Neurocase最新文献

We report the case of DT, a man in his fifties who suffered a large right fronto-parietal hemorrhage, resulting in a dense left weakness and a persistent anosognosia for the resultant hemiplegia. DT engaged in several video-feedback sessions. Video feedback therapy has been successful in previously reported cases of anosognosia, resulting in immediate and lasting resolution. In the current case, similarly dramatic effects were observed, but with a subsequent recurrence of the anosognosic ideation. The present case sheds light on the interplay of neurologic and psychological mechanisms involved in anosognosia and on some of the pragmatic emotional considerations of engaging in this form of rehabilitative therapy.

We report a case of a 39-year-old woman with persistent vegetative state (PVS) following cardiac arrest and a right lower extremity fracture. Despite comprehensive rehabilitation for over 4 months, there was no improvement. Neuroelectrophysiological and neuroimaging assessments showed poor brain function, and the coma recovery scale-revised scale results suggested low arousal probability. Furthermore, patients with PVS exhibit autonomic reactivity and physiological responses to external stimuli. It is important to note that while these reactions may manifest as responsiveness to external stimuli, they should be interpreted as automatic physiological responses rather than indicative of consciousness.

The majority of genetic Primary progressive aphasia (PPA) patients harbor mutations in the granulin (GRN) gene. The present case showed impaired performances in single-word retrieval in spontaneous speech and naming, and repetition. Head MRI revealed marked lateral atrophy in the left parietal cortex. A diagnosis of logopenic variant PPA (lvPPA) was established. Genetic analysis showed a heterozygous 10-bp frameshift deletion in exon 4 of the GRN gene (NM_002087.4), leading to transformation of cysteine into alanine at amino acid 92 and creation of a premature stop codon at position 161. This patient represented a rare case of GRN-associated lvPPA. A new mutation site was detected in exon 4 of GRN gene.

Purpose: The current study aimed to examine the linguistic characteristics of Korean-speaking individuals diagnosed with primary progressive aphasia(PPA).

Methods: Two individuals with agrammatic/non-fluent variants of nfvPPA and two with semantic variants of svPPA participated in this study. Picture description tasks were used to collect connected speech samples. Analysis focused on linguistic variables, including quantitative(number of utterances, words, nouns, and verbs), syntactic(mean length of utterance in morphemes, case markers per utterance, predicates per utterance), and semantic variables(correct information units, verb types). Additionally, participants completed two types of confrontation naming tasks.

Results: The nfvPPA group exhibited fewer linguistic units overall compared to the svPPA group, with noun-verb dissociation apparent only in the nfvPPA group. The svPPA group showed poorer performance in content-related linguistic variables. A notable clinical symptom specific to Korean, case marker deficits, was observed in the nfvPPA group.

Discussion: The study identified distinct linguistic patterns associated with the subtype of PPA in Korean speakers. The evaluation and interpretation of Korean-specific linguistic variables are crucial for classifying Korean-speaking individuals with PPA. Understanding these variables can enhance our comprehension of the unique linguistic deficits present in Korean PPA, particularly in relation to confrontation naming tasks and their implications for diagnosis and classification.

A 59-year-old male with severe treatment-resistant OCD achieved sustained symptom improvement after discontinuing deep brain stimulation (DBS) for over four years. Despite partial relief with ventral capsule/ventral striatum (VC/VS) DBS, complications led to device removal in 2018. Remarkably, the patient remained largely symptom-free, suggesting neuroplasticity changes in dysfunctional neurocircuits. This rare case highlights DBS's role in psychiatry, emphasizing the need for tailored surgical strategies and long-term follow-ups to optimize outcomes and understand DBS mechanisms.

A 75-year-old Chinese American man presented to behavioral neurology clinic for a second opinion of dementia with Lewy body disease (DLB). The clinical manifestations met the criteria for a probable DLB diagnosis. Yet, in-depth evaluation unveiled clinical history, family history, and neuroimaging evidences that suggested a diagnosis of behavioral variant frontotemporal dementia (FTD). A heterozygous pathogenic variant in the microtubule-associated protein Tau (MAPT) was identified through genetic testing and confirmed the diagnosis of autosomal dominant MAPT-related FTD. This case is the first reported instance of MAPT-related FTD presenting with well-formed visual hallucinations in an elderly Chinese American.

This case study explores the psychological and neuropsychological traits of a 55-year-old woman, D.R., who has Cotard's, believing her torso has dissolved and food bypasses her legs. Her delusion emerged amid major depressive disorder with psychotic features, following prodromal symptoms like body distortion and somatosensory abnormalities. A neuropsychological assessment during remission revealed low-level visual perceptual deficits in an otherwise intact cognitive profile. Subtle distortions in bodily signals and specific attribution styles were identified as vulnerability factors, suggesting that the delusion may emerge when already strained information processing systems are further challenged. This relates to models of delusion formation.

This study aims to reveal the effect of visuoperceptual rehabilitation combined with neuromodulation on visual impairment recovery in chronic cortical blindness. A 71-year-old patient with cortical blindness was assessed using perimetry, pattern electroretinogram (pERG), Canadian Occupational Performance Measurement (COPM), and Montreal Cognitive Assessment (MoCA) at baseline and after treatment. After 12 rTMS sessions and 50 visual perceptual rehabilitation sessions, perimetry, pERG, COPM, and MoCA significantly improved the visual field and daily functioning. Both COPM-MoCA scores exceeded clinical significance. The results indicate that combining vision therapy with rTMS may improve vision field, daily function, and satisfaction in a chronic blindness case.

This case report presents the story of Mr. S, a professional orchestral musician with declining musical sight-reading ability, followed by progressive visuospatial and language deficits. Our novel musical assessment battery revealed deficits in music-reading (musical alexia) and music-writing (musical agraphia), with spared auditory perception and expression. Taken with neuropsychological testing, clinical history, and imaging, we conclude that his symptoms evolved from musical alexia to a multidomain, neurodegenerative process centered in the dominant inferior parietal lobe and temporoparietal junction. We suspect a primary TDP-opathy with comorbid preclinical Alzheimer's disease. Mr. S's case highlights musical symptoms as meaningful, early indicators of neurodegeneration.