脑损伤新生儿救治的选择

脑损伤是婴儿死亡、儿童残疾的主要原因之一。关于有严重脑损伤新生儿（包括脑瘫、智能精神发育落后等）是否该救治,牵涉到很多矛盾的思想观点。通过分析新生儿期脑损伤发生的高危因素,且提出相应的综合处置意见,认为要和谐地解决此矛盾,需要医院、家庭和社会有关部门的共同努力。     

Compensating for Cognitive Deficits Following Brain Injury

Two of the most important goals of rehabilitation are to (a) reduce everyday consequences of impaired cognitive functioning (disabilities) and (b) reduce the level of handicap (the extent to which these problems prevent successful return to society). One of the ways by which we can achieve these goals is to enable people to compensate for their cognitive deficits. This paper (i) describes a theoretical framework for understanding compensatory behavior, (ii) discusses different forms of compensation, (iii) considers compensation for several cognitive disorders, and (iv) presents suggestions for predicting which patients will find it easy to compensate and which require more intensive and focused rehabilitation.     

Impairments of Attention Following Childhood Traumatic Brain Injury

Attentional deficits are commonly reported following traumatic brain injury (TBI) in adults, although the occurrence of such problems is less well documented in young children. This study aimed to investigate residual attentional abilities associated with TBI during childhood, by examining a number of aspects of attention including sustained, focussed, and divided attention, attentional shift, and response inhibition. Eighteen children with a history of TBI, aged between 8 and 14 years and 18 non-injured matched controls participated in the study. Results show that attentional skills may be differentially impaired after TBI, with children who have sustained moderate-to-severe TBI exhibiting significant deficits on the following attentional domains: sustain, focus, and response inhibition. These findings support the view that attentional impairments following pediatric TBI, while not global, may be more generalized than those reported for adult samples, perhaps reflecting the relative immaturity of attentional skills at the time of injury.     

Attentional Skills in the Acute Phase Following Pediatric Traumatic Brain Injury

Only a limited number of studies have investigated attention following pediatric head-injury. The present study examined sustained attention and processing speed in a group of children who had sustained a mild (n = 27), moderate (n = 33) or severe (n = 16) traumatic brain injury (TBI). No significant differences were evident between the TBI groups on reaction time measures. Results did show that the severe TBI group exhibited greater deficits in the area of sustained attention, in comparison to children with mild and moderate injuries, in the acute stage following traumatic brain injury. This difficulty may impact on the future development of skills dependent on intact attentional capacity.     

Lack of Inhibition: A Motivational Deficit in Children With Attention Deficit/Hyperactivity Disorder and Children With Traumatic Brain Injury*

Recent research has demonstrated that both brain-injured children and children with attention deficit/hyperactivity disorder (ADHD) suffer from response inhibition deficits. To investigate whether these deficits can be influenced by motivational factors, the stop-signal task was performed with and without reward contingencies for successful inhibition. Three groups of children between 8 and 12 years of age, participated in the study: 31 children with ADHD, 37 with traumatic brain injuries (TBI), and 26 normal controls. Results indicated that, although all groups showed comparable learning effects, reward contingencies had different effects on the groups. Whereas the performance of children with ADHD under reward contingencies were brought up to the performance level of normal controls, rewards were found less effective at improving response inhibition in children with TBI. The results further support a motivational/energetic explanation of the inhibitory deficit in children with ADHD, and of a primary response inhibition deficit due to structural brain damage in children with TBI.     

A Meta-Analysis of Neuropsychological Predictors of Outcome Following Stroke and Other Non-Traumatic Acquired Brain Injuries in Adults

Neuropsychology Review - A number of cognitive abilities have been reported to predict outcome following a non-traumatic acquired brain injury (ABI) in adults. However, the results are...     

Neuropsychological Effects of Brain Arteriovenous Malformations

Brain arteriovenous malformations (AVM's) are developmental, chronic lesions that provide unique information about the human brain and can be a useful model for neuroscientists to study cerebral reorganization and hemodynamics. We review the neuroanatomy, epidemiology, natural history, imaging and treatment of brain AVMs, and provide a model with which to better understand neuropsychological functioning and brain reorganization. We suggest that future studies must exclude ruptured AVMs if they wish to further explain focal neurological/cognitive deficits associated with this neurovascular anomaly.     

