This chapter begins with an effort to understand altered attentiveness seen in patients with petit mal epilepsy at the time of their characteristic seizure discharge. To buttress the point about significant reduction of visual sensory input during spike-wave seizures. Most recently the people have recorded from single neurons in rostral brainstem during task performance in intact animals using Evarts' chronic single unit recording technique. The majority of the type 1 responses appeared to be associated with the flux of sensorimotor activity involved in the execution of the go response. The presence of anticipatory unit activity in the reticular system has been reported previously by Sparks and Travis in the monkey and by Olds, Mink, and Best in the rat. The role of the mesencephalon in the pathophysiology of petit mal epilepsy has obviously still to be established; however, these data on cellular inhabitants of this region of the brain appear to add to the reasonableness of the inference of involvement. .

The Genain Quadruplets, a genetically identical group of sisters, all developed schizophrenia by their early 20s. Beginning in the 1950s, under the direction of David Rosenthal, they have been studied extensively with a number of neurobiological, neuroradiological and neurobehavioral measures at the Intramural Program of the National Institute of Mental Health (NIMH). A major focus of research interest has been the fact that they varied greatly in the severity of their illness. The present report emphasizes the important role that Monte Buchsbaum had in their evaluation, especially with respect to neuroradiology, during their second period of study at NIMH in the 1980s. It is of special interest that Buchsbaum et al. (1984) concluded “No strong relationship is shown between these (radiological) measures and illness severity or drug responsivity.” The inference, therefore, is that the differences in illness severity among the sisters were not readily attributable to differences in the amount of damaged brain, at least as could be determined by the imaging methods available in the 1980s. The current report also summarizes the results of the other studies performed on the sisters in the 1980s, to which Monte Buchsbaum contributed.

This chapter reviews brain regions involved in attention to allow incorporation of the behavioral findings into a neuropsychological/neuroanatomical context. Cognitive psychologists have become interested in the problem of attention, and insightful and original analyses and models have been contributed by D. Kahneman, M. I. Posner, R. M. Shiffrin and W. Schneider, and others. Attention can be subdivided into a number of separate functions, including focus, execute, sustain, encode, and shift. The complexities of some of the models proposed by cognitive psychologists are beyond current knowledge of the correspondence between function and structure in the brain. A theoretical account of attention impairment that is limited to failure of arousal or incapacity to orient seems to capture relatively little of a complex behavior. The technique perfected by E. Evarts for studying the functions of individual nerve cells in behaving monkeys has stimulated a variety of behaviorally oriented studies.

Abstract The history of attention studies in neuropsychology is in many ways a history of all of neuropsychology. Many clinical groups have been studied, and there has been extensive research aimed at relating aspects of attentive behavior to underlying brain structures. In addition, models of the different components of attention have been proposed, dating back nearly 40 years. This review, by nature and necessity selective, begins with early descriptions of symptoms seen in clinical groups and discusses more recent findings, including impaired attention in various disorders, the possible etiology(ies) of impaired attention, and behavioral and psychophysiological studies of attention. Also reviewed are animal models of attention and attention disturbance, the neuroanatomical bases of attention, and speculations on the relation between our concepts of attention and consciousness.

Abstract We review the changing conceptions of schizophrenia over the past 50 years as it became understood as a disorder of brain function and structure in which neurocognitive dysfunction was identified at different illness phases. The centrality of neurocognition has been recognized, especially because neurocognitive deficits are strongly related to social and role functioning in the illness, and as a result neurocognitive measures are used routinely in clinical assessment of individuals with schizophrenia. From the original definitions of the syndrome of schizophrenia in the early 20th century, impaired cognition, especially attention, was considered to be important. Neurocognitive impairments are found in the vast majority of individuals with schizophrenia, and they vary from mild, relatively restricted deficits, to dementia-like syndromes, as early as the first psychotic episode. Neurocognitive deficits are found in the premorbid phase in a substantial minority of pre-teenage youth who later develop schizophrenia, and they apparently worsen by the prodromal, high-risk phase in a majority of those who develop the illness. While there is limited evidence for reversibility of impairments from pharmacological interventions in schizophrenia, promising results have emerged from cognitive remediation studies. Thus, we expect cognitive interventions to play a larger role in schizophrenia in the coming years. Moreover, because youth at risk for schizophrenia can be identified by an emergent high-risk syndrome, earlier interventions might be applied in a pre-emptive way to reduce disability and improve adaptation. The notion of schizophrenia as a developmental neurocognitive disorder with stages opens up a window of possibilities for earlier interventions. (JINS, 2017, 23, 881–892)

