Pathological visual field and brain tumor]

The general relationships between an operatively or autoptically localized tumor and the visual field determined by means of ikineticer perimetry are investigated, the patient stock being a total of 1756 neurosurgical brain-tumor inpatients. Examination of the visual field was possible with four fifths of the brain-tumor patients. Hemianopic, quadrantanopsic, or scotomatous defects of a topically localizable nature could be found in almost one third of the total patient stock available for examination. The clinically particularly interesting criteria of localization of homonymous-hemianopsia defects such as macular sparing and incongruence/congruence of visual field changes should be of no importance to the localization within the visual pathway of brain-tumor patients.     

Hidden reality: sexual sphere in brain tumor patients

Most reports emphasize that tumors and their treatments affect sexual function. To date, no studies have focused on sexual functioning in patients with brain tumors. Our study’s objective is to describe the sexual sphere of patients with brain tumors and examine the possible differences between patients who reported sexual dysfunctions and those who did not with respect to their psychological and functional status. We tested 46 patients with brain tumors. We used an ad hoc questionnaire to assess patients’ subjective perception of their own sexual sphere. To assess patients’ psychological status, we used the following questionnaires: Hospital Anxiety and Depression Scale; Psychological Distress Inventory; EORTC QLQ-C30; EORTC QLQ-BN20. Fifty-eight percent of patients reported sexual disturbance. Our data showed that a lack of or decrease in sexual desire is the most common sexual problem reported by our patients (56%). Patients with sexual problems reported higher levels of anxiety and depression and a worse self-reported quality of life (QoL) than did those who did not perceive adverse changes in their sexual sphere. In addition, we found that patients with a better performance status (KPS) reported more changes in sexual behaviors than did those who had performance difficulties. Of the patients, 15.2% received information regarding possible changes in the sexual sphere by physicians. Additionally, 10.8 of 15.2% of the patients reported having explicitly requested information from physicians. The study demonstrated a relation between QoL and sexual function. Therefore, it would be important to encourage clinicians to ask questions regarding patients’ sexual issues, thus providing them with an opportunity to expose their difficulties and receive adequate support.     

Working memory and attention in pediatric brain tumor patients treated with and without radiation therapy

Children are at risk for cognitive difficulties following the diagnosis and treatment of a brain tumor. Longitudinal studies have consistently demonstrated declines on measures of intellectual functioning, and recently it has been proposed that specific neurocognitive processes underlie these changes, including working memory, processing speed, and attention. However, a fine-grained examination of the affected neurocognitive processes is required to inform intervention efforts. Radiation therapy (RT) impacts white matter integrity, likely affecting those cognitive processes supported by distributed neural networks. This study examined working memory and attention in children during the early delayed stages of recovery following surgical resection and RT. The participants included 27 children diagnosed with pediatric brain tumor, treated with (n = 12) or without (n = 15) RT, who completed experimental and standardized measures of working memory and attention (n-back and digit span tasks). Children treated with radiation performed less well than those who did not receive radiation on the n-back measure, though performance at the 0-back level was considerably poorer than would be expected for both groups, perhaps suggesting difficulties with more basic processes such as vigilance. Along these lines, marginal differences were noted on digit span forward. The findings are discussed with respect to models of attention and working memory, and the interplay between the two.     

O2 multistep method as a supplement to therapy of standard brain energy balance disorders]

The possibility of improving the brain's energy state by the O2 multistep method is discussed. An outline is given of several variations of the O2 multistep method, and this is followed by a discussion of the results of studies of the increase and decrease in concentration of high-energy phosphates in the brains of rats during and after the O2 multistep process. In conclusion, the author reports a twin series of tests where psychic irritations lasting for a short time only were triggered and in which such irritations were suppressed through using the O2 multistep procedure.     

Results of nuclear medical, electroencephalographic, and angiographic examinations after brain tumor operations]

The methods of nuclear medicine and electro-encephalography allow, in combination, in almost every case the answer to the question of the cerebral tumour relapse. Our evaluation confirms the discovery of the greater sensitivity of the isotopic methods with relapses of glioblastomas, while relapses of meningiomas, astrocytomas, oligodendrogliomas and spongioblastomas can be recognized more frequently only by electro-encephalographic methods. The value of angiography is limited in cases of cerebral tumour relapses without pathological vascularisation, since the swelling can spread in the resection cavity without retroaction on the surrounding areas. For this reason vascular displacement (an only be observed very late on. Clinical judgement is furthermore complicated by the fact that after the removal of the primary tumour, often no reposition of the arteries ensues. After our exainations, a negative angiographic condition can be rule out a diagnosis of a relapse which has been established by electro-encephaolographic and isotopic methods.     

Evolutionary neurology,responsive equilibrium,and the moral brain

The relation between morality and the brain is a topic usefully examined through the evolutionary neurology of John Hughlings-Jackson, who considered higher mental function to be progressively inclusive integration of sensori-motor processes. His view, based on careful observations of patients with neurological disorders, implies that moral reasoning involves integration and coordination of behaviour through a process of representation and re-representation encompassing broader and broader types of information sensitive to environmental contingencies. The relevant information is processed in diverse brain areas: superior temporal sulcus (STS), inferior parietal lobule (IPL), inferior frontal gyrus (IFG), dorsolateral prefrontal (DLPF) areas, as well as anterior temporal (AT) structures. Moral function can be regarded as maximally integrating emotion, social cognition, and other-regarding sensibilities using propositionally organised cognitive structures that map a shared world of human activity and relationships so that they take account of what in social and personal life counts as something.     

