摘要:

ObjectiveTo study the relationship between peripheral autonomic arousal and emotional experience.BackgroundSeveral theories of emotional experience suggest that this experience is, at least in part, related to feedback from the viscera and the autonomic nervous system.MethodTo partially test this hypothesis and to learn if there are hemispheric asymmetries of emotional experience, we studied skin conductance responses (SCR) and verbal report in patients with right hemisphere damage (RHD), patients with left hemisphere damage (LHD), and normal control subjects during the anticipation of electric shocks.ResultsDuring the shock condition, RHD and LHD subjects had smaller SCRs than did normal control subjects. Verbal report measures, however, revealed that subjects reported feeling less pleasant, more aroused, and less in control during the shock condition compared to the no-shock condition. Unlike the SCR results, the verbal report of emotional experience did not differ between the patients with RHD, patients with LHD, and normal control subjects.ConclusionsEmotional experience is not dependent upon activation of and feedback from the autonomic nervous system.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to correlate various alien hand syndromes (AHS) with sites of lesion in 16 patients with anterior cerebral artery (ACA) territory infarction.BackgroundAll previous reports of AHS were case studies. Their clinico-anatomic correlations were still controversial. While the callosal lesion appears necessary for various types of AHS, which portion of the corpus callosum is associated with which syndrome is still not yet completely resolved.MethodSixteen patients with ACA territory infarction were selected from a stroke registry containing 7355 individuals. They were divided into three lesion groups according to location identified by computed tomography or magnetic resonance imaging: mesial frontal, callosal and combined mesial frontal and callosal. Neurobehavioral examination focused on the presence or absence of grasp reflex, various alien hand signs, intermanual conflict, and callosal disconnection syndrome. By gross visual analysis of the obtained data, a trend for clinico-anatomic correlation emerged.ResultsPatients with restricted mesial frontal lesions (three subjects), restricted anterior callosal lesions (four subjects) or “restricted” mesial frontal and anterior callosal lesions (two subjects) did not have symptoms of AHS. The remaining seven patients with extensive callosal injury involving the midbody and isthmus all had symptoms of AHS. Four of the patients with relatively isolated callosal involvement showed intermanual conflict (IMC) associated with a callosal AHS, while the remaining three patients with additional lesions involving the mesial frontal cortex showed impulsive reaching and grasping behaviors of the contralesional hand (a component of frontal AHS) and IMC (a component of callosal AHS).ConclusionsA comparison of the lesions and symptoms of seven patients in two different groups shows that mesial frontal and anterior callosal (genu and rostral body) lesions are associated with a contralateral frontal AHS. Isolated involvement of the callosal midbody and isthmus is associated with a callosal AHS. When the mesial frontal cortex and corpus callosum (genu and whole body) are extensively involved, a mixed frontal and callosal AHS may occur in the same patient.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo investigate the relationship of frontal lobe lesions and neuropsychologic performance in school-aged children to determine whether damage to frontal regions results in specific cognitive sequelae.BackgroundThe role of the frontal lobes in executive function remains incompletely understood, particularly in children.MethodThis retrospective study included children aged 8 to 17 with brain lesions of various etiology (n = 63) or diverse psychiatric disorders (n = 48). All were evaluated for details of neurologic and medical history and for scores on the Wechsler Intelligence Scale for Children (WISC-III) and the Wisconsin Card Sorting Test, and all but the psychiatric patients had neuroimaging scans. Five groups were analyzed—dorsolateral frontal, medial-orbital frontal, focal nonfrontal, diffuse, and psychiatric—and neuropsychologic test results were compared using a Kruskal-Wallis nonparametric analysis of variance.ResultsChildren with damage to dorsolateral frontal regions were more impaired on the Wisconsin Card Sorting Test than those in all other groups. Comparable performance on the Wechsler scale was found in all groups, suggesting that intellectual functioning did not account for this difference.ConclusionsThese data provide evidence for a prominent role of the dorsolateral frontal regions in the mediation of executive function in children. They also support the use of the Wisconsin Card Sorting Test in children as a measure of dorsolateral frontal integrity.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveIdeomotor apraxia was studied in patients with Alzheimer disease (AD) and unilateral left hemispheric damaged (LHD) stroke to determine whether these groups differed.BackgroundGiven that the neuropathology of AD is bilateral and more diffuse than the localized involvement in patients after an LHD stroke, and given that the cognitive deficits in AD are more widespread than in LHD stroke, the authors predicted that patients with these disorders would differ in response to an auditory command task administered to evaluate ideomotor apraxia and that the two patient groups would be significantly more impaired than healthy matched control subjects.MethodsTwenty-one persons were studied, including equal numbers of patients with AD, patients with unilateral LHD stroke, and control subjects. An auditory command test of limb apraxia was administered and videotaped to score performance and to code spatial-temporal or content errors.ResultsThe patients with AD and LHD stroke were significantly more impaired than healthy control subjects. Whereas the patients with AD and LHD stroke were equally apraxic and did not differ in their performance of transitive limb movements, the patients with AD were significantly more impaired than the patients with stroke when performing intransitive limb movements. A positive correlation was found between severity of dementia and severity of apraxia in the patients with AD. The patients with LHD stroke were as likely to make spatial-temporal as content errors when performing intransitive limb movements, whereas the patients with AD made content errors only. Error types produced with transitive limb movements did not differ between groups; spatial-temporal errors were the most common errors made both by patients with AD and patients with LHD stroke.ConclusionsAs predicted, patients with AD and with LHD stroke were impaired when producing limb movements after auditory command, and both patient groups were significantly more impaired than the healthy adults. Patients with AD were significantly more impaired than patients with stroke when performing intransitive limb movements, and error types differed by group. Patients with AD and patients with stroke were equally impaired when performing transitive movements, and error types did not differ by group. Patients with ideomotor apraxia are often degraded in their production of transitive and intransitive movements, and the observation that performance may differ depending on the type of limb movement suggests that movement representations for transitive and intransitive movements may be at least partially independent.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to determine whether an adolescent athlete, in the absence of concussion, would be expected to show an improvement in cognitive function during the course of a high school football season.BackgroundAt least 60,000 American high school football players suffer cerebral concussion every year, and symptoms may persist for 4 or more years in as many as 24%.Method34 members of a cohort of healthy athletes, aged 13–18, were administered a computerized neuropsychologic test battery from the Automated Neuropsychological Assessment Metrics (ANAM) before and after the 1997 high school football season, with a mean interval of 16.1 (range 12.3–20.4) weeks between tests. Preseason and postseason scores on eight tests were compared, with significance determined by paired t-test. For those tests in which an improvement was noted, one-way analysis of variance and Wilcoxon tests were used with both preseason and postseason data to determine if there was a measurable difference in cognitive processing efficiency between older and younger subjects.ResultsImprovements in processing efficiency (p< 0.001) were noted on tests designed to measure visual scanning and sustained attention (CDS), immediate recall (CDI), and short-term memory (CDD). Older subjects generally performed better on each of these tests, though the difference was significant in only one case (postseason CDI, 17–18 year olds vs. 13–14 year olds, Wilcoxon,p= 0.043).ConclusionsOur findings suggest that ANAM is sensitive to differences and improvements in cognitive function during a 4 month interval in adolescence. They also suggest that using “return to baseline” cognitive function as the criterion for evidence of recovery from concussion may be insufficient, especially when the baseline measurement was obtained 4 or more months prior to the date of “full recovery.”

