Pub Date : 2024-10-22DOI: 10.1097/WNN.0000000000000377
Anne Sommerfeld, Manfred Herrmann, Marcus Heldmann, Peter Erhard, Thomas F Münte
Background: Impulsivity resulting in unrestrained eating has been implicated as a contributing factor for obesity. Delay discounting (DD) tasks where individuals choose between a smaller immediate reward and a larger delayed reward provide useful data to describe impulsive decision-making and to determine the extent to which delayed rewards are discounted.
Objective: To study the association between body mass index(BMI) and delay discounting for food and money in adult women.
Methods: We used a DD task with real food rewards to investigate impulsive decision-making as related to BMI in participants who self-identified as women. Participants in group A had a mean BMI of 21.4 (n = 14), and participants in group B had a mean BMI of 32.2 (n = 14). Each group was tested in a hungry state during a single session. We performed fMRI during a DD task requiring participants to choose between a food item (one sandwich) constituting a smaller immediate reward and multiple food items (two, three, or four sandwiches) constituting a series of larger delayed rewards available at different intervals. The steepness of the discounting curve for food was determined from these decisions. Participants then completed a monetary discounting task to facilitate a comparison of the discounting of food and monetary rewards.
Results: Participants in group B discounted food rewards more steeply than monetary rewards. Decisions for delayed rewards led to increased activations of brain areas related to executive control on fMRI, such as the head of the caudate nucleus and the anterior cingulate cortex (ACC) in group A, but not group B participants.
Conclusion: Our findings suggest that group B had difficulty deciding against the immediate food rewards due to insufficient recruitment of cortical control areas. Therefore, impulsivity is an important target for behavioral interventions in individuals with obesity.
{"title":"Associations Between Intertemporal Food Choice and BMI in Adult Women: An fMRI Study Using a Quasi-realistic Design.","authors":"Anne Sommerfeld, Manfred Herrmann, Marcus Heldmann, Peter Erhard, Thomas F Münte","doi":"10.1097/WNN.0000000000000377","DOIUrl":"https://doi.org/10.1097/WNN.0000000000000377","url":null,"abstract":"<p><strong>Background: </strong>Impulsivity resulting in unrestrained eating has been implicated as a contributing factor for obesity. Delay discounting (DD) tasks where individuals choose between a smaller immediate reward and a larger delayed reward provide useful data to describe impulsive decision-making and to determine the extent to which delayed rewards are discounted.</p><p><strong>Objective: </strong>To study the association between body mass index(BMI) and delay discounting for food and money in adult women.</p><p><strong>Methods: </strong>We used a DD task with real food rewards to investigate impulsive decision-making as related to BMI in participants who self-identified as women. Participants in group A had a mean BMI of 21.4 (n = 14), and participants in group B had a mean BMI of 32.2 (n = 14). Each group was tested in a hungry state during a single session. We performed fMRI during a DD task requiring participants to choose between a food item (one sandwich) constituting a smaller immediate reward and multiple food items (two, three, or four sandwiches) constituting a series of larger delayed rewards available at different intervals. The steepness of the discounting curve for food was determined from these decisions. Participants then completed a monetary discounting task to facilitate a comparison of the discounting of food and monetary rewards.</p><p><strong>Results: </strong>Participants in group B discounted food rewards more steeply than monetary rewards. Decisions for delayed rewards led to increased activations of brain areas related to executive control on fMRI, such as the head of the caudate nucleus and the anterior cingulate cortex (ACC) in group A, but not group B participants.</p><p><strong>Conclusion: </strong>Our findings suggest that group B had difficulty deciding against the immediate food rewards due to insufficient recruitment of cortical control areas. Therefore, impulsivity is an important target for behavioral interventions in individuals with obesity.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-21DOI: 10.1097/WNN.0000000000000380
Durjoy Lahiri, Bruna Seixas-Lima, Carlos Roncero, Kathryn Stokes, Swayang Sudha Panda, Howard Chertkow
Psychotropic polypharmacy presents a diagnostic challenge that may be further complicated by inadequate medication history and underappreciation of the cognitive effects of such polypharmacy. Here we present the case of a 57-year-old man who presented to our memory clinic with progressive cognitive decline and a prior neuropsychological evaluation supporting the diagnosis of a neurodegenerative disorder. He was taking multiple psychotropic medications at the time, but the exact dosages were unclear due to a lack of collateral history. He was also taking prescribed opioids and a combination of buprenorphine and naloxone for pain relief, again with unclear dosages at the time of presentation. Brain imaging and cerebrospinal spinal fluid biomarker testing were negative for Alzheimer pathophysiologic processes. Months later, the patient was taken to the emergency room after an overdose caused by overuse of opioid medications. Once he was taken off all psychoactive medications, the patient's cognitive impairment completely reversed, and he became independent in activities of daily living. Psychotropic polypharmacy can have a myriad of cognitive manifestations which need to be better recognized by clinicians. Deprescription of such medications should be attempted whenever clinically appropriate.
