ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe major aim of this study was to determine whether a combination of hand preference inventories and hand performance measures identifies distinct handedness groups. If distinct groups are identified, then these subgroupings can be used in future studies to learn more about the neurobiology of these distinct handedness groups.BackgroundAlthough most individuals classify themselves as right-or left-handed, it is not entirely clear whether handedness should be determined based on preference inventories, hand performance tasks, or a combination of these measures. Given that hand preference is linked in part to hemispheric specialization of language, it is important to clearly define hand preference groups if lateralized differences between right-and left-handers are to be explored. Healthy adult right-and left-handers were examined from a multivariate perspective in an attempt to determine whether handedness subgroups exist within performance data.MethodHand preference of 62 right-and left-handed male and female adults was assessed using items from Briggs and Nebes' and Oldfield's handedness inventories. Individuals were assigned to right-and left-hand preference groups, both by visually inspecting the distribution of preference scores and via cluster analysis. Asymmetries in performance of unimanual motor tasks (grooved pegboard, finger-tapping, and grip strength) were then examined using a multivariate approach.ResultsSixteen items from the two-handedness inventories were used to determine preference-based handedness groups. Two non-overlapping groups, right-and left-hand preference, were identified. Writing hand was highly correlated with hand-preference group, as only three individuals in the entire sample wrote with the non-preferred hand. The expected unimodal distributions of performance asymmetry scores, known as laterality quotients (LQs), were seen. However, when thoseLQs were viewed from a multivariate perspective, distinct performance-based groups emerged. In more than 90% of the observed cases, the performance-based groups corresponded to preference-based groups. No sex differences were found; the relationship between preference and performance measures was not significantly different for men and women.ConclusionsWriting hand was highly correlated with scores from a hand preference inventory. In contrast, the use of a single hand performance measure, finger tapping or pegboard, did not always correctly classify an individual as right-or left-handed. However, when both of these hand performance measures were used together, individuals were correctly classified as right-or left-handed. Using this approach, two approximately non-overlapping groups, right-and left-handers, emerged. Thus, handedness is probably not a one-dimensional trait or behavior, and must be defined using multiple measures that assess different aspects of hand preference and performance. The implications for hemispheric specialization of language and neural asymmetry research are discussed.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Objective“Theory of Mind” (ToM) is the capacity to attribute mental states to oneself and to others and to interpret behavior in terms of mental states. Deficits in both ToM and pragmatic abilities have been described in patients with neurologic disorders, such as frontal lobe lesions and right hemisphere strokes, but have not been assessed in demented patients.MethodsThis study examined ToM and pragmatic abilities in a consecutive series of 34 patients with probable Alzheimer disease (AD) using a second-order false belief story, 11 short stories assessing understanding of social situations, and a test of pragmatic abilities assessing both indirect requests and conversational implications.ResultsSixty-five percent of AD patients with mild dementia could not pass a second-order false belief task, whereas no failures were found in a group of 10 age-comparable healthy controls. AD patients who did not pass the second-order false belief task had more severe deficits on tests of verbal anterograde memory, verbal comprehension, abstract thinking, and naming, as compared with AD patients who passed the task. AD patients also showed significantly more severe pragmatic deficits than age-comparable healthy controls, and there was a significant association between ToM and pragmatic deficits. On the other hand, there were no significant associations between ToM or pragmatic deficits, and behavioral problems frequently reported in AD such as depression, delusions, apathy, and irritability.ConclusionsThis initial exploratory investigation demonstrated significant deficits in both ToM and pragmatic abilities in a consecutive series of AD patients with mild dementia.