Left Hemisphere Group Research Articles

Monocular eye patching modulates reorienting of covert attention in patients with unilateral middle cerebral artery stroke

Unilateral brain lesions can lead to impaired contralesional attention and reduced ipsilesional and enhanced contralesional superior colliculus (SC) activity. We aimed to investigate whether modulation of SC activation via monocular eye patching can improve contralesional attention. Twenty left-hemispheric (LH) and 20 right-hemispheric (RH) patients with an acute or subacute middle cerebral artery (MCA) stroke completed an endogenous version of the Posner cueing task twice, while the left or right eye was covered with an eye patch. The LH and RH patients showed significantly slower reactions to contralesional than to ipsilesional stimuli. In addition, the eye patch modulated responses to invalidly but not those to validly cued stimuli. Post hoc analyses could not discriminate whether this effect pertained to a particular target side or eye patch position. However, exploratory analyses indicated that the observed eye patch effect might affect the RH group more than the LH group. As predicted 36 years ago, monocular eye patching modulates visuospatial attention, presumably due to differences in SC activation between the two eye patch conditions. However, this modulation seems too weak and unspecific, and therefore possibly not strong enough to be a treatment option for patients with visuospatial attention impairments.

Incidence and Risk Factors for Dysphagia Following Cerebellar Stroke: a Retrospective Cohort Study

The cerebellum is known to play a supportive role in swallowing-related functions; however, wide discrepancies about the incidence rate of swallowing disorders following cerebellar strokes exist within the literature. This study aimed to investigate the incidence rate of dysphagia and the factors which may affect the presence of dysphagia and clinical recovery in individuals diagnosed with cerebellar stroke. A retrospective chart audit of 1651 post-stroke patients (1049 males and 602 females) admitted with a cerebellar stroke to a comprehensive tertiary hospital in China was conducted. Data on demographics, medical, along with swallowing function assessment were collected. Differences between dysphagic and non-dysphagic groups were evaluated using t-tests and Pearson’s chi-square test. Univariate logistic regression analysis was performed to establish factors associated with the presence of dysphagia. A total of 11.45% of participants were identified with dysphagia during inpatient admission. Individuals with mixed types of stroke, multiple lesions in the cerebellum, and ages older than 85 years old were more likely to develop dysphagia. Moreover, the prognosis of dysphagia following a cerebellar stroke was associated with lesions in different parts of the cerebellum. The cumulative recovery rates from the best to worse were the right hemisphere group, the cerebellum vermis or peduncle group, and both the hemisphere group and the left hemisphere group, respectively.

Acquired reading impairment following brain injury

This large-scale patient study investigated the rate, unique signatures associated with acquired reading impairments, its neurocognitive correlates, and long-term outcome in 731 acute stroke patients using the sentence and non-word reading subtests of Birmingham Cognitive Screen (BCoS). The objectives for the study were to explore the (i) potentially different error patterns among adult patients, (ii) associative relationship between the different subclasses of reading impairment and performance in other cognitive domains, and (iii) recovery rates in patients nine months post-lesion compared with their initial performance. The study revealed distinctive reading impairment profiles in patients with left hemisphere (LH) and right hemisphere (RH) lesions. Some interesting associations between reading disorder and other cognitive functions were observed. Nine months post-lesion, both groups showed some recovery in reading performance compared with their baseline performance, but the rate of improvement was higher for the LH group. The study reveals unique reading profiles and impairment patterns among left and right hemisphere lesions. The findings of the study provide a deeper understanding of reading deficits that will inform clinical practice, planning of rehabilitative interventions of brain injured patients, and the scientific community.

The Hemisphere of the Brain in Which a Stroke Has Occurred Visible in the Heart Rate Variability.

The aim of this study was to assess whether heart rate variability (HRV) could predict which hemisphere of the brain was affected during an acute ischemic stroke (AIS). To achieve this goal, we compared HRV between patients with a right (RH) and left hemispheric (LH) stroke. The studied group consisted of 64 patients with AIS (25 with RH and 39 with LH stroke, with a mean age of 64 ± 12 and 66 ± 13, p = 0.3, respectively) using 24 h Holter ECG records at NN intervals performed at a mean of 4.3 ± 2 days following their AIS. Standard linear methods were used to analyze HRV in the time and frequency domains, as well as nonlinear methods, including sample entropy, detrended fluctuation analysis, and asymmetry measures. Patients with an LH stroke had significantly greater values for sample entropy compared to subjects with an RH stroke (1.31 ± 0.53 vs. 0.92 ± 0.46, p = 0.003, Bonferroni-corrected p = 0.033, effect size = 0.8). The LH stroke group also had higher RMSSD (113 ± 81 vs. 76 ± 61, p = 0.06), pNN50 (33.35 ± 28.54 vs. 18.52 ± 23.75, p = 0.02), and HFnu (48.42 ± 16.41 vs. 42.66 ± 17.88, p = 0.11) values, when compared to the RH group, which was possibly related to higher activity in the parasympathetic system in the LH group. Conversely, subjects with RH stroke had higher LFnu (57.34 ± 17.88 vs. 51.58 ± 16.41, p-value = 0.11) and LF/HF ratios (2.24 ± 2.87 vs. 1.68 ± 2.50, p-value = 0.11), which were likely related to higher activity in the sympathetic nervous system, when compared to the LH stroke group. Our pilot study demonstrated that patients with RH stroke had lower HRV complexity than those with LH stroke, indicating that HRV could be useful in the discrimination of hemispheric involvement in AIS.

Neuroanatomical Correlates of Macrolinguistic Aspects in Narrative Discourse in Unilateral Left and Right Hemisphere Stroke: A Voxel-Based Morphometry Study.

Background A growing body of literature has demonstrated the importance of discourse assessment in patients who suffered from brain injury, both in the left and right hemispheres, as discourse represents a key component of functional communication. However, little is known about the relationship between gray matter density and macrolinguistic processing. Purpose This study aimed to investigate this relationship in a group of participants with middle-low to low socioeconomic status. Method Twenty adults with unilateral left hemisphere (n = 10) or right hemisphere (n = 10) chronic ischemic stroke and 10 matched (age, education, and socioeconomic status) healthy controls produced three oral narratives based on sequential scenes. Voxel-based morphometry analysis was conducted using structural magnetic resonance imaging. Results Compared to healthy controls, the left hemisphere group showed cohesion impairments, whereas the right hemisphere group showed impairments in coherence and in producing macropropositions. Cohesion positively correlated with gray matter density in the right primary sensory area (PSA)/precentral gyrus and the pars opercularis. Coherence, narrativity, and index of lexical informativeness were positively associated with the left PSA/insula and the superior temporal gyrus. Macropropositions were mostly related to the left PSA/insula and superior temporal gyrus, left cingulate, and right primary motor area/insula. Discussion Overall, the present results suggest that both hemispheres are implicated in macrolinguistic processes in narrative discourse. Further studies including larger samples and with various socioeconomic status should be conducted. Supplemental Material https://doi.org/10.23641/asha.14347550.

Hemisphere-Specific Functional Remodeling and Its Relevance to Tumor Malignancy of Cerebral Glioma Based on Resting-State Functional Network Analysis.

Background: Functional remodeling may vary with tumor aggressiveness of glioma. Investigation of the functional remodeling is expected to provide scientific relevance of tumor characterization and disease management of glioma. In this study, we aimed to investigate the functional remodeling of the contralesional hemisphere and its utility in predicting the malignant grade of glioma at the individual level with multivariate logistic regression (MLR) analysis. Subjects and Methods: One hundred and twenty-six right-handed subjects with histologically confirmed cerebral glioma were included with 80 tumors located in the left hemisphere (LH) and 46 tumors located in the right hemisphere (RH). Resting-state functional networks of the contralesional hemisphere were constructed using the human brainnetome atlas based on resting-state fMRI data. Functional connectivity and topological features of functional networks were quantified. The performance of functional features in predicting the glioma grade was evaluated using area under (AUC) the receiver operating characteristic curve (ROC). The dataset was divided into training and validation datasets. Features with high AUC values in malignancy classification in the training dataset were determined as predictive features. An MLR model was constructed based on predictive features and its classification performance was evaluated on the training and validation datasets with 10-fold cross validation. Results: Predictive functional features showed apparent hemispheric specifications. MLR classification models constructed with age and predictive functional connectivity features (AUC of 0.853 ± 0.079 and 1.000 ± 0.000 for LH and RH group, respectively) and topological features (AUC of 0.788 ± 0.150 and 0.897 ± 0.165 for LH and RH group, respectively) achieved efficient performance in predicting the malignant grade of gliomas. Conclusion: Functional remodeling of the contralesional hemisphere was hemisphere-specific and highly predictive of the malignant grade of glioma. Network approach provides a novel pathway that may innovate glioma characterization and management at the individual level.

