Group Intervention Studies in the Cognitive Rehabilitation of Individuals with Traumatic Brain Injury: Challenges Faced by Researchers

There are many factors to consider in designing and interpreting group studies. These include both analytic considerations, such as the selection of valid and reliable outcome measures, and subjective considerations, such as the selection of outcomes that are perceived to be important to participants and researchers. In this paper, we review key issues to consider in the design of group studies in neurorehabilitation, using problem-solving studies in traumatic brain injury as an example.     

The P600 as an indicator of syntactic ambiguity

In a study using event-related brain potentials, we show that the current characterization of the P600 component as an indicator of revision processes (reanalysis and repair) in sentence comprehension must be extended to include the recognition of syntactic ambiguity. By comparing the processing of ambiguous and unambiguous sentence constituents in German, we show that the P600 is elicited when our language processing system has syntactic alternatives at a certain item given in the input string. That the P600 is sensitive to syntactic ambiguity adds crucial evidence to current debates in psycholinguistic modelling, as the results clearly favour parallel models of syntactic processing which assume that ambiguity is recognized and costly.     

Grammar overrides frequency: evidence from the online processing of flexible word order

We show that online processing difficulties induced by word order variations in German cannot be attributed to the relative infrequency of the constructions in question, but rather appear to reflect the application of grammatical principles during parsing. Event-related brain potentials revealed that dative-marked objects in the initial position of an embedded sentence do not elicit a neurophysiologically distinct response from subjects, whereas accusative-marked objects do. These differences are predictable on the basis of grammatical distinctions (i.e. underlying linguistic properties), but not on the basis of frequency information (i.e. a superficial linguistic property). We therefore conclude that the former, but not the latter, guides syntactic integration during online parsing.     

Processing syntactic functions of words in normal and dyslexic readers

Readers with dyslexia were compared with normal readers for the ability to identify the grammatical function of words in the course of sentence processing by means of electrophysiological measures along with behavior measures. Participants were 18 dyslexic and 18 normally reading, native Hebrew-speaking male university students, aged 18 to 27 years. Obtained results confirmed the hypothesis (Leikin & Breznitz, 1999) that Hebrew readers used lexical-morphological properties of words to identify their grammatical roles. However, the morphologically based strategy acquired full expression only in the presence of the verb, which in the Hebrew sentence fulfills the central role. Seemingly, readers use a few different procedures to identify the grammatical roles of words. Selection of a particular strategy seems to be influenced by diverse factors, including syntactic and lexical-morphological characteristics of the stimuli and level of reading skills. In addition, the results showed significant differences in sentence processing between normal and dyslexic readers, as reflected by ERP measures. These results are in line with the hypothesis, suggesting the existence of a syntactic processing weakness in readers with dyslexia.     

Adult age differences in visual word identification: functional neuroanatomy by positron emission tomography

Adult age differences in the neural systems mediating semantic (context-independent) memory were investigated using positron emission tomography (PET). Younger (20-29 years) and older (62-70 years) participants performed lexical decision (word/nonword discrimination) and nonsemantic (simple visual search) baseline tasks during PET scanning. Within the lexical decision task, display duration and presentation rate were varied across scans. The behavioral data suggested that although an age-related slowing was evident in visual feature and response processing, the retrieval of semantic/lexical information was similar for younger and older adults. For both age groups, lexical-related activation occurred in inferior prefrontal and occipitotemporal regions of the left hemisphere. Differential activation, as a function of age group, was observed in the left occipitotemporal pathway as a result of older adults' maintaining higher levels of neural activity in striate cortex (during visual search) and in inferior temporal cortex (during lexical decision). The prefrontal activation was similar for the two age groups. Thus, although this form of semantic memory retrieval does not undergo significant age-related decline, an age-related change in the associated pattern of neural activation is evident. These findings differ from previous neuroimaging studies of episodic (context-dependent) memory retrieval, which have suggested that age-related compensatory mechanisms are expressed primarily by greater activation of prefrontal regions for older adults than for younger adults.     

Learning related modulation of functional retrieval networks in man

The medial temporal lobe has been implicated in studies of episodic memory tasks involving spatio-temporal context and object-location conjunctions. We have previously demonstrated that an increased level of practice in a free-recall task parallels a decrease in the functional activity of several brain regions, including the medial temporal lobe, the prefrontal, the anterior cingulate, the anterior insular, and the posterior parietal cortices, that in concert demonstrate a move from elaborate controlled processing towards a higher degree of automaticity. Here we report data from two experiments that extend these initial observations. We used a similar experimental approach but probed for effects of retrieval paradigms and stimulus material. In the first experiment we investigated practice related changes during recognition of object-location conjunctions and in the second during free-recall of pseudo-words. Learning in a neural network is a dynamic consequence of information processing and network plasticity. The present and previous PET results indicate that practice can induce a learning related functional restructuring of information processing. Different adaptive processes likely subserve the functional re-organisation observed. These may in part be related to different demands for attentional and working memory processing. It appears that the role(s) of the prefrontal cortex and the medial temporal lobe in memory retrieval are complex, perhaps reflecting several different interacting processes or cognitive components. We suggest that an integrative interactive perspective on the role of the prefrontal and medial temporal lobe is necessary for an understanding of the processing significance of these regions in learning and memory. It appears necessary to develop elaborated and explicit computational models for prefrontal and medial temporal functions in order to derive detailed empirical predictions, and in combination with an efficient use and development of functional neuroimaging approaches, to further the understanding of the processing significance of these regions in memory.     

Does dyslexia develop from learning the alphabet in the wrong hemisphere? A cognitive neuroscience analysis

A new perspective is described which views developmental dyslexia as the outcome of learning to write the alphabet in the nondominant (right) hemisphere. The letter-level and whole-word subtypes of dyslexia are seen as differing responses adopted to cope with this predicament. Striking similarities between dyslexics and callosotomy patients in the allocation of covert attention to lateralized stimuli provide direction for integrating a diversity of dyslexic research within this framework. This synthesis, together with information from pure alexia, brain activation, and reading research, lends insight into the neural circuitry of the compensatory strategies adopted by the two dyslexic subtypes.     

Dying to Be Old: A Sociological Analysis of Old Age as Cause of Death

While gerontology and issues of aging are attracting more focus and scholarship, little has been done to examine the social constructions of old age as perception, particularly in historical contexts. We use data from gravestones and burial records (1870s–1950s) of a single, large, midwestern cemetery to examine those who were said to have died of old age or senility for patterned differences in the application of these labels. We then compare this labeled group with all others of the same age range in the cemetery for fundamental demographic differences that would explain the presence or absence of these elder-status labels. Though differences in patterns between and within groups were often small and not statistically significant, they are typically in the direction predicted, and contribute to some historical sense of old age as social construction.     

The behavioral complications of pallidal stimulation: a case report

We report a case of recurrent manic episodes associated with chronic deep brain stimulation (DBS) targeting globus pallidus (GP) in the treatment of Parkinson's disease (PD). Cardinal PD symptoms and dyskinesia improved with DBS, and neuropsychological testing found improvements in visuospatial measures associated with left DBS and in verbal memory with right DBS when compared to the patient's preoperative baseline. Under conditions of right, left, and bilateral DBS, the patient experienced bouts of mania and hypomania lasting several days at a time. Positron emission tomography (PET) with (15)O-labeled water was performed after his first manic episode under four conditions: no stimulation, right DBS, left DBS, and bilateral DBS. Although no manic switch occurred during the course of the PET study, all three DBS conditions were associated with decreases in regional flow in the left parahippocampus and hippocampus and right mid-cingulate gyrus. Increases in flow in left inferior frontal area, bilateral insula, dorsolateral prefrontal cortex, and cuneus were common to all DBS conditions. GP stimulation in PD may be associated with behavioral and cognitive effects. Distributed blood flow changes observed with pallidal DBS support a role for the pallidum in cognition and affective regulation.     

The Black Foe: Being Towards Death1

The ontology of death is universal, hence archetypal. Nowhere do we witness any organic creature escape its talons. Analytical psychology has had an intimate relationship to death for the simple fact that it contemplates the soul, the numinous, and an afterlife. From Hegel to Heidegger, Freud and Jung, death was an existential force that sustained and transformed life, the positive significance of the negative. Rather than merely a destructive phenomenon, death informs Being, the power of nothingness that dialectically drives life. In this paper, I will introduce the notion of what I call the omega principle, the psychological orientation and trajectory of our being towards death, which we may say is a universal preoccupation and recapitulation of the collective unconscious that subsumes our personal relation to death, an eternal return of the objective psyche constellated as esse in anima.