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1
Cohen-Inbar, Or, Daniel M. Trifiletti y Jason P. Sheehan. Stereotatic Radiosurgery and Microsurgery for Brain Metastases. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.003.0024.
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This chapter describes the case of a patient with brain metastases due to metastatic breast cancer. MRI is the best imaging modality for visualizing brain metastases, and advanced techniques such as perfusion imaging and diffusion weighted imaging may provide important additional information beyond standard anatomic imaging. Patients with brain metastases due to systemic cancer may benefit from targeted therapies such as surgery and stereotactic radiosurgery. Understanding the differences between radiation modalities such as stereotactic radiosurgery and whole brain radiotherapy is important for counseling patients.
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Boedhoe, Premika S. W. y Odile A. van den Heuvel. The Structure of the OCD Brain. Editado por Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0023.
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This chapter summarizes the most consistent findings of structural neuroimaging studies of obsessive-compulsive disorder (OCD), and discusses their relationship within the implicated brain networks. The techniques used in these studies are diverse, and include manual tracing of specific regions of interest, whole-brain voxel-based morphometry (VBM) for both gray matter and white matter volume comparisons, FreeSurfer to investigate differences in cortical thickness and subcortical volumes, and other methods such as covariance analyses. Findings on white matter integrity with tract-based spatial statistics (TBSS) and in diffusion tensor imaging (DTI) studies are discussed as well.The literature shows that the pathophysiology of OCD cannot be explained by alterations in function and structure of the classical cortico-striato-thalamo-cortical (CSTC) regions exclusively, but that fronto-limbic and fronto-parietal connections are important as well, and the role of the cerebellum needs more attention in future research.
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Hillmer, Ansel T., Kelly P. Cosgrove y Richard E. Carson. PET Brain Imaging Methodologies. Editado por Dennis S. Charney, Eric J. Nestler, Pamela Sklar y Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0009.
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While quantitative and pharmacologically specific aspects distinguish molecular imaging, they also impose the need for considerable expertise to design, conduct, and analyze molecular imaging studies. Positron emission tomography (PET) brain imaging provides a powerful noninvasive tool for quantitative and pharmacologically specific clinical research. This chapter describes basic methodological considerations for PET brain imaging studies. First the physiological interpretation of the most common outcome measures of binding potential (BPND) and volume of distribution (VT) are described. Next, aspects of acquisition of PET imaging data and blood measurements for analysis are discussed, followed by a summary of standard data analysis techniques. Finally, various applications for the study of mental illness, including group differences, measurements of drug occupancy, and assay of acute neurotransmitter release are discussed.
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Gattringer, Thomas, Christian Enzinger, Stefan Ropele y Franz Fazekas. Brain imaging (CT/MRI). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198722366.003.0007.
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In the acute phase of a suspected stroke, timely brain imaging with rapid and qualified interpretation is a crucial diagnostic step to inform patient management. While brain computed tomography is usually sufficient to indicate thrombolysis within the approved time window (by rapidly excluding intracranial haemorrhage), it often fails to show the actual site and extent of infarction as well as other pathologies, which may mimic a stroke. Magnetic resonance imaging (MRI) has a much higher sensitivity and specificity for ischaemic vascular brain changes and thus allows direct demonstration of the area(s) of acute ischaemic damage. This helps in the diagnosis of clinically uncertain cases, may give aetiological clues, and can also provide pathophysiologic insights into stroke evolution with respective consequences for patient treatment. The capability to rule out many other disorders that may mimic stroke is also an important asset of MRI. All these advantages make MRI the preferred tool in the workup of young individuals with suspected stroke. However, this needs ready availability and adequately tailored and short imaging protocols in order not to delay treatment.
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Seeck, Margitta, L. Spinelli, Jean Gotman y Fernando H. Lopes da Silva. Combination of Brain Functional Imaging Techniques. Editado por Donald L. Schomer y Fernando H. Lopes da Silva. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228484.003.0046.
