Cognitive rehabilitation of chronic alcohol abusers

The current literature suggests that individuals who chronically abuse alcohol exhibit a wide variety of cognitive deficits resulting from cerebral dysfunction that is either directly or indirectly related to their alcohol consumption history. Cognitive deficits have been hypothesized as having implications for standard alcohol treatment efficacy as they may directly affect cognitively impaired individuals’ abilities to utilize various treatment modalities. Although evidence is accumulating that suggests this is actually the case, the majority of alcohol treatment programs neither directly consider the impact cognitive deficits have on treatment efficacy nor do they employ cognitive rehabilitation treatment strategies to remediate identified cognitive deficits. Few studies exist that investigate the remediability of neurobehavioral deficits or the efficacy of integrating cognitive rehabilitation strategies into more traditional treatment programs. Empirical investigations conducted to date indicate that some cognitive deficiencies secondary to alcoholism are amenable to cognitive rehabilitation and this remediation is generalizable. Rigorous well-controlled treatment outcome investigations are needed in order to determine the efficacy of cognitive rehabilitation techniques in naturalistic settings using ecological outcome measures. Also, emphasis should be placed on integrating cognitive rehabilitation techniques with proven efficacy into traditional alcoholism treatment programs.     

The functional‐cognitive framework as a tool for accelerating progress in cognitive neuroscience: On the benefits of bridging rather than reducing levels of analyses

The subject matter of neuroscience research is complex, and synthesising the wealth of data from this research to better understand mental processes is challenging. A useful strategy, therefore, may be to distinguish explicitly between the causal effects of the environment on behaviour (i.e. functional analyses) and the mental processes that mediate these effects (i.e. cognitive analyses). In this article, we describe how the functional‐cognitive (F‐C) framework can accelerate cognitive neuroscience and also advance a functional treatment of brain activity. We first highlight that cognitive neuroscience can particularly benefit from the F‐C approach by providing an alternative to the problematic practice of reducing cognitive constructs to behavioural and/or neural proxies. Next, we outline how functional (behaviour–environment) relations can serve as a bridge between cognitive and neural processes by restoring mental constructs to their original role as heuristic tools. Finally, we give some examples of how both cognitive neuroscience and traditional functional approaches can mutually benefit from the F‐C framework.     

动、名词词类特异性损伤的研究现状

词汇的各类知识信息（如,语法信息）在人脑中的表征和加工方式是当前学者们研究的热点之一,以患者为研究对象已成为了其中一种重要的研究手段。期间,人们发现脑损伤使得一些患者对动词或名词表现出选择性认知加工障碍,即出现了动、名词词类特异性损伤。通过探讨这一现象发生的机理,将为揭示词类的语法信息在人脑中的表征和加工方式提供了契机。文章介绍了这一现象的表现形式,即一些脑损伤患者对有关动词的知识比有关名词的知识丧失得更严重,而有些患者的损伤模式却与其恰好相反。另外,文中也阐述了对该现象的3种理论解释：语法解释、语义－概念解释和词典解释。     

Hemispheric Asymmetries: Attention to Visual and Auditory Primitives

A computational theory of hemispheric asymmetries in perception (double filtering by frequency) is described. Its central tenet is that the cerebral hemispheres first perform symmetric filtering of visual and auditory information. Functional hemispheric asymmetry arises from a second filtering stage (containing filters skewed in different directions in the two hemispheres). The first stage selects a range of task-relevant spatial or auditory frequencies from the absolute values. This range is passed to the asymmetric filters. In this way, the hemispheric difference becomes one of relative rather than absolute information. Behavioral deficits due to unilateral lesions in neurological patients and neuroimaging and electrophysiological measures in normal subjects implicate posterior cortex in these hemispheric differences.     

Cognitive deficits in developmental disorders

The existence of specific developmental disorders such as dyslexia and autism raises interesting issues about the structure of the normally developing mind. In these disorders distinct cognitive deficits can explain a range of behavioural impairments and have the potential to be linked to specific brain abnormalities. One possibility is that there are specific mechanisms dedicated to particular types of information processing. These mechanisms may function independently of more general information processing systems and may have a distinct anatomical basis in the brain.     

