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Biomedical subjects

L Fasotti

Publications and source records attributed to L Fasotti.

5 recordsLinked to original sources

Positive behavioural disturbances in the rehabilitation phase after severe traumatic brain injury: an historic cohort study.

PRIMARY OBJECTIVE: To investigate the association of post-traumatic amnesia (PTA) with positive behavioural disturbances (PBD) in an historic cohort of patients with severe traumatic brain injury (TBI) and to evaluate the use and effects of neuroleptic drugs in this cohort. RESEARCH DESIGN: Historic cohort study. METHODS: The medical files of 60 patients with severe TBI, selected for inpatient rehabilitation during a period of 5.5 years, were independently examined for the presence of PTA and PBD at admission in the rehabilitation centre as well as for the concomitant use of neuroleptic drugs. All TBI patients with PBD at admission were subjected to special nursing measures consisting of a structured and safe environment, a minimum number of caregivers and provision of simple and consistent feedback. As a basic policy, the use of neuroleptic medication was minimized or stopped. RESULTS: Of the 28 patients suffering from PTA at admission, 16 demonstrated PBD (positive predictive value 0.57 (95% CI 0.45-0.70)). In contrast, all the 32 patients without PTA but one did not show PBD (negative predictive value 0.97 (95% CI 0.93-1.00)). Seven of the 17 patients with PBD (41%) had been prescribed neuroleptic medication, of whom five patients (81%) experienced undesired side effects. Because of the special nursing measures, these drugs could be stopped or substituted by non-neuroleptic behaviour-modifying drugs in all patients within 3 weeks, without aggravation of their PBD. CONCLUSIONS: These results suggest that impaired attention and memory may play a critical role in the development of PBD in patients with severe TBI. From this perspective, maximum effort must be made to improve TBI patients' level of attention, memory and orientation instead of using mechanical or chemical restraints.

Adult↗

Development of neuropsychiatric symptoms in poststroke patients: a cross-sectional study.

OBJECTIVE: The study aimed to characterize neuropsychiatric symptomatology and its evolution in a large group of poststroke patients during their first year. METHOD: The Neuropsychiatric Inventory (NPI) was administered to a sample of 124 poststroke patients, divided into three independent groups on the basis of time from stroke (2, 6 and 12 months). The controls were 61 healthy subjects. RESULTS: A wide range of neuropsychiatric symptoms was found significant in the poststroke population: mostly depression (61%), irritability (33%), eating disturbances (33%), agitation (28%), apathy (27%) and anxiety (23%). Modifications in terms of greater depression, anxiety, irritability and eating disturbances evolved in the year following stroke. Other symptoms were significantly present depending on time from stroke. Clear relations with other clinical and demographic variables were also found. CONCLUSION: Neuropsychiatric symptoms constitute an important part of comorbidity in stroke patients; thus, suitable assessment tools may improve clinical understanding of these patients.

Aged↗

Stroop interference and disorders of selective attention.

Fourteen patients with right-hemisphere CVA and 8 patients with a left-hemisphere CVA were examined for selective attention deficits using a variant of the Stroop color-word task: the picture-word interference task. Experiments 1 and 2 first compared the performance of the two patient groups and a control group in three tasks of increasing difficulty: picture-word detection, word reading, and picture naming. The results showed that (a) the two patient groups were significantly slower than the control group, but did not differ from each other, and (b) the difference in mean RT between the two patient groups and the control group did not increase with task difficulty. In Experiment 3, the subjects were required to name pictures while ignoring accompanying distractors: nonletter symbols, unrelated words or semantically related words. In this task, the right hemisphere patients showed a much larger semantic interference effect than both the left hemisphere patients and the control group. It is argued that this finding most probably reflects problems in visual selective attention with the right hemisphere patients.

Aged↗

Categorization of arithmetic word problems by normals, frontal and posterior-injured patients.

An important stage in the solution of mathematical word problems is the formation of a global internal representation of the problem. There is ample evidence that the recognition of problem schemata or problem types plays a major role in this representation stage. In the present study, a sorting task is used in order to examine the knowledge of arithmetical word-problem schemata in a group of normals, a group of patients with frontal lesions, and a group of patients with left posterior brain lesions. Quantitative and qualitative analyses show that normals classify the word problems according to principles that are essential for problem solving. These analyses also reveal that the general sorting dimensions of the frontal and the left posterior brain-damaged groups, as measured by a multidimensional scaling procedure, are similar. Cluster analysis shows that both groups base their sorting behavior mainly on superficial text characteristics, such as the objects found in the various word problems. The implications of these differences in sorting behavior for arithmetical word-problem solving are discussed.

Adult↗

The internal representation of arithmetical word problem sentences: frontal and posterior-injured patients compared.

Patients with frontal and left posterior brain lesions have severe difficulties in arithmetical word problem solving. In the present study the origin of these difficulties is investigated from an information-processing perspective. Following this perspective the first stage in word problem solving consists of a translation of individual sentences to an internal representation. This translation process is examined in 30 frontal patients, 10 left posterior-injured patients, and 10 healthy controls with a recognition and a sentence-picture matching task. In addition, the relationship between sentence representation and arithmetical word problem solving is studied. The results suggest that error rates in the translation of different types of arithmetical word problem propositions differ substantially in our three groups. A relationship between translation skills and arithmetical word problem solving ability is also found.

Adolescent↗