{"title":"Psychotropic Polypharmacy Leading to Reversible Dementia: A Case Report.","authors":"Durjoy Lahiri, Bruna Seixas-Lima, Carlos Roncero, Kathryn Stokes, Swayang Sudha Panda, Howard Chertkow","doi":"10.1097/WNN.0000000000000380","DOIUrl":"https://doi.org/10.1097/WNN.0000000000000380","url":null,"abstract":"<p><p>Psychotropic polypharmacy presents a diagnostic challenge that may be further complicated by inadequate medication history and underappreciation of the cognitive effects of such polypharmacy. Here we present the case of a 57-year-old man who presented to our memory clinic with progressive cognitive decline and a prior neuropsychological evaluation supporting the diagnosis of a neurodegenerative disorder. He was taking multiple psychotropic medications at the time, but the exact dosages were unclear due to a lack of collateral history. He was also taking prescribed opioids and a combination of buprenorphine and naloxone for pain relief, again with unclear dosages at the time of presentation. Brain imaging and cerebrospinal spinal fluid biomarker testing were negative for Alzheimer pathophysiologic processes. Months later, the patient was taken to the emergency room after an overdose caused by overuse of opioid medications. Once he was taken off all psychoactive medications, the patient's cognitive impairment completely reversed, and he became independent in activities of daily living. Psychotropic polypharmacy can have a myriad of cognitive manifestations which need to be better recognized by clinicians. Deprescription of such medications should be attempted whenever clinically appropriate.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-03DOI: 10.1097/WNN.0000000000000378
Joël Macoir, Robert Laforce, Carol Hudon
Background: Although episodic memory is the primary concern in individuals with mild cognitive impairment (MCI), other cognitive functions may also be affected, including language. Language impairment in individuals with MCI has been attributed primarily to the breakdown of semantic representations, difficulties in accessing semantic information, and the weakening of executive functions. However, in most prior studies of word processing in individuals with MCI, researchers have used measures focused on noun production.
Objective: To investigate how verb production tasks might aid in detecting cognitive impairment in individuals with MCI.
Methods: We compared the performance of 45 individuals with MCI and 45 healthy controls on action naming and action fluency tasks.
Results: In the action naming task, the performance of participants with MCI was significantly impaired compared to healthy controls in terms of total score, the number of semantic errors produced, and the use of generic terms. In the action fluency task, participants with MCI produced significantly fewer verbs, fewer clusters, and fewer switches than healthy controls.
Conclusion: The results of our study emphasize the utility of verb production tasks in the identification of cognitive impairment in individuals with MCI and provide evidence of the importance of including action naming and action fluency tasks in the assessment of individuals with MCI.