Cognitive deficits related to major organ failure: The potential role of neuropsychological testing

Until recently, little attention has been paid to the possibility of cognitive deficits in patients with disease or failure of major organs such as the liver, kidney, or heart. However, there is a growing awareness that major organ failure often has neuropsychological sequelae. These sequelae may at times be quite subtle and not detectable under gross. examination. Nevertheless, even subtle deficits may have a major impact on adherence to medical regimens, psychosocial adjustment, and quality of life of patients. Neuropsychological assessment has a potentially valuable role to play both in research and in clinical work. It can be useful in adding to our knowledge of the cognitive effects of various types, severity and duration of major organ disease, as well as sequelae associated with treatment. It also is a potentially valuable clinical tool for identifying cognitive deficits that will affect the quality of life and probability of survival for organ failure patients.     

Adults With Attention‐Deficit/Hyperactivity Disorder: Assessment and Treatment Strategies

Attention‐deficit/hyperactivity disorder (ADHD) among adults is characterized by inattentiveness and impulsivity. This article provides counselors with information about the etiology, assessment, and treatment of adult ADHD. The identification of the genetic and neurological features of ADHD has led to improvements in evaluation and treatment. Assessment of ADHD requires knowledge of the defining characteristics, subtypes, comorbid features, and functional aspects of ADHD. Effective treatments include both medical management and counseling to address psychosocial deficits.     

Declarative memory deficits and schizophrenia: problems and prospects

Cognitive deficits are among the most important factors leading to poor functional outcomes in schizophrenia, with deficits in declarative memory among the largest and most robust of these. Thus far, attempts to enhance cognition in schizophrenia have shown only modest success, which underlies increasing efforts to develop effective treatment strategies. This review is divided into three main parts. The first section delineates the nature and extent of the deficits in both patients with schizophrenia and in their adult, non-psychotic relatives. The second part focuses on structural and functional abnormalities in the hippocampus, both in people with schizophrenia and in animal studies that model relevant features of the illness. The third section views problems in declarative memory and hippocampal function from the perspective of elevated rates of common medical disorders in schizophrenia, with a focus on insulin insensitivity/diabetes. The likelihood that poor glucose regulation/availability contribute to declarative memory deficits and hippocampal abnormalities is considered, along with the possibility that schizophrenia and poor glucose regulation share common etiologic elements, and with clinical implications of this perspective for enhancing declarative memory.     

Conceptual structure and the structure of concepts: a distributed account of category-specific deficits

We present a new account of the fine-grained structure of semantic categories derived from neuropsychological, behavioral, and developmental data. The account places theoretical emphasis on the functions of the referents of concepts. We claim (i) that the distinctiveness of functional features correlated with perceptual features varies across semantic domains; and (ii) that category structure emerges from the complex interaction of these variables. The representational assumptions that follow from these claims make strong predictions about what types of semantic information are preserved in patients showing category-specific deficits following brain damage. These claims are illustrated with a connectionist simulation which, when damaged, shows patterns of preservation of distinctive and shared functional and perceptual information which varies across semantic domains. The data model both dissociations between knowledge for artifacts and for living things and recent neuropsychological evidence concerning the robustness of functional information in the representation of concepts.     

Connecting the Many Levels and Facets of Cognitive Aging

Basic cognitive mechanisms, such as the abilities to briefly maintain, focus, and process information, decline with age. Related fields of cognitive aging research have been advancing rapidly, but mostly independently, at the biological, information processing, and behavioral levels. To facilitate integration, this article reviews research on cognitive aging at the different levels, and describes a recent integrative theory postulating that aging-related deficiencies in neurotransmission cause increased noise in information processing and less distinctive cortical representation, which in turn lead to cognitive deficits. Aging-related attenuation of catecholaminergic modulation can be modeled by lowering a neural network parameter to reduce the signal-to-noise ratio of information processing. The performance of such models is consistent with benchmark phenomena observed in humans, ranging from age differences in learning rate, asymptotic performance, and interference susceptibility to intra- and interindividual variability and ability dedifferentiation. Although the details of the conjectured sequence of effects linking neuromodulation to cognitive aging deficits await further empirical validation, cross-level theorizing of the kind illustrated here could foster the coevolution of related fields through cross-level data synthesis and hypothesis testing.     

