Neuropsychiatry, neuropsychology, and behavioral neurology最新文献

{"title":"Telephone adaptation of the Modified Mini-Mental State Exam (3MS). The Cache County Study.","authors":"M C Norton,&nbsp;J A Tschanz,&nbsp;X Fan,&nbsp;B L Plassman,&nbsp;K A Welsh-Bohmer,&nbsp;N West,&nbsp;B W Wyse,&nbsp;J C Breitner","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To examine the concurrent validity of a newly developed telephone adaptation of the Modified Mini-Mental State Exam.</p><p><strong>Background: </strong>Longitudinal studies of cognition may be advantaged by availability of assessment instruments that can be used over the telephone, as well as in person.</p><p><strong>Method: </strong>Subjects were 263 noninstitutionalized elderly residents of a rural community in southern Idaho, aged 65 to 93, who had little or no cognitive difficulty. At an average interval of four weeks, we administered the Modified Mini-Mental State Exam (3MS) and the newly adapted Telephone Modified Mini-Mental State Exam (T3MS). Order of administration was randomly assigned.</p><p><strong>Results: </strong>Agreement between scores on the two instruments was good (r = 0.82, p < 0.001). When we applied various cutoff scores to the instruments, thereby generating assignments of individuals to \"screen positive\" and \"screen negative\" groups, the percent agreement in screening results ranged from 80% to 96% as we reduced the cutoff scores from 90 to 74 (100 points possible).</p><p><strong>Conclusions: </strong>At least among subjects without major cognitive syndromes, the Telephone Modified Mini-Mental State Exam provides a reasonable substitute for the more costly in-person 3MS. The telephone instrument should now be tested over a broader range of cognitive abilities in order to assess its validity in more impaired subjects, e.g., by studying an institutionalized sample.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 4","pages":"270-6"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21389194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset paranoid psychosis as a distinct clinicopathologic entity: magnetic resonance imaging data in elderly patients with paranoid psychosis of late onset and schizophrenia of early onset.","authors":"J M Tonkonogy,&nbsp;J L Geller","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to equalize the influence of age-related changes and to test the hypothesis that specific structural brain changes are mediating the development of unique clinical features in late-onset paranoid psychosis (LOPP).</p><p><strong>Background: </strong>Findings of unique white matter lesions have been recently described in patients with LOPP. These findings have not been consistent, however, when age-matched normal subjects have been used as a control group.</p><p><strong>Method: </strong>Magnetic resonance imaging data were compared in 13 patients with LOPP, mean age 66.33, and 35 elderly patients with early-onset paranoid schizophrenia (PSCH), mean age 63.89. Patients in the LOPP group differed from the PSCH group by the mild degree or absence of negative symptoms, the absence of formal thought disorders, and by prevalence of female patients.</p><p><strong>Results: </strong>Analysis of the magnetic resonance imaging data revealed statistically significant differences between the LOPP and PSCH groups. White matter hyperintensity was almost threefold more frequent in LOPP than in PSCH groups, 69.2% versus 22.9% respectively. Ventricular enlargement and cortical atrophy were more frequent in the PSCH group, reaching, for moderate to severe abnormalities, 28.6% for ventricular enlargement and 22.9% for cortical atrophy; moderate to severe abnormalities were absent in all 13 patients of the LOPP group.</p><p><strong>Conclusions: </strong>These data point to the possibility that late-onset paranoid psychosis is a distinct clinicopathological entity, with white matter hyperintensity mediating the development of LOPP in a significant percentage of the cases. The vascular origin of white matter lesions in LOPP is suggested.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 4","pages":"230-5"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21389860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional versus nonemotional lexical perception in patients with right and left brain damage.","authors":"B A Cicero,&nbsp;J C Borod,&nbsp;C Santschi,&nbsp;H M Erhan,&nbsp;L K Obler,&nbsp;R M Agosti,&nbsp;J Welkowitz,&nbsp;I S Grunwald","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study examined lexical emotional perception in patients with unilateral brain damage.</p><p><strong>Background: </strong>Hypotheses pertaining to laterality and emotion were tested. More specifically, we were interested in whether the right hemisphere is dominant for verbally-presented emotion. In addition, we examined whether emotional content improves the performance of patients with left brain damage (LBD) and language deficits.