bluuebunny/crossref_metadata_2025 huggingface dataset:
A selective Impairment in the Phonological Output Lexicon
Authors: Imamura T. , Yamadori A. , Aoki M. , Mochizuki R. , Kogure K.
Published: March 2014

It has been proposed that words are stored in a functional structure which consists of a semantic system and modality-specific input and output lexicons. We report a patient with disturbed word finding for given letters, but not for specific categories. The patient had difficulty in phonological similarity judgements of pictures, but performed normally on semantic similarity judgements. We conclude that this patient's impairments stemmed from a disturbance restricted to the subsystem for active judgement and selection of representations in the phonological output lexicon.
Transdermal Physostigmine—Absence of Effect on Topographic Brain Mapping
Authors: Neufeld M. Y. , Mawassi F. , Levy A. , Treves T. A. , Korczyn A. D.
Published: March 2014

Nine patients with primary degenerative dementia (PDD) participated in an open trial of transdermal physostigmine (TPh). In order to evaluate the neurophysiologic effects of TPh, EEG data were recorded and compared at baseline and following 2 months of continuous treatment. There was no significant effect of TPh on EEG spectra in patients with PDD.
Prefrontal Abilities
Authors: Benson D. F.
Published: March 2014

The neuroanatomical region that has most prominently altered with the advancing cognitive competency of the human is the prefrontal cortex, particularly the rostral extreme. While the prefrontal cortex does not appear to contain the neural networks that carry out cognitive activities, the management of these high level manipulations, so uniquely characteristic of the human, appears dependent upon the prefrontal cortex.
Progressive Dysphasic Dementia with Bucco-Facial Apraxia: A Case Report
Authors: Cappa S. F. , De Fanti C. A. , De Marco R. , Magni E. , Messa C. , Fazio F.
Published: March 2014

A patient with progressive dementia, prominent non-fluent aphasia and signs of frontal lobe involvement, was evaluated by neuropsychological testing, magnetic resonance imaging (MRI) and high resolution single photon emission tomography (SPET). The presence of severe bucco-facial apraxia, associated with spared imitation of limb movements, correlated well with a marked reduction of cerebral perfusion in the left fronto-temporal cortex. This case emphasizes the usefulness of SPET as a valuable alternative to PET for the diagnosis of conditions, such as progressive neuropsychological syndromes, where a coupled reduction of metabolism and blood flow can be expected.
Sensitivity and Specificity of the Mini-Mental State Exam in the Diagnosis of Dementia
Authors: Sabe L. , Jason L. , Juejati M. , Leiguarda R. , Starkstein S.
Published: March 2014

The Mini-Mental State Exam (MMSE) is a brief cognitive test that assesses several cognitive domains, such as orientation, attention, concentration, memory, language, and constructional abilities. While the MMSE was found to be valid and reliable in the diagnosis of moderate dementia, its sensitivity and specificity for the diagnosis of mild dementia has been rarely examined. We assessed the specificity and sensitivity of the MMSE in a consecutive series of 44 patients with mild dementia, and a group of age-comparable normal controls. While the specificity of the MMSE for the diagnosis of mild dementia was very high (100%), the sensitivity was only 55% [20 of the 44 patients with mild dementia had an MMSE score in the normal range (≥26 points)]. On the other hand, the assessment with both the Buschke Selective Reminding and the Boston Naming tests discriminated mild Alzheimer's disease patients with normal MMSE scores from controls with a sensitivity and specificity of 64%. In conclusion, the assessment with verbal memory and naming tasks provided a significantly more sensitive measure of early dementia than the MMSE.
Factorial Structure of Cognitive Activity Using a Neuropsychological Test Battery
Authors: Ardila A. , Rosselli M. , Bateman J. R.
Published: March 2014

A general neuropsychological test battery was assembled and individually given to a 98-subject sample, aged 11–12 years old. The battery included some basic and common tests routinely used in the evaluation of language, memory, spatial abilities, concept formation, and praxic abilities. Twenty-five different scores were calculated. A factor analysis with varimax rotation disclosed nine different factors, accounting for about 70% of the variance. Factor I was measured by a Sequential Verbal Memory test and Verbal Fluency subtests (“verbal factor”). Factor II was measured by the Wechsler Memory Scale Visual Memory subtests (immediate and delayed reproduction), and the Rey-Osterrieth Complex Figure (copy and immediate reproduction) (“non-verbal memory and constructional factor”). Factor III was measured by the WMS Logical Memory subtests (immediate and delayed; “verbal memory factor”). Factor IV was associated with fine movements (tapping subtests, right and left hand; “fine movements factor”). Factor V was specially measured by the Information subtest of the WMS and the Boston Naming Test (“verbal knowledge”). Factor VI represented a “praxic ability factor” (ideomotor praxis tests). Delayed Associative Learning subtest measured Factor VII; and Digits measured Factor VIII. Factor IX was a “mental control factor” (Mental Control subtest of the Wechsler Memory Scale). The implications of these results to theories relating to the structure of cognitive activity are discussed.
Is Disturbed Transfer of Learning in Callosal Agenesis due to a Disconnection Syndrome?
Authors: Imamura T. , Yamadori A. , Shiga Y. , Sahara M. , Abiko H.
Published: March 2014

