<p>Savant syndrome is a rare condition in which some people have extraordinary talents despite some serious mental or physical disability. It is a syndrome with remarkable features, standing in stark contrast to a person’s overall character. The term savant, or idiot savant, describes a person who, in spite of low intelligence, has a skill in some specific narrow area. Savants can have a specific talent in, for instance, music, art, calendar calculation or foreign language but whatever the specific talent is, it is always connected to extraordinary memory. Savant syndrome seems to be also connected to autism or autistic characteristics. In this paper I aim to give a clear description of the savant syndrome and explain its connection to autism. Further, I present how specific theories try to describe the causes of savant syndrome, and connect the theories to results of empirical research in order to give an overall view of the syndrome’s appearance. I will also compare the theories and evaluate their strengths and weaknesses with respect to the discoveries and progress that has been made within the area of savant syndrome research.</p>

The purpose of this dissertation was to examine aspects of self-awareness in patients with brain injuries: In Study 1 two measures for the assessment of self-awareness were compared (i.e., questionnaire approach vs. predicted performance method). Study 2 analyses the relationship between awareness, goal setting ability (i.e., the ability to set realistic goals), and outcome in the rehabilitation setting as well as in an experimental task. / Ziel dieser Dissertation war es, Aspekte des Störungsbewusstseins von Patienten mit Hirnschädigungen zu untersuchen: In Studie 1 wurden zwei Methoden zu Erfassung/Messung des Störungsbewusstseins verglichen (Fragebogen-Methode und Leistungsvorhersage-Methode). In Studie 2 wurde der Zusammenhang zwischen Störungsbewusstsein, realistischen Zielsetzungen, und Rehabilitationserfolg sowohl im Rehabilitationskontext als auch in einer experimentellen Aufgabe untersucht.

Concussion affects the adolescent population in large numbers, primarily because of the popularity of team sports that are played in middle and high school. This adolescent age group is more susceptible to the adverse effects of concussion due to physiological immaturity, and recovery for this population takes longer than in adults. Speech-language pathologists, who are trained to treat cognitive-communication deficits, are present in the majority of school systems throughout the United States, and could be a useful resource to manage and treat students who incur concussion. However, speech-language pathologists historically have not treated students with concussion, and may not be receiving adequate education regarding concussion in graduate programs. This study sought to ascertain the education, training, and experience regarding concussion of speech-language pathologists in Texas secondary schools. Anonymous survey responses were collected via an Internet survey platform, yielding 49 respondents for the final data pool. The answers provided by these respondents indicate Texas speech-language pathologists are not yet receiving adequate concussion education and training. Respondents reported low confidence levels in several key areas of concussion knowledge, and doubt regarding the speech-language pathologist's role in managing concussion. Recommendations include concussion-targeted graduate school curriculum as an extension of traumatic brain injury curriculum, increased continuing education efforts by ASHA regarding concussion and the speech-language pathologist's role in treating concussion, and further advocacy by ASHA for speech-language pathologists to be part of concussion management teams based in schools. / text

The purpose of this study was to examine the extent to which learning and recall are facilitated by semantic and phonological targets. A list-learning paradigm was administered to 10 individuals with a history of traumatic brain injury. Participants were asked to recall and identify words that were present on the list. The lists consisted of semantically related associate words and phonologically related associate words. Participants recalled significantly more semantically related associates than phonological associates. Demographic factors such as age, time-post injury, and educational attainment did not have a significant effect on the recall ability for either word target type. Word recognition ability also was not influenced by target type. The results of this study found adults with TBI use a semantic network following brain injury and that semantic targets are more beneficial for recall than phonological targets. / text

Learning and memory impairments are among the most common and enduring cognitive consequences of traumatic brain injury (TBI). Researchers have yet to reach a consensus with regard to the basic cognitive mechanism underlying new learning and memory disturbances after TBI. The purpose of the present study was to investigate the current views regarding the cognitive processes thought to explain impairments in verbal learning and memory subsequent to brain injury. Specifically, this study sought to examine the roles of the central executive component of working memory and processing speed in verbal learning ability following TBI. Latent variable structural equation modeling (SEM) was used to analyze the data of 70 post-acute care TBI patients between the ages of 16 and 65, who completed a full neuropsychological evaluation. Results indicated that verbal learning and memory difficulties following TBI were explained primarily in terms of the central executive aspects of working memory, after accounting for the relative contributions of processing speed in the model. The direct effect of processing speed on verbal learning and memory was not significant when working memory was taken into account in the model. Rather, the effects of processing speed on verbal learning ability were largely indirect through the central executive component of working memory. Results highlight the importance of both working memory and processing speed in supporting verbal learning and memory processes after TBI. Practical implications for targeting remediation efforts and directing approaches to memory rehabilitation are discussed in light of the study’s findings. / text

