"Auditory hallucinations" from a hearing aid?
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Aged↗
Biomedical subjects
D N Brooks
Publications and source records attributed to D N Brooks.
An evaluation of tailored psychological treatment of insomnia.
It seems sensible to tailor treatments of insomnia in relation to the presenting characteristics of the sleeper and of the complaint. This report describes the first study formally to examine the comparative effectiveness of tailored and untailored (randomly allocated) treatments. We developed a questionnaire to facilitate the designing of individualized programmes. Results indicated that statistical analysis may underestimate the benefits of tailoring. Measures of clinically significant change, however, suggested that tailored treatment though it may be highly effective, is no more so than stimulus control therapy.
Adult↗
A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia.
A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.
Adult↗
The pattern of function-related regional cerebral blood flow investigated by single photon emission tomography with 99mTc-HMPAO in patients with presenile Alzheimer's disease and Korsakoff's psychosis.
Single photon emission tomography (SPET) with the lipophilic blood flow marker 99mTc-hexamethyl propyleneamine oxime (99mTc-HMPAO) has been used to determine regional uptake of radiolabel into brain regions of patients with presenile Alzheimer's disease and Korsakoff's psychosis, and age-matched controls. Using occipital cortical uptake as reference area, the pattern of relative regional cerebral blood flow (rCBF) was determined in other cortical areas and basal ganglia. In Alzheimer's disease, reduction in rCBF occurred most strikingly in posterior temporal and parietal areas. By contrast, in Korsakoff's psychosis, posterior temporal rCBF was maintained, although there was a trend to reduced tracer uptake in other cortical areas. These impairments of flow were correlated with impairments of neuropsychological function. In Alzheimer's disease, left posterior temporal and left parietal regions in particular showed rCBF to be strongly correlated with most aspects of cognitive function. In Korsakoff's psychosis, however, impaired flow in frontal regions was correlated with impaired performance on tests of memory and orientation. The findings in Alzheimer's disease show quantitative parallels with those from studies using Positron Emission Tomography (PET), and extend our understanding of the relationship between cognition and regional brain function in dementia. The findings in Korsakoff's psychosis offer the first direct evidence linking frontal lobe dysfunction with the cognitive impairment seen in the disorder.
Adult↗
CNV abnormalities following closed head injury.
Event-related potentials (ERPs) were recorded in a GO/NO-GO reaction time task from 20 closed head injury patients, at least 6 months postinjury, and from 20 controls. In this task the pitch of an initial tone (Sl) indicated whether or not a response was required to a second tone (S2) occurring 1.5 s later. In the control group both the early, frontal-maximum, and the later vertex-maximum, components of the contingent negative variation (CNV) were larger on GO than NO-GO trials. In the patients, the early frontal CNV wave did not differentiate GO and NO-GO trials, and the late CNV showed a smaller separation between these trial types than did the late CNV of the control group. These CNV abnormalities may reflect impairments in selectively orienting to salient stimuli, and in differential response preparation. Such impairments might in turn reflect the damage to the frontal lobes and/or their connections that commonly occurs as a result of closed head injury.
Acoustic Stimulation↗
Recommended minimum data to be collected in research studies on Alzheimer's disease. The MRC (UK) Alzheimer's Disease Workshop Steering Committee.
In order to be able to compare the results of research work carried out in different centres on Alzheimer's disease and dementia, it is necessary for there to be standardised assessment methods. The Medical Research Council organised a workshop in order to see whether workers in Britain in the field of dementia research could agree on such standardised assessment methods. The workshop agreed guidelines for the minimum data which should be collected, in clinical and pathological studies, on patients with presumed Alzheimer's disease and dementia. These recommendations are compared with other approaches based on research diagnostic criteria.
Aged↗
Lip-reading instruction and hearing aid use.
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Hearing Aids↗
The effect of attitude on benefit obtained from hearing aids.
Hearing aids are obtained or provided with the primary objective of diminishing the handicapping effect of hearing impairment. The benefit obtained from amplification by an individual can be assessed in many different ways. The amount of use made of the hearing aid has the merits of reasonable accuracy, relevance and simplicity in determination. Poor use of hearing aids may be a result of many factors. Modern instruments are technically adequate to the needs of most candidates provided they are correctly fitted. The reasons for disuse and under-use nowadays appear to be more related to the attitude of the potential user. To investigate this aspect of hearing aid provision, questionnaires have been sent to hearing aid candidates prior to the supply of the instrument. These questionnaires have been designed to assess such factors as failure to come to terms with the hearing loss, perceptions of stigma associated with hearing aids, lack of support or even overt hostility from close relatives, and withdrawal from social contacts. The relationships between these attitude measurements and outcome in terms of daily use of the aid 4 months later have been investigated. The findings of this study support the concept that attitude is a significant determinant of hearing aid use, and also suggest that aberrant attitudes can, in many individuals, be modified by counselling such that a better outcome can be achieved.
Aged↗
Referral patterns of elderly patients with dementia or depression.
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Aged↗
Substituting behavioural treatment for drugs in the treatment of insomnia: an exploratory study.
