Comprehensive driving assessment: neuropsychological testing and on-road evaluation of brain injured patients

The study investigates the correspondence between neuropsychological test results and on-road driving performance among 55 patients with a CT-verified brain damage or documented neurological disorder (cerebrovascular accident: 43, traumatic brain injury: 5, multiple sclerosis: 4, other: 3). 5 patients showed unimpaired test profiles and passed the on-road evaluation. 18 patients showed severe neuropsychological deficits contrary to driving and were not recommended for on-road evaluation. Of the remaining 32 patients with some neuropsychological deficits, all 100% in the minor impaired group (n = 8) passed the driving evaluation, compared to 69% in the mildly impaired (n = 16) and 38% in the moderately impaired group (n = 8). Measures of reduced visuoconstructive ability, reaction time, visual attention, and awareness of cognitive impairments, were found to discriminate between groups. It is concluded that neuropsychological assessment of targeted functions provide an ecological valid prediction of driving skill after brain damage, but that on-road evaluation is needed as supplement in cases with ambiguous test findings.     

The differential effects of thalamus and basal ganglia on facial emotion recognition

This study examined if subcortical stroke was associated with impaired facial emotion recognition. Furthermore, the lateralization of the impairment and the differential profiles of facial emotion recognition deficits with localized thalamic or basal ganglia damage were also studied. Thirty-eight patients with subcortical strokes and 19 matched normal controls volunteered to participate. The participants were individually presented with morphed photographs of facial emotion expressions over multiple trials. They were requested to classify each of these morphed photographs according to Ekman's six basic emotion categories. The findings indicated that the clinical participants had impaired facial emotion recognition, though no clear lateralization pattern of impairment was observed. The patients with localized thalamic damage performed significantly worse in recognizing sadness than the controls. Longitudinal studies on patients with subcortical brain damage should be conducted to examine how cognitive reorganization post-stroke would affect emotion recognition.     

Using perfusion fMRI to measure continuous changes in neural activity with learning

In this study, we examine the suitability of a relatively new imaging technique, arterial spin labeled perfusion imaging, for the study of continuous, gradual changes in neural activity. Unlike BOLD imaging, the perfusion signal is stable over long time-scales, allowing for accurate assessment of continuous performance. In addition, perfusion fMRI provides an absolute measure of blood flow so signal changes can be interpreted without reference to a baseline. The task we used was the serial response time task, a sequence learning task. Our results show reliable correlations between performance improvements and decreases in blood flow in premotor cortex and the inferior parietal lobe, supporting the model that learning procedures that increase efficiency of processing will be reflected in lower metabolic needs in tissues that support such processes. More generally, our results show that perfusion fMRI may be applied to the study of mental operations that produce gradual changes in neural activity.     

Timing in cognition and EEG brain dynamics: discreteness versus continuity

This article provides an overview of recent developments in solving the timing problem (discreteness vs. continuity) in cognitive neuroscience. Both theoretical and empirical studies have been considered, with an emphasis on the framework of operational architectonics (OA) of brain functioning (Fingelkurts and Fingelkurts in Brain Mind 2:291-29, 2001; Neurosci Biobehav Rev 28:827-836, 2005). This framework explores the temporal structure of information flow and interarea interactions within the network of functional neuronal populations by examining topographic sharp transition processes in the scalp EEG, on the millisecond scale. We conclude, based on the OA framework, that brain functioning is best conceptualized in terms of continuity-discreteness unity which is also the characteristic property of cognition. At the end we emphasize where one might productively proceed for the future research.     

Positive facial affect facilitates the identification of famous faces

Several convergent lines of evidence have suggested that the presence of an emotion signal in a visual stimulus can influence processing of that stimulus. In the current study, we picked up on this idea, and explored the hypothesis that the presence of an emotional facial expression (happiness) would facilitate the identification of familiar faces. We studied two groups of normal participants (overall N=54), and neurological patients with either left (n=8) or right (n=10) temporal lobectomies. Reaction times were measured while participants named familiar famous faces that had happy expressions or neutral expressions. In support of the hypothesis, naming was significantly faster for the happy faces, and this effect obtained in the normal participants and in both patient groups. In the patients with left temporal lobectomies, the effect size for this facilitation was large (d=0.87), suggesting that this manipulation might have practical implications for helping such patients compensate for the types of naming defects that often accompany their brain damage. Consistent with other recent work, our findings indicate that emotion can facilitate visual identification, perhaps via a modulatory influence of the amygdala on extrastriate cortex.     

