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Aim of the studyPurpose: The objective of this research was to determine the level of motivation for stutter treatment and its dependence on age, gender, and the conception of stuttering.Subject or material and methodsMethods: In our study, the Conception of Stuttering Scale (CSS) and the Motivation for Stutter Therapy Scale (MSTS) were used. Participants: The research involved 297 participants, 81 women and 216 men, all aged from 18 to 54 years. All participants had started to stutter before the age of 7, they all had stutter symptoms (confirmed by an experienced speech therapist), thought themselves to be stutterers, and had undergone at least one therapy.ResultsOverall, the respondents were likely to consider stuttering a speech impediment, logoneurosis, communication disorder, or an illness. They mostly supported the idea of comprehensively diagnosing stuttering and they did not have a uniform conception of stutter therapy. They were most likely to opt for therapies based on speech practice or psychotherapy. Their motivation for speech therapy was mostly moderate. Motivation for stutter therapy was markedly higher in women than in men.. A significant positive correlation was revealed between speech practice and non-acceptance of stuttering.DiscussionStuttering persons have differing conceptions of the etiology, basis, diagnosis, and treatment of stuttering. Motivation for stutter therapy in adults is moderate and is not associated with their concept of stuttering.ConclusionsStuttering persons have differing conceptions of the etiology, basis, diagnosis, and treatment of stuttering. Motivation for stutter therapy in adults is moderate and is not associated with their concept of stuttering.

Introduction In spite of the rapid development in various communication-support technologies for those waking up from a coma, studies describing the sole process of reconstructing communication in this group of patients are scarce. Objective The aim of this study was to analyze communication reactions in a minimal state of consciousness and describe the nonverbal behaviours characteristic for each stages significant for the therapy of communication. Material and methods 18 severely brain-injured patients in a minimal state of consciousness participated in the half-year observation study, which included people experiencing at least 4 weeks of consciousness disorder/coma. Age of patients 25±5 years. Psychological assessment included: observation of various attempts of communications undertaken by patients, caregivers and family interview, the Glasgow Coma Scale (GCS) and Individual Communication Sheet. Results Data analysis showed a significant increase in preverbal communication, both in primal and sensory areas when compared between Stage II (GCS=6-8 points) and Stage III (GCS=9-12 points). After a time, primary communication reached a high level. Patients produced communication attempts from the behaviour organization level, and an increase in the nonverbal communication level was noted. Based on observations, nonverbal communication profiles for each stage of waking up from a coma were introduced. Conclusions It was found that in the process of waking up from a coma the patients communicate with the use of the preverbal level of primal communication, the sensory and behaviour organization activities. The characteristics of the communication reactions show that in Stage III there is a significant increase in two preverbal communication areas: primal and sensory acts, when compared with Stage II.

Objective. The study aimed to evaluate the application of ERPs neuromarkers for the assessment and treatment of a patient with chronic crossed aphasia after severe TBI and a long-term coma. Case report An ambidextrous female patient, aged 29, suffered from posttraumatic chronic crossed aphasia, severe TBI and a prolonged coma after a car accident. The patient took part in two differentiated rehabilitation programmes of neurotherapy included 20 sessions of relative beta training and 20 sessions of rTMS; both programmes were combined with behavioural training. The patient was tested 3 times: before the experiment, after completion of programme A, and after completion of programme B. Results In the 1st recording, the neuromarker of aphasia was found - an excess of the P2 wave over the left temporal area. There was a cognitive control deficit - an excess of omission errors and an increase of RT variability - all indexes of sporadic ADHD. In the 2nd recording, slight improvements in cognitive control, and language functions were found. In the 3rd recording, after the rTMS sessions most of her cognitive dysfunctions had been resolved, including language functions. It should be stressed that the activation (especially the increase in the ERP potential of the right side over the frontal lobe) was found. The neuromarker of aphasia did not change, only the location had slightly moved frontally. Conclusions The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programmes.

