Behavioural Neurology - Volume 18, issue 3

Authors: Camarda, Rosolino | Camarda, Cecilia | Monastero, Roberto | Grimaldi, Silvia | Camarda, Lawrence K.C. | Pipia, Carmela | Caltagirone, Carlo | Gangitano, Massimo

Article Type: Research Article

Abstract: We evaluated the relationship between motor and neuropsychological deficits in subjects affected by amnestic Mild Cognitive Impairment (aMCI) and {early} Alzheimer's Disease (AD). Kinematics of goal-directed movement of aMCI and AD subjects were compared to those of age-matched control subjects. AD showed a slowing down of motor performance compared to aMCI and controls. No relationships were found between motor and cognitive performances in both AD and aMCI. Our results suggest that the different motor behaviour between …AD and aMCI cannot be related to memory deficits, probably reflecting the initial degeneration of parietal-frontal circuits for movement planning. The onset of motor dysfunction in early AD could represent the transition from aMCI to AD. Show more

Keywords: Alzheimer's Disease, Mild Cognitive Impairment, kinematics, pointing, neuropsychology

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 135-142, 2007

Authors: Bartolo, Angela | Daumüller, Meike | Della Sala, Sergio | Goldenberg, Georg

Article Type: Research Article

Abstract: The praxic semantic system comprises a conceptual knowledge system, which stores functional information about objects, and an action knowledge system, which stores information about the correct manipulation of objects. Moreover, mechanical problem solving abilities permit to take advantages from objects structure to use unfamiliar tools or discover alternative ways of using familiar tools. This study aims at investigating whether conceptual knowledge, action knowledge and mechanical problem solving abilities intervene in the production …of gestures with objects (i.e. pantomimes and object use) by testing a group of brain damaged patients. Results showed that the mechanical problem solving abilities are not sufficient to produce pantomimes and that only severe deficits in the praxic semantic system would affect the production of these gestures. Furthermore, a double dissociation was observed between mechanical problem solving abilities and the capacity to use multiple objects. Overall, the results indicate that the praxic semantic system can be disrupted at different levels, suggesting that the semantic system for object has to be conceived as fractionated in different entities. Show more

Keywords: Limb apraxia, action semantic, mechanical problem solving, object function, brain damage, conceptual knowledge

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 143-147, 2007

Authors: Chaudhry, Priyanka | Kharkar, Siddharth | Heidler-Gary, Jennifer | Hillis, Argye E. | Newhart, Melissa | Kleinman, Jonathan T. | Davis, Cameron | Rigamonti, Daniele | Wang, Paul | Irani, David N. | Williams, Michael A.

Article Type: Research Article

Abstract: Studies of the cognitive outcome after shunt insertion for treatment of Normal Pressure Hydrocephalus have reported widely mixed results. We prospectively studied performance of 60 patients with Normal Pressure Hydrocephalus on a comprehensive battery of neuropsychological tests before and after shunt surgery to determine which cognitive functions improve with shunt insertion. We also administered a subset of cognitive tests before and after temporary controlled drainage of cerebrospinal fluid to determine if change on …this brief subset of tests after drainage could predict which patients would show cognitive improvement three to six months after shunt insertion. There was a significant improvement in learning, retention, and delayed recall of verbal memory three to six months after surgery (using paired t-tests). The majority (74%) of patients showed significant improvement (by at least one standard deviation) on at least one of the memory tests. Absence of improvement on verbal memory after temporary drainage of cerebrospinal fluid had a high negative predictive value for improvement on memory tests at 3–6 months after surgery (96%; p=0.0005). Also, the magnitude of improvement from Baseline to Post-Drainage on few specific tests of learning and recall significantly predicted the magnitude of improvement after shunt surgery on the same tests (r^{2} =0.32–0.58; p=0.04–0.001). Results indicate that testing before and after temporary drainage may be useful in predicting which patients are less likely to improve in memory with shunting. Show more

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 149-158, 2007

Authors: Raggi, Alberto | Marcone, Alessandra | Iannaccone, Sandro | Ginex, Valeria | Perani, Daniela | Cappa, Stefano F.