Analysis of Scores of SCL-90 of Patients with Traumatic Subdural Effusion.

Objective To investigate the factors affecting changes of Symptom Check List-90 （SCL-90） of patients with traumatic subdural effusion. Methods One hundred and forty-two cases of patients with traumatic subdural effusion from the Center of Forensic Identification, Wannan Medical College collected from 2007-2018 were tested with SCL-90. The differences between SCL-90 results and the national norm and the influences of gender, age, education level, the number of effusion sites and location on SCL-90 results were analyzed. Results The differences between the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia and psychosis factors and total mean scores in SCL-90 of traumatic subdural effusion and that of the national norm had statistical significance （P<0.05）. The differences in depression and hostility factor scores between males and females had statistical significance （P<0.05）. The differences in compulsion, anxiety and terror factor scores and total mean scores among different age groups had statistical significance （P<0.05）. The differences in hostility, paranoia and psychosis factors among patients with different degrees of education had statistical significance （P<0.05）. The differences in depression, anxiety, hostility and terror factor scores and total mean scores among single-site group, double-site group and multi-site group had statistical significance （P<0.05）. The differences in somatization, depression and anxiety factor scores and total mean scores between the right cerebral hemisphere group and the left cerebral hemisphere group and bilateral hemisphere group had statistical significance （P<0.05）. Conclusion Traumatic subdural effusion can cause certain psychological changes, which are related to the primary trauma of arachnoid tear as well as the number and location of effusion sites. Attention should be paid to the influence of the above factors during the assessment of psychological symptoms.

Cognitive Function Differences based on Hemispheric Lesions of First-Ever Ischemic Stroke Patients

Ischemic stroke is one of stroke subtype often correlated with disturbance of cognitive function. We conduct an observational study with cross-sectional design of 70 ischemic stroke patients. Objective of this study is to evaluate cognitive differences based on hemispheric lateralization lesions. We used Montreal Cognitive Assessment – Indonesian version (MoCA-Ina) to assess cognitive function resulting on 70 patients, consist of 48 subjects (68.57 %) of left hemispheric stroke and 22 subjects (31.43%) of right hemispheric stroke. As much as 68 subjects (97.14 %) are categorized as having cognitive disturbance. Mean differences of MoCA-Ina was assessed using Mann-Whitney test resulting no significant differences between left vs right hemisphere groups (18.94 + 3.26 vs 19.82 + 3.13; p= 0.320). Further study would warrant lesions lateralizations could affects cognitive performance of ischemic stroke patients.

Relationship between location of cerebral infarction and features of videofluoroscopic swallowing

