Clinical neurological indicators are only moderately correlated with quantitative neuropsychological test scores in patients who display mild-moderate brain impairment following closed-head injuries

Emergence of complex partial epilepsy-like experiences following closed head injuries: personality variables and neuropsychological profiles

To pursue Richard Roberts' epileptic spectrum disorder (ESD) and the emergence of complex partial epilepsy-like experiences, items and total scores for the ESD Inventory were examined for 185 patients who had sustained mechanical impacts (and were diagnosed with or without neuropsychological impairment) and a reference group (n=68) of university students. Results from neuropsychological, personality, neurological screening, and interview data supported the role of temporal lobe origins for these experiences. The incidences of these experiences were sufficient to adversely affect adaptation and to produce psychiatric profiles. Although only 70% of the patients who were impaired versus not impaired could be differentiated by items from the ESD Inventory, >95% of the patients with scores >100 on the ESD Inventory displayed abnormal scores on more than four Minnesota Multiphasic Personality Inventory scales. These results support Roberts' ESD concept and strongly suggest that persistent, subclinical occurrence of these experiences could be the cause or major correlate of neuropsychological impairment for these patients.

Case report: A prototypical spontaneous 'sensed presence' of a sentient being and concomitant electroencephalographic activity in the clinical laboratory

The sensed presence of a 'Sentient Being' has been hypothesized to be the transient awareness of the right hemispheric equivalent of the left hemispheric sense of self. When the clinical context is supportive for the expression of anomalous cognition, the experience is reported frequently by patients who display complex partial epileptic-like symptoms and signs following a mild closed head injury. This article describes a patient with a history of presences subsequent to a 'mild' closed head injury who reported strong experiences during an electroencephalographic screening within a very quiet and darkened setting at the end of a day of neuropsychological assessments. The right-sided presence was preceded by the sensation of an 'electric shock' through the right hand and then both hands. Whole body 'icy coldness' and then vibrations 'moved' through her entire body. The experiences were concomitant with paroxysmal irregular 4-5-Hz activity over the temporal lobes. This case illustrates that many sensed presences might be similar to 'epileptic auras' for patients who also display elevated complex partial epileptic-like experiences following closed head injuries and that close attention to typically ignored electroencephalographic 'transients' may be helpful indicators.

Mechanical impacts to the skulls of rats produce specific deficits in maze performance and weight loss: evidence for apoptosis of cortical neurons and implications for clinical neuropsychology

The purpose of this experiment was to induce closed head injuries that might be applicable to clinical neuropsychology. Six adult female albino rats were struck over the right dorsal skull by a 200-gm weight that fell through a 0.9-m tube while another six rats served as controls. The rats that received the impact to the skulls displayed significantly more weight loss and fewer completions of the maze during the subsequent two to four days (effect size about 40%) while their open field behaviors, response latencies to thermal stimulation of the feet, and immobility within a conditioned fear setting did not differ significantly from those of controls. Histological analyses of the brains about 35 days after the impact indicated striking alterations in the morphology of cerebral cortical neurons, strongly suggestive of an apoptotic-like process, within the dorsal cerebral cortices below the likely impact site. Distributions of clusters of these aberrant-looking cells were also evident opposite to the impact site within the ventral cerebrum. Because apoptosis is involved with minimal inflammation and edema, detection of diffuse apoptosis by MRI and CT would be unlikely even though the influence on adaptability would be significant.

A brief (one-hour) quantitative neuropsychological assessment with three performance-based tests: strong concordance with proficiency scores for a more extensive test battery

Raw scores for each of several dozens of traditional and more recently developed neuropsychological tests were correlated with an impairment index composed of all of these scores from the records of 162 patients who had been assessed following impacts of substantial mechanical energies. A score of either less than 20 correct binaural responses for a dichotic word listening task, more than 99 sec. for Trails B, and more than 3.8 min. to complete the Tactual Performance Test with both hands correctly classified 85% of patients whose z scores were less than -1.0 (below average) or -1.0 or above (average) for a composite neurocognitive index. The results suggest that these three tests, administrable within about one hour, may be employed as a more objective criterion rather than "clinical impressions" for discerning if patients require more extensive neuropsychological testing.

Remote viewing with the artist Ingo Swann: neuropsychological profile, electroencephalographic correlates, magnetic resonance imaging (MRI), and possible mechanisms

In the present study, the artist Ingo Swann, who helped develop the process of remote viewing (awareness of distant objects or places without employing normal senses), was exposed during a single setting of 30 min. to specific patterns of circumcerebral magnetic fields that significantly altered his subjective experiences. Several times during subsequent days, he was asked to sit in a quiet chamber and to sketch and to describe verbally distant stimuli (pictures or places) beyond his normal senses. The proportions of unusual 7-Hz spike and slow wave activity over the occipital lobes per trial were moderately correlated (rho=.50) with the ratings of accuracy between these distal, hidden stimuli and his responses. A neuropsychological assessment and Magnetic Resonance Imaging indicated a different structural and functional organization within the parieto-occipital region of the subject's right hemisphere from organizations typically noted. The results suggest that this type of paranormal phenomenon, often dismissed as methodological artifact or accepted as proofs of spiritual existence, is correlated with neurophysiological processes and physical events. Remote viewing may be enhanced by complex experimentally generated magnetic fields designed to interact with the neuromagnetic "binding factor" of consciousness.

