ABSTRACT
To restore the ability to drive is one aim of the rehabilitation of patients with neurological disabilities. In some instances, an evaluation is required to judge a patient's fitness to drive in today's traffic. Forty-three patients of the neurorehabilitation unit of the Valens Clinic were assessed by a standard traffic psychological test protocol and a control drive. In 88%, there was agreement between the judgments based on each procedure. Four patients had failed either the psychological tests or the control drive but not both. Six patients had failed the psychological test and the control drive. Two drove nevertheless, and three patients stopped driving. Nineteen of 32 patients cleared to drive were followed up. Eleven drove without accidents or traffic fines. The traffic psychological tests and control drive yield complementary information on the fitness to drive. However, the assessments need to be improved. New generations of interactive driving simulators may refine the fitness to drive evaluation and become useful tools in driving rehabilitation.
Subject(s)
Automobile Driving/standards , Disability Evaluation , Nervous System Diseases/rehabilitation , Accidents, Traffic/statistics & numerical data , Adolescent , Adult , Aged , Automobile Driving/psychology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Nervous System Diseases/psychology , Psychological TestsABSTRACT
OBJECTIVES: To determine the influence of motivation on performance in a divided attention test of patients after mild traumatic brain injury (MBI). METHODS: Comparison of the performance of 12 patients with MBI with 10 patients with severe brain injury (SBI) and 11 healthy controls in a computer supported divided attention task before (T1) and after (T2) verbal motivation. RESULTS: At T1, the MBI group performed the same as the SBI group but significantly worse than the controls in all variables. At T2, the MBI group performed worse than the controls at T2 but the results were equal to the results of the controls at T1 and significantly better than the SBI group at T1 or T2. At T2 the MBI group performed at the level of published norms for the rest. CONCLUSION: Before verbal motivation the MBI group's results in the divided attention task were comparable with those from patients with severe brain injury. They failed to exploit their performance potential when it depended on self motivation but were able to perform at the level of the control group when external motivation was applied.
Subject(s)
Brain Concussion/diagnosis , Brain Injury, Chronic/diagnosis , Head Injuries, Closed/diagnosis , Neuropsychological Tests , Adult , Aged , Attention , Female , Glasgow Coma Scale , Humans , Male , Middle Aged , Motivation , Reference Values , Whiplash Injuries/diagnosisABSTRACT
Quality of life research with the elderly has usually focused on the impact of decline in function, and used a pre-determined model of quality of life in old age. The Schedule for the Evaluation of Individual Quality of Life (SEIQoL) allows individuals to nominate, weigh and assess those domains of greatest relevance to their quality of life. The SEIQoL was administered to 56 healthy elderly community residents at baseline and 12 months later. Quality of life levels were significantly higher at baseline (t = -2.04; p = 0.04) than that of a previously studied sample of healthy adults below 65 years of age, and did not change significantly over the study period. The domains nominated by both samples as relevant to their quality of life differed notably. Health status was not correlated with the perceived importance of health at baseline, and showed only a low correlation (r = 0.27) at 12 months. The weight placed on health did not increase over the study period despite a significant decline in health status. The value of allowing the individual to define personal quality of life values in a research context is explored.
Subject(s)
Health Status , Quality of Life , Adult , Age Factors , Aged , Aged, 80 and over , Case-Control Studies , Female , Follow-Up Studies , Humans , Ireland , Male , Models, Theoretical , Psychometrics , Reproducibility of Results , Urban HealthABSTRACT
MRI is a noninvasive method to assess the maturation of the brain. T2 values decrease after birth in proportion to histologically ascertained maturational changes of cortical and subcortical structures. T2 values of 8 anatomical brain structures were sampled in 5 healthy children aged 8 years, four healthy children aged 10 years and 8 healthy adults aged 24 or 25 years. The results of the study indicated that T2 values decrease after the first decade of life, consistent with maturational changes of the CNS persisting into the 2nd and 3rd decades of life.
Subject(s)
Brain/growth & development , Magnetic Resonance Imaging/methods , Adolescent , Adult , Child , Female , Humans , Male , Reference ValuesABSTRACT
We examined four patients with transcortical sensory aphasia and eight with milder language disturbances but with similar thalamic and/or temporo-occipital lesions. Specific attention was paid to differentiation of the computed tomographic lesion site of the milder cases from the transcortical sensory aphasia cases. The critical lesion for transcortical sensory aphasia in these patients involved pathways in the posterior periventricular white matter adjacent to the posterior temporal isthmus, pathways that are probably converging on the inferolateral temporo-occipital cortex. Analysis of the language function of these patients, of the influence of sensory modalities on language function, and of the interaction between semantic memory and semantic lexical functions suggests the existence of a specific brain system for semantic functions. This semantic system has a particular distributed anatomy. We propose that damage to this system may have a variety of clinical manifestations in language and in memory, depending on the exact lesion configuration.