La prévalence des troubles du sommeil et de douleur chronique est élevée chez le patient ayant subi un traumatisme crânien cérébral léger (TCCL). L’interaction entre ces plaintes est suggérée chez les patients avec un TCCL mais son étiologie reste encore peu connue. Les résultats de recherche présentés dans le premier article de cette thèse suggèrent que les patients avec un TCCL qui souffrent de douleur ont une modification des ondes cérébrales durant leur sommeil, ce qui pourrait expliquer en partie comment les deux symptômes interagissent. De plus, la douleur, surtout si associée à des troubles de l’humeur, semble jouer un rôle majeur dans la persistance des symptômes post-commotionnels. Le deuxième article de cette thèse décrit une exacerbation des symptômes post-commotionnels chez le patient ayant eu un TCCL et souffrant de douleur. La persistance ou l’apparition de la douleur chronique à long terme serait prédite par le polymorphisme val66met du gène brain-derived neurotrophic factor (BDNF). Une étude subséquente, présentée dans le troisième article, nous a permis d’approfondir les bases génétiques et cellulaires du rôle du BDNF dans la persistance des symptômes post-commotionnels. Des polymorphismes fréquents dans le gène BDNF ont révélé des variantes liées au mauvais pronostic suite à un TCCL. De plus, l’analyse de cellules extraites de patients ayant subi un TCCL démontrent que l’expression de la protéine BDNF peut être modifiée chez le patient de génotype met66 et ayant subi un TCCL, lui conférant ainsi un rôle neuroprotecteur potentiel. En résumé, nous avons tenté de démontrer dans cette thèse que la douleur suite à un TCCL joue un rôle important dans les perturbations du sommeil et dans la persistance des symptômes post-commotionnels. Une prédisposition génétique pourrait contribuer à expliquer le mauvais pronostic et la chronicité des symptômes post-commotionnels suite à un TCCL. / Mild traumatic brain injury (MTBI) is a major public health concern as patients are left, amongst other symptoms, with sleep complaints and chronic pain. An interaction between these symptoms is suggested. For instance, a night of poor sleep is usually followed by hypersensitivity to pain and chronic pain always leads to sleep complaints. This interaction is suggested following an MTBI, however, data sustaining that hypothesis are still lacking. Data from the first article suggest that pain and other post-concussion symptoms are correlated with sleep-wake disturbances post-MTBI. MTBI patients with pain have more rapid electroencephalographic (EEG) waves during sleep than those without pain. This may suggest that there is an intrinsic physiological relationship between the two complaints. Moreover, pain seems to play an important role in the persistence of post-concussive symptoms. The second article of this thesis describes and details the exacerbation of post-concussive symptoms in the presence of pain following MTBI. The val66met polymorphism in the Brain-derived neurotrophic factor (BDNF) gene is an important predisposing factor for chronic pain. Lastly, a subsequent study, presented in the third article details the genetic and cellular basis of the role of BDNF in the persistence of post-concussive symptoms. Common polymorphisms in the BDNF genes were genotyped and revealed variants related to post-concussive symptoms following MTBI. Moreover, protein expression studies in lymphoblast cells of MTBI patients showed a modified expression of BDNF with the met genotype that might be neuroprotective. In summary, this thesis first shows that pain contributes to sleep-wake disturbances following MTBI and that the chronicity of post-concussive symptoms, including chronic pain, may be dependent on polymorphisms in the BDNF gene.

Atliktas perspektyvusis stebėjimo tyrimas, kurio metu buvo tirti sunkią galvos smegenų traumą patyrę vaikai, gydyti KMUK Vaikų intensyviosios terapijos skyriuje. Pacientų būklė pagal GBS vertinta išvykstant iš gydymo įstaigos ir po šešių mėnesių. Darbo tikslas Nustatyti sunkią galvos smegenų traumą patyrusių vaikų ligos baigčių prognozinius veiksnius. Darbo uždaviniai 1. Įvertinti ankstyvas ir vėlyvas sunkią galvos traumą patyrusių vaikų ligos baigtis. 2. Nustatyti sunkią galvos traumą patyrusių vaikų vidinio kaukolės slėgio ir smegenų perfuzinio slėgio ryšį su ligos baigtimis. 3. Nustatyti sunkią galvos traumą patyrusių vaikų traumos pobūdžio ryšį su ligos baigtimis. 4. Nustatyti paciento būkės vertinimo skalių ir laboratorinių tyrimų kritines reikšmes ir jų prognozinę vertę. 5. Nustatyti laboratorinių tyrimų kritines reikšmes ir jų prognozinę vertę. Išgyveno 80,5 proc. sunkią galvos smegenų traumą patyrusių vaikų. Išvykstant iš gydymo įstaigos 50 proc. pacientų, o po šešių mėnesių – 24,2 proc. pacientų traumos baigtis buvos bloga. Įtakos traumos baigtims turėjo kraujavimas po kietuoju smegenų dangalu, smegenų edema, kaukolės kaulų lūžiai. Nustatytos laktatų, gliukozės kiekio kraujo serume, vaikų traumų skalės, Glazgo komų skalės ir vaikų mirštamumo indekso 2 kritinės reikšmės, prognozuojančios mirtį, blogą baigtį išvykstant iš gydymo įstaigos ir po šešių mėnesių. Dekompresinė kraniotomija, atlikta, kai VKS = 24,5 mmHg,o SPS = 46.5 mmHg ligos baigčių nepakeitė. / The prospective observational study involved children after severe traumatic brain injury treated in Pediatric Intensive Care Unit of Kaunas University of Medicine Hospital. The outcome according to Glasgow Outcome Scale was assessed on discharge and after six months The aim of the study was to determine the prognostic factors in children after severe traumatic brain injury. The objectives of the study: 1. To evaluate early and late outcomes in children after severe traumatic brain injury 2. To evaluate the relation of intracranial pressure and cerebral perfusion pressure with outcome in children after severe traumatic brain injury. 3. To evaluate the relation between type of injury and outcome. 4. To determine the threshold values for trauma scoring scales and to evaluate their prognostic significance. 5. To determine the threshold values for laboratory findings and to evaluate their prognostic significance. The survival rate was 80.5 %.half of patients had bad outcome on discharge and 24.4 % – had bad outcome after six months. The prognostic factors of outcome for children after severe traumatic brain injury were subdural hemorrhage, cerebral edema and skull fracture. Threshold values of Pediatric Trauma Score, Glasgow Coma Score and Pediatric index of Mortality 2 for death and bad outcomes on discharge and after six months were ascertained. Decompressive craniectomy performed at ICP ≥ 24.5 mmHg, CPP ≤ 46.5 mmHg had no impact on outcome in children after severe traumatic... [to full text]

