摘要:

SummaryCurrent brain imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), provide noninvasive, high-resolution images that depict fine anatomic structure and delineate pathology by control of image contrast and sensitivity to the physicochemical microenvironment. These methods, although invaluable for the identification, characterization, and localization of lesions, do not provide any assessment of the functional viability of brain tissues, nor of the spatial organization of sensory, motor, and cognitive systems. However, such additional functional information is of great significance to the clinician in the determination of treatment strategies and patient management.

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryHand preference is perhaps the most evident behavioral asymmetry observed in humans. Anatomic brain asymmetries that may be associated with hand preference have not been extensively studied, and no clear relationship between asymmetries of the motor system and hand preference have been established. Therefore, using volumetric magnetic resonance imaging methodologies, the surface area of the hand representation was measured along the length of the central sulcus in 15 consistent right- and 15 left-handers matched for age and gender. There was a significant leftward asymmetry of the motor hand area of the precentral gyrus in the right-handers, but no directional asymmetry was found in the left-handers. When asymmetry quotients were computed to determine the distribution of interhemispheric asymmetries, the left motor bank was greater than the right motor bank in 9 of 15 right-handers, the right motor bank was greater than the left motor bank in 3 of 15 right-handers, and the motor banks were equal in 3 of 15 right-handers. In contrast, among left-handers, the left motor bank was greater than the right motor bank in 5 of 15, the right motor bank was greater than the left motor bank in 5 of 15, and the motor banks were equal in 5 of 15. Although no direct measure of motor dexterity and skill was performed, these data suggest that anatomic asymmetries of the motor hand area may be related to hand preference because of the differences in right-handers and left-handers. Furthermore, the predominant leftward asymmetry in right-handers and the random distribution of asymmetries in the left-handers support Annett's right-shift theory. It is unclear, however, whether these asymmetries are the result of preferential hand use or are a reflection of a biologic preference to use one limb over the other.

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryUnilateral spatial neglect can be reduced by cold water caloric stimulation of the contralesional ear. Three hypotheses may account for this response. Caloric stimulation may increase the arousal of the damaged hypoaroused hemisphere. Moving stimuli to ipsilesional space improves the performance of patients with neglect. Caloric stimulation may move viewer-centered spatial maps in an ipsilesional direction. Unilateral neglect may be related to a spatial attentional bias. Vestibular stimulation may temporarily influence this bias. To learn if vestibular stimulation may induce an attentional spatial bias, the authors studied eight normal subjects by having these subjects attempt to bisect lines before and during vestibular stimulation. If caloric stimulation alters neglect because it changes the attentional spatial bias, the authors should be able to induce neglect in normal subjects by pertubating the vestibular system. Vestibular stimulation was induced by spinning a chair and then abruptly stopping the spinning chair. The authors found that after normal subjects were rotated to the left, they misbisected lines to the left but did not misbisect lines after they were rotated to the right. Although these results support the postulate that vestibular stimulation can induce an attentional spatial bias, the authors' results also suggest that there are intrinsic attentional asymmetries.

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryEarly alexia and higher visual impairments characterize Posterior cortical atrophy (PCA), a progressive dementing syndrome most often caused by Alzheimer disease. Posterior cortical atrophy is rare, and the nature of the visual impairments in PCA are unclear. The authors observed two patients who had an insidiously progressive reading difficulty characterized by letter-by-letter reading and otherwise intact cognitive functions. Over time, these patients developed “ventral simultanagnosia” with preserved detection of multiple stimuli but inability to interpret whole scenes. Subsequently, they progressed to Balint syndrome with “dorsat simultanagnosia,” optic ataxia, and oculomotor apraxia. Structural imaging was normal, but functional imaging revealed posterior cortical dysfunction. On a letter reading task, both patients had a word superiority effect, and on a whole word leading task, they could not read most words with missing or crosshatched letters. An inability to assess whole scenes progressed to an inability to detect more than one stimulus in an array. These findings suggest an evolution of PCA with progressive difficulty in visual integration beginning with letters, progressing to whole scenes, and culminating in Balint syndrome. These changes may reflect an extension of the pathophysiology of PCA from the extrastriate visual cortex to its occipitotemporal and occipitoparietal connections.

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryTo learn more about the functional anatomy of language, the authors used [99mTc]HMPAO single photon emission computed tomography (SPECT) functional imaging to study nonword rhyming, lexical-semantics and syntax. The authors did not find any task-related differences in cerebral blood flow using region-by-region analysis of variance. This led them to examine individual subject's task-related patterns of cerebral blood flow. This analysis revealed regions of interest with little or no change but also regions with changes as great as 30%. There was marked subject-to-subject variability in the pattern of blood flow, which precluded statistically significant results using analysis of variance. An alternative analytic strategy based on numbers of subjects exceeding a minimum threshold task-related change in cerebral blood flow was tested and shows promise in identifying commonalities and differences in individual task-related blood flow patterns. The authors conclude that the complex and difficult to interpret pattern of blood flow changes observed in this study reflect in considerable part the combined effects of variability in task strategy, owing in part to insufficiently constrained task performance, and variability in functional anatomy. The authors also tested the differences in results achieved with simple normalization and analysis of covariance approaches and found them to be insignificant.

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryThis study examined patterns and associates of excessive eating (hyperphagia) in a community-based registry of patients with dementia. From patients enrolled in the Mayo Clinic Alzheimer's Disease Patient Registry (n= 439), 39 were identified with excessive eating reported on the Behavior Symptom Checklist at some time during their illness. They were matched for age, gender, duration of disease, and Global Deterioration Scale (GDS) score to “normal eaters.‘’ Annualized weight change was determined based on weight from the 6 months before the evaluation to weight 6 months after the evaluation. Annualized weight change scores were not significantly different between excessive eaters and normal eaters nor between wanderers and non-wanderers. In cross-sectional analysis, univariate modeling suggested age at onset, GDS, and Mini-Mental State Examination score to be significant predictors of excessive eating. Using multivariate logistic model with backward elimination, only age of onset and GDS were retained as associates of excess eating. Rater type also emerged as a significant predictor for excessive eating with family raters reporting this behavior in 16% of patients compared to 5% for other raters. In χ-square analyses excessive eating was associated with greater frequency of wandering, unpredictable behavior, inappropriate dressing, inappropriate bodily concerns, and threatening self-harm. Associates of excess eating were subsequently examined separately in wandering and nonwandering excessive eaters. Logistic modeling suggested that among nonwanderers, patients who were younger but more severely demented were likely to have reported excessive eating. These results suggest hyperphagia to be present in approximately 10% of a community-based cohort of patients with dementia and associated with increasing functional decline. Excessive eating does not appear to arise from memory dysfunction, but for wanderers may result from needing increased caloric intake because of increased activity levels. Thus, for wandering excessive eaters, it may be appropriate to endure the eating to ensure appropriate caloric intake. Non-wandering excessive eaters were younger, had greater dementia severity, and had more unpredictable behavior. They may have dementia with prominent frontal lobe involvement and may respond to any food stimulus respective of hunger. Restricting food exposure may be an effective management intervention for them.

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryA 49-year-old man with right temporal lobe epilepsy developed the chronic delusion that his body emitted a foul odor (olfactory reference syndrome). Before the delusional symptoms, he had partial seizures with unpleasant olfactory hallucinations. Subsequently ictal olfactory symptoms abated but a disabling delusional syndrome developed. The only prior case of the olfactory reference syndrome in a patient with epilepsy had a right frontal lesion. The case further supports the association of right hemisphere lesions and delusional disorders.

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1998

数据来源: OVID