Behavioural Neurology The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Traumatic Brain Injury Rehabilitation in Hong Kong: A Review of Practice and Research Thu, 08 Oct 2015 17:25:27 +0000 Background. The rising public health concern regarding traumatic brain injury (TBI) implies a growing need for rehabilitation services for patients surviving TBI. Methods. To this end, this paper reviews the practices and research on TBI rehabilitation in Hong Kong so as to inform future developments in this area. This paper begins by introducing the general situation of TBI patients in Hong Kong and the need for rehabilitation. Next, the trauma system in Hong Kong is introduced. Following that is a detailed description of the rehabilitation services for TBI patients in Hong Kong, as exemplified by a rehabilitation hospital in Hong Kong. This paper will also review intervention studies on rehabilitating brain-injured populations in Hong Kong with respect to various rehabilitation goals. Lastly, the implications of culture-related issues will be discussed in relation to TBI. Results/Conclusions. The intervention studies conducted in Hong Kong are generally successful in achieving various rehabilitative outcomes. Additionally, certain cultural-related issues, such as the stigma associated with TBI, may impede the rehabilitative process and lead to various psychosocial problems. Junhong Yu, Helena M. K. Tam, and Tatia M. C. Lee Copyright © 2015 Junhong Yu et al. All rights reserved. Musical Sequence Learning and EEG Correlates of Audiomotor Processing Wed, 07 Oct 2015 13:06:18 +0000 Our motor and auditory systems are functionally connected during musical performance, and functional imaging suggests that the association is strong enough that passive music listening can engage the motor system. As predictive coding constrains movement sequence selections, could the motor system contribute to sequential processing of musical passages? If this is the case, then we hypothesized that the motor system should respond preferentially to passages of music that contain similar sequential information, even if other aspects of music, such as the absolute pitch, have been altered. We trained piano naive subjects with a learn-to play-by-ear paradigm, to play a simple melodic sequence over five days. After training, we recorded EEG of subjects listening to the song they learned to play, a transposed version of that song, and a control song with different notes and sequence from the learned song. Beta band power over sensorimotor scalp showed increased suppression for the learned song, a moderate level of suppression for the transposed song, and no suppression for the control song. As beta power is associated with attention and motor processing, we interpret this as support of the motor system’s activity during covert perception of music one can play and similar musical sequences. Matt D. Schalles and Jaime A. Pineda Copyright © 2015 Matt D. Schalles and Jaime A. Pineda. All rights reserved. Sound Richness of Music Might Be Mediated by Color Perception: A PET Study Wed, 07 Oct 2015 07:47:45 +0000 Objects. We investigated the role of the fusiform cortex in music processing with the use of PET, focusing on the perception of sound richness. Method. Musically naïve subjects listened to familiar melodies with three kinds of accompaniments: (i) an accompaniment composed of only three basic chords (chord condition), (ii) a simple accompaniment typically used in traditional music text books in elementary school (simple condition), and (iii) an accompaniment with rich and flowery sounds composed by a professional composer (complex condition). Using a PET subtraction technique, we studied changes in regional cerebral blood flow (rCBF) in simple minus chord, complex minus simple, and complex minus chord conditions. Results. The simple minus chord, complex minus simple, and complex minus chord conditions regularly showed increases in rCBF at the posterior portion of the inferior temporal gyrus, including the LOC and fusiform gyrus. Conclusions. We may conclude that certain association cortices such as the LOC and the fusiform cortex may represent centers of multisensory integration, with foreground and background segregation occurring at the LOC level and the recognition of richness and floweriness of stimuli occurring in the fusiform cortex, both in terms of vision and audition. Masayuki Satoh, Ken Nagata, and Hidekazu Tomimoto Copyright © 2015 Masayuki Satoh et al. All rights reserved. Assessment of Hair Aluminum, Lead, and Mercury in a Sample of Autistic Egyptian Children: Environmental Risk Factors of Heavy Metals in Autism Mon, 05 Oct 2015 11:24:19 +0000 Background and Aims. The etiological factors involved in the etiology of autism remain elusive and controversial, but both genetic and environmental factors have been implicated. The aim of this study was to assess the levels and possible environmental risk factors and sources of exposure to mercury, lead, and aluminum in children with autism spectrum disorder (ASD) as compared to their matched controls. Methods. One hundred ASD children were studied in comparison to 100 controls. All participants were subjected to clinical evaluation and measurement of mercury, lead, and aluminum through hair analysis which reflects past exposure. Results. The mean Levels of mercury, lead, and aluminum in hair of the autistic patients were significantly higher than controls. Mercury, lead, and aluminum levels were positively correlated with maternal fish consumptions, living nearby gasoline stations, and the usage of aluminum pans, respectively. Conclusion. Levels