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1
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ERPS AS AN INDEX OF IMPAIRED COGNITIVE CONTROL IN AN ISCHEMIC BRAIN STROKE APHASIC PATIENT

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Cielebąk K., Grzywniak C.
Acta Neuropsychologica
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2021
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vol. 19(1)
11-22
EN
Stroke is a sudden-onset neurological deficit resulting from focal vascular lesions. This is either due to a clot-induced obstruction of a vessel (ischemic stroke) or a rupture of a vessel causing haemorrhage (hemorrhagic stroke). The appropriate diagnosis of brain stroke aphasic patients is a major public health problem one so important for effective rehabilitation. Here an important role is played by the diagnosis of impaired cognitive processes. The aim of the research was to find the index of impaired cognitive control with the use of ERPs in a patient following an ischemic stroke with aphasia. A male patient, aged 69, after an ischemic brain stroke experienced 4 months previously with resulting naming problem, was admitted to the Reintegrative and Teaching Center of the Polish Neuropsychological Society. In the neuropsychological evaluation three neuropsychological tests were employed: (a) the Boston Naming Test-Polish version, to evaluate the naming and word finding problem; (b) the nonverbal Bell test to ascertain a selective, visuospatial and strategic attentional evaluation; (c) the Digit Memory test to evaluate working memory capabilities; (d) ERPs as a neurophysiological index of impaired cognitive control. Significant changes were observed in testing. All cognitive functions including naming, nonverbal, visuospatial and strategic attention, along with the digit memory deviate substantially from the norm. The patient obtained a lo wer score, compared to the norm (p <0.05). Boston Naming Test (patient = 21< Mean-Norm = 57.29; SD= 0.52). Bell test (patient = 23 < Mean-Norm = 31.29; SD= 2.52). Digit Memory Test scores: Forward digit span (patient = 3 < Mean-Norm = 7.65, SD = 0.49). Backward digit span (patient = 2
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ERPS AS AN INDEX OF IMPAIRED WORKING MEMORY IN AN ISCHEMIC BRAIN STROKE APHASIC PATIENT AWAKENED FROM A LONG-TERM COMA FOLLOWING AN AMPHETAMINE OVERDOSE

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Wilczek-Rużyczka E., Grzywniak C., Korab M., Cielebąk K.
Acta Neuropsychologica
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2021
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vol. 19(2)
137-145
EN
Nowadays, amphetamines constitute the prescription drugs most commonly abused by adolescents and young adults (Berman, O’Neill, Fears et al. 2008). The prevalence of problematic (mainly illegal) use of amphetamines as a stimulant by college students, and here especially before serious examinations, has also been rising. This fact represents a serious public health concern. The patient, aged 19, was awakened from from a long-term coma that had lasted 21 days following an amphetamine overdose and manifested tetraparesis, cortical blindness and deficits in cognitive and emotional processes. After a year of rehabilitation the majority of symptoms had disappeared, but cortical blindness andworking memory deficits remained. In addition, frontal lobe syndrome symptoms appeared. After two years of therapy as a result of immense tiredness caused by all an night wedding reception she started to manifest Charles-Bonnet syndrome. She experienced strange visual sensations such as visual hallucinations and saw various non-existing shapes (coloured blots, patterns and fireworks of vivid colours). She also saw objects (often terrifying) as well as animals (mainly African) and people with deformed faces and long teeth, and persons in African dress with feathers and coral beads in their hair. Her real identity was not remembered by the patient for longer than 2 hours and even then she insisted on being referred to as Shakira. She was given a qEEG examination (in open and closed eyes conditions) and ERPs with the use of auditory stimuli at the period when the hallucinations (to a small degree) still occurred. Studies conducted into the functional neuroimaging of the brain work in milliseconds in the examined patient can explain her symptoms. A comparison of the subject’s ERPs with the grand average of ERPs in healthy controls shows that the N170 and N 250 components are impaired in the subject: the occipital-temporal area of the subject brain shows a strong positivity instead of negativities. This positivity might reflect an enhanced reactivity of neurons in the corresponding area induced by the removal of lateral inhibition from the neurons as a result of local damage. ------------------------------------------------------------------------------------------------------------------------------------
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CREATIVE POTENTIAL OF MICROGENETIC THEORY

