Pub Date : 2024-03-01DOI: 10.1097/WNN.0000000000000358
Natalie C Ridgely, Steven Paul Woods, Troy A Webber, Andrea I Mustafa, Darrian Evans
Background: Executive dysfunction, which is common among persons with HIV (PWH), can have an adverse impact on health behaviors and quality of life. Intra-individual variability (IIV) is a measure of within-person variability across cognitive tests that is higher in PWH and is thought to reflect cognitive dyscontrol.
Objective: To assess whether cognitive IIV in the laboratory is associated with self-reported executive dysfunction in daily life among older PWH.
Method: Participants included 71 PWH aged ≥50 years who completed six subtests from the Cogstate battery and two subscales from the Frontal Systems Behavior Scale (FrSBe; self-report version). Cognitive IIV was calculated from the Cogstate as the coefficient of variation derived from age-adjusted normative T scores.
Results: Cognitive IIV as measured by the Cogstate showed a significant, positive, medium-sized association with current FrSBe ratings of executive dysfunction but not disinhibition.
Conclusion: Higher cognitive IIV in the laboratory as measured by the Cogstate may be related to the expression of HIV-associated symptoms of executive dysfunction in daily life for older PWH.
{"title":"Cognitive Intra-individual Variability in the Laboratory Is Associated With Greater Executive Dysfunction in the Daily Lives of Older Adults With HIV.","authors":"Natalie C Ridgely, Steven Paul Woods, Troy A Webber, Andrea I Mustafa, Darrian Evans","doi":"10.1097/WNN.0000000000000358","DOIUrl":"10.1097/WNN.0000000000000358","url":null,"abstract":"<p><strong>Background: </strong>Executive dysfunction, which is common among persons with HIV (PWH), can have an adverse impact on health behaviors and quality of life. Intra-individual variability (IIV) is a measure of within-person variability across cognitive tests that is higher in PWH and is thought to reflect cognitive dyscontrol.</p><p><strong>Objective: </strong>To assess whether cognitive IIV in the laboratory is associated with self-reported executive dysfunction in daily life among older PWH.</p><p><strong>Method: </strong>Participants included 71 PWH aged ≥50 years who completed six subtests from the Cogstate battery and two subscales from the Frontal Systems Behavior Scale (FrSBe; self-report version). Cognitive IIV was calculated from the Cogstate as the coefficient of variation derived from age-adjusted normative T scores.</p><p><strong>Results: </strong>Cognitive IIV as measured by the Cogstate showed a significant, positive, medium-sized association with current FrSBe ratings of executive dysfunction but not disinhibition.</p><p><strong>Conclusion: </strong>Higher cognitive IIV in the laboratory as measured by the Cogstate may be related to the expression of HIV-associated symptoms of executive dysfunction in daily life for older PWH.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693571","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 : 2023-12-11DOI: 10.1097/wnn.0000000000000364
Amauri Dalla Corte, Giulia Pinzetta, Andressa Goldman Ruwel, Taylor Felipe Alves Maia, Theonas Leal, Leonardo Almeida Frizon, Gustavo Rassier Isolan
The amygdala consists of a collection of nuclei that are deep within the medial temporal lobe. Despite its small size, the amygdala is one of the most densely connected structures in the brain, and it plays a role in many superior neural functions, including neurovegetative control, motor control, memory processing, and neuromodulation. Advances in neuroimaging technology for examining brain activity have opened up new ways of understanding the functional contribution of this structure to emotions, learning, and related memories. Many studies have shown that the amygdala plays a key role in the pathophysiology of neuropsychiatric disorders, such as anxiety disorders, depression, aggression, and temporal epilepsy. This article reviews the anatomical structure of the amygdaloid complex and the connectivity among its subdivisions and with other brain structures, which will serve as a basis for understanding the clinical correlations.
