Journal of the International Neuropsychological Society : JINS
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J Int Neuropsychol Soc · Jul 2007
Cognitive sequelae in acute respiratory distress syndrome patients with and without recall of the intensive care unit.
Some critically ill patients have dramatic recollections of the intensive care unit (ICU), whereas 23-50% have little or no recollection of their ICU stay. In addition, cognitive impairments are common following critical illness and ICU treatment. Little is known regarding the relationship between cognitive sequelae and ICU recall. ⋯ Patients without ICU recall had a greater magnitude of cognitive impairments at hospital discharge, but not at 1- or 2-year follow-up. Profile analysis showed significant group differences in general intellectual functioning, executive function, processing speed, and spatial skills at hospital discharge, but not at 1- or 2-year follow-up. Estimated premorbid intelligence scores were inversely related to the magnitude of cognitive sequelae, suggesting greater "cognitive reserve" in patients with fewer cognitive decrements.
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J Int Neuropsychol Soc · May 2007
ReviewMeasurement of cerebral perfusion with arterial spin labeling: Part 1. Methods.
Arterial spin labeling (ASL) is a magnetic resonance imaging (MRI) method that provides a highly repeatable quantitative measure of cerebral blood flow (CBF). As compared to the more commonly used blood oxygenation level dependent (BOLD) contrast-based methods, ASL techniques measure a more biologically specific correlate of neural activity, with the potential for more accurate estimation of the location and magnitude of neural function. ⋯ ASL measures of perfusion can aid in the interpretation of the BOLD signal change and, when combined with BOLD, can measure the change in oxygen utilization accompanying changes in behavioral state. Whether used alone to probe neural activity or in combination with BOLD techniques, ASL methods are contributing to the field's understanding of healthy and disordered brain function.
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J Int Neuropsychol Soc · Jan 2007
Randomized Controlled TrialNeuropsychological performance following staged bilateral pallidal or subthalamic nucleus deep brain stimulation for Parkinson's disease.
Deep brain stimulation (DBS) has the potential to significantly reduce motor symptoms in advanced Parkinson's disease (PD). Controversy remains about non-motor effects of DBS and the relative advantages of treatment at two brain targets, the globus pallidus internus (GPi) and the subthalamic nucleus (STN). We investigated effects of DBS on neuropsychological functioning in 42 patients with advanced PD randomly assigned to receive staged bilateral DBS surgery of either the GPi or STN. ⋯ There were few significant differences related to treatment at the two surgical targets. Supplementary analyses suggested that decrements in select neuropsychological domains following DBS are unrelated to age or post-surgical reduction in dopaminergic medication dose. Findings are discussed with reference to possible causes of neuropsychological decline and the need for further controlled studies of specific neuropsychological effects of DBS.
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J Int Neuropsychol Soc · Nov 2006
Comparative Study Clinical TrialA pilot study of use-dependent learning in the context of Constraint Induced Language Therapy.
This investigation reports the results of a pilot study concerning the application of principles of use-dependent learning developed in the motor rehabilitation literature as Constraint Induced Therapy to language rehabilitation in a group of individuals with chronic aphasia. We compared treatment that required forced use of the language modality, Constraint Induced Language Therapy, (CILT) to treatment allowing all modes of communication. ⋯ Results suggest that whereas both interventions yielded positive outcomes, CILT participants showed more consistent improvement on standard aphasia measures and clinician judgments of narrative discourse. These findings suggest that CILT intervention may be a viable approach to aphasia rehabilitation.
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J Int Neuropsychol Soc · Jan 2006
Evaluating the utility of ICD-10 diagnostic criteria for postconcussion syndrome following mild traumatic brain injury.
The present study investigated the utility of the International Classification of Diseases and Related Health Problems, 10th edition (ICD-10) diagnostic criteria for postconcussion syndrome (PCS) symptoms by comparing symptom endorsement rates in a group of patients with mild traumatic brain injury (MTBI) to those of a noninjured control group at one month and three months post-injury. The 110 MTBI patients and 118 control participants were group-matched on age, gender, and education level. ⋯ Collectively, the ICD-10 PCS symptoms accurately classified the MTBI patients at one month post-injury, with the optimal positive test threshold of endorsement of five symptoms coinciding with a sensitivity and specificity of 73% and 61%, respectively. The ICD-10 PCS symptoms were unable to accurately classify the MTBI patients at three months post-injury.