Behavioural Neurology - Volume 15, issue 3-4

Authors: Sterr, Annette

Article Type: Research Article

Abstract: Basic neuroscience research on brain plasticity, motor learning and recovery has stimulated new concepts in neurological rehabilitation. Combined with the development of set methodological standards in clinical outcome research, these findings have led to a double-paradigm shift in motor rehabilitation: (a) the move towards evidence-based procedures for the assessment of clinical outcome & the employment of disablement models to anchor outcome parameters, and (b) the introduction of practice-based concepts that are derived …from testable models that specify treatment mechanisms. In this context, constraint-induced movement therapy (CIT) has played a catalytic role in taking motor rehabilitation forward into the scientific arena. As a theoretically founded and hypothesis-driven intervention, CIT research focuses on two main issues. The first issue is the assessment of long-term clinical benefits in an increasing range of patient groups, and the second issue is the investigation of neuronal and behavioural treatment mechanisms and their interactive contribution to treatment success. These studies are mainly conducted in the research environment and will eventually lead to increased treatment benefits for patients in standard health care. However, gradual but presumably more immediate benefits for patients may be achieved by introducing and testing derivates of the CIT concept that are more compatible with current clinical practice. Here, we summarize the theoretical and empirical issues related to the translation of research-based CIT work into the clinical context of standard health care. Show more

Citation: Behavioural Neurology, vol. 15, no. 3-4, pp. 55-63, 2004

Authors: Allam, Mohamed Farouk | Campbell, Michael J. | Del Castillo, Amparo Serrano | Navajas, Rafael Fernández-Crehuet

Article Type: Research Article

Abstract: Our aim was to estimate the pooled risk of current and former smoking for Parkinson's disease (PD).We have reviewed all observational studies that evaluated the association between PD risk and smoking habit. Twenty six studies were identified: 21 case-control, 4 cohort and 1 cross-sectional. The cross-sectional study did not compare former with never smokers. These studies were carried out between 1968 and 2000. There was an obvious protective effect of current smoking in the …pooled estimate [risk estimate 0.37 (95% confidence interval 0.33 to 0.41)]. Former versus never smokers had pooled risk estimate of 0.84 (95% confidence interval 0.76 to 0.92). Current and former smoking do not, therefore, exert the same protective effect against PD so that it is unnecessary to postulate a biological mechanism through which smoking protects against PD. The results show that the reverse direction of causation is a more probable explanation, i.e. movement disorders of PD protect against smoking. Another explanation is that failure to develop strong smoking habits in early adult life might be a prodromal symptom of the disease and could perhaps be its first clinical manifestation. Show more

Keywords: Parkinson's disease, smoking, systematic review, meta-analysis

Citation: Behavioural Neurology, vol. 15, no. 3-4, pp. 65-71, 2004

Authors: Dabby, Ron | Watemberg, Nathan | Lampl, Yair | Eilam, Anda | Rapaport, Abraham | Sadeh, Menachem

Article Type: Research Article

Abstract: Pathological laughter is an uncommon symptom usually caused by bilateral, diffuse cerebral lesions. It has rarely been reported in association with isolated cerebral lesions. Midbrain involvement causing pathological laughter is extremely unusual. We describe three patients who developed pathological laughter after midbrain and pontine-midbrain infarction. In two patients a small infarction in the left paramedian midbrain was detected, whereas the third one sustained a massive bilateral pontine infarction extending to the midbrain. …Laughter heralded stroke by one day in one patient and occurred as a delayed phenomenon three months after stroke in another. Pathological laughter ceased within a few days in two patients and was still present at a two year follow-up in the patient with delayed-onset laughter. Pathological laughter can herald midbrain infarction or follow stroke either shortly after onset of symptoms or as a delayed phenomenon. Furthermore, small unilateral midbrain infarctions can cause this rare complication. Show more

Citation: Behavioural Neurology, vol. 15, no. 3-4, pp. 73-76, 2004

Authors: Brand, Matthias | Labudda, Kirsten | Kalbe, Elke | Hilker, Rüdiger | Emmans, David | Fuchs, Gerd | Kessler, Josef | Markowitsch, Hans J.

