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Riadh O, Naoufel O, Ben Rejeb MR, Le Gall D. The role of cognitive estimation in understanding the mental states of others. Cogn Neuropsychol 2024:1-20. [PMID: 38782712 DOI: 10.1080/02643294.2024.2354449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
Previous studies have emphasized the critical role of the prefrontal cortex in cognitive estimation and theory of mind, however, none of them has questioned the possible role of cognitive estimation processes in understanding the mental states of others. In this study, we compared 30 patients with focal prefrontal cortex damage and 30 control subjects matched by gender, age, and education level on their performances on a cognitive estimation task and two tasks assessing theory of mind: the "Faux-Pas" task and the Reading the Mind in the Eyes task. The results showed that patients were significantly impaired compared with control subjects on both abilities of cognitive estimation and theory of mind. Moreover, regression analyses showed that performance on theory of mind was predicted by the scores on cognitive estimation. Finally, using voxel-based lesion analysis, we identified a partially common bilaterally distributed prefrontal network involved in both these domains centred within the ventral and dorsomedial areas with extension to the dorsolateral prefrontal cortex.
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Affiliation(s)
- Ouerchefani Riadh
- Higher Institute of Human sciences, University of Tunis El-Manar, Tunis, Tunisia
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, Angers, France
| | | | - Mohamed Riadh Ben Rejeb
- Faculty of Human and Social Science of Tunisia, Department of Psychology, University of Tunis I, Tunis, Tunisia
| | - Didier Le Gall
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, Angers, France
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Benjamin S, Schildkrout B, Smith TW, MacGillivray L, Adams CBL, Lauterbach MD, Rice JF, Smock WS, Tucker DM. Life-long deficits in social adaptation and the frontal lobes: New evidence, seventy-five years after Ackerly and Benton's landmark case report of JP. Cortex 2023; 158:4-23. [PMID: 36403380 DOI: 10.1016/j.cortex.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/24/2022] [Accepted: 08/29/2022] [Indexed: 01/18/2023]
Abstract
The case of JP, reported by Ackerly and Benton in 1948 with a detailed follow-up by Ackerly in 1964, stands as the index case of developmental prefrontal damage and its impact on social adaptation. Although the 1948 case report included findings from a 1933 pneumoencephalogram and exploratory craniotomy, a definitive cause was never established for JP's prefrontal damage. Etiologies were never determined for the left-sided seizures that occurred when JP was age four, nor for the progressive anterograde amnesia that JP developed in middle age. Given Ackerly's thoroughness and long-term follow-up of his patient, it was hoped that a brain cutting would have been done, though no report of a post-mortem examination was published. The lead author of this paper (SB) set out to discover what had happened to JP after Ackerly's 1964 report and whether a brain cutting had in fact occurred. Using a variety of investigative approaches, it was discovered that a post-mortem brain examination had taken place. Those present at the brain cutting were identified, and the still-living witnesses to the brain cutting were interviewed. Previously unpublished, relevant materials were uncovered from archival sources. A film of the brain cutting, as well as photos, were located. A film of Ackerly interviewing JP prior to JP's death at age sixty-four also was found. The authors studied autopsy findings in the newly discovered video and still images. These findings were judged consistent with massive perinatal hemorrhagic damage to both frontal lobes. JP's left-sided seizures were likely due to activation of a focus from his congenital brain damage. The anterograde amnesia that was documented when JP was twenty-five and that was noted to worsen when he was forty-nine remains unexplained but may have been related to slowly progressive hydrocephalus. This paper expands what is known about the case of JP, making it the only report of a person with congenital frontal injury followed for their entire life including post-mortem brain examination.
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Affiliation(s)
- Sheldon Benjamin
- Departments of Psychiatry and Neurology, University of Massachusetts T H Chan School of Medicine, Worcester, MA, USA.
| | - Barbara Schildkrout
- Harvard Medical School, Department of Psychiatry, Brigham and Women's Hospital, USA.
| | - Thomas W Smith
- Department of Pathology (Neuropathology), University of Massachusetts T H Chan School of Medicine, Worcester, MA, USA.
| | - Lindsey MacGillivray
- Department of Psychiatry, University of Toronto, Centre for Mental Health, University Health Network, Toronto, Ontario, Canada.
| | | | - Margo D Lauterbach
- Concussion Clinic, Sheppard Pratt, Towson, MD, USA; University of Maryland School of Medicine, USA.
| | | | - William S Smock
- University of Louisville School of Medicine, Louisville Metropolitan Police Department, Louisville, KY, USA.
| | - Daniel M Tucker
- Child and Adolescent Psychiatry, Lifespring Health Systems, Jeffersonville, IN, USA.
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Ouerchefani R, Ouerchefani N, Ben Rejeb MR, Le Gall D. Impaired Perception of Unintentional Transgression of Social Norms after Prefrontal Cortex Damage: Relationship to Decision Making, Emotion Recognition, and Executive Functions. Arch Clin Neuropsychol 2021; 37:249-273. [PMID: 34619764 DOI: 10.1093/arclin/acab078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/06/2021] [Accepted: 09/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Patients with prefrontal cortex damage often transgress social rules and show lower accuracy in identifying and explaining inappropriate social behavior. The objective of this study was to examine the relationship between the ability to perceive other unintentional transgressions of social norms and both decision making and emotion recognition as these abilities are critical for appropriate social behavior. METHOD We examined a group of patients with focal prefrontal cortex damage (N = 28) and a group of matched control participants (N = 28) for their abilities to detect unintentional transgression of social norms using the "Faux-Pas" task of theory of mind, to make advantageous decisions on the Iowa gambling task, and to recognize basic emotions on the Ekman facial affect test. RESULTS The group of patients with frontal lobe damage was impaired in all of these tasks compared with control participants. Moreover, all the "Faux-Pas", Iowa gambling, and emotion recognition tasks were significantly associated and predicted by executive measures of inhibition, flexibility, or planning. However, only measures from the Iowa gambling task were associated and predicted performance on the "Faux-Pas" task. These tasks were not associated with performance in recognition of basic emotions. These findings suggest that theory of mind, executive functions, and decision-making abilities act in an interdependent way for appropriate social behavior. However, theory of mind and emotion recognition seem to have distinct but additive effects upon social behavior. Results from VLSM analysis also corroborate these data by showing a partially overlapped prefrontal circuitry underlying these cognitive domains.
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Affiliation(s)
- Riadh Ouerchefani
- University of Tunis El Manar, High Institute of Human sciences, Department of Psychology, 26 Boulevard Darghouth Pacha, Tunis, Tunisia.,Univ Angers, Université de Nantes, LPPL, SFR Confluences, Angers, France
| | | | - Mohamed Riadh Ben Rejeb
- University of Tunis I, Faculty of Human and Social Science of Tunisia, Department of Psychology, Boulvard 9 Avril, C.P. 1007, Tunis, Tunisia
| | - Didier Le Gall
- Univ Angers, Université de Nantes, LPPL, SFR Confluences, Angers, France
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Chevignard M, Câmara-Costa H, Dellatolas G. Pediatric traumatic brain injury and abusive head trauma. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:451-484. [PMID: 32958191 DOI: 10.1016/b978-0-444-64150-2.00032-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Childhood traumatic brain injury (TBI) commonly occurs during brain development and can have direct, immediately observable neurologic, cognitive, and behavioral consequences. However, it can also disrupt subsequent brain development, and long-term outcomes are a combination of preinjury development and abilities, consequences of brain injury, as well as delayed impaired development of skills that were immature at the time of injury. There is a growing number of studies on mild TBI/sport-related concussions, describing initial symptoms and their evolution over time and providing guidelines for effective management of symptoms and return to activity/school/sports. Mild TBI usually does not lead to long-term cognitive or academic consequences, despite reports of behavioral/psychologic issues postinjury. Regarding moderate to severe TBI, injury to the brain is more severe, with evidence of a number of detrimental consequences in various domains. Patients can display neurologic impairments (e.g., motor deficits, signs of cerebellar disorder, posttraumatic epilepsy), medical problems (e.g., endocrine pituitary deficits, sleep-wake abnormalities), or sensory deficits (e.g., visual, olfactory deficits). The most commonly reported deficits are in the cognitive-behavioral field, which tend to be significantly disabling in the long-term, impacting the development of autonomy, socialization and academic achievement, participation, quality of life, and later, independence and ability to enter the workforce (e.g., intellectual deficits, slow processing speed, attention, memory, executive functions deficits, impulsivity, intolerance to frustration). A number of factors influence outcomes following pediatric TBI, including preinjury stage of development and abilities, brain injury severity, age at injury (with younger age at injury most often associated with worse outcomes), and a number of family/environment factors (e.g., parental education and occupation, family functioning, parenting style, warmth and responsiveness, access to rehabilitation and care). Interventions should identify and target these specific factors, given their major role in postinjury outcomes. Abusive head trauma (AHT) occurs in very young children (most often <6 months) and is a form of severe TBI, usually associated with delay before appropriate care is sought. Outcomes are systematically worse following AHT than following accidental TBI, even when controlling for age at injury and injury severity. Children with moderate to severe TBI and AHT usually require specific, coordinated, multidisciplinary, and long-term rehabilitation interventions and school adaptations, until transition to adult services. Interventions should be patient- and family-centered, focusing on specific goals, comprising education about TBI, and promoting optimal parenting, communication, and collaborative problem-solving.