Objective To explore whether the pattern of dysphagia verified using videofluoroscopic swallowing study (VFSS) was associated with the location of the infarction in stroke patients. Methods Ninety-two patients with dysphagia (admitted between January 2015 and August 2016) who had first onset of cerebral infarction confirmed by magnetic resonance imaging were included in this study. They were divided into a unilateral brainstem group (n=29), a left hemisphere (cortex + white matter) group (n=37) and a right hemisphere (cortex + white matter) group (n=26) according to the location of the stroke. All subjects were evaluated using VFSS, and the oral transit time (OTT), triggering of pharyngeal swallowing (TPS), presence of residue in the vallecular and pyriform sinus, penetration, aspiration, cough reaction and upper esophageal sphincter (UES) opening were recorded and compared among the three groups. Results There were no significant differences among the three groups in OTT (χ2=0.712, P=0.918), TPS (1.564, P=0.458), penetration(χ2=5.615, P=0.060) and cough reaction (χ2=5.882, P=0.053). The unilateral brainstem group had significantly more residue in the vallecular and pyriform sinus than the left hemisphere group (χ2=6.508, P=0.011). Aspiration was significantly more frequently found in the unilateral brainstem group than in the left hemisphere group (χ2=7.803, P=0.005). The unilateral brainstem group was more likely to have insufficient UES opening than the left hemisphere (χ2=29.555, P<0.001) and right hemisphere groups (χ2=24.630, P<0.001). Conclusions Unilateral brainstem stroke is more likely to cause dysphagia than the unilateral cerebral hemisphere stroke, characterized by the abnormal residue in the vallecular and pyriform sinus, aspiration and the degree of UES opening. No significant differences were found in the dysphagia between stroke survivors with stroke in right and left hemispheres. Key words: Stroke; Locations; Videofluoroscopic swallowing study; Aspiration; Residue; Upper esophageal sphincter

Verbal short-term memory and language impairments in Cantonese speakers after stroke

Purpose: The study examined the relationship between verbal short-term memory (STM) and language impairment in Cantonese speakers after stroke. It is hypothesised that Cantonese speakers with left-hemisphere (LH) stroke would perform worse than those with right hemisphere (RH) stroke and normal controls. Specific linguistic factors of Cantonese might affect results in the tasks.Method: Fifteen participants with LH stroke, 10 with RH stroke and 25 healthy controls were tested with auditory–verbal immediate serial recall (ISR) tasks and auditory linguistic tasks. All stroke participants were assessed with the Cantonese version of Western Aphasia Battery (CAB).Result: The LH group performed significantly worse than the RH and healthy control groups in the auditory verbal ISR and auditory linguistic tasks. There were significant lexicality, frequency and imageability effects in most tasks. Auditory discrimination and word comprehension tasks, but not the auditory word recognition task had correlations with ISR tasks.Conclusion: Verbal STM and language performance of Cantonese-speakers with history of LH stroke were inferior to RH stroke and healthy controls. The effects of lexicality, word frequency and imageability on verbal STM memory performance were found. Cantonese tones have effects on performance in auditory word recognition task, similar to onset, nucleus and rime.

Reappraisal generation after acquired brain damage: The role of laterality and cognitive control.

In the past decade, there has been growing interest in the neuroanatomical and neuropsychological bases of reappraisal. Findings suggest that reappraisal activates a set of areas in the left hemisphere (LH), which are commonly associated with language abilities and verbally mediated cognitive control. The main goal of this study was to investigate whether individuals with focal damage to the LH (n = 8) were more markedly impaired on a reappraisal generation task than individuals with right hemisphere lesions (RH, n = 8), and healthy controls (HC, n = 14). The reappraisal generation task consisted of a set of ten pictures from the IAPS, depicting negative events of different sorts. Participants were asked to quickly generate as many positive reinterpretations as possible for each picture. Two scores were derived from this task, namely difficulty and productivity. A second goal of this study was to explore which cognitive control processes were associated with performance on the reappraisal task. For this purpose, participants were assessed on several measures of cognitive control. Findings indicated that reappraisal difficulty – defined as the time taken to generate a first reappraisal – did not differ between LH and RH groups. However, differences were found between patients with brain injury (LH + RH) and HC, suggesting that brain damage in either hemisphere influences reappraisal difficulty. No differences in reappraisal productivity were found across groups, suggesting that neurological groups and HC are equally productive when time constraints are not considered. Finally, only two cognitive control processes inhibition and verbal fluency- were inversely associated with reappraisal difficulty. Implications for the neuroanatomical and neuropsychological bases of reappraisal generation are discussed, and implications for neuro-rehabilitation are considered.