Article Type: Research Article

Abstract: A high percentage of Parkinson's disease (PD) patients show cognitive impairments in addition to the cardinal motor symptoms. These deficits primarily concern executive functions most probably linked to dysfunctions in prefrontal regions due to decreased dopaminergic transmission in fronto-striatal loops. To investigate possible associations between decision-making and executive functions in PD, we examined 20 non-demented PD patients and 20 healthy control subjects with a neuropsychological test battery and the Game of Dice …Task. In this computerised decision-making task, the rules for gains and losses and the winning probabilities are obvious and stable. Thus, strategic components besides feedback processing might influence decision-making in this task. We found that PD patients were impaired in the Game of Dice task performance and that the frequency of disadvantageous choices correlated with both executive functions and feedback processing. We suggest that decision-making deficits of PD patients in explicit gambling situations might be associated with dysfunctions in two different fronto-striatal loops: the limbic-orbitofrontal-striatal loop, involved in feedback processing, and the dorsolateral prefrontal-striatal loop, involved in executive functions. Show more

Keywords: gambling, executive functions, feedback processing, dorsolateral prefrontal cortex, orbitofrontal cortex

Citation: Behavioural Neurology, vol. 15, no. 3-4, pp. 77-85, 2004

Authors: Kurland, Jacquie | Naeser, Margaret A. | Baker, Errol H. | Doron, Karl | Martin, Paula I. | Seekins, Heidi E. | Bogdan, Andrew | Renshaw, Perry | Yurgelun-Todd, Deborah

Article Type: Research Article

Abstract: Cortical reorganization in poststroke aphasia is not well understood. Few studies have investigated neural mechanisms underlying language recovery in severe aphasia patients, who are typically viewed as having a poor prognosis for language recovery. Although test-retest reliability is routinely demonstrated during collection of language data in single-subject aphasia research, this is rarely examined in fMRI studies investigating the underlying neural mechanisms in aphasia recovery. The purpose of this study was to acquire fMRI test-retest data …examining semantic decisions both within and between two aphasia patients. Functional MRI was utilized to image individuals with chronic, moderate-severe nonfluent aphasia during nonverbal, yes/no button-box semantic judgments of iconic sentences presented in the Computer-assisted Visual Communication (C-ViC) program. We investigated the critical issue of intra-subject reliability by exploring similarities and differences in regions of activation during participants' performance of identical tasks twice on the same day. Each participant demonstrated high intra-subject reliability, with response decrements typical of task familiarity. Differences between participants included greater left hemisphere perilesional activation in the individual with better response to C-ViC training. This study provides fMRI reliability in chronic nonfluent aphasia, and adds to evidence supporting differences in individual cortical reorganization in aphasia recovery. Show more

Keywords: nonfluent aphasia, fMRI reliability, nonverbal semantic decisions

Citation: Behavioural Neurology, vol. 15, no. 3-4, pp. 87-97, 2004

Authors: Hawkins, Keith A. | Dean, David | Pearlson, Godfrey D.

Article Type: Research Article

Abstract: Practice effects in memory testing complicate the interpretation of score changes over repeated testings, particularly in clinical applications. Consequently, several alternative forms of the Auditory Verbal Learning Test (AVLT) have been developed. Studies of these typically indicate that the forms examined are equivalent. However, the implication that the forms in the literature are interchangeable must be tempered by several caveats. Few studies of equivalence have been undertaken; most are restricted to the comparison of …single pairs of forms, and the pairings vary across studies. These limitations are exacerbated by the minimal overlapping across studies in variables reported, or in the analyses of equivalence undertaken. The data generated by these studies are nonetheless valuable, as significant practice effects result from serial use of the same form. The available data on alternative AVLT forms are summarized, and recommendations regarding form development and the determination of form equivalence are offered. Show more

Keywords: Rey Auditory Verbal Learning Test, RAVLT, AVLT, alternative forms, memory, practice effects, neuropsychological testing

Citation: Behavioural Neurology, vol. 15, no. 3-4, pp. 99-107, 2004