123例青年出血性脑卒中的影像学特点及病因分析

青年出血性脑卒中的早期诊断和及早发现病因对临床治疗方案的选择有着极其重要的作用。本文收集了123例青年出血性脑卒中患者,对其影像学特点及病因进行了回顾性分析。青年出血性脑卒中通过CT或MRI可以确诊,其最主要的病因是高血压病,其次是颅内动脉瘤和动静脉畸形。     

预期性、词频和笔画数对中文词汇识别影响的眼动研究

本研究采用眼动追踪技术,通过对预期性和词频、预期性和笔画数在词汇识别过程中是否存在交互作用进行考察,以探讨预期性效应对词汇识别产生影响的加工阶段。结果显示,预期性和词频、预期性和笔画数之间均不存在交互作用。由此表明,预期性、词频和笔画数均独立地对中文文本阅读中的词汇识别产生显著的影响,该结果符合E-Z读者模型的研究假设。     

Treatment of Poststroke Anxiety in an Older Adult Male: A Single-Case Analysis

A single-case analysis was carried out to study the nonpharmacological treatment of post-stroke anxiety in an older adult male. The intervention consisted of a biofeedback-assisted program of autogenic training; efficacy was demonstrated using multiple discontinuations and reinstatements of treatment. Physiological indices and self-report measures of anxiety and depression documented treatment success, although a moderate increase in fear was evident on the Fear Survey Schedule II at the final follow-up assessment.     

How do valence and meaning interact? The contribution of semantic control

The hub-and-spoke model of semantic cognition proposes that conceptual representations in a heteromodal ‘hub’ interact with and emerge from modality-specific features or ‘spokes’, including valence (whether a concept is positive or negative), along with visual and auditory features. As a result, valence congruency might facilitate our ability to link words conceptually. Semantic relatedness may similarly affect explicit judgements about valence. Moreover, conflict between meaning and valence may recruit semantic control processes. Here we tested these predictions using two-alternative forced-choice tasks, in which participants matched a probe word to one of two possible target words, based on either global meaning or valence. Experiment 1 examined timed responses in healthy young adults, while Experiment 2 examined decision accuracy in semantic aphasia patients with impaired controlled semantic retrieval following left hemisphere stroke. Across both experiments, semantically related targets facilitated valence matching, while related distractors impaired performance. Valence congruency was also found to facilitate semantic decision-making. People with semantic aphasia showed impaired valence matching and had particular difficulty when semantically related distractors were presented, suggesting that the selective retrieval of valence information relies on semantic control processes. Taken together, the results are consistent with the hypothesis that automatic access to the global meaning of written words affects the processing of valence, and that the valence of words is also retrieved even when this feature is task-irrelevant, affecting the efficiency of global semantic judgements.     

Oxford cognitive screen: A critical review and independent psychometric evaluation

The Oxford cognitive screen (OCS) is a stroke-specific cognitive screening assessment. Although the test developers have provided psychometric information for the assessment, the OCS has received minimal external scrutiny, with which to triangulate the underpinning psychometrics. The purpose of this study is to provide a critical review and independent validation of the OCS. This study analysed data from an anonymised clinical database, which consisted of 316 patients who were assessed using the OCS on an Acute Stroke Unit. The rates of impairment on tests of memory and receptive communication were lower than expectation, suggesting that these subtests may be relatively insensitive. Patients with aphasia were more likely to be unable to categorised as impaired on non-language tests, suggesting that they remain sensitive to language processing or non-dominant hand usage. Some of the subtests of the OCS achieve high retest reliability, which makes them good candidates for measuring cognitive change over time. Although the OCS has many advantages, it is also important to adequately consider its limitations, that is insensitivity to memory problems, the potential confounding impact of non-dominant hand usage, and the potential that some tests may sample overall cognitive ability instead of domain-specific functioning.     

Depression After Mild Traumatic Brain Injury: A Review of Current Research

Research pertaining to the occurrence of depression and/or depression symptomatology after a Mild Traumatic Brain Injury (MTBI) was reviewed. We found that methodological differences such as the criteria used to assess MTBI and depression, time that elapsed since brain injury, and control group variations confounded comparisons across studies. Nevertheless, the studies are consistent with at least a 35% prevalence of, and left frontal damage with depression after MTBI, an overlap of symptoms of depression and Postconcussion Syndrome (PCS), and indicate that depression can continue for many years following the injury. Our conclusion is that MTBI is the triggering event for a set of pathophysiological changes and a concomitant depressive episode in a vulnerable subset of the population. Due to a paucity of research, it cannot be definitively concluded that the underlying substrates of depression seen after MTBI and clinical depression are the same. Implications for future investigations are discussed.     

