Behavioural Neurology - Volume 27, issue 2

Authors: Consonni, Monica | Iannaccone, Sandro | Cerami, Chiara | Frasson, Paola | Lacerenza, Marco | Lunetta, Christian | Corbo, Massimo | Cappa, Stefano F.

Article Type: Research Article

Abstract: OBJECTIVE: The study aims to assess the spectrum of cognitive and behavioural disorders in patients affected by Amyotrophic Lateral Sclerosis (ALS) according to the recent consensus criteria [9]. The study also intends to assess the impact of physical disability on cognitive and behavioural abnormalities. METHODS: Detailed neurological, neuropsychological and neurobehavioral evaluations were administered to 23 ALS patients, 11 Lower Motor Neuron Disease (LMND) patients and 39 healthy controls. Strong et al.'s …criteria [9] were applied to diagnose the presence of cognitive/behavioural impairment. Clinical and neuropsychological scores were used for group comparisons and correlation analyses. RESULTS: In comparison with LMND and controls, a subgroup of ALS patients (∼30%) manifested executive dysfunction, which was severe enough to classify them as cognitively impaired. Action naming difficulties and short-term memory deficits were also observed. Aspontaneity, disorganization and mental rigidity reached clinical relevance in 20% of ALS patients. A small percentage of ALS patients (13%) also had comorbid dementia. The cognitive or behavioural status was not related to the clinical features of ALS. CONCLUSION: The use of consensus criteria for cognitive and behavioural impairment and the comparison with the LMND group proved useful in defining the spectrum of non-motor manifestations of ALS. Show more

Keywords: Amyotrophic Lateral Sclerosis, Lower Motor Neuron Disease, cognitive impairment, behavioural impairment, dysexecutive syndrome, motor disability

DOI: 10.3233/BEN-2012-110202

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 143-153, 2013

Authors: Manganotti, Paolo | Del Felice, Alessandra

Article Type: Research Article

Abstract: Transcranial magnetic stimulation (TMS) evolved from a simple method to stimulate the motor cortex to an invaluable tool for multiple diagnostic, research, and therapeutic applications. A further development of this noninvasive brain stimulation technique is concomitant electroencephalographic (EEG) recording during TMS. The theoretical underpinnings and the technological innovation of TMS-EEG co-registration have opened new ways to study brain excitability in neurological conditions previously investigated with conventional EEG alone. A further …advance in TMS research applications is the perturbational approach: magnetic pulses can interfere not only with dynamic, often pathological rhythms in epilepsy or altered consciousness states, but also modulate physiological states such as sleep and sleep deprivation. So applied, TMS-EEG co-registration can reveal different neurophysiological and behavioral patterns in the awake state, sleep or sleep deprivation. In this review, we discuss the use of TMS and TMS-EEG co-registration in epilepsy, a still rather limited although promising area of study. Show more

Keywords: TMS-EEG co-registration, cortical excitability, sleep deprivation, sleep

DOI: 10.3233/BEN-2012-120263

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 155-167, 2013

Authors: Ma, Hui-Ing | Hwang, Wen-Juh | Chang, Shao-Hsia | Wang, Tsui-Ying

Article Type: Research Article

Abstract: All published studies on micrographia, a diminution of letter size, examine handwriting in the horizontal direction. Writing horizontally typically requires increased wrist extension as handwriting progresses from left to right. Chinese characters, however, can be written not only horizontally from left to right, but also vertically from top to bottom. We examined the effect of handwriting direction on character size and stroke length. Fifteen participants with Parkinson's disease (PD) and 15 age-matched controls wrote …the same Chinese characters both horizontally and vertically. Handwriting performance was recorded with a digitizing tablet, and a custom-written computer program was used to provide objective data about character size and stroke length. The PD group had a linear decrease in overall character size and horizontal strokes along the writing sequence in the horizontal direction, but not in the vertical direction. The controls had shorter horizontal strokes in the horizontal than the vertical direction, but there was no progressive shortening of stroke length along the writing sequence. The results suggest that traditionally reported progressive micrographia in horizontal writing may not be generalizable to vertical writing. The observed decrease of handwriting size in the horizontal direction suggests that micrographia in PD may be associated with wrist extension. For clinical implications, patients may mitigate their micrographia by changing handwriting direction. Show more

Keywords: Handwriting, micrographia, motor skill, Parkinson's disease

DOI: 10.3233/BEN-120285

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 169-174, 2013

Authors: Gainotti, Guido | Spinelli, Pietro | Scaricamazza, Eugenia | Marra, Camillo