{"title":"Anatomical Organization of the Amygdala: A Brief Visual Review","authors":"Amauri Dalla Corte, Giulia Pinzetta, Andressa Goldman Ruwel, Taylor Felipe Alves Maia, Theonas Leal, Leonardo Almeida Frizon, Gustavo Rassier Isolan","doi":"10.1097/wnn.0000000000000364","DOIUrl":"https://doi.org/10.1097/wnn.0000000000000364","url":null,"abstract":"The amygdala consists of a collection of nuclei that are deep within the medial temporal lobe. Despite its small size, the amygdala is one of the most densely connected structures in the brain, and it plays a role in many superior neural functions, including neurovegetative control, motor control, memory processing, and neuromodulation. Advances in neuroimaging technology for examining brain activity have opened up new ways of understanding the functional contribution of this structure to emotions, learning, and related memories. Many studies have shown that the amygdala plays a key role in the pathophysiology of neuropsychiatric disorders, such as anxiety disorders, depression, aggression, and temporal epilepsy. This article reviews the anatomical structure of the amygdaloid complex and the connectivity among its subdivisions and with other brain structures, which will serve as a basis for understanding the clinical correlations.","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584430","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 : 2023-12-11DOI: 10.1097/wnn.0000000000000362
Jessica S. Sanders, Moriah Mabry, Sharon Scarbro, Christopher M. Filley
As patients with neurodevelopmental disorders (NDDs) transition from pediatric to adult health care systems, they often have difficulty finding physicians to address their NDD-related needs. In response to this care gap, we established a new consultation clinic within a behavioral neurology clinic in an adult neurology department to address the neurodevelopmental concerns of these adult patients. To characterize the population of adult patients with NDDs seen in the adult NDD clinic in its first year. Data were obtained by a retrospective chart review of all patients with NDDs seen in the adult NDD clinic from September 2020 through December 2021. Of the 86 patients who were seen in the adult NDD clinic, the average age was 34 years (SD = 15, range = 18–74 years). Developmental diagnoses included intellectual disability (63%), autism spectrum disorder (47%), Down syndrome (15%), cerebral palsy (9%), and other genetic disorders (26%). Comorbidities addressed included behavioral concerns (34%), anxiety (29%), seizure disorders (22%), and depression (15%). Behavioral and/or mental health concerns prompted 65% of the initial clinic visits. The most common recommendation made was to begin or increase exercise (59%), followed by facilitating connection to community, social, and employment resources. Adults with NDDs have diagnoses, comorbidities, and concerns that are similar to, but also distinct from, those addressed in other adult neurology clinics. This study addresses the need for, and feasibility of, caring for the diverse population of adults with NDDs in an adult neurology setting.
{"title":"New Frontier: The First Year of an Adult Neurodevelopmental Disabilities Clinic","authors":"Jessica S. Sanders, Moriah Mabry, Sharon Scarbro, Christopher M. Filley","doi":"10.1097/wnn.0000000000000362","DOIUrl":"https://doi.org/10.1097/wnn.0000000000000362","url":null,"abstract":"\u0000 \u0000 As patients with neurodevelopmental disorders (NDDs) transition from pediatric to adult health care systems, they often have difficulty finding physicians to address their NDD-related needs. In response to this care gap, we established a new consultation clinic within a behavioral neurology clinic in an adult neurology department to address the neurodevelopmental concerns of these adult patients.\u0000 \u0000 \u0000 \u0000 To characterize the population of adult patients with NDDs seen in the adult NDD clinic in its first year.\u0000 \u0000 \u0000 \u0000 Data were obtained by a retrospective chart review of all patients with NDDs seen in the adult NDD clinic from September 2020 through December 2021.\u0000 \u0000 \u0000 \u0000 Of the 86 patients who were seen in the adult NDD clinic, the average age was 34 years (SD = 15, range = 18–74 years). Developmental diagnoses included intellectual disability (63%), autism spectrum disorder (47%), Down syndrome (15%), cerebral palsy (9%), and other genetic disorders (26%). Comorbidities addressed included behavioral concerns (34%), anxiety (29%), seizure disorders (22%), and depression (15%). Behavioral and/or mental health concerns prompted 65% of the initial clinic visits. The most common recommendation made was to begin or increase exercise (59%), followed by facilitating connection to community, social, and employment resources.\u0000 \u0000 \u0000 \u0000 Adults with NDDs have diagnoses, comorbidities, and concerns that are similar to, but also distinct from, those addressed in other adult neurology clinics. This study addresses the need for, and feasibility of, caring for the diverse population of adults with NDDs in an adult neurology setting.\u0000","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584462","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 : 2023-12-11DOI: 10.1097/wnn.0000000000000361
M. Lopez, Kristen Mordecai, Anna E. Blanken, W. LaFrance
{"title":"Caring for Patients With Functional Neurological Disorder—A New Paradigm","authors":"M. Lopez, Kristen Mordecai, Anna E. Blanken, W. LaFrance","doi":"10.1097/wnn.0000000000000361","DOIUrl":"https://doi.org/10.1097/wnn.0000000000000361","url":null,"abstract":"","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584590","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}
Background: The predictive ability of the Frontal Assessment Battery (FAB) for postoperative cognitive improvement in idiopathic normal pressure hydrocephalus (iNPH) is unstudied.
