Impaired Information Processing Research Articles

White matter abnormalities of right hemisphere attention networks contribute to visual hallucinations in dementia with Lewy bodies

ObjectiveFunctional alterations of the visual attention networks in a setting of impaired visual information processing have a role in the genesis of visual hallucinations (VH) in dementia with Lewy bodies (DLB). This multimodal MRI study aims at exploring structural and functional basis of VH. Methods23 DLB patients (10 with and 13 without VH) and 13 healthy controls were studied. They underwent MRI with T1-w sequences to measure cortical thickness, DTI for whole-brain and single tract microstructural properties and rs-fMRI of the default mode, dorsal and ventral attention, and visual networks. ResultsIn DLB with VH, whole-brain DTI revealed a lower fractional anisotropy and a greater mean diffusivity in the right frontal and temporo-parietal white matter tracts. Tracts dissection showed lower fractional anisotropy in the right inferior and superior (ventral part) longitudinal fasciculi (ILF and SLF) (p < .05, corrected), and greater mean diffusivity (p < .05). The extent of white matter microstructural alterations involving the right ILF and SLF correlated with the severity of VH (r = .55, p < .01; r = .42, p < .05, respectively), and with performance in the visual attention task (r = −.56 and r = −.61; p < .01, respectively). Cortical thickness in the projection areas of the right SLF was significantly reduced (p < .05). Patients with VH also showed an altered functional connectivity in the ventral attention network, connected by the ventral portion of the SLF (p < .05). ConclusionsOur findings suggest that a combination of microstructural and functional alterations involving the attention networks in the right hemisphere may be important in the genesis of VH.

The relation of depression with structural brain abnormalities and cognitive functioning: the Maastricht study.

Individuals with depression often experience widespread and persistent cognitive deficits, which might be due to brain atrophy and cerebral small vessel disease (CSVD). We therefore studied the associations between depression, markers of brain atrophy and CSVD, and cognitive functioning. We used cross-sectional data from the population-based Maastricht study (n = 4734; mean age 59.1 ± 8.6 years, 50.2% women), which focuses on type 2 diabetes. A current episode of major depressive disorder (MDD, n = 151) was assessed by the Mini-International Neuropsychiatric Interview. Volumes of cerebral spinal fluid, white matter, gray matter and white matter hyperintensities, presence of lacunar infarcts and cerebral microbleeds, and total CSVD burden were assessed by 3 T magnetic resonance imaging. Multiple linear and logistic regression analyses tested the associations between MDD, brain markers and cognitive functioning in memory, information processing speed, and executive functioning & attention, and presence of cognitive impairment. Structural equation modeling was used to test mediation. In fully adjusted models, MDD was associated with lower scores in information processing speed [mean difference = -0.18(-0.28;-0.08)], executive functioning & attention [mean difference = -0.13(-0.25;-0.02)], and with higher odds of cognitive impairment [odds ratio (OR) = 1.60(1.06;2.40)]. MDD was associated with CSVD in participants without type 2 diabetes [OR = 1.65(1.06;2.56)], but CSVD or other markers of brain atrophy or CSVD did not mediate the association with cognitive functioning. MDD is associated with more impaired information processing speed and executive functioning & attention, and overall cognitive impairment. Furthermore, MDD was associated with CSVD in participants without type 2 diabetes, but this association did not explain an impaired cognitive profile.

Recent updates of eye movement abnormalities in patients with schizophrenia: A scoping review

AimAlthough eye‐tracking technology expands beyond capturing eye data just for the sole purpose of ensuring participants maintain their gaze at the presented fixation cross, gaze technology remains of less importance in clinical research. Recently, impairments in visual information encoding processes indexed by novel gaze metrics have been frequently reported in patients with schizophrenia. This work undertakes a scoping review of research on saccadic dysfunctions and exploratory eye movement deficits among patients with schizophrenia. It gathers promising pieces of evidence of eye movement abnormalities in attention‐demanding tasks on the schizophrenia spectrum that have mounted in recent years and their outcomes as potential biological markers.MethodsThe protocol was drafted based on PRISMA for scoping review guidelines. Electronic databases were systematically searched to identify articles published between 2010 and 2020 that examined visual processing in patients with schizophrenia and reported eye movement characteristics as potential biomarkers for this mental illness.ResultsThe use of modern eye‐tracking instrumentation has been reported by numerous neuroscientific studies to successfully and non‐invasively improve the detection of visual information processing impairments among the screened population at risk of and identified with schizophrenia.ConclusionsEye‐tracking technology has the potential to contribute to the process of early intervention and more apparent separation of the diagnostic entities, being put together by the syndrome‐based approach to the diagnosis of schizophrenia. However, context‐processing paradigms should be conducted and reported in equally accessible publications to build comprehensive models.