The ear craves the familiar: Pragmatic repetition in left and right cerebral damage

Background: Repetition occurs plentifully in normal conversation, but empirical studies of the pragmatic use of repetition are rare and pragmatic repetition, defined as verbal repetition in conversational use, in disordered language has not been systematically investigated. Applying a method of analysis that was piloted utilising normal discourse, discourse samples from persons with left and right brain damaged were examined for incidence and charcteristics of repetition.Aims: The purpose of this exploratory study was to examine verbal repetition following cerebral hemispheric damage. From previous studies of hemispheric influences on communicative competence, it was hypothesised that unilateral damage would affect verbal repetition differently. Following earlier results for hemispheric effects on proportion of formulaic expressions, overall more verbal repetition was predicted in persons with left hemisphere damage than those with right hemisphere damage or healthy speakers. Furthermore, previous studies led to a prediction of more repetition of formulaic (than novel, propositional) expressions following left hemisphere damage than the other two study groups. We explored whether characteristics and functions of repetition, developed as part of a new method for quantifying repetition in spontaneous speech, differed systematically between groups.Methods & Procedures: Transcripts of discourse by persons diagnosed with a single cerebral vascular accident and from age- and education-comparable healthy control (HC) participants were analysed. A method was developed for quantifying verbal repetition and identifying five factors, specifically localness (immediate, delayed, or distant), preservation of the original target (identical or altered), source (self or other), grammatical unit of speech (word, phrase, clause, or sentence), and phrase type (formulaic or novel), and three functions (maintaining form, enhancing content, and socialisation).Outcomes & Results: Results revealed significantly higher use of repetition by left hemisphere (28%) than right hemisphere-damaged (RHD) participants (19%) or the HC group (18%). The proportion of formulaic expression repeated by the left hemisphere group was significantly higher (57%) than the right hemisphere group (30%). Fewer repetitions were used by the left hemisphere group (25%) for the function of enhancing the content of talk as compared to the HC group (40%), whereas the RHD group used the least repetition for socialisation (15%).Conclusions: Pragmatic repetition is to be distinguished from rote repetition (on command) in aphasia diagnosis and from pathological repetition behaviours, including perseveration, following brain damage. The method described here allows for the measurement of pragmatic repetition and its characteristics in normal and disordered language. The findings support previous results for pragmatic and formulaic language behaviours in these populations. This study provides new information on the roles of repetition in normal conversation and on the impact of neurological damage on this function. Identification and measurement of repetition will inform perspectives on evaluation and rehabilitation of conversational speech.

Synchronization analysis between heart rate variability and EEG activity before, during, and after epileptic seizure

Abstract An innovative concept for synchronization analysis between heart rate (HR) components and rhythms in EEG envelopes is represented; it applies time-variant analyses to heart rate variability (HRV) and EEG, and it was tested in children with temporal lobe epilepsy (TLE). After a removal of ocular and movement-related artifacts, EEG band activity was computed by means of the frequency-selective Hilbert transform providing envelopes of frequency bands. Synchronization between HRV and EEG envelopes was quantified by Morlet wavelet coherence. A surrogate data approach was adapted to test for statistical significance of time-variant coherences. Using this processing scheme, significant coherence values between a HRV low-frequency sub-band (0.08-0.12 Hz) and the EEG δ envelope (1.5-4 Hz) occurring both in the preictal and early postictal periods of a seizure can be shown. Investigations were performed for all electrodes at 20-s intervals and for selected electrode pairs (T3÷C3, T4÷C4) in a time-variant mode. Synchronization was more pronounced in the group of right hemispheric TLE patients than in the left hemispheric group. Such a group-specific augmentation of synchronization confirms the hypothesis of a right hemispheric lateralization of sympathetic cardiac control of the low-frequency HRV components.

P.2.c.003 Subjective Well-being under Neuroleptic Scale in outpatients with bipolar disorder

Lange G, Waked W, Kirshblum S, DeLuca J. Organizational strategy influence on visual memory performance after stroke: cortical/subcortical and left/right hemisphere contrasts. Arch Phys Med Rehabil 2000;81:89-94. Objective: To examine how organizational strategy at encoding influences visual memory performance in stroke patients. Design: Case control study. Setting: Postacute rehabilitation hospital. Participants: Stroke patients with right hemisphere damage (n = 20) versus left hemisphere damage (n = 15), and stroke patients with cortical damage (n = 11) versus subcortical damage (n = 19). Main Outcome Measures: Organizational strategy scores, recall performance on the Rey-Osterrieth Complex Figure (ROCF). Results: Results demonstrated significantly greater organizational impairment and less accurate copy performance (ie, encoding of visuospatial information on the ROCF) in the right compared to the left hemisphere group, and in the cortical relative to the subcortical group. Organizational strategy and copy accuracy scores were significantly related to each other. The absolute amount of immediate and delayed recall was significantly associated with poor organizational strategy scores. However, relative to the amount of visual information originally encoded, memory performances did not differ between groups. Conclusions: These findings suggest that visual memory impairments after stroke may be caused by a lack of organizational strategy affecting information encoding, rather than an impairment in memory storage or retrieval. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Aphasia severity and salivary cortisol over time