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Several tools are available to map brain electrical activity. Clinical applications focus on epileptic activity, although electric source imaging (ESI) and electroencephalography-coupled functional magnetic resonance imaging (EEG–fMRI) are also used to investigate non-epileptic processes in healthy subjects. While positron-emission tomography (PET) reflects glucose metabolism, strongly linked with synaptic activity, and single-photon-emission computed tomography (SPECT) reflects blood flow, fMRI (BOLD) signals have a hemodynamic component that is a surrogate signal of neuronal (synaptic) activity. The exact interpretation of BOLD signals is not completely understood; even in unifocal epilepsy, more than one region of positive or negative BOLD is often observed. Co-registration of medical images is essential to answer clinical questions, particularly for presurgical epilepsy evaluations. Multimodal imaging can yield information about epileptic foci and underlying networks. Co-registering MRI, PET, SPECT, fMRI, and ESI (or magnetic source imaging) provides information to estimate the epileptogenic zone and can help optimize surgical results.
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Thompson, Evan. Looping Effects and the Cognitive Science of Mindfulness Meditation. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190495794.003.0003.
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Cognitive neuroscience tends to conceptualize mindfulness meditation as inner observation of a private mental realm of thoughts, feelings, and body sensations, and tries to model mindfulness as instantiated in neural networks visible through brain imaging tools such as EEG and fMRI. This approach confuses the biological conditions for mindfulness with mindfulness itself, which, as classically described, consists in the integrated exercise of a whole host of cognitive and bodily skills in situated and ethically directed action. From an enactive perspective, mindfulness depends on internalized social cognition and is a mode of skillful, embodied cognition that depends directly not only on the brain, but also on the rest of the body and the physical, social, and cultural environment.
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Rubia, Katya. ADHD brain function. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198739258.003.0007.
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ADHD patients appear to have complex multisystem impairments in several cognitive-domain dissociated inferior, dorsolateral, and medial fronto-striato-parietal and frontocerebellar neural networks during inhibition, attention, working memory, and timing functions. There is emerging evidence for abnormalities in motivation and affect control regions, most prominently in ventral striatum, but also orbital/ventromedial frontolimbic areas. Furthermore, there is an immature interrelationship between hypoengaged task-positive cognitive control networks and a poorly ‘switched off’ default mode network, both of which impact performance. Stimulant medication enhances the activation of inferior frontostriatal systems, while atomoxetine appears to have more pronounced effects on the dorsal attention network. More studies are needed to understand the neurofunctional correlates of the effects of age, gender, ADHD subtypes, and comorbidities with other psychiatric conditions. The use of pattern recognition analyses applied to imaging to make individual diagnostic or prognostic predictions are promising and will be the challenge over the next decade.
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Kleege, Georgina. Touching on Science. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190604356.003.0003.
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While the Hypothetical Blind man is a useful prop for philosophical theories of mind, he also influences the research of many contemporary neuroscientists. This chapter will survey cases of “restored sight” from the eighteenth century to the present. These cases follow such a predictable script that they have supplied the plots of such literary texts as Wilke Collins’s Poor Miss Finch and Brian Friel’s Molly Sweeney. The chapter will go on to describe research on brain plasticity that employs blind subjects to investigate various aspects of tactile perception and mental imaging, without any direct applications for blind people themselves.
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Bodart, Olivier y Steven Laureys. Imaging the central nervous system in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0224.
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Imaging techniques play a major role in managing patients with acute severe neurological signs. Initial evaluation of patients with traumatic brain injuries is best performed with a computed tomography (CT) scan, both for its ability to demonstrate most of the significant lesions and for logistical reasons. Magnetic resonance imaging (MRI) is able to provide more subtle information, as well as prognosis indicators, but is impractical until the patient’s condition has been stabilized. MRI has the same advantages for assessing anoxic brain injuries. In strokes, MRI has become the technique of choice, as it is able to highlight new lesions among older ones, and can identify ischaemic lesions only a few minutes after the event. At the same time MRI can identify or exclude contraindications for intravenous thrombolysis. Subarachnoid haemorrhages are best initially assessed with CT followed by a digital suppression angiogram to identify arterial aneurysms or arteriovenous malformations. In spine imaging, CT scan works the best in indicating traumatic bone lesions, while MRI is unsurpassed in examining the spinal cord and ligamentous injuries, and can provide prognostic indicators of the expected functional outcome.