Introduction and objective Heat stress induces the expression of genes encoding heat-shock proteins and immune response mediators. The aim of this study was to determine the differences in the expression of genes encoding heat-shock proteins 70 kDa and27 kDa, interleukin 6, interleukin 10and C-reactive protein, between athletes and non-athletes after sauna bathing. Materials and method Athletes (n=9) and non-athletes (n=9) were exposed to a Finnish sauna twice during one session at a temperature of 98.2 °C and humidity of 10% ± 2%, with a 5 min break for cooling down under a shower. The groups did not differ in terms of age, height or body mass. Blood samples were taken before and after sauna exposure in order to assess gene expression, using reverse transcription polymerase chain reaction. Results Differences were observed in leukocyte mRNA levels of tested genes between athletes and non-athletes. In the non-athlete group, all the tested genes were expressed at higher levels as a response to the same heat challenge. Conclusion It appears that expression of stress-related genes induced by heat stress is dependent on the level of physical activity.

Objective The study aimed to evaluate the hyperactivity of the frontal lobes in a patient with obsessive-compulsive disorders. Case description A 21-year-old female met the diagnostic criteria of DSM-5 since her behaviour was characterized by a preoccupations with negative thoughts and by repetitive attempts to decrease or stop those behaviours. Two working hypotheses were tested to find neuromarkers of OCD and anxiety in the patient described. In agreement with the 'OCD hypothesis' an increase of the frontal beta activity and an increase of the parietalalpha activity pattern was found. The 'anxiety' hypothesis found confirmation in an increased left temporal P1 wave in response to the visual stimuli observed in ERPs. In all three conditions (EO, EC, GO/NOGO task), two characteristics were deviant from the normative average data in EEG spectra. First, an increase of frontal beta activity and the increase of parietal alpha activity was noted. The independent component analysis applied for 700 ms EEG fragments in GO and NOGO conditions revealed a strong activation over the central areas. Conclusions Specific patterns of QEEG and ERPs, the increase of beta activity frontally, and the increase of parietal alpha activity pattern which produce hyper-frontality, might be useful in the diagnosis of an OCD patient. ERPs in a GO/NOGO task can be used in the assessment of functional brain changes in OCD patients.

We evaluated the effectiveness of three different rehabilitation programs for chronic behavioral disorders in traumatic brain injury (TBI) patients with orbito-frontal damage (OFC), incurred from 13 to 15 years prior to enrollment. From among 547 adult patients with severe TBIs treated neurosurgically from 1999 to 2003, 60 were selected for the study, divided into three groups of 20, matched for age and sex. Each group received one of three different rehabilitation protocols. Group A received a comprehensive program with two components: (1) a 6-month early neuropsychological rehabilitation program targeting cognitive deficits, beginning immediately post-injury, and (2) the “Academy of Life” program, with weekly meetings aimed at reducing behavioral disorders in social transactions. Group B received only cognitive rehabilitation, while Group C received only the “Academy of Life” progam. The Frontal Behavioral Inventory (FBInv) was used to assess behavioral disorders at baseline and again after completion of the study. At baseline, all 60 patients still displayed all or most of the common behavioral symptoms characteristic of frontal syndrome. The improvement achieved by group A (the comprehensive program) was significantly better upon completion of the study than that shown by the patients in groups B (cognitive only) and C (social skills only). A comprehensive program of rehabilitation, which combines early neuropsychological rehabilitation of cognitive deficits with the “Academy of Life” program, aimed at improving social skills, proved to be more effective than either of these two components administered without the other

Introduction Some studies have shown the influence of Qigong on gene expression in different cells, but there is little data associated with the influence of this kind of therapy on genes expression in pheripheral monocellucar blood cells. Objective The aim of this study was to evaluate changes in the expression of genes associated with cellular stress response in peripheral mononuclear blood cells (PMBC) in healthy women. Material and methods The experiment took place at the Japanese Martial Arts Centre "DOJO" in Stara Wieś, Poland, conducted over the course of a 4-day qigong training session. To evaluate the genes effect of this training, blood samples were taken before and after the training period. This experiment involved 20 healthy women (aged 56.2±9.01, body height 164.8±6.5 and mass 65.5±8.2). To determine the expression of HSF-1, HSPA1A, NF-kB, IL10 and CCL2 mRNA, 3 ml of venous blood was collected. The blood samples were placed in tubes allowing for separation (BD Vacutainer CPT TM) before and after the 4 days of qigong training. Isolated PMBC were used to determine gene expression using real-time qRT-PCR (quantitative reverse transcription polymerase chain reaction). Results Significant decreases in NF-kB and CCL2 mRNA and increases in IL10, HSF1 and HSPA1A m-RNA were detected after 4 days of qigong training. The obtained findings suggest that qigong caused a reduction in the inflammatory and intensified anti-inflammatory gene expression, as well as a higher expression of HSF-1 and HSPA1A. Conclusions The adaptive response to qigong training was similar to the adaptive response to physical activity and was detected through gene expression in PMBC. Furthermore, this kind of training is especially indicated for women because of their higher susceptibility to psychosocial stress when compared to men.