Article Type: Research Article

Abstract: The corticobasal degeneration syndrome has been suggested to be part of a complex of conditions (including the different subtypes of frontotemporal dementia and progressive supranuclear palsy), which reflect a spectrum of pathological substrates. This concept is supported by the frequent clinical overlap that can be observed among patients diagnosed with these conditions. We report three clinical cases, characterized by the overlap of the clinical features of corticobasal degeneration syndrome with, respectively, nonfluent …progressive aphasia, progressive supranuclear palsy and semantic dementia. Current diagnostic criteria emphasize differences in clinical presentation, which probably reflect the preferential location of pathology in the early stages of disease. However, with disease progression, a considerable clinical overlap can be expected among the different syndromes. This concept should be extended not only to the cognitive and behavioural features of the frontotemporal dementia subtypes, but also to the movement disorders of corticobasal degeneration and supranuclear palsy. Show more

Keywords: Corticobasal degeneration, frontotemporal dementia, nonfluent progressive aphasia, progressive supranuclear palsy, semantic dementia

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 159-164, 2007

Authors: Yilmaz, Hikmet

Article Type: Research Article

Abstract: Purpose: Levetiracetam-treated patients commonly report daytime drowsiness, fatique, asthenia and decreasing of motor activity. However the origin of these reported side effects are still debated, we aimed to clarify effect of levetiracetam on sleep. Therefore this prospective study was conducted to evaluate the effects of levetiracetam on motor activity, amount and continuity of sleep and napping. Methods: Various tests were performed on twenty two patients treated with levetiracetam (10 monotherapy, 12 …add-on therapy) at least three days before the initiation of treatment, and consecutively for five to eight days at the third week of treatment. These tests included sleep logs, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Modified Maintenance of Wakefulness Test and actimetric measurements. In order to evaluate the sleep behavior of these patients the following sleep parameters were estimated: bedtime, wake-up time, sleep-onset time, sleep-offset time, sleep latency, total sleep time, wake time after sleep onset, fragmentation index, total activity score, nap episodes, total nap duration and sleep efficiency. Twenty members of staff from our hospital (Doctor, nurse, secretary, civil servant etc.) were evaluated as control subjects in the study. Results: After three-week treatment with levetiracetam (in particular with add-on therapy), Epworth Sleepiness Scale scores, napping episodes and total nap durations increased and sleep latencies decreased. While durations of Modified Maintenance of Wakefulness Test and total activity scores decreased. However the total sleep time and the sleep efficiency did not show any difference from the pre-treatment values. Conclusions: Our results suggest that levetiracetam leads to drowsiness by decreasing the daily motor activity and increasing the naps; however this agent does not have any major effects on total sleep time and sleep efficiency during night. Actimetric analyses give information about continuity of sleep and sleep/wake states however does not give satisfactory information about architecture of sleep. In order to determine the effects of levetiracetam on the sleep architecture we need similiar protocol studies by full night polysomnography. Show more

Keywords: Actimeter, levetiracetam, nap episodes, total activity score, drowsiness, sleep efficiency

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 165-170, 2007

Authors: Chan, Raymond C.K. | Chen, Eric Y.H.