Objective: To compare the predictive ability of the FAB and the Mini-Mental State Examination (MMSE) for postoperative cognitive improvement in individuals with iNPH after shunt surgery.
Method: We retrospectively reviewed the medical records of individuals with iNPH who had shunt surgery between January 2016 and October 2018. Individuals had completed the tap test and clinical evaluations (FAB, MMSE, Timed Up and Go [TUG]) both before and 24-48 hours after CSF tapping and after surgery. We excluded individuals without complete clinical evaluations and those with shunt surgery performed >6 months after CSF tapping. Factors associated with postoperative FAB and MMSE improvement as per the 2011 iNPH guidelines were extracted using univariate and multivariate logistic regression analyses. Independent variables were baseline FAB and MMSE scores, FAB and MMSE score changes and TUG amelioration rate after CSF tapping, Evans index, age, and days from CSF tapping to surgery and from surgery to postoperative assessment.
Results: The mean number of days from CSF tapping to surgery and from surgery to postoperative assessment were 77.5 (SD = 36.0) and 42.0 (SD = 14.5), respectively. Logistic regression analyses showed significant associations in the univariate analyses of postoperative FAB improvement with baseline FAB scores ( P = 0.043) and with FAB score changes after CSF tapping ( P = 0.047).
Conclusion: The FAB may help predict postoperative cognitive improvement after shunt surgery better than the MMSE.
{"title":"Predictive Ability of Frontal Assessment Battery for Cognitive Improvement After Shunt Surgery in Individuals With Idiopathic Normal Pressure Hydrocephalus.","authors":"Yuki Asahara, Machiko Suda, Shusaku Omoto, Kazushige Kobayashi, Masamichi Atsuchi, Hiroyasu Nagashima, Masahiko Suzuki","doi":"10.1097/WNN.0000000000000350","DOIUrl":"10.1097/WNN.0000000000000350","url":null,"abstract":"<p><strong>Background: </strong>The predictive ability of the Frontal Assessment Battery (FAB) for postoperative cognitive improvement in idiopathic normal pressure hydrocephalus (iNPH) is unstudied.</p><p><strong>Objective: </strong>To compare the predictive ability of the FAB and the Mini-Mental State Examination (MMSE) for postoperative cognitive improvement in individuals with iNPH after shunt surgery.</p><p><strong>Method: </strong>We retrospectively reviewed the medical records of individuals with iNPH who had shunt surgery between January 2016 and October 2018. Individuals had completed the tap test and clinical evaluations (FAB, MMSE, Timed Up and Go [TUG]) both before and 24-48 hours after CSF tapping and after surgery. We excluded individuals without complete clinical evaluations and those with shunt surgery performed >6 months after CSF tapping. Factors associated with postoperative FAB and MMSE improvement as per the 2011 iNPH guidelines were extracted using univariate and multivariate logistic regression analyses. Independent variables were baseline FAB and MMSE scores, FAB and MMSE score changes and TUG amelioration rate after CSF tapping, Evans index, age, and days from CSF tapping to surgery and from surgery to postoperative assessment.</p><p><strong>Results: </strong>The mean number of days from CSF tapping to surgery and from surgery to postoperative assessment were 77.5 (SD = 36.0) and 42.0 (SD = 14.5), respectively. Logistic regression analyses showed significant associations in the univariate analyses of postoperative FAB improvement with baseline FAB scores ( P = 0.043) and with FAB score changes after CSF tapping ( P = 0.047).</p><p><strong>Conclusion: </strong>The FAB may help predict postoperative cognitive improvement after shunt surgery better than the MMSE.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920823","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 : 2023-12-01DOI: 10.1097/WNN.0000000000000348
Naz Mirzai, Kévin Polet, Adeline Morisot, Solange Hesse, Alain Pesce, Sandrine Louchart de la Chapelle, Galina Iakimova
Background: Facial emotion recognition (FER) is commonly impaired in individuals with neurodegenerative disease (NDD). This impairment has been linked to an increase in behavioral disorders and caregiver burden.