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo examine performance on an objective measure of route learning in Alzheimer disease (AD) patients.BackgroundTopographic disorientation (TD) is a common problem among AD patients. The underlying cognitive deficits that contribute to TD in AD patients are not well understood.MethodThis study examined 19 healthy older individuals (controls) and 16 AD patients who were administered a comprehensive neuropsychological battery along with a novel Route Learning Test (RLT). Areas assessed included incidental learning, spatial relations, recall of the walking route, and recognition of landmarks.ResultsDespite comparable performance on basic visuospatial ability measures, AD patients performed significantly worse than controls on the RLT and evidenced poor incidental learning for environmental details. A measure of egocentric and allocentric orientation ability was the best predictor of RLT performance in AD patients. Among RLT subtests, AD patients performed best on recognition of landmarks compared with recognition and recall of spatial layout or recognition of incidental items in the environment.ConclusionsOur findings suggest that poor performance on the RLT in AD patients is characteristic of poor spatial orientation or spatial reasoning. Therefore, episodes of TD in AD patients may occur secondary to poor spatial orientation.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo assess psychiatric outcome in patients with an established diagnosis of a hyperkinetic (i.e. tremor, dystonia, myoclonus) psychogenic movement disorder.BackgroundLongitudinal studies of patients with psychogenic movement disorders (PMD) have to date suffered from small sample size, lack of sample homogeneity (psychogenic movements grouped with other somatoform disorders, mixed hyper and hypokinetic movements), the absence of structured psychiatric interviews, and a failure to adequately address the extent of psychiatric co-morbidity by adopting a hierarchical approach to diagnosis.MethodsA sample of 88 patients with documented PMD according to the criteria of Fahn and Williams were followed up on average 3.2 years (sd = 2.2; range 1–7 years) after first being assessed at a tertiary referral clinic for patients with movement disorders. The detailed psychiatric assessment included the Structured Clinical Interview for Axis (SCID-I) and Axis II (SCID-II) DSM-IV disorders which generated diagnoses with respect to major mental illness (SCID-I) and personality disorders (SCID-II) respectively.ResultsOf 88 subjects initially seen in clinic, three had died (one by suicide), two were in nursing homes (Alzheimers disease, terminal cancer) and three had emigrated. Of the remaining 80 subjects, 42 (52.5%) agreed to be interviewed. There were no demographic or illness-related differences between those who agreed or refused participation. At follow-up, the mean age of subjects was 48.6 (13.3) years, 62.7% were female and 75% were unemployed. An Axis I diagnosis of mental illness was made in 40 (95.3%) subjects. The PMD had remitted in four subjects, but had been replaced in two of them by a different mental disorder. Thirty-eight percent of subjects with PMD had developed additional unexplained medical symptoms at follow-up. Point and lifetime prevalence rates for other Axis I diagnoses were: major depression 19.1% and 42.9%; anxiety disorders 38.2% and 61.9%; co-morbid major depression and anxiety disorders 11.9% and 28.6%. Personality disorders were present in 45% of the sample. No subject viewed their PMD as primarily psychiatric in origin. Poor outcome with respect to the abnormal movements was associated with long duration of symptoms, insidious onset of movements and psychiatric co-morbidity on Axis I diagnoses.ConclusionsFollow-up data of patients with PMD revealed a persistence in abnormal movements in more than 90% of subjects. Prevalence rates of mental illness in excess of those found in the general population and in neurologic disorders plus an inability to acknowledge the essentially psychologic nature of their condition characterized the outcome picture and carries a poor longer term prognosis.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to examine verbal fluency in a group of patients with bipolar disorder (BPD) during an acute episode of mania, and to determine whether performance was related to disease chronicity. We hypothesized that manic patients with BPD would be impaired on verbal fluency, and that this impairment would be greatest in those individuals who had experienced a greater number of manic episodes.MethodForty-five manic inpatients with bipolar disorder, and 30 healthy volunteers completed tests of phonemic and semantic verbal fluency. The patients were dichotomized into those experiencing their first episode of mania (FE) and those who had experienced multiple episodes (ME).ResultsOn the phonemic fluency task, ME patients produced significantly fewer words than both healthy volunteers and FE patients, and they made a greater number of errors. No significant group differences in overall output were found on the semantic fluency task, although the ME group was more error-prone than were the other groups.ConclusionsThese findings suggest that verbal fluency is more impaired in ME patients than in patients who have experienced only a single manic episode.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo evaluate reports of neuropsychological symptoms among women occupationally exposed to products commonly used in nail studios.BackgroundTypical preparations found in nail studios contain a variety of organic solvents (e.g., toluene, acetone, formaldehyde) and (meth)acrylates with known neurotoxic properties. Little research has focused on the neuropsychological sequelae of exposure to these substances occurring in the cosmetics industry.MethodParticipants included nail salon technicians (n = 150) and controls (n = 148). Nail technicians were compared with demographically similar controls using the Neuropsychological Impairment Scale, a self-reported measure of neuropsychological and psychological symptoms. Aspects of the workplace environment (e.g., square footage of the salon, adequacy of ventilation, hours worked) also were assessed.ResultsA MANOVA revealed small but significant differences in the overall level of symptoms as well as in individual scales measuring neurologic complaints, cognitive efficiency, memory, verbal learning, and academic skills (p< 0.001). Moreover, nail technicians were significantly more likely to score above the clinical cutoffs than were controls on four of the seven clinical scales and two of the three summary indices. Multiple regression analysis indicated that the severity of symptoms was associated with level of occupational exposure (p< 0.01). The cumulative impact of workplace size and ventilation were most strongly associated with symptom severity.ConclusionsExposure to low-level neurotoxins common to nail studios results in the self-reported experience of cognitive and neurologic symptoms similar to other types of solvent and (meth)acrylate exposure. The profile of reported symptoms is consistent with deficits typically observed in this type of neurotoxic exposure: neurologic complaints as well as perceived problems with cognitive efficiency, memory, and learning. Additionally, the nail technicians reported a higher overall level of complaints and greater severity of symptoms than did the controls.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveRelationships between the vestibular system and the body schema have been suggested but never demonstrated in amputees. We studied the effects of vestibular stimulation on body representation in amputees focusing on the phantom limb phenomenon.MethodProspective study in 31 amputated subjects of one or several limbs before the age of 16 years. The amputees underwent a caloric vestibular stimulation test, ipsilateral (n = 31) and contralateral (n = 8) to the side of amputation. Amputees were asked to report their perceptions spontaneously and to answer open questions. Four types of perceptions were analyzed: normal phantom, deformed phantom, painful phantom, and no phantom, before, during, and after the vestibular stimulation test. Data were compared between the two groups for pre-and post-test perceptions (&khgr;2test).ResultsVestibular caloric stimulation provoked temporary perception of a normal phantom limb in 16 of 17 amputees who previously did not experience phantoms. For 12 of 12 amputees who currently experienced deformed or painful phantom limbs, caloric stimulation led to temporary replacement of the abnormal phantom with a non-painful normal phantom.ConclusionsThe phenomena observed: 1) throw light on assumed mechanisms controlling construction of static and dynamic engrams used to produce the body schema; 2) complete the neuromatrix theory proposed to explain the phantom limb phenomenon; and 3) suggest that the vestibular system triggers the procedure of reconstruction of the global body schema.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo review the clinical, psychometric, laboratory, and radiologic findings of 6 patients with Sneddon's syndrome (SS) who presented with cognitive dysfunction rather than stroke.Design and MethodsCase series. All patients fulfilled were diagnosed as SS based on the co-occurrence of livedo racemosa and neurologic disease. Patients presenting with clinical stroke were excluded.ResultsPatients presented with cognitive complaints at an early age and all noted skin lesions from 6 months to 10 years before onset of cognitive symptoms. Associated systemic disorders included hypertension and seizures. Laboratory evidence of a hypercoagulable condition was identified in 4 of 6 cases. Brain MRI scans demonstrated atrophy, especially in parieto-occipital regions and cerebral blood flow on brain SPECT scan was reduced in a similar distribution.ConclusionPatients with SS can develop dementia without antecedent clinical stroke. While the specific pathogenic mechanism of dementia in SS remains speculative, the disease predominantly injures brain tissue in vascular “watershed” territories.

ISSN:0894-878X    

出版商:OVID    

年代:2001

数据来源: OVID