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveEarly information processing deficits are consistently reported for patients with schizophrenia. A growing number of studies have applied a transient (magnocellular) or sustained (parvocellular) explanation to account for deficient processing of briefly presented visual stimuli, moving stimuli, and stimuli requiring eye movements in patients with schizophrenia. This reasoning is based on research that makes the distinction between a magnocellular channel, which primarily responds to low spatial frequency and moving or rapidly presented visual information, and a parvocellular channel, which is primarily responsive to high spatial frequency and detailed information.BackgroundAlthough the preponderance of findings offer support for transient (“where is it”) as opposed to sustained (“what is it”) deficit in patients with schizophrenia, there remains a need for more specific depiction of the deficit.MethodThe present study evaluated normal control subjects and patients with schizophrenia recruited from in-patient and out-patient settings. A Motion Defined Letter task was used, owing to its sensitivity to transient (magnocellular) activation.ResultsTwenty-three patients with schizophrenia and sixteen normal control subjects were tested on eight dot velocity levels, ranging from 88 arc min/sec to 0.69 arc min/sec. A repeated measures analysis of variance indicated that the performance of patients with schizophrenia was significantly poorer than that of their normal counterparts on the three fastest dot velocity conditions (88 arc min/sec,p< 0.0001, 44 arc min/sec,p< 0.00001, and 22 arc min/sec,p< 0.00003), but performance did not differ on the five slower dot velocity conditions. A regression analysis revealed that the dosage of medication was positively associated with performance on three middle range dot velocity conditions (11 arc min/secF(1,22) = 6.99;p< 0.025; 5.5 arc min/sec,F(2,20) = 0.379;p= 0.05, and 2.25 arc min/secF(2,20) = 7.37;p< 0.005).ConclusionsThe findings afford support for an early information processing deficit in schizophrenics. These data also support the neurophysiologic model that explains the poor performance of patients with schizophrenia as it relates to a transient channel deficiency.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo examine neuropsychologic functions in patients with chronic obstructive pulmonary disease (COPD) and mild hypoxemia compared with patients with mild Alzheimer disease and normal controls.BackgroundCognitive deficits have been documented in patients with COPD, but few studies have compared the neuropsychologic status of these patients with that of other neurologic groups.MethodCognitive test results from 32 patients with COPD and mild hypoxemia (mean age, 70.3 years; mean education, 13.2 years; mean partial arterial oxygen pressure. 68.8 mm Hg) who had no neurologic symptoms were compared with 31 subjects with mild Alzheimer disease (AD) and 31 normal controls similar in age, education, and sex. Seventy-three percent of the patients with COPD were receiving supplementary oxygen.ResultsSignificant group differences across 11 cognitive scores were found using analysis of variance, and post hoc analyses indicated that patients with mild AD performed significantly worse than normal controls and patients with COPD on most tests. The group with COPD and the group with AD demonstrated lower letter fluency compared with controls. Although the patients with COPD performed significantly worse than controls on verbal fluency tasks, they were not in the clinically impaired range, and, overall, the group with COPD was similar to the controls on most cognitive tests.ConclusionsThese findings suggest that many patients with COPD and mild hypoxemia who don't have neuropsychiatric histories may perform normally on cognitive measures. Oxygen therapy may partially account for preservation of cognitive function in these patients. Results also suggest that patients with COPD and normal controls can be readily distinguished from patients with mild AD based on levels and patterns of neuropsychologic test results. Any significant cognitive deficits in patients with mildly hypoxemic COPD may warrant continued neurologic evaluation.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo provide an update of the neurobiologic basis of human immunodeficiency virus (HIV)-associated dementia (HAD), with emphasis on the relationship between dopamine (DA) system dysfunction and behavioral manifestations.BackgroundHIV has a propensity to invade subcortical central nervous system areas, particularly the basal ganglia. Indeed, the core symptoms of HAD are similar to those seen in patients with frontal-striatal dysfunction, the “subcortical dementias” (e.g., Parkinson disease, Huntington disease, progressive supranuclear palsy).FindingsDamage to DA neurons appears to occur in early stages of the disease. Patients with HIV have decreased levels of cerebrospinal fluid DA, and patients with HAD have a reduction of the DA metabolite homovanillic acid but a relative preservation of other neurotransmitters, suggesting a loss of DA neurons. Neuropathologic examinations have shown neuronal loss of the globus pallidus, which is less severe in the neocortex. Furthermore, extrapyramidal signs and marked hypersensitivity to DA antagonists (e.g., neuroleptics) have a propensity to develop in patients with acquired immunodeficiency syndrome.ConclusionsNeurobiologic investigations suggest that DA system dysfunction plays a critical role in the clinical manifestation of HIV infection, especially HAD. The causes of the vulnerability of this system to the infection are unknown. Understanding this mechanism is important to develop neuroprotective agents in the treatment of HAD and to design new therapies for HAD-related psychiatric symptoms.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThis study was designed to further define the electroencephalographic abnormalities seen in the Landau-Kleffner syndrome variants and the associated clinical features.BackgroundLandau-Kleffner syndrome is rare, but its putative variants are more common.MethodWe report two patients with centro-temporal spikes, autistic epileptiform regression, and variably prominent oro-motor symptoms.ResultsThe epileptic aphasia pattern found among patients with prominent Rolandic spikes may more frequently involve expressive language than is seen in the typical Landau-Kleffner syndrome, where verbal auditory agnosia is the rule.ConclusionsThis clinical difference likely reflects the location of the epileptiform activity (centro-temporal as opposed to anterior or mid-temporal) on buccal-lingual function, vocalization, and language production.

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1999

数据来源: OVID