Women outperform men in remembering to remember

The study of gender differences in prospective memory (i.e., remembering to remember) has received modest attention in the literature. The few reported studies investigating either subjective or objective evaluations of prospective memory have shown inconsistent data. In this study, we aimed to verify the presence of gender differences during the performance of an objective prospective memory test by considering the weight of specific variables such as length of delay, type of response, and type of cue. We submitted a sample of 100 healthy Italian participants (50 men and 50 women) to a test expressly developed to assess prospective memory: The Memory for Intentions Screening Test. Women performed better than men in remembering to do an event-based task (i.e., prompted by an external event) and when the task required a physical response modality. We discuss the behavioural differences that emerged by considering the possible role of sociological, biological, neuroanatomical, and methodological variables

Sensitivity and Specificity of Qualitative Visual Field Tests for Screening Visual Hemifield Deficits in Right-Brain-Damaged Stroke Patients

A timely detection of visual hemifield deficits (VHFDs; hemianopias or quadrantanopias) is critical for both the diagnosis and treatment of stroke patients. The present study determined the sensitivity and specificity of four qualitative visual field tests, including face description, confrontation tests (finger wiggle), and kinetic boundary perimetry, to screen large and dense VHFDs in right-brain-damaged (RBD) stroke patients. Previously, the accuracy of qualitative visual field tests was examined in unselected samples of patients with heterogeneous aetiology, in which stroke patients represented a very small fraction. Building upon existing tests, we introduced some procedural ameliorations (incl. a novel procedure for kinetic boundary perimetry) and provided a scoresheet to facilitate the grading. The qualitative visual field tests’ outcome of 67 consecutive RBD stroke patients was compared with the standard automated perimetry (SAP; i.e., reference standard) outcome to calculate sensitivity and specificity, as well as positive and negative predictive values (PPV and NPV), both for each individual test and their combinations. The face description test scored the lowest sensitivity and NPV, while the kinetic boundary perimetry scored the highest. No test returned false positives. Combining the monocular static finger wiggle test (by quadrants) and the kinetic boundary perimetry returned the highest sensitivity and specificity, in line with previous studies, but with higher accuracy (100% sensitivity and specificity). These findings indicate that the combination of these two tests is a valid approach with RBD stroke patients, prompting referral for a formal visual field examination, and representing a quick, easy-to-perform, and inexpensive tool for improving their care and prognosis

'Less is more': validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs).

Background: Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). Objective: To use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements. Methods: BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model. Results: The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p-values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements. Conclusions: After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers

Psychotherapy and Art Therapy: A pilot study of group treatment for patients with traumatic brain injury

Here we investigated the efficacy of group Psychotherapy and Art Therapy in rebuilding self-identity after traumatic brain injury (TBI), assessing their effects on psychological aspects in twelve patients with severe TBI. Overall, the results show an increased ability to adapt to the experiences of life as well as a higher level of awareness, social functioning and emotional autoregulation. Furthermore, patients exhibited a reduction in depressive symptoms and in the perception of physical problems. Results highlight the importance of treatments focusing on the patients’ emotional needs, in addition to the classic rehabilitation (i.e. physiotherapy, cognitive therapy)

Impact of Traumatic Brain Injury on different formats of topographical representation.

Navigating in the environmental space requires processing and integrating different types of visuospatial information. It depends on activity of a large-scale brain network, which regions play different and complementary contributions. Thus, white matter damage may greatly impact on this complex skill. Here, we aimed to test whether and how diffused axonal damage, proper of traumatic brain injury (TBI), affects spatial navigation. We use the laboratory-based setting (LBS) we recently developed, which allows for testing route learning (RK; route learning task), landmark knowledge (LK; landmark recognition task), survey knowledge (SK; landmark positioning task) and landmark ordering (LO; ordering task). We compared the performance of patients with TBI (N = 18) with that of healthy controls (HC; N = 34) matched for age and gender. The inverse efficiency score index (IES), that balances and integrates accuracy and response time, was computed for each task of the LBS. Then we performed Mann-Whitney U tests to compare indexes of the two groups; in each group, Spearman's correlation coefficient was computed as well. The two groups differed significantly on the second attempt of the RK, but not on the third attempt, suggesting that although it took more time, patients with TBI learned the path similarly to the HC. However, performances differed significantly in LK and SK task, suggesting a deficit in recollecting figurative memory of the landmarks and shifting from an egocentric to an allocentric representation. Performance did not differ significantly in the LO. Consistently with our previous results, performances on LO were associated with SK in HC; instead, they were associated with RK in patients with TBI. Results suggest that HC used SK to perform LO; instead, TBI used the route information they had correctly acquired, suggesting a different strategy in this sample of patients