Characteristics Predicting Effective Outcomes After Coping Effectiveness Training for Patients With Spinal Cord Injuries

Coping effectiveness training (CET), based on R. S. Lazarus and S. Folkmans (1984) theory of stress and coping, teaches appraisal and coping skills. It has been adapted for use with people with spinal cord injuries and the effect of this intervention on coping, anxiety and depression and self perception has been investigated. Using data from P. Kennedy, J. Duff, M. Evans, and A. Beedies (2003) study, the psychological characteristics of people who benefited from CET (no increase in depression and anxiety at the end of CET and 6 weeks after) were compared with those who did not benefit. Coping strategies were not predictive factors but differences in some self-perception items were found between the two groups. Age, gender, level, and type of injury were not shown to be predictive but time since injury was, suggesting that the effectiveness of a CET programme could be maximized by reducing the time between onset of injury and the start of CET.     

Kicking coordination captures differences between full-term and premature infants with white matter disorder

This study explores the relation of white matter disorder (WMD) to intralimb coordination patterns in premature infants with very low birth weight (VLBW). We specifically measured the temporal-spatial characteristics of intralimb coordination patterns of the legs. Three groups of infants were compared at one month corrected age (CA): 10 premature infants born VLBW and WMD (PTWMD), 10 premature infants born VLBW without WMD (PT) and 10 full term infants (FT). Using kinematic variables, we discriminate among VLBW infants with WMD from the two comparison groups. Infants born with WMD maintain patterns of tight coupling among leg joints (all flexion or all extension) while PT and FT term infants have begun to decouple leg joints by this age (combinations of flexion with extension). The coupling pattern is captured through joint correlations, discrete relative phase, and phase plane portraits. The PTWMD infants also demonstrate aberrant patterns of coordination evident through both temporal and spatial characteristics of the kicks. This is the first evidence that movement disorder associated with brain lesions can be identified and quantified with kinematic variables as early as one month of age.     

Suicide and self-inflicted injuries

The present study addressed itself to the problem of self-inflicted injuries (SII) in the Israeli army, and to the wider question whether non-fatal self injuries and suicide are part of the same phenomenon. The findings show that in some cases SII is an unsucessful suicide while in others SII is anything but a reflection of a death wish. It appears that the modus operandi is a major indication as to the intentions of the actor. The study also demonstrates the difference between the population of the suiciders and that of the SII victims. While suiciders seem to score higher on the Performance Prediction Score (PPS) and Combat Suitability Scale, the SII population seems to be overly represented in the lower parts of the PPS and the Combat Suitability Scale. The study used a data set that represents a 5 year period, and followed the consequences of the SII in terms of medical status and occupational assignment of the actors. The findings yielded some possible policy implications, in terms of a better classification of the relevant populations, and a possible attribution of a more refined meaning to the behavior. © 1994 Wiley-Liss, Inc.     

Neural localization of semantic context effects in electromagnetic and hemodynamic studies

Measures of electrical brain activity (event-related potentials, ERPs) have been useful in understanding language processing for several decades. Extant data suggest that the amplitude of the N400 component of the ERP is a general index of the ease or difficulty of retrieving stored conceptual knowledge associated with a word, which is dependent on both the stored representation itself, and the retrieval cues provided by the preceding context. Recordings from patients with brain damage, intracranial recordings, and magnetoencephalographic data implicate a (probably large portion of) the left temporal lobe as the largest source of the N400 semantic context effect, with a substantial but lesser contribution from the right temporal lobe. Event-related functional magnetic resonance (fMRI) studies using semantic context manipulations are dominated by observations of greater hemodynamic activity for incongruent sentence completions or semantically unrelated words than congruent or related words, consistent with the direction of the ERP effect. The locations of the hemodynamic effects show some variability across studies, but one commonly identified region is the left superior temporal gyrus, which is compatible with the electrophysiological results. A second commonly identified region in the fMRI studies is the left inferior frontal gyrus, which does not appear to make a substantial contribution to the N400 effect.     

DECREASING CHILDREN'S RISK TAKING ON THE PLAYGROUND

Playground mishaps are some of the most common sources of injury and are the leading killer of children. The present study used a multiple baseline design across three classrooms (N = 379 children). With minimal teaching and rewards, children decreased and maintained decreased risky playground behaviors on slides. Floor effects on climbers prevented the demonstration of similar effects. The decreases seen in risky slide behavior are discussed within the context of preventive safety training for playground injuries.