The current study explored the complicated interplay between aphasia and the stress biomarker, cortisol, in left-hemisphere (LH) and right-hemisphere (RH) stroke patients. Nineteen LH patients and 12 RH patients began the study between one to six months post stroke and were followed for three months. During this time, language skills were assessed monthly while afternoon salivary cortisol samples were collected biweekly. The LH and RH groups showed improvements in language test scores over the course of three months; however, only naming skills in the RH group appeared to be associated with afternoon salivary cortisol levels. Furthermore, contradicting previous reports regarding laterality and cortisol regulation in humans, the current study found that both LH patients and RH patients exhibited similar afternoon salivary cortisol levels across all time points.

The EC301-CR test of acalculia for patients with cerebral infarction

Objective To investigate errors and the mechanism of acalculia in patients with left or right hemisphere cerebral infarction.Methods Fifty-six patients with single hemisphere cerebral infarction and 56 normal adults who were matched in age,sex and years of education were tested with EC301-CR.The patients were divided into a left hemisphere cerebral infarction group(n =34)and a right hemisphere cerebral infarction group(n =22).Results The scores on 30 out of 32 EC301-CR items were significantly lower among the patients than in the normal control group.Scores on 14 EC301-CR items were significantly lower in the left hemisphere group than in the right hemisphere group.In the left hemisphere group the item scores of aphasia patients were significantly lower than those of no-aphasia patients except on digit identity.Conclusion Mathematical processing and calculation were impaired in patients with single hemisphere cerebral infarction.Calculation was significantly worse among left hemisphere patients compared with right hemisphere cerebral infarction.There was a highly significant correlation between acalculia and aphasia. Key words: Cerebral infarction; Acalculia; EC301 test

Reading disorders and weak Verbal IQ following left hemisphere stroke in children: No evidence of compensation

Children who suffer a left-hemisphere (LH) stroke do not appear to experience the verbal deficits that are apparent in adults with similar lesions. To explain these findings it has been suggested that the plasticity of the developing brain enables homologous areas in the right hemisphere (RH) to compensate for LH weakness. In this paper we find evidence against this theory from investigations into the effect of LH and RH lesions on intelligence and literacy skills in a group of children with unilateral postnatal stroke. At group level, there was no significant effect of LH stroke on Verbal IQ (VIQ) or upon reading ability, when compared with RH stroke. But at the individual level, the majority of children with LH stroke achieved standard scores below average, with some below −2 SD. The standard scores of children with RH lesions were normally distributed, showing no detrimental effect that would indicate compensation. Large discrepancies between VIQ and Performance IQ (PIQ), in both directions, were also a characteristic of the LH group. Using normative data that we collected on the reading of irregular and regular words and nonwords, we identified patterns of phonological and surface dyslexia in both lesioned groups. We argue that LH stroke reduces the efficiency of verbally-related skills, but that the processes available to children with postnatal lesions are those available to normally developing children, and that these can entail processes in either hemisphere.

