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Biomedical subjects

L Diller

Publications and source records attributed to L Diller.

At least 55 records · Page 3Linked to original sources
PubMed1989

First year after stroke: tracking cognitive and affective deficits.

A total of 58 cerebrovascular accident (CVA) rehabilitation inpatients with lateralized brain damage were assessed at two time points (T1 = admission to rehabilitation facility, about 7 weeks post-CVA, and T2 = 10 months post-CVA) in the following domains: hemispatial neglect, reaction time, depression, and affect comprehension. Performance was compared with 22 age-matched control subjects. Repeated measures ANOVAs were performed with patients subdivided into groups by laterality of lesion and visual field status (a strong predictor of psychometric performance, particularly in the hemispatial-neglect domain). During this initial year after stroke onset, significant improvements were observed in hemispatial neglect and affect comprehension in the two right-brain-damaged groups, but not the left-brain-damaged group. There was also a trend for improvement in observer rating of depression in all three groups. However, there was poor resolution of reaction time and self-reported depression in all three groups. These findings suggest that these latter domains should be targeted for more aggressive therapeutic intervention. An important component of such intervention, in addition to direct treatment of deficits, should be education of both patient and family as to the nature of deficits, expectations regarding resolution, and appropriate attributions of changed behavior after stroke.

Affect↗
PubMed1988

Relationship among CT scans, neurological exam, and neuropsychological test performance in right-brain-damaged stroke patients.

Right-hemisphere stroke rehabilitation inpatients were assessed by: (1) CT scans; (2) neurological exam; and (3) cognitive and affective psychometric measures. Damage to temporal, parietal, and occipital regions was associated with visual-spatial impairments. Surprisingly, parietal damage was no more related than temporal and occipital damage to severity of visual inattention. While the neurologist's ratings of lability and depression were related to CT-scan measures, patients' self-report of depression was not so related. These findings support a less specific and probably greater interlobule organization of the right, as compared with left, hemisphere, and highlight the need for multifaceted affective assessment in such a brain-damaged group.

Brain↗
PubMed1988

Unilateral spatial neglect: biases in contralateral search and fine spatial attention.

Contralateral search and fine spatial attentional asymmetries, two aspects of hemispatial neglect, were examined in a total of 91 right brain damaged (RBD) and 40 non-aphasic left brain damaged (LBD) stroke rehabilitation inpatients. Fine spatial attentional asymmetries within a hemispace were found in both RBD and LBD patients on the LAVA figure-match test. This finding is in contrast to Gainotti's hypothesis that such problems in extracting contralateral visual information are uniquely characteristic of RBD patients. Furthermore, the study suggests that the gross search and fine attentional aspects of neglect are dissociable and may reflect different underlying mechanisms of hemispatial neglect.

Journal Article↗
PubMed1986

Proper and common nouns: form class judgments in Broca's aphasia.

Studies of agrammatic Broca's aphasics' comprehension of sentences containing articles have demonstrated profound deficits. It has not been clear whether the impairments are due to an inability to isolate the article in the stream of speech, or to difficulty in the construction and/or interpretation of various syntactic, semantic, or pragmatic levels of representation. This paper reports three experiments on Broca's aphasics' ability to distinguish between common nouns (e.g., "a rose") and proper nouns (e.g., "Rose"). This grammatical form class decision is signaled by the presence or absence of an article, and is represented at the lexical node level of linguistic analysis. The three experiments demonstrated that Broca's aphasics point to pictures representing classes of objects when asked to point to "the X" and point to pictures representing unique individuals when asked to point to "X". Thus, they were shown to be able to use the presence or absence of an article to determine lexical category. Their performance was especially accurate in an oral language context which was highly redundant and in a written language context where patients themselves could control the rate of information flow. They were quantitatively impaired, relative to controls, in a third study, which made higher information processing demands. Moreover, in this third study nonsense syllables preceding the noun which are phonologically similar to a known article were much more likely to evoke the misclassification of its noun as common than were phonologically distinct nonsense syllables. These data indicate that Broca's aphasics indeed have some difficulty isolating the article in the stream of speech. Nevertheless, detailed analyses of aphasics' performance revealed their ability to distinguish between common nouns and proper nouns even under these demanding conditions. Taken together, the three studies show that insofar as agrammatic patients are able to keep track of the presence or absence of articles, they can make a grammatical decision at the lexical node level of linguistic analysis. We conclude, then, that agrammatic Broca's aphasics are particularly impaired in the use of articles to construct and/or interpret phrasal constituents.