Objective: To identify interventions targeting the improvement of FER ability in individuals with NDD and investigate the magnitude of the efficacy of the interventions. We also wanted to explore the duration of the effects of the intervention and their possible impacts on behavioral and psychological symptoms of dementia and caregiver burden.
Method: We included 15 studies with 604 individuals who had been diagnosed with NDD. The identified interventions were categorized into three types of approach (cognitive, neurostimulation, and pharmacological) as well as a combined approach (neurostimulation with pharmacological).
Results: The three types of approaches pooled together had a significant large effect size for FER ability improvement (standard mean difference: 1.21, 95% CI = 0.11, 2.31, z = 2.15, P = 0.03). The improvement lasted post intervention, in tandem with a decrease in behavioral disorders and caregiver burden.
Conclusion: A combination of different approaches for FER ability improvement may be beneficial for individuals with NDD and their caregivers.
背景:面部情绪识别(FER)通常在神经退行性疾病(NDD)患者中受损。这种损害与行为障碍和照顾者负担的增加有关。目的:确定旨在改善NDD患者生活自理能力的干预措施,并探讨干预措施的有效性。我们还想探索干预效果的持续时间及其对痴呆行为和心理症状以及照顾者负担的可能影响。方法:我们纳入了15项研究,604名被诊断为NDD的个体。确定的干预措施分为三种类型的方法(认知,神经刺激和药理学)以及联合方法(神经刺激与药理学)。结果:三种方法合并对FER能力的改善有显著的效应量(标准平均差:1.21,95% CI = 0.11, 2.31, z = 2.15, P = 0.03)。这种改善在干预后持续存在,同时行为障碍和照顾者负担也在减少。结论:对NDD患者及其照护者来说,联合使用不同的方法来提高FER能力可能是有益的。
{"title":"Can the Ability to Recognize Facial Emotions in Individuals With Neurodegenerative Disease be Improved? A Systematic Review and Meta-analysis.","authors":"Naz Mirzai, Kévin Polet, Adeline Morisot, Solange Hesse, Alain Pesce, Sandrine Louchart de la Chapelle, Galina Iakimova","doi":"10.1097/WNN.0000000000000348","DOIUrl":"10.1097/WNN.0000000000000348","url":null,"abstract":"<p><strong>Background: </strong>Facial emotion recognition (FER) is commonly impaired in individuals with neurodegenerative disease (NDD). This impairment has been linked to an increase in behavioral disorders and caregiver burden.</p><p><strong>Objective: </strong>To identify interventions targeting the improvement of FER ability in individuals with NDD and investigate the magnitude of the efficacy of the interventions. We also wanted to explore the duration of the effects of the intervention and their possible impacts on behavioral and psychological symptoms of dementia and caregiver burden.</p><p><strong>Method: </strong>We included 15 studies with 604 individuals who had been diagnosed with NDD. The identified interventions were categorized into three types of approach (cognitive, neurostimulation, and pharmacological) as well as a combined approach (neurostimulation with pharmacological).</p><p><strong>Results: </strong>The three types of approaches pooled together had a significant large effect size for FER ability improvement (standard mean difference: 1.21, 95% CI = 0.11, 2.31, z = 2.15, P = 0.03). The improvement lasted post intervention, in tandem with a decrease in behavioral disorders and caregiver burden.</p><p><strong>Conclusion: </strong>A combination of different approaches for FER ability improvement may be beneficial for individuals with NDD and their caregivers.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9761689","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 : 2023-12-01DOI: 10.1097/WNN.0000000000000356
Jessica Robin, Mengdan Xu, Liam D Kaufman, William Simpson, Stella McCaughey, Nadine Tatton, Charles Wolfus, Michael Ward
Background: Changes to speech and language are common symptoms across different subtypes of frontotemporal dementia (FTD). These changes affect the ability to communicate, impacting everyday functions. Accurately assessing these changes may help clinicians to track disease progression and detect response to treatment.
Objective: To determine which aspects of speech show significant change over time and to develop a novel composite score for tracking speech and language decline in individuals with FTD.
