Neuropsychological outcome at 1-year post head injury.

Neuropsychological outcome at 1 year postinjury was examined prospectively in representative groups of 4–6 adult head-injured participants and 121 general-trauma control participants. A comprehensive battery of neuropsychological measures was administered. The head-injured group performed significantly worse than the trauma controls on most measures (p?     

One year psychosocial outcome in head injury

Dermatoglyphic traits in an endogamous community of the village Chmelnica (North-Eastern part of Slovakia) are reported and their frequency is compared with an average Slovak population. The results of this study demonstrate the regional variability and the particular dermatoglyphic specificity of the investigated population. The most conspicuous are the increased intergender differences in the course of the main lines on the palms, their consequently higher quantitative expression by indices, and the higher quantitative values of total line numbers on fingers that was observed for females of our sample.     

Alcohol use and its effects on neuropsychological outcome in head injury.

Neuropsychological outcome was examined in relation to head-injury severity and degree of alcohol problems in a large sample of head-injured Ss to determine whether preinjury alcohol abuse exacerbates the neuropsychological effects of a head injury. The results showed neuropsychological outcome is significantly related to head-injury severity and to alcohol use. However, the mechanisms responsible for the alcohol-related impairments are not as clear as those for head injury. Although it is difficult to untangle the specific contributions of a host of factors to the impairments observed, the results point to a subtype that is characterized by limited education, neuropsychological impairments, and a lifestyle concurrent with heavy drinking, including an increased risk for head injuries. Contrary to expectation, there was no evidence for a greater head-injury effect in those with more severe alcohol problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Feasibility of the neuropsychological spectrum in prediction of outcome following head injury

This study provided further substantiation of the neuropsychological spectrum conceptualization (Templer, Campodonico, Trent, Spencer, & Hartlage, to appear; Templer, Spencer, & Hartlage, 1993; Templer, Campodonico, Trent, & Spencer, 1991). Two hundred and two traumatic brain injury patients were administered the Wechsler Adult Intelligence Scale-Revised, the Luria-Nebraska Neuropsychological Battery, the Wisconsin Card Sorting Test, the Booklet Category Test, and Trails A and B. The correlations between neuropsychological and intellectual tests were significantly lower than the correlations within intelligence tests and within neuropsychological tests. Neuropsychological tests predicted outcome better than intelligence tests. This was interpreted in terms of outcome for severely brain-damaged patients being more dependent upon basic neuropsychological functioning than on abstract thinking ability.     

Contributions of neuroimaging to neuropsychological research on closed head injury.

Reviews the contributions of neuroimaging to research on neuropsychological outcome of closed head injury. Studies quantifying cerebral atrophy and investigations of focal brain lesions are discussed. Use of magnetic resonance imaging (MRI) to characterize the location, size, and depth of focal brain lesions is reviewed. The disparities between the findings of computerized tomography (CT) and MRI are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of severe penetrating head injury on psychosocial adjustment.

The long-term effects of severe penetrating head injury on adjustment levels were studied. Forty-one World War II veterans who suffered penetrating injury to the brain were interviewed 40 years after their initial injury using the Washington Psycho-Social Seizure Inventory (WPSI). The results support a comparable behavioral impact of right and left hemispheric lesions. Similarly, no significant relations were found between anterior and posterior locus of damage and psychosocial difficulties, although the results pertaining to the right-anterior group could be interpreted as suggestive of much greater maladjustment in all life dimensions assessed by the WPSI. Findings are discussed in terms of theoretical positions on hemispheric specialization and long-term expectancies that hold implications for planning rehabilitation programs for such patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Jugular venous desaturation and outcome after head injury

Early experience with continuous monitoring of jugular venous oxygen saturation (SjvO2) suggested that this technology might allow early identification of global cerebral ischaemia in patients with severe head injury. The purpose of the present study was to examine the relationship between episodes of jugular venous desaturation and neurological outcome. One hundred and sixteen severely head-injured patients had continuous monitoring of SjvO2 during days 1-5 after injury. Episodes of jugular venous desaturation (SjvO2 < 50% for more than 10 minutes) were prospectively identified, and the incidence of desaturation was correlated with neurological outcome: 77 episodes of desaturation occurred in 46 of the 116 patients; 27 had one episode and 19 had multiple episodes of desaturation. The causes of these episodes were systemic (n = 36), cerebral (n = 35), or both (n = 6). Most of the episodes were less than 1 hour in duration, and it is probable that many of them would not have been detected without continuous measurement of SjvO2. Episodes of desaturation were most common on day 1 after injury, and were twice as common in patients with a reduced cerebral blood flow as in patients with a normal or elevated cerebral blood flow. The occurrence of jugular venous desaturation was strongly associated with a poor neurological outcome. The percentage of patients with a poor neurological outcome was 90% with multiple episodes of desaturation and 74% in patients with one desaturation, compared to 55% in patients with no episodes of desaturation. When adjusted for all co-variates that were found to be significant, including age, Glasgow coma score, papillary reactivity, type of injury, lowest recorded cerebral perfusion pressure, and highest recorded temperature, the incidence of desaturation remained significantly associated with a poor outcome. Although a cause and effect relationship with outcome cannot be established in this study, the data suggest that monitoring SvO2 might allow early identification and therefore treatment of many types of secondary injury to the brain.     

