ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundSchizophrenia and mesial temporal lobe epilepsy (TLE) represent two common brain disorders that share dysfunction of temporo-limbic neural substrates.ObjectiveWe evaluated whether patients with schizophrenia exhibited olfactory performance more similar to right or left temporal lobe epilepsy patients.MethodsOdor identification ability and detection threshold sensitivity were measured in 40 patients with schizophrenia, 14 patients with right-and 18 patients with left-temporal lobe epilepsy (TLE) patients, and 25 healthy controls. Odor identification was assessed with the University of Pennsylvania Smell Identification Test (UPSIT) and odor detection threshold sensitivity with a single-staircase procedure using the stimulant phenyl ethyl alcohol (PEA).ResultsRelative to controls, only patients with schizophrenia and right TLE exhibited significant impairment in UPSIT performance. Left TLE patients and controls performed comparably on the UPSIT. Detection threshold sensitivity to PEA did not differ significantly among the four groups.ConclusionsThese data suggest a greater reliance of olfactory processing on right hemisphere structures and are also consistent with recent neuroimaging studies that have implicated aberrant processing of olfactory information in right hemispheric brain regions in schizophrenia.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo determine the relation between subcortical hyperintensities (SHs) visible on magnetic resonance imaging and executive function among patients with vascular dementia.BackgroundThe relation between SHs and executive dysfunction is not well understood, because studies have varied widely in methodology and have produced conflicting results.MethodWe examined the relation between SHs (expressed as a percentage of total brain volume, not including ventricular volume) and six tests of executive function in a well-defined group of 24 individuals with vascular dementia. Executive tests were divided in two groups: Attention/Speed and Abstraction/Problem Solving. Bivariate correlations were computed between individual neuropsychological variables and SHs.ResultsResults showed significant bivariate correlations between SHs and three of the four tests in the Attention/Speed domain. Subcortical hyperintensities shared virtually no association with performance on tests in the Abstraction/Problem-Solving domain.ConclusionsThe finding that SHs are significantly associated with psychomotor slowing and attentional dysfunction is consistent with what is known about the behavioral manifestations of subcortical disease. More detailed investigations of the regional distribution of SHs as well as measures of atrophy, hypoperfusion, and hypometabolism may be necessary to accurately characterize the complex relation between vascular disease and different aspects of executive dysfunction.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo examine the performance of individuals with vascular dementia (VaD) on the Hooper Visual Organization Test (HVOT) and to determine the influence of naming on HVOT performance in this population.BackgroundThe HVOT is commonly administered to assess visuospatial perception among neurologic patients, but the test requires verbal identification of stimuli as well as spatial ability. Previous studies have examined the influence of naming on the HVOT, but the issue has not been systematically addressed in individuals with subcortical VaD.MethodIndividuals with a diagnosis of VaD were administered the HVOT, three additional measures of visuospatial function (Block Design and Picture Completion subtests of the Wechsler Adult Intelligence Scale-Revised, Rey-Osterrieth Complex Figure Test copy trial), and the Boston Naming Test (BNT).ResultsOn average, the VaD patients performed poorly compared with normative data on each of the cognitive measures, with the most pronounced deficit evident on the BNT. Regression analyses revealed that more than 60% of the variance in performance on the HVOT was accounted for by performance on the Block Design subtest of the Wechsler Adult Intelligence Scale–Revised; performance on the BNT did not contribute significantly.ConclusionsThe results suggest that VaD patients perform below expectations on the HVOT and that the measure is robust to naming deficits in this population.