Method: We recruited individuals with FTD to complete remote digital speech assessments based on a picture description task. Speech samples were analyzed to derive acoustic and linguistic measures of speech and language, which were tested for longitudinal change over the course of the study and were used to compute a novel composite score.
Results: Thirty-six (16 F, 20 M; M age = 61.3 years) individuals were enrolled in the study, with 27 completing a follow-up assessment 12 months later. We identified eight variables reflecting different aspects of language that showed longitudinal decline in the FTD clinical syndrome subtypes and developed a novel composite score based on these variables. The resulting composite score demonstrated a significant effect of change over time, high test-retest reliability, and a correlation with standard scores on various other speech tasks.
Conclusion: Remote digital speech assessments have the potential to characterize speech and language abilities in individuals with FTD, reducing the burden of clinical assessments while providing a novel measure of speech and language abilities that is sensitive to disease and relevant to everyday function.
{"title":"Development of a Speech-based Composite Score for Remotely Quantifying Language Changes in Frontotemporal Dementia.","authors":"Jessica Robin, Mengdan Xu, Liam D Kaufman, William Simpson, Stella McCaughey, Nadine Tatton, Charles Wolfus, Michael Ward","doi":"10.1097/WNN.0000000000000356","DOIUrl":"10.1097/WNN.0000000000000356","url":null,"abstract":"<p><strong>Background: </strong>Changes to speech and language are common symptoms across different subtypes of frontotemporal dementia (FTD). These changes affect the ability to communicate, impacting everyday functions. Accurately assessing these changes may help clinicians to track disease progression and detect response to treatment.</p><p><strong>Objective: </strong>To determine which aspects of speech show significant change over time and to develop a novel composite score for tracking speech and language decline in individuals with FTD.</p><p><strong>Method: </strong>We recruited individuals with FTD to complete remote digital speech assessments based on a picture description task. Speech samples were analyzed to derive acoustic and linguistic measures of speech and language, which were tested for longitudinal change over the course of the study and were used to compute a novel composite score.</p><p><strong>Results: </strong>Thirty-six (16 F, 20 M; M age = 61.3 years) individuals were enrolled in the study, with 27 completing a follow-up assessment 12 months later. We identified eight variables reflecting different aspects of language that showed longitudinal decline in the FTD clinical syndrome subtypes and developed a novel composite score based on these variables. The resulting composite score demonstrated a significant effect of change over time, high test-retest reliability, and a correlation with standard scores on various other speech tasks.</p><p><strong>Conclusion: </strong>Remote digital speech assessments have the potential to characterize speech and language abilities in individuals with FTD, reducing the burden of clinical assessments while providing a novel measure of speech and language abilities that is sensitive to disease and relevant to everyday function.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163518","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 : 2023-12-01DOI: 10.1097/WNN.0000000000000354
Michitaka Funayama, Asuka Nakajima
Individuals with childhood apraxia of speech often exhibit greater difficulty with expressive language than with receptive language. As a result, they may benefit from alternative modes of communication. Here, we present a patient with childhood apraxia of speech who used pointing as a means of communication at age 2 ¼ years and self-made gestures at age 3½, when he had severe difficulties speaking in spite of probable normal comprehension abilities. His original gestures included not only word-level expressions, but also sentence-length ones. For example, when expressing "I am going to bed," he pointed his index finger at himself (meaning I ) and then put both his hands together near his ear ( sleep ). When trying to convey the meaning of "I enjoyed the meal and am leaving," he covered his mouth with his right hand ( delicious ), then joined both of his hands in front of himself ( finish ) and finally waved his hands ( goodbye ). These original gestures and pointing peaked at the age of 4 and then subsided and completely disappeared by the age of 7, when he was able to make himself understood to some extent with spoken words. The present case demonstrates an adaptive strategy for communication that might be an inherent competence for human beings.