Disturbed intermanual transfer of tactile learning in callosal agenesis has been interpreted as a sign of disconnection syndrome. We observed this sign in one of four acallosal patients with a conventional form-board task, and tried to elucidate the nature of the deficit. The form-board performance of the patient with disturbed transfer of learning totally depended on motor skill, while the other acallosals and normal controls executed the task based on spatial and somesthetic information. All acallosals and normals, however, failed to show transfer of learning with another tactile task which needed motor skill but not spatial-somesthetic information. These findings suggest that the task-performing strategies in form-board learning change the state of interhemispheric transfer. Unimanual learning effect is transferred if spatial-somesthetic information is acquired in the process of learning, but is not transferred if motor skill is the exclusive content of learning. We conclude that disturbed “transfer” of learning in some acallosals is not a true disconnection sign. It should be attributed to a lack of appropriate strategy, as a result of ineffective problem solving in tactile tasks.
Suicide in Patients with Motor Neuron Disease
Authors: Bak S. , Stenager E. N. , Stenager E. , Boldsen J. , Smith T. A.
Published: March 2014

The aim of the present study was to assess, through an epidemiological study, whether suicide risk is increased in patients with motor neuron disease (MND). The study involved 116 patients with MND. In the study period 92 patients died, 47 males and 45 females. No patients committed suicide. The number of expected suicides was 0.27 for males and 0.12 for females, a total of 0.38. The difference between observed and expected suicides was not statistically significant for males and females.
Psychiatric Symptoms in Patients with Focal cortical Degeneration
Authors: Lawrence R. M. , Ronca M. A. , Tyrrell P. , Rossor M. N.
Published: March 2014

The psychiatric phenomenology exhibited by a mixed group of patients with focal cortical degeneration (FCD) is described. The diagnosis of FCD was made in the presence of a slowly progressive focal neuropsychological deficit without evidence of infarct or neoplasm. Localized or asymmetric atrophy was present on neuroimaging (CT or MRI) and positron emission tomography demonstrated focal hypometabolism or in those assessed later in the disease an area of maximal hypometabolism which correlated with the neuropsychological deficit. FCD patients exhibited prominent obsessive–compulsive behaviour. Obsessive–compulsive features were often repetitive, stereotyped and bizarre and occurred in association with frontal and left temporal atrophy and hypometabolism and were absent in those with predominant posterior cortical pathology.
Structural Correlates of Neurological Signs in Huntington’s Disease: A Quantitative Approach
Authors: Loh E. A. , Roberts J. K. A. , Mohr E.
Published: March 2014

Huntington's disease (HD) is a genetically transmitted disorder associated with atrophy of the basal ganglia. Studies of the neuroanatomical correlates of HD have focused primarily on the anterior areas of the basal ganglia and on establishing an association between structural changes resulting from the presence and course of the illness. The objective of the present study was to assess the value of measurements of the third ventrical and lentiform regions. Computed tomographic (CT) brain scan measures of the basal ganglia of patients in the “early” and “late” stages of the disease were correlated with scores on a quantified neurological examination (QNE) and compared with scans of age-matched control groups. Basal ganglia atrophy was assessed by two conventional “anterior” measures: the maximal distance between the frontal horns of the lateral ventricles (FH) and the minimum distance between the caudate nuclei (CC), and two measures of more “posterior” regions: the width of the third ventricle (3V), and a measure of the lentiform regions (LENTI). In the group of patients with HD, CT scan measures were strongly correlated with disease duration. Further, in the “late” group, all CT measures were significantly correlated with QNE scores, with the two “posterior” measures being equally, if not more strongly correlated with QNE scores than the conventional “anterior” measures. Separate correlations of the CT indices of atrophy and QNE scores in the “early” and “late” HD groups revealed relationships between basal ganglia atrophy and motor abnormality consistent with earlier reports.
Reduplication of Visual Stimuli
Authors: Young A. W. , Hellawell D. J. , Wright S. , Ellis H. D.
Published: March 2014

Investigation of P.T., a man who experienced reduplicative delusions, revealed significant impairments on tests of recognition memory for faces and understanding of emotional facial expressions. On formal tests of his recognition abilities, P.T. showed reduplication to familiar faces, buildings, and written names, but not to familiar voices. Reduplication may therefore have been a genuinely visual problem in P.T.'s case, since it was not found to auditory stimuli. This is consistent with hypotheses which propose that the basis of reduplication can lie in part in malfunction of the visual system.
Abnormalities of Early “Memory-Scanning” Event-Related Potentials in Patients with Temporal Lobe Epilepsy
Authors: Grippo A. , Pelosi L. , Holly M. , Hayward M. , Barrett G. , Blumhardt L. D.
Published: March 2014