of mercury, lead, and aluminum in the hair of autistic children are higher than controls. Environmental exposure to these toxic heavy metals, at key times in development, may play a causal role in autism. Farida El Baz Mohamed, Eman Ahmed Zaky, Adel Bassuoni El-Sayed, Reham Mohammed Elhossieny, Sally Soliman Zahra, Waleed Salah Eldin, Walaa Yousef Youssef, Rania Abdelmgeed Khaled, and Azza Mohamed Youssef Copyright © 2015 Farida El Baz Mohamed et al. All rights reserved. Music Perception Influences Language Acquisition: Melodic and Rhythmic-Melodic Perception in Children with Specific Language Impairment Mon, 05 Oct 2015 07:58:34 +0000 Language and music share many properties, with a particularly strong overlap for prosody. Prosodic cues are generally regarded as crucial for language acquisition. Previous research has indicated that children with SLI fail to make use of these cues. As processing of prosodic information involves similar skills to those required in music perception, we compared music perception skills (melodic and rhythmic-melodic perception and melody recognition) in a group of children with SLI (, five-year-olds) to two groups of controls, either of comparable age (, five-year-olds) or of age closer to the children with SLI in their language skills and about one year younger (, four-year-olds). Children with SLI performed in most tasks below their age level, closer matching the performance level of younger controls with similar language skills. These data strengthen the view of a strong relation between language acquisition and music processing. This might open a perspective for the possible use of musical material in early diagnosis of SLI and of music in SLI therapy. Stephan Sallat and Sebastian Jentschke Copyright © 2015 Stephan Sallat and Sebastian Jentschke. All rights reserved. The Influence of Music on Prefrontal Cortex during Episodic Encoding and Retrieval of Verbal Information: A Multichannel fNIRS Study Mon, 05 Oct 2015 06:35:53 +0000 Music can be thought of as a complex stimulus able to enrich the encoding of an event thus boosting its subsequent retrieval. However, several findings suggest that music can also interfere with memory performance. A better understanding of the behavioral and neural processes involved can substantially improve knowledge and shed new light on the most efficient music-based interventions. Based on fNIRS studies on music, episodic encoding, and the dorsolateral prefrontal cortex (PFC), this work aims to extend previous findings by monitoring the entire lateral PFC during both encoding and retrieval of verbal material. Nineteen participants were asked to encode lists of words presented with either background music or silence and subsequently tested during a free recall task. Meanwhile, their PFC was monitored using a 48-channel fNIRS system. Behavioral results showed greater chunking of words under the music condition, suggesting the employment of associative strategies for items encoded with music. fNIRS results showed that music provided a less demanding way of modulating both episodic encoding and retrieval, with a general prefrontal decreased activity under the music versus silence condition. This suggests that music-related memory processes rely on specific neural mechanisms and that music can positively influence both episodic encoding and retrieval of verbal information. Laura Ferreri, Emmanuel Bigand, Patrick Bard, and Aurélia Bugaiska Copyright © 2015 Laura Ferreri et al. All rights reserved. Neurophysiological Indicators of Residual Cognitive Capacity in the Minimally Conscious State Sun, 04 Oct 2015 15:15:36 +0000 Background. The diagnostic usefulness of electrophysiological methods in assessing disorders of consciousness (DoC) remains to be established on an individual patient level, and there is need to determine what constitutes robust experimental paradigm to elicit electrophysiological indices of covert cognitive capacity. Objectives. Two tasks encompassing active and passive conditions were explored in an event-related potentials (ERP) study. The task robustness was studied in healthy controls, and their utility to detect covert signs of command-following on an individual patient level was investigated in patients in a minimally conscious state (MCS). Methods. Twenty healthy controls and 20 MCS patients participated. The active tasks included (1) listening for a change of pitch in the subject’s own name (SON) and (2) counting SON, both contrasted to passive conditions. Midline ERPs are reported. Results. A larger P3 response was detected in the counting task compared to active listening to pitch change in the healthy controls. On an individual level, the counting task revealed a higher rate of responders among both healthy subjects and MCS patients. Conclusion. ERP paradigms involving actively counting SON represent a robust paradigm in probing for volitional cognition in minimally conscious patients and add important diagnostic information in some patients. Solveig L. Hauger, Caroline Schnakers, Stein Andersson, Frank Becker, Torgeir Moberget, Joseph T. Giacino, Anne-Kristine Schanke, and Marianne Løvstad Copyright © 2015 Solveig L. Hauger et al. All rights reserved. Interaction of Musicianship and Aging: A Comparison of Cortical Auditory Evoked Potentials Sun, 04 Oct 2015 11:43:58 +0000 Objective. The goal of this study was to begin to explore whether the beneficial auditory neural effects of early music training persist throughout life and influence age-related changes in neurophysiological processing of sound. Design. Cortical auditory evoked potentials (CAEPs) elicited