Search

Objective: In cortical deafness, no auditory signals can be perceived by the cortex despite normal peripheral hearing. Cortical deafness rarely persists, but generally evolves into other cortical auditory syndromes. In this report, we describe a patient showing a stable and persisting pattern of cortical deafness 16 months after two major ischemic strokes., Methods: Voxel based morphometric evidence from high resolution three-dimensional MRI and data from tractography are reported for the first time, to our knowledge, in this syndrome in addition to behavioral and electrophysiological findings., Results: The most remarkable findings came from the tractography data, where an asymmetric pattern was found showing severe damage of connections within the anterior right hemisphere, in regions subserving self-awareness. Frontal asymmetry, although detectable by the morphometric analysis, was less informative than that detected in the tractography data., Conclusion: The evidence from this case study suggests that damage to the neural systems involved in awareness may play an important role in the emergence of cortical deafness and its persistence., ((c) 2012 APA, all rights reserved.)

Background: Episodic memory and semantic abilities deteriorate early in Alzheimer disease (AD). Since the cognitive system includes interconnected and reciprocally influenced neuronal networks, the authors hypothesized that stimulation of lexical-semantic abilities may benefit semantically structured episodic memory., Objective: To investigate the effects of lexical-semantic stimulation (LSS) on verbal communication and episodic memory in early AD., Methods: Forty AD participants were randomized to LSS or unstructured cognitive stimulation (UCS) as control condition. Treatments lasted 3 months, 2 sections a week. The primary outcome measures were the Mini-Mental State Examination (MMSE), Boston Naming Test (BNT), Verbal Naming Test (VNT), Phonemic and Semantic Fluency, Story Recall, and Rey Auditory Verbal Learning (RAVL). Secondary outcome measures were neuropsychological tests assessing cognitive functions not stimulated by the intervention, such as attention, executive functions, and visual-spatial abilities, and the instrumental activities of daily living scale. A 6-month follow-up assessment was administered to the LSS group., Results: LSS treatment yielded significant improvements of the MMSE, BNT, VNT, Brief Story Recall, and RAVL delayed recall mean scores. Among secondary outcome measures, only working memory and the speed of a task assessing executive functions (Stroop test) improved after LSS. Unstructured cognitive stimulation intervention did not improve any cognitive domain. Six months after LSS discontinuation, the MMSE mean score remains significantly higher than the baseline value., Conclusion: LSS treatment may improve episodic memory in AD patients and may be regarded as a clinical option to counteract the cognitive decline typical of the disease.

Behavioral, neuropsychological, and neuroimaging data support the idea that numbers are represented along a mental number line (MNL), an analogical, visuospatial representation of number magnitude. The MNL is left-to-right oriented in Western cultures, with small numbers on the left and larger numbers on the right. Left neglect patients are impaired in the mental bisection of numerical intervals, with a bias toward larger numbers that are relatively to the right on the MNL. In the present study we investigated the effects of optokinetic stimulation (OKS) - a technique inducing visuospatial attention shifts by means of activation of the optokinetic nystagmus - on number interval bisection. One patient with left neglect following right-hemisphere stroke (BG) and four control patients with right-hemisphere damage, but without neglect, performed the number interval bisection task in three conditions of OKS: static, leftward, and rightward. In the static condition, BG misbisected to the right of the true midpoint. BG misbisected to the left following leftward OKS, and again to the right of the midpoint following rightward OKS. Moreover, the variability of BG's performance was smaller following both leftward and rightward OKS, suggesting that the attentional bias induced by OKS reduced the "indifference zone" that is thought to underlie the length effect reported in bisection tasks. We argue that shifts of visuospatial attention, induced by OKS, may affect number interval bisection, thereby revealing an interaction between the processing of the perceptual space and the processing of the number space.

This study investigated the production of compounds in Italian-speaking patients affected by different aphasia categories (i.e., Broca's, Wernicke's, and anomic aphasia) in a confrontation naming task. Questions of theoretical interest concerning the processing of compounds within the framework of the "lemma theory" as well as the role of morphological productivity in compound processing are addressed. Results indicate that all persons with aphasia retain knowledge of the morphological status of words, even when they fail to retrieve the corresponding phonological form (the "compound effect"). A difference was found among aphasia categories in the type of errors produced (omission vs. substitution) and in the position (first or second) of these errors within the compound words. In Broca's aphasia, the first component is omitted more frequently than the second one, but only in verb-noun compounds. Anomic and Wernicke's aphasia, unlike in Broca's aphasia, seem to retain sensitivity to morphological productivity.

