Neurocase最新文献

Psychotic symptoms, characterized by hallucinations, delusions, and cognitive disturbances, are associated with various psychiatric and neurological disorders. This manuscript explores two cases of acute psychotic episodes triggered by the regular consumption of herbal products. The cases highlight the need for increased awareness of the potential toxic side effects of herbal products. The impact of herbal ingredients like maca and matcha on neurotransmitter activity is explored, shedding light on the underlying mechanisms leading to psychosis. The manuscript highlights the need to report both the benefits and risks of herbal products, challenging the misconception that they are inherently safe.

Moyamoya is a rare chronic brain vascular disease with a set of potential life-threatening consequences due to a high probability of stroke occurrence. Here we present a case of a patient with moyamoya disease, who has been dynamically observed over more than 4 years after the first manifestation of her symptoms. In this study we report fMRI and DTI findings obtained at the final follow-up point, four years after two revascularization surgeries were successfully performed. Our findings lend support to the idea that revascularization surgery is effective in preventing future strokes, but may lead to only minor improvement in cognitive performance.

Introduction: Othello syndrome is a psychosis with delusions of infidelity, where the patient harbors a persistent, unfounded belief - a "delusion" - that their partner is being unfaithful. This condition can manifest in certain psychiatric conditions and neurological disorders, such as neurodegenerative diseases, as parkinson's disease treatment side effects, or occasionally after a stroke.

Case: We report a rare case of a 50-year-old woman, with no previous psychiatric history, who developed a delusion of infidelity, leading to verbal and physical aggressions with bladed weapons, days after experiencing a bi-thalamic infarct due to the occlusion of the Percheron artery.

Discussion: Psychosis is the third most common psychiatric symptom post-stroke, with delusional disorders being the most prevalent type. Within this category, delusional jealousy is the second most common subtype, following persecutory delusions. Although no specific brain lesions are exclusively responsible for jealousy delusions, lesions in various regions, particularly in the right hemisphere, have been implicated. Thalamic strokes disrupt the frontal-subcortical-thalamic circuitry, crucial for executive functions, and the dorsomedial nuclei, leading to alterations in limbic circuitry and emotional regulation. These damages can result in significant impairments in impulse control and judgment, manifesting as behavioral disorders due to a flawed interpretation of a partner's actions as infidelity. In this case, our patient experienced a bi-thalamic infarct predominantly on the right side.

Conclusion: Othello syndrome represents a challenging post-stroke complication, highlighting the intricate relationship between neurological damage and psychiatric manifestations. Recognizing and promptly addressing this syndrome is crucial, given its potential for dangerous outcomes.

Naming impairment is a hallmark of logopenic primary progressive aphasia (lvPPA), yet its effects in bilingualism remain understudied. This study examined naming accuracy in a 78-year-old Chinese-English bilingual woman with lvPPA over two years using a modified Boston Naming Test. Naming accuracy was higher in her second, but more frequently used language (English) than her first, but less frequently used language (Chinese). Regression analyses revealed that familiarity predicted naming in Chinese, while word length and age of acquisition influenced English. Decline was linked to age of acquisition in Chinese and emotional properties in English, highlighting language-specific patterns in bilingual lvPPA.

After experiencing two ischemic brain attacks, a 40-year-old, right-handed, female amateur cello player developed apraxia of speech (AOS) and amusia, especially on the aspect of the beat. Her tempo became gradually faster, but while playing, she could not recognize that. When she listened to her own recorded performances, she could identify the differences immediately and precisely. Brain MRI showed lesions in the right superior temporal lobe, temporal plate, and right and left precentral gyri. Neuromusicological assessments revealed severe beat impairment and moderate pitch impairment. We diagnosed her with beat deafness of music, possibly caused by the bilateral precentral gyri lesions.

Neurodegeneration with brain iron accumulation (NBIA) is a genetic disorder characterized by iron accumulation in the basal ganglia. Patients may develop behavioral abnormalities, dementia, movement disorders, and neuropsychiatric symptoms such as emotional lability, depression, anxiety, hallucinations, impulsivity, obsessions, and hyperactivity. In this case, a 46-year-old male patient with a C19orf12 mutation experienced depressive complaints before movement disorders, followed by cognitive deficits and psychotic symptoms as the disease progressed. The patient's response to quetiapine treatment is crucial for managing neuropsychiatric symptoms. This case could contribute to the literature on presentation, differential diagnosis, and management of neuropsychiatric symptoms in rare NBIA patients.

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.

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.

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.