摘要:

Summary:Eleven patients underwent injection of amobarbital into their right and left internal carotid arteries (Wada test) to determine propositional language dominance as part of a standard clinical evaluation when considering ablative neurosurgery for control of epileptic seizures. During the right-sided injection, patients were asked to recall verbally an emotional life experience that had been identified before the Wada test as part of a research project to assess affective prosody. To our astonishment, most of the patients dramatically altered their recall of the affective but not the factual content of the life event. This paper recounts these serindipitous and unexpected observations and, in conjunction with a literature review, develops the formative concept that social emotions are modulated by the left hemisphere, whereas primary emotions are modulated by the right hemisphere, a hypothesis that readily encompasses two divergent but commonly held views concerning the lateralization of emotions in the brain—all (primary) emotions are modulated by the right hemisphere versus positive emotions are modulated by the left hemisphere while negative emotions are modulated by the right. A comprehensive neurology of emotions relevant to understanding psychiatric behaviors is then synthesized, which also accounts for the psychological constructs of repression and the subconscious.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:The utility of the Wisconsin Card Sorting Test (WCST) to effectively differentiate diagnostic groups was evaluated. Performance on the WCST was contrasted among samples of schizophrenic, mood-disordered, and traumatically brain-injured patients, as well as normal controls. The controls performed significantly better than all three patient groups, without any differentiation among the patient samples. The pattern of performance, over time, also did not differ between the groups. The poor discrimination between the patient groups may provide evidence for multiple cognitive processes being involved in WCST performance (e.g., attention, executive functioning). Consequently, similar WCST performance could result from deficiencies in different cognitive processes.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:We compared patients with Alzheimer's disease (AD) who were unaware of their cognitive impairments to AD patients who were aware of their deficits. The two groups did not differ in sex, age, education, or premorbid intelligence. Although the groups did not differ in dementia severity, memory function, or language ability, the unaware group demonstrated significantly poorer visuoconstructive ability. We conclude that unawareness of cognitive impairments in AD is accompanied by prominent visuoconstructive dysfunction and suggest that this reflects extensive involvement of the right cerebral hemisphere by the neurodegenerative process.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:Neurobehavioral investigations of vascular dementia have been hindered by the clinical heterogeneity within this group. Patients with vascular dementia in the current study were diagnosed with Binswanger's disease (BD) according to recently specified clinical and radiologic criteria. Patients with BD and Alzheimer's disease (AD) were assessed on Mattis' Dementia Rating Scale (DRS), the Rush Patient Behavior Checklist (RPBC), and the Hamilton Rating Scale (HRS) for depression. The two samples were comparable in terms of age, education, and Mini-Mental State Examination scores. Of the DRS subscales, only Conceptualization showed a differential performance, with BD patients having lower scores than AD patients. BD patients also had higher scores on the RPBC Apathy subscale as well as more depressive symptoms on the HRS. The findings are discussed in terms of differential diagnosis of these dementia syndromes.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:This investigation was designed to evaluate cognitive and behavioral status in an adult population of sickle cell anemia patients with and without structural CNS lesions demonstrated by neuroimaging techniques. This work was intended as a pilot investigation; therefore, not all patients underwent full testing or neuroimaging procedures. Three of the patients had no neurodiagnostic procedures, while eight had either an MRI study, CT scan, or electroencephalogram (EEG). All participants underwent standardized neuropsychological assessment of cognitive and behavioral functioning. The subjects included 6 females and 5 males ranging in age from 21 to 36. The set of neurobehavioral tasks presented measured attention and orientation, motor function, gross verbal skill, perceptual and constructional ability, memory, conceptual function, and intellectual functioning. All subjects scored in the impaired range of at least 1 of the 10 tasks. The findings show that visual-spatial and visual-motor tasks seem to be overwhelmingly impaired in this adult population, which is consistent with findings in studies of young sickle cell patients. Our results suggest that impaired performance on the neuropsychological measures is independent of the abnormalities demonstrated by MRI, CT, or EEG. Considering the idea that neuropsychological deficits may be overlooked in adult sickle cell patients, or be discounted as representing a (psychiatric) functional disorder rather than the result of an organic process, our findings imply that standardized and comprehensive neuropsychological assessment is a valuable tool for the clinician working with this population.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:Numerous cases of atypical cerebral lateralization have appeared in the literature, yet these are heterogeneous and often fail to illuminate causal mechanisms. We evaluated neurobehavioral and neuroanatomical asymmetries in a 32-year-old woman with insulin-dependent diabetes mellitus, nonspecific immune dysfunction, and premature birth who developed Broca's aphasia, Gerstmann's syndrome, hemispatial neglect, and receptive paralinguistic impairments following a right frontoparietal infarction. She performed five out of seven tasks with her right hand, including writing. Using three-dimensional reconstructions of magnetic resonance images, we quantified the sizes of the left and right planum temporale (PT) and found her right PT to be larger than her left, a pattern associated with left-handedness. The presence of this structural asymmetry, which is known to develop prenatally, suggests that the factors responsible for this individual's anomalous neurobehavioral profile were present in the prenatal environment.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:There has been little investigation of the attentional processes associated with multiple personality disorder (MPD). Divided attention performance in the copresent condition (i.e., two personalities simultaneously attending to the environment) was studied in a subject diagnosed with MPD. As predicted, recall of both visually presented digits and auditory consonants was enhanced in the copresent condition and was significantly better than the same divided attention performance when only one personality participated. A comparison with a normal reference group suggested the MPD subject performed similar to the normal group in both single-task performance and divided attention performance in the copresent condition. However, performance of the MPD subject appeared attenuated when only one alter attended to the tasks. A possible increase in brain activation during the copresent condition may explain these findings. Further research of attentional processes associated with MPD and other dissociative disorders is indicated.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:The uniformity of the neuropsychological deficits found in different forms of subcortical dementia has received limited attention. This is particularly true of relatively rare disorders such as Hallervorden-Spatz syndrome and Fahr's disease. The current investigation presents case study data related to the neuropsychological functioning of 12 patients with different forms of subcortical dementia. Findings are consistent with proposed subcortical characteristics of psychomotor slowing, impaired retrieval, and personality/mood alterations within a context of unimpaired vocabulary, verbal abstraction, and recognition memory. Heterogeneity is noted across cases on neuropsychological tasks of attention/concentration, naming, verbal fluency, visual constructional abilities, and visual memory. Contrasting clinical features may indicate dementia progression, individual variability, or anatomic subgroups.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:A 57-year-old man developed signs of cognitive decline followed, 2 years later, by mild extrapyramidal symptoms. Neuropathologic examination demonstrated Lewy bodies almost exclusively confined to the substantia nigra and brainstem nuclei (consistent with idiopathic Parkinson's disease [PD] alone) with the superimposition of dystrophic neurites in areas CA2–3 of the hippocampus immunostained with antibodies to ubiquitin. This case study demonstrates that dementia may be a presenting symptom of PD and supports a continuity between PD and diffuse Lewy body disease.

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1994

数据来源: OVID