Recognitive characteristics in patients with cerebrovascular disease in different cerebral areas

Objective To study the recognition in patients with cerebrovascular disease in different areas. Methods The recognitive tests including Chinese words recognizing test and nonsense pictures recognizing test were accomplished in computer, and the differences of recognitive functions between patients with cerebrovascular disease (70 cases, they divided into basal ganglia damaged group, frontal lobe damaged group and temporal lobe damaged group according to damaged brain areas;divided into cortex group and under cortex group according to damaged gray matter or white matter;divided into left and right hemisphere groups according to different damaged hemispheres) and normal controls(75 cases) were compared. The scores of patients with cerebrovascular disease in different cerebral areas were compared too. Results The two scores of the Chinese words recognizing test and nonsense pictures recognizing test in patients with cerebrovascular disease (10.13±2.72,9.50 ±3.02) were significantly lower than that in normal controls( 12.96 ±2.97,13.35 ±2.56) ( t_1 = 5.98, t_2=8.30, both P<0.01) , and in patients with cerebrovascular disease focuses in cortex (9.08 ±2. 11, 8.26 ±2.72)were lower than that in patients with cerebrovascular disease focuses in under cortex(11.38 ±2.86, 10.97 ±2.72) (t_1 = 3.86, t_2=4. 15, both P<0.01) ;the scores of Chinese characters recognizing test in patients with left hemisphere lesion(9. 33 ± 2.61) was lower than that in patients with right hemisphere lesion( 10. 84 ± 2.65 ) ( t ,= 2. 39, P < 0. 05 ). The scores of all tests in patients with cerebrovascular disease focuses in basal ganglia,frontal lobe and temporal lobe were significantly different(F_1 =10.00, F_2 = 11.64, both P<0.01). The scores of the two tests in patients with cerebrovascular disease focuses in temporal lobe(8. 30 ± 2.08, 7. 35 ± 2. 83 ) were lower than that in patients with cerebrovascular disease focuses in basal ganglia(11. 38 ± 2. 86, 10.97 ±2.72) and frontal lobe(9. 94 ± 1. 83, 9.28 ±2.24) (P<0.01, P<0.05) ;the scores of the two tests in patients with cerebrovascular disease focuses in frontal lobe(9.94 ± 1. 83, 9.28 ± 2. 24) were lower than that in patients with cerebrovascular disease focuses in basal ganglia(11. 38 ±2.86, 10.97 ±2.72) (P<0.05). Conclution The disturbances of recognition were observed in patients with cerebrovascular disease. The disturbances of recognition in patients with cerebrovascular dis-ease focuses in cortex were more serious than that in patients with cerebrovascular focuses in under cortex;the disturbances in patients with temporal lobe lesion were most serious. Key words: Cerebrovascular disease; Recognition memory; Different areas

Psychosocial impairments in children with epilepsy depend on the side of the focus

This article explores the idea that epileptic activity may interfere with psychosocial functions and development in children. In an adult population with epilepsy, left hemispheric seizure focus predicts worse psychosocial functioning. The developmental aspects of these disturbances require further studies. We studied self-report measures of cognitive (locus of control) and emotional (Beck Youth Inventories of Emotional and Social Impairment) functions in 30 children with partial epilepsy (6–15 years) and 60 healthy matched controls. Multivariate statistics revealed significant lateralization effects, with left-sided foci ( n = 15) leading to more external locus of control. Opposite to adults, the children with right hemispheric foci ( n = 15) exhibited more emotional impairments (anger, disruptive behavior) than the left hemispheric group. The cognitive and emotional dysfunctions in epilepsy may result from the interaction of focus lateralization and brain development. The cognitive disturbances beginning in childhood may lead to the stronger emotional impairments observed in adults with left hemispheric seizures.

Early Cognitive Outcome After Neonatal Stroke

The purpose of this study was to assess the cognitive development of 27 children with nonhemorrhagic neonatal stroke (occurring within the first 28 days of life). The cognitive evaluation consisted of the Bayley Scales of Infant Development, administered at 12 and/or 24 months poststroke. Compared with the normative sample, children with neonatal stroke obtained significantly lower scores on the Bayley Psychomotor Development Index at 12 months poststroke and on the Bayley Mental and Psychomotor Development Indices at 24 months poststroke. Outcome did not differ based on stroke type or laterality of infarct. However, there was a trend toward higher scores on the Bayley Psychomotor Development Index at 24 months in the left hemisphere group compared to the right hemisphere group. Overall, children with neonatal stroke evidenced significant impairment within the first 2 years poststroke. Further research is required to confirm whether cognitive impairments in these children resolve, remain in the low-average range, or increase with development as more complex skills are learned.