by harmonic tone complexes were examined, including P1-N1-P2, mismatch negativity (MMN), and P3a. Study Sample. Data from older adult musicians () and nonmusicians () (ages 55–70 years) were compared to previous data from young adult musicians () and nonmusicians () (ages 18–33 years). Results. P1-N1-P2 amplitudes and latencies did not differ between older adult musicians and nonmusicians; however, MMN and P3a latencies for harmonic tone deviances were earlier for older musicians than older nonmusicians. Comparisons of P1-N1-P2, MMN, and P3a components between older and young adult musicians and nonmusicians suggest that P1 and P2 latencies are significantly affected by age, but not musicianship, while MMN and P3a appear to be more sensitive to effects of musicianship than aging. Conclusions. Findings support beneficial influences of musicianship on central auditory function and suggest a positive interaction between aging and musicianship on the auditory neural system. Jennifer L. O’Brien, Dee A. Nikjeh, and Jennifer J. Lister Copyright © 2015 Jennifer L. O’Brien et al. All rights reserved. Inferior Frontal Gyrus Activation Underlies the Perception of Emotions, While Precuneus Activation Underlies the Feeling of Emotions during Music Listening Sun, 04 Oct 2015 08:54:24 +0000 While music triggers many physiological and psychological reactions, the underlying neural basis of perceived and experienced emotions during music listening remains poorly understood. Therefore, using functional magnetic resonance imaging (fMRI), I conducted a comparative study of the different brain areas involved in perceiving and feeling emotions during music listening. I measured fMRI signals while participants assessed the emotional expression of music (perceived emotion) and their emotional responses to music (felt emotion). I found that cortical areas including the prefrontal, auditory, cingulate, and posterior parietal cortices were consistently activated by the perceived and felt emotional tasks. Moreover, activity in the inferior frontal gyrus increased more during the perceived emotion task than during a passive listening task. In addition, the precuneus showed greater activity during the felt emotion task than during a passive listening task. The findings reveal that the bilateral inferior frontal gyri and the precuneus are important areas for the perception of the emotional content of music as well as for the emotional response evoked in the listener. Furthermore, I propose that the precuneus, a brain region associated with self-representation, might be involved in assessing emotional responses. Ken-ichi Tabei Copyright © 2015 Ken-ichi Tabei. All rights reserved. The Mismatch Negativity: An Indicator of Perception of Regularities in Music Sun, 04 Oct 2015 08:51:39 +0000 This paper reviews music research using Mismatch Negativity (MMN). MMN is a deviation-specific component of auditory event-related potential (EPR), which detects a deviation between a sound and an internal representation (e.g., memory trace). Recent studies have expanded the notion and the paradigms of MMN to higher-order music processing such as those involving short melodies, harmony chord, and music syntax. In this vein, we firstly reviewed the evolution of MMN from sound to music and then mainly compared the differences of MMN features between musicians and nonmusicians, followed by the discussion of the potential roles of the training effect and the natural exposure in MMN. Since MMN can serve as an index of neural plasticity, it thus can be widely used in clinical and other applied areas, such as detecting music preference in newborns or assessing wholeness of central auditory system of hearing illness. Finally, we pointed out some open questions and further directions. Current music perception research using MMN has mainly focused on relatively low hierarchical structure of music perception. To fully understand the neural substrates underlying processing of regularities in music, it is important and beneficial to combine MMN with other experimental paradigms such as early right-anterior negativity (ERAN). Xide Yu, Tao Liu, and Dingguo Gao Copyright © 2015 Xide Yu et al. All rights reserved. A Voxel-Based Morphometry Study of the Brain of University Students Majoring in Music and Nonmusic Disciplines Thu, 01 Oct 2015 08:57:51 +0000 The brain changes flexibly due to various experiences during the developmental stages of life. Previous voxel-based morphometry (VBM) studies have shown volumetric differences between musicians and nonmusicians in several brain regions including the superior temporal gyrus, sensorimotor areas, and superior parietal cortex. However, the reported brain regions depend on the study and are not necessarily consistent. By VBM, we investigated the effect of musical training on the brain structure by comparing university students majoring in music with those majoring in nonmusic disciplines. All participants were right-handed healthy Japanese females. We divided the nonmusic students into two groups and therefore examined three groups: music expert (ME), music hobby (MH), and nonmusic (NM) group. VBM showed that the ME group had the largest gray matter volumes in the right inferior frontal gyrus (IFG; BA 44), left middle occipital gyrus (BA 18), and bilateral lingual gyrus. These differences are considered to be caused by neuroplasticity during long and continuous musical training periods because the MH group showed intermediate volumes in these regions. Kanako Sato, Eiji Kirino, and Shoji Tanaka Copyright © 2015 Kanako Sato et al. All rights reserved. Melodic Contour