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PubMed2002

Merging pathways: music therapy in neurosurgical rehabilitation.

Relatively few departments of Music Therapy are found within neurosurgical rehabilitation clinics. In institutions where these departments exist, music therapy has become an integral part of multi-professional treatment and research activities (Gilbertson 1999). The diverse intervention strategies in Music Therapy focus upon auditory, motor, visual, cognitive and affective processing which are all involved in receptive and expressive musical behaviour and which affect related non-musical behaviour. A clear differentiation is made between primary and adjunct therapy roles. The related fields of neuromusicology, neuroanatomy, neuropsychology, music psychology and humanistic psychology are primary sources in the development of models of clinical application (Hodges 1996). Our main interests are focussed on the following issues and areas of clinical application: The initialisation of contact with patients in vegetative status Communicative interaction with patients who can not (initially) use verbal communication (aphasic disorders) Temporal motor organisation with patients with sensomotor disorders Cognitive organisation and mnemonic framework with patients with neuropsychological functional disorders (concentration, memory, perception) Treatment of spatial perception disorders (neglect) Enhancing personal and social integration following individual isolation, social withdrawal. These topics will be discussed and highlighted with clinical examples.

Humans↗
PubMed1979

Cognitive abilities and disabilities in infantile autism: a review.

The literature on various aspects of learning and performance in autistic children is reviewed and interpreted as indicating very little that is specific to autism. Inadequate and inconsistent methodology precludes generalizations concerning the nature of the disorder. It is suggested that future research should be particularly concerned with controlling for developmental influences on performance, and with investigation of the higher functioning autistic children who are less governed by retardation factors. The current evidence is considered to support a hypothesis concerning abnormal hemisphere functioning in this group of children.

Autistic Disorder↗
PubMed2001

Influence of a complementary treatment with oral enzymes on patients with colorectal cancers--an epidemiological retrolective cohort study.

PURPOSE: To evaluate the impact of postoperative treatment with an oral enzyme (OE) preparation given complementary to an antineoplastic therapy in patients with all stages of colorectal cancer. METHODS: The design of this epidemiological study was a retrolective cohort analysis with parallel groups. Design and conduct of the study were performed to current standards for prospective, controlled clinical trials. Of a cohort of 1,242 patients with colorectal cancer (documented in 213 centres), 616 had received complementary treatment with OE (182 OE only, 405 other complementary drugs, 29 protocol violators) and 626 had not received OE (368 control only, 229 other complementary drugs, 29 protocol violators). Of 1,162 patients who had undergone primary surgery, 526 received adjuvant chemotherapy and 218 radiotherapy. The median follow-up time for the OE group was 9.2 months and for the control group 6.1 months. The primary test criterion of efficacy for OE treatment was the multivariate effect size of the changes from baseline of the disease- and therapy-associated signs and symptoms (nausea, vomiting, changes in appetite, stomach pain or stomach disorder, tiredness, depression, memory or concentration disorder, sleep disturbance, dizziness, irritability, dyspnoea at rest, dyspnoea during activity, headache, tumour pain, cachexia, skin disorders and infections). Tumour-related events, e.g. death, were evaluated by the number of events observed and time to event. Safety of treatment with OE was analysed in terms of number and severity of adverse events, their duration, treatment and outcome. RESULTS: A significant reduction in disease-associated signs and symptoms was observed in patients treated with OE alone, but not in those receiving OE in addition to other complementary treatments. Adverse reactions to chemo- and radiotherapy were diminished in all patients receiving OE. Analysis of survival did not demonstrate a reduced number of deaths in the OE group. However, a trend to prolongation of survival was demonstrated, particularly in the patients with disease stage Dukes' D, in the subgroup receiving OE in addition to other complementary treatments. Similar but less-pronounced trends were observed for disease stages Dukes' B and C. In the OE group, 21 of 616 patients (3.4%) experienced OE-associated adverse reactions, all of them mild to moderate gastrointestinal symptoms. CONCLUSION: Complementary treatment of colorectal cancer patients with OE improves their quality of life by reducing both the signs and symptoms of the disease and the adverse reactions associated with adjuvant antineoplastic therapies. This epidemiological retrolective cohort analysis provides evidence that patients may also benefit by a prolongation of survival time. OE were generally well tolerated.