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Brennan, Brian P. y Scott L. Rauch. Functional Neuroimaging Studies in Obsessive-Compulsive Disorder: Overview and Synthesis. Editado por Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0021.
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Studies using functional neuroimaging have played a critical role in the current understanding of the neurobiology of obsessive-compulsive disorder (OCD). Early studies using positron emission tomography (PET) identified a core cortico-striatal-thalamo-cortical circuit that is dysfunctional in OCD. Subsequent studies using behavioral paradigms in conjunction with functional magnetic resonance imaging (fMRI) have provided additional information about the neural substrates underlying specific psychological processes relevant to OCD. More recently, studies utilizing resting state fMRI have identified abnormal functional connectivity within intrinsic brain networks including the default mode and frontoparietal networks in OCD patients. Although these studies, as a whole, clearly substantiate the model of cortico-striatal-thalamo-cortical circuit dysfunction in OCD and support the continued investigation of neuromodulatory treatments targeting these brain regions, there is also growing evidence that brain regions outside this core circuit, particularly frontoparietal regions involved in cognitive control processes, may also play a significant role in the pathophysiology of OCD.
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Hoftman, Gil D. y Dean F. Salisbury. Neurobiology of Schizophrenia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199331505.003.0005.
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Schizophrenia is a brain disease with unknown etiology; a variety of neurodevelopmental mechanisms contribute to its pathogenesis. In this chapter, we review some of the most salient neurobiological findings that seem to be linked with the pathophysiology of psychosis generally and schizophrenia specifically. Several important findings have been made from neuroimaging and neuropathology, including reduced whole-brain volume, enlarged ventricles, and decreased cortical gray matter. Abnormalities in the prefrontal cortex, such as decreased dendritic spine density, are particularly important for cognitive and negative symptoms in schizophrenia. Functional imaging suggests that patterns of activation may be closely linked to symptom clusters. We will review neurotransmitter abnormalities, especially dopamine but also glutamate and GABA, and relevant circuitry and connectivity problems related to pathology. Finally, we will discuss genetics and heritability, and the challenges of identifying relevant loci in such a complex disorder.
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Kaufmann, Liane, Karin Kucian y Michael von Aster. Development of the numerical brain. Editado por Roi Cohen Kadosh y Ann Dowker. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199642342.013.008.
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This article focuses on typical trajectories of numerical cognition from infancy all the way through to adulthood (please note that atypical pathways of numerical cognition will be dealt in‘Brain Correlates of Numerical Disabilities’). Despite the fact that developmental imaging studies are still scarce to date there is converging evidence that (1) neural signatures of non-verbal number processing may be observed already in infants; and (2) developmental changes in neural responsivity are characterized by increasing functional specialization of number-relevant frontoparietal brain regions. It has been suggested that age and competence-related modulations of brain activity manifest as an anterior-posterior shift. On the one hand, the recruitment of supporting frontal brain regions decreases, while on the other hand, reliance on number-relevant (fronto-)parietal neural networks increases. Overall, our understanding of the neurocognitive underpinnings of numerical development grew considerably during the last decade. Future research is expected to benefit substantially from the fast technological advances enabling researchers to gain more fine-grained insights into the spatial and temporal dynamics of the neural signatures underlying numerical development.
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Shaw, Philip y Eszter Szekely. Insights from neuroanatomical imaging into ADHD throughout the lifespan. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198739258.003.0008.