Article Type: Research Article

Abstract: The mechanisms subsuming the brain organization of categories and the corresponding gender related asymmetries are controversial. Some authors believe that the brain organization of categories is innate, whereas other authors maintain that it is shaped by experience. According to these interpretations, gender-related asymmetries should respectively be inborn or result from the influence of social roles. In a previous study, assessing the familiarity of young students with different 'biological' and 'artefact' categories, we …had observed no gender-related difference on any of these categories. Since these data could be due to the fact that our students belonged to a generation in which the traditional social roles have almost completely disappeared, we predicted that gender-related asymmetries should be found in older men and women. The familiarity of young and elderly men and women with various semantic categories was, therefore, studied presenting in the verbal and pictorial modality different kinds of living and artefact categories. Results confirmed the hypothesis, because elderly women showed a greater familiarity for flowers and elderly men for animals. These findings are consistent with the hypothesis assuming that gender-related asymmetries for different semantic categories is due to the influence of gender-related social roles. Show more

Keywords: Semantic categories, gender-related asymmetries, living beings, familiarity ratings, social roles

DOI: 10.3233/BEN-120277

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 175-181, 2013

Authors: Foley, Jennifer A. | Kaschel, Reiner | Sala, Sergio Della

Article Type: Research Article

Abstract: Several studies have found dual tasking to be impaired in Alzheimer's disease (AD), but unaffected by healthy ageing. It is not known if this deficit is specific to AD, or also present in other neurodegenerative disorders that can occur in later life, such as Parkinson's disease (PD). Therefore, this study investigated dual tasking in 13 people with PD, 26 AD and 42 healthy age-matched controls. The people with AD demonstrated a specific impairment in dual tasking, …which worsened with increasing disease severity. The people with PD did not demonstrate any deficits in dual tasking ability, when compared to healthy controls, suggesting that the dual task impairment is specific to AD. Show more

Keywords: Parkinson's disease, Alzheimer's disease, dual task

DOI: 10.3233/BEN-110238

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 183-191, 2013

Authors: Raggi, Alberto | Tasca, Domenica | Rundo, Francesco | Ferri, Raffaele

Article Type: Research Article

Abstract: Complex higher-order cognitive functions and their possible changes with aging are mandatory objectives of cognitive neuroscience. Event-related potentials (ERPs) allow investigators to probe the earliest stages of information processing. N100, Mismatch negativity (MMN) and P3a are auditory ERP components that reflect automatic sensory discrimination. The aim of the present study was to determine if N100, MMN and P3a parameters are stable in healthy aged subjects, compared to those of normal young adults. Normal young …adults and older participants were assessed using standardized cognitive functional instruments and their ERPs were obtained with an auditory stimulation at two different interstimulus intervals, during a passive paradigm. All individuals were within the normal range on cognitive tests. No significant differences were found for any ERP parameters obtained from the two age groups. This study shows that aging is characterized by a stability of the auditory discrimination and novelty processing. This is important for the arrangement of normative for the detection of subtle preclinical changes due to abnormal brain aging. Show more

Keywords: Normal aging, event-related potentials, ERPs, auditory discrimination, novelty processing

DOI: 10.3233/BEN-120261

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 193-200, 2013

Authors: Lenne, Bruno | Blanc, Jean-Luc | Nandrino, Jean-Louis | Gallois, Philippe | Hautecæur, Patrick | Pezard, Laurent

Article Type: Research Article

Abstract: The disturbance of cortical communication has been hypothesized as an important factor in the appearance of cognitive impairment in (MS). Cortical communication is quantified here in control subjects and patients with relapsing-remitting multiple sclerosis (RRMS) on the basis of mean coherence in the δ, �, α, β and γ bands and using mutual information computed between pairs of bipolar EEG signals recorded during resting condition. Each patient received also a cognitive assessment using a battery of neuropsychological …tests specific to cognitive deficits in MS. No difference was observed for the coherence indices whereas inter-hemispheric and right hemisphere mutual information is significantly lower in patients with MS than in control subjects. Moreover, inter-hemispheric mutual information decrease significantly with illness duration and right mutual information differentiate cognitively deficient and non-deficient patients. Mutual information allows to quantify the cortical communication in patients with RRMS and is related to clinical characteristics. Cortical communication quantified in a resting state might be a potential marker for the neurological damage induced by RRMS. Show more

Keywords: Multiple sclerosis, EEG signals, mutual information, coherence, inter-hemispheric communication

DOI: 10.3233/BEN-120278

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 201-212, 2013

Authors: Caffarra, Paolo | Gardini, Simona | Dieci, Francesca | Copelli, Sandra | Maset, Laura | Concari, Letizia | Farina, Elisabetta | Grossi, Enzo