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Affiliation(s)
- Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury and Outreach Team for Children and Adolescents with Acquired Brain Injury, Saint Maurice Hospitals, Saint Maurice, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, Paris, France; GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France.
| | - Hugo Câmara-Costa
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France; Centre d'Etudes en Santé des Populations, INSERM U1018, Paris, France
| | - Georges Dellatolas
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
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Maggio MG, Maresca G, Stagnitti MC, Anchesi S, Casella C, Pajno V, De Luca R, Manuli A, Calabrò RS. Social cognition in patients with acquired brain lesions: An overview on an under-reported problem. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:419-431. [PMID: 32301351 DOI: 10.1080/23279095.2020.1753058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Social cognition (SC) consists of mental representations of interpersonal relationships, which are used flexibly by the individual to promote functional social behaviors and achieve the goals. SC is a multidimensional construct and is supported by the activity of distributed neural networks in which different cortical and subcortical regions of the brain are involved. The review aims to evaluate the current literature on SC taking into account how it is compromised in acquired brain injury. Studies performed between 2010 and 2019 and fulfilling the selected criteria were searched on PubMed, Scopus, Cochrane and Web of Sciences databases. Impairment of SC is a neglected but common consequence of ABI, often leading to disordered interpersonal functioning and poor regulation of personal behavior with impaired social adaptation and quality of life of both the patient and his/her family. This review supports the idea that SC could have an important role in the management of neurological patients by both clinicians and caregivers.
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Corrigan JD, Hagemeyer AN, Weil ZM, Sullivan L, Shi J, Bogner J, Yang J. Is Pediatric Traumatic Brain Injury Associated with Adult Alcohol Misuse? J Neurotrauma 2020; 37:1637-1644. [PMID: 32111142 DOI: 10.1089/neu.2019.6897] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Evidence suggests that pediatric traumatic brain injury (TBI) may be causally related to alcohol misuse later in life; however, the nature and extent of the association has not been well described. This study examined the relationship between pediatric TBI and adult alcohol misuse in a population sample ≥20 years of age. We sought to determine (1) whether first self-reported incidence of TBI with loss of consciousness (LOC) before the age of 20 increased the risk for alcohol misuse later in life; and (2) whether sex, injury severity, and age at time of injury modified the association. We found a greater likelihood of binge but not heavy drinking for those whose first self-reported TBI with LOC occurred before the age of 20 when compared with those whose first self-reported TBI with LOC occurred later in life (28.5% vs. 20.4%, p = 0.003). When limited to those with only mild TBI, the relationship to binge drinking remained significant (31.9% vs. 19.3%, p < 0.001) and was evident for both males (38.4% vs. 25.6%, p = 0.016) and females (20.9% vs. 12.4%, p = 0.044). When controlling for sex, age, and race/ethnicity, reporting a first TBI with LOC before age 20 was associated with binge drinking only for those with mild TBI (adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI] = 1.00-1.74). Results also showed that those with first TBI with LOC occurring between the ages of 10 and 19 years were more likely to binge drink as adults than those first injured earlier in life, regardless of TBI severity. Further research is needed at both the epidemiological and pre-clinical levels to better understand this relationship.
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Affiliation(s)
- John D Corrigan
- Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus Ohio, USA
| | - Abby N Hagemeyer
- Violence and Injury Prevention Section, Ohio Department of Health, Columbus, Ohio, USA
| | - Zachary M Weil
- WVU Department of Neuroscience, Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA
| | - Lindsay Sullivan
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Junxin Shi
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jennifer Bogner
- Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus Ohio, USA
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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Abstract
Over the past 150 years, the frontal lobes (FLs) have been implicated in the neural mediation of both normal and abnormal moral conduct and social behavior (MCSB). Despite the remarkable advances that have permeated this period up to the present, a comprehensive account of the neural underpinnings of MCSB has stubbornly defied the best minds of psychology, psychiatry, and neurology. The goal of this chapter is to review a few practical and conceptual achievements that have proved heuristically valuable as an impetus for further advance of knowledge. In virtually all cases in which MCSB was compromised by brain damage, the injuries were located (i) in the prefrontal cortices, (ii) in their connections with the temporal poles and anterior insula, or (iii) in related subcortical structures and pathways, such as the thalamic dorsomedial nucleus or the anterior thalamic radiation. The clinicoanatomic associations among these structures originated the "frontal network systems" concept, which satisfactorily explains the occurrence of classical FL syndromes in patients with lesions outside the prefrontal cortices. Overall, clinicoanatomic observational studies and experimental evidence from patients with acquired sociopathy/psychopathy indicate that abnormalities of MCSB are the final common pathway of single or mixed impairments of subordinate psychologic and neural domains that support MCSB. Independent studies on normal volunteers concur with this view, indicating that MCSB is shaped by the dynamic interplay of subordinate psychologic domains, such as moral sensitivity and judgment, and their neural correlates.
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8
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Williams C, Wood RL, Alderman N, Worthington A. The Psychosocial Impact of Neurobehavioral Disability. Front Neurol 2020; 11:119. [PMID: 32153495 PMCID: PMC7047747 DOI: 10.3389/fneur.2020.00119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 02/03/2020] [Indexed: 11/24/2022] Open
Abstract
Neurobehavioral disability (NBD) comprises elements of executive and attentional dysfunction, poor insight, problems of awareness and social judgement, labile mood, altered emotional expression, and poor impulse control, any or all of which can have a serious impact upon a person's decision-making and capacity for social independence. The aim of this narrative review is to explore some of the more intrusive forms of NBD that act as obstacles to psychosocial outcome to act as a frame of reference for developing effective rehabilitation interventions. Special consideration is given to the psychosocial impact of three core forms of NBD: a failure of social cognition, aggressive behavior, and problems of drive/motivation. Consideration is also given to the developmental implications of sustaining a brain injury in childhood or adolescence, including its impact on maturational and social development and subsequent effects on long-term psychosocial behavior.
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Affiliation(s)
- Claire Williams
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom
| | | | - Nick Alderman
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom.,Elysium Neurological Services, Elysium Healthcare, Badby Park, Daventry, United Kingdom
| | - Andrew Worthington
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, United Kingdom.,Swansea University Medical School, Swansea University, Swansea, United Kingdom.,Headwise Limited, Birmingham, United Kingdom
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9
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Weil ZM, Karelina K, Corrigan JD. Does pediatric traumatic brain injury cause adult alcohol misuse: Combining preclinical and epidemiological approaches. Exp Neurol 2019; 317:284-290. [DOI: 10.1016/j.expneurol.2019.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/15/2019] [Accepted: 03/21/2019] [Indexed: 12/27/2022]
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de Oliveira-Souza R, Paranhos T, Moll J, Grafman J. Gender and Hemispheric Asymmetries in Acquired Sociopathy. Front Psychol 2019; 10:346. [PMID: 30941065 PMCID: PMC6433972 DOI: 10.3389/fpsyg.2019.00346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/04/2019] [Indexed: 01/22/2023] Open
Abstract
The emergence of enduring antisocial personality changes in previously normal individuals, or "acquired sociopathy," has consistently been reported in patients with bilateral injuries of the ventromedial prefrontal cortex. Over the past three decades, cases of acquired sociopathy with (a) bilateral or (b) unilateral sparing of the ventromedial prefrontal cortex have been reported. These cases indicate that at least in a few individuals (a') neural structures beyond the ventromedial prefrontal cortex are also critical for normal social behavior, and (b') the neural underpinnings of social cognition may be lateralized to one cerebral hemisphere. Moreover, researchers have presented evidence that lesion laterality and gender may interact in the production of acquired sociopathy. In the present review, we carried out a comprehensive literature survey seeking possible interactions between gender and hemispheric asymmetry in acquired sociopathy. We found 85 cases of acquired sociopathy due to bilateral (N = 48) and unilateral (N = 37) hemispheric injuries. A significant association between acquired sociopathy and right hemisphere damage was found in men, whereas lesions were bilateral in most women with acquired sociopathy. The present survey shows that: (i) the number of well-documented single-cases of acquired sociopathy is surprisingly small given the length of the historical record; (ii) acquired sociopathy was significantly more frequent in men after an injury of the right or of both cerebral hemispheres; and (iii) in most women who developed acquired sociopathy the injuries affected both cerebral hemispheres. These findings may be especially valuable to neuroscientists and to functional neurosurgeons in particular for the planning of tumor resections as well as for the choice of the best targets for therapeutic neuromodulation.
