Effectiveness of an Educational Intervention on Reducing Misconceptions Among Ethnic Minorities With Complicated Mild to Severe Traumatic Brain Injury.

OBJECTIVE: To evaluate the effectiveness of an educational intervention designed to reduce traumatic brain injury (TBI)-related misconceptions among blacks and Latinos with complicated mild to severe TBI. DESIGN: Randomized controlled trial with masked 1-month follow-up. SETTING: Community. PARTICIPANTS: Persons (N=52) with complicated mild to severe TBI (mean best day 1 Glasgow Coma Scale score, 11.27±3.89) were randomly recruited from 141 eligible participants (mean age, 37.71±13.88y; age range, 19-66y; mean months postinjury, 24.69±11.50); 25 participants (48.1%) of participants were black and 27 (51.9%) were Hispanic/Latino. Of the Hispanic/Latino participants, 18 (66.7%) were non-U.S. born and 12 (44.4%) spoke Spanish as their primary language. Twenty-seven individuals were randomized to the educational intervention group and 25 were randomized to the wait-list control group. INTERVENTIONS: Single-session educational intervention with written materials provided in English or Spanish. MAIN OUTCOME MEASURES: Forty-item Common Misconceptions about Traumatic Brain Injury Questionnaire administered at baseline and 1-month follow-up. RESULTS: After controlling for ethnic and language differences, a significant between-group main effect (P=.010) and a significant time-group interaction for the Common Misconceptions about Traumatic Brain Injury Questionnaire were noted (Wilks Λ=.89; F1,46=6.00; P=.02). The intervention group showed a decrease in TBI misconception percentages, whereas the wait-list control group maintained similar percentages. At 1-month follow-up, the wait-list control group reported more misconceptions than did the intervention group (P=.019). CONCLUSIONS: An educational intervention developed to address the recovery process, common symptoms, and ways to handle the symptoms provides promise as a tool to decrease TBI misconceptions among persons from ethnically and educationally diverse backgrounds. The effects of therapist characteristics and the client-therapist relation on outcomes should be further explored.

Neurofeedback training for peak performance.

AIM: One of the applications of the Neurofeedback methodology is peak performance in sport. The protocols of the neurofeedback are usually based on an assessment of the spectral parameters of spontaneous EEG in resting state conditions. The aim of the paper was to study whether the intensive neurofeedback training of a well-functioning Olympic athlete who has lost his performance confidence after injury in sport, could change the brain functioning reflected in changes in spontaneous EEG and event related potentials (ERPs). CASE STUDY: The case is presented of an Olympic athlete who has lost his performance confidence after injury in sport. He wanted to resume his activities by means of neurofeedback training. His QEEG/ERP parameters were assessed before and after 4 intensive sessions of neurotherapy. Dramatic and statistically significant changes that could not be explained by error measurement were observed in the patient. CONCLUSION: Neurofeedback training in the subject under study increased the amplitude of the monitoring component of ERPs generated in the anterior cingulate cortex, accompanied by an increase in beta activity over the medial prefrontal cortex. Taking these changes together, it can be concluded that that even a few sessions of neurofeedback in a high performance brain can significantly activate the prefrontal cortical areas associated with increasing confidence in sport performance.

The effect of programed physical activity measured with levels of body balance maintenance.

Background The aim of the research was an evaluation of 2 training programs covering the same standard physical activity in the initial stage (warm-up) and the main (motor exercises) as well as a separate end part in Program A of stretching and in Programme B of vibration training designed to improve the level of body balance. Material and Methods We tested 40 randomly chosen students of the Academy of Physical Education and Sport in Gdansk, subsequently divided into two 20-person groups: C (average age 21.3±1.2), and E (average age 21.8±1.1). The training of body balance was conducted for 8 weeks: we used in Group C Program A and in group E Program B. The evaluation of body balance was done 3 times: at the beginning, at midway point, and at the end of the experiment. The stabilographic tests with posture-graphical method and the task of 1-leg balance standing with eyes closed was used. Results It was found that in the first examination both groups did not significantly differ in terms of the tested parameters of balance. During the training process we obtained increased time of maintaining balance on 1 leg. This difference was significant between tests 1 and 2 both for Group C (p=0.0002) and for E (p=0.0034), while between the tests 2 and 3 in Group E (p=0.0213) only. Conclusions The training Program B is more effective to maintain balance on 1 leg when compared to Program A.

Evaluation of a neurotherapy program for a child with ADHD with Benign Partial Epilepsy with Rolandic Spikes (BPERS) using event-related potentials.

BACKGROUND: We hypothesized that there would be a good response to relative beta training, applied to regulate the dynamics of brain function in a patient with benign partial epilepsy with Rolandic Spikes (BPERS), associated with neuropsychiatric deficits resembling the symptoms of attention deficit-hyperactivity disorder (ADHD). CASE REPORT: The patient, E.Z., age 9.3, was suffering from neuropsychiatric symptoms, cognitive dysfunction, especially attention deficits, and behavioral changes, rendering him unable to function independently in school and in many situations of everyday life. He was treated for epilepsy, but only slight progress was made. The patient took part in 20 sessions of relative beta training combined with behavioral training. We used standardized neuropsychological testing, as well as ERPs before the experiment and after the completion of the neurotherapy program. Neuropsychological testing at baseline showed multiple cognitive deficits. Over the course of neurotherapy, E.Z.'s verbal and non-verbal IQ increased significantly. His cognitive functions also improved, including immediate and delayed logical and visual recall on the WMS-III, maintaining attention on the WMS-III, and executive functions, but remained below norms. Physiologically, the patient showed substantial changes after neurotherapy, including fewer spikes and an increased P300 NOGO component. CONCLUSIONS: The cognitive deficits characteristic for ADHD in a child with BPERS may be unresponsive to antiepileptic treatment, but are reversible after a carefully selected neurotherapy program, combined with antiepileptic treatment. Event Related Potentials (ERPs) in the GO/NOGO task can be used to assess functional brain changes induced by neurotherapeutical programs.

Aggressive and impulsive behaviors in Frontotemporal dementia and Alzheimer's disease.

BACKGROUND: Differentiating FTD and AD is of great clinical significance, due to the very different efficacy of cholinesterase inhibitors in the two disorders. Previous studies have pointed to behavioral differences in FTD and AD, but less attention has been paid to comparing aggressive and impulsive behaviors in the AD and the FTD. MATERIAL/METHODS: Nursing home residents diagnosed with AD (NINCDS/ADRDA criteria) or the behavioral variant of FTD (Frontotemporal Dementia and Pick's Disease Working Group criteria) were included in the research group. Individuals diagnosed with AD who showed atrophy of the frontal lobes in neuroimaging were excluded from the study, as were patients matching the clinical criteria for bvFTD, but with lesions in the temporal lobes. Agitation and aggressive behaviors were assessed using the Cohen-Mansfield Agitation Inventory (CMAI), whereas behavioral and psychological symptoms were assessed with the Neuropsychiatric Inventory - Nursing Home Version (NPI-NH). RESULTS: The overall NPI-NH score, including with some partial scores (apathy/indifference and disinhibition), together with the intensity of aberrant motor behavior differentiated individuals with AD from those with bvFTD. On the CMAI scale, both the overall score and physical aggressive behaviors differentiated the two study groups. CONCLUSIONS: Our research confirms previous results indicating a greater intensity of behavioral pathology in FTD. A detailed assessment of aggressive behaviors revealed further differences between AD and FTD in this respect.