Cognitive function after open-heart surgery: Are postoperative neuropsychological deficits caused by cardiopulmonary bypass?

Despite the many technological developments in arterial perfusion and cardiac surgical procedures, open-heart surgery is still believed to pose a significant risk for cerebral injury. There are several potential causes of brain damage during open-heart surgery, including prolonged or severe arterial hypotension, as well as emboli emanating from the cardiopulmonary bypass circuit or the operative field. This article reviews the available neuropsychological studies of outcome following cardiac valve replacement and coronary artery bypass grafting. Because both procedures are life-saving operations, the research in this area has been quasi-experimental and fraught with methodological problems. Nonetheless, the findings converge to suggest that cognitive dysfunction occurs after open-heart surgery, and that the deficits are attributable, at least in part, to factors specific to the operation or to the patient being maintained on cardiopulmonary bypass. Preliminary findings suggest that embolization is the primary cause of perioperative deficits in uncomplicated operations. Studies have also consistently found preoperative deficits in this population, suggesting that neuropsychological dysfunction is caused by severe chronic cardiac disease as well as open-heart surgery.     

Two-month-old infants’ sensitivity to allophonic differences

The present study investigated 2-month-olds’ abilities to discriminate allophonic differences that are potentially useful in segmenting fluent speech. Experiment 1 investigated infants’ sensitivity to the kind of distinction that may signal the presence or absence of a word boundary. When tested with the high-amplitude sucking procedure, infants discriminated pairs of items, such as “nitrate” versus “night rate” and “nikrate” versus “nike rate.” By greatly reducing the potential contribution of prosodic differences to these contrasts, Experiment 2 evaluated whether the allophonic differences for /t/ and /r/ were sufficient for infants to distinguish the “nitrate” versus “night rate” pair. Infants distinguished “nitrate” from a cross-spliced version of “night rate,” which differed only in the allophones for /t/ and /r/ that it included. Thus, infants appear to possess one of the prerequisite capacities (i.e., the ability to discriminate allophonic distinctions) necessary to use allophonic information in segmenting fluent speech.