Asymmetry of Regional Phase Synchrony Cortical Networks Under Cognitive Alertness and Vigilance Decrement States.

This study investigates intra-regional connectivity and regional hemispheric asymmetry under two vigilance states: alertness and vigilance decrement. The vigilance states were induced on nine healthy subjects while performing 30 min in-congruent Stroop color-word task (I-SCWT). We measured brain activity using Electroencephalography (EEG) signals with 64-channels. We quantified the regional network connectivity using the phase-locking value (PLV) with graph theory analysis (GTA) and Support Vector Machines (SVM). Results showed that the vigilance decrement state was associated with impaired information processing within the frontal and central regions in delta and theta frequency bands. Meanwhile, the hemispheric asymmetry results showed that the laterality shifted to the right-temporal in delta, right-central, parietal, and left frontal in theta, right-frontal and left-central, temporal and parietal in alpha, and right-parietal and left temporal in beta frequency bands. These findings represent the first demonstration of intra-regional connectivity and hemispheric asymmetry changes as a function of cognitive vigilance states. The overall results showed that vigilance decrement is region and frequency band-specific. Our SVM model achieved the highest classification accuracy of 99.73% in differentiating between the two vigilance states based on the frontal and central connectivity networks measures.

State anxiety influences P300 and P600 event-related potentials over parietal regions in the hollow-mask illusion experiment.

The hollow-mask illusion is an optical illusion where a concave face is perceived as convex. It has been demonstrated that individuals with schizophrenia and anxiety are less susceptible to the illusion than controls. Previous research has shown that the P300 and P600 event-related potentials (ERPs) are affected in individuals with schizophrenia. Here, we examined whether individual differences in neuroticism and anxiety scores, traits that have been suggested to be risk factors for schizophrenia and anxiety disorders, affect ERPs of healthy participants while they view concave faces. Our results confirm that the participants were susceptible to the illusion, misperceiving concave faces as convex. We additionally demonstrate significant interactions of the concave condition with state anxiety in central and parietal electrodes for P300 and parietal areas for P600, but not with neuroticism and trait anxiety. The state anxiety interactions were driven by low-state anxiety participants showing lower amplitudes for concave faces compared to convex. The P300 and P600 amplitudes were smaller when a concave face activated a convex face memory representation, since the stimulus did not match the active representation. The opposite pattern was evident in high-state anxiety participants in regard to state anxiety interaction and the hollow-mask illusion, demonstrating larger P300 and P600 amplitudes to concave faces suggesting impaired late information processing in this group. This could be explained by impaired allocation of attentional resources in high-state anxiety leading to hyperarousal to concave faces that are unexpected mismatches to standard memory representations, as opposed to expected convex faces.

Intuitive Judgments in Depression and the Role of Processing Fluency and Positive Valence: A Preregistered Replication Study.

Recent preliminary evidence indicates that depression is associated with impaired intuitive information processing. The current study aimed at replicating these findings and to move one step further by exploring whether factors known as triggering intuition (positivity, processing fluency) also affect intuition in patients with depression. We pre-registered and tested five hypotheses using data from 35 patients with depression and 35 healthy controls who performed three versions of the Judgment of Semantic Coherence Task (JSCT, Bowers et al., 1990). This task operationalizes intuition as the inexplicable and sudden detection of semantic coherence. Results revealed that depressed patients and healthy controls did not differ in their general intuitive performance (Hypothesis 1). We further found that fluency did not significantly affect depressed patients' coherence judgments (H2a) and that the assumed effect of fluency on coherence judgments was not moderated by depression (H2b). Finally, we found that triads positive in valence were more likely to be judged as coherent as compared to negative word triads in the depressed sample (H3a), but this influence of positive (vs. negative) valence on coherence judgments did not significantly differ between the two groups (H3b). Overall the current study did not replicate findings from previous research regarding intuitive semantic coherence detection deficits in depression. However, our findings suggest that enhancing positivity in depressed patients may facilitate their ability to see meaning in their environment and to take intuitive decision.