We have recorded auditory event-related potentials (ERPs) evoked by the “memory-scanning” (digit-probe identification/matching) paradigm that was originally described by Sternberg (1966), in 17 patients with complex partial seizures (temporal lobe epilepsy) and in 17 matched healthy control subjects. The patients, who had all complained spontaneously of memory difficulties, had significantly reduced scores on psychological tests of memory with relatively intact digit span and cognition. Their performance of the memory-scanning task was characterized by a higher error rate, longer reaction times and an increased slope of the reaction time/set size relationship. The associated ERPs in both patients and controls showed there were significant effects of memory load on several major components, but only a reduced amplitude of the N170 and a prolonged latency of the N290 waves distinguished the patients. In addition, the N170 wave in the patients decreased further as memory load increased. The prolonged N290 latency in the patients appeared to reflect the slowed processing time. This study has shown that ERPs generated by a short-term memory task are abnormal in patients with temporal lobe epilepsy who have neuropsychologically documented cognitive and memory deficits. Some of the significant waveform alterations occur earlier than those reported in previous ERP studies and provide electrophysiological support for the hypothesis that abnormalities of the early stages of short-term memory processing may contribute to the memory difficulties experienced by patients with temporal lobe epilepsy.
Do Young Schizophrenics with Recent Onset of Illness Show Evidence of Hypofrontality?
Authors: Gureje O. , Olley O. , Acha R. A. , Osuntokun B. O.
Published: March 2014

Young schizophrenic patients (n= 43), manic controls (n= 32), both groups diagnosed according to the Research Diagnostic Criteria and on remission from acute illness, and 53 normal subjects were given a battery of neuropsychologic tests selected to assess different functional areas in the brain. Compared with normal controls, patient groups showed evidence of impaired functioning of many cortical areas but with the schizophrenics having the worst performance. In addition, schizophrenic patients performed poorly in tests designed to assess frontotemporal cortical functioning. This pattern of deficits differentiated schizophrenics from both manic and normal subjects. The results suggest that widespread cognitive deficits are a feature of both schizophrenia and mania but that frontal lobe dysfunction may be more specific to the former. It would also appear that these impairments are not artefacts of age, chronicity or of institutionalization, and are present even in schizophrenic patients who may have an illness with putative better outcome than those studied in previous reports.
Pathways and Patterns of Cell Loss in Verified Alzheimer’s Disease: A Factor and Cluster Analysis of Clinico-Pathological Subgroups
Authors: Förstl H. , Levy R. , Burns A. , Luthert P. , Cairns N.
Published: March 2014

Thirty-seven patients with neuropathologically verified Alzheimer's disease (AD) have been studied prospectively. A principal components analysis of neuron numbers in cortical and subcortical areas revealed two variables: Variable I with high loadings for the hippocampo-parahippocampo-parietal neuron counts and Variable II with high loadings for coeruleo-frontal cell numbers. Both may reflect functional neuroanatomical connections which may act as pathways of neurodegeneration in AD. A cluster analysis based on these neuron numbers yielded three groups of patients: Cluster A with low hippocampo-parahippocampo-parietal cell counts, Cluster B with well-preserved neuron numbers, and Cluster C with low coeruleo-frontal neuron numbers. Differences in clinical features between these patient groups indicated the potential clinical relevance of these clusters.
Progressive Perceptual-Motor Impairment without Generalized Dementia: A Type of Cortical Degenerative Syndrome
Authors: Abe K. , Yorifuji S. , Tanabe H. , Yanagihara T.
Published: March 2014

A patient developed slowly progressive clumsiness of both upper extremities with associated impainnent of daily activities without loss of muscle strength or abnormal muscle tone. Her sensory function was normal in the primary modalities but was impaired in the discriminative tasks. A single photon emission computed tomography using 123I-iodoamphetamine showed the areas with reduced uptake in the postcentral cortices. Based on the analysis of her motor impairment, we conclude that clumsiness of hands results from higher sensory disturbance.
Multiple Cerebral Infarction Associated with Neuroleptic-Induced Lupus Anticoagulant
Authors: Laugharne J. D. E.
Published: March 2014

A 39 year old schizophrenic woman with a 20 year history of neuroleptic treatment suffered bilateral cerebral infarcts and coagulation studies revealed a lupus anticoagulant (LA). She highlights the poorly recognized risk of thrombosis in patients on neuroleptics who develop LA. In this case the LA may have been induced by long-term therapy with haloperidol, a novel and potentially important association.
Crossed Non-Dominant Hemisphere Syndrome in a Right-Hander
Authors: Fujimori M. , Wakisaka K. , Yamadori A. , Imamura T. , Uehara T. , Yamashita K. , Tabuchi M.
Published: March 2014

A right-handed patient with a large left temporo-parietal infarction manifested various non-dominant hemisphere signs. He had two left-handed children. On neurobehavioural examinations, he did not show aphasia or ideomotor apraxia, but did show hemispatial neglect, spatial agraphia, constructional apraxia, auditory and tactile extinction, anosodiaphoria and affective changes, all of which are usually observed after right hemispheric damage. We conclude that he has a reversed cerebral laterality of cognitive functions and showed crossed non-dominant hemisphere syndrome.
Creutzfeldt-Jakob Disease with Mixed Transcortical Aphasia: Insights into Echolalia
Authors: McPherson S. E. , Kuratani J. D. , Cummings J. L. , Shih J. , Mischel P. S. , Vinters H. V.
Published: March 2014

Aphasia is a common manifestation of Creutzfeldt-Jakob disease (CJD), and investigation of the linguistic disorders of CJD patients may provide insights into the neurobiological mechanisms of language and aphasia. We report an autopsy-confirmed case of CJD in which the presenting symptom was change in language abilities. The patient ultimately evidenced mixed transcortical aphasia (MTA) with echolalia. Disruption of frontal-subcortical circuits with environmental dependency accounts for the symptoms in MTA, including intact repetition and echolalia. Observation in this patient and a review of the literature suggest that frontal-subcortical circuit dysfunction may contribute to the syndrome of echolalia. This hypothesis offers an alternative explanation to “isolation” of the speech area as the cause of MTA.
Anterograde and Retrograde Amnesia following Bitemporal Infarction
Authors: Schnider A. , Regard M. , Landis T.
Published: March 2014

A patient suffered very severe anterograde and retrograde amnesia following infarction of both medial temporal lobes (hippocampus and adjacent cortex) and the left inferior temporo-occipital area. The temporal stem and the amygdala were intact; these structures do not appear to be critical for new learning in humans. Extension of the left-sided infarct into the inferior temporo-occipital lobe, an area critically involved in visual processing, appears to be responsible for our patient's loss of remote memories.
Measuring Dysgraphia: A Graded-Difficulty Spelling Test
Authors: Baxter D. M. , Warrington E. K.
Published: March 2014

In this paper we describe the construction of a graded-difficulty spelling test for adults consisting of two alternative forms each containing 30 words (GDST, Forms A and B). The spelling test, together with background tests of verbal and non-verbal skills, was administered to 100 control patients with orthopaedic injuries. The two forms of the spelling test were highly correlated (0.92). Spelling was highly correlated with reading (0.75, 0.77) and moderately correlated with vocabulary (0.57) and naming (0.39, 0.40). There was no correlation between spelling skills and non-verbal reasoning. The test was validated in a group of 26 patients with left hemisphere and 20 patients with right hemisphere lesions. Spelling was shown to be lateralized to the left hemisphere and there appeared to be a shift in scores of the left hemisphere group towards the lower quartile, with 65% of the left hemisphere group falling within this band. The most severe spelling impairments were invariably associated with other language disorders but a number of dissociations were documented at spelling levels falling between the 5th and 25th percentile band. Two patients with left hemisphere lesions (8%) were identified as having selective dysgraphias. The lack of overlap between the anatomical sites of the two patients with specific lexical dysgraphia argues against a single site for this type of dysgraphia and argues for further refinement of this classification of spelling disorder.
Asymmetrical Blood Flow in the Temporal Lobe in the Charles Bonnet Syndrome: Serial Neuroimaging Study
Authors: Adachi N. , Nagayama M. , Anami K. , Arima K. , Matsuda H.
Published: March 2014

Clinical features and results of neuroimagings of an 86 year old woman with the Charles Bonnet syndrome are reported. She had become completely blind bilaterally due to cataracts and glaucoma. Shortly after an operation for cataracts, she developed visual hallucinations which lasted for 22 years. She had no deterioration of intelligence. Computed tomography (CT) and magnetic resonance imaging (MRI) showed moderate generalized atrophy, particularly of the temporal lobes. A serial single photon emission computed tomography (SPECT) study during visual hallucinations demonstrated hyperperfusion in the left temporal region and the basal ganglia and hypoperfusion in the right temporal region. These findings suggest that asymmetrical blood flow, particularly in the temporal regions, may be correlated with visual hallucination in the Charles Bonnet syndrome.
Is There a Place for Ipsilesional Eye Patching in Neglect Rehabilitation?
Authors: Soroker N. , Cohen T. , Baratz C. , Glicksohn J. , Myslobodsky M. S.
Published: March 2014

Neglect behavior of experimental animals with unilateral posterior cortical lesions improves with the placement of a second lesion in the contralesional superior colliculus or in the intercollicular commissure. Given that the retinotectal fibers are mainly crossed, it has been speculated that ipsilesional eye patching, by depriving the contralesional superior colliculus of its main facilitatory visual input, might achieve similar results, and thus be used as a remediation maneuver in patients with neglect. From six patients with severe persistent neglect, only one showed an unequivocal beneficial effect from ipsilesional eye patching. We discuss the factors which possibly underlie success and failure with this procedure, and the place for it in neglect rehabilitation.
Long-Term Follow-Up of Patients Suffering from Obsessive-Compulsive Disorder Treated as In-Patients
Authors: Ashworth P. C. H. , Davidson K. M. , Shapiro C. M.
Published: March 2014

Few patients with obsessive-compulsive disorder (OCD) require in-patient treatment. There is sparse information on outcome of OCD patients treated as in-patients. This paper is a descriptive account of the current functioning of 54 OCD patients treated in hospital, on average 10 years prior to the study. Follow-up reveals that outcome for the majority of patients is poor with 29 (59%) of the sample showing at least mild symptomatology or some difficulty in several areas of functioning.
A selective agraphia of Kana
Authors: Abe K. , Yokoyama R.
Published: March 2014

