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All contemporary psychotherapies agree that (failing) emotion regulation is central to psychological disorders and that psychotherapy is about improving emotion regulation. In his research on the "emotion-laden" complex Jung put an emphasis on the role of failing emotion regulation in contributing to psychological disorders as well as to change in the process of psychotherapy, but he left this field of research and took a very different direction in favour of his archetype concept. Psychodynamic approaches generally argue that changes in emotion regulation are accomplished through corrective emotional experiences in the therapeutic relationship. Insights from affective neurosciences and attachment research have had a major influence on how the therapeutic relationship is constructed in contemporary psychodynamic approaches. There is a lack of similar developments in analytical psychology, which leads to substantial differences between the models of Jungian psychotherapy in contrast to other contemporary psychodynamic approaches. The implications of these differences for the practice of psychotherapy and especially the role of the therapeutic relationship are pointed out.
Toutes les psychothérapies actuelles s'accordent sur le fait que la régulation (défaillante) de l'émotion est au centre des désordres psychologiques et que la psychothérapie vise à améliorer la régulation de l'émotion. Dans sa recherche sur le « complexe à haute charge émotionnelle ¼, Jung a mis l'accent sur le rôle de la régulation défaillante de l'émotion comme participant aux désordres psychologiques ainsi qu'au changement dans le processus de psychothérapie. Mais il a abandonné ce champ de recherche et pris une direction très différente, y préférant son concept de l'archétype. Les approches psychodynamiques plaident généralement en faveur de l'idée que les changements dans la régulation de l'émotion sont atteints par les expériences émotionnelles corrective dans la relation thérapeutique. Des apports venant des neurosciences affectives et des recherches sur l'attachement ont eu une influence majeure sur comment la relation thérapeutique est construite dans les approches psychodynamiques actuelles. De tels développements font défaut dans la psychologie analytique, ce qui conduit à des différences considérables entre les modèles de psychothérapie jungienne en contraste avec les autres approches psychodynamiques actuelles. L'article souligne les conséquences de ces différences dans la pratique de la psychothérapie, tout particulièrement en ce qui concerne le rôle de la relation thérapeutique.
Todas las psicoterapias contemporáneas coinciden en que la regulación (fallida) de las emociones es central a los trastornos psicológicos y que la psicoterapia consiste en mejorar la regulación de las emociones. En su investigación sobre el complejo "de tonalidad afectiva", Jung hizo hincapié en el rol de una fallida regulación emocional en el desarrollo de los trastornos psicológicos, así como al cambio en el proceso de psicoterapia, pero abandonó este campo de investigación y tomó una dirección muy diferente en favor de su concepto de arquetipo. En general, los enfoques Psicodinámicos sostienen que los cambios en la regulación de las emociones se logran a través de experiencias emocionales correctivas en la relación terapéutica. Los conocimientos de las neurociencias afectivas y la investigación sobre el apego han tenido una gran influencia en cómo comprender la conformación de la relación terapéutica en los abordajes psicodinámicos contemporáneos. Faltan desarrollos similares en la psicología analítica, lo que conduce a diferencias sustanciales entre los modelos de la psicoterapia Junguiana en contraste con otros enfoques psicodinámicos contemporáneos. Se señalan las implicaciones de estas diferencias para la práctica de la psicoterapia y se destaca especialmente el rol de la relación terapéutica.
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Santiago Ramón y Cajal (1852-1934) revolutionized the branches of neuroscience in a forceful way, and he did it with extreme delicacy and candor. His scientific writings and drawings are full of allusions to Nature, a fact that demonstrates how he saw, understood and enjoyed it with exquisite sensitivity and pressing emotion. Neuroscience awakened in him the utmost curiosity to delve into the powerful mysteries of the mind, and neurohistology allowed him to satisfy his deepest concerns for fascinating scenarios, a desire not sufficiently fulfilled throughout the fields, mountains and forests of his childhood and youth. Through that wonderful microscopic world Cajal changed the size of the dreamed landscapes but not the dimension of the longed-for adventures. Exploring and entering unknown paths he unraveled some of the greatest enigmas that the nervous system hid, but he would do so with a deep feeling toward the infinite beauty that Nature itself offered him. In short, Nature was the vital axis of Cajal's overwhelming and complex personality, his most genuine essence and the inexhaustible source of inspiration where he poured his imagination and fantasy. He became a vocational adventurer, an insatiable explorer, a talented artist and an exquisite humanist. An eminently romantic soul who knew how to link Nature and Neuroscience with unconditional and perpetual emotionality.
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BACKGROUND: The rapid advancement of technology-focused strategies in neurorehabilitation has brought optimism to individuals with neurological disorders, caregivers, and physicians while reshaping medical practice and training. OBJECTIVES: We critically examine the implications of technology in neurorehabilitation, drawing on discussions from the 2021 and 2024 World Congress for NeuroRehabilitation. While acknowledging the value of technology, it highlights inherent limitations and ethical concerns, particularly regarding the potential overshadowing of humanistic approaches. The integration of technologies such as robotics, artificial intelligence, neuromodulation, and brain-computer interfaces enriches neurorehabilitation by offering interdisciplinary solutions. However, ethical considerations arise regarding the balance between compensation for deficits, accessibility of technologies, and their alignment with fundamental principles of care. Additionally, the pitfalls of relying solely on neuroimaging data are discussed, stressing the necessity for a more comprehensive understanding of individual variability and clinical skills in rehabilitation. RESULTS: From a clinical perspective, the article advocates for realistic solutions that prioritize individual needs, quality of life, and social inclusion over technological allure. It underscores the importance of modesty and honesty in responding to expectations while emphasizing the uniqueness of each individual's experience. Moreover, it argues for the preservation of human-centric approaches alongside technological advancements, recognizing the invaluable role of clinical observation and human interaction in rehabilitation. CONCLUSION: Ultimately, the article calls for a balanced attitude that integrates both scientific and humanistic perspectives in neurorehabilitation. It highlights the symbiotic relationship between the sciences and humanities, advocating for philosophical questioning to guide the ethical implementation of new technologies and foster interdisciplinary dialogue.
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INTRODUCTION: Repetitive transcranial magnetic stimulation (rTMS) alleviates symptoms of major depressive disorder, but its neurobiological mechanisms remain to be fully understood. Growing evidence from proton magnetic resonance spectroscopy (1HMRS) studies suggests that rTMS alters excitatory and inhibitory neurometabolites. This preliminary meta-analysis aims to quantify current trends in the literature and identify future directions for the field. METHODS: Ten eligible studies that quantified Glutamate (Glu), Glu+Glutamine (Glx), or GABA before and after an rTMS intervention in depressed samples were sourced from PubMed, MEDLINE, PsychInfo, Google Scholar, and primary literature following PRISMA guidelines. Data were pooled using a random-effects model, Cohen's d effect sizes were calculated, and moderators, such as neurometabolite and 1HMRS sequence, were assessed. It was hypothesized that rTMS would increase cortical neurometabolites. RESULTS: Within-subjects data from 224 cases encompassing 31 neurometabolite effects (k) were analyzed. Active rTMS in clinical responders (n = 128; k = 22) nominally increased glutamatergic neurometabolites (d = 0.15 [95% CI: -0.01, 0.30], p = 0.06). No change was found in clinical nonresponders (p = 0.8) or sham rTMS participants (p = 0.4). A significant increase was identified in Glx (p = 0.01), but not Glu (p = 0.6). Importantly, effect size across conditions were associated with the number of rTMS pulses patients received (p = 0.05), suggesting dose dependence. CONCLUSIONS: Clinical rTMS is associated with a nominal, dose-dependent increase in glutamatergic neurometabolites, suggesting rTMS may induce Glu-dependent neuroplasticity and upregulate neurometabolism. More, larger scale studies adhering to established acquisition and reporting standards are needed to further elucidate the neurometabolic mechanisms of rTMS.
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What is the function of auditory hemispheric asymmetry? We propose that the identification of sound sources relies on the asymmetric processing of two complementary and perceptually relevant acoustic invariants: actions and objects. In a large dataset of environmental sounds, we observed that temporal and spectral modulations display only weak covariation. We then synthesized auditory stimuli by simulating various actions (frictions) occurring on different objects (solid surfaces). Behaviorally, discrimination of actions relies on temporal modulations, while discrimination of objects relies on spectral modulations. Functional magnetic resonance imaging data showed that actions and objects are decoded in the left and right hemispheres, respectively, in bilateral superior temporal and left inferior frontal regions. This asymmetry reflects a generic differential processing-through differential neural sensitivity to temporal and spectral modulations present in environmental sounds-that supports the efficient categorization of actions and objects. These results support an ecologically valid framework of the functional role of auditory brain asymmetry.
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Estimulação Acústica , Percepção Auditiva , Lateralidade Funcional , Imageamento por Ressonância Magnética , Humanos , Masculino , Feminino , Imageamento por Ressonância Magnética/métodos , Lateralidade Funcional/fisiologia , Adulto , Estimulação Acústica/métodos , Percepção Auditiva/fisiologia , Adulto Jovem , Mapeamento Encefálico/métodos , Córtex Auditivo/fisiologia , Córtex Auditivo/diagnóstico por imagemRESUMO
BACKGROUND: Vagally-mediated heart rate variability (vm-HRV) shows promise as a biomarker of internal training load (ITL) during exergame-based training or motor-cognitive training in general. This study evaluated the test-retest reliability of vm-HRV during exergaming in healthy older adults (HOA) and its validity to monitor ITL. METHODS: A within-subjects (repeated-measures) randomized study was conducted that included baseline assessments and 4 measurement sessions. Participants played 5 exergames at 3 standardized levels of external task demands (i.e., "easy", "challenging", and "excessive") in random order for 90 s. Test-retest reliability was assessed on the basis of repeated-measures analyses of variance (ANOVA), intraclass correlation coefficients (ICC3,1), standard errors of measurement (SEM), and smallest detectable differences (SDD). Validity was determined by examining the effect of game level on vm-HRV in the ANOVA. RESULTS: Fourty-three HOA (67.0 ± 7.0 years; 58.1% females (25 females, 18 males); body mass index = 23.7 ± 3.0 kg·m-2) were included. Mean R-R time intervals (mRR) and parasympathetic nervous system tone index (PNS-Index) exhibited mostly good to excellent relative test-retest reliability with no systematic error. Mean SEM% and SDD% were 36.4% and 100.7% for mRR, and 44.6% and 123.7% for PNS-Index, respectively. Significant differences in mRR and PNS-Index were observed between standardized levels of external task demands, with mostly large effect sizes (mean r = 0.847). These results persisted irrespective of the type of neurocognitive domain trained and when only motoric and cognitive demands were manipulated while physical intensity was kept constant. The remaining vm-HRV parameters showed inconsistent or poor reliability and validity. CONCLUSION: Only mRR and PNS-Index demonstrated reliable measurement and served as valid biomarkers for ITL during exergaming at a group level. Nonetheless, the presence of large SEMs hampers the detection of individual changes over time and suggests insufficient precision of these measurements at the individual level. Future research should further investigate the reliability and validity of vm-HRV with a specific focus on comparing different measurement methodologies and exercise conditions, particularly focusing on ultra-short-term HRV measurements, and investigate the potential implications (i.e., superiority to other markers of ITL or monitoring strategies?) of using vm-HRV as a biomarker of ITL.
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PURPOSE: Understanding the complex bidirectional interactions between neurons and glioma cells could help to identify new therapeutic targets. Herein, the techniques and application of novel neuroscience tools implemented to study the complex interactions between brain and malignant gliomas, their results, and the potential therapeutic opportunities were reviewed. METHODS: Literature search was performed on PubMed between 2001 and 2023 using the keywords "glioma", "glioblastoma", "circuit remodeling", "plasticity", "neuron networks" and "cortical networks". Studies including grade 2 to 4 gliomas, diffuse midline gliomas, and diffuse intrinsic pontine gliomas were considered. RESULTS: Glioma cells are connected through tumour microtubes and form a highly connected network within which pacemaker cells drive tumorigenesis. Unconnected cells have increased invasion capabilities. Glioma cells are also synaptically integrated within neural circuitry. Neurons promote tumour growth via paracrine and direct electrochemical mechanisms, including glutamatergic AMPA-receptors. Increased glutamate release in the tumor microenvironment and loss of peritumoral GABAergic inhibitory interneurons result in network hyperexcitability and secondary epilepsy. Functional imaging, local field potentials and subcortical mapping, performed in awake patients, have defined patterns of malignant circuit remodeling. Glioma-induced remodeling is frequent in language and even motor cortical networks, depending on tumour biological parameters, and influences functional outcomes. CONCLUSION: These data offer new insights into glioma tumorigenesis. Future work will be needed to understand how tumor intrinsic molecular drivers influence neuron-glioma interactions but also to integrate these results to design new therapeutic options for patients.
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Neoplasias Encefálicas , Glioma , Humanos , Glioma/patologia , Glioma/metabolismo , Glioma/fisiopatologia , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/fisiopatologia , Invasividade Neoplásica , Animais , Rede Nervosa/fisiopatologia , Rede Nervosa/patologia , Neurônios/patologia , Neurônios/fisiologia , Neurônios/metabolismoRESUMO
BACKGROUND: Exergame-based training is currently considered a more promising training approach than conventional physical and/or cognitive training. OBJECTIVES: This study aimed to provide quantitative evidence on dose-response relationships of specific exercise and training variables (training components) of exergame-based training on cognitive functioning in middle-aged to older adults (MOA). METHODS: We conducted a systematic review with meta-analysis including randomized controlled trials comparing the effects of exergame-based training to inactive control interventions on cognitive performance in MOA. RESULTS: The systematic literature search identified 22,928 records of which 31 studies were included. The effectiveness of exergame-based training was significantly moderated by the following training components: body position for global cognitive functioning, the type of motor-cognitive training, training location, and training administration for complex attention, and exercise intensity for executive functions. CONCLUSION: The effectiveness of exergame-based training was moderated by several training components that have in common that they enhance the ecological validity of the training (e.g., stepping movements in a standing position). Therefore, it seems paramount that future research focuses on developing innovative novel exergame-based training concepts that incorporate these (and other) training components to enhance their ecological validity and transferability to clinical practice. We provide specific evidence-based recommendations for the application of our research findings in research and practical settings and identified and discussed several areas of interest for future research. PROSPERO REGISTRATION NUMBER: CRD42023418593; prospectively registered, date of registration: 1 May 2023.
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Cognição , Jogos de Vídeo , Humanos , Cognição/fisiologia , Idoso , Pessoa de Meia-Idade , Terapia por Exercício/métodos , Exercício Físico/fisiologiaRESUMO
In the context of socio-technical systems, traditional engineering approaches are inadequate, calling for a fundamental change in perspective. A different approach encourages viewing socio-technical systems as complex living entities rather than through a simplistic lens, which enhances our understanding of their dynamics. However, these systems are designed to facilitate human activities, and the goal is not only to comprehend how they operate but also to guide their function. Currently, we lack the appropriate terminology. Hence, we introduce two principal concepts, simplexity and complixity, drawing inspiration from how nature conceals intricate mechanisms beneath straightforward, user-friendly interfaces.
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INTRODUCTION: The combination of exergame-based motor-cognitive training with resonance breathing guided by heart-rate variability biofeedback (HRV-BF) targets various relevant mechanisms of action to alleviate the pathological state in mild neurocognitive disorders (mNCD). METHODS: This randomized controlled trial (RCT) investigated the effectiveness of adding this novel intervention approach to usual care in mNCD. The individualized intervention was delivered via the "Brain-IT" training concept, which was iteratively co-designed, tested, and refined with patient and public involvement. RESULTS: We observed statistically significant effects with large effect sizes for global cognitive performance, immediate verbal recall, and delayed verbal recall in favor of the intervention group. Fifty-five percent of participants showed a clinically relevant improvement in response to training. DISCUSSION: Confirmatory RCTs are warranted to investigate whether the observed improvements in cognitive performance translate to affecting the rates of progression to or onset of dementia and test the implementation of the training in clinical practice. HIGHLIGHTS: We proposed a novel intervention approach for mild neurocognitive disorders. It combines exergame-based training with biofeedback-guided resonance breathing. Our results confirm the effectiveness of this approach. Fifty-five percent of participants showed a clinically relevant improvement in response to training.
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Biorretroalimentação Psicológica , Disfunção Cognitiva , Humanos , Masculino , Feminino , Biorretroalimentação Psicológica/métodos , Idoso , Disfunção Cognitiva/terapia , Frequência Cardíaca/fisiologia , Terapia por Exercício/métodos , Transtornos Neurocognitivos/terapia , Jogos de Vídeo , Pessoa de Meia-Idade , Resultado do Tratamento , Exercícios Respiratórios/métodos , Testes Neuropsicológicos/estatística & dados numéricosRESUMO
The shift towards remote or online therapy was compelled by the Pandemic. Many colleagues, who neither had practice using this modality, nor had ever considered it as a possibility, ultimately adopted it. This experience brought with it a substantial expansion of online therapy beyond that moment of emergency. It opened up new prospects of intervention, but at the same time it required a greater measure of reflection in order to understand how to inhabit this new therapy space. Setting aside provisory, intermittent, or emergency situations, which temporarily transfer therapy into a "field of tents" (Bolognini, 2021), the author proposes to consider how online psychotherapy redefines an important element of the psychoanalytic setting-the issue of the space. This is no longer the therapist's place of work, envisaged and organized by him/her/them, fixed in time, and contrived only to welcome the therapeutic relationship-one of the crucial aspects of the external setting, which together with the temporal dimension, fulfills the therapy ritual. Assuming the framework to be essential to the psychoanalytic process, this paper will focus on the methodology of online therapy. The author will describe the contributions of the neurosciences, to provide a deeper understanding of the distinctive characteristics of sharing in an online vs. an offline space. Online therapy should be assessed for its distinguishing qualities within a complete theoretical, technical, and clinical reflection specific to each case. Proceeding as if it were a mere relocation of an in-person analysis would enhance the seductiveness of a therapy that is easily accessible with any laptop anywhere, anytime, and in which one could mistake an online connection for a deep connection.
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Terapia Psicanalítica , Humanos , Terapia Psicanalítica/métodos , Telemedicina , COVID-19 , Relações Profissional-PacienteRESUMO
The invention of film technologies in France at the end of the 19th century inspired neurologists and associated professionals to engage with this new medium to demonstrate their theories of the brain, the nervous system, and the mind. Beginning with the origins of cinema in Paris, this article explores how film technologies were used at La Salpêtrière, and beyond, to visualise internal mental processes, and to support the burgeoning sciences of the mind. This film-making became increasingly sophisticated by the late 1910s and early 1920s, creating innovative ways to present psychological experiences on film. This article focuses on films produced by Albert Londe, Vincenzo Neri, Gheorghe Marinescu, and Jean Comandon. It argues that these polymaths created new filming techniques that built complexity into the visual articulation of psychological concepts. Their films were essential to shaping early debates in neurology, psychology, and the observational sciences during this critical period in the establishment of the modern sciences of the self.
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OBJECTIVE: Provide a synthesis of the current literature about the effects of detraining on cognitive functions in older adults. METHODS: The PICOS acronym strategy was performed in PubMed/MEDLINE, Web of Science, Cochrane Library and PsycINFO database. The Preferred Reporting Items for Systematic Review and Meta-Analyses statement had been followed in the present study, in which the search was conducted on October 2023. The study selection consisted in original articles including older adults, detraining after training exercise period, use of tests or scales to measure cognitive function. The Downs and Black checklist had been used to assess the studies quality. Sample characteristics, type of previous training, detraining period, cognitive functions measurements and main results were extracted by 2 investigators. RESULTS: From 1927 studies, 12 studies were included, being 11 studies identified via systematic research, and 1 study by citation search. Older adults, ranged from 60 to 87 years old, were assessed after detraining. The cognitive functions most evaluated were global cognition and executive functions. One study evaluated both cognitive outcome and cerebral blood flow. Most of the studies demonstrated a decline in the cognitive function after detraining. CONCLUSION: Exercise detraining period, ranging from 10 days to 16 weeks, can effect negatively the cognitive function in older adults.
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Cognição , Exercício Físico , Humanos , Idoso , Cognição/fisiologia , Exercício Físico/psicologia , Exercício Físico/fisiologia , Idoso de 80 Anos ou mais , Função Executiva/fisiologia , Pessoa de Meia-Idade , Disfunção CognitivaRESUMO
OBJECTIVES: Although an increasing number of studies show that time-restricted feeding may improve metabolic health, studies examining the behavioral effects of this eating pattern are limited. This study examined the effect of time-restricted feeding on impulsivity in adults. METHODS: Thirty adults aged 25-41 years participated in this randomized controlled trial. The intervention group followed time-restricted feeding for 4 weeks and there was no energy restriction in the intervention group (n = 15) or control group (n = 15). Impulsivity was assessed before and after the intervention with the Barratt Impulsiveness Scale and the Go/NoGo task. RESULTS: The compliance rate (the percentage of days when participants had a feeding time of ≤ 8 hours/day) of the intervention group to the time-restricted feeding pattern was 92.38 ± 4.24%. The Barratt Impulsiveness Scale-11 total score of the intervention group increased from 55.53 ± 6.37 to 59.47 ± 7.67 (p = 0.02). During the Go/NoGo task, an indicator of inhibitory control, the reaction time to food and non-food stimuli was significantly shortened in the intervention group (respectively; p = 0.009, p = 0.01). In the control group, no significant change was detected in impulsivity determined by the BIS-11 or Go/NoGo task. DISCUSSION: This study showed that although time-restricted feeding may reduce body weight, it can lead to increased impulsivity and impaired inhibitory control.Trial registration: ClinicalTrials.gov identifier: NCT04960969.
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The purpose of this review is to highlight the most important aspects of the anatomical and functional uniqueness of the human brain. For this, a comparison is made between our brains and those of our closest ancestors (chimpanzees and bonobos) and human ancestors. During human evolution, several changes occurred in the brain, such as an absolute increase in brain size and number of cortical neurons, in addition to a greater degree of functional lateralization and anatomical asymmetry. Also, the cortical cytoarchitecture became more diversified and there was an increase in the number of intracortical networks and networks extending from the cerebral cortex to subcortical structures, with more neural networks being invested in multisensory and sensory-motor-affective-cognitive integration. These changes permitted more complex, flexible and versatile cognitive abilities and social behavior, such as shared intentionality and symbolic articulated language, which, in turn, made possible the formation of larger social groups and cumulative cultural evolution that are characteristic of our species.
Esta revisão se propõe a relatar os aspectos mais importantes da singularidade anatômica e funcional do cérebro humano. Para isso, faz-se uma comparação entre o nosso cérebro e os de nossos parentes evolutivos mais próximos (chimpanzés e bonobos) e os ancestrais humanos. Durante a evolução humana ocorreu aumento absoluto do tamanho do cérebro e do número de neurônios corticais cerebrais, maior grau de lateralização funcional e assimetria anatômica cerebral, citoarquitetura cortical mais diversificada e aumento das redes neurais intracorticais e do córtex cerebral para as estruturas subcorticais acompanhada de mudança em direção ao investimento de redes neurais na integração multissensorial e sensório-motora-afetiva-cognitiva. Essas mudanças possibilitaram capacidades cognitivas e comportamentos sociais complexos, flexíveis e versáteis, destacando-se a intencionalidade compartilhada e a linguagem articulada simbólica, que permitiram a formação de grupos sociais maiores e a evolução cultural cumulativa característica de nossa espécie.
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Over the last years, fractals have entered into the realms of clinical neurosciences. The whole brain and its components (i.e., neurons and astrocytes) have been studied as fractal objects, and even more relevant, the fractal-based quantification of the geometrical complexity of histopathological and neuroradiological images as well as neurophysiopathological time series has suggested the existence of a gradient in the pattern representation of neurological diseases. Computational fractal-based parameters have been suggested as potential diagnostic and prognostic biomarkers in different brain diseases, including brain tumors, neurodegeneration, epilepsy, demyelinating diseases, cerebrovascular malformations, and psychiatric disorders as well. This chapter and the entire third section of this book are focused on practical applications of computational fractal-based analysis into the clinical neurosciences, namely, neurology and neuropsychiatry, neuroradiology and neurosurgery, neuropathology, neuro-oncology and neurorehabilitation, neuro-ophthalmology, and cognitive neurosciences, with special emphasis on the translation of the fractal dimension and other fractal parameters as clinical biomarkers useful from bench to bedside.
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Neoplasias Encefálicas , Epilepsia , Humanos , Biomarcadores , Encéfalo/patologia , Neoplasias Encefálicas/diagnóstico por imagem , FractaisRESUMO
The first chapter of this book introduces some history, philosophy, and basic concepts of fractal geometry and discusses how the neurosciences can benefit from applying computational fractal-based analysis. Further, it compares fractal with Euclidean approaches to analyzing and quantifying the brain in its entire physiopathological spectrum and presents an overview of the first section of this book as well.
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Common data elements (CDEs) for concussion, as established by international bodies, are not being widely used in Ontario, resulting in significant variability in the data being assessed and collected across clinics. CDEs support standardization of care as well as large-scale data sharing for high impact research. A collaborative network - Concussion Ontario Network: Neuroinformatics to Enhance Clinical care and Translation (CONNECT) - comprised of health care professionals, researchers, members from advocacy groups, and patients was formed to establish and implement CDEs for concussion care and research. While the seeds have been planted and initial effectiveness demonstrated, future challenges exist.
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Cerebral visual impairments have been of great interest to neurologists, ophthalmologists, and neuroscientists. Complicated or partial varieties related to cortical blindness are discussed in this review. They are a fascinating alphabet of eponymic clinical syndromes, bordering neurology, ophthalmology, and even psychiatry. Recent functional imaging and experimental studies have contributed further knowledge of cognitive visual organization in addition to the classical lesion evidence.