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Affiliation(s)
- Ricardo de Oliveira-Souza
- Department of Neurology and Neuropsychiatry, D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Departments of Neurology and Psychiatry, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thiago Paranhos
- Department of Neurology and Neuropsychiatry, D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- School of Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Moll
- Department of Neurology and Neuropsychiatry, D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Jordan Grafman
- Shirley Ryan AbilityLab, Department of Physical Medicine, Rehabilitation, and Psychology, Neurology, Cognitive Neurology and Alzheimer's Center, Feinberg School of Medicine, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL, United States
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Stanciu MA, Rafal RD, Turnbull OH. Preserved re-experience of discrete emotions: Amnesia and executive function. J Neuropsychol 2018; 13:305-327. [PMID: 29411941 DOI: 10.1111/jnp.12147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 11/27/2017] [Indexed: 11/30/2022]
Abstract
Amnesic patients can re-experience emotions elicited by forgotten events, suggesting that brain systems for episodic and emotional memory are independent. However, the range of such emotional memories remains under-investigated (most studies employing just positive-negative emotion dyads), and executive function may also play a role in the re-experience of emotions. This is the first investigation of the intensity of the emotional re-experience of a range of discrete emotions (anger, fear, sadness, and happiness) for a group of amnesic patients. Twenty Korsakoff syndrome (KS) patients and 20 neurologically normal controls listened to four novel emotional vignettes selectively eliciting the four basic emotions. Emotional experience was measured using pen-and-paper Visual Analogue Mood Scales and episodic memory using verbal recollections. After 30 min, the recollection of stories was severely impaired for the patient group, but the emotional re-experience was no different from that of controls. Notably, there was no relationship between episodic recall and the intensity of the four emotions, such that even profoundly amnesic patients reported moderate levels of the target emotion. Exploratory analyses revealed negative correlations between the intensity of basic emotions and executive functions (e.g., cognitive flexibility and response inhibition) for controls but not patients. The results suggest that discrete emotions can be re-experienced independently of episodic memory, and that the re-experience of certain discrete emotions appears to be dampened by executive control. KS patients with absent or mild cognitive symptoms should benefit from emotion-regulation interventions aimed at reducing the recognized affective burden associated with their episodic memory deficit.
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12
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Dachtyl SA, Morales P. A Collaborative Model for Return to Academics After Concussion: Athletic Training and Speech-Language Pathology. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:716-728. [PMID: 28793153 DOI: 10.1044/2017_ajslp-16-0138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 03/17/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE In this article, we describe an academic concussion management protocol designed for grades Pre-K to 12, called Cognitive Return to Exertion (CoRTEx). Collaboration between the speech-language pathologist (SLP) and athletic trainer (AT) is highlighted. METHOD A description of CoRTEx is provided, and the need for collaboration is emphasized. A case study illustrates an example of how CoRTEx can be implemented at the individual student level. RESULTS A total of 165 students went through CoRTEx from the pilot in April 2014 through December 2016. Referrals to CoRTEx were highest for football, blows to the head, and soccer. Anecdotal evidence suggests that CoRTEx provided necessary support for students and their families, although research is needed to provide objective data. CONCLUSIONS CoRTEx and other similar protocols can be used as models for SLPs to create their own academic concussion management protocols. For cases in which the injured student is an athlete, the SLP-AT collaboration is critical to carefully coordinate return to academics and return to play so that students are successful in school, as well as ready to safely return to sport. Suggestions are made for designing research studies that can provide empirical evidence for the efficacy of such academic concussion management protocols.
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Affiliation(s)
- Sarah A Dachtyl
- Sahuarita Unified School District, Arizona
- Northern Arizona University, Flagstaff
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13
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Abstract
Social cognitive neuroscience is a rapidly emerging field that utilizes cognitive neuroscientific techniques (e.g., lesion studies, neuroimaging) to address concepts traditionally in the social psychological realm (e.g., attitudes, stereotypes). The purpose of this article is to review published neuroscientific and neuropsychological research into social cognition. The author focuses on the role of the prefrontal cortex in social behavior and presents a framework that provides cohesion of this research. The article proposes that this framework will be useful in guiding future social cognitive neuroscientific research.
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Affiliation(s)
- Jacqueline N. Wood
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD
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14
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Weil ZM, Corrigan JD, Karelina K. Alcohol abuse after traumatic brain injury: Experimental and clinical evidence. Neurosci Biobehav Rev 2016; 62:89-99. [DOI: 10.1016/j.neubiorev.2016.01.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/16/2015] [Accepted: 01/21/2016] [Indexed: 01/06/2023]
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15
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Lind K, Toure H, Brugel D, Meyer P, Laurent-Vannier A, Chevignard M. Extended follow-up of neurological, cognitive, behavioral and academic outcomes after severe abusive head trauma. CHILD ABUSE & NEGLECT 2016; 51:358-367. [PMID: 26299396 DOI: 10.1016/j.chiabu.2015.08.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/06/2015] [Accepted: 08/03/2015] [Indexed: 06/04/2023]
Abstract
Studies about long-term outcome following abusive head trauma (AHT) are scarce. The aims of this study were to report long-term neurological, cognitive, behavioral and academic outcomes, ongoing treatments and/or rehabilitation, several years after AHT diagnosis, and factors associated with outcome. In this retrospective study, all patients admitted to a single rehabilitation unit following AHT between 1996 and 2005, with subsequent follow-up exceeding 3 years, were included. Medical files were reviewed and a medical interview was performed with parents on the phone when possible. The primary outcome measure was the Glasgow Outcome Scale (GOS). Forty-seven children (out of 66) met the inclusion criteria (mean age at injury 5.7 months; SD=3.2). After a median length of follow-up of 8 years (range 3.7-12), only seven children (15%) had "good outcome" (normal life - GOS I) and 19 children (40%) presented with severe neurological impairment (GOS III and IV). Children sustained epilepsy (38%), motor deficits (45%), visual deficit (45%), sleep disorders (17%), language abnormalities (49%), attention deficits (79%) and behavioral disorders (53%). Most children (83%) had ongoing rehabilitation. Only 30% followed a normal curriculum, whereas 30% required special education services. Children with better overall outcome (GOS I and II) had significantly higher educated mothers than those with worse outcomes (GOS III and IV): graduation from high school 59% and 21% respectively (p=0.006). This study highlights the high rate of severe sequelae and health care needs several years post-AHT, and emphasizes the need for extended follow-up of medical, cognitive and academic outcomes.
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Affiliation(s)
- Katia Lind
- Rehabilitation Department for Children with Acquired Neurological Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France; General Pediatric Department, Hôpital Necker-Enfants-Malades, 149 rue de Sèvres, F-75015 Paris, France; Paris Descartes University, 12 rue de l'Ecole de Médecine, F-75006 Paris, France
| | - Hanna Toure
- Rehabilitation Department for Children with Acquired Neurological Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France; Outreach Team for Children and Adolescents with Acquired Brain Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France
| | - Dominique Brugel
- Rehabilitation Department for Children with Acquired Neurological Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France; Outreach Team for Children and Adolescents with Acquired Brain Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France
| | - Philippe Meyer
- Paris Descartes University, 12 rue de l'Ecole de Médecine, F-75006 Paris, France; Pediatric Neurosurgery Department, Hôpital Necker-Enfants-Malades, 149 rue de Sèvres, F-75015 Paris, France
| | - Anne Laurent-Vannier
- Rehabilitation Department for Children with Acquired Neurological Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France; Outreach Team for Children and Adolescents with Acquired Brain Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France
| | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury - Saint Maurice Hospitals, 14 rue du Val d'Osne, 94410 Saint Maurice, France; Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB), 75013 Paris, France
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Babikian T, Merkley T, Savage RC, Giza CC, Levin H. Chronic Aspects of Pediatric Traumatic Brain Injury: Review of the Literature. J Neurotrauma 2015; 32:1849-60. [DOI: 10.1089/neu.2015.3971] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and Mattel Children's Hospital at UCLA, Los Angeles, California
| | - Tricia Merkley
- Department of Clinical Neuropsychology, Barrow Neurological Institute, Phoenix, Arizona
| | | | - Christopher C. Giza
- Department of Pediatrics and Neurosurgery, David Geffen School of Medicine and Mattel Children's Hospital at UCLA, Los Angeles, California
| | - Harvey Levin
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
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Right frontal pole cortical thickness and executive functioning in children with traumatic brain injury: the impact on social problems. Brain Imaging Behav 2015; 10:1090-1095. [PMID: 26542618 DOI: 10.1007/s11682-015-9472-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cognitive and social outcomes may be negatively affected in children with a history of traumatic brain injury (TBI). We hypothesized that executive function would mediate the association between right frontal pole cortical thickness and problematic social behaviors. Child participants with a history of TBI were recruited from inpatient admissions for long-term follow-up (n = 23; average age = 12.8, average time post-injury =3.2 years). Three measures of executive function, the Trail Making Test, verbal fluency test, and the Conners' Continuous Performance Test-Second edition (CPT-II), were administered to each participant while caregivers completed the Childhood Behavior Checklist (CBCL). All participants underwent brain magnetic resonance imaging following cognitive testing. Regression analysis demonstrated right frontal pole cortical thickness significantly predicted social problems. Measures of executive functioning also significantly predicted social problems; however, the mediation model testing whether executive function mediated the relationship between cortical thickness and social problems was not statistically significant. Right frontal pole cortical thickness and omission errors on the CPT-II predicted Social Problems on the CBCL. Results did not indicate that the association between cortical thickness and social problems was mediated by executive function.
