Disturbances in higher order consciousness encountered in neuropsychological rehabilitation and assessment.

Objective: The purpose of this invited paper was to summarize my clinical research on disturbances of higher order consciousness (i.e., primarily on self-awareness but including anosognosia and impaired awareness of another person's cognitive/emotional state) that contributed to my receiving the Distinguished Career Award from the International Neuropsychology Society.

Are there predictable neuropsychological impairments in persons with functional movement disorder?

This study attempted to partially test the hypotheses recently proposed by Spagnolo, Garvey, and Hallett that patients with functional movement disorders (FMDs) should demonstrate impaired performance when presented with tasks that sample affect expression/perception, working memory, and cognitive/motor control. A retrospective chart review of the neuropsychological test performance of 17 adult FMD patients was performed to test these hypotheses. Performance on the Barrow Neurological Institute Screen for Higher Cerebral Functions, the Wechsler Adult Intelligence Scale-Fourth Edition, and the modified version of the Halstead Finger Tapping Test were used to measure these behaviors.

White Matter Microstructure Analysis in Subjective Memory Complaints and Cognitive Impairment: Insights from Diffusion Kurtosis Imaging and Free-Water DTI.

Background: Dementia is characterized by a cognitive decline in memory and other domains that lead to functional impairments. As people age, subjective memory complaints (SMC) become common, where individuals perceive cognitive decline without objective deficits on assessments. SMC can be an early sign and may precede amnestic mild cognitive impairment (MCI), which frequently advances to Alzheimer's disease (AD).

Studying lack of awareness of cognitive decline in neurodegenerative diseases requires measures of both anosognosia and denial.

The cause(s) of lack of awareness of cognitive decline in neurodegenerative diseases can be multifactorial. Yet neurologically oriented research on anosognosia of cognitive decline almost exclusively assumes that the underlying disturbance of neuro-networks that support various cognitive functions accounts for the reduced self-awareness. Cultural and psychosocial factors, including the person's emotional state, however, can contribute to the underreporting or avoidance of admitting to cognitive impairments in neurodegenerative diseases.

The transition from Mild Cognitive Impairment of the Amnestic Type to early dementia: A phenomenological and neuropsychological case analysis.

The scientific literature on neuropsychological correlates of Mild Cognitive Impairment of the Amnestic Type (MCI-A) often reports large group findings and employs multivariate statistics to describe domains of cognitive impairment associated with the transition of MCI-A to early dementia, typically of the Alzheimer's Type (AD). Individual patients may vary, however, in terms of specific changes in their neuropsychological test performance as they transition from MCI-A to probable AD. The subjective experiences of individuals during this time of transition can also vary but rarely are reported.

Neuropsychological and Social Characteristics of a 7 Year Old Child with Hypomelanosis of Ito Followed for 11 Years.

Hypomelanosis of Ito (HI) is a neurocutaneous disorder associated with central nervous system abnormalities, including speech delay and intellectual disability. The long term neuropsychological and social characteristics of these children are unknown. Neuropsychological observations and parental reports were obtained yearly on a child with HI from ages 7 to 18 years.

George P. Prigatano's contributions to neuropsychological rehabilitation and clinical neuropsychology: A 50-year perspective.

In the 1970s and 1980s, a multitude of cognitive rehabilitation programs proliferated to facilitate recovery after brain injury. However only a few programs provided a framework for ameliorating disturbances in the cognitive, psychological, and interpersonal spheres of the brain-injured patient. Greatly influenced by Leonard Diller and Yehuda Ben-Yishay's ideas and methods, George P.

Screening for more than level of cognitive functioning: the BNI screen for higher cerebral functions.

Objective: This paper describes the BNI Screen for Higher Cerebral Functions (BNIS) and reviews studies that comment on its reliability, validity, and clinical and research utility. The ability of the BNIS to assess non-cognitive higher brain functions is also described.

Methods: We reviewed the original administration manual, studies published in the BNI Quarterly of the Barrow Neurological Institute, and peer-reviewed studies on the BNI Screen identified by an academic database, PubMed and Google Scholar.

End of Life Neuropsychological Impairments and Psychological Care of Persons With Advanced Parkinsonism.

Decline in executive functioning, before frank dementia occurs, has been reported in patients with a history of stroke and malignant brain tumors. This may also be true in patients with advanced Parkinson's disease (PD). In this paper, we summarize the limited research on the motor and cognitive predictors of mortality in advanced PD.

Impaired self-awareness and denial of disability in a community sample of people with traumatic brain injury.

Purpose: To examine the nature and severity of impaired self-awareness (ISA) and denial of disability (DD) in a community-dwelling traumatic brain injury (TBI) population. Additionally, to investigate reliability, internal consistency, and feasibility of the Clinician's Rating Scale for evaluating Impaired Self-Awareness and Denial of Disability after brain injury (CRS-ISA-DD).

Materials And Methods: ISA and DD were studied using the CRS-ISA-DD in a cross-sectional study with 78 TBI patients (3.

Neuropsychological rehabilitation, neuroimaging and neuroplasticity: A clinical commentary.

Initial brain imaging studies on recovery of motor functioning after stroke suggested their potential prognostic value in neurorehabilitation. However, the value of brain imaging in documenting brain changes associated with cognitive and behavioral treatment effects seem less likely. Also, neuroimaging studies at that time seem to have little, if any, value for treatment planning.

Patient Competency Rating Scale-Brazilian Revised Version (PCRS-R-BR): Normative and Psychometric Data in 154 Healthy Individuals.

Patient Competency Rating Scale (PCRS-R-BR) is a clinical tool to evaluate the degree of competence in cognitive skills perceived by patients with brain injuries. However, no studies have investigated the influence of sociodemographic variables on self-report and self-awareness of healthy individuals. This study aimed to (1) present normative data from the PCRS-R-BR in a healthy adult Brazilian sample; and (2) investigate psychometric properties of the scale One hundred and fifty-four adults that were divided in three age groups and two education groups and their informants completed the PCRS-R-BR.

Inhibitory Control of Adjacent Finger Movements while Performing a Modified Version of the Halstead Finger Tapping Test: Effects of Age, Education and Sex.

Objective: Selective motor inhibition is known to decline with age. The purpose of this study was to determine the frequency of failures at inhibitory control of adjacent finger movements while performing a repetitive finger tapping task in young, middle-aged and older adults. Potential education and sex effects were also evaluated.

Self-awareness and underestimation of cognitive abilities in patients with adult temporal lobe epilepsy after surgical treatment.

Introduction: Self-awareness of cognitive, emotional, functional, and social performance is critical for compliance with treatment. However, few studies have investigated self-awareness and the associated effects on other cognitive variables in patients with temporal lobe epilepsy (TLE) after surgical treatment.

Aim: This study was designed to investigate the prevalence of impaired self-awareness (ISA) in patients with TLE who have undergone surgical treatment.

Maladaptive Denial of Severe Pain and Acute Orthopedic Injuries in a Patient With a Schizoaffective Disorder.

Persistent denial of severe and acute pain following orthopedic injuries has not been previously reported. We present a case of a 24-year-old woman with a history of schizoaffective disorder who suffered severe pain secondary to acute orthopedic injuries who insisted, "I am fine! There is nothing wrong with me." Her maladaptive denial resulted in an initial refusal of necessary medical/surgical care, but she eventually accepted the necessary treatments despite her persistent belief she did not need such care.

Impaired Self-Awareness and Denial During the Postacute Phases After Moderate to Severe Traumatic Brain Injury.

While a number of empirical studies have appeared on impaired self-awareness (ISA) after traumatic brain injury (TBI) over the last 20 years, the relative role of denial (as a psychological method of coping) has typically not been addressed in these studies. We propose that this failure has limited our understanding of how ISA and denial differentially affect efforts to rehabilitate persons with TBI. In this selective review paper, we summarize early findings in the field and integrate those findings with more recent observations (i.

Kinematic recordings while performing a modified version of the Halstead Finger Tapping Test: Age, sex, and education effects.

: This study attempts to demonstrate that kinematic recordings of finger movements help explain the well-known effects of age, education, and sex on the Halstead Finger Tapping Test (HFTT). : High-speed kinematic recordings were obtained on 107 healthy adults (ages 21 to 80 years) while they performed a modified version of the Halstead Finger Tapping Test (HFTT). The number of "valid" taps and "invalid" taps (i.

Subjective ratings of cognitive and emotional functioning in patients with mild cognitive impairment and patients with subjective memory complaints but normal cognitive functioning.

In a retrospective chart review, 39 patients referred for a clinical neuropsychological examination were identified as showing either mild cognitive impairment of the amnestic type (MCI-A;  = 21) or subjective memory complaints but with normal memory function (SMC;  = 18). During the clinical interview, patients and informants were routinely asked to make subjective ratings regarding the patient's cognitive and affective functioning in everyday life. The purpose of this study was to determine whether these two patient groups (and their informants) significantly differed in their subjective reports about level of cognitive and affective difficulties.

Impaired Self-Awareness of Motor Disturbances in Parkinson's Disease.

Traditionally, anosognosia for cognitive or motor impairments in patients with Parkinson's disease (PD) was viewed as unlikely unless the patient was demented. More recent research has suggested that a portion of non-demented PD patients (30%-50%) in fact have impaired subjective awareness (ISA) of their motor impairments (ISAm). This empirical finding has implications for the clinical neuropsychological examination of PD patients and raises theoretical questions relevant to the broader study of anosognosia seen in other patient groups.

Cognition in epilepsy patients with hypothalamic hamartomas.

Many patients with epilepsy caused by hypothalamic hamartomas (HHs) have cognitive impairments during the course of the disease or following neurosurgical treatment. The purpose of this study was to assess cognitive function in these patients, as well as factors influencing preoperative cognitive performance and cognitive outcome after neurosurgical treatment. Using the two largest and most detailed neuropsychology datasets on HH and epilepsy from two centers, we retrospectively report on cognitive functions in 48 patients with structural epilepsy due to HH (mean age ± standard deviation [SD] 20 ± 12 years, range 5-53 years, median 16 years; disease duration mean 17 ± 11 years).

Memory and executive functions correlates of self-awareness in traumatic brain injury.

Objective: The purpose of this study was to investigate the contribution of executive functions (EF) components and episodic and working memory variables, as well as clinical and demographic factors, to awareness of cognitive ability in traumatic brain injury (TBI).

Methods: Sixty-five TBI patients (mild: n = 26; moderate/severe: n = 39) took part in the study. Independent stepwise regression models were calculated for EF and memory predictors, with awareness being measured by patient/informant discrepancy in the Patient Competency Rating Scale.

Performance of a Brazilian sample on the Portuguese translation of the BNI Screen for Higher Cerebral Functions.

Introduction: The Barrow Neurological Institute (BNI) Screen for Higher Cerebral Functions (BNIS) has been translated into several languages and found useful in evaluating multiple domains of cognitive and affective dysfunction, particularly in neuro-rehabilitation settings. Normative data from countries with high literacy rates have reported strikingly similar mean level of performance scores on this test, with age typically correlating higher with total score performance than education. In the present study, we obtain convenience sample normative data from a native Brazilian population on a Portuguese translation of the BNIS (i.