{"title":"The Impact of Lexical-semantic Impairment on Spoken Verb Production in Individuals With Mild Cognitive Impairment.","authors":"Joël Macoir, Robert Laforce, Carol Hudon","doi":"10.1097/WNN.0000000000000378","DOIUrl":"https://doi.org/10.1097/WNN.0000000000000378","url":null,"abstract":"<p><strong>Background: </strong>Although episodic memory is the primary concern in individuals with mild cognitive impairment (MCI), other cognitive functions may also be affected, including language. Language impairment in individuals with MCI has been attributed primarily to the breakdown of semantic representations, difficulties in accessing semantic information, and the weakening of executive functions. However, in most prior studies of word processing in individuals with MCI, researchers have used measures focused on noun production.</p><p><strong>Objective: </strong>To investigate how verb production tasks might aid in detecting cognitive impairment in individuals with MCI.</p><p><strong>Methods: </strong>We compared the performance of 45 individuals with MCI and 45 healthy controls on action naming and action fluency tasks.</p><p><strong>Results: </strong>In the action naming task, the performance of participants with MCI was significantly impaired compared to healthy controls in terms of total score, the number of semantic errors produced, and the use of generic terms. In the action fluency task, participants with MCI produced significantly fewer verbs, fewer clusters, and fewer switches than healthy controls.</p><p><strong>Conclusion: </strong>The results of our study emphasize the utility of verb production tasks in the identification of cognitive impairment in individuals with MCI and provide evidence of the importance of including action naming and action fluency tasks in the assessment of individuals with MCI.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1097/WNN.0000000000000374
Madeleine Diepman, Christina Seery, Shameer Rafee, Rachel Somers, Séan O'Riordan, Michael Hutchinson, Fiadhnait O'Keeffe
Background: Individuals with idiopathic adult-onset isolated cervical dystonia (CD) may have cognitive difficulties and increased mood challenges. Social cognition and executive functioning may be particularly affected.
Objective: To explore social cognition and executive functioning performance in individuals with CD, using the Cambridge Neuropsychological Test Automated Battery (CANTAB), as previous research has used traditional, nondigital neuropsychological assessments. We sought to investigate the relationships between social cognition, executive functioning, mood, and disability in individuals with CD.
Methods: We recruited 37 individuals with CD, including 26 women with an age range of 33 to 69 years (M = 56.64, SD = 8.31) from a dystonia clinic in a hospital neurology department. The individuals completed selected tasks from the CANTAB measuring social cognition and executive functioning. We compared the individuals' performance with CANTAB normative data. Depression, anxiety, disease severity, and disability were measured.
Results: The individuals with CD had significantly lower scores than the CANTAB normative data in both social cognition and executive functioning tasks, with the largest differences evident in problem-solving, attention, and positive emotion bias tasks. Poorer emotion recognition was associated with increased difficulties in problem-solving tasks. The individuals demonstrated a bias toward identifying happiness in facial affect, which was related to a poorer recognition of emotions. Cognitive performance was not related to CD severity or disability or to current mood symptoms.
Conclusion: Difficulties with both social cognition and executive functioning were identified in the individuals with CD, and are likely important targets for clinical interventions.
背景:特发性成人孤立性颈肌张力障碍(CD)患者可能会出现认知困难和情绪问题。社交认知和执行功能可能尤其受到影响:由于之前的研究使用的是传统的非数字神经心理学评估方法,因此我们使用剑桥神经心理学测试自动化电池(CANTAB)来探索 CD 患者的社交认知和执行功能表现。我们试图研究 CD 患者的社会认知、执行功能、情绪和残疾之间的关系:我们从一家医院神经内科的肌张力障碍诊所招募了 37 名 CD 患者,其中包括 26 名女性,年龄在 33 岁至 69 岁之间(M = 56.64,SD = 8.31)。这些患者完成了 CANTAB 中测量社会认知和执行功能的部分任务。我们将他们的表现与 CANTAB 常模数据进行了比较。我们还对抑郁、焦虑、疾病严重程度和残疾情况进行了测量:结果:CD患者在社会认知和执行功能任务中的得分明显低于CANTAB常模数据,其中在问题解决、注意力和积极情绪偏差任务中的差异最大。较差的情绪识别能力与问题解决任务的难度增加有关。这些人在面部情绪中表现出一种识别快乐的偏向,这与较差的情绪识别能力有关。认知能力的高低与抑郁症的严重程度、残疾程度或当前的情绪症状无关:结论:CD患者在社会认知和执行功能方面都存在困难,这可能是临床干预的重要目标。
{"title":"Social Cognition, Executive Functioning, Mood, and Disability in Cervical Dystonia.","authors":"Madeleine Diepman, Christina Seery, Shameer Rafee, Rachel Somers, Séan O'Riordan, Michael Hutchinson, Fiadhnait O'Keeffe","doi":"10.1097/WNN.0000000000000374","DOIUrl":"10.1097/WNN.0000000000000374","url":null,"abstract":"<p><strong>Background: </strong>Individuals with idiopathic adult-onset isolated cervical dystonia (CD) may have cognitive difficulties and increased mood challenges. Social cognition and executive functioning may be particularly affected.</p><p><strong>Objective: </strong>To explore social cognition and executive functioning performance in individuals with CD, using the Cambridge Neuropsychological Test Automated Battery (CANTAB), as previous research has used traditional, nondigital neuropsychological assessments. We sought to investigate the relationships between social cognition, executive functioning, mood, and disability in individuals with CD.</p><p><strong>Methods: </strong>We recruited 37 individuals with CD, including 26 women with an age range of 33 to 69 years (M = 56.64, SD = 8.31) from a dystonia clinic in a hospital neurology department. The individuals completed selected tasks from the CANTAB measuring social cognition and executive functioning. We compared the individuals' performance with CANTAB normative data. Depression, anxiety, disease severity, and disability were measured.