Information processing in hoarding disorder: A systematic review of the evidence

• Information processing difficulties are said to play a role in maintaining hoarding. • There is consistent evidence for deficits in sustained attention and inhibition. • Evidence for deficits in other areas of executive functioning is contradictory. • Research needs to use consistent methods to diagnose hoarding and measure cognition. Hoarding Disorder (HD), conceptualised as difficulties with discarding possessions resulting in distress, the accumulation of items creating a cluttered, unusable environment, and significant impairment in functioning, is reported to affect 1.5% of adults. In addition, evidence suggests that those with HD experience further difficulties in executive functioning, including inhibition, attention, and decision-making. Deficits in executive function and other areas of information processing are hypothesised to play a key role in maintaining HD. This review aimed to systematically review the evidence for impaired information processing in this population when compared to community controls, focusing specifically on studies using clinician-delivered interviews to diagnose HD, and those using primary assessments of neuropsychological function. 12 studies were included in this review. Results suggest consistent evidence for some difficulties in sustained attention, motor inhibition and organisation, however literature on deficits in other areas of executive function is wide ranging, limiting the extent to which firm conclusions can be drawn. Further research is needed to investigate deficits in other areas of information processing in HD, with a focus on consistent methods to diagnose HD and measure neuropsychological function, as these design issues place restrictions on a full understanding of the true deficits associated with HD. Consideration should be given to whether recorded deficits are ‘true’ or are difficulties associated with the emotional context of hoarding. It is hypothesized that future research will reveal more distinct subgroups of people with hoarding difficulties, only some of whom will show true neuropsychological deficits.

Interval Timing in Pediatric Multiple Sclerosis: Impaired in the Subsecond Range but Unimpaired in the One-Second Range.

Background: For adult multiple sclerosis (MS) patients, impaired temporal processing of simultaneity/successiveness has been frequently reported although interval timing has been investigated in neither adult nor pediatric MS patients. We aim to extend previous research in two ways. First, we focus on interval timing (instead of simultaneity/successiveness) and differentiate between sensory-automatic processing of intervals in the subsecond range and cognitive processing of intervals in the one-second range. Second, we investigate whether impaired temporal information processing would also be observable in pediatric MS patients' interval timing in the subsecond and one-second ranges.Methods: Participants were 22 pediatric MS patients and 22 healthy controls, matched for age, gender, and psychometric intelligence as measured by the Culture Fair Test 20-R. They completed two auditory interval-timing tasks with stimuli in the subsecond and one-second ranges, respectively, as well as a frequency discrimination task.Results: Pediatric MS patients showed impaired interval timing in the subsecond range compared to healthy controls with a mean difference of the difference limen (DL) of 6.3 ms, 95% CI [1.7, 10.9 ms] and an effect size of Cohen's d = 0.830. The two groups did not differ significantly in interval timing in the one-second range (mean difference of the DL = 26.9 ms, 95% CI [−14.2, 67.9 ms], Cohen's d = 0.399) or in frequency discrimination (mean difference of the DL = 0.4 Hz, 95% CI [−1.1, 1.9 Hz], Cohen's d = 0.158).Conclusion: The results indicate that, in particular, the sensory-automatic processing of intervals in the subsecond range but not the cognitive processing of longer intervals is impaired in pediatric MS patients. This differential pattern of results is unlikely to be explained by general deficits of auditory information processing. A tentative explanation, to be tested in future studies, points to subcortical deficits in pediatric MS patients, which might also underlie deficits in speech and visuomotor coordination typically reported in pediatric MS patients.

Incidence of postoperative cognitive dysfunction in older women undergoing pelvic organ prolapse surgery.

Postoperative cognitive dysfunction (POCD), a transient impairment of memory, concentration, and information processing, has been reported after 7-26% of non-cardiac surgeries with associated increase in morbidity and death. Our primary aim was to determine the incidence of POCD 2 weeks after prolapse surgery in women ≥ 60years old. Our secondary aim was to identify risk factors for POCD. Prospective cohort study of women ≥ 60years old scheduled for pelvic organ prolapse surgery. Exclusion criteria included cognitive impairment history, major neurologic disorder, and abnormal cognition screen. A comprehensive neuropsychologic (NP) battery (eight tests), administered 2 weeks pre- and post-surgery, assessed premorbid IQ and domains of attention, memory, and executive function. The primary outcome was defined as decline of ≥ 1 SD on ≥ 2 NP tests or decline of ≥ 2 SD on ≥ 1 test. Raw scores were transformed to Z-scores. NP testing was completed by 72 women, median age 72 (IQR 69-77) years. Procedures included 16 (22.9%) laparoscopic sacrocolpopexies, 23 (32.9%) transvaginal reconstructions, and 29 (41.4%) obliterative surgeries, performed under general (63, 90%), regional (5, 7.1%), or sedation (2, 2.9%) anesthesia with a median hospital stay of 0.6 (IQR 0.6-0.75) days. POCD incidence was 33.3% (n = 24). POCD was associated with greater frailty (p = 0.006) and higher baseline depression (p = 0.05) but not with older age (p = 0.77) or inhalational gas use (p = 1.0). In this cohort, one in three women manifested POCD 2 weeks after prolapse surgery. Preoperative counseling should include discussions on POCD given its detrimental impact on postoperative recovery and independence.

