Electronic memory aids for outpatient brain injury: follow-up findings.

The introduction of highly portable computers extends the range of tools potentially useful to persons with functional impairments of prospective memory resulting from brain injury. This study reviews the experience of 12 patients with brain injury undergoing outpatient treatment using palmtop computers to assist with memory dependent activities in their everyday lives. During the initial supervised trial period, each was provided a palmtop computer based memory aid capable of generating audible and visible reminder cues. Subsequently, patients were contacted for follow-up between 2 months and 4 years after initial trial usage, and surveyed as to the utility of the computer. Nine patients found palmtop computers were useful during supervised trials. Seven of nine patients actually continued to use such devices after the usage trials had ended. Experience with this technology has shown it to be useful in a high proportion of patients for assisting with memory dependent functions.

Utility of a microcomputer as an external memory aid for a memory-impaired head injury patient during in-patient rehabilitation.

Memory deficit is one of the most frequent cognitive complications encountered after brain injury. It is recognized as difficult to treat. Over the past decades, various strategies of memory remediation have been used. Among them, prosthetic devices, such as notebooks and alarms, have shown some benefit. This study describes the case of a 22-year-old man who demonstrated deficits in memory and executive function. In an in-patient rehabilitation setting, a microcomputer was introduced as an external memory aid. With this intervention, the patient demonstrated an immediate improvement in the ability to attend every therapy and ask for every medication on his schedule. This case study demonstrates the usefulness of a microcomputer as an external memory aid for a memory-impaired head injury survivor.

Behavioral correlates of computed tomographic (CT) scan changes in older psychiatric patients.

Fifty psychiatric inpatients aged 50 and over, with no hard neurologic findings, and with a variety of DSM-III diagnoses (adjustment disorder, affective illness, and dementia), were rated for behavioral and psychiatric symptoms using the Geriatric Rating Scale and the Nurse's Assessment of Global Symptomatology-Elderly. These clinical ratings were correlated with computed tomographic (CT) scan assessments of various superficial cerebral regions as well as with linear measures of ventricular size. Behavioral deficits in activities of daily living (ADL) plus an interactional variable, inability to respond to requests, were correlated with superior temporal and inferior parietal CT abnormalities, particularly on the left side. Suspiciousness and peculiar thinking, mood lability and irritability, as well as impaired memory with confusion, perplexity, and disorientation were also associated with atrophy in these same regions. Prefrontal area defects correlated with mood lability and deficits in visual-interactional responsiveness. Statistically controlling for effects of age and alcohol abuse did not alter the basic nature of these results. Regional cerebral specialization in relation to these results are discussed using concepts developed by Luria.