</p><p><strong>Results: </strong>The individuals with CD had significantly lower scores than the CANTAB normative data in both social cognition and executive functioning tasks, with the largest differences evident in problem-solving, attention, and positive emotion bias tasks. Poorer emotion recognition was associated with increased difficulties in problem-solving tasks. The individuals demonstrated a bias toward identifying happiness in facial affect, which was related to a poorer recognition of emotions. Cognitive performance was not related to CD severity or disability or to current mood symptoms.</p><p><strong>Conclusion: </strong>Difficulties with both social cognition and executive functioning were identified in the individuals with CD, and are likely important targets for clinical interventions.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1097/WNN.0000000000000371
Hiroaki Kawashima, Michitaka Funayama, Yoshie Inaba, Mikoto Baba
Phonemic paraphasia, a common characteristic of conduction aphasia, has traditionally been attributed to phonological representation dysfunction. An alternative hypothesis posits that phonemic paraphasia arises from difficulty converting phonemes into their corresponding articulatory maneuvers. However, detailed case studies supporting this theory have been lacking. In this report, we present the case of a 61-year-old right-handed man with right temporo-parietal infarction who exhibited crossed aphasia characterized by typical conduction aphasia symptoms (eg, relatively fluent speech with intact comprehension, frequent phonemic paraphasia, and pronounced difficulties in oral repetition) in the absence of distorted articulation, syllable segmentation, and prosody impairment. Despite the frequent occurrence of phonemic paraphasia and articulatory challenges, our patient's phonological representations remained relatively intact. His phonemic paraphasia was often self-corrected to produce correct responses, a feature known as conduit d'approche. During the oral repetition of individual mora (ie, the smallest unit of speech in Japanese), we observed that the patient consistently traced the corresponding Hiragana phonetic symbol accurately, despite his difficulties in articulation. We substantiated this phenomenon through objective assessment and posit that it resulted from an unusual separation of language functions in crossed aphasia-specifically, a disconnection between phonological representations in the right temporo-parietal cortex and speech articulation engrams in the left hemisphere. In this case of conduction aphasia, articulatory-based phonemic paraphasia may be viewed as an inability to convert phonemes into the appropriate articulatory maneuvers rather than as phonological representation dysfunction or apraxia of speech.
{"title":"Articulatory-based Phonemic Paraphasia in Conduction Aphasia: A Dysfunction in Phoneme-to-Articulation Conversion Uncovered Through Crossed Aphasia.","authors":"Hiroaki Kawashima, Michitaka Funayama, Yoshie Inaba, Mikoto Baba","doi":"10.1097/WNN.0000000000000371","DOIUrl":"10.1097/WNN.0000000000000371","url":null,"abstract":"<p><p>Phonemic paraphasia, a common characteristic of conduction aphasia, has traditionally been attributed to phonological representation dysfunction. An alternative hypothesis posits that phonemic paraphasia arises from difficulty converting phonemes into their corresponding articulatory maneuvers. However, detailed case studies supporting this theory have been lacking. In this report, we present the case of a 61-year-old right-handed man with right temporo-parietal infarction who exhibited crossed aphasia characterized by typical conduction aphasia symptoms (eg, relatively fluent speech with intact comprehension, frequent phonemic paraphasia, and pronounced difficulties in oral repetition) in the absence of distorted articulation, syllable segmentation, and prosody impairment. Despite the frequent occurrence of phonemic paraphasia and articulatory challenges, our patient's phonological representations remained relatively intact. His phonemic paraphasia was often self-corrected to produce correct responses, a feature known as conduit d'approche. During the oral repetition of individual mora (ie, the smallest unit of speech in Japanese), we observed that the patient consistently traced the corresponding Hiragana phonetic symbol accurately, despite his difficulties in articulation. We substantiated this phenomenon through objective assessment and posit that it resulted from an unusual separation of language functions in crossed aphasia-specifically, a disconnection between phonological representations in the right temporo-parietal cortex and speech articulation engrams in the left hemisphere. In this case of conduction aphasia, articulatory-based phonemic paraphasia may be viewed as an inability to convert phonemes into the appropriate articulatory maneuvers rather than as phonological representation dysfunction or apraxia of speech.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1097/WNN.0000000000000372
Marcus Heldmann, Gregor Spitta, Tobias Wagner-Altendorf, Thomas F Münte
Background: The rubber hand illusion (RHI) is a well-established method for studying body ownership: Given adequate concordance of visual, sensory, and proprioceptive stimuli, the individual experiences a rubber hand as his or her own.
Objective: To study the effects of a threat to the rubber hand.
Methods: We created a typical RHI paradigm but added threatening pain: Both the real hand of an individual and the rubber hand were stroked with a brush, either synchronously (RHI-inducing condition) or asynchronously (control condition), but only the rubber hand was then pricked with a needle to create a threatening pain condition. Event-related potentials (ERPs) were recorded in a group of 23 typically-developed individuals. ERP effects were source-localized using low-resolution electromagnetic tomography.
Results: The individuals consistently reported experience of the RHI during the experiment when the brush strokes were applied synchronously to both the real hand and the rubber hand. ERP analysis revealed that synchronous brush stroking gave rise to higher amplitude of frontal ERPs in the 100-200 ms range than asynchronous brush stroking, which was interpreted as reflecting the RHI. In the threatening pain condition, ERPs showed a greater positivity at frontocentral electrodes, source localized in the supplementary motor area (SMA).
Conclusion: SMA activation could reflect a control mechanism over reflexive motor activity, facilitating a possible threat-related response. Further studies should address ERP effects and the extent of the RHI to standard and threat stimuli in a correlative fashion to further elucidate the functional significance of the neurophysiological findings.
{"title":"Threatening an Illusory Limb: An Event-related Potential Study of the Rubber Hand Illusion.","authors":"Marcus Heldmann, Gregor Spitta, Tobias Wagner-Altendorf, Thomas F Münte","doi":"10.1097/WNN.0000000000000372","DOIUrl":"10.1097/WNN.0000000000000372","url":null,"abstract":"<p><strong>Background: </strong>The rubber hand illusion (RHI) is a well-established method for studying body ownership: Given adequate concordance of visual, sensory, and proprioceptive stimuli, the individual experiences a rubber hand as his or her own.</p><p><strong>Objective: </strong>To study the effects of a threat to the rubber hand.</p><p><strong>Methods: </strong>We created a typical RHI paradigm but added threatening pain: Both the real hand of an individual and the rubber hand were stroked with a brush, either synchronously (RHI-inducing condition) or asynchronously (control condition), but only the rubber hand was then pricked with a needle to create a threatening pain condition. Event-related potentials (ERPs) were recorded in a group of 23 typically-developed individuals. ERP effects were source-localized using low-resolution electromagnetic tomography.</p><p><strong>Results: </strong>The individuals consistently reported experience of the RHI during the experiment when the brush strokes were applied synchronously to both the real hand and the rubber hand. ERP analysis revealed that synchronous brush stroking gave rise to higher amplitude of frontal ERPs in the 100-200 ms range than asynchronous brush stroking, which was interpreted as reflecting the RHI. In the threatening pain condition, ERPs showed a greater positivity at frontocentral electrodes, source localized in the supplementary motor area (SMA).</p><p><strong>Conclusion: </strong>SMA activation could reflect a control mechanism over reflexive motor activity, facilitating a possible threat-related response. Further studies should address ERP effects and the extent of the RHI to standard and threat stimuli in a correlative fashion to further elucidate the functional significance of the neurophysiological findings.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1097/WNN.0000000000000370
Maileen G Ulep, Pierre Liénard
Background: Impairment in semantic knowledge contributes to Alzheimer disease (AD)-related decline. However, the particulars of the impact AD has on specific domains of knowledge remain debatable.
