Social competence following mild head injury and moderate traumatic brain injury: Investigating the neuropsychological relationships between arousal, social decision-making and depression

Client-directed long-term rehabilitative goals and life satisfaction following head injury emphasize the importance of social inclusion, rather than cognitive or physical, outcomes. However, very little research has explored the socio-emotional factors that pose as barriers to social reintegration following injury. This study investigates social barriers following head injury (i.e., decision-making - Iowa Gambling Task [IGT] and mood – depression) and possible amelioration of those challenges (through treatment) in both highly functioning university students with and without mild head injury (MHI) and in individuals with moderate traumatic brain injury (TBI). An arousal manipulation using emotionally evocative stimuli was introduced to manipulate the subject’s physiological arousal state. Seventy-five university students (37.6% reporting a MHI) and 11 patients with documented moderate TBI were recruited to participate in this quasi-experimental study. Those with head injury were found to be physiologically underaroused (on measures of electrodermal activation [EDA] and pulse) and were less sensitive to the negative effects of punishment (i.e., losses) in the gambling task than those without head injury, with greater impairment being observed for the moderate TBI group. The arousal manipulation, while effective, was not able to maintain a higher state of arousal in the injury groups across trials (i.e., their arousal state returned to pre-manipulation levels more quickly than their non-injured cohort), and, subsequently, a performance improvement was not observed on the IGT. Lastly, head injury was found to contribute to the relationship between IGT performance and depressive symptom acknowledgment and mood status in persons with head injury. This study indicates the possible important role of physiological arousal on socio- emotional behaviours (decision-making, mood) in persons with even mild, non-complicated head injuries and across the injury severity continuum.

Neuropsychological predictors of treatment outcome in obsessive compulsive disorder (OCD)

Contexte: En dépit de la preuve substantielle pour l'efficacité générale de la thérapie cognitivo-comportementale pour le trouble obsessionnel-compulsif (TOC), il existe une controverse à propos de l'amélioration de certains déficits neuropsychologiques dans ce trouble. Objectif: Le but de cette étude est d'évaluer: 1) la corrélation de la gravité du TOC et les résultats des tests neuropsychologiques et 2) l'amélioration clinique et neuropsychologique des patients souffrant de TOC qui ont terminé avec succès leur traitement. Méthode: Cette étude évalue les fonctions neurocognitives et l'état clinique de 27 participants du groupe TOC et 25 participants du groupe témoin. La fonction neurocognitive de chaque participant a été évaluée en utilisant le test de Rey-Osterreich Figure complexe (RCFT), le test de fluidité D-KEFS et l’essai Cardebat-D. Nous avons également, utilisé l'inventaire d'anxiété de Beck (IAB), l’Inventaire de dépression de Beck (IDB) et l'échelle d'obsession-compulsion de Yale-Brown (Y-BOCS) pour vérifier la présence de l'anxiété et de la dépression avec le TOC et la gravité des symptômes chez les patients souffrant de TOC. Résultats: Notre étude conclut qu’il y une différence significative de la fonction de la mémoire selon le score au sous test de copie entre les participants souffrant de TOC et le groupe témoin. De plus, nous avons constaté une différence considérable dans le score de rappel immédiat et différé du RCFT avant et après le traitement dans le groupe de TOC. Conclusion: En résumé, la présente étude a démontré que les patients atteints de TOC ont des troubles cognitifs spécifiques et que la thérapie cognitivo-comportementale serait un traitement qui pourrait améliorer, au moins, certaines dysfonctions neurocognitives.

Objective neuropsychological deficits in post-traumatic stress disorder and mild traumatic brain injury: what remains beyond symptom similarity?

This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.

Reliability of the Brief Neuropsychological Assessment Instrument Neupsilin

This study aimed to evaluate the reliability of Neupsilin Brief Neuropsychological Assessment Instrument, a brief battery developed in Brazil. Hundred two Brazilian man and women participated, from 18 to 40 years of age. It was evaluated the test-retest reliability of the Neupsilin tasks and the reliability of the correction of the constructional praxis task by different evaluators. The data were analyzed by Spearman’s correlation, intraclass correlation and Cronbach’s alpha. Language, memory, praxis and executive functions presented the highest correlations in the test-retest analyses. The agreement in the correction of the constructional praxis task was moderate to high. The results indicate temporal reliability of Neupsilin tasks and inter-rater agreement in the correction of the constructional praxis task. Suggestions to improve the tasks, the validity and reliability of Neupsilin were presented.

Brief neuropsychological assessment of adults post-stroke in the left hemisphere

The neuropsychological assessment investigates cognitive deficits to improve the diagnosis, the prognosis and the rehabilitation of patients. In Brazil, stroke is a major cause of hospitalization and the leading cause of mortality and disability. The stroke in the left hemisphere (LH) is associated with different degrees of loss of language and other cognitive impairments, for example, in the memory. We compared the performance in brief neuropsychological tasks of the left hemisphere poststroke patients, without moderate or severe aphasia, with healthy controls. A list of 135 patients was selected based on inclusion criteria. The study included 15 patients with left stroke, paired by sex, age and education to 30 neurologically healthy adults. The data resulting from application of the Neupsilin Brief Neuropsychological Assessment Instrument were analyzed with the nonparametric Mann-Whitney U. Adults with LH stroke showed a significant reduction in performance when compared to healthy controls on language, working memory and ideomotor praxis, results also found in other studies of patients with left hemisphere stroke