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The relatively recent advent of magnetic resonance imaging has given us an invaluable ‘window’ into the brain in ADHD. Here we review the literature on the structural neuroimaging of ADHD throughout the lifespan. Meta-analyses and large individual studies converge to find anomalies in the basal ganglia in ADHD; some appear developmentally stable, while others are progressive. Compromise of the cerebral cortex and cerebellum are also commonly reported, and developmental trajectories of these structures have been linked with the highly variable clinical course of the disorder. ADHD can be considered dimensionally, lying at the extreme end of a continuous distribution of symptoms and underlying cognitive processes. Some studies find such dimensionality is also present in ADHD-related neuroanatomical change. Pilot studies have examined how variation in some candidate genes is tied to neuroanatomy in the disorder. Studies at the level of the entire genome await much larger cohorts.
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Diaz, Roberto Jose, Gregory W. Basil y Ricardo J. Komotar. Primary CNS Lymphoma. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.003.0008.
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Central nervous system (CNS) lymphoma must be considered in the differential diagnosis of any immunocompromised patient with a solid brain lesion. In such patients, diagnosis can be made via a careful review of important signs, symptoms, and classic radiologic findings. While there is no single physical exam finding classic for lymphoma, the clinician must carefully evaluate patients for the presence or absence of findings that may suggest an alternative diagnosis. Such findings include the stigmata of endocarditis, symptoms suggestive of pneumonia, or additional non-CNS mass lesions. Additionally, several imaging modalities including magnetic resonance imaging, diffusion-weighted magnetic resonance imaging, susceptibility weighted imaging, and dynamic contrast-enhanced imaging can be useful in identifying this condition. While steroids can be helpful in reducing the disease burden and decreasing edema, they may also hinder diagnosis. Surgery may be indicated for either diagnostic or decompressive purposes; however, the mainstay of treatment is chemotherapeutic and immunotherapeutic agents with radiation reserved for refractory cases.
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Chang, Eugene. Neuroprotection for Premature Birth and Neonatal Brain Injury. Editado por David L. Reich, Stephan Mayer y Suzan Uysal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190280253.003.0014.
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Preterm birth is associated with increased risk of perinatal brain injury. Although there has been little headway made in reducing preterm birth rates, survival of infants born prematurely has improved greatly. Because of this, the neurodevelopmental consequences related to prematurity have become significant issues, especially in those infants born at less than 32 weeks gestation. Hypoxic-ischemic encephalopathy commonly leads to neonatal brain injury both before and after delivery. While perinatal birth asphyxia accounts for a proportion of neonatal brain injury in neonates younger than 37 weeks, preterm birth is the more significant risk factor. This chapter explores the neurodevelopmental consequences associated with preterm birth, the pathophysiology of perinatal brain injury, and the imaging modalities used to assess the newborn brain. Finally, various neuroprotective interventions in clinical use and in development will be described.
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Andres, Michael y Mauro Pesenti. Finger-based representation of mental arithmetic. Editado por Roi Cohen Kadosh y Ann Dowker. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199642342.013.028.
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Human beings are permanently required to process the world numerically and, consequently, to perform computations to adapt their behaviour and they have developed various calculation strategies, some of them based on specific manipulations of the fingers. In this chapter, we argue that the way we express physically numerical concepts by raising fingers while counting leads to embodied representations of numbers and calculation procedures in the adult brain. To illustrate this, we focus on number and finger interactions in the context of simple arithmetic operations. We show that the fixed order of fingers on the hand provides human beings with unique facilities to increment numerical changes or represent a cardinal value while solving arithmetic problems. In order to specify the influence of finger representation on mental arithmetic both at the cognitive and neural level, we review past and recent findings from behavioural, electrophysiological, and brain imaging studies. We start with anthropological and developmental data showing the role of fingers in the acquisition of arithmetic knowledge, then address the issue of whether number and finger interactions are also observed in adults solving arithmetic problems mentally. We suggest that arithmetic performance depends on the integrity of finger representations in children and adults. Finally, we overview the results of recent functional magnetic resonance imaging (fMRI) studies showing a common brain substrate for finger and number representations during and after the acquisition of arithmetic skills.