Psychological distress and subjective well‐being in partners of somatically ill or physically disabled: The Nord‐Trøndelag Health Study

Borren, I., Tambs, K., Idstad, M., Ask, H. & Sundet, J. M. (2012). Psychological distress and subjective well‐being in partners of somatically ill or physically disabled: The Nord‐Trøndelag Health Study. Scandinavian Journal of Psychology 53, 475–482. This study investigated the cross‐sectional associations between various somatic conditions in one partner and the level of distress and well‐being in the spouse. The study is based on survey data from the Norwegian Nord‐Trøndelag Health Study, HUNT II (1995–1997). A sample of 9,797 married or cohabiting couples with valid data on subjective well‐being (SWB), psychological distress (Hopkins Symptom Check List (SCL)‐10) and somatic illness were identified. Regression analyses stratified by sex were conducted with SCL‐10 and SWB scores as dependent variables and a joint somatic score as predictor, including; stroke, cancer, angina, myocardial infarction and physical disability (PD). The contribution of each somatic condition was also explored. Spouses of persons previously diagnosed with at least one somatic condition scored significantly lower on SWB and significantly higher on SCL‐10 than spouses of healthy persons, though effect sizes were small. The effect seems to be at least partly mediated by the ill partner’s psychological distress. Of the specific conditions, PD had the most significant contribution for both genders, though an association between male angina and spousal distress/SWB was also demonstrated.     

Spatial analysis after perinatal stroke: patterns of neglect and exploration in extra-personal space

This study was conducted to determine whether school-aged children who had experienced a perinatal stroke demonstrate evidence of persistent spatial neglect, and if such neglect was specific to the visual domain or was more generalized. Two studies were carried out. In the first, 38 children with either left hemisphere (LH) or right hemisphere (RH) damage and 50 age-matched controls were given visual cancellation tasks varying in two factors: target stimuli and stimulus array. In the second study, tactile neglect was evaluated in 41 children with LH or RH damage and 72 age-matched controls using a blindfolded manual exploration task. On the visual cancellation task, LH subjects omitted more target stimuli on the right, but also on the left, compared with controls. Children with RH lesions also produced a larger number of omissions on both the left and right sides than controls, but with poorer performance on the left. On the manual exploration task, LH children required significantly longer times to locate the target on both sides of the board than did controls. RH children had significantly prolonged search times on the left side, but not on the right, compared with controls. In both tasks, LH subjects employed unsystematic search strategies more often than both control and RH children. The search strategy of RH children also tended to be erratic when compared to controls, but only in the random arrays of the visual cancellation tasks; structure of the target stimuli improved their organization. These results demonstrate that children with early LH brain damage display bilateral difficulties in visual and tactile modalities; a pattern that is in contrast to that seen in adults with LH damage. This may result from disorganized search strategies or other subtle spatial or attentional deficits. Results of performance of RH children suggests the presence of contralateral neglect in both the visual and tactile modalities; a finding that is similar to the neglect in adult stroke patients with RH lesions. The fact that deficits in spatial attention and organizational strategies are present after very early focal damage to either the LH or the RH broadens our understanding of the differences in functional lateralization between the immature and mature brain. These results also add to evidence for limitations to plasticity in the developing brain. Our findings may have therapeutic and rehabilitative implications for the management of children with early focal brain lesions.     

Face and location processing in children with early unilateral brain injury

Human visuospatial functions are commonly divided into those dependent on the ventral visual stream (ventral occipitotemporal regions), which allows for processing the ‘what’ of an object, and the dorsal visual stream (dorsal occipitoparietal regions), which allows for processing ‘where’ an object is in space. Information about the development of each of the two streams has been accumulating, but very little is known about the effects of injury, particularly very early injury, on this developmental process. Using a set of computerized dorsal and ventral stream tasks matched for stimuli, required response, and difficulty (for typically-developing individuals), we sought to compare the differential effects of injury to the two systems by examining performance in individuals with perinatal brain injury (PBI), who present with selective deficits in visuospatial processing from a young age. Thirty participants (mean = 15.1 years) with early unilateral brain injury (15 right hemisphere PBI, 15 left hemisphere PBI) and 16 matched controls participated. On our tasks children with PBI performed more poorly than controls (lower accuracy and longer response times), and this was particularly prominent for the ventral stream task. Lateralization of PBI was also a factor, as the dorsal stream task did not seem to be associated with lateralized deficits, with both PBI groups showing only subtle decrements in performance, while the ventral stream task elicited deficits from RPBI children that do not appear to improve with age. Our findings suggest that early injury results in lesion-specific visuospatial deficits that persist into adolescence. Further, as the stimuli used in our ventral stream task were faces, our findings are consistent with what is known about the neural systems for face processing, namely, that they are established relatively early, follow a comparatively rapid developmental trajectory (conferring a vulnerability to early insult), and are biased toward the right hemisphere.     

IQ and Scores on the Mini-Mental State Examination (MMSE): Controlling for Effort and Education Among Geriatric Inpatients

ABSTRACT

The Mini-Mental State Examination (MMSE) and the Peabody Picture Vocabulary Test, Third Edition (PPVT-III) were administered to 76 Extended Care Center inpatients of a Veterans Affairs Medical Center, 56 of whom did not carry a diagnosis associated with brain impairment, and 20 of whom had a diagnosis associated with degenerative or cerebrovascular conditions. MMSE and PPVT-III scores, the latter of which estimates verbal IQ, were significantly correlated in both groups, even when controlling for the effects of education. This correlation was attenuated, but remained significant, in the face of varying levels of patient effort. The findings of this study support earlier findings, which also suggest that interpretation of “impaired” performance on the MMSE for those with IQ scores below 90 should be interpreted with caution. Average MMSE scores for Wechsler IQ classifications are provided.