</p><p><strong>Method: </strong>Subjects were 11 patients with right brain damage (RBD), 10 patients with LBD, and 15 normal control adults. The subject groups did not differ significantly on demographic or basic cognitive variables; the patient groups were similar on neurologic variables. Parallel emotional experimental and nonemotional control tasks included word identification (or recognition), sentence identification, and word discrimination. There were eight emotional categories (e.g., happiness) and eight nonemotional categories (e.g., vision).</p><p><strong>Results: </strong>A significant interaction among Group, Condition, and Task revealed that patients with RBD were significantly impaired relative to patients with LBD and normals within the emotional condition, particularly for the identification tasks. Furthermore, the performance of patients with LBD and language deficits was improved by emotional content for the sentence identification task.</p><p><strong>Conclusions: </strong>These findings suggest that the right hemisphere has a unique contribution in the identification of lexical emotional stimuli. Implications for rehabilitation of patients with LBD and language deficits and patients with RBD by means of emotion-based strategies are discussed.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 4","pages":"255-64"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21389192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smooth pursuit tracking deficits of patients with schizophrenia at specific within-sine wave bins.","authors":"B D Schwartz,&nbsp;B A Maron,&nbsp;W J Evans,&nbsp;D K Winstead","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Early information processing deficits are consistently reported for patients with schizophrenia on smooth pursuit tracking tasks. A growing number of studies have applied a transient (magnocellular) or sustained (parvocellular) explanation to account for deficient processing of briefly presented visual stimuli, moving stimuli, and particularly, stimuli requiring smooth tracking eye movements in patients with schizophrenia.</p><p><strong>Objective: </strong>Although the preponderance of findings offer support for transient (where is it?) as opposed to sustained (what is it?) deficit, a need remains for specific depiction of the deficit. This was accomplished by applying a unique analytic method to a smooth pursuit tracking task.</p><p><strong>Methods: </strong>Fourteen patients with schizophrenia and fifteen normal control subjects were tested on smooth pursuit tracking performance at five different \"within-wave\" dot velocity frequencies that ranged from .3 to 1.1 hz. Performance data was extracted from each of the five frequencies and then separated into 12 discrete components that corresponded to light velocity (i.e., 12 bins).</p><p><strong>Results: </strong>A repeated measures multivariate analysis of covariance indicated that the performance of patients with schizophrenia was significantly poorer than that of their normal counterparts for three separate analyses of the time in smooth pursuit, F(11,594) = 8.99; p <0.00001, percentage of time in smooth pursuit, F(11,594) = 3.06; p <0.0005, and time in saccade eye movement, F(11,594) = 3.11; p <0.0004. A regression analysis revealed that the medication dosage was not significantly associated with performance on any of the critical measures, although trends were observed.</p><p><strong>Conclusions: </strong>The findings provide support for an early information processing deficit in patients with schizophrenia. In addition, the results support the current neurophysiologic model for abnormal smooth pursuit tracking in patients with schizophrenia, specifically implicating a transient channel deficiency.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 4","pages":"221-9"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21389859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated measures of cognitive processing efficiency in adolescent athletes: implications for monitoring recovery from concussion.","authors":"J C Daniel,&nbsp;M H Olesniewicz,&nbsp;D L Reeves,&nbsp;D Tam,&nbsp;J Bleiberg,&nbsp;R Thatcher,&nbsp;A Salazar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine whether an adolescent athlete, in the absence of concussion, would be expected to show an improvement in cognitive function during the course of a high school football season.</p><p><strong>Background: </strong>At least 60,000 American high school football players suffer cerebral concussion every year, and symptoms may persist for 4 or more years in as many as 24%.</p><p><strong>Method: </strong>34 members of a cohort of healthy athletes, aged 13-18, were administered a computerized neuropsychologic test battery from the Automated Neuropsychological Assessment Metrics (ANAM) before and after the 1997 high school football season, with a mean interval of 16.1 (range 12.3-20.4) weeks between tests. Preseason and postseason scores on eight tests were compared, with significance determined by paired t-test. For those tests in which an improvement was noted, one-way analysis of variance and Wilcoxon tests were used with both preseason and postseason data to determine if there was a measurable difference in cognitive processing efficiency between older and younger subjects.