Effectiveness of holistic neuropsychological rehabilitation for Spanish population with acquired brain injury measured using Rasch analysis.

INTRODUCTION: The Rasch model is increasingly used in the field of rehabilitation because it improves the accuracy of measurements of patient status and their changes after therapy. OBJECTIVE: To determine the long-term effectiveness of a holistic neuropsychological rehabilitation program for Spanish outpatients with acquired brain injury (ABI) using Rasch analysis. METHODS: Eighteen patients (ten with long evolution - patients who started the program > 6 months after ABI- and eight with short evolution) and their relatives attended the program for 6 months. Patients' and relatives' answers to the European Brain Injury Questionnaire and the Frontal Systems Behavior Scale at 3 time points (pre-intervention. post-intervention and 12 month follow-up) were transformed into linear measures called logits. RESULTS: The linear measures revealed significant improvements with large effects at the follow-up assessment on cognitive and executive functioning, social and emotional self-regulation, apathy and mood. At follow-up, the short evolution group achieved greater improvements in mood and cognitive functioning than the long evolution patients. CONCLUSIONS: The program showed long-term effectiveness for most of the variables, and it was more effective for mood and cognitive functioning when patients were treated early. Relatives played a key role in the effectiveness of the rehabilitation program.

[Changes in episodic and semantic memory associated with temporal lobectomy]. / Cambios en memoria episódica y semántica asociados a la lobulectomía temporal.

INTRODUCTION: Temporal lobectomy (TL) is an effective treatment for drug refractory temporal lobe epilepsy. The main neuropsychological consequences of the intervention are changes in episodic and semantic memory. Aim. To study the consequences of right temporal lobectomy (RTL) and left temporal lobectomy (LTL) on episodic and semantic mnemonic functioning. PATIENTS AND METHOD: 27 patients who had undergone TL in the Hospital Universitario Virgen de las Nieves in Granada were submitted to pre and post surgical evaluation by means of a battery of neuropsychological tests that included episodic and semantic memory tests for both verbal and visual material. RESULTS AND CONCLUSIONS: ANOVA analysis was employed to analyse the pre and post surgical changes for the whole group of patients, and Student s t and Wilcoxon s non parametric test were used for each group of RTL and LTL. No deterioration was found in ipsilateral memory after the intervention, that is to say, in the verbal memory of the patients submitted to LTL and in the visual memory of RTL patients. With regard to contralateral memory, that is, the visual memory of patients submitted to LTL and the verbal memory of RTL patients, the ANOVA analyses of the whole group revealed a statistically significant improvement. The analyses performed for the whole group (LTL and RTL), however, did not reveal any statistically significant changes.

Cambios en la memoria episódica y semántica asociados a la lobulectomía temporal / Changes in episodic and semantic memory associated to temporal lobectomy

Introducción. La lobulectomía temporal (LT) representa un tratamiento eficaz para la epilepsia del lóbulo temporal refractaria al tratamiento farmacológico. Las principales consecuencias neuropsicológicas de la intervención son los cambios en memoria episódica y semántica. Objetivo. Estudiar las consecuencias de la lobulectomía temporal derecha (LTD) y lobulectomía temporal izquierda (LTI) sobre el funcionamiento mnésico episódico y semántico. Pacientes y métodos. 27 pacientes sometidos a LT en el Hospital Universitario Virgen de las Nieves de Granada. Se evaluaron pre y posquirúrgicamente mediante una amplia batería de pruebas neuropsicológicas, que incluía tests de memoria episódica y semántica, tanto para material verbal como visual. Resultados y conclusiones. Se analizaron los cambios pre y posquirúrgicos mediante análisis ANOVA para todo el conjunto de pacientes, y t de Student y test no paramétrico de Wilcoxon para cada grupo de LTD y LTI. No se han encontrado empeoramientos en la memoria ipsilateral a la intervención, es decir, en la memoria verbal de los pacientes sometidos a LTI y en la memoria visual de las LTD. Respecto a la memoria contralateral, es decir, la memoria visual de los pacientes sometidos a LTI y la memoria verbal de los pacientes con LTD, los análisis de todo el grupo mediante ANOVA revelaron una mejora estadísticamente significativa. En cambio, los análisis realizados a cada grupo (LTI y LTD) no mostraron cambios estadísticamente significativos (AU)