Neurobehavioral and neurometabolic (SPECT) correlates of paranormal information: involvement of the right hemisphere and its sensitivity to weak complex magnetic fields

Experiments were designed to help elucidate the neurophysiological correlates for the experiences reported by Sean Harribance. For most of his life he has routinely experienced "flashes of images" of objects that were hidden and of accurate personal information concerning people with whom he was not familiar. The specificity of details for target pictures of people was correlated positively with the proportion of occipital alpha activity. Results from a complete neuropsychological assessment, Single Photon Emission Computed Tomography (SPECT), and screening electroencephalography suggested that his experiences were associated with increased activity within the parietal lobe and occipital regions of the right hemisphere. Sensed presences (subjectively localized to his left side) were evoked when weak, magnetic fields, whose temporal structure simulated long-term potentiation in the hippocampus, were applied over his right temporoparietal lobes. These results suggest that the phenomena attributed to paranormal or "extrasensory" processes are correlated quantitatively with morphological and functional anomalies involving the right parietotemporal cortices (or its thalamic inputs) and the hippocampal formation.

Subjective improvement following treatment with carbamazepine (Tegretol) for a subpopulation of patients with traumatic brain injuries

Over a 3-yr period, 19 patients who had sustained brain traumas during motor vehicle incidents and who exhibited abnormal scores for a dichotic word-listening task and Roberts' Epileptic Spectrum Disorder Inventory more than one year after the injury were recommended for treatment with carbamazepine (Tegretol). The psychiatric profile of these patients, as defined by the Minnesota Multiphasic Personality Inventory, was similar to the profile of patients from other studies who had displayed more objective improvement following this treatment. Of the 14 patients 12 who followed the recommendation retrospectively reported that within a few weeks after treatment they experienced marked reductions in the incidence of sudden confusion and depression, increased attention and focus, and either elimination or attenuation of an aversive sensed presence. Such results suggest that many of the debilitating symptoms that persist for months to years after a traumatic brain injury may be electrical in nature rather than due to "psychological responses" and might be treatable by appropriate dosages of carbamazepine or other, e.g., Gabapentin (Neurontin) antiepileptic compounds.

Discrepancies between standardized measures of cognitive level and Halstead-Reitan impairment indices as inferences of brain damage following head injuries

z scores for measures of intelligence, memory, educational achievement, and neuropsychological impairment were obtained for 193 patients who had sustained impacts of mechanical energy to their skulls. Two sets of normative data, adjusted for age and sex and not adjusted for these variables, were employed to compute indices of neurocognitive proficiency (the inverse of impairment). 80% or 76 of the 96 patients whose Halstead-Reitan Indices were greater than 0.4 displayed scores for neurocognitive proficiency that were two or more standard deviations below the averages of their scores for intelligence, memory, and educational achievement. None of the patents whose Impairment Indices were 0.4 or less displayed this discrepancy. There were no statistically significant differences between these two groups of patients with respect to the presence of unconsciousness following the injury or the duration of posttraumatic memory disruptions. The results indicate that quantitative scores for neuropsychological impairments are still the most accurate criteria to discern brain dysfunction within the mild to moderate range.

PERSONALITY NOT INTELLIGENCE OR EDUCATIONAL ACHIEVEMENT DIFFERENTIATE UNIVERSITY STUDENTS WHO ACCESS SPECIAL NEEDS FOR “LEARNING DISABILITIES”

University students who had been referred over a three year period from a special needs office because of putative learning disabilities were compared to randomly selected cohorts. There was no evidence of learning disabilities. Standardized scores for intelligence memory and educational achievement were all within the average range for both groups. Although there was no evidence of significant psychopathology in either group, the special needs group was significantly more immature, dependent, attention seeking and emotionally sensitive than the reference group. Only four of these variables were required to classify accurately 94% of all of the students (canonical correlation = 0.82). The results indicated that standardized norm-referenced assessment is essential to determine the actual etiologies for university students who request “special needs” because of putative learning disabilities. Implications of strategies for counselling these students are discussed.

"Subclinical" dosages of lithium and pilocarpine that do not evoke overt seizures affect long-term spatial memory but not learning in rats

After training is an automated radial maze, 11 male rats were injected with either "subclinical" dosages of lithium and pilocarpine or saline and then tested 5 days or 4 months later. When employed as their own controls or when compared with a saline-injected reference group, the rats that had received the lithium and pilocarpine displayed memory deficits but not learning learning deficits after the longest of the two delays (effect size was 41%). These results suggest that subtle disruption in memory but not learning to criterion could be associated with "subclinical electrical seizures" or the micromorphological changes associated with this activity.

Test-retest scores for patients who display neuropsychological impairment following "mild head injuries" from mechanical impacts

A total of 20 patients who had sustained of significant mechanical energies to the skull (> 40 km/hour) were assessed at Time 1, about one year (68% between 2 mo. and 12 mo.) postincident while Time 2 was about two years later. During Time 1 this group was impaired (proficiency z < -2.00) according to two standardized neuropsychological indices and exhibited abnormally elevated psychometric depression (z > 2.00). There were no statistically significant improvements for the scores between Times 1 and 2 on the Halstead-Reitan Impairment Index, the Memory Quotient, Depression, or an impairment index composed of standardized scores for 31 neuropsychological tests. These results indicated that the presumption of some neuropsychologists that patients with "mild head injury" have fully recovered within one year or will continue to improve after about one year following the incident may not be valid for all patients who sustain such brain trauma.

Weak, but complex pulsed magnetic fields may reduce depression following traumatic brain injury

Many patients who display psychological depression following a traumatic brain injury do not respond completely to antidepressant drugs. We hypothesized that this type of depression is strongly correlated with subclinical, complex partial seizure-activity within the hippocampal-amygdaloid region that continues for months to years after apparent neurological and behavioral "recovery." Four depressed patients who had sustained traumatic brain injuries and who exhibited mild to moderate brain impairment according to standardized tests received 30 min. of weak (1 microT) burst-firing magnetic fields across the temporal lobes once per week for 5 weeks. There was a significant improvement of depression and reduction of phobias while physical symptoms and other complaints were not changed.