{"title":"Development of Self-made Gestures as an Adaptive Strategy for Communication in an Individual With Childhood Apraxia of Speech.","authors":"Michitaka Funayama, Asuka Nakajima","doi":"10.1097/WNN.0000000000000354","DOIUrl":"10.1097/WNN.0000000000000354","url":null,"abstract":"<p><p>Individuals with childhood apraxia of speech often exhibit greater difficulty with expressive language than with receptive language. As a result, they may benefit from alternative modes of communication. Here, we present a patient with childhood apraxia of speech who used pointing as a means of communication at age 2 ¼ years and self-made gestures at age 3½, when he had severe difficulties speaking in spite of probable normal comprehension abilities. His original gestures included not only word-level expressions, but also sentence-length ones. For example, when expressing \"I am going to bed,\" he pointed his index finger at himself (meaning I ) and then put both his hands together near his ear ( sleep ). When trying to convey the meaning of \"I enjoyed the meal and am leaving,\" he covered his mouth with his right hand ( delicious ), then joined both of his hands in front of himself ( finish ) and finally waved his hands ( goodbye ). These original gestures and pointing peaked at the age of 4 and then subsided and completely disappeared by the age of 7, when he was able to make himself understood to some extent with spoken words. The present case demonstrates an adaptive strategy for communication that might be an inherent competence for human beings.</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151570","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 : 2023-12-01DOI: 10.1097/WNN.0000000000000352
Howard S Kirshner
{"title":"Aranzio's Seahorse and the Search for Memory and Consciousness.","authors":"Howard S Kirshner","doi":"10.1097/WNN.0000000000000352","DOIUrl":"10.1097/WNN.0000000000000352","url":null,"abstract":"","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10507148","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 : 2023-12-01DOI: 10.1097/WNN.0000000000000353
Michael P H Stanley, David A Silbersweig, David L Perez
Dividing the brain-mind into the specialized fields of neurology and psychiatry has produced many granular advantages, but these silos have imposed barriers to comprehensively understanding and contextualizing the fundamentals governing mental life and its maladies. Scientific inquiry into these fundamentals cannot reach its full potential without interdigitating the boundaries of two specialties of the same organ for both scholarship and clinical practice. We propose that to truly integrate disorders of the brain and the mind for research and clinical care, we must carefully reexamine the classification of its disorders (nosology) as an instrument to develop a coherent pathological and psychological framework. We call on professional organizations from neurology, psychiatry, behavioral neurology, neuropsychiatry, neuropsychology, and other relevant subspecialties (eg, geriatric psychiatry) to convene a multidisciplinary task force to define the current classification principles of their subspecialties and work toward developing an integrated nosology. The effect of a shared classification system, which we acknowledge is a difficult proposition philosophically and politically, would have transformative potential across educational, clinical, scientific, programmatic, and sociocultural realms. If accomplished, this initiative would provide a definitive step toward reducing stigma (and promoting reimbursement parity) for the full spectrum of complex brain disorders (regardless of traditional neurologic vs psychiatric conceptualizations).
{"title":"Toward a Unified Classification System for Brain-Mind Disorders: Putting Calls for Integrated Clinical Neuroscience Into Action.","authors":"Michael P H Stanley, David A Silbersweig, David L Perez","doi":"10.1097/WNN.0000000000000353","DOIUrl":"10.1097/WNN.0000000000000353","url":null,"abstract":"<p><p>Dividing the brain-mind into the specialized fields of neurology and psychiatry has produced many granular advantages, but these silos have imposed barriers to comprehensively understanding and contextualizing the fundamentals governing mental life and its maladies. Scientific inquiry into these fundamentals cannot reach its full potential without interdigitating the boundaries of two specialties of the same organ for both scholarship and clinical practice. We propose that to truly integrate disorders of the brain and the mind for research and clinical care, we must carefully reexamine the classification of its disorders (nosology) as an instrument to develop a coherent pathological and psychological framework. We call on professional organizations from neurology, psychiatry, behavioral neurology, neuropsychiatry, neuropsychology, and other relevant subspecialties (eg, geriatric psychiatry) to convene a multidisciplinary task force to define the current classification principles of their subspecialties and work toward developing an integrated nosology. The effect of a shared classification system, which we acknowledge is a difficult proposition philosophically and politically, would have transformative potential across educational, clinical, scientific, programmatic, and sociocultural realms. If accomplished, this initiative would provide a definitive step toward reducing stigma (and promoting reimbursement parity) for the full spectrum of complex brain disorders (regardless of traditional neurologic vs psychiatric conceptualizations).</p>","PeriodicalId":50671,"journal":{"name":"Cognitive and Behavioral Neurology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137888","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}