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EFFECT OF INDIVIDUALLY-TAILORED TDCS AND SYMBOLIC ART THERAPY FOR CHRONIC ASSOCIATIVE PROSOPAGNOSIA AFTER INFECTION BY SARS-COV-2, NEUROCOVID-19 AND ISCHEMIC STROKE

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Pąchalska M. , Góral-Półrola J. , Chojnowska-Ćwiąkała I.

tom 19(3)

329-345

Background The rehabilitation of patients with chronic prosopagnosia that occurs following a stroke is a challenge for modern medicine. Dysfunction to the facial processing areas is permanent and standard rehabilitation brings only limited improvement. Therefore, therapists suggest reinforcing the compensatory strategies used by such patients such as voice, figure, and gait recognition to help with the identification of a particular person, which promotes their social functioning. New neurotechnologies, especially QEEG/ERPs, displays of functional brain impairment in prosopagnosia, may be helpful in developing an appropriate neurotherapy protocol and create the conditions for other forms of rehabilitation in such patients. The purpose of our study was twofold: 1) to evaluate QEEG/ ERPs shows of post-stroke functional impairment associated with prosopagnosia, 2) to construct a neurofeedback protocol based on these indices to sup- port the neuropsychological rehabilitation of the case study described herein. We present the case of a 23-year-old right-handed student of the Graphics Faculty of the Academy of Fine Arts, with chronic associative prosopagnosia after infection with SARS-CoV-2 followed by Covid-19 and a right hemisphere stroke. He was re- ferred in April 2021 for diagnosis and therapy at the Reintegration and Training Cen- ter of the Polish Neuropsychological Society (PTNeur). Six months earlier, in October 2020, the patient had been admitted to the Infectious Disease Hospital. COVID-19 was diagnosed based on coronavirus 2 (SARS-CoV-2) reverse transcrip- tion PCR (RT-PCR) on a nasopharyngeal swab. The neurological examination re- vealed muscle weakness on the left side of the body, slow and aprosodic speech, preserved comprehension, and acute left homonymous hemianopsia, as well as prosopagnosia and mirror symptom. The patient was sedated and mechanically ventilated for six days. The CT-scan showed foci in the posterior part of the superior temporal lobe and hyperintense changes in the blood supply area of the right middle cerebral artery. After 30 days of hospitalization, the patient was discharged from this hospital and referred to an outpatient rehabilitation center for five months. Ther- apy improved his general condition but did not remove the chronic prosopagnosia: a personal tragedy for the patient which prevented him from continuing his studies. He was diagnosed at the PTNeur Reintegration and Training Center within the next few weeks: (1). ophthalmologic examinations revealed no pathology; (2) neuropsy- chological testing confirmed the presence of chronic apperceptive prosopagnosia; (3) examination of event-related potentials (ERPs) revealed a large delay of the N170 wave, particularly on the right side, indicating a slowing of the rate of nerve impulses in early face processing and a cause of prosopagnosia. The patient was referred for rehabilitation: he participated in 20 sessions of individually tailored anodal transcranial direct current stimulation (tDCS) twice a week for ten weeks, and in parallel, for indi- vidualized Prosopagnosia Symbolic Art Therapy provided once a week for ten weeks. By the end of therapy, the patient was not only recognizing but also painting portraits of faces. He returned to college, finished and defended a master’s thesis in Artistic Drawing, in which facial presentation played an important role. Quantitative EEG (QEEG) and event-related potentials (ERPs) neuromarkers helped to understand the mechanism of prosopagnosia and to choose an individualized protocol, thus the appropriate application of tDCS in our patient, which accelerated the recovery of the ability to perform complex tasks and created the conditions for Symbolic Art Therapy. Modern medicine can successfully use such a management protocol in individuals with chronic prosopagnosia.

Psychologiczna charakterystyka perfekcjonizmu u młodzieży

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Świerczyńska J. , Pawłowska B. , Chojnowska-Ćwiąkała I. , Troczyńska B.

nr (1/2021)

285-299

Aim. The aim of the work was to compare the intensity of perfectionism in the study subjects, considering their division by sex, place of residence and family structure. The study included a group of 345 persons (198 girls and 147 boys) aged 12–16 years. Methods. The Frost Multidimensional Questionnaire for Testing Perfectionism (FMPS), translated and developed by Tucholska and a sociodemographic survey by Justyna Świerczyńska were used in the work. Results and conclusions. The obtained results prove the presence of signifi cant differences in terms of the intensity of perfectionism and its dimensions among the studied girls and boys, people living in the city and in the countryside, and growing up in complete and single-parent families. Signifi cant correlations were also shown between the subjects’ perfectionism and their age, school performance and the level of parents’ education. The obtained results indicate that boys display a higher level of perfectionism than girls. Neurotic perfectionism is associated with the older age of the studied girls. Adaptive perfectionism is associated with living in the city, being brought up in a complete family, higher education of parents, higher grade point average and positive assessment of oneself as a student.

Cel. Celem pracy jest porównanie nasilenia perfekcjonizmu u badanych osób z uwzględnieniem ich podziału na płeć, miejsce zamieszkania oraz strukturę rodziny. Analizie poddano zależności między nasileniem perfekcjonizmu a wiekiem badanych, ich osiągnięciami szkolnymi oraz poziomem wykształcenia rodziców. Badaniami objęto grupę 345 osób (198 dziewcząt i 147 chłopców) w wieku od 12 do 16 lat. Metody. Zastosowano Wielowymiarowy Kwestionariusz do Badania Perfekcjonizmu FMPS autorstwa Frosta w tłumaczeniu i opracowaniu Stanisławy Tucholskiej oraz ankietę socjodemograficzną autorstwa Justyny Świerczyńskiej. Wyniki i wnioski. Otrzymane wyniki informują o występowaniu istotnych różnic w zakresie nasilenia perfekcjonizmu i jego wymiarów między badanymi dziewczętami i chłopcami, osobami mieszkającymi w mieście i na wsi oraz wychowującymi się w rodzinach pełnych i niepełnych. Znaczące zależności ujawniono ponadto między perfekcjonizmem badanych, a ich wiekiem, osiągnięciami szkolnymi oraz poziomem wykształcenia rodziców. Otrzymane wyniki informują, że chłopcy mają wyższy poziom perfekcjonizmu niż dziewczęta. Neurotyczny perfekcjonizm łączy się ze starszym wiekiem badanych dziewcząt. Adaptacyjny perfekcjonizm łączy się z zamieszkiwaniem w mieście, wychowaniem się w rodzinie pełnej, wyższym wykształceniem rodziców, wyższą średnią ocen i pozytywną oceną siebie jako ucznia.