We report a patient who developed selective Kana (phonogram) agraphia following an infarct in the left middle frontal gyrus known as Exner's area. He had well-preserved ability for comprehension, reading, and writing Kanji (ideogram). Kana errors consisted of substitution with another letter while the number of target words was well preserved. It is suggested that a dominant middle frontal gyrus lesion can result in agraphia.
Can Tactile Neglect Occur at an Intra-Limb Level? Vibrotactile Reaction Times in Patients with Right Hemisphere Damage
Authors: Mattingley J. B. , Bradshaw J. L.
Published: March 2014

Visual reaction time (RT) studies on patients with right hemisphere (RH) damage have demonstrated that the attentional imbalance to stimuli occupying left and right positions exists even within the “intact” ipsilesional hemifield. The purpose of the present study was to test whether such patients might also exhibit relative left-sided impairments in the tactile modality, where stimuli and responses involve the index and middle fingers of the non-hemiplegic ipsilesional hand. Eight patients with RH damage, and eight matched normal controls, were tested using a vibrotactile choice RT paradigm, with the responding hand held in prone or supine posture, and located either at the body midline, or in left or right hemispace. Patients showed significantly slower RTs with the left than the right finger in both hand postures, a difference which remained constant as a function of the hemispatial location of the responding hand. In the prone posture, patients' left finger RTs were slower than those of controls, who showed no difference between left and right finger RTs, while their right finger RTs were faster than those of controls. In the supine posture, both patients and controls exhibited slower left than right finger RTs, though in controls the left finger disadvantage was attributed to biomechanical rather than attentional factors. Patients also made more errors with left than right finger stimuli, both as failures of detection and as incorrect responses, while controls made fewer errors overall and showed no differences between fingers. These data demonstrate a bias in the distribution of attention to tactile stimuli at an intra-limb level, and suggest that the attentional imbalance created by RH damage may be supramodal.
Unexpected Reading Dissociation in a Brazilian “nisei” with Crossed Aphasia
Authors: Caramelli P. , Parente M. A. M. P. , Hosogi M. L. , Bois M. , Lecours A. R.
Published: March 2014

There is an increased interest in reading impairments in the Japanese language, due to its particular writing system which includes two different scripts, Kanji (logograms) and Kana (phonograms). Reading dissociations between Kanji and Kana have been described, showing that each system is processed differently by the cerebral hemispheres. We describe the case of a 68 year old Brazilian “nisei” (i.e. born from Japanese parents) who had knowledge of both Japanese and Portuguese. He presented an ischemic stroke affecting the right hemisphere and subsequently developed a Broca's aphasia and an unexpected reading dissociation, with an impairment in Kana reading comprehension and a good performance in Kanji and in Portuguese. These findings suggest that the patient's right and left hemispheres have assumed opposite roles not only for oral but also for written language decodification.
Contact with a Nurse Practitioner: A Short-Term Evaluation Study in Parkinson’s Disease and Dystonia
Authors: Jahanshahi M. , Brown R. G. , Whitehouse C. , Quinn N. , Marsden C. D.
Published: March 2014

Forty patients with Parkinson's disease and 24 patients with dystonia took part in a study aiming to assess the value of access to and contact with a nurse practitioner over a 6 month period. Patients in each group were randomly allocated to “intervention” or “control” groups, which were matched on important variables. All patients completed a set of questionnaires relating to psychosocial function at two time points separated by 6 months. In the intervening period, those allocated to the “intervention” group received two home visits and five telephone calls from the nurse practitioner. This contact was not provided to the “control” group. The nurse practitioner had a major impact on the provision of information and the facilitation of referral to other health-care agencies. The results of an independent assessment indicated that the patients in the “intervention” programme had found access to and contact with a nurse practitioner of great value. In contrast, the results of the questionnaire assessment did not reveal any statistically significant change in psychosocial functioning from the first to the second assessment for either the “intervention” or “control” groups. The lack of change in the questionnaire measures is discussed in terms of possible sampling bias and the duration of intervention and follow-up. Recommendations are made for future studies, and for the possible provision of clinical services.
An Unusual Psychiatric Emergency: Herpes Simplex Encephalitis
Authors: Doyle H. , Varian J.
Published: March 2014

A case of fatal herpes simplex virus (HSV) encephalitis, presenting as a psychiatric emergency, is reported. The possibility of HSV encephalitis presenting mainly or solely with psychiatric symptoms is highlighted. HSV can cause a severe form of encephalitis which may present with mainly psychiatric symptoms in some cases. Early treatment with anti-viral agents can reduce mortality and morbidity, but accurate early diagnosis may be very difficult. HSV encephalopathy may mimic psychiatric illness and has been likened to syphilis as the great imitator. The case presented here should serve to raise awareness of the psychiatric features and the need to consider this diagnosis in patients with atypical behavioural disturbance.
An MRI, SPECT and Neuropsychological Study of a Patient Presenting with Capgras Syndrome
Authors: Mackie J. , Ebmeier K. P. , O'Carroll R. E.
Published: March 2014