Šiuo tyrimu siekta įvertinti, kaip keičiasi vaikų po sunkaus ir vidutinio sunkumo trauminio galvos smegenų sužalojimo būklė taikant kineziterapiją ankstyvuoju reabilitacijos etapu bei nustatyti veiksnius, kurie labiausiai įtakoja vaikų po traumos pažintinių funkcijų ir motorikos atsigavimą. Tyrimo uždaviniai: 1. Įvertinti vaikų po sunkaus ir vidutinio sunkumo trauminio galvos smegenų sužalojimo pažintinių funkcijų ir motorikos sutrikimus ankstyvojo reabilitacijos etapo pradžioje. 2. Įvertinti vaikų po sunkaus ir vidutinio sunkumo trauminio galvos smegenų sužalojimo pažintinių funkcijų ir motorikos kitimą ankstyvajame reabilitacijos etape taikant individualizuotą kineziterapiją. 3. Nustatyti veiksnius, turinčius įtakos vaikų po sunkaus trauminio galvos smegenų sužalojimo pažintinių funkcijų bei motorikos atsigavimui ankstyvajame reabilitacijos etape ir įvertinti jų prognozinę vertę. Atlikus tyrimą nustatyta, kad vaikams po sunkaus ir vidutinio sunkumo trauminio galvos smegenų sužalojimo ankstyvajame reabilitacijos etape stebimi motorikos (raumenų tonuso, raumenų jėgos, judesių koordinacijos) ir pažintinių funkcijų (sąmonės) sutrikimai sąlygoja šių vaikų hipokinezę bei savarankiškos veiklos sutrikimus. Individualizuota kineziterapija, taikoma vaikams po trauminio galvos smegenų sužalojimo ankstyvajame reabilitacijos etape, daugumai ligonių ženkliai pagerina jų savarankiškumą, tačiau pusei vaikų po sunkaus trauminio galvos smegenų sužalojimo ankstyvojo reabilitacijos... [toliau žr. visą tekstą] / Aim of the study – to establish the factors influencing the recovery of cognitive and motor functions during application of physical therapy in ESR among children suffering severe and moderate TBI. Objectives: 1. To evaluate the cognitive and motor disorders at baseline (start of ESR) among children suffering severe and moderate TBI. 2. To evaluate the changes of cognitive and motor functions applying personally-adjusted physical therapy during ESR for children suffering severe and moderate TBI. 3. To establish the factors influencing the recovery of cognitive and motor functions during ESR among children suffering severe and moderate TBI and to estimate factors’ predictive validity. The children after severe and moderate traumatic brain injury have motor (muscle tone and force, movements coordination) and cognitive (consciousness) disorders during early stage of rehabilitation resulting in hypokinesis and restricted independent activity. Individually-adjusted physical therapy during early stage of rehabilitation for patients after traumatic brain injury significantly improves their independence, though by the end of early stage of rehabilitation among severe traumatic brain injury cases the disorders of balance and walking still persist. About half of those children have motor disorders (toileting, dressing lower and upper body, bathing, independent walk, and walking stairs) and cognitive disorders (communication, social interaction, and problem solving). The motor... [to full text]

This qualitative study explored and described the lived experience of people with brain injuries with regard to resuming their worker roles. Based on the results, an occupational therapy practice model to facilitate return to work was developed. The theoretical framework of occupational science with emphasis on occupational risk factors informed the study. The research design was a theory generative design based on a qualitative, phenomenological, explorative and descriptive research approach utilizing the methods of theory generation as advocated by Chinn and Kramer (1999), Walker and Avant (2005) and Dickoff, James and Wiedenbach (1968).

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