Journal of clinical and experimental neuropsychology
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J Clin Exp Neuropsychol · Nov 2004
Comparative StudyClipping versus coiling: neuropsychological follow up after aneurysmal subarachnoid haemorrhage (SAH).
Patients treated with microsurgical clipping of ruptured intracranial aneurysms often suffer from neuropsychological deficits in spite of a good neurological outcome. The purpose of this study was to explore if the deficits are related to the type of therapy. Two groups of 16 patients each suffering from aneurysmal SAH, matched for sex, age, aneurysm-site and Hunt and Hess score, and 16 control subjects were examined with a battery of neuropsychological tests including memory, attention, and executive function. ⋯ Both patient groups showed deficits in verbal and visual memory. Clipped patients were slightly more impaired than coiled patients, especially on measures of affect and on a self-assessment measure of executive function. The pattern of results suggests that the neuropsychological outcome after aneurysmal SAH is affected by both the severity of the bleeding and the type of therapy.
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J Clin Exp Neuropsychol · Oct 2004
Comparative Study Clinical TrialNeurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen.
The primary aim of the current study was to examine whether neurocognitive functioning among breast cancer survivors (BCS) exposed to systemic adjuvant chemotherapy differs from that seen among BCS who did not receive chemotherapy. The performance of each of these BCS groups was compared to a demographically matched comparison group without history of breast cancer, a group not included in the majority of previous cognitive functioning studies. We also sought to explore whether usage of the anti-estrogen drug tamoxifen, a common component of breast cancer treatment, was related to neurocognitive functioning. ⋯ Although patients who received chemotherapy (with and without tamoxifen) performed worse than those treated with surgery only on several domains, neither group was significantly different from demographically matched comparison subjects without a history of breast cancer. Finally, we found no relationship between subjective cognitive complaints and objective performance, although cognitive complaints were associated with measures of psychological distress and fatigue. We highlight ways in which these data converge with other recent studies to suggest that systemic chemotherapy, especially in combination with tamoxifen, can have adverse yet subtle effects on cognitive functioning.
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J Clin Exp Neuropsychol · May 2004
Comparative StudyPreservation of reasoning in primary progressive aphasia: further differentiation from Alzheimer's disease and the behavioral presentation of frontotemporal dementia.
Primary Progressive Aphasia (PPA) is a clinical dementia syndrome characterized by the gradual dissolution of language without impairment of other cognitive domains for at least the first 2 years of illness (M.-M. Mesulam, 1982, 2001). It is difficult to demonstrate the integrity of nonlanguage domains in PPA because most neuropsychological tests of memory, reasoning, and attention require language competence for their performance. ⋯ Patients with PPA and controls performed similarly, detecting commonalities among objects and shifting from one sorting principle to another. In contrast, both AD and FTD subjects were significantly impaired on both measures. These results provide evidence of preserved reasoning in PPA, further differentiating this syndrome from other behaviorally focal dementia syndromes.
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J Clin Exp Neuropsychol · May 2003
Comparative StudyUpper limb exteroceptive somatosensory and proprioceptive sensory afferent modulation of hemispatial neglect.
In many paradigms of stimulation techniques aimed at reducing hemispatial neglect, somatosensory and proprioceptive stimulation are often interchanged, although the anatomical and functional pathways transmitting these signals are clearly different. Therefore, we have investigated the effects of one somatosensory stimulation technique, the cyclic pressure application (CPA), and have compared them with the effects of left transcutaneous electrical stimulation (TENS) on the expression of left hemispatial neglect in 13 stroke patients, as assessed by two visuospatial exploration tasks: the Star Cancellation task and Schenkenberg's Line Bisection task. In a first experiment, four treatment conditions were given: TENS, CPA, TENS + CPA, as well as a placebo condition. ⋯ In order to determine whether unconscious proprioceptive afferent information instead of exteroceptive somatosensory stimulation is a sufficient condition to improve hemispatial neglect, we carried out a second experiment, only with patients suffering from complete somatosensory loss. The effects of the different treatments were investigated, using the same sequence as for Experiment 1, but, this time, the applied intensity of TENS was manipulated over two conditions : (1) one in which the intensity of TENS stimulation was below the motor (proprioceptive) threshold and (2) one in which the intensity was determined following the degree of proprioceptive stimulation demonstrated by the point at which a visible muscle contraction during the stimulation could be elicited. The results demonstrated that proprioceptive-based TENS stimulation is a sufficient condition to reduce hemispatial neglect, even when a severe somatosensory loss was present.
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J Clin Exp Neuropsychol · Dec 2002
Comparative StudyAssigned versus self-set goals and their impact on the performance of brain-damaged patients.
The purpose of this study was to investigate the role played by goal difficulty and goal origin (i.e., self-set vs. assigned) on the performance of patients with brain injuries in a simple arithmetic task. Eighty-seven patients with either cerebral vascular accidents or traumatic brain injuries were investigated. Patients were randomly assigned to one of three conditions: (1) one in which a specific, high goal was assigned, (2) one in which a "do your best" goal was given, and (3) one in which a personal goal has to be stated. ⋯ Self-set goals were attained by most of the patients and only 1 patient showed a high discrepancy between self-set goal and actual performance. These findings suggest that goal origin and goal difficulty are important moderators in the goal setting process. Furthermore, patients with brain injuries do not necessarily set unrealistic high goals.