Emotional biases in confabulation : the role of the frontal lobes

Bibliography: leaves 57-61.The neuropsychological understanding of confabulation has recently been enriched by the finding that confabulating patients present positive emotional biases in their false recollections. The exact mechanisms of this motivational phenomenon have been heuristically linked to the frontal lobe impairment accompanying confabulation. The present study aims at providing direct support for this claim. A patient with damage to the prefrontal cortex is examined and his performance is contrasted with two confabulating patients, a patient with non-frontal neurological damage and twenty matched controls on a number of tests of emotional processing

The genesis and development of the Groote Schuur neurocognitive screening battery : a neurocognitive screening tool for the South African context

Includes bibliographical references (leaves 308-336).This study sought to address this need by developing and validating the Groote Schuur Neurocognitive Screening Battery Prototype, a theory-driven tool created in response to requests by Groote Schuur Hospital neurologists for a suitable replacement for the Mini-Mental State Examination. The design of this battery constitutes a "middle ground" between the hypothetico-deductive and psychometric approaches to neurocognitive assessment. However, the Prototype had a number of limitations: it was not available in languages other than English, it contained many culturally biased tests and its validity and reliability had yet to be formally established

Hypofractionated image-guided radiotherapy for the treatment of acoustic neuromas: A dosimetrically acceptable alternative to stereotactic radiosurgery in a resource-constrained environment

Purpose: Treatment options for acoustic neuromas (ANs) are limited in low- and middle-income countries. The aim of this study was to investigate whether hypofractionated image-guided radiotherapy (IGRT) is a clinically acceptable treatment option for departments where no other radiosurgery options are available. Methods and materials: Fifteen dynamic conformal arc plans that had been clinically utilised were evaluated against the Radiation Therapy Oncology Group (RTOG) radiosurgery criteria and published indices. Analysis involved evaluating critical structure doses and the volume of normal tissue receiving 12 and 10 Gy single fraction equivalent dose (V12Eq and V10Eq). Results: Overall, there was only one RTOG protocol deviation in the whole patient group, where quality of coverage was compromised in order to achieve brainstem tolerance. Conformity indices were within clinically acceptable limits (CIPaddick ≥ 0.6) despite being inferior to the published Universitair Ziekenhuis Brussel (UZB) Gamma Knife and CyberKnife results (p < 0.0001). Homogeneity was superior to the Gamma Knife (p < 0.0001) and Novalis dynamic conformal arc (p = 0.0002) results. Gradient index results were inferior to all published techniques, but doses to the normal structures were well controlled with the exception of the cochlea. The V10Eq data showed increased sensitivity when compared with V12Eq. Conclusion: Dynamic arc IGRT allows for good coverage of AN lesions, but the dose fall-off is not as steep as that obtained with mainstream radiosurgery systems. Contouring and planning should include detailed critical structures analysis. For normal brain parenchyma analysis, V10Eq is a superior risk indicator when compared to V12Eq for this technique. Dynamic arc IGRT offers a dosimetrically acceptable treatment alternative for patients without serviceable hearing, in departments where there are no mainstream radiosurgery treatment options available

I am who I am through who we are: The potential role of ubuntu in neurorehabilitation

Este documento explora el concepto africano de Ubuntu y su potencial para influir en nuestra forma de pensar sobre la prestación de asistencia sanitaria y social a largo plazo dentro de un contexto de neuro-rehabilitación. Se presta especial atención a la potencial importancia de lograr una conexión social a largo plazo para los clientes y sus familiares después de que las intervenciones de neuro-rehabilitación hayan finalizado. Se proporcionan una pequeña viñeta de caso y un informe de práctica practica hospitalaria, como dos ejemplos para ilustrar algunos de los puntos clave al respecto. Además, los autores incorporan algunos aspectos de la filosofía de Ubuntu que podrían ayudar a los programas de neuro-rehabilitación que podrían influir en la reducción de la discapacidad social como un objetivo más explícito a largo plazo para el resultado