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Zamarian, L. y Margarete Delazer. Arithmetic Learning in Adults. Editado por Roi Cohen Kadosh y Ann Dowker. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199642342.013.007.
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Neuroimaging has significantly contributed to our understanding of human learning by tracking the neural correlates underlying the acquisition of new expertise. Studies using functional magnetic resonance imaging (fMRI) suggest that the acquisition of arithmetic competence is reflected in a decrease of activation in frontal brain regions and a relative increase of activation in parietal brain regions that are important for arithmetic processing. Activation of the angular gyrus (AG) is related to fact learning, skilled retrieval, and level of automatization. fMRI investigations extend the findings of cognitive studies showing that behavioural differences between trained and untrained sets of items, between different arithmetic operations, and between different training strategies are reflected by specific activation patterns. fMRI studies also reveal inter-individual differences related to arithmetic competence, with low performing individuals showing lower AG activation when answering calculation problems. Importantly, training attenuates inter-individual differences in AG activation. Studies with calculation experts suggest that different strategies may be used to achieve extraordinary performance. While some experts recruit a more extended cerebral network compared with the average population, others use the same frontoparietal network, but more efficiently. In conclusion, brain imaging studies on arithmetic learning and expertise offer a promising view on the adaptivity of the human brain. Although evidence on functional or structural modifications following intervention in dyscalculic patients is still scarce, future studies may contribute to the development of more efficient and targeted rehabilitation programmes after brain damage or in cases of atypical numerical development.
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Roberts, Timothy P. L. y Luke Bloy. Neuroimaging in Pediatric Psychiatric Disorders. Editado por Dennis S. Charney, Eric J. Nestler, Pamela Sklar y Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0060.
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Noninvasive imaging and electrophysiological techniques have been developed to probe specific aspects of brain function and dysfunction, providing exquisite spatial maps of functional centers and temporal characteristics. The evolution of these techniques has advanced from single-modality methods identifying functional localization, specialization and segregation, through real-time measures of neuronal activity, toward multimodality integration of structural, functional, and spectro-temporal approaches. While these have an immediate impact in conditions where physical brain lesions are evident (e.g., brain tumor and stroke), making a commensurate contribution within neuropsychiatry is more complex. Nonetheless, by combining concepts of morphology, neurochemistry, neural signal propagation, and regional connectivity, there appears to be ample opportunity to contribute not only to the diagnosis of patients with mental illness but to the stratification and subtyping across behavioral phenotypes and, ultimately, to patient management. Here we present an overview of the most common noninvasive neuroimaging methodologies and their applications to pediatric neurodevelopmental disorders.
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Shils, Jay L., Sepehr Sani, Ryan Kochanski, Mena Kerolus y Jeffrey E. Arle. Recording Techniques Related to Deep Brain Stimulation for Movement Disorders and Responsive Stimulation for Epilepsy. Editado por Donald L. Schomer y Fernando H. Lopes da Silva. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228484.003.0038.
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Neuromodulation therapies are now common treatments for a variety of medically refractory disorders, including movement disorders and epilepsy. While surgical techniques for each disorder vary, electricity is used by both for relieving symptoms. During stereotactic placement of the stimulating electrode, either deep brain stimulation electrodes or cortical strip electrodes, intraoperative neurophysiology is used to localize the target structure. This physiology includes single-unit recordings, neurostimulation evoked response evaluation, and intracranial electroencephalography (EEG) to ensure the electrode leads are in the optimal location. Because the functional target for the responsive neurostimulator is more easily visualized on preoperative magnetic resonance imaging, intraoperative physiology is used more as a confirmatory tool, in contrast to the more functional localization-based use during electrode placement for movement disorders. This chapter discusses surgical placement of the electrodes for each procedure and the physiological guidance methodology used to place the leads in the optimal location.
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Kipps, Christopher y John Hodges. Clinical cognitive assessment. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0010.
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Cognitive symptoms arise from the location of brain dysfunction and are not linked directly to any particular pathology. In the early stages of disease, symptoms may be non-specific, and while certain symptom clusters are commonly seen in particular disorders, atypical presentations are not infrequent. For example, in Alzheimer’s disease, patients may present with a focal language syndrome instead of the more commonly appreciated autobiographical memory disturbance despite identical pathology. In our approach to the cognitive assessment, we maintain a symptom oriented approach. This facilitates the localisation of pathology and subsequent clinical diagnosis, which may then be supplemented by associated neurological signs, imaging or other investigations.
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Mellman, Thomas A. Sleep and PTSD. Editado por Charles B. Nemeroff y Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0023.
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The Chapter reviews two long standing concerns of sleep research in PTSD. The first is characterizing dysregulations of arousal that manifest in relation to sleep including disturbances of sleep initiation, maintenance, and depth. The other is characterizing nightmare disturbances in PTSD and establishing the role of the neurophysiological substrate of dreams, rapid eye movement sleep (REMS), in the disorder. While there has been uncertainty and controversy regarding these issues, a comprehensive look at findings and their context (e.g. duration of PTSD, setting of recordings) allows some reconciliation of findings. Recent developments include assessment of autonomic balance during sleep and application of functional brain imaging. Emerging research on the role of sleep, particularly REMS, on emotional learning has been linked to PTSD. Treatments specifically targeting nightmares and other sleep disruptions, such as the alpha adrenergic antagonist prazosin and imagery rehearsal therapy, continue to be developed and evaluated.
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De Smedt, Bert y Roland H. Grabner. Applications of Neuroscience to Mathematics Education. Editado por Roi Cohen Kadosh y Ann Dowker. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199642342.013.48.
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In this chapter, we explore three types of applications of neuroscience to mathematics education: neurounderstanding, neuroprediction, and neurointervention.Neurounderstandingrefers to the idea that neuroscience is generating knowledge on how people acquire mathematical skills and how this learning is reflected at the biological level. Such knowledge might yield a better understanding of the typical and atypical development of school-taught mathematical competencies.Neuropredictiondeals with the potential of neuroimaging data to predict future mathematical skill acquisition and response to educational interventions. Inneurointervention, we discuss how brain imaging data have been used to ground interventions targeted at mathematics learning and how education shapes the neural circuitry that underlies school-taught mathematics. We additionally elaborate on recently developed neurophysiological interventions that have been shown to affect mathematical learning. While these applications offer exciting opportunities for mathematics education, some potential caveats should be considered, which are discussed at the end of this chapter.
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Belser, Julia Watts. Materiality and Memory. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190600471.003.0005.
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This chapter reads Bavli Gittin’s destruction narratives through the lens of ecological materialist criticism, tracing the trail of blood and other fleshy residues of the body that run through the account of the devastation of Betar. These tales imagine the body dismembered, undone by the conqueror’s violence. Filled with transcorporeal images of blood and brain seeping into the land, they blur the boundaries between human bodies and the rest of the material world. While these tales memorialize the lingering presence of body and blood in the land, they also betray an anxious instability: the tangible remains of Jewish death are all too easily rendered ephemeral. This chapter traces tensions over materiality and memory, permanence and erasure, heroism and defeat in the tales of the boiling blood of the slain prophet Zechariah and the martyrdom of the mother of seven sons, parsing the Bavli’s complex discourse of ruin and redemption.
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Kane, Robert L. y Thomas D. Parsons, eds. The Role of Technology in Clinical Neuropsychology. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190234737.001.0001.
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Neuropsychology as a field has been slow to embrace and exploit the potential offered by technology to either make the assessment process more efficient or to develop new capabilities that augment the assessment of cognition. The Role of Technology in Clinical Neuropsychology details current efforts to use technology to enhance cognitive assessment with an emphasis on developing expanded capabilities for clinical assessment. The first sections of the book provide an overview of current approaches to computerized assessment along with newer technologies to assess behavior. The next series of chapters explores the use of novel technologies and approaches in cognitive assessment as they relate to developments in telemedicine, mobile health, and remote monitoring including developing smart environments. While still largely office-based, health care is increasingly moving out of the office with an increased emphasis on connecting patients with providers, and providers with other providers, remotely. Chapters also address the use of technology to enhance cognitive rehabilitation by implementing conceptually-based games to teach cognitive strategies and virtual environments to measure outcomes. Next, the chapters explore the use of virtual reality and scenario-based assessment to capture critical aspects of performance not assessed by traditional means and the implementation of neurobiological metrics to enhance patient assessment. Chapters also address the use of imaging to better define cognitive skills and assessment methods along with the integration of cognitive assessment with imaging to define the functioning of brain networks. The final section of the book discusses the ethical and methodological considerations needed for adopting advanced technologies for neuropsychological assessment. Authored by numerous leading figures in the field of neuropsychology, this volume emphasizes the critical role that virtual environments, neuroimaging, and data analytics will play as clinical neuropsychology moves forward in the future.
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Stokes, Lauren. Fear of the Family. Oxford University Press, 2022. http://dx.doi.org/10.1093/oso/9780197558416.001.0001.
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Since the mid-1970s, so-called family migration has been the predominant legal pathway for migration into Europe and North America. But what has it meant for millions of people to be defined primarily through their role as “family migrants,” whether at the immigration office, in the courtroom, in the workplace, or in the family itself? Fear of the Family addresses these questions by investigating the history of guest worker migration to the Federal Republic of Germany. Ironically, West German employers initially turned to foreign “guest workers” to avoid the complications of families. Foreigners were meant to work in Germany in the prime of their productive years while raising their children and growing old elsewhere, with another country bearing the costs of their education, retirement, and medical care. But guest workers refused to offshore their family life, pressuring the state first to tolerate and later to open an official legal pathway for family reunification. The state’s perspective on the role of family migration changed over time, and debate over this form of migration also continues to this day, as politicians call for “managed migration” to capture the best brains and most in-demand skills while demanding an end to the “chain migration” that is imagined as nothing but a burden. Fear of the Family shows how these categories were established and how generations of migrant families have fought against the assumptions contained within them.
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Vallar, Giuseppe y Nadia Bolognini. Unilateral Spatial Neglect. Editado por Anna C. (Kia) Nobre y Sabine Kastner. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199675111.013.012.
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Left unilateral spatial neglect is the most frequent and disabling neuropsychological syndrome caused by lesions to the right hemisphere. Over 50% of right-brain-damaged patients show neglect, while right neglect after left-hemispheric damage is less frequent. Neglect patients are unable to orient towards the side contralateral to the lesion, to detect and report sensory events in that portion of space, as well as to explore it by motor action. Neglect is a multicomponent disorder, which may involve the contralesional side of the body or of extra-personal physical or imagined space, different sensory modalities, specific domains (e.g. ‘neglect dyslexia’), and worsen sensorimotor deficits. Neglect is due to higher-order unilateral deficits of spatial attention and representation, so that patients are not aware of contralesional events, which, however, undergo a substantial amount of unconscious processing up to the semantic level. Cross-modal sensory integration is also largely preserved. Neglect is primarily a spatially specific disorder of perceptual consciousness. The responsible lesions involve a network including the fronto-temporo-parietal cortex (particularly the posterior-inferior parietal lobe, at the temporo-parietal junction), their white matter connections, and some subcortical grey nuclei (thalamus, basal ganglia). Damage to primary sensory and motor regions is not associated to neglect. A variety of physiological lateralized and asymmetrical sensory stimulations (vestibular, optokinetic, prism adaptation, motor activation), and transcranial electrical and magnetic stimulations, may temporarily improve or worsen neglect. Different procedures have been successfully developed to rehabilitate neglect, using both ‘top down’ (training the voluntary orientation of attention) and ‘bottom up’ (the above-mentioned stimulations) approaches.