Neurocase最新文献

There is uncertainty about whether delusion formation in Alzheimer's disease (AD) can be explained by false memories. "Metamemory," the ability to self-evaluate memory and identify memory errors, is impaired in people with delusions in schizophrenia. Our objective was to investigate whether false memory and metamemory were associated with delusions in AD. Participants with mild AD, with and without delusions, completed a computerized word recognition task and a metamemory measure. Group differences were compared using independent-samples t-tests or Mann Whitney tests. Significant findings were explored through binary logistic regression modeling. Participants with delusions (n = 10) gave more high confidence responses, significantly so for correct responses; percentage of high confidence correct responses for those with delusions (mean (SD)) was 69.7% (31.0%) and for those without (n = 14) was 43.5% (29.9%); t₂₂ = -2.09, p = .049. This remained significant when sex was included in regression modeling; for each 1.0% increase in high confidence correct responses, participants were 5.4% more likely to have delusions (Exp(β) 1.054, 95% CI 1.007-1.105, p = .025). Findings provide tentative support for a link between metamemory and delusions in AD. This should be explored in a larger sample as it has potential implications for treatment.

A diagnosis of behavioral variant frontotemporal dementia (bvFTD) often relies on informant reports of significant behavioral changes. "BvFTD-by-proxy" describes situations of neuropsychiatric changes reported solely by an informant under circumstances that may raise questions regarding their objectivity. We present three cases of bvFTD-like symptoms reported by spouses, where progression was unclear, testing showed mild but stable executive dysfunction, and neuroimaging was unremarkable. The subjective nature of bvFTD criteria leaves patients vulnerable to misleading informant reports, especially amid relational discord, and may threaten patient autonomy. Recognizing and managing this situation is critical but time-consuming, often requiring coordinated care across multiple providers.

Moral cognition has largely been studied via dilemmas in which making a utilitarian choice causes instrumental harm (negative dimension). Studies of utilitarianism link this behavior with socioemotional unresponsiveness. However, there is a positive dimension of utilitarianism in which one sacrifices the good of oneself or close others for the overall welfare. We measured utilitarian choices multidimensionally in a patient with behavioral variant frontotemporal dementia (bvFTD), incorporating dilemmas accounting for negative and positive dimensions. Despite socioemotional deficits our patient was highly utilitarian in the positive, dimension of utilitarianism. This case study challenges the tendency to automatically associate bvFTD with antisocial tendencies.

This study explores Vincent van Gogh's struggles with executive functions and his experiences with episodes of depression. In the final years of his life, Van Gogh encountered visual and auditory hallucinations, often lasting for few days. His correspondence reveals his concerns about the clarity of his mind during this period, suggesting the possibility of visual hallucinations influencing his artistic work. He mentioned the term "delirium" in his letters, indicating the presence of a brief psychotic episode. This study also considers the potential influence of factors like nutrition, tobacco, alcohol consumption, somatic diseases, and psychological distress on his susceptibility to delirium.

Objective: To describe a case of Post-Treatment Lyme Disease Syndrome (PTLDS) with an atypical cognitive profile.

Method: A 41-year-old PTLDS patient underwent comprehensive neuropsychological testing and psychological assessment.

Results: The patient exhibited impaired intensive attention but preserved selective attention. Executive functions were normal. Short-term and anterograde memory were intact, while retrograde and semantic memory were significantly impaired. The patient also experienced identity loss, specific phobias, dissociative symptoms, and depressed mood.

Conclusions: Severe episodic-autobiographical and retrograde semantic amnesia was consistent with some reports of dissociative amnesia. Loss of identity and phobias were also highly suggestive of a psychogenic mechanism underlying amnesia.

The case study explores bilingualism and neurodegenerative disorders, specifically progressive supranuclear palsy (PSP) with speech and language disorder (PSP-SL). It features a 78-year-old Mexican American woman who exhibits echolalia only in response to Spanish. This selective impairment suggests unevenly affected language control mechanisms despite her proficiency in both languages. Cognitive function is evaluated with neuropsychological tests; she's diagnosed with PSP-SL, depression, and anxiety. Echolalia in response to one language implies complex phonological retrieval mechanisms. Such observations prompt further inquiry into bilingual language control and processing mechanisms. The case supports evidence that bilingualism may attenuate neurodegeneration effects, suggesting better inhibitory control over disinhibited speech through enhanced executive functioning benefits.

Cenobamate (CNB) is one of the newer antiseizure medications for the treatment of focal-onset seizures. The cognitive profile of CNB is not yet known in detail. Here we present the case of an 18-year-old male high school student with epilepsy who received adjunctive CNB. Under 400 mg/d of CNB in combination with lamotrigine, a neuropsychological reassessment revealed a severe deterioration of the formerly normal episodic memory functions, while executive functions remained unaffected. The de novo memory deficit had already led to a collapse in school performance and he unexpectedly failed to obtain the general qualification for university entrance. Given the beneficial effect of CNB on seizure control, a dose reduction of CNB to 200 mg/d and introduction of valproic acid was performed. This led to a full recovery of objective memory performance. To our knowledge this is the very first report of a dose-dependent, selective and severe decline in episodic memory performance under CNB, potentially impeding academic achievement. The findings call for a cognitive monitoring of CNB which also addresses episodic memory in addition to executive functions. Systematic studies on episodic memory upon CNB treatment would help to appreciate the scope of this apparently reversible adverse effect.

Herein, we report a 62-year-old female patient with Multiple system atrophy (MSA) at whom the sympathetic skin responses (SSRs) were absent at initial investigations. However, the levodopa therapy provided normalization of SSRs and moderately improvement in orthostatic hypotension-related symptoms. Based on this rare illustration, we discuss the possible mechanisms underlying the pathophysiology of autonomic dysfunction in MSA. We remark on the need for future clinical and experimental studies in this field.

Susac syndrome is a rare immune-mediated endotheliopathy affecting the microvasculature. It presents three main symptoms: encephalopathy, branch retinal artery occlusions, and hearing loss . Here we present a new case report focusing on the evolution of the cognitive profile. The patient underwent two neuropsychological examinations. The first, one month after the onset of the symptomatology, highlighted a prevalent involvement of verbal executive functions. The second, conducted six months later, revealed a global improvement in most previously deficient areas, although with the persistence of a difficulty in cognitive estimation. . This case illustrates the importance of a comprehensive analysis of patients with Susac syndrome to appreciate the whole range of cognitive deficits and reliably evaluate symptom evolution.