摘要:

The study of post-stroke depression affords an opportunity to examine the relationship of mood to cerebral lesion characteristics defined by computed tomography (CT). We undertook a study of this relationship in 35 hospitalized Australian patients. The results provided evidence that anterior lesion location in the left hemisphere was associated with both a diagnosis of depression and the severity of depressive symptoms—but only after the influence of pre-stroke vulnerability to depression was removed. Among patients without a prior history of affective disorder, severity of depressive symptoms was significantly correlated (r = −0.872; p = 0.0001) with anterior location among left but not right hemisphere lesions. The findings suggest that, although lesion location may be an etiological factor in some post-stroke depressions, other variables that increase vulnerability to depression should be controlled for in future studies of this topic.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Review of the recent literature on Capgras syndrome reveals primary and secondary subtypes of the disorder having distinctly different neurodiagnostic findings, clinical presentations, and response to psychotropic medications. Primary cases tended to have negative neurodiagnostic work-ups, positive psychiatric histories (usually of paranoid schizophrenia), and gradual onset before age 40. Paranoia and violence were common in these primary cases, but neuroleptic response was good. In contrast, the secondary Capgras cases had positive neurodiagnostic findings (usually indicating right frontotemporal dysfunction), negative psychiatric histories, and sudden onset after age 40. There was a relative absence of paranoia and violence and more variable response to neuroleptics in the secondary cases. Two cases epitomizing the primary and secondary types are described, and a neuropsychological model for the disorder is presented.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Although antidepressant-associated dyskinesia has been previously reported, this side effect has not been documented for fluoxetine, a selective inhibitor of presynaptic re-uptake of serotonin. Because of its clinical importance and its contribution to the understanding of the psychopharmacology of dyskinesia, such a case is described. The dyskinesia associated with antidepressants and also with fluoxetine appears to differ from that of neuroleptics. Antidepressants including fluoxetine may exacerbate rather than cause the pathophysiological process involved in the dyskinesia.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The schizophrenia-like psychosis of epilepsy is among the most well studied of organic psychotic disorders. It occurs in approximately 7% of epilepsy patients and is more common in patients with foci in the temporal lobes than in those with primary generalized seizures. The syndrome includes delusions, hallucinations, first-rank symptoms, and thought disorder. Risk factors for the development of psychosis include onset of central nervous system disorder in adolescence, temporal lobe location of pathology, left-sided laterality of lesion, abnormal neurological examination, and sinistrality. Studies with positron emission tomography demonstrate diminished cerebral oxygen metabolism in several cortical areas compared with nonpsychotic epileptic control subjects; changes were particularly marked in the left temporal lobe. The schizophrenia-like syndrome of epilepsy provides a biological model of the study of the pathophysiology of psychosis.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Delusions are common in Alzheimer's disease. In this paper, longitudinal studies from the Alzheimer's Disease Research Center at Washington University School of Medicine examining the relationship of delusions to stage and progression of illness are reviewed. Methodologic issues involving research design and assessment tools are addressed, and the advantages of studying delusions of Alzheimer's disease at several levels, ranging from psychologic to neuroanatomic, are discussed.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Hallucinations (false perceptions without preserved insight) are distinguishable from hallucinosis (false perceptions with intact insight); both are referred to as “secondary psychoses” when they occur after stroke. Factors predisposing to hallucinations include lesions of the right temporo-parieto-occipital area, seizures, and subcortical atrophy. Visual hallucinations were also associated with auditory hallucinations, delusions, and depression.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Behavioral neurology has traditionally been primarily concerned with disorders of behavior that are associated with diseases affecting cortical, and more recently, subcortical gray matter. The role of diseases of cerebral white matter in the genesis of neurobehavioral disorders has been relatively neglected. Dementia is known to be one sequel of white matter disease of the brain, and detailed analyses of this syndrome are beginning to appear. Psychosis is also thought to occur in this setting, although descriptions are often fragmentary and inconclusive. In this article, we summarize the literature on psychosis in cerebral white matter disease, and illustrate a case of psychosis in a patient with metachromatic leukodystrophy. Preliminary hypotheses are reviewed, and we suggest that psychosis in this context results from frontal-limbic disconnection, direct temporolimbic involvement, or both.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Psychosis is common in degenerative disorders of the basal ganglia, either as a result of the disease itself or as a complication of pharmacotherapy. Delusions and hallucinations may occur as part of affective syndromes or schizophrenia-like psychoses. Treatment with neuroleptic medication may be efficacious, although response is variable. Diseases involving the caudate nuclei or producing relative dopamine excess are most frequently associated with psychosis.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Eighteen patients with an onset of psychosis after the age of 45 [laterlife psychosis (LLP)] and 12 with late-life onset psychotic depression (LLPD) were studied and compared to 30 elderly controls utilizing magnetic resonance imaging (MRI) and brain single photon emission computerized tomography (SPECT) with99mTc hexamethyl propyleneamine oxime. In the LLP group 55% had a clinical and MRI evaluation suggesting cerebrovascular disease, compared to 33% in the LLPD and 7% in the elderly controls. Six percent of the LLP, 33% of the LLPD, and 3% of the controls had clinical evidence of early degenerative dementia. In most cases, SPECT confirmed clinical and MRI findings. Thirteen of 18 LLP, 8 of 12 LLPD and only 4 of 30 controls had abnormal SPECT. Eighty-three percent of the LLP and 83% of the LLPD groups had at least one small area of hypoperfusion in either the temporal or frontal regions, compared to 27% of the controls. This work suggests a possible role for the use of SPECT in the study of patients with late-life psychosis and late-life depression.

ISSN:0894-878X    

出版商:OVID    

年代:1992

数据来源: OVID