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Bondi CO, Semple BD, Noble-Haeusslein LJ, Osier ND, Carlson SW, Dixon CE, Giza CC, Kline AE. Found in translation: Understanding the biology and behavior of experimental traumatic brain injury. Neurosci Biobehav Rev 2015; 58:123-46. [PMID: 25496906 PMCID: PMC4465064 DOI: 10.1016/j.neubiorev.2014.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 10/26/2014] [Accepted: 12/02/2014] [Indexed: 12/14/2022]
Abstract
The aim of this review is to discuss in greater detail the topics covered in the recent symposium entitled "Traumatic brain injury: laboratory and clinical perspectives," presented at the 2014 International Behavioral Neuroscience Society annual meeting. Herein, we review contemporary laboratory models of traumatic brain injury (TBI) including common assays for sensorimotor and cognitive behavior. New modalities to evaluate social behavior after injury to the developing brain, as well as the attentional set-shifting test (AST) as a measure of executive function in TBI, will be highlighted. Environmental enrichment (EE) will be discussed as a preclinical model of neurorehabilitation, and finally, an evidence-based approach to sports-related concussion will be considered. The review consists predominantly of published data, but some discussion of ongoing or future directions is provided.
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Affiliation(s)
- Corina O Bondi
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bridgette D Semple
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
| | - Linda J Noble-Haeusslein
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States
| | - Nicole D Osier
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shaun W Carlson
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - C Edward Dixon
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Christopher C Giza
- Pediatric Neurology and Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States; UCLA Brain Injury Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony E Kline
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States; Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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Kramers-Olen AL. Neuroscience, moral development, criminal capacity, and the Child Justice Act: justice or injustice? SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2015. [DOI: 10.1177/0081246315603633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Child Justice Act of 2008 has set the minimum age for criminal capacity at 10 years with a rebuttable presumption of criminal incapacity between the ages of 10 and 14 years. The legislation requires that expert evidence be led (by clinical psychologists or psychiatrists) in order to assist the court to determine whether accused children and adolescents between 10 and 14 years of age can be held criminally responsible. The Child Justice Act requires an examination of the cognitive, moral, emotional, psychological, and social development of the accused child/adolescent. This article critically examines the neuroscience literature on brain development, decision-making and moral development in children and adolescents as it relates to legal prescripts inherent in the Child Justice Act, in particular with regard to accused children and adolescents’ understanding of the wrongfulness of an act, and their ability to act in accordance with that understanding.
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Affiliation(s)
- Anne L Kramers-Olen
- Department of Behavioural Medicine, University of KwaZulu-Natal, South Africa
- Fort Napier Hospital, South Africa
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Pedroli E, Serino S, Cipresso P, Pallavicini F, Riva G. Assessment and rehabilitation of neglect using virtual reality: a systematic review. Front Behav Neurosci 2015; 9:226. [PMID: 26379519 PMCID: PMC4548208 DOI: 10.3389/fnbeh.2015.00226] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/10/2015] [Indexed: 12/13/2022] Open
Abstract
After experiencing a stroke in the right hemisphere, almost 50% of patients showed Unilateral Spatial Neglect (USN). In recent decades, Virtual Reality (VR) has been used as an effective tool both for the assessment and rehabilitation of USN. Indeed, this advanced technology allows post-stroke patients to interact with ecological and engaging environments similar to real ones, but in a safe and controlled way. To provide an overview of the most recent VR applications for the assessment and rehabilitation of USN, a systematic review has been carried out. Since 2010, 13 studies have proposed and tested innovative VR tools for USN. After a wide description of the selected studies, we discuss the main features of these VR tools in order to provide crucial indications for future studies, neurorehabilitation interventions, and clinical practice.
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Affiliation(s)
- Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano Milan, Italy
| | - Silvia Serino
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano Milan, Italy
| | - Federica Pallavicini
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano Milan, Italy ; Department of Psycholgy, Università Cattolica del Sacro Cuore Milan, Italy
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Holland JN, Schmidt AT. Static and Dynamic Factors Promoting Resilience following Traumatic Brain Injury: A Brief Review. Neural Plast 2015; 2015:902802. [PMID: 26347352 PMCID: PMC4539485 DOI: 10.1155/2015/902802] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/15/2015] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) is the greatest contributing cause of death and disability among children and young adults in the United States. The current paper briefly summarizes contemporary literature on factors that can improve outcomes (i.e., promote resilience) for children and adults following TBI. For the purpose of this paper, the authors divided these factors into static or unmodifiable factors (i.e., age, sex, intellectual abilities/education, and preinjury psychiatric history) and dynamic or modifiable factors (i.e., socioeconomic status, family functioning/social support, nutrition, and exercise). Drawing on human and animal studies, the research reviewed indicated that these various factors can improve outcomes in multiple domains of functioning (e.g., cognition, emotion regulation, health and wellness, behavior, etc.) following a TBI. However, many of these factors have not been studied across populations, have been limited to preclinical investigations, have been limited in their scope or follow-up, or have not involved a thorough evaluation of outcomes. Thus, although promising, continued research is vital in the area of factors promoting resilience following TBI in children and adults.
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Affiliation(s)
- Jessica N. Holland
- Department of Psychology and Philosophy, Sam Houston State University, Campus Box 2447, Huntsville, TX 77341, USA
| | - Adam T. Schmidt
- Department of Psychology and Philosophy, Sam Houston State University, Campus Box 2447, Huntsville, TX 77341, USA
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Sommer M, Meinhardt J, Rothmayr C, Döhnel K, Hajak G, Rupprecht R, Sodian B. Me or you? Neural correlates of moral reasoning in everyday conflict situations in adolescents and adults. Soc Neurosci 2014; 9:452-70. [PMID: 24971880 DOI: 10.1080/17470919.2014.933714] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Throughout adolescence, progress in the understanding of the moral domain as well as changes in moral behavior is observable. We tested 16 adolescents (14-16 years of age) and 16 healthy adults (22-31 years of age) on the developmental changes in everyday moral decision making using functional magnetic resonance imaging (fMRI). Using verbal stories describing everyday moral conflict situations, subjects had to decide between a moral standard or a personal desire. In the moral conflict situations, adolescents not only chose significantly more often the hedonistic alternative than adults, but they also reported higher certainty ratings. Contrasted with everyday social conflict situations that required a decision between a social-oriented behavior and a personal need, moral conflict situations induced an activity increase in frontal areas, the middle temporal gyrus, the thalamus, and the parahippocampal gyrus in adolescents compared to adults. Moreover, a closer look at the moral conflict situations revealed that adolescents showed more activity than adults in brain areas that are also centrally involved in theory of mind (ToM) during morally oriented decisions in contrast to personal-oriented decisions. This indicated that the development of moral reasoning may be strongly correlated with the development of ToM reasoning.
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Affiliation(s)
- Monika Sommer
- a Department of Psychiatry and Psychotherapy , University Regensburg , Regensburg , Germany
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Braun CMJ, Guimond A, Payette JF, Daigneault S. Specific early vulnerability of high-order executive function to focal brain lesions and long-term impact on educational persistence: Sparing of incidental episodic memory. Dev Neurorehabil 2013; 16:89-101. [PMID: 23477462 DOI: 10.3109/17518423.2012.723761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We investigated mental functions expected to remain impaired or not ain adulthood following childhood-onset brain lesions. METHODS Thirty unilaterally lesioned young adults were tested a decade after lesion onset with an effort-demanding complex executive function (EF) task as well as a task of incidental declarative retrospective episodic recognition memory (IRM). Thirty neurotypical participants were also tested. RESULTS The EF task was significantly impaired in the lesion group and significantly more so than the IRM task. Regarding the lesioned cases, performance on EF, but not IRM, was significantly positively correlated with long-term educational persistence (EP). Both EF and EP but not IRM were significantly positively correlated with the age of onset of the lesion. Severity of neurological impairment was unrelated to any variable. CONCLUSION Mental abilities acquired through early schooling remain impaired into adulthood when early schooling is disturbed, not everyday memory which does not depend on schooling.