Article Type: Research Article

Abstract: The differential diagnosis across different variants of degenerative diseases is sometimes controversial. This study aimed to validate a qualitative scoring method for the pentagons copy test (QSPT) of Mini-Mental State Examination (MMSE) based on the assessment of different parameters of the pentagons drawing, such as number of angles, distance/intersection, closure/opening, rotation, closing-in, and to verify its efficacy to differentiate dementia with Lewy Body (DLB) from Alzheimer's disease (AD). We established the reliability …of the qualitative scoring method through the inter-raters and intra-subjects analysis. QSPT was then applied to forty-six AD and forty-six DLB patients, using two phases statistical approach, standard and artificial neural network respectively. DLB patients had significant lower total score in the copy of pentagons and number of angles, distance/intersection, closure/opening, rotation compared to AD. However the logistic regression did not allow to establish any suitable modeling, whereas using Auto-Contractive Map (Auto-CM) the DLB was more strongly associated with low scores in some qualitative parameters of pentagon copying, i.e. number of angles and opening/closure and, for the remaining subitems of the MMSE, in naming, repetition and written comprehension, and for demographic variables of gender (male) and education (6–13 years). Twist system modeling showed that the QSPT had a good sensitivity (70.29%) and specificity (78.67%) (ROC-AUC 0.74). The proposed qualitative method of assessment of pentagons copying used in combination with non-linear analysis, showed to be consistent and effective in the differential diagnosis between Lewy Body and Alzheimer's dementia. Show more

Keywords: Dementia with Lewy Body, Alzheimer's disease, copy of pentagons, differential diagnosis, MMSE

DOI: 10.3233/BEN-120319

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 213-220, 2013

Authors: Paolini, Susy | Paciaroni, Lucia | Manca, Antonio | Rossi, Roberto | Fornarelli, Daniela | Cappa, Stefano F. | Abbatecola, Angela M. | Scarpino, Osvaldo

Article Type: Research Article

Abstract: Language disorders can be the first symptom of many neurodegenerative diseases, including Alzheimer's disease (AD) and primary progressive aphasia (PPA). The main variants of PPA are: the non-fluent/agrammatic variant, the semantic variant and the logopenic variant. Several additional variants of PPA, however, have been described and are considered as atypical presentations. We describe the case of a woman presenting a progressive isolated language disturbance, characterized by an early dysprosodia, phonological and …semantic paraphasias, agrammatism, impairment in repetition, writing of non-words and sentence comprehension. This clinical picture pointed to an atypical presentation of the non-fluent variety. The frequent symptom overlap between the different variants of PPA, most likely reflecting differences in the topography of the pathological changes, needs to be considered in the definition of diagnostic criteria. Show more

Keywords: Dementia, primary progressive aphasia, progressive non fluent aphasia, dysprosodic disorder, foreign accent syndrome

DOI: 10.3233/BEN-120299

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 221-227, 2013

Authors: Nomura, Keiko | Kazui, Hiroaki | Tokunaga, Hiromasa | Hirata, Masayuki | Goto, Tetsu | Goto, Yuko | Hashimoto, Naoya | Yoshimine, Toshiki | Takeda, Masatoshi

Article Type: Research Article

Abstract: How the dominant uncinate fasciculus (UF) contributes to naming performance is uncertain. In this case report, a patient with an astrocytoma near the dominant UF was given a picture-naming task during intraoperative electrical stimulation in order to resect as much tumourous tissues as possible without impairing the dominant UF function. Here we report that the stimulations with the picture-naming task also provided some insights into how the dominant UF contributes to naming performance. The stimulation induced …naming difficulty, verbal paraphasia, and recurrent and continuous perseveration. Moreover, just after producing the incorrect responses, the patient displayed continuous perseveration even though the stimulation had ended. The left UF connects to the inferior frontal lobe, which is necessary for word production, so that the naming difficulty appears to be the result of disrupted word production caused by electrical stimulation of the dominant UF. The verbal paraphasia appears to be due to the failure to select the correct word from semantic memory and the failure to suppress the incorrect word. The left UF is associated with working memory, which plays an important role in recurrent perseveration. The continuous perseveration appears to be due to disturbances in word production and a failure to inhibit an appropriate response. These findings in this case suggest that the dominant UF has multiple roles in the naming of objects. Show more

Keywords: Left uncinate fasciculus, naming objects, awake surgery, intraoperative electrical stimulation, low-grade astrocytoma

DOI: 10.3233/BEN-110249

Citation: Behavioural Neurology, vol. 27, no. 2, pp. 229-234, 2013