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveAt a minimum of 6 months after their stroke, 16 single supratentorial lacunar infarct (SSLI) patients and 16 controls underwent neuropsychological testing. After 6 months, neuropsychological testing was repeated to investigate the robustness and validity of the initial test results.BackgroundAn SSLI can cause subtle cognitive disturbances, which could explain the decrease in quality of life often observed in patients with these lesions. It is unclear at which stage after the occurrence of neurologic deficit possible neuropsychological impairment can be interpreted as chronic and at what moment neuropsychological testing can best be performed.MethodPatients and controls were administered a specifically developed neuropsychological test battery that included 14 standardized tasks tapping the main cognitive domains. Differences in test-performances between the groups were analyzed by parametric statistics.ResultsAt both examinations, similar abnormalities were found on five demanding neuropsychological tasks (language, concept shifting, abstraction, incidental memory, and verbal fluency), suggesting a generalized energetic deficiency.ConclusionsThis long-term follow-up study showed evidence of subtle neurocognitive deficits after the occurrence of an SSLI, which are robust after 6 months. These mild cognitive disturbances may explain the decrease in quality of life that patients with an SSLI often experience.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe Texas Functional Living Scale (TFLS) is a new performance-based measure of functional abilities with an emphasis on instrumental activities of daily living skills that is brief and weighted toward cognitive tasks. The purpose of this study was to examine its psychometric properties and clinical utility in patients with Alzheimer disease (AD) and normal elderly individuals.BackgroundMeasures of daily functional capacities used in patients with dementia often rely upon informant-based behavioral ratings or lengthy assessments of instrumental activities of daily living. Few existing quantitative tools emphasize performance-based cognitively-oriented tasks designed for patients with AD, although there is a need for such measures.MethodTwenty-two AD patients and 21 healthy controls were administered the TFLS and a measure of global cognitive status (Mini-Mental State Examination). Additionally, informant-based ratings of daily living skills (Blessed Dementia Rating Scale) and emotional and behavioral status (Consortium to Establish a Registry for Alzheimer's Disease Behavior Rating Scale for Dementia) were obtained from caregivers of the AD patients. All subjects were re-evaluated approximately 1 month later using the same instruments.ResultsThe TFLS showed a strong correlation with the Mini-Mental State Examination (r= 0.92). At 1 month, test-retest reliability was high, and TFLS subscale scores were highly correlated (r> 0.90 for most) with the total score. The TFLS was moderately correlated with informant ratings of functional skills as assessed with the Blessed Dementia Rating Scale but was unrelated to emotional and behavioral symptoms as assessed with the Consortium to Establish a Registry for Alzheimer's Disease Behavior Rating Scale for Dementia.ConclusionsThe TFLS showed evidence of good reliability, internal consistency, and convergent and discriminant validity with several popular measures of global cognitive status and behavioral functioning. It is a brief and easily administered performance-based measure of daily functional capabilities that is sensitive to level of cognitive impairment and seems applicable in patients with varying degrees of dementia.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThis study examined progressive speech intensity decay using two speech tasks: sustained vowel phonation (Experiment 1) and sentence reading (Experiment 2).BackgroundParkinsonian speech intensity has often been clinically observed to fade out or trail off. This gradual diminution of intensity is not unlike the well-documented progressive reduction of force underlying (upper limb) micrographic parkinsonian handwriting and (lower limb) marche à petit pas. Motor instability in speech intensity has yet to be investigated in a controlled experimental setting, however.MethodThirteen Parkinson disease (PD) patients and their matched controls participated in Experiment 1; data from 6 PD patients and controls who naturally (i.e., without prior instruction) read the target sentence within a breath span were included in the analysis for Experiment 2. Participants were instructed to inhale maximally before vocalizing, and the extent of intensity declination over the breath span was measured.ResultsParkinson disease patients demonstrated a consistently greater level of progressive intensity decay compared with matched controls for both speech tasks. This successful documentation and analysis of fading speech was interpreted as evidence for motor instability within the speech motor system in PD.ConclusionsIt was concluded that the control of force in complex motor sequences involving speech and limb movement is affected by a common deficit in the frontostriatal circuit.