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Affiliation(s)
- Claude M J Braun
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.
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Semple BD, Blomgren K, Gimlin K, Ferriero DM, Noble-Haeusslein LJ. Brain development in rodents and humans: Identifying benchmarks of maturation and vulnerability to injury across species. Prog Neurobiol 2013; 106-107:1-16. [PMID: 23583307 PMCID: PMC3737272 DOI: 10.1016/j.pneurobio.2013.04.001] [Citation(s) in RCA: 1315] [Impact Index Per Article: 119.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/03/2013] [Accepted: 04/03/2013] [Indexed: 12/13/2022]
Abstract
Hypoxic-ischemic and traumatic brain injuries are leading causes of long-term mortality and disability in infants and children. Although several preclinical models using rodents of different ages have been developed, species differences in the timing of key brain maturation events can render comparisons of vulnerability and regenerative capacities difficult to interpret. Traditional models of developmental brain injury have utilized rodents at postnatal day 7-10 as being roughly equivalent to a term human infant, based historically on the measurement of post-mortem brain weights during the 1970s. Here we will examine fundamental brain development processes that occur in both rodents and humans, to delineate a comparable time course of postnatal brain development across species. We consider the timing of neurogenesis, synaptogenesis, gliogenesis, oligodendrocyte maturation and age-dependent behaviors that coincide with developmentally regulated molecular and biochemical changes. In general, while the time scale is considerably different, the sequence of key events in brain maturation is largely consistent between humans and rodents. Further, there are distinct parallels in regional vulnerability as well as functional consequences in response to brain injuries. With a focus on developmental hypoxic-ischemic encephalopathy and traumatic brain injury, this review offers guidelines for researchers when considering the most appropriate rodent age for the developmental stage or process of interest to approximate human brain development.
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Affiliation(s)
- Bridgette D. Semple
- Department of Neurological Surgery, University of California San Francisco, 513 Parnassus Avenue, Room HSE-722, San Francisco, CA 94143-0112, USA
| | - Klas Blomgren
- Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden
- Department of Pediatrics, Queen Silvia's Children's Hospital, University of Gothenburg, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Q2:07, SE 171 76 Stockholm, Sweden
| | - Kayleen Gimlin
- Department of Neurological Surgery, University of California San Francisco, 513 Parnassus Avenue, Room HSE-722, San Francisco, CA 94143-0112, USA
| | - Donna M. Ferriero
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Linda J. Noble-Haeusslein
- Department of Neurological Surgery, University of California San Francisco, 513 Parnassus Avenue, Room HSE-722, San Francisco, CA 94143-0112, USA
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA, USA
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Bahia VS, Takada LT, Caixeta L, Lucato LT, Porto CS, Nitrini R. Prefrontal damage in childhood and changes in the development of personality: a case report. Dement Neuropsychol 2013; 7:132-135. [PMID: 29213829 PMCID: PMC5619555 DOI: 10.1590/s1980-57642013dn70100019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Frontal lobe lesions are associated with behavioral abnormalities and executive
dysfunction. When these lesions occur early in life, the symptoms are even more
severe as the anatomical and functional substrates underlying personality and
behavior are damaged, distorting normal modulation by interaction with the
psychosocial environment. We present a case of a 40-year-old man who suffered a
frontal lobe lesion at the age of nine years and developed impulsivity,
disinhibition and inappropriate behaviors while showing some preservation of
insight. Brain MRI revealed lesions to bilateral orbitofrontal cortex,
ventromedial prefrontal cortex, anterior cingulate gyri and genu of the
corpus callosum, which were more extensive on the right
side. The right prefrontal dorsolateral cortex was severely damaged, whereas the
right ventrolateral prefrontal cortex was spared. We will discuss the
correlation of the damaged pre frontal regions with the symptoms presented by
the patient.
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Affiliation(s)
- Valéria Santoro Bahia
- MD, PhD, Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo SP, Brazil
| | - Leonel Tadao Takada
- MD, Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo SP, Brazil
| | - Leonardo Caixeta
- MD, PhD, Associate Professor of Neuroscience, Federal University of Goiás, Goiânia GO, Brazil. Coordinator, Cognitive and Behavioral Neurology Unit, Hospital das Clínicas
| | - Leandro Tavares Lucato
- MD, PhD, Neuroradiologist, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil. Centro de Diagnósticos Brasil, São Paulo SP, Brazil
| | - Claudia Sellitto Porto
- PhD, Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo SP, Brazil
| | - Ricardo Nitrini
- MD, PhD, Full Professor, Behavioral and Cognitive Neurology Unit, Department of Neurology, and CEREDIC, Hospital das Clínicas, University of São Paulo School of Medicine, HC/FMUSP
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Semple BD, Canchola SA, Noble-Haeusslein LJ. Deficits in social behavior emerge during development after pediatric traumatic brain injury in mice. J Neurotrauma 2012; 29:2672-83. [PMID: 22888909 PMCID: PMC3510450 DOI: 10.1089/neu.2012.2595] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The pediatric brain may be particularly vulnerable to social deficits after traumatic brain injury (TBI) due to the protracted nature of psychosocial development through adolescence. However, the majority of pre-clinical studies fail to assess social outcomes in experimental pediatric TBI. The current study evaluated social behavior in mice subjected to TBI at post-natal day (p)21. Social behaviors were assessed by a partition test, resident-intruder, three-chamber, and tube dominance tasks during adolescence (p35-42) and again during early adulthood (p60-70), during encounters with unfamiliar, naïve stimulus mice. Despite normal olfactory function and normal social behaviors during adolescence, brain-injured mice showed impaired social investigation by adulthood, evidenced by reduced ano-genital sniffing and reduced following of stimulus mice in the resident-intruder task, as well as a loss of preference for sociability in the three-chamber task. TBI mice also lacked a preference for social novelty, suggestive of a deficit in social recognition or memory. By adulthood, brain-injured mice exerted more frequent dominance in the tube task compared to sham-operated controls, a finding suggestive of aggressive tendencies. Together these findings reveal reduced social interaction and a tendency towards increased aggression, which evolves across development to adulthood. This emergence of aberrant social behavior, which parallels the development of other cognitive deficits in this model and behaviors seen in brain-injured children, is consistent with the hypothesis that the full extent of deficits is not realized until the associated skills reach maturity. Thus, efficacy of therapeutics for pediatric TBI should take into account the time-dependent emergence of abnormal behavioral patterns.
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Affiliation(s)
- Bridgette D Semple
- Department of Neurological Surgery, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94143-0112, USA.
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27
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Weiss EM. Neuroimaging and neurocognitive correlates of aggression and violence in schizophrenia. SCIENTIFICA 2012; 2012:158646. [PMID: 24278673 PMCID: PMC3820648 DOI: 10.6064/2012/158646] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 09/02/2012] [Indexed: 06/02/2023]
Abstract
Individuals diagnosed with major mental disorders such as schizophrenia are more likely to have engaged in violent behavior than mentally healthy members of the same communities. Although aggressive acts can have numerous causes, research about the underlying neurobiology of violence and aggression in schizophrenia can lead to a better understanding of the heterogeneous nature of that behavior and can assist in developing new treatment strategies. The purpose of this paper is to review the recent literature and discuss some of the neurobiological correlates of aggression and violence. The focus will be on schizophrenia, and the results of neuroimaging and neuropsychological studies that have directly investigated brain functioning and/or structure in aggressive and violent samples will be discussed as well as other domains that might predispose to aggression and violence such as deficits in responding to the emotional expressions of others, impulsivity, and psychopathological symptoms. Finally gender differences regarding aggression and violence are discussed. In this context several methodological and conceptional issues that limited the comparison of these studies will be addressed.
