Biomedical subjects

R M Ruff

Publications and source records attributed to R M Ruff.

At least 19 recordsLinked to original sources

PubMed1992

Parallel and serial visual search after closed head injury: electrophysiological evidence for perceptual dysfunctions.

Event-related potentials (ERPs) were recorded from closed head injury (CHI) patients at least 2 years postinjury and from controls in order to assess their parallel and serial processing abilities during visual search. In Experiment 1, stimuli consisted of arrays of eight triangles; half of the arrays contained a target item. In the "feature-present" condition, the target item was a triangle with an additional horizontal line that could be detected automatically and in parallel, while in the "feature-absent" condition all items except for the target triangle had an additional horizontal line, thus requiring a serial search. In Experiment 2, stimuli consisted of eight solid bars (50%), seven solid bars and a vertical open bar (25%), and seven solid bars and a horizontal open bar (25%): the array containing the horizontal bar served as a target. By recording ERPs to the arrays containing vertical open bars, which were similar to the target items, parallel processing of "pop-out" stimuli could be studied in the absence of any overt response. ERP data were compared with the results of neuropsychological and neuroimaging (MRI, CAT) examination. Patient exhibited a decreased behavioral performance both in the parallel and in the serial processing mode. Furthermore, abnormalities of early and intermediate ERP components (P1, N1, P2, N2) were found, whereas the late component (P3) was less affected by CHI. The results were interpreted as an index of CHI-induced dysfunctions in perceptual processes such as simple feature registration and early target discrimination. It was suggested that these dysfunctions contribute to impairments of parallel as well as serial processes in visual search.

Adult↗

PubMed1992

The Ruff 2 and 7 Selective Attention Test: a neuropsychological application.

The neuropsychological application of the Ruff 2 and 7 Selective Attention Test as a measure of visual selective attention was investigated. The instrument was constructed as a paper-and-pencil approach to evaluate sustained attention utilizing different distractor conditions in the study of voluntary or intentional aspects of attention. Four patient groups with cerebral lesions confined to either the right or left anterior or left or right posterior region (ns = 8, 8, 8, 6) were studied. Patients with right-hemispheric lesions showed a greater over-all reduction in processing speed independent of the serial or parallel processing mode in comparison to individuals with left-sided lesions. Furthermore, as predicted, the two groups with anterior brain damage showed a larger discrepancy between serial and parallel processing modes than patients with posterior lesions. Specifically, the right frontal cases showed the greatest differential of accuracy on the serial and parallel tasks.

Adult↗

PubMed1991

Vegetative state after closed-head injury. A Traumatic Coma Data Bank Report.

To elucidate the clinical course of the vegetative state after severe closed-head injury, the Traumatic Coma Data Bank was analyzed for outcome at the time of discharge from the hospital and after follow-up intervals ranging up to 3 years after injury. Of 650 patients with closed-head injury available for analysis, 93 (14%) were discharged in a vegetative state. In comparison with conscious survivors, patients in a vegetative state sustained more severe closed-head injury as reflected by the Glasgow Coma Scale scores and pupillary findings and more frequently had diffuse injury complicated by swelling or shift in midline structures. Of 84 patients in a vegetative state who provided follow-up data, 41% became conscious by 6 months, 52% regained consciousness by 1 year, and 58% recovered consciousness within the 3-year follow-up interval. A logistic regression failed to identify predictors of recovery from the vegetative state.

Adolescent↗

PubMed1991

Neuropsychological sequelae of arteriovenous malformations.

A total of 24 patients harboring arteriovenous malformations (AVMs) in either the dominant hemisphere (n = 12) or the nondominant hemisphere (n = 12) were examined neuropsychologically. When compared with 24 matched normal control subjects, the AVM patients demonstrated differential degrees of impairment in verbal or visuospatial processing, depending on whether the lesion involved the dominant or nondominant hemisphere. As predicted, most compelling were the findings of cognitive deficit associated with the hemisphere contralateral to the AVM relative to matched normal control subjects. Evidence of higher cortical dysfunction contralateral to the residing AVM is discussed in the context of cerebrovascular steal.

Adult↗

PubMed1990

Computer-assisted attention retraining in head-injured individuals: a controlled efficacy study of an outpatient program.

The efficacy of a computer-assisted attention retraining program was evaluated with 29 outpatients suffering from moderate to severe traumatic brain injury. Ss who were at least 12 months postinjury were randomly assigned either to the attention training program or a memory training program that served as a control condition. Training lasted 9 weeks with two 2-hr sessions per week for both groups. The experimental design evaluated outcome by juxtaposing a multiple baseline procedure for a 1st set of measures of attention and memory with a pre and post group comparison that relied on a 2nd set of neuropsychological tests. The experimental group improved significantly in comparison with the control group on measures of attention. The reversed pattern for the memory measures was not observed. None of the treatment effects generalized to the 2nd set of dependent variables.