Long-term neuropsychological outcome and loss of social autonomy after traumatic brain injury

OBJECTIVE: To assess which social activities were still impaired 5 years after a traumatic brain injury (TBI) in adults, and which neuropsychological impairments were associated with this loss of social autonomy. DESIGN: Cross-sectional study of 79 patients selected from the follow-up cohort of an epidemiologic survey of 2,116 TBI patients. SETTING: The present study was of ambulatory patients seen at hospital or at their homes. The inception cohort was from the trauma center of a university hospital and from a general hospital that is representative of level II trauma centers in Aquitaine, France. PATIENTS: Seventy-nine patients selected from a representative sample of 407 patients who were included in the 5-year follow-up study of the initial cohort (convenience sample). MAIN OUTCOME MEASURES: Glasgow Outcome Scale (GOS) and loss of social autonomy as assessed by the European Brain Injury Society's European Head Injury Evaluation Chart; assessment of neurobehavioral impairments by means of the Neurobehavioral Rating Scale-Revised. RESULTS: Up to 16 patients suffered disability for at least one social skill because of cognitive/behavioral reasons. Seven needed full-time supervision. Performing administrative tasks and financial management, writing letters and calculating, driving, planning the week, and using public transport were the most impaired social abilities. Loss of social autonomy was mainly observed in severely injured patients. Univariate analysis showed that mental fatigability, motor slowing, memory difficulties, and disorders of executive function were associated with low scores on the GOS, unemployment, and difficulties in shopping, using public transport, and performing financial management and administrative tasks. CONCLUSION: Persistent impairments of executive functions and speed of psychomotor processing are major factors associated with loss of social autonomy and inability to return to work long after TBI in adults. Improving these impairments in concrete social situations represents a major challenge for cognitive rehabilitation.     

Predictors of long-term outcome in severe head injury

Potentiometric choline electrodes were developed on the basis of the mediator-free bioelectrocatalysis. The electrodes made of a composite carbon-polymer material contain choline oxidase and peroxidase coimmobilized on the surface of the electrode. The rate of the potential increase was shown to be proportional to the choline concentration within a broad range of variation. Coupling of choline-sensitive electrodes with butyrylcholinesterase makes possible both the direct detection of butyrylcholine and analysis of butyrylcholinesterase inhibitors.     

Effect of minor head injury on neuropsychological performance in asymptomatic HIV–2 infection.

The performance of 24 asymptomatic Ss who were seropositive for HIV–2 and who had a history of minor closed head injury (CHI) was compared with the performance of age- and education-matched HIV–2+ and HIV–2– controls on a battery of neuropsychological tasks. Ss were volunteers for a longitudinal study of HIV–2 infection and were not selected because of neurobehavioral symptoms. No differences were found for measures of intellectual ability, frontal and executive function, memory, attention and concentration, psychomotor speed, auditory reaction time (RT), or the Hamilton depression and anxiety rating scales. Differences were observed between the 2 HIV–2+ groups on a visual RT measure, but these effects failed to reach significance after Bonferroni's correction. The failure to find group differences may be due to the short duration of unconsciousness experienced by the CHI group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective four-year follow-up study of children at risk for ADHD: psychiatric, neuropsychological, and psychosocial outcome

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a familial disorder that places the siblings of ADHD children at high risk for ADHD, conduct, mood, and anxiety disorders. Although the pattern of psychiatric risk has been well documented by prior family studies, neither the short- nor long-term outcome of these high-risk siblings has been prospectively examined. OBJECTIVE: To document the 4-year psychiatric, psychosocial, and neuropsychological outcome of the siblings of children with ADHD. METHOD: DSM-III-R structured diagnostic interviews and blind raters were used to conduct a 4-year follow-up of siblings from ADHD and control families. The siblings were also evaluated for cognitive, achievement, social, school, and family functioning. RESULTS: At follow-up, significant elevations of behavioral, mood, and anxiety disorders were found among the siblings of ADHD children. The high-risk siblings had high rates of school failure and showed evidence of neuropsychological and psychosocial dysfunction. These impairments aggregated among the siblings who had ADHD. CONCLUSIONS: The siblings of ADHD children are at high risk for clinically meaningful levels of psychopathology and functional impairment. In addition to supporting hypotheses about the familial transmission of ADHD, the results suggest that the high-risk siblings might be appropriate targets for primary preventive interventions.     

Assessment of strategic self-regulation in traumatic brain injury: Its relationship to injury severity and psychosocial outcome.