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe purpose of the current study was to address whether improvement in anxious symptoms after surgical treatment of Parkinson disease (PD) reflects a true reduction in anxiety as opposed to an epiphenomenon of parkinsonian symptom amelioration.BackgroundRecent research suggests that anxiety is common in PD. An association between surgical intervention for PD and anxiety reduction has been reported; however, it is not clear which specific symptoms of anxiety improve.MethodThirty-nine PD patients completed the Beck Anxiety Inventory (BAI) approximately 1 month before and 4 months after surgery. Twenty-four participants underwent unilateral pallidotomy, 10 underwent deep brain stimulating electrode implantation of the internal segment of the globus pallidus, 4 underwent thalamic deep brain stimulating electrode implantation, and 1 underwent left thalamotomy.ResultsStatistically significant reductions were found postoperatively in terms of BAI total score as well as neurophysiologic, autonomic, and subjective factors from the BAI. The panic factor did not significantly change after surgery, possibly secondary to limited power afforded by the sample size.ConclusionsResults suggest that surgical intervention for PD is associated with reduction in anxiety symptoms distinct from symptoms of PD. In other words, improvement in anxious symptoms reflects a true reduction in anxiety rather than simply being an epiphenomenon of parkinsonian symptom amelioration.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo compare patients with Alzheimer disease (AD) and Parkinson disease (PD) with regard to their awareness of cognitive, emotional/social interaction, self-care, and motor-related neurologic deficits.BackgroundUnawareness of deficits, a clinically important symptom, is found in AD. It has been hypothesized to be associated with disruption of frontal-subcortical circuits but has been little studied in other neurodegenerative disorders. Because PD has a different anatomic-pathologic substrate, a comparison of impairment of awareness in AD and PD may shed light on the neural basis of this phenomenon.MethodImpairment of awareness was measured as the difference between patient self-report and caregiver ratings of patient abilities on questionnaires tapping cognitive, emotional/social interaction, self-care, and motor function. These “discrepancy scores” were then compared between the two diagnostic groups and examined in relation to selected neuropsychological test data.ResultsIn general, both AD and PD patients rate themselves as being less impaired than do their caregivers. The two diagnostic groups, AD and PD, differ significantly, however, on awareness discrepancy measures in the cognitive domain. In their ratings of patient cognitive skills, AD caregivers rate patients as significantly more impaired than patients rate themselves, whereas PD caregivers and patients do not differ significantly on these ratings. Impaired awareness in PD but not in AD is associated with poorer overall cognitive function and performance on tests measuring memory, attention, and constructional ability.ConclusionsBoth AD and PD patients display impaired awareness of deficits in multiple domains, including motor-related neurologic function. Parkinson disease patients with comparatively intact cognitive function display relatively preserved awareness of motor and other deficits.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe purpose of this experiment was to investigate the influence of depressed mood on functional motor asymmetry among school-aged boys. Thus, left-and right-hand grip strength as well as fatigue across successive trials was examined among 38 right-handed school-aged boys, half of whom had been classified as depressed (n = 19) and the other half as nondepressed (n = 19).BackgroundThere is support in the literature that depressed individuals experience relative right anterior activation, and previous reports of functional motor asymmetries among depressed adults are generally supportive of this notion. To date, however, little is known regarding the neuropsychology of depression as it may pertain to children; in particular, the possibility of functional motor asymmetry within this population has yet to be explored.MethodParticipants were asked to squeeze a hand dynamometer four times successively with each hand. The order of hand presentation was counterbalanced, and the dependent measure was in kilograms.ResultsAs hypothesized, depressed boys failed to demonstrate asymmetry for grip strength, although nondepressed boys exhibited right-hand grip strength. In addition, based on trend, right-hand grip strength for depressed boys fatigued more rapidly across successive trials than did right-hand grip strength for nondepressed boys. In contrast, depressed boys maintained left-hand grip strength longer across successive trials than did nondepressed boys.ConclusionsThe data are interpreted as consistent with current neuropsychological theories of emotion, particularly depression, and suggest that the functional motor asymmetries (i.e., failure to demonstrate asymmetric grip strength) observed in depressed adults are also present among depressed children. Implications for increased right hemisphere activation, decreased left hemisphere activation, or a combination of both are discussed.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID