Cognitive Impact of Fatigue in Forensic Neuropsychology Context

Physical and mental fatigue are common factors affecting function and recovery in litigated injuries and illnesses. Despite the high prevalence of fatigue-related symptoms and anticipated impact on cognitive functioning, forensic neuropsychological assessments are often challenged by the following approaches to the evaluation of fatigue: (1) confusing physical and mental fatigue; (2) referencing fatigue as a factor in existence but disregarding its specific cognitive impact; (3) over-attribution of all identified problems to fatigue; and (4) neglecting the impact of fatigue on effort in testing. In the context of a wide range of idiosyncratic approaches applied by neuropsychologists with respect to the significance of fatigue factors and the role of the assessor in accounting for them, there is a risk of confusion. Yet, impairments caused by fatigue can be disabling and resistant to treatment, and even more so when the treatment is based on incorrect diagnostic, causality, and prognostic assumptions. The current review will focus on integrating the available empirical evidence from neuroscience and neuropsychology regarding our current understanding of the cognitive impact of fatigue. Our critical review will emphasize the implications of the accumulating new evidence for forensic assessment determinations regarding causality, diagnosis, and impact on function, as well as prognosis and treatment. To this end, electronic search engines including PubMed, PsycINFO, and Google Scholar (up to January 2018) have been screened and reviewed both for the neuroscience and neuropsychological literature related to mental fatigue.     

Impact of Tinnitus on Cognitive Function in Forensic Neuropsychology Context

Tinnitus, a common hearing condition encountered in medicolegal evaluations, often but not always in association with traumatic brain injuries, can adversely impact both cognitive and affective functioning and neuropsychological test results. Although it has been traditionally conceptualized as primarily related to cochlear pathology, tinnitus has been seen more recently as a condition involving brain plasticity. Its persistent clinical effect on cognition and affect is compounded by comorbid psychiatric syndromes such as depression. Understanding the impact of tinnitus, a factor often difficult to capture and neglected in forensic neuropsychology, is essential for determination of causality, diagnosis, prognosis, functional outcomes, and treatment in medicolegal neuropsychological assessment. This paper aims to critically review and integrate the available empirical evidence from neuroscience and neuropsychology regarding the cognitive and affective impact of tinnitus. Our research review will emphasize the implications of the new evidence for the forensic assessment determinations. To this end, electronic search engines, including PubMed, PsycINFO, and Google Scholar (up to January 2018), have been screened and reviewed for the neuroscience and neuropsychological literature related to tinnitus.     

Post-cremation taphonomy and artifact preservation

Contemporary commercial cremation is a reductive taphonomic process that represents one of the most extreme examples of postmortem human alteration of bone. The thorough reduction and fragmentation of cremated human remains often leaves little biological evidence of diagnostic value. Instead, non-osseous artifacts often provide the best evidence of the origin of the cremated remains, the identity of the decedent, and commingling of the remains of more than one individual. Once human remains have been cremated they are most commonly placed into a processor and reduced into small fragments and fine ash suitable for inurnment or scattering. The type of processor determines the size and utility of the particulates and artifacts available for analysis. The newest type of processors have changed the manner and degree of postmortem bone modification and altered the preservation of diagnostic bone fragments and cremation artifacts. This paper addresses the impact of the newest cremation procedures on forensic analysis of cremated remains.