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Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The goals of the present research were two fold: first to examine an acute head injury sample to test memory functions, second to study what parts of the memory process are most affected during post traumatic amnesia with special emphasis on retrieval of structured material in delayed recall. Subsidiary interests include studying recovery and the relationship between memory functioning and severity of injury. After head injury a common complaint is a transitory period of amnesia for recent events (PTA). PTA is often thought of as one stage in the recovery of consciousness and is believed to be an index of neurological severity. A model was proposed to account for amnesia. Two separate memory mechanisms prior to permanent storage were hypothesized, one for short term and the other for long term storage. Inputs are coded on the basis of recurrent patterns of common features. Retrieval occurs by means of the coded representation. Amnesia is viewed as a malfunctioning of the coding mechanism. Amnesia is thus held to be an inability to fully utilize coding of stimulus material as an aid in recall. Following this theory, it was predicted that the perceptive and cognitive functions were operating in amnesia and that immediate recall was also unimpaired. The major prediction was that retrieval of structured stimulus material by delayed recall would be impaired compared to normals, while retrieval of unrelated stimulus material would be unimpaired. Retrieval by recognition would only be mildly impaired because less information is required for recognition than for recall. Hence, the memory event can be reconstructed in recognition on the basis of partial coding. It was further predicted that, with recovery, there would be improvement of memory functioning and that there would be a relationship between severity of injury and memory functioning. A Memory Scale was constructed which included four subtests designed to test the above theory. Each subtest included both related and unrelated stimulus material. An additional test (a Picture Similarities Test) was employed to measure conceptualization. Forty seven acute head injury patients were tested as soon after injury as possible and matched with forty four control subjects (patients with acute trauma, but no head injury) on the basis of age, education, occupation and performance on the Ammons Picture Vocabulary Test. Head injury patients with approximately normal intelligence (Ammons I.Q. 80 or above) followed the predictions with these exceptions: Immediate recall and recognition of related stimulus material showed a trend toward impairment, though immediate recall and recognition of unrelated stimulus material did not. The findings with the patients with normal intelligence suggest, that while cognitive and perceptual abilities are not affected by trauma, utilization of organization as an aid in recall of related stimulus material is not as effective in the experimental· as in the control group. Head injury patients with low I.Q.'s (79 or below on the Ammons) demonstrated impairment of perception and immediate recall as well as the predicted impairment of delayed recall. These patients appeared to exhibit a generalized cognitive disturbance. No definite trends toward recovery were observed on any of the memory tests. There was also no relationship between severity of injury and performance on the Memory Scale. However, there was a significant correlation between performance on the Ammons and Picture Similarities tests and neurological severity. Patients with the lowest scores on these tests were most impaired neurologically. Intelligence thus appears to be more closely associated with severity of injury than is memory functioning per se. / 2031-01-01

Alzheimer's Disease (AD) is a neurodegenerative disorder affecting over 35 million people. Early diagnosis and intervention are crucial for improving outcomes. Digital Cognitive Biomarkers (DCBs) offer a promising approach for early detection and disease management, quantifying cognitive processes of encoding and retrieval through a hierarchical Bayesian cognitive processing model using wordlist memory tests. We hypothesize that DCBs will correlate with classic AD cerebrospinal fluid (CSF) biomarkers (Aβ42, T-tau, p-tau) in patients with varying cognitive decline levels compared to healthy elderly controls. Using Alzheimer's Disease Neuroimaging Initiative (ADNI) data and paired Pearson correlation coefficient analysis, our results support the hypothesis, indicating that DCBs correlate with CSF biomarkers and demonstrating their potential as a noninvasive diagnostic tool for AD. Furthermore, DCBs exhibited improved diagnostic accuracy compared to classic AD CSF biomarkers, as indicated by the area under the Receiver Operating Characteristic curve analysis. DCBs hold promise for monitoring disease progression, response to therapeutics, and identifying patients at earlier disease stages. Future research should validate these findings in diverse populations and conduct longitudinal studies to assess DCBs' potential in tracking disease progression and treatment response. Integrating DCBs with other diagnostic approaches, such as neuroimaging, could enhance overall AD diagnosis accuracy and provide a comprehensive understanding of an individual's cognitive health. In conclusion, DCBs may offer a valuable, noninvasive tool for early diagnosis and management of Alzheimer's Disease, supporting the initial hypothesis.

The pathomechanism of migraine attacks is not understood well, however, is currently believed to be a brain disorder. Migraine is a multifactorial disorder that needs to be investigated in multiple research areas to shed light into its mechanism and find ways to treat it effectively. Migraine episodes come from one or many things at the same time, and such vary from person to person. However, sufficient evidence in recent studies show there is a strong relationship between genetics with patients having specific genes that may be responsible for the disease or a genetic sequence passed down through generations in families, especially in the case of migraine with aura. Several genes including P/Q type calcium channel gene mutations, Na+ /K+ pump ATP1A2 malfunctions and Na+ gated voltage channel Nav 1.1 have been implicated with familial hemiplegic migraines with aura (Samsam 2012). Additionally, insulin resistance has been shown to be a very prevalent factor in migraine patients, but more research has yet to be done to support such claim. Also, many studies suggest the possibility of migraine attacks occurring due to a lack of energy in the patient´s brain. Meaning that exhaustion of the brain can also lead to a migraine episode. In this thesis, we investigated the genetic causes of migraine and reviewed the recent genes implicated in the pathomechanism of migraines. Further, we explored several articles that investigated the metabolic changes that occur in the brain during a migraine attack and looked for reasons behind such changes.

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El ingenioso hidalgo Don Quixote de la Mancha sits at the crossroads of two defined Spanish early modern contexts, combining Renaissance ideals with Baroque elements into one Golden Age masterpiece. The theme of duality present throughout the work finds true expression in Cervantes’ well-educated protagonist, Alonso Quijano. In him, the reader glimpses the struggle between antiquity versus early modernity, ideality versus reality, instability versus sanity, and unhealthiness versus healthiness. These medical themes and the underlying sociocultural facets will be investigated by thoroughly evaluating Cervantes’ treatment of human consciousness. In doing so, this study aims to explore the following questions: to what extent does Cervantes present relevant medical knowledge applicable to the Renaissance and Baroque periods of Spanish history? How do these medical allusions and references influence the reader’s perception of Don Quixote as insane? Could/Would a medical diagnosis of some neurologically or psychologically based disorder be applied? Finally, to what extent of the protagonist’s behavior may be medically attributed and to what extent may be the result of sociocultural disconnection? Following an in-depth review of Spanish literature and medical knowledge, it will be necessary to examine the work for episodes in which Don Quixote experiences pronounced fatigue, forgetting spells, head trauma, sleep disturbances, and headaches. This psychoanalytical process of interpreting Spanish medicine through the lens of literature illuminates the scientific background inherent in the novel and establishes a foundation for uncovering the connections between medicine, culture, and literature in Golden Age Spain.