An exploration of anomia rehabilitation in drug-resistant temporal lobe epilepsy.

Around 40% of patients who undergo a left temporal lobe epilepsy (LTLE) surgery suffer from anomia (word-finding difficulties), a condition that negatively impacts quality of life. Despite these observations, language rehabilitation is still understudied in LTLE. We assessed the effect of a four-week rehabilitation on four drug-resistant LTLE patients after their surgery. The anomia rehabilitation was based on cognitive descriptions of word finding deficits in LTLE. Its primary ingredients were psycholinguistic tasks and a psychoeducation approach to help patients cope with daily communication issues. We repeatedly assessed naming skills for trained and untrained words, before and during the therapy using an A-B design with follow-up and replication. Subjective anomia complaint and standardized language assessments were also collected. We demonstrated the effectiveness of the rehabilitation program for trained words despite the persistence of seizures. Furthermore, encouraging results were observed for untrained items. Variable changes in anomia complaint were observed. One patient who conducted the protocol as self-rehabilitation responded similarly to the others, despite the different manner of intervention. These results open promising avenues for helping epileptic patients suffering from anomia. For example, this post-operative program could easily be adapted to be conducted preoperatively.

Single case-control design for the study of the neuropsychological deficits and dissociations in Huntington's disease-like 2.

The Single-Case Methodology in Neuropsychology (Crawford & Howell, 1998) is a research design and robust inferential statistical method that facilitates the neuropsychological description of one case in terms of the differences between its profile and the performance of a carefully matched sample (Crawford & Garthwaite, 2012). The comparison is made by means of a t-test statistic that treats the normative sample as a sample and not as a population, with a particular effect-size associated with the size (n) of the sample. It is an ideal method for the neuropsychological investigation of rare diseases, such as Huntington's Disease Like-2 (HDL2), especially when the cases are embedded in contexts of great diversity. This paper presents a step by step guide to the implementation of this method in a series of demographically and clinically diverse group of patients. •The application of a Single-Case Methodology in Neuropsychology enables the characterisation of rare diseases while controlling for demographic and context-related variables.•The implementation Single-Case Methodology in Neuropsychology provides test norms for homogenous groups that can be used by practitioners in their clinical work.•The method was customised for the South African population by controlling variables of specific relevance, such as linguistic diversity and quality of education.

"Shallow draughts intoxicate the brain": lessons from cognitive science for cognitive neuropsychology.

This article presents a sobering view of the discipline of cognitive neuropsychology as practiced over the last three or four decades. Our judgment is that, although the study of abnormal cognition resulting from brain injury or disease in previously normal adults has produced a catalogue of fascinating and highly selective deficits, it has yielded relatively little advance in understanding how the brain accomplishes its cognitive business. We question the wisdom of the following three "choices" in mainstream cognitive neuropsychology: (a) single-case methodology, (b) dissociation between functions as the most important source of evidence, and (c) a central goal of diagramming the functional architecture of cognition rather than specifying how its components work. These choices may all stem from an excessive commitment to strict and fine-grained modularity. Although different brain regions are undoubtedly specialized for different functions, we argue that parallel and interactive processing is a better assumption about cognitive processing. The essential goal of specifying representations and processes can, we claim, be significantly assisted by computational modeling which, by its very nature, requires such specification.