Our study aims to assess the long-time effects of group therapy intervention on marriage communication between fluent and non-fluent aphasic patients and their spouses. From the initial cohort of 150 couples four experimental groups have been selected, each comprising 20 subjects: (1) patients with fluent aphasia (FAP) (2) patients with fluent aphasia spouses (FAPS) (3) patients with non-fluent aphasia (NFAP) (4) patients with non-fluent aphasia spouses (NFAPS). All aphasic patients had mild or moderate fluent or nonfluent aphasia, as confirmed by the Cracow Neuropsychological Battery for Aphasia Examination – CNBA (Pąchalska, 1999). To assess the 3 aspects of interactions between spouses: support, engagement and depreciation we use the Communication in Marriage Questionnaire – KKM scores (Kaźmierczak, Plopa, 2008). These patients attended the groups sessions administered according to Pąchalska’s Model of Aphasia Group Therapy (1991a; 1991b) . It was found that after the long-time group intervention the experimental and the control groups of aphasic patients as well as their spouses differ one from another. NFAP as well as FAP therapy patients had higher KKM scores in the support received from their spouses and their spouses engagement in communication and lower scores in depreciation in their spouses’ behavior than did the controls. Also NFAPS evaluated support and engagement expressed by their aphasic partner higher than the control group. However FAPS and the control group KKM scores were quite similar, except for the support expressed by their aphasic partner. Long-time group therapy for patients with aphasia with the presence of caregivers not only improves the communication with significant others but also it is associated with better marital interactions and communication after therapy as reflected in the KKM scores than in the case of the controls, and improves the patient’s and caregivers’ perception of quality of life.

Health-related quality of life (HRQoL) plays a role as a patient-centered meaningful endpoint, assessing the direct clinical benefit for a patient. The inclusion of HRQoL measurements in a glioma patient may provide important data to inform clinicians on treatment decision-making. The aim of the study was to evaluate cognitive decline and HRQoL in the clinical care of a patient following neurosurgery on of glioblastoma multiforme (GBM). A 69-year-old female developed malignant brain glioma in the right temporal-occipital area; this being confirmed by CT and MR study and neuropathological findings. She had complained of headaches, dizziness, nausea, vomiting as well as attention and memory loss, and anxiety, sadness and a slowing down in the performance of daily activities. The symptoms rapidly became worse and she was referred to a neurosurgery department for consultation. She was successfully neurosurgically operated on. She was examined with the use of ne uro psycho logical tests three times: the first examination was conducted before the neurosurgical operation, the second two weeks after, and the third half year after the neurosurgical operation. In the first examination by the standard Polish version of the Mindstreams™ Interactive Computer Tests disturbances for all the tested cognitive functions occurred. The greatest changes were to occur however in the areas of visual-spatial functions. attention, executive functions and memory. In the second test, a return to the norm was achieved for the disturbed cognitive and executive functions. In the third examination (half a year after the neurosurgical operation), the cognitive and executive functions were still not bad, but had slightly decreased. Similar trend was observed in HRQoL. A significant difference in the health profile between the 1 st and 2 nd as well as between 1 st and 3 rd examination was detected for the eight SF-36 domains - HRQoL was improved. While only slight but no significant changes occurred between 2 nd and 3 rd examination. HRQoL was still not bad, but had slightly decreased. The patient after the neurosurgical operation of glioblastoma multiforme (GBM) is capable of carrying out daily activities, but shows some level of reduced complains for functional capacity, pain, general health and vitality, emotional and social functioning for mental health which has led to the impaired HRQoL.

bObjective./bThe aim of the study was determination of the level in expression genes associated with cell stress response in a patient with PTSD.bCase study./bA 57-year-old PTSD patient, A.P., was the subject of the study. Blood samples were taken from the ulnar vein to assess the relative expression of the tested genes in leukocytes via a quantitative reverse transcription polymerase chain reaction (qRT-PCR).bResults./bA considerably decreased level in the expression HSF-1, NF-kB, Hif-1 and IL6 m-RNA was observed in the patient when compared to the control group. A low expression in HSPA1A, HSPB1, IL10 and CRP m-RNA compared with the control group was also noted.bConclusion./bIt is possible that the lower level of transcriptional factors: HSF-1, NF-kB and Hif-1 as well as IL6 m-RNA may be associated with the effect of the PTSD patient's treatment.