Objective: To investigate the impact of AD on specific semantic categories that are integral to daily functions-living things and man-made objects.
Method: We administered a free-listing task (written version) to 19 individuals with AD and 15 cognitively normal older adults and assessed the task's relationship with other cognitive and functional tests in clinical use. We compared the contents of the lists of salient concepts generated by the AD and control groups.
Results: Group membership (AD or control), after controlling for age, sex, formal education, and an estimate of premorbid intellectual ability, predicted the groups' performance on the free-listing task across two categories. Functional status was inversely related to performance on the free-listing task, holding demographic variables constant. Based on a comparison of the contents of the free lists that were generated by the two groups, it was possible to conclude that, in individuals with AD, conceptual knowledge central to the respective categories was well preserved, whereas the peripheral conceptual material showed evidence of degradation.
Conclusion: The free-listing task, which is an easy-to-administer and cost-effective tool, could aid in the preliminary detection of semantic knowledge dysfunction, revealing concepts that are better preserved and, possibly, the characterization of AD. Cognitive assessment tools that can be applied across cultures are needed, and the free-listing task has the potential to address this gap.
{"title":"Free-listing and Semantic Knowledge: A Tool for Detecting Alzheimer Disease?","authors":"Maileen G Ulep, Pierre Liénard","doi":"10.1097/WNN.0000000000000370","DOIUrl":"10.1097/WNN.0000000000000370","url":null,"abstract":"<p><strong>Background: </strong>Impairment in semantic knowledge contributes to Alzheimer disease (AD)-related decline. However, the particulars of the impact AD has on specific domains of knowledge remain debatable.</p><p><strong>Objective: </strong>To investigate the impact of AD on specific semantic categories that are integral to daily functions-living things and man-made objects.</p><p><strong>Method: </strong>We administered a free-listing task (written version) to 19 individuals with AD and 15 cognitively normal older adults and assessed the task's relationship with other cognitive and functional tests in clinical use. We compared the contents of the lists of salient concepts generated by the AD and control groups.</p><p><strong>Results: </strong>Group membership (AD or control), after controlling for age, sex, formal education, and an estimate of premorbid intellectual ability, predicted the groups' performance on the free-listing task across two categories. Functional status was inversely related to performance on the free-listing task, holding demographic variables constant. Based on a comparison of the contents of the free lists that were generated by the two groups, it was possible to conclude that, in individuals with AD, conceptual knowledge central to the respective categories was well preserved, whereas the peripheral conceptual material showed evidence of degradation.</p><p><strong>Conclusion: </strong>The free-listing task, which is an easy-to-administer and cost-effective tool, could aid in the preliminary detection of semantic knowledge dysfunction, revealing concepts that are better preserved and, possibly, the characterization of AD. Cognitive assessment tools that can be applied across cultures are needed, and the free-listing task has the potential to address this gap.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1097/WNN.0000000000000376
Cierra M Keith, Katharine E Lindberg, Kirk Wilhelmsen, Rashi I Mehta, Camila Vieira Ligo Teixeira, Mark Miller, Melanie Ward, R Osvaldo Navia, William T McCuddy, Liv Miller, Kirk Bryant, Michelle Coleman, Pierre-François D'Haese, Marc W Haut
Background: While the cognitive hallmark of typical Alzheimer disease (AD) is impaired memory consolidation, increasing evidence suggests that the frontal lobes and associated executive functions are also impacted.
Objective: We examined two neurobehavioral executive function tasks and associations with cortical thickness in patients diagnosed with mild cognitive impairment (MCI), suspected AD dementia, and a healthy control group.
Methods: First, we compared group performances on a go/no-go (GNG) task and on Luria's Fist-Edge-Palm (FEP) motor sequencing task. We then examined correlations between neurobehavioral task performance and the thickness of frontal cortical regions, AD signature regions, broader unbiased brain regions, and white matter hyperintensities (WMH).
