Measuring recovery from post traumatic amnesia.

Three groups of participants were assessed. Each participant was tested on 20 occasions. The groups comprised people (i) in post traumatic amnesia (PTA) following severe head injury (n=9), (it) with severe head injury but not in PTA (n=10), and (iii) with no history of head injury or other neurological condition (n=13). Subjects were given several tests of memory, attention and learning in order to determine which tests were good at (a) distinguishing people in PTA from those not in PTA, and (b) monitoring recovery over time. The results indicate that people in PTA have a wide range of deficits and their cognitive recovery is a gradual process rather than an all-or-none phenomenon. In terms of measurement, the study suggests that a good test of PTA should include orientation questions, together with a reaction time measure, a visual recognition test and a speed of information processing measure. Most of the tests administered were good at distinguishing between brain-injured and nonbrain-injured people, although only two tests distinguished between the two brain-injured groups, i.e. those in PTA and those out of PTA. Almost all tests were good at monitoring recovery from PTA.

Myotonic dystrophy and progressive cognitive decline: a common condition or two separate problems?

We report the case of NG, a 43-year old woman with myotonic dystrophy (MYD) who has shown a slow decline in both motor and cognitive abilities since her referral to us at age 32. MYD is an autosomal dominant disorder characterised by weakening and wasting of the muscles together with impaired muscle relaxation. Cognitive abilities are usually little affected in the adult onset form, although there is a high risk of cognitive impairment in those with childhood onset. Cognitive decline is also typically associated with maternal inheritance. NG, who was diagnosed with MYD at the age of 18, inherited it from her father. We report the decline in NG's cognitive abilities over 11 years of longitudinal assessment, and consider whether she is an atypical MYD patient or whether the MYD and cognitive decline are attributable to two separate pathological processes.