Traumatic Brain Injury as a Risk Factor for Alzheimer's Disease: A Review

Accumulating epidemiological evidence implicates traumatic brain injury as a pathogenic agent in the development of Alzheimer's disease (AD). Considering the increase in the prevalence of both traumatic brain injury and AD in recent times, the possibility that brain trauma may provoke the early development of AD has important implications for health service planning, preventative efforts, and medico-legal compensation settlements. This paper evaluates the plausibility of the proposed link between traumatic brain injury and AD, largely by way of exploring a theoretical perspective advanced by Satz (1993) and considering recent contributions from the epidemiological, neuropathological, and biochemical literature that are pertinent to this issue. The literature reviewed provides sufficient support and empirical vindication to give credence to the proposed association between these two neuropsychological entities at the statistical, theoretical, and biological level.     

“易”的世界观和思维模式

本文认为,《周易》的阴阳世界观注重的是阴阳间的关系,而这种关系又有两个重要状态,一个是“空无”,另一个是“中庸”。对于这两种状态的不同态度形成了古人不同的人生态度和理想追求。同时,本文还认为,《周易》所运用的是取象比类式的象数推演体系,它不同于概念式的演绎体系。人类生活有很多重要内容不能通过概念式的语言去思维和表达,而这些“不可言说”的内容却往往可以用“象征语言”和象数思维来表达。     

Functional analysis and treatment of inappropriate sexual behavior

The results of a functional analysis showed that inappropriate sexual behaviors exhibited by a 9-year-old boy who had been diagnosed with traumatic brain injury were maintained by positive reinforcement in the form of social attention. An intervention consisting of functional communication training and extinction resulted in reduced levels of inappropriate sexual behaviors.     

Weak coherence,no theory of mind,or executive dysfunction? Solving the puzzle of pragmatic language disorders

Deficits in pragmatic language ability are common to a number of clinical populations, for example, right-hemisphere damage (RHD), Autism and traumatic brain injury (TBI). In these individuals the basic structural components of language may be intact, but the ability to use language to engage socially is impaired. Despite the nature of these difficulties being well documented, exactly what causes these difficulties is less clear. Furthermore, the current status of causal explanations for pragmatic difficulties across these populations is divergent and sometimes contradictory. This paper explores the empirical validity of three theories that attempt to explain pragmatic language impairment. It is recommended that a new, more convergent approach to investigating the causes of pragmatic language disability be adopted.     

On matters of mind and body: regarding Descartes

In this paper the author considers Descartes’ place in current thinking about the mind‐body dilemma. The premise here is that in the history of ideas, the questions posed can be as significant as the answers acquired. Descartes’ paramount question was ‘How do we determine certainty?’ and his pursuit of an answer led to cogito ergo sum. His discovery simultaneously raised the question whether mind is separate from or unified with the body. Some who currently hold that brain and subjectivity are unified contend that the philosopher ‘split’ mind from body and refer to ‘Descartes’ error’. This paper puts forward that Descartes’ detractors fail to recognise Descartes’ contribution to Western thought, which was to introduce the Enlightenment and to give a place to human subjectivity. Added to this, evidence from Descartes’ correspondence with Princess Elisabeth of Bohemia supports the conclusion that Descartes did in fact believe in the unity of mind and body although he could not reconcile this rationally with the certainty from personal experience that they were separate substances. In this Descartes was engaged in just the same dilemma as that of current thinkers and researchers, a conflict which still is yet to be resolved.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

The psychological neuroscience of depression: implications for understanding effects of deep brain stimulation

In this article it is suggested that current psychological theories of depression presuppose that this condition will develop as a result of a vicious circle involving negatively biased communication between systems of emotional stress-/alarm-signaling, executive functions and mood regulation. These systems may from a neuroanatomical point of view be located in the limbic system, the orbitofrontal and lateral prefrontal cortex and the hypothalamus-pituitary-adrenal (HPA-) axis respectively. The theoretical and practical implications of this model for the understanding of pharmacological treatments of depression are briefly discussed and this theory is related to the catecholamine hypothesis of depression. The model is furthermore discussed in relation to deep brain stimulation (DBS) of treatment resistant major depression. Similarities and differences between this perspective and the one advocated by the "homeostatic theory" of depression are discussed. It is concluded that a topographical psychological theory may offer a useful heuristic in thinking about depression and that it offers several testable predictions about treatments of the disorder.     

Modulation of N400 in chronic non-fluent aphasia using low frequency Repetitive Transcranial Magnetic Stimulation (rTMS)

Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43 months post stimulation. The present study aimed to investigate the electrophysiological correlates associated with the application of rTMS through measurement of the semantic based N400 Event-related brain potentials (ERP) component. Low frequency (1 Hz) rTMS was applied to the anterior portion of the homologue to Broca’s area (pars triangularis), for 20 min per day for 10 days, using a stereotactic neuronavigational system. Twelve non-fluent persons with aphasia, 2-6 years post stroke were stimulated. Six participants were randomly assigned to receive real stimulation and six participants were randomly assigned to receive a blind sham control condition. ERP measures were recorded at baseline, 1 week and 2 months subsequent to stimulation. The findings demonstrate treatment related changes observed in the stimulation group when compared to the placebo control group at 2 months post stimulation indicating neuromodulation of N400 as a result of rTMS. No treatment related changes were identified in the stimulation group, when compared to the sham group from baseline to 1 week post stimulation. The electrophysiological results represent the capacity of rTMS to modulate neural language networks and measures of lexical-semantic function in participants with non-fluent aphasia and suggest that time may be an important factor in brain reorganization subsequent to rTMS.     

Liberal bias mediates emotion recognition deficits in frontal traumatic brain injury

It is well-known that patients having sustained frontal-lobe traumatic brain injury (TBI) are severely impaired on tests of emotion recognition. Indeed, these patients have significant difficulty recognizing facial expressions of emotion, and such deficits are often associated with decreased social functioning and poor quality of life. As of yet, no studies have examined the response patterns which underlie facial emotion recognition impairment in TBI and which may lend clarity to the interpretation of deficits. Therefore, the present study aimed to characterize response patterns in facial emotion recognition in 14 patients with frontal TBI compared to 22 matched control subjects, using a task which required participants to rate the intensity of each emotion (happiness, sadness, anger, disgust, surprise and fear) of a series of photographs of emotional and neutral faces. Results first confirmed the presence of facial emotion recognition impairment in TBI, and further revealed that patients displayed a liberal bias when rating facial expressions, leading them to associate intense ratings of incorrect emotional labels to sad, disgusted, surprised and fearful facial expressions. These findings are generally in line with prior studies which also report important facial affect recognition deficits in TBI patients, particularly for negative emotions.