Adolescent↗

PubMed1990

Neurobehavioral outcome 1 year after severe head injury. Experience of the Traumatic Coma Data Bank.

The outcome 1 year after they had sustained a severe head injury was investigated in patients who were admitted to the neurosurgery service at one of four centers participating in the Traumatic Coma Data Bank (TCDB). Of 300 eligible survivors, the quality of recovery 1 year after injury was assessed by at least the Glasgow Outcome Scale (GOS) in 263 patients (87%), whereas complete neuropsychological assessment was performed in 127 (42%) of the eligible survivors. The capacity of the patients to undergo neuropsychological testing 1 year after injury was a criterion of recovery as reflected by a significant relationship to neurological indices of acute injury and the GOS score at the time of hospital discharge. The neurobehavioral data at 1 year after injury were generally comparable across the four samples of patients and characterized by impairment of memory and slowed information processing. In contrast, language and visuospatial ability recovered to within the normal range. The lowest postresuscitation Glasgow Coma Scale (GCS) score and pupillary reactivity were predictive of the 1-year GOS score and neuropsychological performance. The lowest GCS score was especially predictive of neuropsychological performance 1 year postinjury in patients who had at least one nonreactive pupil following resuscitation. Notwithstanding limitations related to the scope of the TCDB and attrition in follow-up material, the results indicate a characteristic pattern of neurobehavioral recovery from severe head injury and encourage the use of neurobehavioral outcome measurements in clinical trials to evaluate interventions for head-injured patients.

Adolescent↗

PubMed1989

Motivational effects on neuropsychological functioning: comparison of depressed versus nondepressed individuals.

The neuropsychology of depression was examined in terms of organic and motivational hypotheses. Thirty medication-free depressed outpatients (selected according to Diagnostic and Statistical Manual of Mental Disorders [American Psychiatric Association, 1980] criteria for major depression) and 30 nondepressed normal controls were evaluated with a variety of neuropsychology measures. Prior to testing, subjects were assigned randomly to either a motivated or nonmotivated condition. A task measuring level of motivation demonstrated efficacy of the two motivation conditions. A 2 x 2 (Diagnosis x Motivational Level) multivariate analysis of variance of all the dependent measures revealed a significant main effect for depression, but no effect for motivation and no interaction. Univariate analyses demonstrated that the depressed group was impaired on visuospatial short-term memory and learning and on verbal learning. The finding of neuropsychological deficit in depressed subjects was not attributable to motivational factors. The problems with conceptualizing depression as a right-hemisphere dysfunction are discussed.

Depressive Disorder↗

PubMed1989

Selective Reminding Tests: a normative study of verbal learning in adults.

Verbal learning was assessed according to the Selective Reminding Test (SRT) in order to establish normative data and to provide a comparison with measures of immediate attention, verbal IQ, and verbal memory. The 392 subjects, stratified by sex (202 women, 190 men), age (4 groups: 16-70 years), and education (3 groups), were free of conflicting pathologies. Learning curves were established on centiles (75, 50, 25, 5). Sex differences favoring women were found in percent of finishers (those who reached criterion), and at all percentile levels of acquisition. Data were analyzed for group differences in performance on the SRT and related concurrent measures, but sex differences were not found on the VIQ or immediate attention tests. Also, assumptions of age and education stratification were not confirmed. However, those who completed the task were better able to form associational strategies than those who were unable to finish. The present data indicate that it is important to use detailed norms by gender and criterion level if clinical interpretations are to be valid.

Adolescent↗

PubMed1987

Neurobehavioral outcome following minor head injury: a three-center study.

The majority of hospital admissions for head trauma are due to minor injuries; that is, no or only transient loss of consciousness without major complications and not requiring intracranial surgery. Despite the low mortality rate following minor head injury, there is controversy surrounding the extent of morbidity and the long-term sequelae. The authors postulated that consecutively admitted patients who fulfilled research diagnostic criteria for minor head injury and who were carefully screened for antecedent neuropsychiatric disorder and prior head injury would exhibit subacute cognitive and memory deficits that would resolve over a period of 1 to 3 months postinjury. To evaluate this hypothesis, the neurobehavioral functioning of 57 patients was compared within 1 week after minor head injury (baseline) and at 1 month postinjury with that of 56 selected control subjects at three medical centers. Quantified tests of memory, attention, and information-processing speed revealed that neurobehavioral impairment demonstrated at baseline by all means of measurement generally resolved during the first 3 months after minor head injury. Although nearly all patients initially reported cognitive problems, somatic complaints, and emotional malaise, these postconcussion symptoms had substantially resolved by the 3-month follow-up examination. The data suggest that a single uncomplicated minor head injury produces no permanent disabling neurobehavioral impairment in the great majority of patients who are free of preexisting neuropsychiatric disorder and substance abuse.

