Yearly Neuropsychological Results

Too often insurance company lawyers try to prove that a person gets well after moderate and even severe traumatic brain injury.  They do this as part of damage control in cases where a person sustains traumatic brain injury and complains of impairments years after the injury.  You need to hire a traumatic brain injury lawyer when you are considering your case.

 A new study reveals that changes in learning and processing speed during the first year of recovery are sensitive indicators when predicting long-term disability and degree of functional independence, though absolute performance at 1 year is also highly associated with functional outcome at 2 years post-injury.

The Study is published in The Clinical Neuropsychologist (Neuropsychology, Development and Cognition: Sec, Volume 25, Number 1, January 2011 , pp. 72-89(18)

Read the abstract here.

Women Beat Men

Women come in first again!  This time it's officially scientific:

Women are better than men at distinguishing between emotions, especially fear and disgust, according to a new study published in the online version of the journal Neuropsychologia....

While women have long been thought to outperform men in neuropsychological tests, until now, these findings were inconsistent. To obtain more conclusive evidence, the Université de Montréal researchers did not use photographs to analyze the reaction of subjects. Instead, the scientists hired actors and actresses to simulate fear and disgust. "Facial movements have been shown to play an important role in the perception of an emotion's intensity as well as stimulate different parts of the brain used in the treatment of such information," says Collignon, who also works as a researcher at the Université catholique de Louvain's Institute of Neuroscience in Belgium.

Read More.

New Study on Neuropsychological Tasks

An interesting study comparing the effect of dual tests on memory and activities of daily living in truamatic brain injury patients was released.

According to a study from Nagoya, Japan, "We quantitatively evaluated memory performance in patients in the chronic stage of closed traumatic brain injury using dual visual tasks."

"Simple memory tests and questionnaires concerning activities of daily living (ADL) were also utilized to evaluate any correlation with the results of the dual tasks. The results of dual tasks and memory tests were correlated with the daily activity scores, but there was no correlation between the results of dual tasks and memory tests," wrote J. Hasegawa and colleagues, Nagoya University, Medical Department.

The researchers concluded: "We concluded that the dual task was effective for detecting memory and ADL disturbances, which were not disclosed by conventional memory tests."

"Data on clinical and experimental neuropsychology described by researchers at Nagoya University, Medical Department." Psychology & Psychiatry Journal. NewsRX. 2009. Retrieved May 08, 2009 from HighBeam Research: http://www.highbeam.com/doc/1G1-198635191.html
 

Brain Damage

Brain damage may occur due to a wide range of conditions, illnesses, injuries, and as a result of iatrogenesis. Possible causes of widespread (diffuse) brain damage include prolonged hypoxia (shortage of oxygen), poisoning by teratogens (including alcohol), infection, and neurological illness. Chemotherapy can cause brain damage to the neural stem cells and oligodendrocyte cells that produce myelin. Common causes of focal or localized brain damage are physical trauma (traumatic brain injury), stroke, aneurysm, surgery, or neurological illness.

The extent and effect of brain injury is often assessed by the use of neurological examination, neuroimaging, and neuropsychological assessment.

Brain injury does not necessarily result in long-term impairment or disability, although the location and extent of damage both have a significant effect on the likely outcome. In serious cases of brain injury, the result can be permanent disability, including neurocognitive deficits, delusions (often specifically monothematic delusions), speech or movement problems, and mental handicap. There may also be personality changes. Severe brain damage may result in persistent vegetative state, coma, or death.

Various professions may be involved in the medical care and rehabilitation of someone who suffers impairment after brain damage. Neurologists, neurosurgeons, and physiatrists are physicians who specialise in treating brain injury. Neuropsychologists (especially clinical neuropsychologists) are psychologists who specialise in understanding the effects of brain injury and may be involved in assessing the extent of brain damage or creating rehabilitation programmes. Occupational therapists may be involved in running rehabilitation programs to help restore lost function or help re-learn essential skills.

It is a common misconception that brain damage sustained during childhood has a better chance of successful recovery than similar injury acquired in adult life. It is contested that in recent studies, severe brain damage inflicted upon children can be alleviated by the interaction of nicotinamide repropagation in nerve cells. In fact, the consequences of childhood injury may simply be more difficult to detect in the short term. This is because different cortical areas mature at different stages, with some major cell populations and their corresponding cognitive faculties remaining unrefined until early adulthood. In the case of a child with frontal brain injury, for example, the impact of the damage may be undetectable until that child fails to develop normal executive functions in his or her late teens and early twenties.

The effects of impairment or disability resulting from brain injury may be treated by a number of methods, including medication, psychotherapy, neuropsychological rehabilitation, snoezelen, surgery, or physical implants such as deep brain stimulation.

APA Statement

The American Psychological Association has published a Statement on Third Party Evaluations in Psychological Testing and Assessment.

An often encountered problem with defense psychological exams is the misuse of testing protocols by defense financed neuropsychologists.  This is often hard to discover since the psychologists frequently complain that allowing third party's to observe testing invalidates the results.  Another argument is that the observation violates copyright.

Having this issue addressed, specifically for the litigation context, is a good thing for genuinely injured examinees who are subject to the manipulation of dishonest psychologists.  Certain psychologists manipulate the exam to obtain results that accuse the examinee of malingering or being dishonest.  Who better then the psychologist to know how to manipulate the data?

Allowing the unintrusive observation of exams by third parties will promote honest evaluations.  Perhaps now the justice that should be afforded to those who have genuine injury will start emerging without the manipulation of dishonest psychological examiners.

Soldiers Finally Getting Fighting Chance!

I am pleased to learn that the military has set up a process of detecting and treating soldiers with brain injury.  The Associated Press published an article today about testing military personnel before they are sent into service.  This mini-neuropsychological test is designed to measure memory and attention, among other cognitive domains, before an injury occurs. 

Before they leave for Iraq, thousands of troops with the 101st Airborne Division line up at laptop computers to take a test: basic math, matching numbers and symbols, and identifying patterns. They press a button quickly to measure response time.

It's all part of a fledgling Army program that records how soldiers' brains work when healthy, giving doctors baseline data to help diagnose and treat the soldiers if they suffer a traumatic brain injury — the signature injury of the Iraq war.

There are an extimated 30% of patients at Walter Reed Hospital receiving care for brain injury.  Of those suffering from what is misleadingly referred to as "mild traumatic brain injury," an estimated 20% go on to suffer permanent lingering problems.  According to research. Walter Reed found that irritability and memory, two classic symtoms of brain injury, are reported more on return home then in the battlefield.

Soldiers sometimes walk away from explosions with no obvious injuries. But the concussion from the blast can have a lingering effect that is not always immediately apparent.

"They look physically normal, but their neurocognitive performance is off," said Col. Mary Lopez, a physician specializing in occupational therapy.

Most brain injuries are mild, and soldiers can recover with rest and time away from the battlefield. But the military estimates that one-fifth of the troops with these mild injuries will have prolonged or lifelong symptoms requiring continuing care.

So little is known about traumatic brain injuries that these baseline readings could become an important cornerstone for future study.

To read the full article click here.