Cognitive and behavioral abnormalities are frequent in Parkinson's disease (PD) but their anatomical correlates are still uncertain. We assessed a cohort of 59 PD patients with and without impulse control disorders (PD-ICDs and PD-CNTR) with magnetic resonance imaging and a comprehensive neuropsychological battery. Thirty-five PD patients presented ICDs according to DSM-IV criteria and Minnesota Impulsive Disorders Interview. We found areas of significant brain atrophy in the middle and superior frontal gyrus in the whole cohort of 59 PD patients vs. healthy controls but there were no morphometric changes in PD-ICDs vs. PD-CNTR. This was consistent with cognitive findings of relatively preserved function in PD-ICDs with the exception for slower performance in the Trail Making Test B-A suggesting difficulties to maintain goal-directed tasks and suppress irrelevant responses. Voxel Based Morphometric regression analysis (VBM) carried out using TMTB-A as independent factor showed a negative gray matter correlation between high TMTB-A scores and left middle frontal cortex, right posterior cingulate area, anterior cingulate and supplementary motor area bilaterally. Our results suggest that PD is characterized by an overall loss of gray matter in pre-frontal regions. However, the contribution of these changes to the development of ICDs is marginal., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Reading compound words was studied in neglect dyslexia in order to assess the influence of 'headedness'. The 'head' of a compound is the component that determines the grammatical category, the syntactic (e.g., the gender) and the semantic properties of the compound as a whole. For example, in the word 'blackberry'berry is the compound's head. The question was addressed of whether or not the privileged status of the head constituent influences processing and determines behavioural patterns in the breakdown of spatial attention in neglect. Italian right-headed (e.g. capobanda, band leader) and left-headed compounds (e.g. astronave, spaceship) were administered to 18 participants affected by neglect dyslexia. Left-headed compounds were read better than right-headed compounds. This result was not due to factors such as frequency, familiarity, age of acquisition or imageability, since these effects were controlled. It is suggested that attention is captured by the head component after implicit reading of the whole word. The head would require a relatively lighter processing load than the modifier and benefit from top-down facilitation., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

This study intended to describe general personality functioning in patients with a progressive course of multiple sclerosis. 55 consecutive rehabilitation inpatients with progressive course of multiple sclerosis were assessed with a multimethod test battery: the Expanded Disability Status Scale, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Rosenberg Self-esteem Scale, and the Rorschach Test administered and scored with Comprehensive System. The control group comprised 55 healthy participants with similar sociodemographic characteristics. Specific differences were found for both cognitive and affective aspects, as the patients with progressive course of multiple sclerosis had less positive self-image, less effective mediation processing, and an affective approach to reality. Present data illustrated the usefulness of examining patients with a progressive course of multiple sclerosis to identify abilities and difficulties in cognitive and affective patterns, and support better adaptation to relationships and the environment.

Objective: This study seeks to identify the possible relationship between certain executive functions and the main personality traits in 25 nondemented Parkinson disease (PD) patients., Background: Both the presence of cognitive changes-mainly concerning executive functions-and peculiar personality traits, such as low novelty seeking, moral rigidity, industriousness, or introversion, were fully documented in PD patients., Methods: Patients underwent the Tower of London test and Alternating Fluency tasks for planning abilities and cognitive flexibility to be assessed. Personality features were evaluated using the Big Five Adjectives checklist., Results: The study provided evidence of a significant correlation between the Tower of London and the Emotional Stability factor and between Alternating Fluencies and the Openness to Experience factor., Conclusions: The Tower of London test and the Emotional Stability factor may require filtering of irrelevant information, activation of inhibition mechanisms, and use of negative feedback. The Alternating Fluency tasks and the Openness to Experience factor may require the ability to switch set and to express flexible thoughts or opinions in daily life. These results indicate that cognitive and personality changes in PD may be different expressions of a common psychologic mechanism related to the dysfunction of the frontostriatal system.

With increasing frequency the lexicon of every language incorporates words taken from other languages (loan words) that become of common use, but whose orthography does not necessarily conform to the rules of the native language. This is particularly true for languages like Italian, where most words can be correctly written by the application of a sublexical phonology-to-orthography conversion procedure. Here we report the case of a neurologically unimpaired, highly educated Italian person, with a specific deficit in writing loan words. The aim of the study is to clarify the nature of her dysgraphic impairment, if linked to a semantic deficit, or alternatively reflecting an acquisition deficit, present both in the phonological and orthographic output lexicons, or specific only for the orthographic lexicon. A qualitative analysis of her errors and a comparison with the performance of a group of age and education matched subjects showed that her error pattern was not an amplification of the task difficulty effect observed in the control subjects, but rather an expression of an impairment in acquiring specific writing procedures.