Disorders of higher mentae functions as first symptoms in patients with brain tumors]

It has been established that in 29 (or 36,25%) of examined patients with neoplasms of the brain in the left dominant hemisphere, disturbances in the psychic functions seem to be the first and most early symptoms of the disease. They develop slowly, progressively, or in the form of epileptic language equivalents (in 5% of examined patients). As early symptoms, disturbances in language indicate existance of a brain disease and give cause to suspect a neoplasm, in this way stating the necessity of further examination, and from the other side - in some cases show the localization of the process.     

Anorexia nervosa and brain tumor in a 14-year-old girl

A 14-year-old girl with anorexia nervosa (AN) was found to have an intracranial neoplasm. Atypical psychological symptoms prompted further evaluation, including electroencephalogram and neuroimaging, which revealed a sellar and suprasellar mass. This patient had an eating disorder and a brain tumor, which appear to be two unrelated conditions. However, it remains unclear how each affected the other. The diagnosis of AN, like all other psychiatric disorders, requires that possible medical etiologies and coexisting medical problems be excluded. AN and other eating disorders are particularly difficult to diagnose in children and adolescents because they often do not present in the manner typical of adults. Perceptual and cognitive disturbances associated with AN are difficult to evaluate because children and adolescents normally change over time as they progress through different stages of development. Therefore, it is particularly important to evaluate for the presence of medical conditions when a diagnosis of an eating disorder is made in a child or adolescent.     

Relationship between emotions and some aspects of respiratory activity: morphology of the chest, cyclic activity, and acid-base balance

The relationship between the style of affective-emotional management measured on the Gottschalk test and respiratory activity of 19 undergraduate students in psychology was examined. The biological measurements were tonic-static attitudes of the chest (morphology), amplitude and duration of the phases of the respiratory activity, and acid-base balance. Statistically significant correlations were observed between affectivity (hostility and anxiety) and some biological scores. A psychophysiological model integrating biological and psychological levels was discussed.     

Facial myokomias in brain stem tumors]

Four cases of brain-stem tumor were described, in which myokymias were electromyographically derived from the region of several cerebral nerves. An attempt is made to interpret the effects of twitching by reference to the electromyogram. Myokymias are a positive indication of organic brain stem damage. The use subtle techniques of electromyographic examination shows that this muscular hyperkinesis is not so infrequent a symptom as is generally believed.     

Executive functions and social skills in survivors of pediatric brain tumor

Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper-and-pencil measures of social skills and real-world executive skills. Social functioning was related to a specific aspect of executive functions, that is, the survivors' variability in response time, such that inconsistent responding was associated with better parent-reported and survivor-reported social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed.     

Simplest tasks have greatest dual task interference with balance in brain injured adults

Attention difficulties and poor balance are both common sequel following a brain injury. This study aimed to determine whether brain injured adults had greater difficulty than controls in performing a basic balance task while concurrently completing several different cognitive tasks varying in visuo-spatial attentional load and complexity. Twenty brain injured adults and 20 age-, sex- and education level-matched controls performed a balance-only task (step stance held for 30 s), five cognitive-only tasks (simple and complex non-spatial, visuo-spatial, and a control articulation task), and both together (dual tasks). Brain injured adults showed a greater centre of pressure (COP) excursion and velocity in all conditions than controls. Brain injured adults also demonstrated greater interference with balance when concurrently performing two cognitive tasks than control subjects. These were the control articulation and the simple non-spatial task. It is likely that distractibility during these simple tasks contributed to an increase in COP motion and interference with postural stability in stance. Performing visuo-spatial tasks concurrently with the balance task did not result in any change in COP motion. Dual task interference in this group is thus unlikely to be due to structural interference. Similarly, as the more complex tasks did not uniformly result in increased interference, a reduction in attentional capacity in the brain injured population is unlikely to be the primary cause of dual task interference in this group.     

Biofeedback of slow brain potentials]

Slow cortical potentials constitute neurophysiological indicators of cortical excitability. Behaviorally they correlate with attention and motor preparation. A system for biofeedback and self-regulation of slow cortical potentials (SCP) has been developed. The portable system allows on-line visual feedback of filtered and corrected slow brain potentials in a predetermined sequence of trials. Three different algorithms for transforming the original SCP-signal into a feedback-signal have been developed and were compared in a controlled outcome study. With the optimal feedback method subjects were able to produce cortical positivity and negativity on command after three sessions. Increases and decreases of negativity of up to 20 microV were also achieved. Therefore a simple and portable PC-based device for the clinical application of SCP-biofeedback is now available.     

Aphasia syndromes in brain tumors. Clinico-pathological correlations]

A clinica-psychological and pathoanatomical analysis of 40 observations with neoplasms of the brain in the left dominant hemisphere and 4 observations with neoplasms in the right subdominant hemisphere, has been carried out. In 36 cases, a desintegration in the language in a form of aphasia, has been established, while in 4 cases this was not present. In 22 observations the established neuro-psychological syndrome completely indicated and coincided with the localization of the neoplasm in the corresponding part or parts of the brain, in 10 it only partialy coincided, while in 4 cases it did not coincide with the localization of the neoplasm in the brain. The established neuro-psychological syndrome in observations with neoplasms in the right subdominant hemisphere possesses only a tentative topico-diagnostical significance. In conclusion the authors consider that the established syndromes of aphasia in patients with neoplasms of the brain may be of a considerable significance and help in substantiating a precise topical diagnosis.     

Lymphocyte sensitivity to brain specific glycoprotein in multiple sclerosis]

The lymphocytes of seven out of eight multiple sclerosis patients were sensitized to brain-specific glycoproteins that had been isolated from extracts of human white matter and purified by means of affinity chromatography utilizing specific antibodies as immunoadsorbents. The diagnosis of multiple sclerosis for the eighth patient, whose lymphocytes were not sensitized, was doubtful. A significant correlation between the severity of the disease and degree of lymphocyte sensitization was not obtained, although the most disabled patient showed the greatest sensitization.