Training and Its Effect on Speech in Noise, Consonant Discrimination, and Prosody Perception for Cochlear Implant Recipients Thu, 01 Oct 2015 08:25:08 +0000 Cochlear implant (CI) recipients generally have good perception of speech in quiet environments but difficulty perceiving speech in noisy conditions, reduced sensitivity to speech prosody, and difficulty appreciating music. Auditory training has been proposed as a method of improving speech perception for CI recipients, and recent efforts have focussed on the potential benefits of music-based training. This study evaluated two melodic contour training programs and their relative efficacy as measured on a number of speech perception tasks. These melodic contours were simple 5-note sequences formed into 9 contour patterns, such as “rising” or “rising-falling.” One training program controlled difficulty by manipulating interval sizes, the other by note durations. Sixteen adult CI recipients (aged 26–86 years) and twelve normal hearing (NH) adult listeners (aged 21–42 years) were tested on a speech perception battery at baseline and then after 6 weeks of melodic contour training. Results indicated that there were some benefits for speech perception tasks for CI recipients after melodic contour training. Specifically, consonant perception in quiet and question/statement prosody was improved. In comparison, NH listeners performed at ceiling for these tasks. There was no significant difference between the posttraining results for either training program, suggesting that both conferred benefits for training CI recipients to better perceive speech. Chi Yhun Lo, Catherine M. McMahon, Valerie Looi, and William F. Thompson Copyright © 2015 Chi Yhun Lo et al. All rights reserved. Sexual Functioning, Desire, and Satisfaction in Women with TBI and Healthy Controls Thu, 01 Oct 2015 07:17:51 +0000 Traumatic brain injury (TBI) can substantially alter many areas of a person’s life and there has been little research published regarding sexual functioning in women with TBI. Methods. A total of 58 women (29 with TBI and 29 healthy controls) from Neiva, Colombia, participated. There were no statistically significant differences between groups in sociodemographic characteristics. All 58 women completed the Sexual Quality of Life Questionnaire (SQoL), Female Sexual Functioning Index (FSFI), Sexual Desire Inventory (SDI), and the Sexual Satisfaction Index (ISS). Results. Women with TBI scored statistically significantly lower on the SQoL (), FSFI subscales of desire (), arousal (), lubrication (), orgasm (), and satisfaction (), and the ISS () than healthy controls. Multiple linear regressions revealed that age was negatively associated with some sexuality measures, while months since the TBI incident were positively associated with these variables. Conclusion. These results disclose that women with TBI do not fare as well as controls in these measures of sexual functioning and were less sexually satisfied. Future research is required to further understand the impact of TBI on sexual function and satisfaction to inform for rehabilitation programs. Jenna Strizzi, Laiene Olabarrieta Landa, Monique Pappadis, Silvia Leonor Olivera, Edgar Ricardo Valdivia Tangarife, Inmaculada Fernandez Agis, Paul B. Perrin, and Juan Carlos Arango Lasprilla Copyright © 2015 Jenna Strizzi et al. All rights reserved. Exploring Vocational Evaluation Practices following Traumatic Brain Injury Thu, 01 Oct 2015 06:31:56 +0000 Background. Individuals with traumatic brain injury (TBI) face many challenges when attempting to return to work (RTW). Vocational evaluation (VE) is a systematic process that involves assessment and appraisal of an individual’s current work-related characteristics and abilities. Objective. The aims of this study are to (1) examine demographic and employment characteristics of vocational rehabilitation providers (VRPs), (2) identify the specific evaluation methods that are used in the VE of individuals with TBI, and (3) examine the differences in assessment method practices based upon evaluator assessment preferences. Methods. This exploratory case study used a forty-six-item online survey which was distributed to VRPs. Results. One hundred and nine VRPs accessed the survey. Of these, 74 completed the survey. A majority of respondents were female (79.7%), Caucasian (71.6%), and holding a master’s degree (74.3%), and more than half (56.8%) were employed as state vocational rehabilitation counselors (VRCs). In addition, over two-thirds (67.6%) were certified rehabilitation counselors (CRCs). Respondents reported using several specific tools and assessments during the VE process. Conclusions. Study findings reveal differences in use of and rationales for specific assessments amongst VRPs. Understanding VRP assessment practices and use of an evidence-based framework for VE following TBI may inform and improve VE practice. Christina Dillahunt-Aspillaga, Tammy Jorgensen Smith, Ardis Hanson, Sarah Ehlke, Mary Stergiou-Kita, Charlotte G. Dixon, and Davina Quichocho Copyright © 2015 Christina Dillahunt-Aspillaga et al. All rights reserved. Production of Verb Tense in Agrammatic Aphasia: A Meta-Analysis and Further Data Sun, 20 Sep 2015 07:01:15 +0000 In a majority of languages, the time of an event is expressed by marking tense on the verb. There is substantial evidence that the production of verb tense in sentences is more severely impaired than other functional categories in persons with agrammatic aphasia. The underlying source of this verb tense impairment is less clear, particularly in terms of the relative contribution of conceptual-semantic