November 29, 2007, 5:19 pm

Envy and gloating confined to ventromedial prefrontal cortex

Emotions associated with social competitiveness may be linked to the ventromedial prefrontal cortex, according to a recent study. The study used a sample of 48 patients with lesions in differing areas of the brain and 35 patients who were healthy as controls. The patients were asked to perform simple cognitive and affective tasks to discover which areas of the brain affect envy and gloating. According to the study, patients with lesions in the right ventromedial prefrontal cortex had difficulty assessing emotions of both envy and gloating. Patients with lesions in the inferior parietal lobule and left hemisphere had greater problems identifying gloating. Conversely, patients with lesions in the right hemisphere of the brain had greater difficulty in identifying envy. The following is an excerpt of an article from Journal Watch that discusses the findings of the study:

Some evidence suggests that the ventromedial prefrontal cortex plays a role in recognizing social competitive emotions. To explore its role in envy and gloating, researchers used simple cognitive and affective tasks, based on cartoons used in child psychology, to compare ability to recognize the emotions of others. Subjects were 48 patients with brain lesions in different locations (ventromedial, dorsolateral, mixed, superior parietal, inferior parietal, and mesial temporal) and 35 healthy controls. Envy was considered negative (the person experiencing it feels bad), and gloating was considered positive (the person experiencing it feels good).

Patients with right ventromedial lesions had difficulty recognizing both envy and gloating. Lesions in the inferior parietal lobule and in the left hemisphere were associated with greater difficulty in recognizing gloating, whereas lesions in the right hemisphere were associated with greater difficulty in recognizing envy. The authors conclude that the ventromedial prefrontal cortex is implicated in decoding these emotions in others and infer that these findings yet again demonstrate the role of the ventromedial cortex in “theory of mind” (awareness of others’ beliefs and thoughts).

Click here to read the entire article from Journal Watch

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November 28, 2007, 1:32 pm

Further Evidence to Neurological Problems in Mentally Disordered Offenders

The research of Dorothy Lewis, MD has pointed to the neurological problems in the offender populations. Doctors Lewis and Pincus studied juvenile offenders and adults in the "Death Row" population noting a high prevalence of neurological symptoms, including brain injury. In a study by Seyed Assadi, MD et al, Neurological Soft Signs in Mentally Disordered Offenders, published in the Journal of Neuropsychiatry and Clinical Neurosciences 19;4, Fall 2007, the authors once again found neurological soft signs in the offender population and that repeat offenders had a higher rate of neurological  signs than single felony offenders. Dr. Assadi's study included a wider range of individuals involving people in all offense groups and consideration of the relationship of sensory integration, psychotic disorders, anxiety, mood disorders and substance abuse.

Studies of this type are important to furthering our understanding of criminal behavior and its treatment.While the studies to date have addressed individual's who have been caught as a result of criminal behavior, the limiting factor is that we don't get to assess individuals who have not been caught.Do they share the same characteristics? Do neurological problems result in flawed planning and inefficient actions which increase the likelihood of getting caught. Clearly, there is a higher prevalence of neurological problems within the offender population and an even higher rate of problems in repeat offenders and more seriously involved felons. Are  we establishing an understanding of the neurobehavioral issues which cause serious criminality?

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, 1:03 pm

Neuroendocrine Effects of TBI

In the Journal of Neuropsychiatry and Clinical Neuroscience 19; 4, Fall 2007, Micol Rothman, MD and his co-authors presented their research on neuroendocrine dysfunction after traumatic brain injury,( Neuroendocrine Effects of TBI ). Rothman and his fellow researchers state that neuroendocrine problems are often under-diagnosed and under-treated and may play a large role in determining the rate of recovery.Dr. Rothman and team report that screening for neuroendocrine deficits is not done routinely and the adverse effects of hormonal deficits include delaying physical and cognitive recovery are not adequately considered. The study examined Anterior Pituitary, Adrenocorticotropin (ACTH) and Thyrotropin Deficiencies as well as Prolactin Dysregulation. Dr. Rothman's study suggests evaluating patients early in their recovery and considering the neuroendocrine issues in formulating acute treatment interventions. Rothman's article recognizes that clinical research in this area may prove difficult, but that consideration of hormonal replacement therapies may boost recovery, especially in severe injuries.

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November 6, 2007, 3:04 pm

Historical Brain Injury Summit

This past weekend, I had the honor of being involved in a history-making brain injury summit, held by the Brain Injury Association of America and the North American Brain Injury Society. A collaborative, cross-system initiative, the conference was a gathering of the most respected minds in brain injury, and the aim of the meeting was to create the start of a white paper that would authoritatively address gaps in service for brain injured vets and civilians.

During the meeting, more than a hundred participants separated into smaller designated workgroups to tackle issues ranging from acute care to systemic challenges. By the end of the conference, most attendees were equally exhausted and exhilarated by the amount of work completed, and the amount of attention the conference received. In the final hours, high-level officials from the Department of Defense arrived to listen to our findings, and they have since requested formal meetings with summit heads to receive the white paper.

This is the first real indication that a revolution in brain injury care is about to take place, and if the summit's recommendations are taken seriously, then legislators will have to sit up and take notice. I'll keep you posted as to new developments, but it's proving to be an exciting time to be championing the well being of those affected by brain injury.

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