Maxillofacial trauma is often associated with injuries to the cranium, especially in high-energy trauma. The management of such cases can be challenging and requires close cooperation between oral and maxillofacial surgery and neurosurgical teams. There are few reports in the current literature describing the complications that develop in patients with maxillofacial trauma and traumatic brain injury (TBI). Complications can be categorized as early or late and/or minor and major. The exact definition of complications and their categorization remains a matter of current debate. We present a 10 year retrospective study of complications and their subsequent management in patients receiving maxillofacial and neurosurgical treatment for maxillofacial trauma associated with TBI. The study population consisted of 47 people, excluded from a maxillofacial trauma population of 579 patients. The severity of the trauma was scored as mild, moderate or severe, using the Glasgow Coma Scale at presentation of the Emergency Department. In total 36 patients (76.6%) developed complications. Patients involved in road traffic collision were most likely to develop complications (92.3%). This was followed by falls (66.7%) as mechanism of the injury. Patients aged 60–69 years experienced the highest complication rate (5), followed by patients aged 20–29 years (4.1) and 30–39 years (3.5). The majority of complications were infection and inflammation (36.4%), followed by neurological deficit (24.0%), physiological dysregulation (11.6%) and facial bone deformity (8.3%). Patients who developed no complications, most often presented with mild TBI (72.7%).The most common treatment modality employed to manage complications was pharmacological, followed by antibiotic treatment, conservative treatment and decompression therapy. The mean hospital stay after the trauma for the patients with complications was 28 days. Thirteen patients (36.1%) were transferred to a rehabilitation centre, a nursing home, or a home for the elderly. Nine patients (25%) completely recovered from their complications and 4 patients (11.1%) died after the trauma. This report provides useful data concerning the rate and type of complications that occur, and the multidisciplinary treatment that is required in traumatic maxillofacial and brain injury patients.

The focus of this review is an analysis of the use of event-related brain potential (ERP) abnormalities as indices of functional pathophysiology in survivors of traumatic brain injury (TBI). TBI may be the most prevalent but least understood neurological disorder in both civilian and military populations. In the military, thousands of new brain injuries occur yearly; this lends considerable urgency to the use of highly sensitive ERP tools to illuminate brain changes and to address remediation issues. We review the processes thought to be indexed by the cognitive components of the ERP and outline the rationale for applying ERPs to evaluate deficits after TBI. Studies in which ERPs were used to clarify the nature of cognitive complaints of TBI survivors are reviewed, emphasizing impairment in attention, information processing, and cognitive control. Also highlighted is research on the application of ERPs to predict emergence from coma and eventual outcome. We describe primary blast injury, the leading cause of TBI for active duty military personnel in present day warfare. The review concludes with a description of an ongoing investigation of mild TBI, aimed at using indices of brain structure and function to predict the course of posttraumatic stress disorder. An additional goal of this ongoing investigation is to characterize the structural and functional sequelae of blast injury.

This chapter reviews the history of research on attention, including studies generated during wartime, and accounts of the impairment seen in brain-injured soldiers, as described by Luria and Rosvold. The chapter goes on to review some of the seminal behavioral, neurophysiological, electrophysiological and anatomical studies done in the past 60 years related to impaired attention, with particular emphasis on absence epilepsy. Assessment of attention is one of the major components of modern neuropsychological practice; it is well known, that in addition to epilepsy and the eponymous ADHD, impaired attention is characteristic of schizophrenia, head injury, and other neuropsychiatric and medical disorders. A model of attention elements is reviewed, and there is discussion of environmental factors that contribute to the development of attention impairment.

We report an investigation of P300 measures of information processing in patients with generalized epilepsy of the absence type and those with complex partial epilepsy. Studies have demonstrated that absence patients perform more poorly than complex partial patients on behavioral tests of sustained attention (the Continuous Performance Test, or CPT). Duncan [Duncan, C.C., 1988. Application of event-related brain potentials to the analysis of interictal attention in absence epilepsy. In: Myslobodsky, M.S., Mirsky, A.F. (Eds.), Elements of Petit Mal Epilepsy. Peter Lang, New York, pp. 341-364] reported that P300 was significantly reduced in a group of absence patients as compared with healthy controls. The present investigation was undertaken to compare the attention deficit in absence patients to that in complex partial seizure patients. Thus, ERPs were recorded while participants with absence seizure disorder, complex partial seizure disorder, and healthy controls performed auditory and visual versions of the CPT. A significant reduction in the amplitude of P300 on the visual CPT was observed in both groups of seizure patients as compared to controls. In contrast, P300 on the auditory CPT was reduced only in the group with absence seizures. These ERP data support and amplify previous behavioral findings of the impaired capacity of absence patients to mobilize and sustain attentional resources. Auditory sustained attention seems to be more affected by the pathophysiology of absence epilepsy than visual attention. Two possible factors may be involved: (a) There are separate visual and auditory attention systems in the brain, and the latter is more vulnerable than the former [Duncan, C.C., Kosmidis, M.H., Mirsky, A.F., 2005. Closed head injury-related information processing deficits: An event-related potential analysis. Int. J. Psychophysiol. 58, 133-157]; and (b) Auditory processing depends on intact mechanisms in the brainstem, which are dysfunctional in patients with absence seizures.

This is a collection of essays by leading neuropsychologists and cognitive neuroscientists to honor Alexander Romanovich Luria and to highlight the enduring impact of his legacy on cognitive neuroscience and clinical neuropsychology. A wide range of topics is covered, from functional neuroimaging in neuropsychology to bedside evaluation techniques. Several generations of neuropsychologists and cognitive neuroscientists are among contributors, including those who closely worked with Luria, their own students, and others influenced in their work by Luria's pioneering insight.