Results: Participants with MCI performed worse than healthy controls, but better than participants with suspected AD dementia on both tasks. Both GNG and FEP (to a slightly greater extent) tasks showed diffuse associations with most AD signature regions and multiple additional regions within the temporal, parietal, and occipital cortices. Similarly, both tasks showed significant associations with all other cognitive tasks examined. Of the frontal regions examined, only the middle frontal gyrus and pars opercularis were associated with performance on these tasks. Interactions between the precuneus and transtemporal gyri were most predictive of GNG task performance, while the interaction between superior temporal and lingual gyri was most predictive of FEP task performance.
Conclusion: This study replicates difficulties with both GNG and FEP tasks in participants with MCI and AD dementia. Both tasks showed widespread associations with the cortical thickness of various brain structures rather than localizing to frontal regions, consistent with the diffuse nature of AD.
背景:典型阿尔茨海默病(AD)的认知特征是记忆巩固功能受损:虽然典型阿尔茨海默病(AD)的认知特征是记忆巩固受损,但越来越多的证据表明,额叶和相关的执行功能也会受到影响:我们研究了被诊断为轻度认知障碍(MCI)的患者、疑似阿兹海默症痴呆症患者以及健康对照组的两项神经行为执行功能任务及其与皮质厚度的关系:首先,我们比较了各组在 "走/不走"(GNG)任务和卢里亚 "拳锋-手掌"(FEP)运动排序任务上的表现。然后,我们研究了神经行为任务表现与额叶皮质区域厚度、AD特征区域、更广泛的无偏倚脑区和白质高密度(WMH)之间的相关性:MCI患者在两项任务中的表现均不如健康对照组,但优于疑似AD痴呆症患者。GNG和FEP(程度稍高)两项任务均显示出与大多数注意力缺失症特征区域以及颞叶、顶叶和枕叶皮层中的多个其他区域的弥漫性关联。同样,这两项任务与所有其他认知任务也有显著关联。在所研究的额叶区域中,只有额叶中回和厣旁与这些任务的表现相关。楔前回和跨颞回之间的相互作用最能预测 GNG 任务的表现,而颞上回和舌回之间的相互作用最能预测 FEP 任务的表现:本研究重复了 MCI 和 AD 痴呆患者在完成 GNG 和 FEP 任务时遇到的困难。这两项任务都与不同大脑结构的皮质厚度有广泛联系,而不是局限于额叶区域,这与 AD 的弥漫性是一致的。
{"title":"Cortical Thickness Correlates of Go/No-go and Motor Sequencing in Mild Cognitive Impairment and Suspected Alzheimer Disease Dementia.","authors":"Cierra M Keith, Katharine E Lindberg, Kirk Wilhelmsen, Rashi I Mehta, Camila Vieira Ligo Teixeira, Mark Miller, Melanie Ward, R Osvaldo Navia, William T McCuddy, Liv Miller, Kirk Bryant, Michelle Coleman, Pierre-François D'Haese, Marc W Haut","doi":"10.1097/WNN.0000000000000376","DOIUrl":"10.1097/WNN.0000000000000376","url":null,"abstract":"<p><strong>Background: </strong>While the cognitive hallmark of typical Alzheimer disease (AD) is impaired memory consolidation, increasing evidence suggests that the frontal lobes and associated executive functions are also impacted.</p><p><strong>Objective: </strong>We examined two neurobehavioral executive function tasks and associations with cortical thickness in patients diagnosed with mild cognitive impairment (MCI), suspected AD dementia, and a healthy control group.</p><p><strong>Methods: </strong>First, we compared group performances on a go/no-go (GNG) task and on Luria's Fist-Edge-Palm (FEP) motor sequencing task. We then examined correlations between neurobehavioral task performance and the thickness of frontal cortical regions, AD signature regions, broader unbiased brain regions, and white matter hyperintensities (WMH).</p><p><strong>Results: </strong>Participants with MCI performed worse than healthy controls, but better than participants with suspected AD dementia on both tasks. Both GNG and FEP (to a slightly greater extent) tasks showed diffuse associations with most AD signature regions and multiple additional regions within the temporal, parietal, and occipital cortices. Similarly, both tasks showed significant associations with all other cognitive tasks examined. Of the frontal regions examined, only the middle frontal gyrus and pars opercularis were associated with performance on these tasks. Interactions between the precuneus and transtemporal gyri were most predictive of GNG task performance, while the interaction between superior temporal and lingual gyri was most predictive of FEP task performance.</p><p><strong>Conclusion: </strong>This study replicates difficulties with both GNG and FEP tasks in participants with MCI and AD dementia. Both tasks showed widespread associations with the cortical thickness of various brain structures rather than localizing to frontal regions, consistent with the diffuse nature of AD.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1097/WNN.0000000000000375
Alexis García-Sarreón, Angel Escamilla-Ramírez, Yasmin Martínez-López, Kevin A García-Esparza, Nora Kerik-Rotenberg, Jesús Ramírez-Bermúdez
