Journal of the International Neuropsychological Society : JINS
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J Int Neuropsychol Soc · Nov 2010
ReviewMild traumatic brain injury and postconcussive symptoms in children and adolescents.
The vast majority of traumatic brain injuries (TBI) in children are of mild severity. Even if only a small proportion of children with mild TBI suffer negative outcomes, then mild TBI is a serious public health problem. This review summarizes the literature regarding the neurobehavioral outcomes associated with mild TBI in children and adolescents, focusing on the longstanding debate regarding postconcussive symptoms and attendant conceptual and methodological issues. The review also discusses future research directions, the long-term goal of which is to develop a comprehensive and integrated biopsychosocial model of outcomes that helps guide clinical management.
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J Int Neuropsychol Soc · Nov 2010
Executive function in patients with obstructive sleep apnea treated with continuous positive airway pressure.
Obstructive sleep apnea (OSA) is characterized by disrupted breathing and hypoxemia during sleep, daytime sleepiness, and changes in cognition and mood. One important question is regarding the reversibility of cognitive deficits after treatment with continuous positive airway pressure (CPAP). Here, we report the outcomes of CPAP treatment as measured by tests of attention and executive function. ⋯ In terms of current neurocognitive function, treated individuals with OSA performed at a comparable level to controls on basic working memory storage functions but still showed a significant reduction on tests of working memory requiring the central executive. The OSA group also performed worse on neuropsychological measures of complex attention, executive function, and psychomotor speed. While CPAP is an effective treatment for OSA in terms of ameliorating breathing disruption and oxygen desaturation during sleep, as well as daytime sleepiness, some cognitive deficits may be more resistant to treatment.
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J Int Neuropsychol Soc · Sep 2010
Case ReportsEnvironment and object mental images in patients with representational neglect: two case reports.
The aim of this study was to shed light on the nature of the imagery deficits in two patients with representational neglect and to determine whether representational neglect is affected by the content of the mental images the patients have to generate, inspect and manipulate. In particular, we submitted two patients with different types of representational neglect to a battery of visual mental imagery tests to assess the different kinds of imagery processes. ⋯ On the other hand, Patient 2, whose performance was asymmetrical on the Familiar Squares Description Test, performed poorly on tasks involving the mental generation, inspection and manipulation of environments, but not on tasks involving the mental generation, inspection and manipulation of objects. Our results demonstrate that environments and objects in the imagery domain can be represented separately and can be selectively affected by damage following brain lesions.
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J Int Neuropsychol Soc · Sep 2010
Postconcussive symptoms after blast and nonblast-related mild traumatic brain injuries in Afghanistan and Iraq war veterans.
Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. ⋯ Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories.