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Biomedical subjects

B Pentland

Publications and source records attributed to B Pentland.

At least 37 records · Page 2Linked to original sources
PubMed1998

Fluoxetine as a treatment for post-stroke emotionalism.

The effectiveness of fluoxetine compared to placebo in the treatment of post-stroke emotionalism was investigated in 20 patients using a double-blind protocol. A total of 19 patients completed the study, as one subject in the treatment group had to be withdrawn. The subjects receiving fluoxetine showed a statistically and clinically significant improvement in their emotionalism compared to the placebo group, which was apparent in the majority of subjects from the third day of treatment.

Aged↗
PubMed1998

Virtual reality: a new prosthesis for brain injury rehabilitation.

Virtual Reality (VR) technology is a relatively new application to rehabilitation medicine, yet it offers considerable potential to achieve significant successes in assessment, treatment and improved outcome, thereby increasing our knowledge of neuroplasticity. The capabilities of VR are especially evident in neurological rehabilitation, where cognitive and behavioural problems often interact with physical impairments to reduce the overall level of functioning and interaction. The need for effective interventions in neurological rehabilitation demands communication and collaboration between disciplines. This paper presents some of the current areas of the clinical applications of VR, emphasising the link between experimental evidence on recovery after brain damage and the clinical problems encountered in a ward setting.

Brain Injuries↗
PubMed1997

Parkinsonism associated with acute intracranial hematomas: an [18F]dopa positron-emission tomography study.

We present the case of a 36-year-old woman with a right temporal hematoma and an overlying subdural hematoma following rupture of a right middle cerebral artery aneurysm. Three weeks after recovering consciousness, she developed a levodopa-responsive parkinsonian syndrome involving the right limbs. A year after the vascular event, she reported subjective improvement in her parkinsonism, which has remained stable since. 18F-dopa positron-emission tomography showed a marked reduction of uptake in the left putamen, raising the possibility that the intracranial hemorrhage unmasked latent Parkinson's disease. To the best of our knowledge, this is the first case of parkinsonism associated with spontaneous acute intracerebral and subdural hematomas.

Acute Disease↗
PubMed1997

Head injury rehabilitation in the U.K.: an economic perspective.

The human and societal costs as a result of traumatic brain injury (TBI) are extensive with approximately 200-300/100,000 of the population requiring hospitalisation each year in the U.K. Advances in neurosurgical management have meant that more people sustaining head injuries are surviving. The need for rehabilitation programmes for these individuals is therefore ever increasing. While in the U.S.A. rehabilitation programmes for TBI patients are well established, in the U.K. the provision of such services is patchy and varies widely in different localities. The belated response to the rehabilitation needs of this group of individuals in the U.K. has coincided with an increased awareness of the economic efficiency of health care provision. This paper critically reviews published studies looking at the economics of rehabilitation services for brain injured patients. No studies in the U.K. were identified and all the sources discussed are from the U.S.A. The methodological guidelines underlying economic appraisal of health care are summarised and the studies assessed to determine the extent to which they fulfil these guidelines. The paper concludes that most studies purporting to provide evidence of cost-effectiveness did not include appropriate data, nor followed the methodological guidelines allowing such claims to be made. Some recommendations for future research are presented.

Brain Injuries↗
PubMed1997

Disability in patients following traumatic brain injury--which measure?

Head injury results in a wide range of functional sequelae. Thus, measuring solely physical aspects of functioning may fail to highlight the actual level of disability. This study compares a commonly used measure of physical disability, the Barthel Index, with three recently devised measures-the OPCS Scales of Disability, the Functional Independence Measure (FIM) and Functional Assessment Measure (FIM + FAM). Fifty-four head-injured subjects were assessed following discharge from an in-patient rehabilitation unit utilizing each measure. The majority of subjects had no detectable disability according to the Barthel Index. In contrast, only four subjects (7%) attained maximal scores for independence with the OPCS scale; two (4%) with the FIM and only one subject (2%) with the FIM + FAM. This reflected the nature of the disabilities in activities such as intellectual functioning, communication, behaviour and wider aspects of mobility measured by the OPCS, FIM and FIM + FAM but not in the Barthel Index. The relationship between all measures was significant (Spearman ranked correlations P < 0.001) but correlations were greater between OPCS, FIM and FIM + FAM than with the Barthel. The results of this study would support considering the use of scales other than the Barthel Index when describing disability following traumatic head injury.

Activities of Daily Living↗
PubMed1996

Early experience of the utility of the European Head Injury Evaluation Chart.

The European Head Injury Evaluation Chart (EHIEC) was designed by the European Brain Injury Society to assess head-injured patients from the initial insult to several years following injury. We describe the experience of using the EHIEC in assessing 56 consecutive traumatically brain-injured people admitted to an early inpatient brain injury rehabilitation programme over a 9-month period. An account of its use on admission and at discharge in a subgroup of 40 cases is also given. The difficulties in relation to the length of time to administer the EHIEC, the wording, definition and scoring of items are discussed. We suggest that an instruction manual is required and conclude that, while in its present form it represents a potentially useful checklist, further work is needed to refine the instrument and establish its validity and reliability.

Activities of Daily Living↗
PubMed1996

Late rehabilitation for closed head injury: a follow-up study of patients 1 year from time of discharge.

Subsequent to the setting up of an outpatient psychological service for head-injured patients, 50 patients were interviewed a year from the time of their discharge from our neurorehabilitation unit. The problems which persisted at this stage are presented and discussed. Some of the difficulties encountered in the evaluation of rehabilitation effects are identified. We conclude that: (1) there is a desperate need in the UK for more long-term support and rehabilitation services for this group of patients and (2) it is essential that such services are carefully monitored and evaluated despite the difficulties involved.

Adolescent↗
PubMed1996

An inter-rater reliability study of the Functional Assessment Measure (FIM+FAM).

There is an increasing demand for measures of outcome to evaluate the effects of rehabilitation interventions for brain injury from clinicians, research workers and healthcare providers and purchasers. The Functional Assessment Measure (FIM+FAM), an expanded derivative of the Functional Independence Measure (FIM), is designed specifically for this purpose for this patient group. This study examined the interrater reliability of the FIM+FAM between two independent raters, a physician and a nurse, the subjects being 30 in-patients in a neurological rehabilitation unit. The results show that the inter-rater reliability was good (kappa values 0.50 to 0.95) for all but one of the 30 items rated on the FIM+FAM. The exception (with a kappa value of 0.35) was "adjustment to limits'. Higher agreement was found for rating of physical activities than for cognitive, communication and behavioural items.

Activities of Daily Living↗
PubMed1993

Cognitive brain potentials in a three-stimulus auditory "oddball" task after closed head injury.

Event-related potentials (ERPs) were recorded in a three stimulus oddball task from 16 patients who had sustained a severe closed head injury at least 6 months before testing, and from 16 control subjects. The stimuli comprised a random sequence of frequent non-target tones (P = 0.70), rare target tones (P = 0.15), and rare novel sounds (P = 0.15). The task requirement was to respond promptly to each target tone. From a latency of 200 msec onwards, the ERPs evoked by frequent non-targets were substantially more negative-going in the head-injured than in the control group. When this difference in the ERPs to the frequent tones was taken into account, there was no evidence to suggest that either the latency or the amplitude of the target-evoked N2 and P3b components differed between the groups. The novel stimuli evoked a prominent P3a component. The amplitude and scalp distribution of this component differed little between the groups, but its peak latency was reliably longer in the head-injured subjects. The findings in respect of the N2 and P3b components suggest that impairments in early processing of task-relevant stimuli are not an invariant feature of closed head injury. The findings regarding P3a suggest that, in the majority of patients, head injury has only a limited effect on the neural systems underlying involuntary shifts of attention.

Acoustic Stimulation↗
PubMed1993

Acute disseminated encephalomyelitis: a case history.

Acute disseminated encephalomyelitis (ADEM) is a rarely reported demyelinating condition of the central nervous system, usually affecting children and young adults. The case of a 23-year-old woman diagnosed as suffering from ADEM is presented. Details are given of her assessment and attempted rehabilitation with particular reference to speech and language. Differentiation of ADEM from multiple sclerosis (MS) is problematic and may be clarified by examination of the pathological effects of the disease processes on speech and language. A general review of the scant literature is included and findings in this patient are compared and contrasted to them.

Acute Disease↗
PubMed1992

Cotard delusion after brain injury.

A right-handed young man with contusions affecting temporo-parietal areas of the right cerebral hemisphere and some bilateral frontal lobe damage became convinced that he was dead (the Cotard delusion), and experienced difficulties in recognizing familiar faces, buildings and places, as well as feelings of derealization. Neuropsychological investigation while these symptoms were resolving revealed impairment on face processing tests. We suggest that these impairments contributed to his Cotard delusion by heightening feelings of unreality, and that the underlying pathophysiology and neuropsychology of the Cotard delusion may be related to other problems involving delusional misidentification.

Brain Injuries↗
PubMed1992

Impaired joint mobility in Guillain-Barré syndrome: a primary or a secondary phenomenon?

Three patients with Guillain-Barré syndrome had significant residual impairment of joint mobility. Pain in the limbs and axial skeleton was a prominent early feature, as were autonomic disturbances and bulbar involvement resulting in prolonged mechanical ventilation. All three patients developed marked joint stiffness and contractures despite having physiotherapy from the outset. The skeletal problems and complications became major components of disability despite improving neurological status.

Aged↗