Virtual reality storytelling as a double-edged sword: Immersive presentation of nonfiction 360°-video is associated with impaired cognitive information processing

ABSTRACT This study examines the effects of the immersive presentation of nonfiction omnidirectional video on audiences’ cognitive processing. Participants watched a sample of 360°-video nonfiction content, presented either in a virtual reality headset or on a computer screen. Measures of heart rate variability and electrodermal activity were collected, together with self-reported ratings of presence, information recognition, and memory. The results indicate that the immersive presentation elicits higher arousal and presence, but also lower focused attention, recognition, and cued recall of information. These effects on focused attention and memory were not mediated by variations on arousal or presence. Implications are discussed in terms of the psychological effects of immersive media, as well as their relevance for media practitioners.

Perceived Executive Functioning among Female Survivors of Intimate Partner Violence

ABSTRACT Current literature demonstrates that female survivors of intimate partner violence (IPV) suffer cognitive impairment. Nonetheless, less is known about how women perceive their cognitive functioning and related factors. The main objective was to assess to what degree abuse severity and mental health are related to perceived cognitive functioning in women who have been exposed to IPV. A group of female IPV survivors (n = 82) were assessed with the Quality of Life Outcomes in Neurological Disorders (Neuro-QOL-EF), Composite Abuse Scale Revised (CASR-SF), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7). Findings revealed self-reported impairment in concentration, information processing, and attention. Associations were found between self-reported executive function (EF) and posttraumatic stress, abuse severity, and depression. Further, a model including abuse severity and posttraumatic stress explained up to 20.8% of the variance in perceived EF. Findings indicate that female survivors report a high prevalence of difficulties in the domain of EF. Self-reported impairment in EF may be indicative of higher levels of posttraumatic stress (PTSD) and depression, meriting further assessment and possibly treatment. This study opens the way for the potential use of perceived cognitive functioning screening tools with female survivors.

Low-frequency oscillations reflect aberrant tone restoration during the auditory continuity illusion in schizophrenia

Patients with schizophrenia (ScZ) often show impairments in auditory information processing. These impairments have been related to clinical symptoms, such as auditory hallucinations. Some researchers have hypothesized that aberrant low-frequency oscillations contribute to auditory information processing deficits in ScZ. A paradigm for which modulations in low-frequency oscillations are consistently found in healthy individuals is the auditory continuity illusion (ACI), in which restoration processes lead to a perceptual grouping of tone fragments and a mask, so that a physically interrupted sound is perceived as continuous. We used the ACI paradigm to test the hypothesis that low-frequency oscillations play a role in aberrant auditory information processing in patients with ScZ (N = 23). Compared with healthy control participants we found that patients with ScZ show elevated continuity illusions of interrupted, partially-masked tones. Electroencephalography data demonstrate that this elevated continuity perception is reflected by diminished 3 Hz power. This suggests that reduced low-frequency oscillations relate to elevated restoration processes in ScZ. Our findings support the hypothesis that aberrant low-frequency oscillations contribute to altered perception-related auditory information processing in ScZ.

Cognitive and emotional impairment in patients with chronic cerebrovascular insufficiency

Cerebrovascular disease is one of the most important problems of clinical neurology, which is a significant cause of cognitive impairment and depression. Chronic forms of cerebrovascular insufficiency are most often associated with cerebral microangiopathy or a disease of small vessels, which is characterized by the presence of lacunae, microinfarction and microbleeding, leukoaraiosis and dilated perivascular spaces. One of the main and most common clinical symptoms is vascular cognitive impairment. They are characterized by extremely variable cognitive deficits, highly dependent on the location and severity of vascular damage. However, clinical manifestations associated with impaired frontal circulation are usually observed. Recent international criteria for vascular cognitive impairment presented by the VASCOG (International Society for Vascular Behavioral and Cognitive Disorders) working group emphasize the particular importance of impaired information processing speed, attention, and/or frontal regulatory functions, often in combination with personality or emotional disorders. The frequency of vascular depression in chronic cerebrovascular insufficiency reaches 70%. The addition of affective disorders significantly aggravates the existing cognitive deficit, increases the risk of dementia. This is due to the fact that depression itself leads to the development of cognitive impairment, causes multiple functional disorders of cerebral microcirculation and a number of other mechanisms. The presence of cerebral microangiopathy underlying this pathology makes the use of drugs with vascular effects in the treatment of these patients. The use of preparations with multimodal action, in particular the combined drug and, is most preferable.