Standard neuropsychological tests administered in a constrained and artificial laboratory environment are often insensitive to the real-life deficits faced by patients with traumatic brain injury (TBI). The Revised Strategy Application Test (R-SAT) creates an unstructured environment in the laboratory in which environmental cues and internal habits oppose the most efficient strategy, thus mimicking the real-life situations that are problematic for patients with TBI. In this study, R-SAT performance was related both to severity of TBI (i.e., depth of coma) sustained 2–3 years earlier and to quality of life outcome as assessed by the Sickness Impact Profile. This relationship held after accounting for variance attributable to TBI-related slowing and inattention. These findings support the validity of the R-SAT and suggest that behavioral correlates of quality of life outcome in TBI can be assessed in the laboratory with unstructured tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypothalamic-pituitary-adrenal axis activity and 1-year outcome in depression

The relationships of longitudinal biological measures to longer-term outcome in depressed patients have not been well explored. This study was designed to investigate whether in a sample of depressed patients: (a) symptomatic and functional outcome at 1 year was significantly different in psychotic major depressed (PMD) patients as compared with nonpsychotic major depressed (NPMD) patients and (b) high urinary or plasma cortisol levels at baseline or 1 year were associated with poorer outcomes at 1 year. Forty-two depressed patients (9 psychotic, 33 nonpsychotic) were evaluated at baseline and at 1 year using a battery of clinical ratings and measures of cortisol. A group of normal, healthy control subjects were similarly evaluated at baseline. At 1-year follow-up, PMD patients did not differ from NPMD patients in their Hamilton Depression Rating Scale (HDRS) and Brief Psychiatric Rating Scale scores (BPRS), but PMD patients demonstrated significantly poorer social and occupational functioning. Significant correlations were observed (n = 18) between higher levels of urinary and plasma cortisol at 1 year and poorer social and occupational functioning at 1 year, independent of the degree of residual depression. In contrast, baseline measures of urinary and plasma cortisol did not predict social and occupational functioning at 1 year.     

Treatment of erectile dysfunction secondary to spinal cord injury: Sexual and psychosocial impact on couples.

17 males with spinal cord injury (SCI) and their partners, screened for suitability for pharmacological intervention for erectile dysfunction, were assessed pre- and postintervention on measures of marital, social, personality, and sexual functioning. Intervention did not affect general measures of life satisfaction or personality functioning. A positive impact on a general measure of marital satisfaction and on several measures of sexual functioning was noted, generally more so for SCI males than their partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Significance of MRI in clarifying whether neuropsychological deficits after head injury are organically based.

Reviews evidence from studies using magnetic resonance imaging (MRI) that bears on the problem of determining the extent of brain damage. It is argued that it is a mistake to focus narrowly on the results of computerized tomography (CT) examination or records of coma. Studies using MRI show that neither a normal CT scan nor a history of short or negligible loss of consciousness precludes the presence of significant brain damage after trauma. Information from a variety of sources should be considered, and posttraumatic amnesia should not be overlooked. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

SPECT cerebral blood flow, MR imaging, and neuropsychological findings in traumatic head injury.

Investigated 16 patients with diffuse or contusional brain damage and 8 patients with focal lesions 5–22 mo postinjury, using single proton emission computed tomography (SPECT) cerebral blood flow (CBF) measurements and neuropsychological examination. All Ss were aged 16–64 yrs. Compared with 16 controls, the diffuse group showed significant differences on 13 of 24 measures after correction for premorbid differences, whereas the focal group was significantly impaired on only 3 tests after correction. SPECT apparently identified abnormalities not demonstrated on magnetic resonance (MR) imaging and vice versa. Abnormal regional CBF seemed to be related to neuropsychological defects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychosocial impact of skin disease. An overview

When the skin is disfigured by disease, it has an impact on the afflicted person. The intensity of the effect depends on many variables including the natural history of the disease, the characteristics of the individual patients and their life situation, as well as the attitudes and assumptions of the culture at large about the meaning of skin disease. Fantasies about skin disease, shared by patients and onlookers alike, relate to guilt, control of bodily boundaries, and perfectionist yearnings. Some issues involved in these fantasies include distortions about contagion, dirt, and sexuality. Ways of helping patients to manage the impact of their skin disease include an empathic doctor-patient alliance, education of patients and the community, and if indicated, referral for psychiatric consultation.     

Late psychosocial improvement in a case of severe head injury with bilateral fronto-orbital lesions.

Describes the results of a 19-yr follow-up study of a head-injured female patient. At age 17 yrs, the S sustained a blunt head trauma with bilateral fronto-orbital lesions verified by late regional cerebral blood flow. The S presented an extreme state of regression for many months after injury. During the first posttraumatic years no behavioral disorders were reported, but after the 5th yr lack of control, including sexual disinhibition, and lack of motivation became severe problems. More than 10 yrs after the accident, a partner applied a simple program of behavioral modification to the S. After 2 yrs of rigid training, an unexpected improvement in psychosocial adaptation took place. (PsycINFO Database Record (c) 2010 APA, all rights reserved)