Neuropsychiatric disturbances associated with traumatic brain injury: a practical approach to evaluation and management.

Traumatic brain injury (TBI) causes a wide variety of neuropsychiatric disturbances associated with great functional impairments and low quality of life. These disturbances include disorders of mood, behavior, and cognition, and changes in personality. The diagnosis of specific neuropsychiatric disturbances can be difficult because there is significant symptom overlap.

Anosognosia for hemiplegia: The contributory role of right inferior frontal gyrus.

Objective: Awareness of motor functioning is most likely a complex process that requires integration of sensory-motor feedback to constantly update the system on the functioning of the limb during motor behavior. Using lesion mapping procedures and behavioral measures, the current study aimed to evaluate neural correlates of anosognosia for hemiplegia (AHP) in the acute stage (first 48 hr) of right hemisphere stroke.

Method: Thirty-five individuals with right hemisphere stroke who presented to an urban medical center within 24 hr of symptom onset were included in the study.

Behavioural interventions for enhancing life participation in behavioural variant frontotemporal dementia and primary progressive aphasia.

Primary progressive aphasia (PPA) and behavioural-variant frontotemporal dementia (bvFTD) are clinical syndromes under the umbrella term 'frontotemporal dementia' (FTD) and are caused by a neurodegenerative disease with an onset most typically in the productive years of adulthood. The cognitive and behavioural impairments associated with FTD interfere with successful engagement in typical life roles, such as parenting, working, and maintenance of interpersonal relationships. There are currently no treatments to stop or slow the degenerative process and there are only very limited medication options for the management of the cognitive-behavioural symptoms.

Development of a foundation for a case definition of post-treatment Lyme disease syndrome.

Objectives: The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America.

Methods: Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment.

Bull's-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans.

Introduction. Lyme disease is an emerging worldwide infectious disease with major foci of endemicity in North America and regions of temperate Eurasia. The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull's-eye lesion and nontarget appearing lesions.

Hope predicts positive functional role outcomes in acute rehabilitation populations.

Purpose/objective: The purpose of this study was to examine the association between facilitating psychological variables and functional rehabilitation outcomes following acute medical rehabilitation.

Research Method/design: Using a longitudinal design and correlational and regression analyses, we studied 174 adults who were participating in inpatient rehabilitation for acute spinal cord dysfunction, stroke, amputation, or orthopedic surgery recovery. All participants completed the Hope Scale, Positive and Negative Affect Schedule, and Functional Independence Measure (FIM) during the first days of their inpatient stay, and then were contacted 3 months after discharge to complete the Craig Hospital Assessment and Reporting Technique (CHART) and FIM.

Impaired emotion processing from vocal and facial cues in frontotemporal dementia compared to right hemisphere stroke.

To advance our understanding about the emotional and cognitive deficits of patients with frontotemporal dementia with behavioral variant (bvFTD), the current study examined comprehension and expression of emotions from prosodic and facial cues in a 66-year-old woman. The patient diagnosed with bvFTD is compared to six patients with acute right hemisphere stroke. Recognition of emotion from prosodic cues was assessed using an identification task in four conditions with decreasing verbal demands (neutral sentences, language-like pseudo sentences, monosyllables, and asyllabic vowel sounds).

Linear path integration deficits in patients with abnormal vestibular afference.

Effective navigation requires the ability to keep track of one's location and maintain orientation during linear and angular displacements. Path integration is the process of updating the representation of body position by integrating internally-generated self-motion signals over time (e.g.

Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?

Purpose: A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time.

Methods: Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study.

Recent trends in rehabilitation interventions for visual neglect and anosognosia for hemiplegia following right hemisphere stroke.

This article highlights the most recent findings regarding the rehabilitation interventions for the syndromes of visual neglect and anosognosia for hemiplegia that occur following right hemisphere stroke. We review papers published in the past 4 years pertaining to therapeutic approaches for these two syndromes in order to identify the trends in the development of effective interventions. Overall, it appears well recognized that visual neglect syndromes and awareness syndromes frequently co-occur and both include complex, multifaceted impairments leading to significant difficulties in daily life functioning following stroke.

The nature of naming errors in primary progressive aphasia versus acute post-stroke aphasia.

Objective: To compare the distribution of error types across subgroups of primary progressive aphasia and poststroke aphasia in different vascular locations.

Method: We analyzed naming errors in 49 individuals with acute left hemisphere ischemic stroke and 55 individuals with three variants of primary progressive aphasia. Location of atrophy or ischemic stroke was characterized using MRI.

Therapeutic engagement: a proposed model of engagement in medical rehabilitation.

A major goal of physical medicine and rehabilitation is the recovery of function after an injury or the underlying medical condition that has caused impairment in one's daily functioning. The rehabilitation process involves a complex interplay of many factors that influence how well a person benefits from medical rehabilitation. There is burgeoning evidence that for patients to maximize rehabilitation benefits, they must be actively involved or engaged in the process.

Positive psychological variables in the prediction of life satisfaction after spinal cord injury.

Objective: To examine relationships between select positive psychological variables and life satisfaction in persons with spinal cord injury during acute rehabilitation and 3 months after discharge.

Design: Prospective observational design; correlational and regression analyses. Eighty-seven adults who were participating in in-patient, acute rehabilitation for spinal cord injury in two metropolitan hospitals completed the following measures: Benefit finding Scale, Hope Scale, Brief Symptom Inventory, COPE, Positive and Negative Affect Schedule, and Satisfaction with Life Scale.

Recent advances in the understanding of neglect and anosognosia following right hemisphere stroke.

This article highlights the latest findings regarding the cognitive-behavioral syndromes of neglect and anosognosia for hemiplegia that occur following right hemisphere stroke. We review papers published in the past 2 years pertaining to neurophysiology, assessment, and intervention for these two syndromes.

Measuring avoidance in medical rehabilitation.

Objective: To establish psychometric properties of the Acceptance and Action Questionnaire (AAQ), a measure of avoidance, in medical rehabilitation populations.

Study Design: Cross-sectional and longitudinal.

Setting: Three acute, inpatient rehabilitation units.

The Hopkins Rehabilitation Engagement Rating Scale: development and psychometric properties.

Objective: To conduct an initial investigation of the psychometric properties of the Hopkins Rehabilitation Engagement Rating Scale (HRERS), a 5-item, clinician-rated measure developed to quantify engagement in acute rehabilitation services.

Design: We used a cross-sectional design to conduct correlational and multivariate analyses to establish the measure's internal consistency, interrater reliability, construct validity, and criterion validity.

Setting: Acute inpatient rehabilitation in 3 metropolitan hospitals.

Construct validity of the Babcock Story Recall Test.

The construct validity of the Babcock Story Recall Test (BSRT), a verbal memory measure, was examined by correlating its scores with scores on other neuropsychological tests in 71 substance abuse outpatients. Scores on the BSRT were strongly correlated with the Wechsler Memory Scale-Revised Logical Memory scores, although they were also correlated with some nonmemory indexes. The results provide some support for the construct validity of the BSRT as a measure of memory for structured verbal information.

The trail making test, part B: cognitive flexibility or ability to maintain set?

The Trail Making Test (TMT) is a well-established test sensitive to impairment in multiple cognitive domains. There has been ambiguity about which cognitive demands are placed on the patient by TMT Part B over and above those required to perform TMT Part A. In particular, cognitive flexibility and ability to maintain a complex response set have been 2 competing hypotheses.