Younger and older adults’ associative memory for medication interactions of varying severity

While older adults face various deficits in binding items in memory, they are often able to remember information that is deemed important. In Experiment 1, we examined how younger and older adults remember medication interactions of varying severity. There were no age differences in overall memory accuracy, but older adults’ performance depended on the severity of the interactions (such that the interactions associated with the most severe health outcomes were remembered most accurately) while younger adults’ did not. In Experiment 2, a similar task was designed to create interference in memory. Even with this more difficult task there were no age differences in recall accuracy, and both age groups remembered the interactions with the severe outcomes most accurately. These findings suggest that, under certain circumstances, older adults do not face deficits in associative recognition accuracy of information that varies in importance.     

The role of inferior frontal cortex in phonological processing

Recent neuroimaging studies of language processing are examining the neural substrate of phonology because of its critical role in mapping sound information onto higher levels of language processing (e.g., words) as well as providing codes in which verbal information can be temporarily stored in working memory. However, the precise role of the inferior frontal cortex in spoken and written phonological tasks has remained elusive. Although lesion studies have indicated the presence of selective deficits in phonological processing, the location of lesions underlying these impairments has not revealed a consistent pattern. Despite efforts to refine methods and tasks, functional neuroimaging studies have also revealed variability in activation patterns. Reanalysis of evidence from these neuroimaging studies suggests that there are functional subregions within the inferior frontal gyrus that correspond to specific components of phonological processing (e.g., orthographic to phonological conversion in reading, and segmentation in speech).     

Evaluation of the effects a caregiver training programme has on the cognitive and functional maintenance of the elderly / Valoración de los efectos de un programa de formación de cuidadores sobre el mantenimiento cognitivo y funcional de ancianos

Abstract

With the increase in the elderly population comes a need to ensure they remain cognitively and functionally stable for as long as possible. Achieving this through a caregiver training programme based on the Person Centred Care (PCC) approach has been suggested. On this basis, the purpose of this study has been to evaluate the effectiveness of a caregiver training programme on the cognitive and functional maintenance of the elderly. The study sample comprised 56 elderly people and 14 caregivers, who were assessed using the MMSE, Clifton, Barthel, EuroQol, RMBPC (elderly) and SSFQ (caregivers) measurement scales. The results at intergroup level show significant differences in the pre-treatment assessment: the control group had higher scores for MMSE, Barthel, EuroQol and RMPBC scales, but that difference disappeared as scores for the treatment group increased. At an intragroup level, increases in scores were observed in the MMSE, Clifton and EuroQol scales for the treatment group and decreases in the Clifton, EuroQol and Barthel scales for the control group. From these results we can conclude that a caregiver training programme based on a PCC approach produces cognitive and functional benefits in the elderly. In addition, caregivers in the treatment group felt more competent, confident and satisfied with their work.     

生物运动及其在社会认知障碍研究中的应用

人类对生物运动具有较强的视觉敏感性,即使在视觉线索有限的情况下,仍能提取其中的社会性信息。本研究系统梳理了当前生物运动视知觉实验研究涉及的各类社会性信息,并归纳分析社会认知缺陷与生物运动视知觉加工之间的内在联系,以期促进对生物运动视知觉加工心理机制问题的深入探讨     

Teacher Beliefs and Responses Toward Student Misbehavior: Influence of Cognitive Skill Deficits

This study aimed to examine whether having knowledge of student cognitive skill deficits changes teacher beliefs and responses in regard to classroom misbehavior. Teachers (N = 272) were randomly assigned to an experimental or control condition. Although teachers in both conditions read the same vignette describing a student's misbehavior, the experimental group also reviewed information about the student's cognitive skill deficits. Teachers provided with cognitive skill deficit information were, on average, less likely to believe the student had control over the misbehavior, suggesting perceptions of unintentionality. Furthermore, they were significantly more likely to indicate positive emotional responses. Results suggest that school psychologists may consider sharing cognitive skill deficits information with teachers who are working with students displaying challenging behavior.     