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Affiliation(s)
- Elisabeth M. Weiss
- Department of Psychology, Karl-Franzens University of Graz, University-Platz 2, 8010 Graz, Austria
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Chevignard MP, Soo C, Galvin J, Catroppa C, Eren S. Ecological assessment of cognitive functions in children with acquired brain injury: a systematic review. Brain Inj 2012; 26:1033-57. [PMID: 22715895 DOI: 10.3109/02699052.2012.666366] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Childhood acquired brain injury (ABI) often leads to impairment in cognitive functioning, resulting in disabilities in both the home and school environment. Assessing the impact of these cognitive deficits in everyday life using traditional neuropsychological tests has been challenging. This study systematically reviewed ecological measures of cognitive abilities available for children with ABI. METHOD Eight databases were searched (until October 2011) for scales: (1) focused on ecological assessment of cognitive functioning; (2) with published data in an ABI population; (3) applicable to children up to 17;11 years of age; and (4) in English. The title and abstract of all papers were reviewed independently by two reviewers. RESULTS Database searches yielded a total of 12 504 references, of which 17 scales met the inclusion criteria for the review, focusing on executive functions (n = 9), memory (n = 3), general cognitive abilities (n = 2), visuo-spatial skills (n = 2) and attention (n = 1). Four tasks used observation of actual performance in a natural environment, five were proxy-reports and six were functional paper and pencil type tasks, performed in an office. CONCLUSION Overall, few measures were found; eight were still experimental tasks which did not provide norms. Executive functions were better represented in ecological assessment, with relatively more standardized scales available.
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Affiliation(s)
- Mathilde P Chevignard
- Rehabilitation Department for Children with Acquired Brain Injury (INR-A), Hôpitaux de Saint Maurice, Saint Maurice, France.
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Gleichgerrcht E, Torralva T, Rattazzi A, Marenco V, Roca M, Manes F. Selective impairment of cognitive empathy for moral judgment in adults with high functioning autism. Soc Cogn Affect Neurosci 2012; 8:780-8. [PMID: 22689217 DOI: 10.1093/scan/nss067] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Faced with a moral dilemma, conflict arises between a cognitive controlled response aimed at maximizing welfare, i.e. the utilitarian judgment, and an emotional aversion to harm, i.e. the deontological judgment. In the present study, we investigated moral judgment in adult individuals with high functioning autism/Asperger syndrome (HFA/AS), a clinical population characterized by impairments in prosocial emotions and social cognition. In Experiment 1, we compared the response patterns of HFA/AS participants and neurotypical controls to moral dilemmas with low and high emotional saliency. We found that HFA/AS participants more frequently delivered the utilitarian judgment. Their perception of appropriateness of moral transgression was similar to that of controls, but HFA/AS participants reported decreased levels of emotional reaction to the dilemma. In Experiment 2, we explored the way in which demographic, clinical and social cognition variables including emotional and cognitive aspects of empathy and theory of mind influenced moral judgment. We found that utilitarian HFA/AS participants showed a decreased ability to infer other people's thoughts and to understand their intentions, as measured both by performance on neuropsychological tests and through dispositional measures. We conclude that greater prevalence of utilitarianism in HFA/AS is associated with difficulties in specific aspects of social cognition.
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Chevignard MP, Catroppa C, Galvin J, Anderson V. Development and Evaluation of an Ecological Task to Assess Executive Functioning Post Childhood TBI: The Children's Cooking Task. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.11.2.125] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractPurpose:Traumatic brain injury (TBI) often leads to executive functions deficits, which may be responsible for severe and longstanding disabilities in everyday activities. Sensitivity and ecological validity of neuropsychological tests of executive functions have been questioned. The aims of this study were to pilot an ecological open-ended assessment of executive functions in children, the ‘Children's Cooking Task’ (CCT), specifically to report its reliability, discriminant validity and concurrent validity.Methods:Twenty-five children with mild (n= 10) or moderate-to-severe TBI (n= 15), and 21 matched controls (aged 8 to 20 years) participated in the study. An open-ended cooking task was designed to test multi-tasking abilities. It required the preparation of two simple recipes using specific instructions. Outcome measures included the number of errors and an overall qualitative analysis of the task. Validating measures of executive functions included the Delis Kaplan Executive Function System, the Six-Part Test and two questionnaires completed by the child's primary care-giver: the Behavior Rating Inventory of Executive Function and the Dysexecutive Questionnaire for Children.Results:Internal consistency of the Children's Cooking Task was high (Cronbach's alpha = .86), as was test–retest reliability (ICC = .89). Children with moderate-to-severe TBI, as well as children with mild TBI made significantly more errors in the Children's Cooking Task in comparison to controls (p< .001). The CCT was correlated with several tests and one questionnaire of executive functioning (Trails, verbal fluency, sorting, 20 questions, Dysexecutive Questionnaire).Discussion and Conclusion:The Children's Cooking Task has good interrater and test–retest reliability, as well as good discriminant and concurrent validity.
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Bachevalier J, Machado CJ, Kazama A. Behavioral outcomes of late-onset or early-onset orbital frontal cortex (areas 11/13) lesions in rhesus monkeys. Ann N Y Acad Sci 2012; 1239:71-86. [PMID: 22145877 DOI: 10.1111/j.1749-6632.2011.06211.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The orbital frontal cortex (OFC) has been implicated in a number of psychiatric disorders, including depression, anxiety, phobia, and obsessive-compulsive disorder. Thus, a better understanding of its functions will likely provide critical information to understand the specific behavioral and cognitive processes affected in these human disorders. In recent years, a growing number of studies have provided evidence for anatomical and functional differentiation within the OFC. Here we discuss the effects of selective OFC (areas 11/13) lesions on social behavior, emotional regulation, and behavioral adaptation. Damage to these specific OFC subfields in adult monkeys resulted in profound changes in the flexible modulation of responses guided by reward value that could explain the poor fear regulation and disturbed social interactions observed in the same animals. A similar pattern of results was found when the OFC lesions were done in infancy. Thus, in monkeys, self-regulation abilities mediated by OFC areas 11/13 emerge from midinfancy through adolescence.
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Boes AD, Grafft AH, Joshi C, Chuang NA, Nopoulos P, Anderson SW. Behavioral effects of congenital ventromedial prefrontal cortex malformation. BMC Neurol 2011; 11:151. [PMID: 22136635 PMCID: PMC3265436 DOI: 10.1186/1471-2377-11-151] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 12/02/2011] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND A detailed behavioral profile associated with focal congenital malformation of the ventromedial prefrontal cortex (vmPFC) has not been reported previously. Here we describe a 14 year-old boy, B.W., with neurological and psychiatric sequelae stemming from focal cortical malformation of the left vmPFC. CASE PRESENTATION B.W.'s behavior has been characterized through extensive review Patience of clinical and personal records along with behavioral and neuropsychological testing. A central feature of the behavioral profile is severe antisocial behavior. He is aggressive, manipulative, and callous; features consistent with psychopathy. Other problems include: egocentricity, impulsivity, hyperactivity, lack of empathy, lack of respect for authority, impaired moral judgment, an inability to plan ahead, and poor frustration tolerance. CONCLUSIONS The vmPFC has a profound contribution to the development of human prosocial behavior. B.W. demonstrates how a congenital lesion to this cortical region severely disrupts this process.
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Affiliation(s)
- Aaron D Boes
- Department of Pediatric Neurology, Massachusetts General Hospital, Harvard University. MC WACC 8-835, 55 Fruit Street. Boston, MA 02114. USA
| | - Amanda Hornaday Grafft
- Departments of Neurology and Psychology, University of Iowa. 200 Hawkins Drive, 2007 RCP, Iowa City, IA 52242. USA
| | - Charuta Joshi
- Department of Pediatric Neurology, University of Iowa. 2506 John Colloton Pavilion, 200 Hawkins Drive, Iowa City, IA 52242. USA
| | - Nathaniel A Chuang
- Department of Neuroradiology, Rady Children's Hospital of San Diego. 3020 Children's Way. MC 5101, San Diego, CA 92123. USA
| | - Peg Nopoulos
- Department of Psychiatry, University of Iowa. 200 Hawkins Drive, W285 GH, Iowa City, Iowa 52242. USA
| | - Steven W Anderson
- Department of Neurology, University of Iowa. 200 Hawkins Drive, 2007 RCP, Iowa City, IA 52242. USA
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Feldstein Ewing SW, Filbey FM, Hendershot CS, McEachern AD, Hutchison KE. Proposed model of the neurobiological mechanisms underlying psychosocial alcohol interventions: the example of motivational interviewing. J Stud Alcohol Drugs 2011; 72:903-16. [PMID: 22051204 PMCID: PMC3211961 DOI: 10.15288/jsad.2011.72.903] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Despite the prevalence and profound consequences of alcohol use disorders, psychosocial alcohol interventions have widely varying outcomes. The range of behavior following psychosocial alcohol treatment indicates the need to gain a better understanding of active ingredients and how they may operate. Although this is an area of great interest, at this time there is a limited understanding of how in-session behaviors may catalyze changes in the brain and subsequent alcohol use behavior. Thus, in this review, we aim to identify the neurobiological routes through which psychosocial alcohol interventions may lead to post-session behavior change as well as offer an approach to conceptualize and evaluate these translational relationships. METHOD PubMed and PsycINFO searches identified studies that successfully integrated functional magnetic resonance imaging and psychosocial interventions. RESULTS Based on this research, we identified potential neurobiological substrates through which behavioral alcohol interventions may initiate and sustain behavior change. In addition, we proposed a testable model linking within-session active ingredients to outside-of-session behavior change. CONCLUSIONS Through this review, we present a testable translational model. Additionally, we illustrate how the proposed model can help facilitate empirical evaluations of psychotherapeutic factors and their underlying neural mechanisms, both in the context of motivational interviewing and in the treatment of alcohol use disorders.