Adolescent↗

PubMed1986

Automatic detection vs controlled search: a paper-and-pencil approach.

A new measure of selective attention was presented to 259 normal volunteers. The test was derived from earlier work which emphasized the importance of controlling the distracting conditions using a selective-attention paradigm. In the present study a paper-and-pencil, digit-cancellation format was introduced and the data documented a significant dissociation between tasks analogous to controlled search and automatic detection, two theoretically important aspects of selective attention. Presented is a discussion of similarities and differences of the new measure and classical methods of discriminating between controlled search and automatic detection and the potential significance of this discrimination in clinical neuropsychological investigations.

Adolescent↗

PubMed1986

On the consistency of the MMPI in borderline personality disorder.

14 patients diagnosed as having Borderline Personality Disorder were examined on two separate occasions with the MMPI. Results strongly suggest that, as a group, borderline patients are quite consistent responders on the MMPI under test-retest conditions (1 to 58 mo.). The frequency distribution of scale elevations and code types was also examined which showed the often-noted heterogeneity of profile code types within this population. Thus, a note of caution is advised for those investigators who assume that a prototypical borderline MMPI profile exists. Specifically, considerable heterogeneity is seen among this sample of patients with respect to a two-point coding strategy, and individual codes change over time.

Adult↗

PubMed1985

Orthodontic treatment and tongue surgery in a class III open-bite malocclusion. A case report.

Cases such as this are a real challenge to clinical orthodontists. They require patience as well as proper diagnosis and treatment planning. The orthodontist must also help the patient psychologically by treating the teeth and surrounding structures and by treating the patient as an individual. It is the feeling of both the Author and the Plastic surgeon in this case, Dr. Fernando Ortiz Monasterio, that this type of surgery would be successful in most non-pathological macroglossia cases. It appears that the sutured areas might be said to develop more dense epithelial tissue, not allowing the tongue to expand and readapt so readily to the position of the teeth in the mandibular arch. This is indicated in the present case, as is demonstrated by the decrease in width of the mandibular arch from the first molar area to the anterior part of the mouth. It should be noted that orthognathic surgery was not as widely used at the time that this patient was studied and treated as it is today. If this case had presented for the first time this year, it is likely that the treatment plan of most orthodontists would have combined orthognathic and tongue surgery, with orthodontics to lessen trauma to the supporting structures of the teeth from the extreme and complicated mechanics which would have to be used in treatment. The psychological aspects of this case were of tremendous importance; the treatment results have undoubtedly changed his life completely (Fig. 10). Once unable to speak clearly with his oversize tongue, he has since gone on to complete his education and is now a successful orthodontist.

Adult↗

PubMed1985

Audiospatial integration.

A method to examine audiospatial integration was developed through studies of normal and brain-injured patients. The method used a sound source sequentially outlining a spatial pattern within an array of 100 loudspeakers. For 48 subjects tested with this method, the presence or absence of visual cues had no effect in audiospatial processing. Eye movements also did not match the perceived sound patterns. Significantly higher hit rates were obtained by placing the panel of loudspeakers in front, behind or above the subject rather than on the left or right. These differences were observed with involuntary but not with voluntary head-fixation. Theoretical concepts of audiospatial processing are discussed.

Acoustic Stimulation↗

PubMed1985

Verbal fluency and figural fluency in bright children.

Intellectually bright children in Grades 2, 4, and 6 from one school and adults were assessed on measures of verbal and on a new measure of figural fluency. Consistent with previous research, age-dependent performance was observed on both fluency tasks. Analysis of covariance with motor speed as the covariate reduced the F ratio for the figural task, although age-related significant differences persisted. Results suggest that age-related improvement of performance on fluency measures with intellectually bright subjects differs from that for intellectually average subjects. Hypotheses are also advanced regarding the proposed reliable figural-fluency task as preferable to previously employed nonverbal measures, suggesting a more valid dissociation of function. These preliminary findings encourage further research on the age- and IQ-related aspects of verbal and figural fluency.

Adult↗

PubMed1985