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Pachalska M., MacQueen B. D., Cielebąk K.
Acta Neuropsychologica
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2018
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vol. 16(2)
125-155
EN
This paper is devoted to illustrating how process neuropsychology and neurolinguistics, based on microgenetic theory androoted in process thought, can help to explain the often baffling symptomatology of brain damage. Our purpose is to present an overview of this difficult and complex subject matter for readers, with particular emphasis on its creative potential. The essence of microgenetic theory in neuropsychology is an account of the phases in brain process through which successive mind/brain states arise and perish over the duration of the psychological present, measured in milliseconds. According to the theory, mental states are rhythmically generated out of a “core” in the anatomically deepest and phylogenetically oldest parts of the central nervous system, over phases to the outermost and youngest regions of the brain, the neocortex. The clinical applications are only one aspect of the creative potential of microgenetic theory. Indeed, the elegance of the theory consists in the way in which it can be extended into a number of different fields of endeavor, providing a kind of “unified field theory” for the explanation of often rather diverse phenomena. This provides an opportunity for neuropsychology and neurolinguistics to resume the interdisciplinary discourse they were founded to conduct.
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EEG NEUROFEEDBACK IN THE TREATMENT OF COGNITIVE DYSFUNCTIONS AFTER THE INFECTION OF SARS-COV-2 AND LONG COVID-19

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Łuckoś M., Cielebąk K., Kamiński P.
Acta Neuropsychologica
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2021
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vol. 19(3)
361-372
EN
Coronavirus disease 2019 (COVID-19) is likely to have long-term mental health effects on individuals who have recovered from COVID-19. According to Centers for Disease Control and Prevention (CDC), individuals diagnosed with COVID-19 can see a range of long-term side effects. The aim of the study was to evaluate the effectiveness of neurotherapy (EEG neurofeedback and goal-oriented cognitive training) in the treatment of neurocognitive dysfunctions in a patient after the infection of SARS-CoV-2 and the long long-term side effects after the contraction of COVID-19. The 48-year-old woman ZR, an accountant by profession, an employee of the administration of the Municipal Board of Municipal Resources, fell ill on October 13, 2020. The disease began with very severe burning headache, eyeballs pain, muscle aches. Ten days later more symptoms joined: loss of smell (anosmia) and loss of taste (ageusia), hearing disorders, shortness of breath and chest pains. The symptoms were associated with SARS-CoV-2 coron- avirus infection confirmed by an rt-PCR genetic test. Brain MRI with intravenous paramagnetic contrast medium injection did not show either lesions of acute microischemic significance or areas of pathological enhancement after paramagnetic contrast medium ad- ministration. The patient was treated at home. In mid-November 2020, about a month after the infection of SARS-CoV-2 and con- tracting NeuroCOVID-19, neurocognitive impairment developed and after half a year she was deteriorating and not able to live in- dependently in society because of her condition. She called her problem "brain fog", and was referred for further diagnosis and therapy to the Reintegration and Training Center of the Polish Neuropsychological Society. We diagnosed a range of long-term side effects and introduced neurotherapy (EEG neurofeedback and goal-oriented cognitive training) in the treatment of neurocognitive dysfunctions. It was found that almost all the long-term side effects were reduced in magnitude. The patient improved and she was able to return to work. EEG neurofeedback and goal-oriented cognitive training might be helpful in the reduction of neurocognitive dysfunctions in patients following the infection of SARS-CoV-2 and long-term side effects after the contraction of COVID-19.
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Quality of life of a patient after endarterectomy of the Internal Carotid Artery (ICA) following an acute ischemic stroke (AIS) during COVID-19

