandemic on these children. This research investigated a topic that has not been covered previously and it also provided the opportunity to know how these children, preadolescents and adolescents living in an already complex environment, have experienced lockdown and restrictions. The study also enriched the literature on this important issue. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Technology plays an increasing role in everyday communication. People regularly use technology in their daily lives for a range of spoken discourse tasks, including monologic discourse and conversational discourse. Written discourse is also commonly supported through technology as part of text messaging, email, and communication on social media. In addition to the increasing use of technology for communication in daily life, technology is also employed in the clinical assessment of discourse impairments after a traumatic brain injury (TBI). During the COVID-19 pandemic, clinicians embraced technology in serving people with TBI as traditional in-person clinical services presented hazards. Technology can also provide the means to collect data about discourse in different contexts, including phone conversations with different communication partners, video conferencing to capture conversations in the home environment, or virtual reality to evaluate discourse in a range of real-life situations, all without leaving the clinical setting. This chapter provides an overview of the use of telepractice in discourse assessment, implementation of technology to support the analysis of discourse, and future directions in evaluating discourse via the application of new and emerging technologies. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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BACKGROUND AND PURPOSE: Coronavirus disease 2019 (COVID-19) affects the brain, leading to long-term complaints. Studies combining brain abnormalities with objective and subjective consequences are lacking. Long-term structural brain abnormalities, neurological and (neuro)psychological consequences in COVID-19 patients admitted to the intensive care unit (ICU) or general ward were investigated. The aim was to create a multidisciplinary view on the impact of severe COVID-19 on functioning and to compare long-term consequences between ICU and general ward patients. METHODS: This multicentre prospective cohort study assessed brain abnormalities (3 T magnetic resonance imaging), cognitive dysfunction (neuropsychological test battery), neurological symptoms, cognitive complaints, emotional distress and wellbeing (self-report questionnaires) in ICU and general ward (non-ICU) survivors. RESULTS: In al, 101 ICU and 104 non-ICU patients participated 8-10 months post-hospital discharge. Significantly more ICU patients exhibited cerebral microbleeds (61% vs. 32%, p < 0.001) and had higher numbers of microbleeds (p < 0.001). No group differences were found in cognitive dysfunction, neurological symptoms, cognitive complaints, emotional distress or wellbeing. The number of microbleeds did not predict cognitive dysfunction. In the complete sample, cognitive screening suggested cognitive dysfunction in 41%, and standard neuropsychological testing showed cognitive dysfunction in 12%; 62% reported ≥3 cognitive complaints. Clinically relevant scores of depression, anxiety and post-traumatic stress were found in 15%, 19% and 12%, respectively; 28% experienced insomnia and 51% severe fatigue. CONCLUSION: Coronavirus disease 2019 ICU survivors had a higher prevalence for microbleeds but not for cognitive dysfunction compared to general ward survivors. Self-reported symptoms exceeded cognitive dysfunction. Cognitive complaints, neurological symptoms and severe fatigue were frequently reported in both groups, fitting the post-COVID-19 syndrome.
Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , COVID-19/complications , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/diagnosis , Prospective Studies , Patients' Rooms , Post-Acute COVID-19 Syndrome , Depression/epidemiology , Critical Care , Intensive Care Units , Survivors/psychology , Fatigue/etiology , Cerebral HemorrhageABSTRACT
Aim/Introduction: Tolosa-Hunt Syndrome (THS) is a rare disease with incidence rate of about 1/106 per year worldwide. Etiology include idiopathic granulomatous, nonspecific unilateral inflammation of the superior orbital fissure- cavernous sinus, causing severe headaches, eye pain, and ophthalmoplegia- paresis of the cavernous sinus nerves, sometimes Horner syndrome. THS is a diagnosis of exclusion that requires careful ruling out of alternative diagnoses. Material(s) and Method(s): We report an interesting case of 45 years old lady, who presented with complains of left sided headache, left eye retro-orbital pain with diplopia (double vision), ptosis and gradual difficulty in eye movements since last 2 months. She had history of nasopharyngeal mucosal swab collection for COVID 19 RT-PCR test after which she started complaints of pain along nasopharynx and later along ipsilateral eye orbit. MRI of brain and bilateral orbit suggested mild relative prominence of peri-optic CSF space along left side, without any abnormality along cavernous sinus or rest of the brain parenchyma. FDG PET/CT (PET/ CT) scan was performed to rule out other cause of THS showed impaired tracer uptake along left eye rectus muscles, suggesting paresis of CN III, IV and VI without any abnormal metabolically active lesion in brain parenchyma or rest of the body. Result(s): Based on clinical, radiological and PET/CT findings presumptive diagnosis of resolving left sided THS secondary to trauma induced inflammation was made. The patient shows clinical improvement after treatment with high dose steroid on follow up. Conclusion(s): PET/CT is helpful in detection of inflammatory tissue is a recognized fact. When MRI is unable to shows any tissue abnormality in cavernous sinus or superior orbital fissure;PET CT can play a role in its ability to demonstrate the paresis of cranial nerves supplying ipsilateral eye extrinsic muscles. Thus reaching the diagnosis of post traumatic inflammatory THS by exclusion. This case of THS with unique PET/ CT findings imply the useful indication of PET/CT in detecting and monitoring of treatment response in THS when MRI is inconclusive.
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This study examined the stability of psychological well-being in people who have experienced a neurological event resulting in focal brain damage. Evidence suggests that psychological well-being is largely stable in healthy adult populations. However, whether such stability exists in neurological patients with acquired brain lesions is an open question. Given the trait-like characteristics of psychological well-being, we hypothesized that psychological well-being would be stable in neurological patients who are in the chronic epoch of recovery (>= 3 months after the neurological event). Eighty participants (women = 40;age: M = 56, standard deviation (SD) = 13) completed the Ryff Scales of Psychological Well-Being (PWBS) twice between 2016 and 2020 (Time 1 [T1] and Time 2 [T2]). The Ryff Scales measure various facets of well-being, including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Approximately half of participants completed their T2 assessment during the COVID-19 pandemic, creating an opportunity to investigate the effects of the pandemic on the stability of psychological well-being in a neurological population that may be particularly vulnerable to reduced well-being in this context. Pearson correlations and within-sample t-tests were conducted to examine the stability of self-reported well-being over time. Test-retest correlations ranged from .71 to .87, and no significant differences in well-being emerged across the two time points. Significant correlations between T1 and T2 were also evident in the subsample of participants who completed their second assessment during the COVID-19 pandemic. These findings provide evidence that long-term psychological well-being is remarkably reliable and consistent over time in patients who have experienced a major neurological event, even when an unprecedented global event occurred between measurement epochs. Treatment implications of these findings are discussed.