Neuropsychological Effects at Early School Age of Fetal Alcohol Exposure of Varying Duration

A comprehensive neuropsychological assessment was performed with forty-six 5- to 9-year-old children exposed to alcohol in utero for varying durations. The children were subdivided according to duration of maternal alcohol abuse, as follows: during trimester I (n = 16), during trimesters I and II (n = 16), and throughout pregnancy (n = 14). A control group (n = 26) consisted of unexposed children. Fetal alcohol exposure throughout pregnancy had significant, diffuse effects on the development of the children, whereas exposure only during early pregnancy did not. Observed cognitive deficits included problems in naming, receptive language, attention, and visual-motor functions. Verbal and visual memory and manual motor precision did not significantly differ between the groups.     

The Prevalence and Characteristics of Alexithymia in Adults Following Brain Injury: A Meta-Analysis

Neuropsychology Review - Alexithymia is the inability to identify and describe one’s own emotions. Some research suggests that organic alexithymia may occur after acquired brain injury (ABI)....     

Agreement between Parents and Children on Ratings of Post-Concussive Symptoms Following Mild Traumatic Brain Injury

The level of parent-child agreement on post-concussive symptoms (PCS) was examined in children following mild traumatic brain injuries (TBI). As part of a larger longitudinal study, 186 children with mild TBI and 99 with orthopedic injuries (OI), from 8 to 15 years of age, were recruited prospectively. Parents and children completed the PCS Interview (PCS-I) and the Health and Behavior Inventory (HBI) at 2 weeks, 1 month, 3 months, and 12 months postinjury. Item-level correlations between child and parent ratings on both measures of PCS were significant but modest in both groups. Parent-child correlations for composite scales on the HBI and the total score on the PCS-I were significant in both groups, but somewhat higher in the OI group than in the mild TBI group. Mean symptom ratings tended to be significantly higher for children as compared to parents, especially for somatic symptoms. Parents and children display modest agreement when reporting PCS; their ratings correlate significantly, but children report higher mean levels of symptoms than parents.     

Children's Narratives Following Traumatic Brain Injury: Linguistic Structure, Cohesion, and Thematic Recall

Narrative discourse and intellectual functioning were examined 3 years following traumatic brain injury (TBI) in children 1 to 8 years of age at the time of injury. The language-impaired TBI group (n= 9) had language deficits during the subacute stage of recovery; their performance was contrasted with that of a TBI comparison group equated on neurologic and demographic variables that did not show subacute language impairment (n= 8) and a sibling comparison group (n= 9). The language-impaired TBI group had lower Verbal and Full-Scale IQ scores and produced fewer words and utterances than the sibling group on a story retelling task; their stories were characterized by fewer complete referential and lexical ties and more referential errors, indicating difficulty conjoining meaning across sentences. The language-impaired TBI group recalled approximately one-third of the propositions needed to maintain the story theme and made more errors sequencing the propositions than either the TBI or the sibling comparison groups. Group differences were not obtained on the Performance IQ scores or on measures of rate or fluency of speech production, mazes, use of conjunctives, or naming errors. The discourse deficiencies of children with TBI and acute language impairment were most pronounced at the level of cognitive organization of the text reflecting text macrostructure and were least apparent at the level of lexical and sentential organization reflecting text microstructure. Results are discussed in terms of the vulnerability of developing language abilities to disruption by brain injury.     

自闭症谱系儿童模仿缺陷的脑神经机制

模仿在人类生命进化中具有举足轻莺的意义,自闭症儿童的认知发展的研究表明,模仿缺陷是导致自闭症谱系儿童沟通障碍、社交困难的核心缺陷.而镜像神经系统机能失常假设有力地解释了自闭症谱系儿童模仿缺陷的神经机制.尽管镜像神经系统的信息加工过程还存在着MOSAIC模型和EP-M模型的争论.但这两种模型都支持自闭症儿童脑神经功能连通异常的假说.     