A 25 year old male patient presented with the “delusion of doubles” (Capgras syndrome). The patient underwent detailed neuropsychological, single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) investigations. The neuropsychological results indicated that he was of average premorbid intelligence, which was consistent with current estimates, and had a degree of everyday memory dysfunction which was below norms derived from healthy controls, but was average relative to schizophrenic norms. He demonstrated average or above average recognition memory for patterns, spaces or words, but exhibited a marked and disproportionate impairment in face recognition, performing at the 5th percentile. In addition he demonstrated markedly impaired performance on various tests of executive function. MRI scanning revealed no focal abnormality; slight ventricular dilatation was noted. SPECT scanning, however, revealed marked right/left asymmetries of tracer uptake, restricted to occipital and calcarine cortices. These asymmetries were well outside those derived from a cohort of healthy controls. These results are discussed in relation to current neuropsychological models of Capgras syndrome.
Neurobehavioral Aspects of the Delayed Encephalopathy of Carbon Monoxide Intoxication: Case Report and Review
Authors: Mendez M. F. , Doss R. C.
Published: March 2014

We report the neurobehavioral aspects of the delayed encephalopathy of carbon monoxide (CO) intoxication in a 29 year old woman and review the literature. Four weeks after CO poisoning, the patient developed a frontal lobe syndrome, visuoperceptual impairment, and diffuse white matter lesions with an otherwise normal neurological examination. In contrast, patients with the classical syndrome also have a parkinsonian state or an akinetic–mute state. The delayed encephalopathy of CO poisoning usually results from demyelination of subcortical white matter, necrosis of the globus pallidus, or both. The clinical aspects, risk factors, neurobiological features, and therapy and prognosis are discussed.
Migraine with Prolonged Aura: Correlation of Clinical and EEG Features
Authors: Ogunyemi A. O.
Published: March 2014

Migraine with prolonged aura has rarely been examined with regard to the sequence of the neurological symptoms and the associated EEG changes. This report describes five patients who underwent clinical assessment and EEG recordings during attacks of migraine with prolonged aura. CT scan of the brain was obtained in four of them. Follow-up EEG was also obtained. The aura symptoms either preceded the headache or were coincident with it. The aura symptoms evolved in a manner consistent with posterior-to-anterior dysfunction of the cerebral cortex. The EEG abnormalities were non-epileptiform and consisted of focal delta slow waves or theta slow waves. The EEG abnormalities showed good correlation with the patients' aura symptoms and resolved when the patients became symptom free. The posterior-to-anterior sequence of the aura symptoms is in accord with the findings during cerebral blood flow studies in patients having migraine with aura. Also the symptoms and EEG changes in our patients indicate dysfunction of the cerebral cortex, consistent with the notion that spreading cortical depression may be the underlying pathophysiological event in migraine with aura.
Frontal Cognitive Function and Memory in Parkinson’s Disease: Toward a Distinction between Prospective and Declarative Memory Impairments?
Authors: Tröster A. I. , Fields J. A.
Published: March 2014

Memory dysfunction is a frequent concomitant of Parkinson's disease (PD). Historically, two classes of hypotheses, focusing on different cognitive mechanisms, have been advanced to explain this memory impairment: one postulating retrieval deficits (common to several neurodegenerative disorders involving the basal ganglia), and the other postulating frontally mediated executive deficits as fundamental to memory impairment. After outlining empirical support for the retrieval deficit hypothesis, research on the more recent “frontal executive deficit hypothesis” is reviewed, and major challenges to this hypothesis are identified. It is concluded that the frontal executive deficit hypothesis cannot adequately account for all memory impairments in PD, and that a more parsimonious theoretical account might invoke a distinction between prospective and declarative memory impairments. It is suggested that there may be three subgroups of PD patients: one demonstrating prospective memory dysfunction only, one with declarative memory dysfunction only, and one with both prospective and declarative memory dysfunction. Consequently, PD might provide a useful model within which to investigate the relationship between prospective and declarative memory.
Unilateral Temporal Lobe Damage and the Partial Kluver–Bucy Syndrome
Authors: Bates G. D. L. , Sturman S. G.
Published: March 2014

The characteristic behavioural constellation of Kluver–Bucy syndrome is believed to be diagnostic of bilateral temporal lobe damage, even in the partial syndrome. The case described is that of a 54 year old woman with gross atrophy of her right temporal lobe following neurosurgery who developed hyperphagia (with driven food-seeking behaviour), placidity and hyposexuality. Her case thereby meets criteria for the partial syndrome but without evidence of bilateral damage. The discussion covers the various presentations of hyperphagia, the significance of the symptom cluster of Kluver–Bucy syndrome and the management difficulties presented by hyperphagia.
Mini-Mental Parkinson: First Validation Study of a New Bedside Test Constructed for Parkinson’s Disease
Authors: Mahieux F. , Michelet D. , Manifacier M.-J. , Boller F. , Fermanian J. , Guillard A.
Published: March 2014

We have developed a brief screening test aimed at identifying cognitive disorders in Parkinson’s disease. The Mini-Mental Parkinson derives from the Mini-Mental State Examination of Folstein. It includes seven ordered subsections, with a total score of 32. A pilot study was conducted in 50 community-dwelling parkinsonian patients, in order to establish its metrological qualities. Comparisons were made with a neuropsychological battery including several tests widely used in the assessment of specific cognitive disorders in Parkinson’s disease. The correlations between the Mini-Mental Parkinson and each component of this battery were substantial, especially for the performance subtests of the WAIS-R (r= 0.62 to 0.72), the Stroop test (r= 0.65) the 15-objects test (r= 0.64), the word fluency (r= 0.63) and the Odd Man Out test (r= 0.61). The validity of each subtest of the Mini-Mental Parkinson was adequate except for one, based on a word choice, which requires a modification in French before definitive use. The test-retest reliability was high (r= 0.84). There was a significant difference in the mean scores in cases with confusional event (22.4), even without current signs of dementia, compared with patients with no such history (27.2). In conclusion, this brief test is suitable for assessment of parkinsonian patients.
Gilles de la Tourette Syndrome: Clinical Features of 75 Cases from Argentina
Authors: Micheli F. , Gatto M. , Gershanik O. , Steinschnaider A. , Fernandez Pardal M. , Massaro M.
Published: March 2014

A series of 75 cases of Gilles de la Tourette syndrome (GTS) from Argentina, whose ages ranged from 6 to 55 with a mean of 20.02, were evaluated to compare findings with those reported for other countries. Mean age at onset was 7.44 years and mean overall duration of symptoms was 12.58 years; 6.7% of cases were mild, 49% moderate and 44.3% severe. Most frequent presenting motor tics were excessive blinking in 41 followed by head jerking in 16 and eye winking in six, while phonic tics included coprolalia in 28.0%, echolalia in 17.5% and palilalia in 10.8%. Abnormal perinatal events were reported in 40.5%, while positive family history for tics was present in 26.66%. Obsessive–compulsive behaviour was evident in 66% and attention deficit disorder in 16% of cases. Self-injurious behaviour comprised onychophagia in 28 patients, lip-biting in seven and self-slapping in eight cases. Almost half of our patients were initially interpreted as having a psychogenic disorder indicating that GTS in Argentina is most likely underdiagnosed. It may be concluded that the overall pattern of GTS is not dissimilar to that described for European, Asian and American populations, thus highlighting the previously recognized cross-cultural uniformity.
Differential Classification of Dementia
Authors: Mohr E. , Brouwers P. , Claus J. J. , Purdon S. E. , Gagnon M. , Chase T. N.
Published: March 2014

In the absence of biological markers, dementia classification remains complex both in terms of characterization as well as early detection of the presence or absence of dementing symptoms, particularly in diseases with possible secondary dementia. An empirical, statistical approach using neuropsychological measures was therefore developed to distinguish demented from non-demented patients and to identify differential patterns of cognitive dysfunction in neurodegenerative disease. Age-scaled neurobehavioral test results (Wechsler Adult Intelligence Scale—Revised and Wechsler Memory Scale) from Alzheimer's (AD) and Huntington's (HD) patients, matched for intellectual disability, as well as normal controls were used to derive a classification formula. Stepwise discriminant analysis accurately (99% correct) distinguished controls from demented patients, and separated the two patient groups (79% correct). Variables discriminating between HD and AD patient groups consisted of complex psychomotor tasks, visuospatial function, attention and memory. The reliability of the classification formula was demonstrated with a new, independent sample of AD and HD patients which yielded virtually identical results (classification accuracy for dementia: 96%; AD versus HD: 78%). To validate the formula, the discriminant function was applied to Parkinson's (PD) patients, 38% of whom were classified as demented. The validity of the classification was demonstrated by significant PD subgroup differences on measures of dementia not included in the discriminant function. Moreover, a majority of demented PD patients (65%) were classified as having an HD-like pattern of cognitive deficits, in line with previous reports of the subcortical nature of PD dementia. This approach may thus be useful in classifying presence or absence of dementia and in discriminating between dementia subtypes in cases of secondary or coincidental dementia.
A Crossed Kana Agraphia
Authors: Abe K. , Yokoyama R. , Yanagihara T.
Published: March 2014

We report a right-handed man who developed selective Kana (phonogram) agraphia following an infarct in the non-dominant right cerebral hemisphere. His ability for comprehension, reading and writing of Kanji (ideogram) was unaffected. Kana errors consisted of substitution with another letter and the number of target words was well preserved. The lesion responsible for his Kana agraphia included the right Wernicke's area (the posterior one-third or one-half of the superior temporal gyrus) on MRI, but he did not have aphasia. Based on these findings, we conclude that the language function in some dextral people may be partially lateralized to the right cerebral hemisphere.
Memory and Cerebral Blood Flow in Cases of Transient Global Amnesia During and After the Attack
Authors: Kazui H. , Tanabe H. , Ikeda M. , Nakagawa Y. , Shiraishi J. , Hashikawa K.
Published: March 2014

We administered various memory tests and neuroimaging examinations to four pure cases who met Hodges' clinical criteria for transient global amnesia (TGA), during and after the attack. The purpose of the present study was to determine whether procedural learning is acquired during TGA and whether priming effects are preserved during TGA, and to investigate the anatomical basis of various memory subcomponents through these cases. Episodic memory was severely disturbed only during TGA, consistent with previous studies. Procedural learning during TGA examined by a drawing skill test and a reading skill test developed by us, and the Tower of Toronto, was preserved during TGA, consistent with one earlier report dealing with procedural memory during TGA. Priming effects during TGA have never been assessed. A word completion priming task with Kanji letters developed by us demonstrated that priming effects were preserved during TGA. Neuroradiologically, single photon emission computed tomograph hippocampal images clearly revealed a hypoperfusion confined to the medial portion of the bilateral temporal lobe only during the attack. These findings indicate that the medial portion of the temporal lobe is important for episodic memory as described in previous reports, but did not play an important role in procedural memory and priming effects.
Facial Expressions and Parkinson’s Disease
Authors: Madeley P. , Ellis A. W. , Mindham R. H. S.
Published: March 2014

Patients with Parkinson's disease (PD) and matched control subjects were photographed posing a range of facial expressions. The same subjects were later asked to identify the posed expressions of the other subjects. They were also asked to rate the quality of expressions posed by the control subjects after being told what each expression was. Expressions posed by healthy control subjects were more readily identifiable than expressions posed by Parkinson's patients, but the two groups did not differ in their ability to recognize facial expressions or in the goodness ratings they gave, and their error patterns were closely similar. There was no significant difference between the groups on other tests of face processing or on ratings of emotionality except for greater reported anxiety in the Parkinson's patients. We conclude that although patients with PD have reduced facial expressiveness, there is no apparent diminution in their comprehension of facial expressions or their day-to-day experience of emotion.
Effects of Simultaneously Applied Short-Term Transcutaneous Electrical Nerve Stimulation and Tactile Stimulation on Memory and Affective Behaviour of Patients with Probable Alzheimer’s Disease
Authors: Scherder E. , Bouma A. , Steen L.
Published: March 2014

In previous studies beneficial effects of peripheral electrical or tactile nerve stimulation were observed on memory and affective behaviour in patients with probable Alzheimer's disease. In the present study, it was investigated whether electrical and tactile stimulation applied simultaneously to Alzheimer patients would exceed the effects which were observed following treatment by each type of stimulation separately. Our data reveal that the simultaneous application of the two types of stimulation had a beneficial effect on non-verbal and verbal long-term recognition memory. In addition, patients who were treated participated more in activities of daily living, and were more interested in social contacts. In spite of these positive results, comparisons with those of previous studies suggest that a combination of electrical and tactile stimulation does not yield more effects than application of each type of stimulation separately.
Computed Tomographic Density Changes in Schizophrenic and Manic Nigerian Subjects
Authors: Ohaeri J. U. , Adeyinka A. O. , Osuntokun B. O.
Published: March 2014

There is paucity of computed tomography (CT) studies from developing countries, where schizophrenia is said to have more favourable outcome and present predominantly with positive symptoms. We highlight the densitometric analysis of frontal and parietal areas, assessed by tracing of regions of interest on the slice that passes through the foramen of Monro and the pineal gland. The relationships of the density values with clinical and CT measures were investigated. Fifty schizophrenics, 14 manic and 41 normal subjects were compared. The schizophrenics were assessed with Andreasen’s scale for negative symptoms, and outcome was based on the social and clinical condition in the past year. There were no significant differences in mean ages and brain slice area across the groups. In analysis of variance, schizophrenics and manics had significantly higher frontal density than normals. Schizophrenics had significantly higher parietal density than manics and normals (p< 0.001). Parietal density was significantly higher than frontal density, for schizophrenics and normals (p< 0.001). For the patients, density values were not significantly correlated with linear CT measures of atrophy (e.g. ventricle: brain area ratio) and duration of illness. Density values were not significantly associated with outcome, presence of negative symptoms, and visual ratings of cortical sulci and central atrophy. Our findings indicate that schizophrenia in developing countries is also associated with non-specific brain abnormalities.
Psychiatric Symptomatology in Early-Onset Binswanger’s Disease: Two Case Reports
Authors: Lawrence R. M. , Hillam J. C.
Published: March 2014

We describe two cases of Binswanger's disease of pre-senile onset which presented with affective and psychotic symptoms well before the appearance of cognitive deterioration and neurological signs, initially evading an accurate diagnosis. Psychiatrists should be aware of white matter disease and its role in the pathogenesis of psychiatric illness. Particular attention should be given to a history of hypertension as a risk factor in the early identification of these cases.
Crossed Aphasia. I: A Case-Study with Purely Deep Lesion
Authors: Laiacona M. , Stangalino C. , Lorenzi L.
Published: March 2014

In this paper, we describe the case of a right-handed man, MR, who after right thalamic haemorrhage presented subtranscortical aphasia. Of the disturbances generally associated with standard left hemisphere functions, the patient presented acalculia but not apraxia. Among the functions attributed to the standard right hemisphere, MR showed impairment in affective language and presented unilateral neglect and a strong position preference.