Adaptation of aphasia tests for neurocognitive screening in South Africa

Two aphasia tests — the Cookie Theft Test and the Boston Naming Test — were adapted to help eliminate western cultural, language and education bias in neurocognitive screening in South Africa. These tests were among the commonly used tests initially chosen for inclusion in a larger neurocognitive screening battery currently being developed and translated for use in South Africa — the Groote Schuur Neurocognitive Battery. The adaptations were made employing quantitative and qualitative converging lines of evidence to evaluate their efficacy. This evidence included consultation with clinicians at Groote Schuur Hospital and translators knowledgeable in Afrikaans and isiXhosa language and culture, qualitative feedback from the research participants, and the results on the tests. The adapted tests were piloted by testing 30 neurocognitively intact controls consisting of equal numbers of Afrikaans, English and isiXhosa speakers, comparing their scores to their performances on the original tests. Three aphasic patients were also briefly tested. Results indicate that the adaptations made to the tests improved the performance of controls over the original versions, and tentatively suggest that the adapted tests should be able to screen for aphasia. This pilot study recommends further changes to the Groote Schuur Naming Test before its introduction into the battery ahead of its validation

I am who I am through who we are: The potential role of ubuntu in neurorehabilitation

This paper explores the African concept of ubuntu, and its potential to influence our thinking about the delivery of long-term health and social care within a neurorehabilitation context. Particular consideration is given to the potential importance of achieving longer-term social connectedness for clients and their relatives after neuro-rehabilitati on interventions have finished. A short case vignette, and a hospital-based practice report, are provided as two examples to illustrate some of the key points made. Incorporating some aspects of the philosophy of ubuntu could potentially help neurorehabilitation programmes to include the reduction social disability as a more explicit longer-term goal for outcome.Este documento explora o conceito africano de Ubuntu e seu potencial para influenciar na nossa forma de pensar sobre a prestação da assistência sanitária e social a longo prazo dentro de um contexto de neuro-rehabilitação. Se presta especial atenção à potencial importância de conseguir uma conexão social a longo prazo para os clientes e seus familiares depois de que as intervenções de neuro-rehabilitação estiverem finalizadas. Se proporciona uma pequena vinheta do caso e um informe de prática hospitalar, como dois exemplos para ilustrar alguns dos pontos chave a esse respeito. Ademais, os autores incorporam alguns aspectos da filosofia de Ubuntu que poderiam ajudar nos programas de neuro-rehabilitação que poderiam influenciar na redução da discapacidade social como um objetivo mais explícito a longo prazo para o resultado.Este documento explora el concepto africano de Ubuntu y su potencial para influir en nuestra forma de pensar sobre la prestación de asistencia sanitaria y social a largo plazo dentro de un contexto de neuro-rehabilitación. Se presta especial atención a la potencial importancia de lograr una conexión social a largo plazo para los clientes y sus familiares después de que las intervenciones de neuro-rehabilitación hayan finalizado. Se proporcionan una pequeña viñeta de caso y un informe de práctica practica hospitalaria, como dos ejemplos para ilustrar algunos de los puntos clave al respecto. Además, los autores incorporan algunos aspectos de la filosofía de Ubuntu que podrían ayudar a los programas de neuro-rehabilitación que podrían influir en la reducción de la discapacidad social como un objetivo más explícito a largo plazo para el resultado

The role of the basolateral amygdala in dreaming

Neuroimaging studies have repeatedly shown amygdala activity during sleep (REM and NREM). Consequently, various theorists propose central roles for the amygdala in dreaming – particularly in the generation of dream affects, which seem to play a major role in dream plots. However, a causal role for the amygdala in dream phenomena has never been demonstrated. The traditional first step in determining this role is to observe the functional effects of isolated lesions to the brain structure in question. However, circumscribed bilateral amygdala lesions are extremely rare. Furthermore, the treatment of the amygdala as a unitary structure is problematic, as the basolateral and centromedial amygdala (BLA and CMA) may serve very different functions. We analysed 23 dream reports collected from eight adult patients with bilateral calcification of the BLA as a result of a very rare genetic condition called Urbach-Wiethe Disease (UWD). We compared these dream reports to 52 reports collected from 17 matched controls. Given that the BLA has been implicated in various affective processes in waking life, we predicted that the emotional content of the patients’ dreams would differ from that of controls. Due to the exploratory nature of this research, a range of different dream characteristics were analysed. A principal components analysis run on all data returned three key factors, namely pleasantness, length and danger. The UWD patients’ dream reports were significantly more pleasant and significantly shorter and less complex than control reports. No differences were found in levels of threat or danger. The results support some current hypotheses concerning the amygdala's role in dreaming, and call others into question. Future research should examine whether these UWD patients show generally impaired emotional episodic memory due to BLA damage, which could explain some of the current findings