A Representational Approach to Executive Function Impairments in Young Adults with Down Syndrome

ABSTRACT Based on a representational perspective, this paper examines executive functioning in Down syndrome. Sixteen young adults with Down syndrome, 16 mental age- and 16 age-matched controls were compared on script sequencing and sorting tasks. Participants were asked to reestablish the sequential structure of script actions given with or without irrelevant actions. Impairments in script information processing were observed only in young adults with Down syndrome, who performed more slowly than controls, making mistakes in ordering actions, but rejecting aberrant elements. These data are consistent with the view that Down syndrome impairs the syntactic but not semantic dimension of script representation.

Impaired early information processing in adult ADHD: a high-density ERP study

BackgroundChildren with attention-deficit/hyperactivity disorder (ADHD) often demonstrate sensory processing difficulties in the form of altered sensory modulation, which may contribute to their symptomatology. Our objective was to investigate the neurophysiological correlates of sensory processing deficits and the electrophysiological characteristics of early information processing in adult ADHD, measured by the P1 event-related potential (ERP).MethodsWe obtained ERPs during a Go/NoGo task from 26 adult patients with ADHD and 25 matched controls using a high-density 128-channel BioSemi ActiveTwo recording system.ResultsADHD patients had a significantly reduced P1 component at occipital and inferotemporal scalp areas compared to controls. The reduction was associated with inattention and hyperactivity symptom severity, as measured by the Conners’ Adult ADHD Rating Scale. ADHD patients with higher inattention scores had significantly smaller P1 amplitudes at posterior scalp sites, while higher hyperactivity scores were associated with higher P1 amplitudes.ConclusionsDeficits in early sensory processing, as measured by the P1 ERP component, are present in adult ADHD patients and are associated with symptom severity. These findings are suggestive of bottom-up cognitive deficits in ADHD driven by impairments in early visual processing, and provide evidence that sensory processing problems are present at the neurophysiological level in this population.

Abnormal Effective Connectivity Underlying Auditory Mismatch Negativity Impairments in Schizophrenia

BackgroundAuditory mismatch negativity (MMN) is a translatable event-related potential biomarker, and its reduction in schizophrenia is associated with the severity of clinical symptoms. While MMN recorded at the scalp is generated by a distributed network of temporofrontal neural sources, the primary contributing sources and the dynamic interactions among sources underlying MMN impairments in schizophrenia have not been previously characterized. MethodsA novel data-driven analytic framework was applied to large cohorts of healthy comparison subjects (n = 449) and patients with schizophrenia (n = 589) to identify the independent contributing sources of MMN, characterize the patterns of effective connectivity underlying reduced MMN in patients, and explore the clinical significance of these abnormal source dynamics in schizophrenia. ResultsA network of 11 independent contributing sources underlying MMN distributed across temporofrontal cortices was identified. Orderly shifts in peak source activity were detected in a steplike manner, starting at temporal structures and progressing across frontal brain regions. MMN reduction in patients was predominantly associated with reduced contributions from 3 frontal midline sources: orbitofrontal, anterior cingulate, and middle cingulate cortices. Patients showed increased connectivity from temporal to prefrontal regions in conjunction with decreased cross-hemispheric connectivity to prefrontal regions. The decreased connectivity strength of precentral to prefrontal regions in patients with schizophrenia was associated with greater severity of negative symptoms. ConclusionsAlterations in the dynamic interactions among temporofrontal sources underlie MMN abnormalities in schizophrenia. These results advance our understanding of the neural substrates and temporal dynamics of normal and impaired information processing with novel applications for translatable biomarkers of neuropsychiatric disorders.

