Behavioural Neurology - Volume 21, issue 3-4

Authors: Cios, Jacquelyne S. | Miller, Regan F. | Hillier, Ashleigh | Tivarus, Madalina E. | Beversdorf, David Q.

Article Type: Research Article

Abstract: Norepinephrine and dopamine are both believed to affect signal-to-noise in the cerebral cortex. Dopaminergic agents appear to modulate semantic networks during indirect semantic priming, but do not appear to affect problem solving dependent on access to semantic networks. Noradrenergic agents, though, do affect semantic network dependent problem solving. We wished to examine whether noradrenergic agents affect indirect semantic priming. Subjects attended three sessions: one each after propranolol (40 mg) (noradrenergic antagonist), ephedrine …(25 mg) (noradrenergic agonist), and placebo. During each session, closely related, distantly related, and unrelated pairs were presented. Reaction times for a lexical decision task on the target words (second word in the pair) were recorded. No decrease in indirect semantic priming occurred with ephedrine. Furthermore, across all three drugs, a main effect of semantic relatedness was found, but no main effect of drug, and no drug/semantic relatedness interaction effect. These findings suggest that noradrenergic agents, with these drugs and at these doses, do not affect indirect semantic priming with the potency of dopaminergic drugs at the doses previously studied. In the context of this previous work, this suggests that more automatic processes such as priming and more controlled searches of the lexical and semantic networks such as problem solving may be mediated, at least in part, by distinct mechanisms with differing effects of pharmacological modulation. Show more

Keywords: semantic, priming, noradrenergic, language, dopaminergic

DOI: 10.3233/BEN-2009-0236

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 137-143, 2009

Authors: Cloutman, Lauren | Newhart, Melissa | Davis, Cameron | Heidler-Gary, Jennifer | Hillis, Argye E.

Article Type: Research Article

Abstract: Background: Impairments in oral word production are common at the onset of stroke. The identification of factors that predict early recovery has important implications for identifying those at greater risk of continued impaired functioning, and the management of the patient's care following discharge. Aims: To identify patterns of performance that are predictors of acute recovery of oral word production abilities following stroke; to identify any association between early and more chronic recovery. Method …and procedures: Acute stroke patients were administered oral word production tasks within 1–2 days of hospital admission, with repeat testing by 7 days; a subset of patients had repeat testing between three weeks to one year later. Performance was examined for error rate and type to identify potential predictors of early recovery. Outcome and results: The proportion of circumlocution and no response errors at initial testing were associated with the magnitude of recovery of language functioning within the first week following stroke. Patient characteristics of age and gender were found to have no influence on the degree of early recovery observed. None of the examined factors predicted late recovery. The degree of early recovery was not associated with the degree of later recovery. Conclusions: The current study identified patterns of task performance that increase our understanding of how oral word production recovers following acute stroke. The finding that the degree of early recovery does not predict the degree of later recovery is consistent with the hypothesis that early and late recovery are due to different mechanisms (restored blood flow in acute stroke, and reorganization in later recovery). Show more

DOI: 10.3233/BEN-2009-0245

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 145-153, 2009

Authors: Giovagnoli, Anna R. | da Silva, Antonio Martins | Federico, Antonio | Cornelio, Ferdinando

Article Type: Research Article

Abstract: Quality of life (QOL) is an important clinical endpoint, but it remarkably varies in patients with similar neurological conditions. This study explored the role of spirituality (i.e., the complex of personal transcendence, connectedness, purpose, and values) in determining QOL in chronic neurological disorders.~Seventy-two patients with epilepsy, brain tumours or ischemic or immune-mediate brain damage compiled inventories for QOL (WHOQOL 100), spirituality (Spiritual, Religious and Personal Beliefs, WHOSRPB), depression (Beck Depression Inventory, BDI), …anxiety (State-Trait Anxiety Inventory, STAI), and cognitive self-efficacy (Multiple Ability Self-Report Questionnaire, MASQ) and underwent neuropsychological testing. With respect to 45 healthy controls, the patients reported worse QOL, with no difference between the four patient subgroups. Factor analyses of the WHOSRPB, STAI, and BDI scores and of the MASQ and neuropsychological test scores yielded four (Personal Meaning, Inner Energy, Awe and Openness, Mood) and three factors (Control Functions, Cognition, Memory), respectively. Mood, Cognition, Inner Energy, schooling, and subjective health status correlated with the WHOQOL scores, but at regression analysis only Mood and Inner Energy predicted QOL. This suggests that spirituality, as a personal dimension distinct from mood, contributes to determine QOL. A multidimensional assessment of QOL, including personal facets, may explain differences between patients with chronic neurological disorders. Show more

Keywords: Quality of life, brain lesions, chronic neurological disorders, mood, spirituality, cognitive functions

DOI: 10.3233/BEN-2009-0243

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 155-163, 2009

Authors: Kito, Yumiko | Kazui, Hiroaki | Kubo, Yoshihiko | Yoshida, Tetsuhiko | Takaya, Masahiko | Wada, Tamiki | Nomura, Keiko | Hashimoto, Mamoru | Ohkawa, Shingo | Miyake, Hiroji | Ishikawa, Masatsune | Takeda, Masatoshi

Article Type: Research Article

Abstract: Objective: To clarify the characteristics of neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods: Neuropsychiatric symptoms of 64 iNPH patients with mild triad symptoms from three kinds of hospitals were evaluated with the Neuropsychiatric Inventory (NPI) and compared with 126 patients with Alzheimer's disease (AD). Results: The most frequently observed neuropsychiatric symptom in the iNPH patients was apathy followed by anxiety and aggression. No symptom was more prevalent or more severe in iNPH than …in AD. The severity of cognitive impairment was correlated with both aberrant motor activity and apathy. Conclusions: Neuropsychiatric symptoms were mild in patients with iNPH and apathy was the most prevalent symptom. The correlation between neuropsychiatric symptoms and cognitive impairment in iNPH appears to arise from a common pathology in the frontal lobe. Show more