</p><p><strong>Results: </strong>Improvements in processing efficiency (p < 0.001) were noted on tests designed to measure visual scanning and sustained attention (CDS), immediate recall (CDI), and short-term memory (CDD). Older subjects generally performed better on each of these tests, though the difference was significant in only one case (postseason CDI, 17-18 year olds vs. 13-14 year olds, Wilcoxon, p = 0.043).</p><p><strong>Conclusions: </strong>Our findings suggest that ANAM is sensitive to differences and improvements in cognitive function during a 4 month interval in adolescence. They also suggest that using \"return to baseline\" cognitive function as the criterion for evidence of recovery from concussion may be insufficient, especially when the baseline measurement was obtained 4 or more months prior to the date of \"full recovery.\"</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 3","pages":"167-9"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21321466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontal lobe lesions and executive dysfunction in children.","authors":"C M Filley,&nbsp;D A Young,&nbsp;M S Reardon,&nbsp;G N Wilkening","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship of frontal lobe lesions and neuropsychologic performance in school-aged children to determine whether damage to frontal regions results in specific cognitive sequelae.</p><p><strong>Background: </strong>The role of the frontal lobes in executive function remains incompletely understood, particularly in children.</p><p><strong>Method: </strong>This retrospective study included children aged 8 to 17 with brain lesions of various etiology (n = 63) or diverse psychiatric disorders (n = 48). All were evaluated for details of neurologic and medical history and for scores on the Wechsler Intelligence Scale for Children (WISC-III) and the Wisconsin Card Sorting Test, and all but the psychiatric patients had neuroimaging scans. Five groups were analyzed--dorsolateral frontal, medial-orbital frontal, focal nonfrontal, diffuse, and psychiatric--and neuropsychologic test results were compared using a Kruskal-Wallis nonparametric analysis of variance.</p><p><strong>Results: </strong>Children with damage to dorsolateral frontal regions were more impaired on the Wisconsin Card Sorting Test than those in all other groups. Comparable performance on the Wechsler scale was found in all groups, suggesting that intellectual functioning did not account for this difference.</p><p><strong>Conclusions: </strong>These data provide evidence for a prominent role of the dorsolateral frontal regions in the mediation of executive function in children. They also support the use of the Wisconsin Card Sorting Test in children as a measure of dorsolateral frontal integrity.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 3","pages":"156-60"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21321464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autistic regression with rolandic spikes.","authors":"R Nass,&nbsp;O Devinsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study was designed to further define the electroencephalographic abnormalities seen in the Landau-Kleffner syndrome variants and the associated clinical features.</p><p><strong>Background: </strong>Landau-Kleffner syndrome is rare, but its putative variants are more common.</p><p><strong>Method: </strong>We report two patients with centro-temporal spikes, autistic epileptiform regression, and variably prominent oro-motor symptoms.</p><p><strong>Results: </strong>The epileptic aphasia pattern found among patients with prominent Rolandic spikes may more frequently involve expressive language than is seen in the typical Landau-Kleffner syndrome, where verbal auditory agnosia is the rule.</p><p><strong>Conclusions: </strong>This clinical difference likely reflects the location of the epileptiform activity (centrotemporal as opposed to anterior or mid-temporal) on buccal-lingual function, vocalization, and language production.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 3","pages":"193-7"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21321368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical correlates of alien hand syndromes.","authors":"J L Chan,&nbsp;A B Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to correlate various alien hand syndromes (AHS) with sites of lesion in 16 patients with anterior cerebral artery (ACA) territory infarction.</p><p><strong>Background: </strong>All previous reports of AHS were case studies. Their clinico-anatomic correlations were still controversial. While the callosal lesion appears necessary for various types of AHS, which portion of the corpus callosum is associated with which syndrome is still not yet completely resolved.</p><p><strong>Method: </strong>Sixteen patients with ACA territory infarction were selected from a stroke registry containing 7355 individuals. They were divided into three lesion groups according to location identified by computed tomography or magnetic resonance imaging: mesial frontal, callosal and combined mesial frontal and callosal. Neurobehavioral examination focused on the presence or absence of grasp reflex, various alien hand signs, intermanual conflict, and callosal disconnection syndrome. By gross visual analysis of the obtained data, a trend for clinicoanatomic correlation emerged.