Study of attention measured by event-related potential as a predictive factor of violence among patients with schizophrenia and substance use disorder

BackgroundThe prediction of violence in patients with psychiatric disorders remains a challenging aspect in the field of clinical research. Many studies search the linkage between aggressive behavior and certain genetic conditions, impaired socio-emotional information processing, demographic, and clinical variables. To our knowledge, by far the relationship between aggressive behavior and impaired attention is not clear. Attention is one of the clinical variables that might have a relation to increased aggressive tendency in many psychiatric patients. So the purpose of this study is to measure the attention using ERP and search for its relation to violence in schizophrenic patients and patients with substance use disorder. This cross-sectional study was carried out on a sample of schizophrenic inpatients and patients with SUD (86 male patients) at the psychiatric department of Al-Hussein University Hospital, Cairo, Egypt.ResultsThe majority of the sample lies in the age group 20–29 years old (38.4%), whereas MOAS showed that the higher tendency to violence was in the dual diagnosis of schizophrenia disorder with SUD followed by patients diagnosed with SUD.P300 wave measurement analysis reflected that the attention is highly affected in SUD patients, while schizophrenics showed delayed thinking. The relationship has a statistical significance (P = 0.001).A statistically significant direct correlation between P300 wave amplitude, latency, and the scale of violence was also found (P = 0.009 and P = 0.022) respectively.ConclusionAffected attention in both schizophrenic and SUD patients could be considered a potential risk factor of violence.

Information Processing in Migraine: A Review of Studies on P300.

Subjective cognitive dysfunction is common among migraineurs. The aim of this review is to evaluate the usefulness of psychophysiology by means of the P300 component of the event-related potential in the understanding of subtle and sub-clinical changes in cognition that may occur during and between migraine episodes. Some P300 studies suggest a potential impairment of information processing, as reflected by only few findings of interictal decreased amplitude and prolonged latency, ictal augmented amplitude and prolonged latency, changes in cognitive habituation, and limited capacity to relocate attention away from painful stimuli. P300 may represent a valuable aid for clinicians to identify patients at risk of chronicization and cognitive weakening due to neurovascular complications; in this perspective a research agenda may be planned involving larger numbers of patients undergoing psychophysiological studies.

Traumatic Brain Injury and Sexuality: User Experience Study of an Information Toolkit.

BackgroundAfter having sustained a traumatic brain injury (TBI), individuals are at risk of functional impairments in information processing, abstract reasoning, executive functioning, attention, and memory. This affects different aspects of communicative functioning. Specific strategies can be adopted to improve the provision of health information to individuals with TBI, including the development of written materials and nonwritten media.ObjectiveA user-centered design was adopted to codevelop four audiovisual presentations, a double-sided information sheet, and a checklist aimed at informing individuals about post-TBI sexuality. The last phase of the project was the assessment of the user experience of the information toolkit, based on the User Experience Honeycomb model.MethodsOverall, two small group discussions and one individual semistructured interview were conducted with individuals with moderate to severe TBI.ResultsThe participants mentioned that the toolkit was easily usable and would have fulfilled a need for information on post-TBI sexuality during or after rehabilitation. They mostly agreed that the minimalist visual content was well-organized, attractive, and relevant. The information was easily located, the tools were accessible in terms of reading and visibility, and the content was also considered credible.ConclusionsAspects such as usability, usefulness, desirability, accessibility, credibility, and findability of information were viewed positively by the participants. Further piloting of the toolkit is recommended to explore its effects on the awareness of the potential sexual repercussions of TBI in individuals and partners.

Efficacy of Pivotal Response Training in Management of Visual Conceptual Deficits in Adult Autistic Population

Background and Objectives: Recent years have witnessed revolutionized increase in number of Autistic individuals. With world-wide prevalence rate ranging from 7-13 cases per 10,000. In India, the occurrence is approximately 1 in 500 people . Among various impairments seen in Autism, visual conceptual deficit is the one which leads to impaired complex information processing and task shifting activities; leading to difficulties in executive functions. The aim of the present study was to examine visual conceptual deficit in these individuals and subsequently give a therapy which aims at reducing this deficit. METHOD: 40 adults with Autism, both male and female satisfying the inclusion criteria was included for the study (age 30-50 years). Their visual conceptual deficit was measured using Comprehensive Trail Making Test. Thereafter, they were subjected to Pivotal Response Training for 8 weeks. After 8 weeks of the therapy the effectiveness of Pivotal Response Training was re-evaluated using Comprehensive Trail Making Test. RESULTS: The subjects showed an improvement in multitask performance post pivotal response training and also significant improvement in visual conceptualization i.e. visual tracking and visual set shifting tasks. Conclusion: The findings in the present study focus a new light on the efficacy of Pivotal Response Training in improvement of visual conceptual deficit in adults with Autism.