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Affiliation(s)
- Sarah W. Feldstein Ewing
- Correspondence may be sent to Sarah W. Feldstein Ewing at the above address or via email at: . Francesca M. Filbey is with the Center for Brain Health, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX. Christian S. Hendershot is also with the Centre for Addiction and Mental Health, Toronto, ON, Canada, and the Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Kent E. Hutchison is also with the Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO
| | - Francesca M. Filbey
- Correspondence may be sent to Sarah W. Feldstein Ewing at the above address or via email at: . Francesca M. Filbey is with the Center for Brain Health, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX. Christian S. Hendershot is also with the Centre for Addiction and Mental Health, Toronto, ON, Canada, and the Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Kent E. Hutchison is also with the Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO
| | - Christian S. Hendershot
- Correspondence may be sent to Sarah W. Feldstein Ewing at the above address or via email at: . Francesca M. Filbey is with the Center for Brain Health, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX. Christian S. Hendershot is also with the Centre for Addiction and Mental Health, Toronto, ON, Canada, and the Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Kent E. Hutchison is also with the Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO
| | | | - Kent E. Hutchison
- Correspondence may be sent to Sarah W. Feldstein Ewing at the above address or via email at: . Francesca M. Filbey is with the Center for Brain Health, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX. Christian S. Hendershot is also with the Centre for Addiction and Mental Health, Toronto, ON, Canada, and the Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Kent E. Hutchison is also with the Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, CO
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Long B, Anderson V, Jacobs R, Mackay M, Leventer R, Barnes C, Spencer-Smith M. Executive Function Following Child Stroke: The Impact of Lesion Size. Dev Neuropsychol 2011; 36:971-87. [PMID: 22004019 DOI: 10.1080/87565641.2011.581537] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Dalwani M, Sakai JT, Mikulich-Gilbertson SK, Tanabe J, Raymond K, McWilliams SK, Thompson LL, Banich MT, Crowley TJ. Reduced cortical gray matter volume in male adolescents with substance and conduct problems. Drug Alcohol Depend 2011; 118:295-305. [PMID: 21592680 PMCID: PMC3170449 DOI: 10.1016/j.drugalcdep.2011.04.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 04/06/2011] [Accepted: 04/07/2011] [Indexed: 11/29/2022]
Abstract
UNLABELLED Boys with serious conduct and substance problems (Antisocial Substance Dependence (ASD)) repeatedly make impulsive and risky decisions in spite of possible negative consequences. Because prefrontal cortex (PFC) is involved in planning behavior in accord with prior rewards and punishments, structural abnormalities in PFC could contribute to a person's propensity to make risky decisions. METHODS We acquired high-resolution structural images of 25 male ASD patients (ages 14-18 years) and 19 controls of similar ages using a 3T MR system. We conducted whole-brain voxel-based morphometric analysis (p<0.05, corrected for multiple comparisons at whole-brain cluster-level) using Statistical Parametric Mapping version-5 and tested group differences in regional gray matter (GM) volume with analyses of covariance, adjusting for total GM volume, age, and IQ; we further adjusted between-group analyses for ADHD and depression. As secondary analyses, we tested for negative associations between GM volume and impulsivity within groups and separately, GM volume and symptom severity within patients using whole-brain regression analyses. RESULTS ASD boys had significantly lower GM volume than controls in left dorsolateral PFC (DLPFC), right lingual gyrus and bilateral cerebellum, and significantly higher GM volume in right precuneus. Left DLPFC GM volume showed negative association with impulsivity within controls and negative association with substance dependence severity within patients. CONCLUSIONS ASD boys show reduced GM volumes in several regions including DLPFC, a region highly relevant to impulsivity, disinhibition, and decision-making, and cerebellum, a region important for behavioral regulation, while they showed increased GM in precuneus, a region associated with self-referential and self-centered thinking.
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Affiliation(s)
- Manish Dalwani
- Department of Psychiatry, University of Colorado Denver School of Medicine, 12469 E. 17th Place, Aurora, CO 80045, USA.
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Clavel V, Bottari C. Analyse Critique D'instruments de Mesure Des AVQ en Pédiatrie: Déficits Exécutifs et Indépendance. The Canadian Journal of Occupational Therapy 2011; 78:220-9. [DOI: 10.2182/cjot.2011.78.4.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Description. Bien que l'évaluation des activités de la vie quotidienne (AVQ) par analyse de tâches soit au cœur du rôle de l'ergothérapeute œuvrant auprès d'enfants ayant un traumatisme craniocérébral (TCC), aucune étude visant l'analyse des instruments utilisés à cet effet selon leur potentiel de mettre en évidence des déficits liés aux fonctions exécutives (ex: formuler un but, planifier) n'a été recensée. But. Déterminer s'il existe des outils de mesure des AVQ qui considèrent les fonctions exécutives, validés auprès d'enfants de 10 à 15 ans ayant un TCC. Méthodologie. Quatre outils, le «Assessment of Motor and Process Skills», le «Children's Kitchen Task Assessment», la «tâche du gâteau au chocolat» et le «Profil des AVQ» ont été analysés selon des critères tels que: 1) complexité des tâches, 2) approche d'évaluation non-structurée, et 3) qualités psychométriques adéquates pour la clientèle cible. Résultats. Ces outils ne sont que partiellement conformes aux critères recherchés. Conclusion. La poursuite des études sur ces outils serait primordiale pour mieux répondre aux besoins de cette clientèle.
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Social communication in young children with traumatic brain injury: relations with corpus callosum morphometry. Int J Dev Neurosci 2011; 30:247-54. [PMID: 21807088 DOI: 10.1016/j.ijdevneu.2011.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 06/17/2011] [Accepted: 07/12/2011] [Indexed: 11/22/2022] Open
Abstract
The purpose of the present investigation was to characterize the relations of specific social communication behaviors, including joint attention, gestures, and verbalization, with surface area of midsagittal corpus callosum (CC) subregions in children who sustained traumatic brain injury (TBI) before 7 years of age. Participants sustained mild (n=10) or moderate-severe (n=26) noninflicted TBI. The mean age at injury was 33.6 months; mean age at MRI was 44.4 months. The CC was divided into seven subregions. Relative to young children with mild TBI, those with moderate-severe TBI had smaller surface area of the isthmus. A semi-structured sequence of social interactions between the child and an examiner was videotaped and coded for specific social initiation and response behaviors. Social responses were similar across severity groups. Even though the complexity of their language was similar, children with moderate-severe TBI used more gestures than those with mild TBI to initiate social overtures; this may indicate a developmental lag or deficit as the use of gestural communication typically diminishes after age 2. After controlling for age at scan and for total brain volume, the correlation of social interaction response and initiation scores with the midsagittal surface area of the CC regions was examined. For the total group, responding to a social overture using joint attention was significantly and positively correlated with surface area of all regions, except the rostrum. Initiating joint attention was specifically and negatively correlated with surface area of the anterior midbody. Use of gestures to initiate a social interaction correlated significantly and positively with surface area of the anterior and posterior midbody. Social response and initiation behaviors were selectively related to regional callosal surface areas in young children with TBI. Specific brainbehavior relations indicate early regional specialization of anterior and posterior CC for social communication.
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Predicting behavioral deficits in pediatric traumatic brain injury through uncinate fasciculus integrity. J Int Neuropsychol Soc 2011; 17:663-73. [PMID: 21492497 PMCID: PMC3707392 DOI: 10.1017/s1355617711000464] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Behavioral dysregulation is a common and detrimental consequence of traumatic brain injury (TBI) in children that contributes to poor academic achievement and deficits in social development. Unfortunately, behavioral dysregulation is difficult to predict from either injury severity or early neuropsychological evaluation. The uncinate fasciculus (UF) connects orbitofrontal and anterior temporal lobes, which are commonly implicated in emotional and behavioral regulation. Using probabilistic diffusion tensor tractography (DTT), we examined the relationship between the integrity of the UF 3 months post-injury and ratings of executive functions 12 months post-injury in children with moderate to severe TBI and a comparison group with orthopedic injuries. As expected, fractional anisotropy of the UF was lower in the TBI group relative to the orthopedic injury group. DTT metrics from the UF served as a biomarker and predicted ratings of emotional and behavior regulation, but not metacognition. In contrast, the Glasgow Coma Scale score was not related to either UF integrity or to executive function outcomes. Neuroanatomical biomarkers like the uncinate fasciculus may allow for early identification of behavioral problems and allow for investigation into the relationship of frontotemporal networks to brain-behavior relationships.