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Cielebąk K., Kobos M., Góral-Półrola J.
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EN
The aim of the study was to evaluate the quality of life of a patient af- terendarterectomy (CEA) of the Internal Carotid Artery (ICA) following an Acute ischemic stroke (AIS) during COVID-19. A right-handed, 51-year-old patient, a visual artist, single, in good health and no chronic illnesses to date, became infected with SARS-CoV-2 and contracted COVID-19. The presence of SARS-CoV-2 virus was confirmed by a RT PCR antigen test. The patient was hospitalized, and required mechanical ventilation at an Intensive Care Unit (ICU) before an acute ischemic stroke (AIS) onset. Except for untreated hypertension, her medical history was unremarkable. Her blood pressure was 180/100 mm Hg; her pulse was 76 beats per minute and was regular. AIS from the left middle cerebral artery (MCA) has resulted primarily in damage to the left hemisphere, and secondary effects on the right side resulting in body weakness and mild anomic aphasia. Magnetic resonance imaging (MRI) confirmed stroke and detected brain tissue damaged by an AIS. It revealed hyperintense foci in the T2 and FLAIR sequences, 21 mm in size in the left hemisphere of the brain. In search of the cause of AIS, CT angiography was performed. It revealed a large (90%) ICA occlusion. The patient was admitted to the emergency room at the Vascular Surgery Clinic with an Endovascular Subunit. The revascularization procedure (CEA) was performed under general endotracheal anesthesia with the use of the protocol and techniques (elaborated at the Department of Vascular Surgery and Endovascular Procedures, The John Paul II Hospital in Krakow). The CEA procedure improved her general health: she regained the ability to name objects and her HRQOL also improved in her perception. The improvement achieved was statistically significant. She returned to painting and functions well in society. The patient’s perception of HRQoL measured by the SF-36 domains was better after the CEA: a significant improvement in self-reported overall health has occured. The HRQoL outcome measures may be valuable in future clinical trials of comparing different methods of treatment offered after AIS.
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FUNCTIONAL NEUROMARKERS OF COGNITIVE IMPAIRMENT IN VASCULAR DEMENTIA: A CASE STUDY

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Supińska M., Górla-Półrola J., Cielebąk K., Herman-Sucharska I., Kropotov J. D., Pąchalska M.
Acta Neuropsychologica
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2020
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vol. 18(3)
313-325
EN
Early diagnosis and monitoring of disease progression in patients with Vascular Dementia (VaD) have become vital in clinical practice, as disease modifying treatments for VaD become available. The goal of our research was to study cognitive impairment in a patient at an early stage of VaD. We evaluated latencies of the P3 GO and NOGO components of event-related potentials (ERPs), elicited in cued GO/NOGO tasks, as potential neuromarkers of cognitive im- pairment, as suggested by previous research. The patient, a right-handed, 53-year-old male with a college edu- cation, suffered a transient ischemic attack (TIA) in 2011. During this attack, which lasted for a few minutes, he was confused and had trouble speaking, trouble seeing in both eyes, difficulty walking, problems with balance and coordination, and strange behavior. Se - ven years later, in 2018, he was assessed using the HBI methodol- ogy, which consisted of recording (1) a 19-channel EEG in resting state (with eyes open and eyes closed), and (2) a cued GO/NOGO task, and then comparing the results with EEG spectra and Event- Related Potentials (ERPs) data from normative and patient data - bases. The patient died in 2019. Post-mortem studies confirmed cortical microhaemorrhages neuropathological criteria for VaD. We did not found deposits of hyperphosphorylated tau (HPτ) and Aβ, which fulfil the neuropathological criteria for AD. The parietal-temporal-occipital EEG power was significantly higher in all conditions in this subject in comparison to healthy controls, indicating idling of the corresponding areas. The amplitude and la- tency of the P3 GO wave were found to be intact in the subject, in- dicating normal posterior cortical functioning in the cognitive task. The latency of the P3 GO wave was found to be significantly higher in the subject, indicating impairment of engagement operations. In a GO/NOGO task, ERPs provide a useful tool for assessment of brain functioning in clinical settings.
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