Aivoverenkiertohäiriöpotilaan oiretiedostuksen puutteellisuuden eli anosognosian tunnistaminen ja kuntoutus

Anosognosiaa eli oiretiedostuksen puutteellisuutta esiintyy keskimäärin 30 %:lla aivoverenkiertohäiriöpotilaista. Anosognosiassa sairauden ja sen aiheuttamien oireiden tiedostaminen on puutteellista tai ei onnistu lainkaan, mikä hidastaa potilaan hakeutumista hoitoon. Tämä heikentää potilaan hoitoennustetta, sillä nopea hoitoon hakeutuminen on tärkeää aivovaurioiden minimoimiseksi. Anosognosia altistaa vaaratilanteille päivittäistoiminnoissa, heikentää potilaan sitoutumista kuntoutukseen, hidastaa kuntoutumista ja ennustaa toimintakyvyn heikkoa palautumista, minkä vuoksi anosognosian tunnistaminen ja kuntoutus on tärkeää. Anosognosian, sen vaikeusasteen ja kognitiivisten liitännäisoireiden selvittämiseksi ja kuntoutustarpeen arvioimiseksi tarvitaan neuropsykologista tutkimusta

Neuropsychological findings in migraine : a systematic review

Patients with migraine often experience cognitive dysfunction during a migraine attack, but they have also been reported to complain about cognitive impairment after an attack and during the interictal period. Objective: The aim of this study was to determine what neuropsychological test methods are used to assess cognitive functioning in migraine patients and to examine the neuropsychological findings in adult (≥18 years) migraineurs compared to adult (≥18 years) healthy controls (HC). Methods: A systematic review was conducted on the literature published between 2012 and the present. The search results were screened and additional studies identified in the lists of references in the selected articles. A total of 16 articles met the inclusion criteria. Results: The 16 articles included in the review compared chronic migraineurs (CM), migraineurs with (MwA) and without aura (MwoA), and migraineurs without aura classification (MIG) to HC. A total of 45 neuropsychological assessment methods were identified. CM and MwA were found to perform significantly worse than HC in executive function, attention, and visual functioning. Additionally, both MwA and MwoA performed significantly worse than HC in memory functions. CM and both MwA and MwoA also performed significantly worse than HC in general cognitive functioning. Surprisingly, MIG performed significantly better than HC in several cognitive domains, including executive, motor, and language functioning and general cognitive functioning. Conclusions: This systematic review mostly concurs with the results of an earlier systematic review on the topic from 2012, but with the important addition that different migraine diagnostic groups should be assessed separately.publishedVersionPeer reviewe

Kognitiivisen toimintakyvyn ja mielialan muutokset uniapneaoireyhtymässä

- Uniapneaoireyhtymään liittyvät kognitiiviset muutokset voivat heikentää työkykyä ja elämänlaatua. - Oireyhtymään liittyvät mielialamuutokset eivät aina johdu sairauden somaattisista oireista. - Ylipainehengityshoito eli CPAP korjaa kognitiivisen toimintakyvyn ja mielialan muutoksia, mutta osa muutoksista voi jäädä pysyviksi muuten tuloksellisesta hoidosta huolimatta. - Neuropsykologisessa tutkimuksessa arvioidaan uniapneaoireyhtymään liittyviä päiväaikaisia oireita ja otetaan kantaa työkyvyn ja ajokyvyn kognitiivisiin edellytyksiin

The Under-Examined Trade-Environment Linkage: Domestic Politics and WTO Disputes

Neglect eli huomiotta jääminen on tarkkaavuuden häiriö, jossa vaurioon nähden vastakkaisen kehonpuoliskon ja toimintatilan huomioiminen on puutteellista tai ei onnistu lainkaan. Sitä esiintyy yli 40 %:lla oikean aivopuoliskon verenkiertohäiriön jälkeen. Huomiotta jääminen heikentää potilaan työ- ja toimintakykyä ja on ehdoton este autolla ajamiselle. Siksi neglectin diagnosointi on tärkeää. Neglectin vaikeusasteen ja liitännäisoireiden selvittämiseksi sekä kuntoutustarpeen arvioimiseksi tarvitaan yleensä laajaa neuropsykologista tutkimusta. Neuropsykologisen kuntoutuksen avulla voidaan kohentaa potilaan toimintakykyä ja oiretiedostusta sekä edistää paluuta työhön

The 'Neglected' Personal Neglect

A review of patients with brain injury showing personal neglect is presented. The aim is to shed light on this aspect of neglect often unresearched or only indirectly investigated, and to discuss recent findings concerning the methods used to assess personal neglect, its neural correlates and its association with the more often explored aspect of extrapersonal neglect. The review was performed using PubMed and PsychInfo databases to search for papers published in the last 123 years (until January 2018). We reviewed 81 papers describing either single or group studies for a total of 2247 patients. The results of this review showed that various aspects of personal neglect are still controversial and outcomes potentially contradictory. Despite the data reported in the present review suggest that personal neglect is more frequently associated with lesions of the right hemisphere, the left hemisphere may also play an important role. Not surprisingly, personal neglect and extrapersonal neglect seem to co-occur. However double dissociations of these two forms of neglect have been reported, and they seem to dissociate both from a functional and an anatomical perspective. More recent interpretations of personal neglect suggest that it may result from a disrupted body representation. The development of reliable psychometric tools with shared diagnostic criteria is essential to identify different degrees of personal neglect for different body parts and to better refine personal neglect in comparison to extrapersonal neglect and disorders related to distortions of personal domain

Memory Functions in Recreational Pistol Sport Shooters: Does Lead Matter?

Objective The aim of our study was to examine the memory functions of pistol sport shooters using powder charges when exposure to lead is expected to be considerably lower than in occupational circumstances. Methods A neuropsychological battery of memory and intelligence tests was administered to 20 sport shooters and 20 controls whose mean ages (SDs) were 55 (9.6) and 54 (9.3) years respectively. Memory functions were evaluated with three subtests of the Wechsler Memory Scale - Revised (WMS-R) and an incidental memory test. Intelligence was assessed with four subtests of the Wechsler Adult Intelligence Scale - Revised (WAIS-R). The level of alcohol consumption and depression were examined in both groups. Blood lead level was determined among the shooters. Results The shooters performed worse than the controls in the tests of incidental and logical memory. The groups did not differ in intelligence, mood or alcohol consumption. The mean (SD) blood lead level of the sport shooters was 0.52 μmol/L (0.40), responding 10.76 μg/dl (8.28). Conclusions Low lead exposure in recreational shooting conditions may impair verbal memory. Therefore it is important to ensure that lead exposure is prevented among those shooting for sport