</p><p><strong>Results: </strong>Patients with restricted mesial frontal lesions (three subjects), restricted anterior callosal lesions (four subjects) or \"restricted\" mesial frontal and anterior callosal lesions (two subjects) did not have symptoms of AHS. The remaining seven patients with extensive callosal injury involving the midbody and isthmus all had symptoms of AHS. Four of the patients with relatively isolated callosal involvement showed intermanual conflict (IMC) associated with a callosal AHS, while the remaining three patients with additional lesions involving the mesial frontal cortex showed impulsive reaching and grasping behaviors of the contralesional hand (a component of frontal AHS) and IMC (a component of callosal AHS).</p><p><strong>Conclusions: </strong>A comparison of the lesions and symptoms of seven patients in two different groups shows that mesial frontal and anterior callosal (genu and rostral body) lesions are associated with a contralateral frontal AHS. Isolated involvement of the callosal midbody and isthmus is associated with a callosal AHS. When the mesial frontal cortex and corpus callosum (genu and whole body) are extensively involved, a mixed frontal and callosal AHS may occur in the same patient.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 3","pages":"149-55"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21321463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ideomotor apraxia in Alzheimer disease and left hemisphere stroke: limb transitive and intransitive movements.","authors":"A L Foundas,&nbsp;B L Macauley,&nbsp;A M Raymer,&nbsp;L M Maher,&nbsp;L J Rothi,&nbsp;K M Heilman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Ideomotor apraxia was studied in patients with Alzheimer disease (AD) and unilateral left hemispheric damaged (LHD) stroke to determine whether these groups differed.</p><p><strong>Background: </strong>Given that the neuropathology of AD is bilateral and more diffuse than the localized involvement in patients after an LHD stroke, and given that the cognitive deficits in AD are more widespread than in LHD stroke, the authors predicted that patients with these disorders would differ in response to an auditory command task administered to evaluate ideomotor apraxia, and that the two patient groups would be significantly more impaired than healthy matched control subjects.</p><p><strong>Methods: </strong>Twenty-one persons were studied, including equal numbers of patients with AD, patients with unilateral LHD stroke, and control subjects. An auditory command test of limb apraxia was administered and videotaped to score performance and to code spatial-temporal or content errors.</p><p><strong>Results: </strong>The patients with AD and LHD stroke were significantly more impaired than healthy control subjects. Whereas the patients with AD and LHD stroke were equally apraxic and did not differ in their performance of transitive limb movements, the patients with AD were significantly more impaired than the patients with stroke when performing intransitive limb movements. A positive correlation was found between severity of dementia and severity of apraxia in the patients with AD. The patients with LHD stroke were as likely to make spatial-temporal as content errors when performing intransitive limb movements, whereas the patients with AD made content errors only. Error types produced with transitive limb movements did not differ between groups; spatial-temporal errors were the most common errors made both by patients with AD and patients with LHD stroke.</p><p><strong>Conclusions: </strong>As predicted, patients with AD and with LHD stroke were impaired when producing limb movements after auditory command, and both patient groups were significantly more impaired than the healthy adults. Patients with AD were significantly more impaired than patients with stroke when performing intransitive limb movements, and error types differed by group. Patients with AD and patients with stroke were equally impaired when performing transitive movements, and error types did not differ by group. Patients with ideomotor apraxia are often degraded in their production of transitive and intransitive movements, and the observation that performance may differ depending on the type of limb movement suggests that movement representations for transitive and intransitive movements may be at least partially independent.</p>","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 3","pages":"161-6"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21321465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hills are alive with the sound of music.","authors":"A G Gordon","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79516,"journal":{"name":"Neuropsychiatry, neuropsychology, and behavioral neurology","volume":"12 3","pages":"198-200"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21321369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}