Showing papers by "Michael P. Alexander published in 2004"
TL;DR: Diffuse, sudden ischemic-hypoxic injury caused by cardiac arrest (CA) does not preferentially damage memory systems, and the common pattern of impairment in the postacute phase after CA is a combination of memory, subtle motor, and variable executive deficits.
Abstract: Background: Although cardiac arrest (CA) is commonly cited as a cause of amnesia, patients referred to the authors’ center with a diagnosis of “amnesia” after CA rarely have isolated memory deficits. Objective: To determine whether CA is a cause of pure amnesia and to assess patterns of cognitive deficits after CA. Methods: The authors used cognitive assessment of 11 consecutive patients referred for memory deficits after CA, targeted at deficit domains identified in the literature reviews, and analysis of specific case reports and prospective studies of cognition after CA. Results: The most common pattern of impairment in their patients was a combination of memory and motor deficits with variable executive impairment. No patient had isolated memory impairment. The case reports do not support the claim that isolated amnesia is a residual of CA; most cases of isolated amnesia are caused by subacute episodes of anoxia or excitotoxic injury. The prospective reports identify highly variable patterns of impairment, but isolated amnesia remains rare. Conclusions: Diffuse, sudden ischemic-hypoxic injury caused by cardiac arrest (CA) does not preferentially damage memory systems. Subacute or stepwise hypoxic or excitotoxic injury may cause isolated hippocampal injury and amnesia. The common pattern of impairment in the postacute phase after CA is a combination of memory, subtle motor, and variable executive deficits.
214 citations
TL;DR: Findings provide functional and anatomical evidence for a dissociation between recall confidence and prospective memory monitoring and are discussed in terms of familiarity and access theories of FOK predictions.
166 citations
TL;DR: Katz et al. as discussed by the authors identified variables that are predictive of independent ambulation after traumatic brain injury (TBI) and defined the time course of recovery, including the ability to participate in motor and functional evaluation on admission to acute rehabilitation, and absence of other neurologic disorders or fractures that affect one's ability to ambulate.
82 citations
TL;DR: The findings demonstrate that elevated false recognition is not characteristic of all frontal patients and may result from more than 1 underlying mechanism.
Abstract: This study examined verbal recognition memory in amnesic patients with frontal lesions (AF), nonamnesic patients with frontal lesions (NAF), and amnesic patients with medial temporal lesions (MT). To examine susceptibility to false alarms, the number of studied words drawn from various categories was varied. The AF and MT groups demonstrated reduced hits and increased false alarms. False alarms were especially elevated when item-specific recollection was strongest in control participants. The NAF group performed indistinguishably from control participants, but several patients showed excessive false alarms in the context of normal hit rates. These patients exhibited impaired monitoring and verification processes. The findings demonstrate that elevated false recognition is not characteristic of all frontal patients and may result from more than 1 underlying mechanism.
50 citations
TL;DR: Generic dysphagia scales, i.e., the Norris and to a lesser degree the ALS FRS‐R bulbar sections, are adequate to diagnose and follow clinically significant dysphagía in ALS, and can be used as an indicator for dysphagian treatment initiation.
Abstract: BACKGROUND: Oropharyngeal dysphagia is highly prevalent in amyotrophic lateral sclerosis (ALS). Patients with dysphagia and weight loss are frequently offered gastrostomy. Although the neurological basis of dysphagia in ALS is complex, there are currently no specifically validated scales for dysphagia in ALS, and the reliability of existing generic scales has not been assessed.METHODS: We undertook a prospective study of 25 patients who fulfilled the criteria for definite or probable ALS. We examined the reliability of the Dysphagia Outcome Severity Scale (DOSS) and the Aspiration‐Penetration Rating Scale (APRS) and the correlation between these scales and the Norris ALS Scale and ALS Functional Rating Scale‐R (ALS FRS‐R).RESULTS: Using the Pearson Product‐Moment Correlation, an expected high linear association between the two disease specific neurological scales was demonstrated. Both dysphagia scales were found to be reliable. Interrelationship evaluation showed a low association between Norris and ALS ...
34 citations