Keywords: idiopathic normal pressure hydrocephalus, neuropsychiatric symptoms, apathy, Neuropsychiatric Inventory (NPI), Alzheimer's disease

DOI: 10.3233/BEN-2009-0233

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 165-174, 2009

Authors: Machado, Álvaro | Ribeiro, Manuel | Rodrigues, Margarida | Ferreira, Carla | Baldeiras, Inês | Ribeiro, M. Helena | Santana, Isabel | Almeida, Rui | Castro, Lígia | Carpenter, Stirling

Article Type: Research Article

Abstract: A 47-year-old woman was seen for progressive behavioural and cognitive disturbances slowly evolving over a 1-year period. Neuropsychological evaluation disclosed moderate to severe impairment of all cortical functions. Besides this no other clinical abnormality was found. MRI diffusion weighted imaging disclosed hyperintense cortical lesions in a ribbon-like fashion, with restricted diffusivity. EEG showed no periodic sharp waves and CSF examination was normal, including protein 14.3.3. She was heterozygote on codon 129. Her …cognitive function continued to decline and she was readmitted for further investigation at the 24th month of disease. Again no ataxia or involuntary movements were observed. MRI disclosed widespread hyperintense lesions over the entire cortex and, for the first time, also caudato-putaminal hyperintensity in T2-weighted images. EEG again failed to show periodic activity. Stereotactic biopsy disclosed moderate spongiform changes, astrocytosis and perivacuolar staining with prion-directed antibodies. Western blot analysis revealed prion type 2 mobility pattern. We discuss the clinical significance of this case: as dementia was the sole finding, and this was slowly-evolving over a 2-year period, MRI findings were the key factor suggesting a prion disease in a woman that otherwise would probably be diagnosed with a primary degenerative dementia. Show more

Keywords: Creutzfeldt-Jacob disease, DWI, MV2, MRI, MRS, SPECT

DOI: 10.3233/BEN-2009-0238

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 175-179, 2009

Authors: Gleichgerrcht, Ezequiel | Cervio, Andrés | Salvat, Jorge | Loffredo, Anselmo Rodríguez | Vita, Luciana | Roca, María | Torralva, Teresa | Manes, Facundo

Article Type: Research Article

Abstract: The aim of this investigation was to evaluate improvement of executive functions after shunt surgery in patients with early normal pressure hydrocephalus (NPH). Patients with NPH were assessed before and after shunt surgery with tests shown to be sensitive to damage to the prefrontal cortex (PFC). Significant differences were found between basal and follow-up performances on the Boston Naming Test, the backwards digits span, Part B of the Trail Making Test, and the number of words …produced on the phonological fluency task. In conclusion, our study reveals that patients with NPH who respond positively to continuous slow lumbar cerebral spinal fluid drainage and receive a ventriculoperitoneal shunt implant, improve their performance on tasks of executive function. Due to the high demand for this form of mental processing in real-life complex scenarios, and based on the severe executive deficits present in both demented and non-demented NPH patients, we encourage the assessment of executive functions in this clinical group. Show more

Keywords: Normal pressure hydrocephalus, ventriculoperitoneal shunt, neuropsychological testing, executive functions, cognitive recovery

DOI: 10.3233/BEN-2009-0249

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 181-185, 2009

Authors: Hiraoka, Kotaro | Suzuki, Kyoko | Hirayama, Kazumi | Mori, Etsuro

Article Type: Research Article

Abstract: We report on a patient with visual agnosia for line drawings and silhouette pictures following cerebral infarction in the region of the right posterior cerebral artery. The patient retained the ability to recognize real objects and their photographs, and could precisely copy line drawings of objects that she could not name. This case report highlights the importance of clinicians and researchers paying special attention to avoid overlooking agnosia in such cases. The factors that …lead to problems in the identification of stimuli other than real objects in agnosic cases are discussed. Show more

Keywords: Visual agnosia, real objects, photographs, line drawings, silhouettes, cerebral infarction, posterior cerebral artery

DOI: 10.3233/BEN-2009-0244

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 187-192, 2009

Authors: Shirani, Peyman | Salamone, Alicia R. | Lahijani, Elham | York, Michele K. | Schulz, Paul E.

Article Type: Research Article

Abstract: A 44-year-old African-American male was admitted to our hospital after a suicide attempt. He had depression, poor cognitive function, choreiform movements, difficulty pronouncing words, and difficulty walking. His symptoms had worsened markedly over several months. Chorea lead to genetic testing that confirmed a diagnosis of Huntington Disease (HD). A CT scan of the head showed wider ventricles than is typical of HD. The head CT and gait change suggested normal pressure hydrocephalus (NPH). Lumbar puncture (LP) …led to improved neuropsychologic test scores and walking thereby supporting the diagnosis of NPH. Surprisingly, the LP also led to an 80% improvement of chorea. There are two other reports of an association between HD and NPH. NPH should be considered in HD patients with atypical symptoms, such as the inability to walk or rapid progression, as its treatment may lead to improved cognition, gait, and chorea. Show more

Keywords: Chorea, Huntington's disease, hydrocephalus

DOI: 10.3233/BEN-2009-0239

Citation: Behavioural Neurology, vol. 21, no. 3-4, pp. 193-195, 2009