Afferent dysgraphia after right cerebral stroke: an autonomous syndrome?

Afferent dysgraphia is an acquired writing deficit characterized by deletions and duplications of letters and strokes. The commonly accepted interpretation states that afferent dysgraphia is associated with three main clinical features: production of spatial writing errors; the presence of left unilateral neglect; and no deterioration in performance when writing blindfolded. In order to test whether these symptoms necessarily co-occur with afferent dysgraphia, we studied the writing performances of a series of eight right brain-damaged patients. In sentence copying, spontaneous handwriting, and writing to dictation they showed afferent dysgraphia. However, signs of left neglect and spatial dysgraphia were evident only in some cases. Furthermore, the frequency of afferent errors increased when patients were required to write without vision. The present study demonstrates that afferent dysgraphia is an autonomous clinical entity and that it results from a selective impairment of a mechanism whose function is that of comparing the information about the number of letters and strokes specified at the level of letter motor programs and the actual number of movements already realized.     

Preserved visual lexicosemantics in global aphasia: a right-hemisphere contribution?

Extensive testing of a patient, GP, who encountered large-scale destruction of left-hemisphere (LH) language regions was undertaken in order to address several issues concerning the ability of nonperisylvian areas to extract meaning from printed words. Testing revealed recognition of superordinate boundaries of animals, tools, vegetables, fruit, clothes, and furniture. GP was able to distinguish proper names from other nouns and from nonwords. GP was also able to differentiate words representing living things from those denoting nonliving things. The extent of LH infarct resulting in a global impairment to phonological and syntactic processing suggests LH specificity for these functions but considerable right-hemisphere (RH) participation in visual lexicosemantic processing. The relative preservation of visual lexicosemantic abilities despite severe impairment to all aspects of phonological coding demonstrates the importance of the direct route to the meaning of single printed words.     

肾移植性别失衡的现状、影响因素及思考

肾移植的性别失衡问题在全球已经很普遍。本文回顾国内外相关文献,着重综述肾移植中存在的性别失衡现状及相关因素,并对肾移植中的性别失衡所产生的临床后果和社会问题进行思考,提出相应的建议和意见,以期改善肾移植中性别不一致现状,优化肾移植治疗效果。     

影响群体道歉有效性的因素

影响群体道歉有效性的因素是多方面的。对侵犯群体而言, 有效的群体道歉需要在言语表达中包含承认错误、承担责任、表达懊悔、做出承诺等内容, 需要讲究群体道歉的行为策略, 同时还应该关注道歉的内部动机对语言表达与行为方式的影响。对受害群体来讲, 侵犯群体道歉的有效性在于道歉本身缓解了其愤怒情绪, 满足了其自尊和期望等心理需求, 同时还要受到他们对道歉真诚性知觉程度的影响。除此之外, 群体道歉还会受到群际关系质量、冲突程度、文化信念等外部因素的影响。在今后的研究中, 应该继续尝试整合群体道歉的过程机制, 丰富群体道歉有效性的考察指标, 发挥道歉在社会生活领域中的积极作用。     

Understanding Motor Awareness Through Normal and Pathological Behavior

ABSTRACT— Data on patients with localized brain damage and on neurologically intact subjects show that normal motor control depends on the functionality of a chain of neurobiological events. These events, through the activation of internal representations of the desired, predicted, and actual condition of one's body with respect to the external world, contribute to the construction of conscious knowledge of voluntary actions and to self-awareness.     

Bilateral facilitation of motor control in chronic hemiplegia

The present study addressed the efficacy of concurrently moving both arms, with and without a load added to the uninvolved arm, in facilitating the quality of movement of the involved side in individuals with moderate, chronic hemiplegia. Six hemiplegic cerebrovascular accident (CVA) subjects with left-hemisphere lesions participated in the study. The four males and two females ranged from 46 to 77 years of age and 30–96 months post-CVA. All subjects scored at least 70% on the Fugl-Meyer test of motor function. The task was to perform discrete unilateral and bilateral elbow extensions in the horizontal plane. The movements were 45° in amplitude and were to terminate in a 10° target zone that was indicated by an illustration of a coffee mug. The instructions were to move toward the mug as smoothly as possible in a movement time (MT) determined to be 20% longer than their minimal MT for that distance. The primary dependent variable was the percentage of continuous vs. discontinuous trajectories observed in each condition, based on whether or not a transient hesitation or reversal was observed. Phase of peak velocity was also quantified as a general indication of the symmetry of the velocity profile. Three of the six subjects exhibited a greater percentage of continuous movements of the involved arm in the nonloaded bilateral condition than the unimanual condition. Five subjects benefited when the uninvolved arm was inertially loaded in the bilateral condition when compared with unimanual performance. Only the oldest subject failed to exhibit facilitation. Peak velocity phase tended to normalize toward symmetry in the bilateral conditions. These findings are consistent with prior evidence that the control of the involved arm improves during bimanual performance for some hemiplegic subjects. It further suggests loading the uninvolved arm may benefit some subjects with respect to unimanual performance, with age perhaps playing a role in determining efficacy.     

The Electroconvulsive Therapy Controversy: Evidence and Ethics

The author reviews literature pertaining to the efficacy and safety of electroconvulsive therapy (ECT), with emphasis on the controversy concerning whether ECT causes brain damage. ECT does appear to be effective in the treatment of severe depression and possibly mania. The types of memory problems caused by ECT are discussed, and evidence suggests that most of these deficits are transitory. Although most evidence points toward modern ECT not causing brain damage, there are still some findings that raise questions about safety. Ethical issues involving this treatment's use, its availability to the public, and informed consent procedures are discussed.