Neuropsychological profile in patients with temporal lobe epilepsy

The temporal lobe epilepsy (TLE) is the most common type of refractory epilepsy in adults. There is a wide consensus regarding the commitment of memory in temporal lobe epilepsy with hippocampal sclerosis. However, the consensus is not as widespread with respect to the other functions such as attention, executive functions, language and intellectual performance. For this study we analyzed retrospectively a group of 76 patients with refractory epilepsy, 48 patients with temporal lobe epilepsy (23 with right lateralization and 25 with left lateralization) and 28 patients with extratemporal epilepsy. We applied a battery of neuropsychological tests used in the Epilepsy Surgery Program at Hospital de Egas Moniz, Lisbon, Portugal. Our results show that the battery of neuropsychological tests is internally consistent in the evaluation of patients with TLE. We have also found that patients with TLE have standard generalized deficits witch could be indicative of areas of engagement besides the hippocampus. One interesting finding was the fact that interference verbal memory (long term memory) remains adequate, suggesting that this function is not compromised in TLE. In addition to the general pattern of cognitive deficits, we can see the impact of the disease at the socio-demographic level, and we can also establish a relationship with neurobiological findings previously described in the literature

Review about neuropsychological processing of tonal attributes of music in the Western context

Many discussions about the music processing have occurred over the years. It is stated, on one hand, the existence of a single joint for grasping the music or any of its attributes by the Central Nervous System. Furthermore, it is claimed also the existence of multiple and diverse systems to understand each aspect of music. In general, model-independent set, studies focusing on the processing of sound components, specifically the musical tones, can significantly clarify the basic functioning of the auditory system and other higher brain functions. In this sense, one of the most prominent approaches in the study of sensory and perceptual processes of hearing, or changed unharmed, has been Neuroscience, which is interested in the interaction between the brain areas corresponding to different cognitive processes. Thus, the purpose of this study was to review the studies that dealt processing models of the attributes of tonal Western music, based on the conception that neuropsychological neural structures are interdependent sensory pathways.

Decoding emotional prosody in Parkinson's disease and its potential neuropsychological basis

Parkinson's disease patients may have difficulty decoding prosodic emotion cues. These data suggest that the basal ganglia are involved, but may reflect dorsolateral prefrontal cortex dysfunction. An auditory emotional n-back task and cognitive n-back task were administered to 33 patients and 33 older adult controls, as were an auditory emotional Stroop task and cognitive Stroop task. No deficit was observed on the emotion decoding tasks; this did not alter with increased frontal lobe load. However, on the cognitive tasks, patients performed worse than older adult controls, suggesting that cognitive deficits may be more prominent. The impact of frontal lobe dysfunction on prosodic emotion cue decoding may only become apparent once frontal lobe pathology rises above a threshold.

Frontonasal Dysplasia, Severe Neuropsychological Delay, and Midline Central Nervous System Anomalies: Report of 10 Brazilian Male Patients

Here we report on 10 male patients with frontonasal dysplasia, cleft lip/palate, mental retardation, lack of language acquisition, and severe central nervous system involvement. Imaging studies disclosed absence of the corpus callosum, midline cysts, and an abnormally modeled cerebellum. Neuronal heterotopias were present in five patients and parieto-occipital encephalocele in three patients. We suggest that this pattern found exclusively in males, most likely represents a newly recognized syndrome distilled from the group of disorders subsumed under frontonasal dysplasia. (C) 2009 Wiley-Liss, Inc.

Neuropsychological Assessment of Current and Past Crack Cocaine Users

Background: Cognitive changes due to crack cocaine consumption remain unclear Methods: For clarification, 55 subjects were assigned to three groups: control group, crack cocaine current users, and ex-users. Participants were submitted to Mini-Mental State Examination (MMSE) and tasks evaluating executive functioning and verbal memory Mood state was also measured. Intergroup comparisons were carried out. Results: Control group performance on the MMSE was better than that of users and ex-users. Verbal memory performance for logical memory of users was impaired. Ex-users scored lower on DSST and Trail Making Test (Part B). Conclusion: Chronic crack cocaine use seems to disrupt general cognitive functioning (MMSE), verbal memory, and attentional resources, but findings suggest that some of these effects could be reversed by abstinence.

Unique neuropsychological profiles in adhd subtype presentations

Learning and memory for verbal and visual information was compared in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) of Combined Type and Predominantly Inattentive Type. Compared to a typically developing group, the ADHD groups were found to have unique difficulties. These findings add to the current research knowledge.

Neuropsychological changes following cognitive-behavioral treatment of obsessive-compulsive disorder (OCD)

Previous research has suggested that individuals with OCD show compromised performance on tests assessing visuospatial and executive processes. This study aimed to further examine such findings by investigating the relationship between OCD symptom improvement following cognitive-behavioral therapy and changes in neuropsychological performance in individuals with OCD (n = 26), compared to test-retest control participants (n = 10). Successful treatment of OCD led to improvements relative to the control group on neuropsychological tasks measuring spatial working memory. Neuroscientific models of OCD consider such findings to be consistent with possible cortical dysfunction in OCD. However, a significant limitation of the study is in its inability to discount alternative explanations for this finding, such as the influence of changes in beliefs. Implications are discussed.

The relationship between neuropsychological performance, cognitive confidence, and obsessive-compulsive phenomena : a pilot study

Drawing on neuropsychological and cognitive-behavioral approaches to Obsessive-Compulsive Disorder (OCD), the present study examined the association between memory performance, cognitive confidence, and OCD phenomena. Forty-six analogue participants completed a series of self-report questionnaires and neuropsychological tasks before and after a manipulation of confidence in memory It was found that cognitive confidence predicts OCD symptoms over and above the influence of depressive symptoms and other OCD-related beliefs. Participants reported higher levels of cognitive confidence following positive feedback on the manipulation task. However, changes in cognitive confidence following the manipulation task were not reflected in neuropsychological performance. Implications for theory and treatment are discussed.