Introduction The paper presents an example of the successful administration of the Augmentative and Alternative Communication (AAC) system. Such an approach is of particular significance in cases of patients with speech and language deterioration, which is observed in a nonfluent/agrammatic variant of primary progressive aphasia (PPA-G). Regaining the ability to communicate with others proves to be very important for the patients’ self-esteem and enables them to restore previously broken social bonds. Case history The patient A.G., aged 73, a right-handed woman, had been a teacher of Polish before suffering from speech disorders of the PPA-G type. As the disease progressed, her communication deteriorated and finally she developed mutism. The patient was given a clinical and imaging-supported diagnosis of an isolated nonfluent/ agrammatic variant of primary progressive aphasia (PPA-G). The Augmentative and Alternative Communication (AAC) system specially designed for her needs was introduced to help the patient to regain the possibility to communicate. After 20 sessions of training with the use of simple equipment she was again able to communicate non-verbally with her son and with the staff of the nursing home. At the same time, a considerable improvements in her social functioning, including daily activities, was observed. Conclusions Loss of the ability to communicate with others has a serious impact upon a patient’s quality of life, and often results in withdrawal and an inability to lead an independent life. The introduction of the Augmentative and Alternative Communication (AAC) system proves to be a great help, not only for regaining the ability to communicate, but also for the restoration of social bonds. In consequence, the previously mute patient begins to show signs of social cooperation.

Background. The goal of the study was threefold: 1) to evaluate QEEG/ERPs in­dexes of functional brain impairment after a stroke associated with chronic crossed transcortical sensory aphasia, 2) to construct a neu­rotherapy protocol to compensate for this functional damage, and 3) to assess the changes in the functional neuromarkers induced by the neurotherapy sessions. Case study. A 72-year-old, strongly right-handed woman with atrial fibrillation sud­denly developed cerebral embolism of the right middle cerebral artery. She was treated conservatively, and the left hemiparesis, and aphasia – in a moderate degree, consequently existed. A CT-scan showed a large infarct lesion partially parallel to Wernicke’s area. After one year of ineffective aphasia therapy we constructed an experimental neuro­therapy protocol (TMS combined with comprehensive aphasia therapy) on the basis of an assessment of the spontaneous QEEG and event-related potentials (ERPs) in the cued GO/NOGO. The patient was assessed before and after the neurotherapy sessions by the same methodology. Conclusions.It was found that before the TMS treatment the temporal area (T6) generates a strong P2 wave in response to visual stimulus indicating a hyper-sensitivity of the neurons located at temporal areas of the right hemisphere. This was connected with crossed transcortical sensory aphasia found within the aphasia profile in the Polish version of the Western Aphasia Battery (K-WAB). The TMS sessions reduced this hyper-sensitivity substantially. The patient speech returned to the norm, she was to return to social life.

Background The purpose of the present study was to assess the influence of vascular factors on the degree of intensity and rate of progression of cognitive disorders in the course of Alzheimer Disease (AD). Material/Methods The research group consisted of 39 persons, all of whom were diagnosed with AD according to the NINCDS/ADRDA criteria. We divided these patients into 2 subgroups, based on the vascular factors measured by the modified Hachinski Ischemic Scale (Ha-mod): group A, without the vascular component (HA-mod score of 0–1 point), and group B, with the vascular component (a score over 1 point). Cognitive functions were evaluated at baseline and again 2 years later, using the Cognitive Part of the Alzheimer Disease Assessment Scale (ADAS-cog). Results We found that the patients from subgroup B, with the stronger vascular component, demonstrated the highest intensity of cognitive disorders at baseline, both in terms of the overall ADAS-cog score, and in the subscores for ideational praxis, orientation, spoken language ability, comprehension of spoken language, and word-finding difficulty in spontaneous speech. Another variable which was connected with the intensity of dementia was age. After 2 years, however, the rate of progression of cognitive disorders was not significantly different between the 2 groups. Conclusions The severity of vascular factors correlates directly with the intensity of cognitive disturbances. At the 2-year follow-up examination, however, no correlation was observed in the research group between greater vascular involvement and more rapid progression of cognitive disorders, as measured by the ADAS-cog scale.