Faculty Bibliography

BACKGROUND AND OBJECTIVE: Medication self-administration (MSA) may be cognitively challenging after stroke, but guidelines are currently lacking for identifying high-functioning stroke survivors who may have difficulty with this task. Complicating this matter, stroke survivors may not be aware of their cognitive problems (cognitive anosognosia) and may over-estimate their MSA competence. The authors wished to evaluate medication self-administration and MSA self-awareness in 24 consecutive acute stroke survivors undergoing inpatient rehabilitation, to determine if they would over-estimate their medication self-administration and if this predicted memory disorder. METHODS: Stroke survivors were tested on the Hopkins Medication Schedule and also their memory, naming mood and dexterity were evaluated, comparing their performance to 17 matched controls. RESULTS: The anosognosia ratio indicated MSA over-estimation in stroke survivors compared with controls--no other over-estimation errors were noted relative to controls. A strong correlation was observed between over-estimation of MSA ability and verbal memory deficit, suggesting that formally assessing MSA and MSA self-awareness may help detect cognitive deficits. CONCLUSIONS: Assessing medication self-administration and MSA self-awareness may be useful in rehabilitation and successful community-return after stroke.

BACKGROUND/AIMS: Healthy individuals demonstrate leftward bias on visuospatial tasks such as line bisection, which has been attributed to right brain dominance. We investigated whether this asymmetry occurred in patients with probable dementia of the Alzheimer type (pAD) which is associated with neurodegenerative changes affecting temporoparietal regions. METHODS: Subjects with pAD and matched controls performed a line bisection task in near and far space under conditions of no distraction, left-sided visual distraction and right-sided visual distraction. RESULTS: Participants with pAD manifested different motor-preparatory 'aiming' spatial bias than matched controls. There were significantly greater rightward 'aiming' motor-intentional errors both without distraction and with right-sided distraction. CONCLUSION: 'Aiming' motor-preparatory brain activity may be induced by distraction in pAD subjects as compared to typical visual-motor function in controls.

Aphasia researchers and clinicians share some basic beliefs about language recovery post stroke. Most agree there is a spontaneous recovery period and language recovery may be enhanced by participation in a behavioral therapy program. The application of biological interventions in the form of pharmaceutical treatments or brain stimulation is less well understood in the community of people who work with individuals having aphasia. The purpose of this article is to review the literature on electrical brain stimulation as an intervention to improve aphasia recovery. The article will emphasize emerging research on the use of transcranial magnetic stimulation (TMS) to accelerate stroke recovery. We will profile the current US Food and Drug Administration (FDA)-approved application to depression to introduce its potential for future application to other syndromes such as aphasia.