The present study investigated the effects of left hemispatial neglect on two tasks activating the mental number line (MNL). Six patients with left neglect performed a mental number bisection task and a modified version of the Spatial Numerical Association of Response Codes (SNARC) task. Effects of left neglect were observed in the number bisection task, but not in the SNARC task. We argue that the dissociation between number bisection and SNARC resembles, in the representational space of the MNL, previously reported dissociations on neglect between explicit knowledge (assessed by direct tasks) and implicit knowledge (assessed by indirect tasks).

Psychophysical and neuropsychological studies have revealed that humans represent numbers along a continuous, left-to-right oriented mental line. However, it has been recently claimed that this format of representation is not special to numbers because non-numerical sequences would be spatially coded in the same way. To test this hypothesis, the present study investigated the effects of left neglect upon the bisection of numerical and non-numerical intervals. Eight patients with left neglect performed a visual line bisection task and three mental bisection tasks with number, letter, and month intervals. The error pattern in the number bisection task, indexed by the modulating effect of interval length, mirrored that of the visual task and confirmed the left-to-right spatial orientation of the mental number line. In contrast, the bisection of non-numerical intervals showed a very different pattern. The results suggest that the spatial layout characterizing numerical representations constitutes a specific property of numbers rather than a general characteristic of ordered sequences.

The aim of this study was to investigate the effect of word stress location in neglect dyslexia. An assessment was made of stress assignment in reading Italian words in 13 patients with neglect dyslexia and 13 matched normal individuals. The correspondence in stress location between target and neglect errors was preserved in 9 patients. Moreover, the proportion of words with stress on the penultimate syllable was about 50% and that on the antepenultimate syllable was also about 50%. This pattern is significantly different from the distribution observed in the Italian lexicon, in which the majority of polysyllabic words are stressed on the penultimate syllable. This result cannot be expected from the application of a "regularization" strategy associated with the operation of a nonlexical reading pathway. Taken together, these findings lead to the conclusion that lexical stress is part of the lexical information preserved in neglect dyslexia., (((c) 2004 APA, all rights reserved))

A single case study of a 58 year-old male with right asymmetric apraxia and akinetic-rigid syndrome is described. Brainimaging scans (MRI, SPECT) indicated asymmetric cortical atrophy compatible with the diagnosis of Corticobasal Degeneration. Reflex myoclonus was absent and myoclonic discharges only appeared in response to pharmacological treatment of limb dystonia and rigidity. Electromyographic evidence of jerky movements was recorded only in the affected right hand and forearm after muscle relaxation, and myoclonus was not preceded by an EEG paroxysm. The cortical components of the correspondent SEPs were not increased in amplitude while LLRs recordings showed a late response over the muscles of the affected side. Furthermore, the duration of post MEP silent period was bilaterally reduced. This single case study report points out that sometimes myoclonus in Corticobasal Degeneration can be masked by the presence of increased muscle tone.

In close analogy with neurophysiological findings in monkeys, neuropsychological studies have shown that the human brain constructs visual maps of space surrounding different body parts. In right-brain-damaged patients with tactile extinction, the existence of a visual peripersonal space centred on the hand has been demonstrated by showing that cross-modal visual-tactile extinction is segregated mainly in the space near the hand. That is, tactile stimuli on the contralesional hand are extinguished more consistently by visual stimuli presented near the ipsilesional hand than those presented far from it. Here, we report the first evidence in humans that this hand-centred visual peripersonal space can be coded in relation to a seen rubber replica of the hand, as if it were a real hand. In patients with left tactile extinction, a visual stimulus presented near a seen right rubber hand induced strong cross-modal visual-tactile extinction, similar to that obtained by presenting the same visual stimulus near the patient's right hand. Critically, this specific cross-modal effect was evident when subjects saw the rubber hand as having a plausible posture relative to their own body (i.e. when it was aligned with the subject's right shoulder). In contrast, cross-modal extinction was strongly reduced when the seen rubber hand was arranged in an implausible posture (i. e. misaligned with respect to the subject's right shoulder). We suggest that this phenomenon is due to the dominance of vision over proprioception: the system coding peripersonal space can be 'deceived' by the vision of a fake hand, provided that its appearance looks plausible with respect to the subject's body.