Process skill rather than motor skill ..

... seems to be a predictor of costs for rehabilitation after a stroke in working age; a longitudinal study with a 1 year follow up post discharge

Ann Bjorkdahl email and Katharina S Sunnerhagen email

BMC Health Services Research 2007, 7:209doi:10.1186/1472-6963-7-209
Published: 21 December 2007
Abstract (provisional)

Background

In recent years a number of costs of stroke studies have been conducted based on incidence or prevalence and estimating costs at a given time. As there still is a need for a deeper understanding of factors influencing these costs the aim of this study was to calculate the direct and indirect costs in a "young" (<65) sample of stroke patients and to explore factors affecting the costs.

Information about Cerebrovascular Disease

By Robert Baird
January 16, 2008


The signs and symptoms of cerebrovascular disease depend on the location of the hemorrhage, thrombus, or embolus and the extent of cerebral tissue affected. General signs and symptoms of a hemorrhagic or ischemic event include motor dysfunction, such as hemiplegia and hemiparesis.

Early in a CVA, the patient may experience flaccid paralysis, followed by increased muscle tone and spasticity. He may lose his gag reflex and ability to cough. He may have communication deficits, such as dysphagia, receptive or expressive aphasia, dysarthria, and apraxia. He also may develop spatial and perceptual deficits, such as the loss of half of his visual field (homonymous hemianopia) and the inability to recognize an object (agnosia).

Other signs and symptoms of a CVA include vomiting, seizures, fever, ECG abnormalities, confusion that leads to a complete loss of consciousness, labored or irregular respirations, apneic periods, increased blood pressure, and bowel and bladder incontinence.

Signs and symptoms specific to a hemorrhagic CVA include abrupt onset of a severe headache, nuchal rigidity, and rapid onset of complete hemiplegia. As the hematoma enlarges, the patient's neurologic deficits worsen from gradual loss of consciousness to coma.

Signs and symptoms of a thrombotic CVA follow the "stroke in evolution" pattern and include the progressive deterioration of motor and sensory function, slow deterioration of speech, and lethargy. These signs and symptoms peak when edema develops, usually about 72 hours after the onset of the thrombotic event.

Next.........

The Mini-Mental State Examination in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia

The Mini-Mental State Examination in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia
Jason E. Osher, MS

Cognitive Neurology and Alzheimer's Disease Center, Nowrthwestern University Feinberg School of Medicine, Chicago, Illinois, Department of Psychiatry and Behavioral Sciences, Nowrthwestern Universtiy Feinberg School of Medicine, Chicago, Illinois, jason-osher@northwestern.edu

Alissa H. Wicklund, PhD

Cognitive Neurology and Alzheimer's Disease Center, Nowrthwestern University Feinberg School of Medicine, Chicago, Illinois

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 22, No. 6, 468-473 (2008)
DOI: 10.1177/1533317507307173
© 2008 SAGE Publications

How left inferior frontal cortex participates in syntactic processing: Evidence from aphasia

from Brain and Language

We report on three experiments that provide a real-time processing perspective on the poor comprehension of Broca’s aphasic patients for non-canonically structured sentences. In the first experiment we presented sentences (via a Cross Modal Lexical Priming (CMLP) paradigm) to Broca’s patients at a normal rate of speech. Unlike the pattern found with unimpaired control participants, we observed a general slowing of lexical activation and a concomitant delay in the formation of syntactic dependencies involving “moved” constituents and empty elements. Our second experiment presented these same sentences at a slower rate of speech. In this circumstance, Broca’s patients formed syntactic dependencies as soon as they were structurally licensed (again, a different pattern from that demonstrated by the unimpaired control group). The third experiment used a sentence-picture matching paradigm to chart Broca’s comprehension for non-canonically structured sentences (presented at both normal and slow rates). Here we observed significantly better scores in the slow rate condition. We discuss these findings in terms of the functional commitment of the left anterior cortical region implicated in Broca’s aphasia and conclude that this region is crucially involved in the formation of syntactically-governed dependency relations, not because it supports knowledge of syntactic dependencies, but rather because it supports the real-time implementation of these specific representations by sustaining, at the least, a lexical activation rise-time parameter.

The autism 'epidemic', is there a sensory perceptual form of autism?

Exploring agnosia, I found the context blindness of simultagnosia, and the object confusion of associative agnosia. So that’s why I still confuse the garlic crusher and the can opener and why I can’t tell people are talking because I just see someone’s mouth moving making noise, then someone else’s but don’t realise they are talking TO EACH OTHER!

And I learned of automobilia in which one can’t recognise vehicles and I remember my frustrated mother hitting me because she had this face blind kid who couldn’t recognise anyone so would treat all as strangers or friends, and couldn’t identify types of cars even though her father owned a car yard. There were drive ins then and my family would go to them. I’d go to the toilet and get into three cars before my parents would spot me running from each and beep the horn. My mother had been afraid I’d be taken by strangers and be unable to name the car. But being hit for something due to brain damage which could no more work than could I sprout a tail, is part of why I’m bothering to write this blog entry.

And I learned of integrative agnosia in Next.............

Musicophilia: Tales of Music and the Brain

by Oliver Sacks
367pp, Picador, £17.99

It is a remarkable fact that if I merely type "the Mission: Impossible theme tune" or "Beethoven's Fifth", you will probably start humming to yourself. We take it for granted, but how is it possible? What is going on in our brains? Oliver Sacks, the neurologist author of The Man Who Mistook His Wife For a Hat, here devotes a book to the cognitive miracles of music. "It really is a very odd business," he muses, "that all of us, to varying degrees, have music in our heads."

The start of a new beginning.

So I'm pretty much convinced that there is something slightly wrong with my Broca's area*. No, it isn't severe damage, I'm sure. But if you have tried to hold a conversation with me before, you probably know of my tendencies to 1) talk too fast for my own good, causing me to 2) stutter, and 3) have a constant misuse of and unnecessary use of (?) vocabulary words.

*Broca's area is a section of the brain that is involved inlanguage processing, speech production, and comprehension.

According to Wikipedia (aka my best friend):

People suffering from damage to this area may show a condition called Broca's aphasia (sometimes known as expressive aphasia, motor aphasia, or nonfluent aphasia), which makes them unable to create grammatically-complex sentences: their speech is often described as telegraphic and contains little but content words. Patients are usually aware that they cannot speak properly. Comprehension in Broca's aphasia is relatively normal, although many studies have demonstrated that Broca's aphasics have trouble understanding certain kinds of syntactically complex sentences.