Depression Following Traumatic Brain Injury: The Validity of the CES-D as a Brief Screening Device

The validity, reliability, and factor structure of the Center for Epidemiological Studies-Depression Scale (CES-D) was examined with 253 patients seen for neuropsychological evaluation following traumatic brain injury (TBI). All patients completed the CES-D; 31 also completed the Beck Depression Inventory (BDI) and 17 completed the Minnesota Multiphasic Personality Inventory-II (MMPI-II). The CES-D demonstrated good concurrent, construct validity, significantly correlating with the BDI (r = .673, p < .0001) and the MMPI-II (Depression Scale T score r = .536, p = .027). The CES-D also demonstrated good internal consistency (coefficient alpha = .8195) and split-half reliability (Spearman–Brown r = .8284). Principal components factor analysis with varimax rotation resulted in a four-factor solution that accounted for 56.01% of the variance. The factor structure differed from the originally reported factor structure, and indicated that somatic difficulties were strongly associated with dysphoric affect in TBI patients. The CES-D is a valid and reliable screening instrument for use with TBI patients.     

Rehabilitation Treatments for Adults with Behavioral and Psychosocial Disorders Following Acquired Brain Injury: A Systematic Review

This review was aimed at systematically investigating the treatment efficacy and clinical effectiveness of neurobehavioral rehabilitation programs for adults with acquired brain injury and making evidence-based recommendations for the adoption of these rehabilitation trainings. Using a variety of search procedures, 63 studies were identified and reviewed using a set of questions about research methods, treatments, results and outcomes for the 1,094 participants. The 63 studies included treatments falling into three general categories: approaches based on applied behavior analysis, interventions based on cognitive-behavior therapy (CBT), and comprehensive-holistic rehabilitation programs (CHRPs). Considerable heterogeneity exists in the reviewed literature among treatment methods and within reported sample subjects. Despite the variety of methodological concerns, results indicate that the greatest overall improvement in psychosocial functioning is achieved by CHRP that can be considered a treatment standard for adults with behavioral and psychosocial disorders following acquired brain injury. Both approaches based on applied behavior analysis and CBT can be said to be evidence-based treatment options. However, findings raise questions about the role of uncontrolled factors in determining treatment effects and suggest the need for rigorous inclusion/exclusion criteria, with greater specification of theoretical basis, design, and contents of treatments for both interdisciplinary-comprehensive approaches and single-case methodologies.     

音高模式加工的大脑偏侧化研究

作为一种超音段成分,音高在言语的理解和产生过程中承担着重要作用,这些作用主要包括:区别不同声调的词汇意义,区别陈述、疑问等不同的语调,标志话语的情绪色彩等。音段、语义和句法信息的加工具有左脑优势,但音高模式加工的单侧优势及其机制还存在很多争论,本文从音高模式加工的两个主要理论———功能假设和声音信号假设出发,对相关研究加以评述。     

Brain lateralization of complex movement: Neuropsychological evidence from unilateral stroke

Complex movement (CM) refers to the representation of a goal-oriented action and is classified as either transitive (use of tools) or intransitive (communication gestures). Both types of CM have three specific components: temporal, spatial, and content, which are subdivided into specific error types (SET). Since there is debate regarding the contribution of each brain hemisphere for the types of CM, our objective was to describe the brain lateralization of components and SET of transitive and intransitive CM. We studied 14 patients with a left hemisphere stroke (LH), 12 patients with a right hemisphere stroke (RH), and 16 control subjects. The Florida Apraxia Screening Test-Revised (FAST-R, Rothi et al., 1988) was used for the assessment of CM. Both clinical groups showed a worse performance than the control group on the total FAST-R and transitive movement scores (p < 0.001). Failures in Spatial and Temporal components were found in both clinical groups, but only LH patients showed significantly more Content errors (p < 0.01) than the control group. Also, only the LH group showed a higher number of errors for intransitive movements score (p = 0.017), due to lower scores in the content component, compared to the control group (p = 0.04). Transitive and intransitive CMs differ in their neurocognitive representation; transitive CM shows a bilateral distribution of its components when compared to intransitive CM, which shows a preferential left hemisphere representation. This could result from higher neurocognitive demands for movements that require use of tools, compared with more automatic communication gestures.     

Outline for the Neuropsychological Examination of Patients with Local Brain Lesions

Neuropsychology Review -