Neurorehabilitation

The logistics of neurorehabilitation of this group of patients differ based on their unique clinical status. Disorders of consciousness (DOC) after severe acquired brain injury (ABI) include coma, vegetative state (VS), and minimally conscious state (MCS). Coma is primarily assessed via the Glasgow Coma Scale (GCS) [1] in the acute phase, whereas the Disability Rating Scale (DRS) [2], Levels of Cognitive Function (LCF) [3], Glasgow Outcome Scale (GOS), and Glasgow Outcome Scale-Extended (GOS-E) [4, 5] are the most commonly used scales in the post-acute phase

Cognitive functions underlying prospective memory deficits: A study on traumatic brain injury

This study investigates prospective memory (PM) deficits as well as the interplay between performance in executive functions (EFs), speed of processing, episodic memory and PM in traumatic brain injury (TBI), differentiating between time based and event based tasks. The Memory for Intentions Screening Test was administrated to a sample of 19 participants with TBI and 50 healthy controls. Tasks probing different EFs (i.e., shifting, updating/working memory, inhibition, and access to long term memory), speed of processing, and episodic memory were also administrated to the TBI group. PM deficits were found in participants with TBI compared to controls. In the role of EFs in PM, only tasks probing updating/working memory and access to the long-term memory showed to play a specific role in PM performance in TBI. However, while updating/working memory was related to both time and event based PM, access to the long term memory was associated to performance on time based PM task only. Speed of processing and retrospective memory abilities do not seem to play a specific role in PM deficit in TBI. Our results provide a better understanding of the PM deficit in TBI, which may contribute to improve existing rehabilitation programs for individuals with TBI

Development of neuropsychiatric disorders in post-stroke patients: a cross sectional study

The study aimed to characterize neuropsychiatric symptomatology and its evolution in a large group of cerebrovascular injured patients during their first year post-stroke. The Neuropsychiatric Inventory (NPI, Cummings et al., 1994), was administered to a sample of 124 patients with unilateral cerebrovascular focal lesion. They were divided into three independent groups on the basis of stroke distance: 45 patients were evaluated 2 months after stroke, 45 patients 6 months after and 34 patients one year after stroke. The controls were 61 healthy subjects. A wide range of neuropsychiatric disorders were found significant in the brain-damaged population with respect to the control group: mostly depression (61%), irritability (43%), apathy (34%), eating disturbances (33%), anxiety (30%) and agitation (28%). Modifications in terms of greater depression, anxiety, irritability and eating disturbances characterized the whole year after stroke. However, other symptoms emerged depending on distance from stroke: agitation, euphoria and aberrant motor behavior were significantly present only at 2 months, and apathetic behavior only in the post-acute phase (6 and 12 months) with nighttime disturbance

Development of neuropsychiatric disorders in post-stroke patients: a cross sectional study

The study aimed to characterize neuropsychiatric symptomatology and its evolution in a large group of cerebrovascular injured patients during their first year post-stroke. The Neuropsychiatric Inventory (NPI, Cummings et al., 1994), was administered to a sample of 124 patients with unilateral cerebrovascular focal lesion. They were divided into three independent groups on the basis of stroke distance: 45 patients were evaluated 2 months after stroke, 45 patients 6 months after and 34 patients one year after stroke. The controls were 61 healthy subjects. A wide range of neuropsychiatric disorders were found significant in the brain-damaged population with respect to the control group: mostly depression (61%), irritability (43%), apathy (34%), eating disturbances (33%), anxiety (30%) and agitation (28%). Modifications in terms of greater depression, anxiety, irritability and eating disturbances characterized the whole year after stroke. However, other symptoms emerged depending on distance from stroke: agitation, euphoria and aberrant motor behavior were significantly present only at 2 months, and apathetic behavior only in the post-acute phase (6 and 12 months) with nighttime disturbance