There is need to investigate directly the generalizability of psychological treatment effects to clinical populations of insomniacs; especially to those who are chronic hypnotic users and are drug-dependent. This paper present two methodological models, based upon the pharmacological literature, which permit the selection of such subjects for research studies. The usefulness of the models is discussed with reference to a preliminary investigation based on 10 cases, and recommendations are made both for further research and clinical practice.
Behavior Therapy↗
Visual event perception in alcoholics.
A series of microcomputer-based procedures were devised to investigate the ability of alcoholics to detect and locate rapid visual changes, and to assess deficits of visual processing in this patient population. Forty alcoholics were tested 7-13 days after cessation of drinking (mean period of abstinence = 9.5 days), and 24 were retested 2-3 weeks later (mean abstinence = 27.8 days). In comparison to a matched control group the alcoholics were impaired on initial testing at locating visual events. Alcoholics also had significantly slower movement times in a visual-choice reaction time task, and were slower on visual search. At retest the alcoholics were impaired on one of the event perception tasks. Alcoholics were not impaired initially on a measure of visual memory span but were impaired at retest, possibly due to a learning deficit. It is concluded that alcoholics show a persisting deficit in the ability to notice and locate rapid visual changes, together with a transitory impairment on timed tasks requiring visually guided movement.
Adult↗
Early and late magnetic resonance imaging and neuropsychological outcome after head injury.
Twenty five adults with closed head injury who had early magnetic resonance imaging (MRI) and computed tomography (CT) were followed up 5 to 18 months after injury. Patients were given a repeat MRI and performed a series of neuropsychological tests. They were classified by the deepest abnormality detectable on scanning. Classifications derived from early and late MRI scanning were significantly correlated. However, measures of neuropsychological outcome showed a strong correlation only with late MRI, and little or no relationship with either early MRI or early CT. Deeper abnormalities detected by late MRI were associated with poorer neuropsychological test performance; late ventricular enlargement was particularly associated with poor outcome. It is concluded that the lesions visualised by MRI are important for neuropsychological outcome, and that functionally significant abnormalities may only be fully apparent on late scanning.
Adolescent↗
Event related potentials from closed head injury patients in an auditory "oddball" task: evidence of dysfunction in stimulus categorisation.
Event-related potentials (ERPs) were recorded from 19 closed head injury (CHI) patients, at least 6 months after injury, and an equal number of control subjects, during a task requiring the covert counting of rare auditory "target" stimuli against a background of frequent "non-targets". In both groups, ERPs to targets contained enhanced frontal N2 and parietal P3 components. N2 was larger in amplitude in the CHI patients than in the controls, and its peak latency was delayed. P3 amplitude was smaller in the patients, but its latency was not significantly different from that of the control group. The delay in N2 latency is interpreted as evidence of an increase in the time needed to achieve stimulus categorisation in CHI patients. The larger N2s in this group are thought to reflect the additional cognitive effort required after CHI to cope with the task. The negative findings with respect to P3 latency suggest that this may be a less sensitive measure of information-processing efficiency in this task than the latency of N2.
Adult↗
Effectiveness of publicity campaign encouraging earlier referral of hearing loss in adults.
During 16,070 consultations in general practice 70 adults complained of difficulty with hearing. A simple poster displayed in the waiting areas together with an accompanying leaflet almost doubled the incidence of presentation of loss of hearing. Nevertheless, more than half of those complaining had failed to notice the prominently displayed personally relevant message, and the beneficial effect was lost almost as soon as the poster was removed.
Advertising↗
Otitis media with effusion: academic attainment and socioeconomic background.
In a recent paper (Brooks, D.N., Otitis media with effusion and academic attainment, Int. J. Pediat. Otorhinolaryngol., 12 (1986) 39-47) the relationship between severity of otitis media with effusion (O.M.E.) in childhood and eventual outcome was explored in a group of 64 individuals. Although the severity of O.M.E. was related to time loss from education through sickness during the first school years, no effect on academic attainment levels was found. Further data have been obtained on the socio-economic groupings (S.E.G.) of 59 of the children. No correlation was found between S.E.G. and either time lost from school through sickness or severity of O.M.E. A strong correlation was found between S.E.G. and eventual academic attainment level.
Absenteeism↗
Otitis media with effusion and academic attainment.
In 1968 an investigation was started into the middle ear function of a group of 80 children aged approximately 5 years. Serial acoustic impedance measurements were performed at closer than monthly intervals over the first full year of their full time education and at increasingly wider intervals thereafter for a period of 10 years. In 1985 the academic attainment levels of the young persons was, where possible, ascertained by questionnaire, supported by search of the school records. For 64 subjects complete data were available and for these, correlations were sought between a measure of academic rating and various measures of middle ear function during the first one or two years of full time education. No correlations were found to support the hypothesis that middle ear dysfunction during the early years of schooling is causally related to poor academic achievement.
Acoustic Impedance Tests↗
Cognitive sequelae of severe head injury in relation to the Glasgow Outcome Scale.
Aspects of reliability and validity of the Glasgow Outcome Scale were studied by examining outcome scale categories and cognitive test scores in 57 patients with severe closed head injury seen within 2 years of injury. Inter-rater reliability of a three and six point scale was high. The three point scale, unlike the six point, showed a significant statistical association with cognitive test scores. The relationship between test score and outcome category was accurate within the first 3 months of injury, but considerably less so thereafter.
Adolescent↗