Kovyazina, M.S.

Relevance. Neuropsychological rehabilitation and assessment are the priority tasks in practice of a clinical psychologist. The modern rehabilitation system can be considered as a partnership between patients, their families and different specialists participating in the rehabilitation process. The existing approaches to neurorehabilitation are aimed at the earliest possible intervention. It`s of particular importance for patients with disorders of consciousness, whose number has been increasing in connection with the development of medicine in recent decades. This leads to the need to develop tools for specialized neuropsychological assessment and methods of neuropsychological rehabilitation of patients in the early stages of recovery of consciousness.

Objective. To summarize neuropsychological diagnostic and rehabilitation experience of working with patients with disorders of consciousness after brain lesions.

Methods. We analyze practical guidelines, applied research and our own hands-on experience of working with patients with disorders of consciousness after brain lesions.

Results. Based on the analysis, the recommended diagnostic tools are formulated that can be used to identify the current level of consciousness and to assess various parameters of psychic activity of patients with disorders of consciousness. In addition, the main directions and neuropsychological methods of rehabilitation work recommended for recovery of consciousness and continuing to be developed now are highlighted.

Conclusion. A new diagnostic and rehabilitation material is presented, which is recommended for use in neuropsychological practice by practicing clinical psychologists with patients with disorders of consciousness after brain lesions.

Acknowledgments: we would like to express our great appreciation to Professor Galina Ivanova, also Valentina Bykova and Olga Maksakova for comments that greatly improved the manuscript.

Relevance. Development and improvement of methodological tools to solve scientific and practical problems is an important issue in modern neuropsychology. This study examines consonant-vowel (СV) syllable test and word test, considers their different functional orientation and shows relevance of the dichotic listening task development. For the first time in Russian neuropsychology the authors developed the dichotic listening consonant-vowel syllables test taking into account the phonetic features of the Russian language.

Objective. Comparison of the equivalence of two dichotic listening tests: the word test that was first tested by B. S. Kotik and the two CV-syllable dichotic listening tests. 

Method. Two groups of respondents participated in the study. The first group of the participants (N = 88; M = 21.08; SD = 2.32) performed the word test and the first CV-syllable test. Participants of the second group (N = 44; M = 24.52; SD = 1.86) were presented with the word test and the second version of CV-syllable dichotic listening test. 

Results. The results confirmed the differences between the word test and the two CV-syllable dichotic listening tests. The differences and nonequivalence of the word test and the CV-syllable tests in laterality index (LI) and productivity coefficients (general productivity, right- and left-ear accuracy scores) are amplified as the stimulus material of CV-syllable dichotic listening is improved and modified. The increase of the load on working memory enhances right ear advantage (LI) and reduces performancewith an increase in the influence of working memory on the results of dichotic listening.

Conclusion. The study shows nonequivalence of the word test and the CV-syllable tests and their different functional orientation for the estimation of hemispheric specialization in audio-verbal domain.

The results of complex neuropsychological examination of the subjects with various pathologies of the corpus callosum (CC) conducted by the author are analyzed in the article. In the survey were used method for the study of the formation of fixed installation in haptic sphere and perceptive priming method. The goal of the study was development of one of neuropsychological factors of hemispheric interaction. Split Brain Syndrome characterized as a neuropsychological syndrome and the symptoms of higher mental functions violations in patients with various pathologies of the CC are described. The author describes the primary symptoms of hemispheric interaction violations caused by commissure pathology. Second part of the paper discusses the point of view of domestic and foreign researchers on the functional role of cerebral hemispheres, their front and rear parts in the human psyche and behavior. In the third part of the article the author describes neuropsychological factor interhemispheric interaction associated with the CC activity. This factor is a syndrome-forming with the CC pathology of various origins. It is integrative as the result of cooperation of two associative brain areas. It could be determined as the factor of formation and reproduction of behavioral acts or psyche selfdetermination factor.

The article cites the work of justifying the legality of the search dependencies between morphometric indicators of MT and indicators of functional asymmetry of the brain. In the experimental studies aimed at the investigation of these dependencies, with mixed results. Studies on the eff ect of the male hormone on the size of MT are analyzed in the fi rst section. In the second section of the article discusses the work of trying to fi nd regularities between the size of MT and the degree of functional asymmetries. Th e results of these studies are interesting in the discussion about the function (braking and/or exciting) MT and its infl uence on the formation of anatomical and functional asymmetries. Of particular interest are the works of the third section, as they assumptions of dependence of the size of MT from the coincidence of speech and manual asymmetries.

Today the nature of neuropsychological syndromes in various corpus callosum (CC) pathology remains an open question. We have examined 30 subjects with cc pathology. All subjects performed the procedure of fixed set by D.N. Uznadze. The analysis of the results demonstrated connection between fixed set functioning and condition of left hemisphere and access to it. The most prominent impairment of set forming dynamics was demonstrated by the subjects with CC pathology. However these subjects have also demonstrated posterior right hemisphere deficit in standard neuropsychological examination. Thus, we can conclude the dissociative nature of the interhemispheric impairment syndrome. 

This article is the study of manual motor activity (his spatial and dynamic organization, interhemispheric transfer and coordination). The study of 58 children (healthy and with the Down syndrome), demonstrate the genesis of cerebral asymmetry and interhemispheric coordination, and the grave disturbances of these functions in dysontogenesis.

Objective. Knowledge, expectations and fears about chemotherapy and radiation therapy for cancer, affecting the subjective well-being and emotional condition of patients, may indirectly affect treatment satisfaction and complaints of side effects.

The aim was to compare treatment representations in patients referred to radiation therapy and chemotherapy, and to identify its relationship with health anxiety and subjective well-being.

Methods and participants. 53 patients referred to radiation therapy and 63 patients referred to chemotherapy completed the Scale of Treatment Representation in Oncological Diseases, Illness and Treatment Self-Regulation Questionnaire, Satisfaction with Life Scale and Scale of Positive and Negative Experiences.

Results. According to the results, the key difficulties with regard to radiation therapy in patients are a lack of understanding of treatment process and a general concern about the need for it. Compared to radiation therapy, with chemotherapy, patients tend to be more doubtful about the effectiveness of treatment and more anxious about the need for it. Moderated mediation analysis demonstrated that lack of understanding, doubts about the effectiveness and anxiety about radiation and chemotherapy are associated with subjective ill-being indirectly - through a higher level of health anxiety.

Conclusions. Feelings of helplessness with regard to treatment mediated the relationship between doubts and confidence about treatment effectiveness and well-being in both groups. With radiation therapy, confidence in the need for treatment was indirectly associated with better well-being - through lower health anxiety.