A review of social disinhibition after traumatic brain injury

Acquired social disinhibition refers to a debilitating behavioural syndrome commonly reported after a severe traumatic brain injury (TBI) and is characterized by inappropriate social behaviour, often described as immaturity and insensitivity towards others. These behaviours can have enduring effects on the social capability of the individual and their relationships with others. However, research into socially disinhibited behaviour after TBI has been thwarted by a lack of consensus in the literature on definition and measurement. This review provides an overview of our current understanding of the definition, measurement, prevalence, associated outcomes, neuropathology, and underlying mechanisms of social disinhibition after TBI. In addition, suggestions are made for future research to further our understanding of this syndrome with the eventual aim of rehabilitating problematic behaviours. It is concluded that an improved understanding of what causes disinhibited behaviour after TBI will be necessary for the development of effective treatment strategies aimed at the rehabilitation of underlying impairments.     

肿瘤临床治疗中应关注肝脏

抗肿瘤细胞毒性药物有不同程度毒副作用,有些严重毒副反应是限制药物剂量或使用的直接原因。肝脏是药物代谢的主要器官,也是药物损伤的主要靶器官。随着临床肿瘤治疗关注治疗带来的副作用与关注疗效同等重要的发展,本文对抗肿瘤细胞毒性药物与肝损伤、发生机制、诊断、分型和临床治疗进展进行了阐述。     

人类社会认知的神经机制:来自社会脑研究的证据

社会认知是指从环境互动的过程中推测他人意图、情感和思想等内部状态的心理加工过程。社会脑假说认为,包括人类在内的灵长类大脑内肯定存在着一个旨在认识和理解他人表情的神经机制,在社会交往中通过该中枢迅速处理与他人相互作用的各种信息。本文通过回顾社会脑的构成与基本功能,镜像神经元的发现及功能,以及社会脑、镜像神经元对社会认知影响的相关研究,提出了人类社会认知不同于其他物种的三个主要区别。     

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.     

Transcranial Doppler Ultrasonography Monitoring of Cerebral Hemodynamics During Performance of Cognitive Tasks: A Review

The examination of blood flow velocity (BFV) changes during the performance of mental tasks is one of the applications of transcranial Doppler (TCD) ultrasonography. The purpose of this review is to summarize the results of the functional TCD literature, to investigate the effects of methodological differences between studies, and to provide guidelines for future research. It is concluded that larger series of more homogeneous groups concerning age and handedness, and stricter criteria for subject selection and laboratory setting are required. The implication of quantitative and qualitative performance measures and psychological parameters (motivation, anxiety, and task anticipation) could also yield important information. We recommend future agreement upon a more standardized methodology. TCD promises to be a useful tool to provide further insight into the cerebral organization and temporal reactivity of the human brain.     

The relation of learning disabilities to the long-term outcomes of concussion

ObjectiveThis study sought to cross-sectionally evaluate the relation between learning disorders (LD) and long-term concussion outcomes.MethodSeventy-three asymptomatic male university athletes (23 history of concussion with LD; 24 history of concussion no LD; 26 controls) completed the Beck Depression Inventory-2 (BDI-II), the Profile of Mood States (POMS), the Cogstate battery, and an Oddball task during which event-related brain potentials were recorded.ResultsConcussed athletes with LD exhibited greater depressive symptoms (BDI-II), greater total mood disturbance (POMS), decreased accuracy on the One-Card Learning and the N-back task (Cogstate), decreased accuracy on the Oddball task, and reduced ERN amplitude relative to both the concussed athletes without a LD and controls. Concussed athletes with LD also exhibited prolonged P3 latency relative to controls. Irrespective of LD, concussed athletes exhibited increased anger-hostility and decreased Pe amplitudes relative to controls. No differences were observed in P3a amplitude or latency.ConclusionHaving LD may be a significant factor moderating the neurophysiological, cognitive and psycho-affective outcomes of concussion, and may explain a significant portion of the persistent deficits observed by researchers and clinicians.