Administration, Oral↗
PubMed1989

The role of individual difference in determining the nature of comprehension defects in aphasia.

This study was concerned with the relationship between locus of lesion and subtypes of language comprehension defect in aphasia. Previous studies had indicated that performance in sound recognition identified two subtypes of aural comprehension deficit and that performance in pantomime recognition identified two subtypes of reading comprehension defect. Defects in sound recognition and pantomime recognition were found in association with a variety of lesion loci. However, comprehension defective aphasics with normal sound recognition or pantomime recognition had lesions closely similar in location and size to those of aphasics who performed poorly on these tests. Findings suggest that whether an aphasic with a language comprehension defect is impaired in sound recognition or pantomime recognition depends, at least in part, on individually variable predisposing factors. It would appear possible that this phenomenon reflects a separate dimension of hemispheric cerebral dominance.

Adult↗
PubMed1986

Neuropsychology of multiple sclerosis: a critical review.

Multiple sclerosis (MS) is a relatively common, chronic progressive neurological illness affecting individuals primarily in the third and fourth decades of life. Autopsy studies indicate that the disease preferentially attacks white matter throughout the CNS, including the cerebral hemispheres. This article reviews the current state of knowledge regarding cognitive dysfunction in MS and relates these findings to neuropathological changes. The view that affective disturbance may also result from cerebral demyelination is presented, along with a brief discussion of MS as a prototype "subcortical" dementia. Finally, methodological problems intrinsic to the study of MS are presented, and suggestions for future research are made.

Cognition Disorders↗
PubMed2006

The role of cognition in tinnitus.

CONCLUSIONS: The role of cognition in tinnitus is difficult to ignore. First, tinnitus is likely to disrupt cognitive functioning, and there are some indications that tinnitus patients have impaired capacity to perform certain cognitive tasks. Second, evidence is emerging that tinnitus patients show cognitive bias in the way they handle information. Such information processing style suggests either depressive functioning, or anxious vigilance, or both. Finally, self-report measures of tinnitus distress all require conscious recollection of how tinnitus is perceived and the consequences of tinnitus. Such reports necessitate cognitive capacity. OBJECTIVES: To review the literature on the interface between cognitive function and tinnitus, with special regard to the role of different levels of information processing. MATERIALS AND METHODS: A selective systematic literature search was conducted using the search engines of Medline and Psychological Abstracts, and by hand search of conference proceedings. RESULTS: There are yet relatively few published studies on cognitive functioning in tinnitus patients. Most research has been conducted by a few separate research groups. However, the available studies clearly implicate an important role of cognitive processes at different levels from basic cognitive function to more conscious appraisal of the consequences of tinnitus. Finally, a tentative model of the road from tinnitus generation to annoyance via cognitive function is suggested.

Cognition Disorders↗
PubMed2004

Posterior cortical atrophy: a review of the literature.

The past three decades have seen an accumulation of reports of neurodegenerative disease with disruption to visual processing. Disorders of both visuospatial processing and visual recognition have been described, though the former predominate. But the conundrum of posterior cortical atrophy (PCA) is that while the clinical presentation is relatively homogeneous, the nosological status remains something of a puzzle. Many cases coming to pathology have had Alzheimer's Disease (AD) but in a different distribution from that seen in typical AD (tAD). Patients with non-specific subcortical gliosis and, more occasionally, Creutzfeldt Jacob disease, neither of which have an obvious affinity with PCA, have also been described. On the other hand, no case of PCA has been reported with the pathology of either corticobasal degeneration or dementia with Lewy Bodies, both of which do commonly present with prominent parietal symptomatology.

Apraxias↗