Article Type: Research Article

Abstract: Background: This study attempted to examine the prevalence and type of neurological signs in Chinese patients with schizophrenia. Methods: A cross-sectional design was adopted with the use of the Cambridge Neurological Inventory (CNI). The CNI is comprised of 7 subscales, including motor coordination, sensory integration, disinhibition, extrapyramidal signs, dyskinesia, catatonia, and pyramidal signs. The former 3 subscales were classified as soft signs, whereas the latter 4 subscales were classified as …hard signs. A total of 250 Chinese schizophrenic patients and 90 normal controls were recruited. Results: Patients exhibited significantly more signs than normal controls in all subscales but pyramidal signs (p < 0.00005). Significant differences were also found in total soft signs, total hard signs as well as total neurological signs (p < 0.0005). The three subscales of soft signs showed a relatively better sensitivity and specificity as compared with the four subscales of hard signs. Improvement in sensitivity and specificity was demonstrated when the subscales were collapsed into total soft signs, total hard signs and total neurological signs. A cut-off of 4 in total soft signs yields a sensitivity of 0.63 and specificity of 0.71; whereas a cut-off of 1 in total hard signs yields a sensitivity of 0.78 and specificity of 0.89. A global cut-off of 5 in total neurological signs results in a sensitivity of 0.81 and specificity of 0.73 for detecting schizophrenia versus normal. Conclusions: High levels of neurological abnormality characterize schizophrenic patients. An extended assessment battery of CNI provides even better discrimination of patients from normal controls, and soft signs are more strongly associated with schizophrenia than are hard signs in the Chinese sample. Show more

Keywords: Neurological signs, prevalence, Cambridge Neurological Inventory, schizophrenia, Chinese

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 171-181, 2007

Authors: Abutalebi, J. | Arcari, C. | Rocca, M.A. | Rossi, P. | Comola, M. | Comi, G.C. | Rovaris, M. | Filippi, M.

Article Type: Research Article

Abstract: Anosognosia for cortical blindness, also called Anton's syndrome, is a rare neurological disorder usually following bilateral lesions to occipital cortices. Neuropsychological, morphological and functional neuroimaging (SPECT and fMRI) findings are reported in a patient who incurred Anton's syndrome after an ischaemic lesion confined to the left occipital lobe involving the corpus callosum. The present case study suggests that Anton's syndrome may also follow from lesions disconnecting the occipital cortices.

Keywords: Cortical blindness, Anton's syndrome, disconnection, SPECT, fMRI

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 183-186, 2007

Authors: Koyama, Shinichi | Kawamura, Mitsuru

Article Type: Research Article

Abstract: We report a patient who has had persistent visual disturbances since she underwent catheter ablation to treat her Wolff-Parkinson-White (WPW) syndrome. We examined her visual symptoms carefully and quantitatively by means of our newly developed method combining image-processing and psychophysics. We first simulated the patient's visual symptoms using image-processing techniques. Since the simulation indicated that she would be very sensitive to the edges of the visual stimuli, we evaluated her sensitivity to the edges …using psychophysics. The results indicated that she was hypersensitive to the clear-cut edges of the visual stimuli. Her visual symptoms were very similar to those of visual aura of migraine, rather than those of photosensitive epilepsy. Magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT), electroenchepalogram (EEG), and visual-evoked potentials (VEP) in the patient were normal. No abnormalities in her fundus, visual field, or electroretinogram were found, either. Transesophageal echocardiography with bubble study indicated that she had a preexisting right-to-left shunt. We hypothesize that visual aura of migraine was triggered and made persistent by the catheter ablation in this patient. Although the relationship between migraine, catheter ablation, and right-to-left shunts is unknown, previous studies on the transcatheter closure of patent foramen ovale suggest a possible link between them. Catheter ablation in patients with migraine and preexisting shunts may lead to exacerbations in migraine symptoms. Show more

Keywords: Catheter ablation, migraine, right-to-left shunt, visual aura, Wolff-Parkinson-White (WPW) syndrome

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 187-192, 2007

Authors: Olojugba, Charles | de Silva, Rajith | Kartsounis, Luke D. | Royan, Lindsay | Carter, Janet

Article Type: Research Article

Keywords: De Clerambault's syndrome, erotomania, fronto-temporal dementia, motor neurone disease

Citation: Behavioural Neurology, vol. 18, no. 3, pp. 193-195, 2007