The clinical features of neuropsychiatric systemic lupus erythematosus (NPSLE) are heterogeneous. Furthermore, therapeutic decision-making for NPSLE depends on the recognition of clinical syndromes that have not been sufficiently studied. This report describes the case of a 36-year-old woman with NPSLE who exhibited severe cognitive dysfunction and affective psychosis with persistent nihilistic delusions such as those described in the Cotard delusion. The patient insisted for several months that she was already dead. CSF analysis showed elevated levels of anti-ribosomal P antibodies and a positive determination of oligoclonal bands. Additionally, 18F -FDG PET/CT imaging revealed severe bilateral frontal hypermetabolism suggestive of brain inflammation and occipital hypometabolism. Results from the Systematic Lupus Erythematosus Disease Activity Index 2000 and the Systemic Lupus Erythematosus Disease Activity Score were consistent with an active state of the immunological disease. We then determined by an algorithm that this neuropsychiatric event could be attributed to the activity of the underlying immunological disease. Despite immunosuppressive and symptomatic treatment, only a partial improvement in cognition was achieved. The psychopathological features of the Cotard delusion remained unchanged 4 months after onset. However, we observed rapid remission of affective psychosis and significant improvement in cognition following electroconvulsive therapy. Subsequent follow-up examinations showed a sustained remission. This case describes a protracted form of the Cotard delusion, the diagnostic challenges that arise in the context of SLE, and treatment dilemmas that necessitate collaboration between neurology, psychiatry, and rheumatology.
{"title":"The Cotard Delusion in a Patient With Neuropsychiatric Systemic Lupus Erythematosus: The Challenges of Autoimmune Psychosis.","authors":"Alexis García-Sarreón, Angel Escamilla-Ramírez, Yasmin Martínez-López, Kevin A García-Esparza, Nora Kerik-Rotenberg, Jesús Ramírez-Bermúdez","doi":"10.1097/WNN.0000000000000375","DOIUrl":"10.1097/WNN.0000000000000375","url":null,"abstract":"<p><p>The clinical features of neuropsychiatric systemic lupus erythematosus (NPSLE) are heterogeneous. Furthermore, therapeutic decision-making for NPSLE depends on the recognition of clinical syndromes that have not been sufficiently studied. This report describes the case of a 36-year-old woman with NPSLE who exhibited severe cognitive dysfunction and affective psychosis with persistent nihilistic delusions such as those described in the Cotard delusion. The patient insisted for several months that she was already dead. CSF analysis showed elevated levels of anti-ribosomal P antibodies and a positive determination of oligoclonal bands. Additionally, 18F -FDG PET/CT imaging revealed severe bilateral frontal hypermetabolism suggestive of brain inflammation and occipital hypometabolism. Results from the Systematic Lupus Erythematosus Disease Activity Index 2000 and the Systemic Lupus Erythematosus Disease Activity Score were consistent with an active state of the immunological disease. We then determined by an algorithm that this neuropsychiatric event could be attributed to the activity of the underlying immunological disease. Despite immunosuppressive and symptomatic treatment, only a partial improvement in cognition was achieved. The psychopathological features of the Cotard delusion remained unchanged 4 months after onset. However, we observed rapid remission of affective psychosis and significant improvement in cognition following electroconvulsive therapy. Subsequent follow-up examinations showed a sustained remission. This case describes a protracted form of the Cotard delusion, the diagnostic challenges that arise in the context of SLE, and treatment dilemmas that necessitate collaboration between neurology, psychiatry, and rheumatology.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1097/WNN.0000000000000373
Howard S Kirshner
{"title":"The Banana Lady and Other Stories of Curious Behavior and Speech.","authors":"Howard S Kirshner","doi":"10.1097/WNN.0000000000000373","DOIUrl":"10.1097/WNN.0000000000000373","url":null,"abstract":"","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}