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Ondruch A, Maryniak A, Kropiwnicki T, Roszkowski M, Daszkiewicz P. Cognitive and social functioning in children and adolescents after the removal of craniopharyngioma. Childs Nerv Syst 2011; 27:391-7. [PMID: 20931204 DOI: 10.1007/s00381-010-1301-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 09/28/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study is to assess cognitive, emotional and social functioning in children and adolescents after the removal of craniopharyngioma. METHODS Twenty-seven children operated for craniopharyngioma and their parents participated in the study. Cognitive functions were assessed with WISC-R/WAIS-R-PL and Rey-Osterrieth Complex Figure Test. Parents completed Achenbach's Child Behaviour Checklist (CBCL) questionnaires on problems in functioning and psychopathological symptoms and took part in an interview on children coping in everyday life. RESULTS Eighty-two percent of patients were diagnosed with an average level of intellectual functioning. No child received results indicating mental disability. In half of the children, effectiveness of visual memory was reduced, despite normal visual-spatial abilities. The results in the CBCL scale indicated more frequent presence of psychopathological symptoms-especially social problems, depression, anxiety and withdrawal. The most frequent problems in children's everyday functioning included inability to control emotions, difficulties in learning, unsatisfactory peer relationships, and unattractive appearance resulting from hormonal disorders (short height and obesity). One third of parents also reported problems with pathological appetite in their children. CONCLUSIONS Despite normal intellectual abilities and relatively good physical condition, children after removal of craniopharyngioma experience many difficulties in everyday life regarding social relationships, emotion control and learning. The analogy between the above-mentioned symptoms and symptoms observed in patients after infantile damage in the frontal area leads to an observation that, apart from endocrine disorders, damage to the frontal lobe caused by the growth of tumour and operational intervention is of crucial importance to the further development of children with craniopharyngioma.
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Affiliation(s)
- Agnieszka Ondruch
- Department of Neurosurgery, Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
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Long B, Spencer-Smith MM, Jacobs R, Mackay M, Leventer R, Barnes C, Anderson V. Executive function following child stroke: the impact of lesion location. J Child Neurol 2011; 26:279-87. [PMID: 21115744 DOI: 10.1177/0883073810380049] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Child stroke is a major cause of death in children, although limited information exists on neurobehavioral functioning of stroke survivors. Executive function (important for goal-directed behavior) is thought to be vulnerable to early insults such as stroke because of its widespread representation in the immature brain. This study investigated the impact of lesion location on executive skills. Twenty-eight children diagnosed with stroke at least 18 months before assessment were recruited. Lesion characteristics were coded from magnetic resonance imaging (MRI) scans. Neurobehavioral assessment focused on cognitive and everyday executive skills. Deficits were found in the context of overall normal intellectual functioning (M = 91.60; SD = 19.40). Generally, insults involving frontal and extra-frontal regions impacted equally on cognitive performance. Everyday deficits were marginally more prominent following frontal insult. Subcortical frontal lesions were associated with impairments in everyday executive skills. Results provide further support for the diffuse representation of executive function in the immature brain.
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Affiliation(s)
- Brian Long
- University of Melbourne, Melbourne, Australia
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Giannopulu I, Sagot I. Ressenti émotionnel positif dans une tâche expérimentale chez l’enfant. ANNALES MEDICO-PSYCHOLOGIQUES 2010. [DOI: 10.1016/j.amp.2009.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lah S, Epps A, Levick W, Parry L. Implicit and explicit memory outcome in children who have sustained severe traumatic brain injury: Impact of age at injury (preliminary findings). Brain Inj 2010; 25:44-52. [DOI: 10.3109/02699052.2010.531693] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Channon S, Crawford S. Mentalising and social problem-solving after brain injury. Neuropsychol Rehabil 2010; 20:739-59. [DOI: 10.1080/09602011003794583] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
BACKGROUND While many children with brain conditions present with cognitive, behavioural, emotional, academic and social impairments, other children recover with seemingly few impairments. Animal studies and preliminary child studies have identified timing of brain lesion as a key predictor in determining functional outcome following early brain lesions. REVIEW This research suggests that knowledge of healthy developmental processes in brain structure and function is essential for better understanding functional recovery and outcome in children with brain lesions. This review paper aims to equip researchers with current knowledge of key principles of developmental processes in brain structure and function. Timetables for development of the prefrontal cortex (PFC), a brain region particularly vulnerable to lesions due to its protracted developmental course, are examined. In addition, timetables for development of executive skills, which emerge in childhood and have a prolonged developmental course that parallels development of the PFC, are also discussed. CONCLUSIONS Equipped with this knowledge, researchers are now in a better position to understand functional recovery and outcome in children with brain conditions.
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Affiliation(s)
- Megan Spencer-Smith
- Critical Care and Neurosciences, Murdoch Childrens Research Institute, Royal Children's Hospital, FlemingtonRoad, Parkville, VIC 3054, Australia.
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Thompson K, Biddle KR, Robinson-Long M, Poger J, Wang J, Yang QX, Eslinger PJ. Cerebral plasticity and recovery of function after childhood prefrontal cortex damage. Dev Neurorehabil 2010; 12:298-312. [PMID: 20477559 DOI: 10.3109/17518420903236262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Recovery of function after early brain injury depends upon both reparative and compensatory processes that are minimally understood. Using functional magnetic resonance imaging (fMRI), this study investigated the reorganization of hemispheric brain activity of a 24 year old male who suffered right prefrontal cortex damage at 7 years of age related to ruptured arteriovenous malformation. His pattern of recovery has been examined and tracked over the past 17 years and evolved from initial significant impairments in executive, spatial and attentional abilities from the brain lesion to remarkable recovery of function. METHODS High field fMRI studies were completed with experimental cognitive tasks sensitive to right prefrontal functions, including visuospatial relational reasoning, spatial working memory, go no-go, emotional face recognition, and coin calculation. RESULTS were compared to a matched control group for total hemispheric activity patterns. RESULTS Analyses revealed that on fMRI activation tasks where the patient scored similar to controls, he activated a broader network of bilateral cortical regions than controls. On tasks where he scored lower than controls, there was under-activation of prefrontal cortical regions in comparison to controls. CONCLUSION Recovery of function after prefrontal cortex damage in childhood can occur and be associated with significant functional reorganization of hemispheric activity patterns (i.e. developmental cerebral plasticity). Although not all tasks showed recovery to the same extent in this case, those tasks with the most robust recovery entailed compensatory activation of additional cortical regions on fMRI. Further studies are needed to confirm and extend these findings.
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Affiliation(s)
- Kyle Thompson
- Department of Neurology, Penn State College of Medicine and Hershey Medical Center, Hershey, Pennsylvania 17033-0859, USA
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Channon S, Lagnado D, Drury H, Matheson E, Fitzpatrick S, Shieff C, Mendoza N, Maudgil D. Causal Reasoning and Intentionality Judgments After Frontal Brain Lesions. SOCIAL COGNITION 2010. [DOI: 10.1521/soco.2010.28.4.509] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sommer M, Rothmayr C, Döhnel K, Meinhardt J, Schwerdtner J, Sodian B, Hajak G. How should I decide? The neural correlates of everyday moral reasoning. Neuropsychologia 2010; 48:2018-26. [DOI: 10.1016/j.neuropsychologia.2010.03.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 03/17/2010] [Accepted: 03/25/2010] [Indexed: 10/19/2022]
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Abstract
Morality may be innate to the human brain. This review examines the neurobiological evidence from research involving functional magnetic resonance imaging of normal subjects, developmental sociopathy, acquired sociopathy from brain lesions, and frontotemporal dementia. These studies indicate a "neuromoral" network for responding to moral dilemmas centered in the ventromedial prefrontal cortex and its connections, particularly on the right. The neurobiological evidence indicates the existence of automatic "prosocial" mechanisms for identification with others that are part of the moral brain. Patients with disorders involving this moral network have attenuated emotional reactions to the possibility of harming others and may perform sociopathic acts. The existence of this neuromoral system has major clinical implications for the management of patients with dysmoral behavior from brain disorders and for forensic neuropsychiatry.
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de Oliveira-Souza R, Moll J. The neural bases of normal and deviant moral cognition and behavior. Top Magn Reson Imaging 2009; 20:261-270. [PMID: 20859187 DOI: 10.1097/rmr.0b013e3181f22f69] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Ricardo de Oliveira-Souza
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
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