Optimizing treatment of schizophrenia. Enhancing affective/cognitive and depressive functioning

Recognition and treatment of schizophrenia has largely focused on positive symptoms of the disorder, such as delusions, hallucinations, and disorganization. However, other important symptoms, such as depression, cognition, and social functioning, have not received comparable attention. Fifty percent of schizophrenic patients suffer from comorbid depression, which is a major risk factor for suicide in this population, while 10% to 25% suffer from comorbid obsessive-compulsive disorder. Cognitive deficits commonly observed in patients with schizophrenia include problems with concentration, attention, and memory, as well as problem-solving and verbal skills. These deficits are observed at early stages of the illness and can predict deficits in functional capabilities, such as occupational and social skills, educational attainment, and the ability to live independently. The severity of such impairments affects all patient in this population, including up to 10% of patients working full time and up to one third of those working part time. In light of the debilitating effects of depression, cognitive impairment, and other aspects of affective functioning on the quality of life of patients with schizophrenia, physicians need to partner with their patients to address these concerns and determine an appropriate treatment regimen. This can be done with simple functional-based cognitive questioning, the use of evidence-based psychosocial practices, and psychoeducation on the many pharmacotherapeutic options. It is recommended that depressive or suicidal symptoms of schizophrenia be treated with an antidepressant or mood stabilizer only if the symptoms have not subsided after treatment of the psychosis with an atypical antipsychotic. Additionally, relative to older medications, atypicals have demonstrated benefit in improving some of the cognitive impairments.     

Cognitive and Emotional Abnormalities in Systemic Lupus Erythematosus: Evidence for Amygdala Dysfunction

Systemic lupus erythematosus (SLE) is a multi-system autoimmune disorder characterized by the production of autoantibodies. Approximately 30-50?% of patients produce autoantibodies directed against N-Methyl-D-aspartic acid receptors (NMDARs). Once they have gained access to brain tissue, these autoantibodies bind to the NR2A subunit of the NMDARs and synergize with glutamate to cause excitatory, non-inflammatory cell death or alter neuron function. Both humans with SLE and animal models of SLE have shown structural and functional damage to the amygdala. The amygdala is a brain region important for processing the emotional relevance of stimuli in the environment. It also serves to modulate perception, attention, and memory to facilitate the processing and learning of relevant stimuli. Research has linked amygdala damage to deficits in emotional memory and emotional behavior. Individuals with SLE often exhibit emotional dysregulation, such as lability and depression; however, the behavioral impact of possible amygdala dysfunction has yet to be studied in this population. The purpose of this review is to 1) examine possible associations between SLE, anti-NMDAR antibodies, amygdala damage, and emotional processing deficits and 2) to identify the clinical, social, and treatment implications for individuals with SLE who suffer from deficits in emotional processing.     

Upper Extremity Proprioception After Stroke: Bridging the Gap Between Neuroscience and Rehabilitation

Proprioception is an important aspect of function that is often impaired in the upper extremity following stroke. Unfortunately, neurorehabilitation has few evidence based treatment options for those with proprioceptive deficits. The authors consider potential reasons for this disparity. In doing so, typical assessments and proprioceptive intervention studies are discussed. Relevant evidence from the field of neuroscience is examined. Such evidence may be used to guide the development of targeted interventions for upper extremity proprioceptive deficits after stroke. As researchers become more aware of the impact of proprioceptive deficits on upper extremity motor performance after stroke, it is imperative to find successful rehabilitation interventions to target these deficits and ultimately improve daily function.     

注意缺陷多动障碍-发展性阅读障碍共患儿童的干预效果及其内在机理

注意缺陷多动障碍和发展性阅读障碍是两类常见的儿童神经发育障碍, 二者共患率高达25%~48%。共患问题不仅使儿童自身面临着严重的认知、行为和心理损害, 还给家庭、学校和社会带来了沉重的负担, 对共患儿童的干预是极为必要且重要的。以共患病理机制假说为基础, 可将既往共患儿童的干预研究划分为以下两大类：(1)基于表型假说的干预方案, 如药物干预、阅读干预以及二者联合干预, 相应方案干预效果的迁移性和稳定性均有待深入考究; (2)基于共同缺陷假说的干预方案, 如针对核心共同认知缺陷之一的加工速度问题的干预已初显成效, 但相关研究较少, 干预效果需更多研究进一步系统性地考察。最后就共患儿童的干预方案现状进行了反思和展望。