Adult↗
PubMed1986

Exploratory eye movements and visual hemi-neglect.

The severity of visual hemineglect (VHN), as defined by a VHN Index from scores obtained on letter cancellation and visual matching tests, was compared to eye movement behavior during a visual searching task in a group of right-hemisphere stroke patients and a group of age-matched normal controls. A strong negative correlation was obtained between the VHN Index and eye movement Exploration Time of the left visuospatial field for the stroke patients, but not for the control subjects. Further analyses failed to discriminate Exploration Time performance of stroke patients with mild VHN from the performance of control subjects, but did discriminate stroke patients with marked VHN from each of these two groups. Covarying for the presence of a left-visual-field sensory defect slightly reduced the significance level of this finding. The results and questions raised by this study are discussed in the context of developing an operational definition for VHN using the method of directly monitoring eye movement.

Aged↗
PubMed1985

Perceptual remediation in patients with right brain damage: a comprehensive program.

This study provided a comprehensive program to treat visual perceptual disturbances associated with right brain damage (RBD). Three types of previously evaluated perceptual remediation were integrated into a sequentially administered remediation program: basic visual scanning, somatosensory awareness and size estimation training, and complex visual perceptual organization. The purpose of the study was to evaluate the immediate (at rehabilitation discharge) and long-term (four months after discharge) effects of this treatment program on patients with RBD. The effects of treatment on ADL and mood state were also examined. Seventy-seven RBD stroke rehabilitation inpatients were studied--including 48 Experimental (E) and 29 Control (C). At rehabilitation discharge, the E group relative to the C group showed greater gains in all three types of perceptual functioning. Four months after discharge from rehabilitation, the C group continued to show gains in perceptual functioning while the E group had reached a plateau. Longitudinal decreases in levels of self-reported anxiety and hostility, but not depression, were noted only for the E group.

Activities of Daily Living↗
PubMed1982

Treating perceptual organization deficits in nonneglecting RBD stroke patients.

Thirty-five right brain-damaged (RBD) stroke patients, enrolled in active rehabilitation programs, participated in this study. Patients were selected on the basis of their evidenced deficits in performing complex visuo-cognitive tasks and the absence of overt evidence of unilateral visual-spatial neglect. Seventeen of the 35 patients were randomly chosen to receive a training program (lasting approximately 1 month) designed to establish a systematic strategy of organizing complex visual material. The remaining 18 patients were re-examined after 1 month, and served as controls. The design of the treatment program was based on the hypothesis that nonneglected RBD patients fail to appreciate and synthesize elements of complex visual material due to a breakdown in compensation for a persistent lateral bias in visual-spatial attention. Upon posttesting, it was found that those patients who received training exhibited significantly improved performance, as compared to controls, on a subgroup of visuo-cognitive tasks. These results are discussed in terms of: (1) offering indirect support for the argument that pathological asymmetries in attention play a significant role in the failure of RBD patients on many visuo-cognitive tasks; and, (2) offering a basis for extending the treatment of perceptual problems in RBD patients.

Attention↗
PubMed1979

Training sensory awareness and spatial organization in people with right brain damage.

Building on a methodology to improve scanning and academic skill performance behavior in persons with acquired right brain damage due to stroke, this study presents 2 additional treatment methods: training in sensory awareness and spatial organization. The 53 patients studied were divided into two groups, experimental (N = 30) and control (N = 23). The experimental group received a treatment program incorporating the 2 new methods as well as a condensed version of the original program. The controls received standard rehabilitation. Both groups were retested after 1 month. Analyses revealed that the performance of those in the experimental group exceeded that of the controls, that those patients in the experimental group with severe impairments improved more than those with mild impairments, and that combined multiple-treatment produces greater generalization than the original single treatment program.

Activities of Daily Living↗
PubMed1977

Visual scanning training effect on reading-related tasks in acquired right brain damage.

This study presents a method for analyzing and remediating the visual perceptual deficits often found in persons with acquired right brain injury due to stroke. A total of 57 patients were randomly assigned to experimental (N=25) or control (N=32) groups. All patients were administered the same test battery prior to assignment. Experimentals received the specific training program and the controls received standard rehabilitation. Both groups were retested after a period of one month. Analysis revealed the superior performance of the experimental group. The results suggest that the academic disorders found in right brain damage can be treated as secondary to a primary disturbance in visual scanning behavior.

Adult↗