and processing demands. This study aimed to provide a more precise characterization of verb tense impairment by examining if there is dissociation within tenses (due to conceptual-semantic differences) and an effect of experimental task (mediated by processing limitations). Two sources of data were used: a meta-analysis of published research (which yielded 143 datasets) and new data from 16 persons with agrammatic aphasia. Tensed verbs were significantly more impaired than neutral (nonfinite) verbs, but there were no consistent differences between past, present, and future tenses. Overall, tense accuracy was mediated by task, such that picture description task was the most challenging, relative to sentence completion, sentence production priming, and grammaticality judgment. An interaction between task and tense revealed a past tense disadvantage for a sentence production priming task. These findings indicate that verb tense impairment is exacerbated by processing demands of the elicitation task and the conceptual-semantic differences between tenses are too subtle to show differential performance in agrammatism. Yasmeen Faroqi-Shah and Laura Friedman Copyright © 2015 Yasmeen Faroqi-Shah and Laura Friedman. All rights reserved. Elevated Blood Ammonia Level Is a Potential Biological Risk Factor of Behavioral Disorders in Prisoners Thu, 17 Sep 2015 12:16:32 +0000 Hydrothion (H2S) and ammonia (NH3) can be toxic for the human central nervous system and cause psychological disturbances and behavioral disorders. In order to evaluate the association between the two potential toxicants and mental health, in this study, we compare a male prisoner and control population. Forty-nine male prisoners and 52 control volunteers took part in the study. An aggressive behavior assessment, the Self-Rating Depression Scale (SDS), and the State-Trait Anxiety Inventory (STAI) were used to characterize the participants’ mental health status. Venous blood was collected for detection of H2S and NH3. The results indicated that blood NH3 was significantly higher in male prisoners than in controls. However, blood H2S was significantly lower. Blood NH3 was also significantly and positively correlated with prisoners. In the multivariate adjusted models, after controlling for age, education, marital status, and BMI, we found a positive association between NH3 and prisoners, but not blood H2S. While the functions of the two toxicants were quite different, blood NH3 may be a potential biological risk factor for behavioral disorders and blood H2S showed neuroprotection. Additionally, the impact of other factors such as diet and gut bacteria should be considered when evaluating risk for behavioral disorders. Yunfeng Duan, Xiaoli Wu, Shan Liang, and Feng Jin Copyright © 2015 Yunfeng Duan et al. All rights reserved. Qualitative Characteristics of Depression in Parkinson’s Patients and Controls Sun, 16 Aug 2015 08:04:29 +0000 Background. Depression is common in Parkinson’s disease (PD); in light of typical PD pathology it may differ phenomenologically from depression in the general population. Objective. To assess depressive symptoms in PD patients and control groups and compare symptom profiles. Methods. After postal screening of 10,000 citizens of Lübeck, 642 participants were examined and the Beck Depression Inventory (BDI) was sufficiently answered by 477 subjects. Based on motor examinations, we distinguished PD patients, Healthy Controls (HC, no motor impairment), and Disease Controls (DC, motor impairment other than PD). Results. The sample comprised 331 men and 311 women, aged 65 ± 8 years. Out of the overall sample, 198 (41.5%) had a BDI score ≥9. BDI results above 9 points occurred in 34.5% of HC, 50.3% of DC, and 42.4% of PD patients. Compared to the control groups (HC, DC) the PD patients endorsed more “dissatisfaction” and “loss of appetite” but less “feelings of guilt,” “self-hate,” and “loss of libido.” Conclusion. Depressive symptoms are more frequent in PD patients compared to HC but not DC. Interestingly, the distribution of individual symptoms of the BDI differs between groups with an emphasis on loss of pleasure/enjoyment in the PD group, a symptom typically considered to be dopaminergically transmitted. Cleo Kritzinger, Eva-Juliane Vollstedt, Katja Hückelheim, Anne Lorwin, Julia Graf, Sinem Tunc, Christine Klein, and Meike Kasten Copyright © 2015 Cleo Kritzinger et al. All rights reserved. Magnetic Resonance Imaging Studies of Postpartum Depression: An Overview Tue, 11 Aug 2015 12:46:37 +0000 Postpartum depression is a frequent and disabling condition whose pathophysiology is still unclear. In recent years, the study of the neural correlates of mental disorders has been increasingly approached using magnetic resonance techniques. In this review we synthesize the results from studies on postpartum depression in the context of structural, functional, and spectroscopic magnetic resonance studies of major depression as a whole. Compared to the relative wealth of data available for major depression, magnetic resonance studies of postpartum depression are limited in number and design. A systematic literature search yielded only eleven studies conducted on about one hundred mothers with postpartum depression overall. Brain magnetic resonance findings in postpartum depression appear to replicate those obtained in major depression, with minor deviations that are not sufficient to delineate a distinct neurobiological profile for this condition, due to the small samples used and the lack of direct comparisons with subjects with major depression. However, it seems reasonable to expect that studies conducted in larger populations, and using a larger variety of brain magnetic resonance techniques than has been done so far, might allow for the identification of neuroimaging signatures for postpartum depression. Marco Fiorelli, Franca Aceti, Isabella Marini, Nicoletta Giacchetti, Enrica Macci, Emanuele Tinelli, Valentina Calistri, Valentina Meuti, Francesca Caramia, and Massimo Biondi Copyright © 2015 Marco Fiorelli et al. All rights reserved. Recent Insights on Prevalence and Corelations of Hypoactive Delirium Mon, 10 Aug 2015 09:32:29 +0000 Delirium is a complex neuropsychiatric syndrome which is common in all medical settings. It often goes unrecognized due to difficulties in the detection of its hypoactive variant. This review aims to provide an up-to-date account on recent research on hypoactive delirium (HD). Thirty-eight studies, which were conducted in various clinical settings, including the Intensive Care Unit (ICU), were included in this review. Those studies involved recent research that has been published during the last 6 years. Prevalence of HD was found to vary considerably among different settings. HD seems to be more common in critically ill patients and less common in patients examined by consultation-liaison psychiatric services and in mixed patient populations. The presence of HD in ICU patients was associated with higher short- and long-term mortality and other adverse outcomes, but no such association was reported in other settings. Research on other possible associations of HD with clinical variables and on symptom presentation yielded inconclusive results, although there is some evidence for a possible association of HD with benzodiazepine use. There are several methodological issues that need to be addressed by future research. Future studies should examine HD in the primary care setting; treatment interventions should also be the objective of future research. Vaios Peritogiannis, Maria Bolosi, Charalampos Lixouriotis, and Dimitrios V. Rizos Copyright © 2015 Vaios Peritogiannis et al. All rights reserved. Management of Gliomas: Overview of the Latest Technological Advancements and Related Behavioral Drawbacks Sun, 09 Aug 2015 13:49:45 +0000 The advancements in basic sciences and the availability of sophisticated technological aids to surgical removal of gliomas have led over the last few years to the rise of innovative surgical strategies, the identification of better prognostic/predictive biomolecular factors, and the development of novel drugs and all are meant to profoundly impact the outcome of patients diagnosed with these aggressive tumours. Unfortunately, the treatment protocols available nowadays still confer only a small survival advantage at a potentially high cost in terms of overall well-being. In this review we identified the potential and limits of the most promising research trends in the management of glioma patients, also highlighting the related externalities. Finally, we focused our attention on the imbalance between the technical and behavioral aspects pertinent to this research area, which ultimately represent the two sides of the same coin. L. Ganau, M. Paris, G. K. Ligarotti, and M. Ganau Copyright © 2015 L. Ganau et al. All rights reserved. Abstract Word Definition in Patients with Amnestic Mild Cognitive Impairment Sun, 09 Aug 2015 13:25:09 +0000 The aims of this study were to investigate concrete and abstract word definition ability (1) between patients with amnestic mild cognitive impairment (aMCI) and normal adults and (2) between the aMCI subtypes (i.e., amnestic single-domain MCI and amnestic multidomain MCI; asMCI and amMCI) and normal controls. The 68 patients with aMCI (29 asMCI and 39 amMCI) and 93 age- and education-matched normal adults performed word definition tasks composed of five concrete (e.g., train) and five abstract nouns (e.g., jealousy). Task performances were analyzed on total score, number of core meanings, and number of supplementary meanings. The results were as follows. First, the aMCI patients scored significantly poorer than the normal controls in only abstract word definition. Second, both subtypes of aMCI performed worse than the controls in only abstract word definition. In conclusion, a definition task of abstract rather than concrete concepts may provide richer information to show semantic impairment of aMCI. Soo Ryon Kim, SangYun Kim, Min Jae Baek, and HyangHee Kim Copyright © 2015 Soo Ryon Kim et al. All rights reserved. Cognitive Impairments in LRRK2-Related Parkinson’s Disease: A Study in Chinese Individuals Thu, 06 Aug 2015 11:37:29 +0000 Background. LRRK2 S1647T has been identified as a polymorphic risk variant for Parkinson’s disease (PD) in Chinese individuals. As LRRK2 is the most common genetic cause for PD, it has drawn great interest regarding whether cognitive impairments in PD are related with LRRK2. Purpose. This study aimed to explore the effects of LRRK2 S1647T polymorphism on cognitive function in PD. Method. 90 PD patients were randomly recruited. They underwent a series of clinical evaluations and genetic testing for the LRRK2 S1647T polymorphism. Global intellect and five cognitive domains (language fluency, visuospatial function, attention, memory, and executive function) were compared between S1647T carriers and noncarriers. Results. No differences in motor features were found between two groups, but the executive function evaluation showed that Stroop word colour test time (SWCT-TIME) scores were lower in LRRK2 S1647T carriers than in noncarriers (). However, multiple linear regression analysis indicated that the correlation between S1647T polymorphism and SWCT-TIME scores did not reach significant level (). Conclusion. Our findings suggest that cognitive impairments are not correlated with different LRRK2 S1647T polymorphisms in Chinese PD individuals. Yifan Zheng, Zhong Pei, Yanmei Liu, Hongyan Zhou, Wenbiao Xian, Yingying Fang, Ling Chen, and Qi Wu Copyright © 2015 Yifan Zheng et al. All rights reserved. The Effect of Spatial Working Memory Deterioration on Strategic Visuomotor Learning across Aging Tue, 28 Jul 2015 12:59:27 +0000 Objective. To evaluate the effect of age-related cognitive changes in a visuomotor learning task that depends on strategic control and contrast it with the effect in a task principally depending on visuomotor recalibration. Methods. Participants performed a ball throwing task while donning either a reversing dove prism or a displacement wedge prism, which mainly depend on strategic control or visuomotor recalibration, respectively. Visuomotor performance was then analysed in relation to rule acquisition and reversal, recognition memory, visual memory, spatial planning, and spatial working memory with tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Results. The results confirmed previous works showing a detrimental effect of age on visuomotor learning. The analyses of the cognitive changes observed across age showed that both strategic control and visuomotor recalibration had significant negative correlations only with the number of errors in the spatial working memory task. However, when the effect of aging was controlled, the only significant correlation remaining was between the reversal adaptation magnitude and spatial working memory. Discussion. These results suggest that spatial working memory decline across aging could contribute to age-dependent deterioration in both visuomotor learning processes. However, spatial working memory integrity seems to affect strategic learning decline even after controlling for aging. Luis A. Uresti-Cabrera, Rosalinda Diaz, Israel Vaca-Palomares, and Juan Fernandez-Ruiz Copyright © 2015 Luis A. Uresti-Cabrera et al. All rights reserved. A Longitudinal Examination of the Hopelessness Theory of Depression in People Who Have Multiple Sclerosis Tue, 28 Jul 2015 11:47:43 +0000 Purpose. Hopelessness theory predicts that negative attributional style will interact with negative life events over time to predict depression. The intention of this study was to test this in a population who are at greater risk of negative life events, people with Multiple Sclerosis (MS). Method. Data, including measures of attributional style, negative life events, and depressive symptoms, were collected via postal survey in 3 phases, each one a year apart. Results. Responses were received from over 380 participants at each study phase. Negative attributional style was consistently able to predict future depressive symptoms at low to moderate levels of association; however, this ability was not sustained when depressive symptoms at Phase 1 were controlled for. No substantial evidence to support the hypothesised interaction of negative attributional style and negative life events was found. Conclusions. Findings were not supportive of the causal interaction proposed by the hopelessness theory of depression. Further work considering other time frames, using methods to prime attributional style before assessment and specifically assessing the hopelessness subtype of depression, may prove to be more fruitful. Intervention directly to address attributional style should also be considered. I. I. Kneebone, S. Guerrier, E. Dunmore, E. Jones, and C. Fife-Schaw Copyright © 2015 I. I. Kneebone et al. All rights reserved. Attitudes toward Physician-Nurse Collaboration in Pediatric Workers and Undergraduate Medical/Nursing Students Sun, 26 Jul 2015 13:09:16 +0000 The purpose of this study was to compare the attitudes of pediatric workers and undergraduate medical/nursing students toward collaboration. Attitude toward collaboration was measured using an adaptation of the Jefferson Scale of Attitude toward Physician-Nurse Collaboration. The 656 questionnaires were gathered from pediatrician, pediatric interns, and medical students (PIS) and pediatric nurses, nursing interns, and nursing students (NIS). Results showed a statistically significant difference in the total mean scores in attitudes towards collaboration with NIS scoring higher. Among the participants of PIS, the pediatricians obtained the highest mean scores, while, among the participants of NIS, the pediatric nurses got higher mean scores than nursing interns. It is desirable that medical and nurse schools should include interprofessional education in their curriculum to increase the understanding of the complementary roles of physicians and nurses and to encourage establishment of an interdependent relationship between them. Yong Wang, Yong-fang Liu, Hao Li, and Tingyu Li Copyright © 2015 Yong Wang et al. All rights reserved. Referral Practices for Cognitive Behavioral Therapy for Insomnia: A Survey Study Tue, 21 Jul 2015 09:26:28 +0000 This study examined referring practices for cognitive behavioral therapy for insomnia (CBTI) by physicians at University of Michigan Hospitals and Weill Cornell Medical College of Cornell University. A five-item questionnaire was sent via email that inquired about the physician’s patient load, number of patients complaining of insomnia, percent referred for CBTI, and impressions of what is the most effective method for improving sleep quality in their patients with insomnia. The questionnaire was completed by 239 physicians. More physicians believed a treatment other than CBTI and/or medication was most effective (N = 83). “Sleep hygiene” was recommended by a third of the sample. The smallest number of physicians felt that CBTI alone was the most effective treatment (N = 22). Additional physician education is needed. Deirdre A. Conroy and Matthew R. Ebben Copyright © 2015 Deirdre A. Conroy and Matthew R. Ebben. All rights reserved. Social Attitudes toward Cerebral Palsy and Potential Uses in Medical Education Based on the Analysis of Motion Pictures Tue, 14 Jul 2015 07:21:49 +0000 This study presents how motion pictures illustrate a person with cerebral palsy (CP), the social impact from the media, and the possibility of cerebral palsy education by using motion pictures. 937 motion pictures were reviewed in this study. With the criteria of nondocumentary movies, possibility of disability classification, and availability, the total number of motion pictures about CP was reduced to 34. The geographical distribution of movie number ever produced is as follows: North America 12, Europe 11, India 2, East Asia 6, and Australia 3. The CP incidences of different motor types in real world and in movies, respectively, are 78–86%, 65% (Spastic); 1.5–6%, 9% (Dyskinetic); 6.5–9%, 26% (Mixed); 3%, 0% (Ataxic); 3-4%, 0% (Hypotonic). The CP incidences of different Gross Motor Function Classification System (GMFCS) levels in real world and in movies, respectively, are 40–51%, 47% (Level I + II); 14–19%, 12% (Level III); 34–41%, 41% (Level IV + V). Comparisons of incidence between the real world and the movies are surprisingly matching. Motion pictures honestly reflect the general public’s point of view to CP patients in our real world. With precise selection and medical professional explanations, motion pictures can play the suitable role making CP understood more clearly. Marek Jóźwiak, Brian Po-Jung Chen, Bartosz Musielak, Jacek Fabiszak, and Andrzej Grzegorzewski Copyright © 2015 Marek Jóźwiak et al. All rights reserved. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes Sun, 12 Jul 2015 10:56:44 +0000 Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic () or hemorrhagic stroke () within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4) at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures. Robert Perna and Jessica Temple Copyright © 2015 Robert Perna and Jessica Temple. All rights reserved. Processing Sentences with Literal versus Figurative Use of Verbs: An ERP Study with Children with Language Impairments, Nonverbal Impairments, and Typical Development Sun, 12 Jul 2015 09:34:59 +0000 Forty native Italian children (age 6–15) performed a sentence plausibility judgment task. ERP recordings were available for 12 children with specific language impairment (SLI), 11 children with nonverbal learning disabilities (NVLD), and 13 control children. Participants listened to verb-object combinations and judged them as acceptable or unacceptable. Stimuli belonged to four conditions, where concreteness and congruency were manipulated. All groups made more errors responding to abstract and to congruent sentences. Moreover, SLI participants performed worse than NVLD participants with abstract sentences. ERPs were analyzed in the time window 300–500 ms. SLI children show atypical, reversed effects of concreteness and congruence as compared to control and NVLD children, respectively. The results suggest that linguistic impairments disrupt abstract language processing more than visual-motor impairments. Moreover, ROI and SPM analyses of ERPs point to a predominant involvement of the left rather than the right hemisphere in the comprehension of figurative expressions. Maria Luisa Lorusso, Michele Burigo, Virginia Borsa, and Massimo Molteni Copyright © 2015 Maria Luisa Lorusso et al. All rights reserved. Changes of Motivational Variables in Patients with Multiple Sclerosis in an Exercise Intervention: Associations between Physical Performance and Motivational Determinants Sun, 12 Jul 2015 08:34:33 +0000 Objectives. This study examines the effects of a standardized fitness training on motivational factors such as the intention to be physically active, self-efficacy, perceived barriers, counterstrategies, and exercise specific social support in patients with progressive Multiple Sclerosis (MS) and the relation of these factors to physical performance. Methods. Moderately disabled patients with secondary or primary progressive MS (Expanded Disability Status Scale of 4–6) were randomized to a training group or a waitlist control group. Patients completed on average 20 sessions of training tailored to their individual fitness at baseline over a course of 8–12 weeks. Motivational variables (stage of change according to the transtheoretical model (TTM), self-efficacy, perceived barriers, counterstrategies, and exercise specific social support) were assessed via questionnaires at baseline and follow-up. Results. Forty patients completed the trial. We found significant effects on stages of change and self-efficacy and a trend in counterstrategies . Significant correlations between change of physical performance during the exercise training and change in the TTM, perceived barriers, and counterstrategies were detected. Conclusion. This study indicates that tailored individual endurance training could stabilize self-efficacy and increase exercise motivation in patients with progressive MS. Motivational variables were related to the physical performance. Wiebke Geertz, Anna-Sophie Dechow, Stefan Patra, Christoph Heesen, Stefan M. Gold, and Karl-Heinz Schulz Copyright © 2015 Wiebke Geertz et al. All rights reserved.