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Evangelisti S, Gramegna LL, De Pasqua S, Rochat MJ, Morandi L, Mitolo M, Bianchini C, Vornetti G, Testa C, Avoni P, Liguori R, Lodi R, Tonon C. In Vivo Parieto-Occipital White Matter Metabolism Is Correlated with Visuospatial Deficits in Adult DM1 Patients. Diagnostics (Basel) 2022; 12:2305. [PMID: 36291994 PMCID: PMC9600392 DOI: 10.3390/diagnostics12102305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is a genetic disorder caused by a (CTG) expansion in the DM protein kinase (DMPK) gene, representing the most common adult muscular dystrophy, characterized by a multisystem involvement with predominantly skeletal muscle and brain affection. Neuroimaging studies showed widespread white matter changes and brain atrophy in DM1, but only a few studies investigated the role of white matter metabolism in the pathophysiology of central nervous system impairment. We aim to reveal the relationship between the metabolic profile of parieto-occipital white matter (POWM) as evaluated with proton MR spectroscopy technique, with the visuoperceptual and visuoconstructional dysfunctions in DM1 patients. MR spectroscopy (3 Tesla) and neuropsychological evaluations were performed in 34 DM1 patients (19 F, age: 46.4 ± 12.1 years, disease duration: 18.7 ± 11.6 years). The content of neuro-axonal marker N-acetyl-aspartate, both relative to Creatine (NAA/Cr) and to myo-Inositol (NAA/mI) resulted significantly lower in DM1 patients compared to HC (p-values < 0.0001). NAA/Cr and NAA/mI correlated with the copy of the Rey-Osterrieth complex figure (r = 0.366, p = 0.033; r = 0.401, p = 0.019, respectively) and with Street’s completion tests scores (r = 0.409, p = 0.016; r = 0.341, p = 0.048 respectively). The proportion of white matter hyperintensities within the MR spectroscopy voxel did not correlate with the metabolite content. In this study, POWM metabolic alterations in DM1 patients were not associated with the white matter morphological changes and correlated with specific neuropsychological deficits.
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Affiliation(s)
- Stefania Evangelisti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
| | - Laura Ludovica Gramegna
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Silvia De Pasqua
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
| | - Magali Jane Rochat
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Luca Morandi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Micaela Mitolo
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Claudio Bianchini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
| | - Gianfranco Vornetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Claudia Testa
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy
| | - Patrizia Avoni
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
- UOC Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
- UOC Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Raffaele Lodi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Caterina Tonon
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
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Berente DB, Zsuffa J, Werber T, Kiss M, Drotos A, Kamondi A, Csukly G, Horvath AA. Alteration of Visuospatial System as an Early Marker of Cognitive Decline: A Double-Center Neuroimaging Study. Front Aging Neurosci 2022; 14:854368. [PMID: 35754966 PMCID: PMC9226394 DOI: 10.3389/fnagi.2022.854368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
Amnestic-type mild cognitive impairment (a-MCI) represents the prodromal phase of Alzheimer's disease associated with a high conversion rate to dementia and serves as a potential golden period for interventions. In our study, we analyzed the role of visuospatial (VS) functions and networks in the recognition of a-MCI. We examined 78 participants (32 patients and 46 controls) in a double-center arrangement using neuropsychology, structural, and resting-state functional MRI. We found that imaging of the lateral temporal areas showed strong discriminating power since in patients only the temporal pole (F = 5.26, p = 0.034) and superior temporal gyrus (F = 8.04, p < 0.001) showed reduced cortical thickness. We demonstrated significant differences between controls and patients in various neuropsychological results; however, analysis of cognitive subdomains revealed that the largest difference was presented in VS skills (F = 8.32, p < 0.001). Functional connectivity analysis of VS network showed that patients had weaker connectivity between the left and right frontotemporal areas, while stronger local connectivity was presented between the left frontotemporal structures (FWE corrected p < 0.05). Our results highlight the remarkable potential of examining the VS system in the early detection of cognitive decline. Since resting-state setting of functional MRI simplifies the possible automatization of data analysis, detection of VS system alterations might provide a non-invasive biomarker of a-MCI.
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Affiliation(s)
| | - Janos Zsuffa
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Tom Werber
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Mate Kiss
- Siemens Healthcare, Budapest, Hungary
| | - Anita Drotos
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Anita Kamondi
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Gabor Csukly
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Research Group of Clinical Neuroscience and Neuroimaging, Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Andras Attila Horvath
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
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Liebermann-Jordanidis H, Roheger M, Boosfeld L, Franklin J, Kalbe E. Which Test Is the Best to Assess Visuo-Cognitive Impairment in Patients with Parkinson's Disease with Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1749-1782. [PMID: 35599499 DOI: 10.3233/jpd-223238] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Visuo-cognitive impairment is common in patients with Parkinson's disease with mild cognitive impairment (PD-MCI) and constitutes a prognostic factor for the conversion to Parkinson's disease dementia (PDD). However, systematic analyses on which neuropsychological tests are most suitable to assess visuo-cognition in PD-MCI and PDD and to differentiate these cognitive stages are lacking. OBJECTIVE To review neuropsychological tests used to assess visuo-cognition including visuo-perceptual and visuo-spatial processing, visuo-constructive copying and drawing on command abilities; and to identify the visuo-cognitive subdomain as well as tests most suitable to discriminate between PD-MCI and PDD. METHODS MEDLINE, PsycINFO, Web of Science Core Collection, and CENTRAL were systematically searched for relevant studies assessing visuo-cognitive outcomes in patients with PD-MCI and PDD. Risk of bias was assessed using a customized form based on well-established tools. Random-effect meta-analyses were conducted. RESULTS 33 studies were included in the systematic review. Data of 19 studies were entered in meta-analyses. Considerable heterogeneity regarding applied tests, test versions, and scoring systems exists. Data indicate that visuo-constructive command tasks are the subdomain best suited to discriminate between PD-MCI and PDD. Furthermore, they indicate that the Rey-Osterrieth-Complex-Figure Test (ROCF), Corsi Block-Tapping Test, Judgment of Line Orientation (JLO), and Clock Drawing Test (CDT) are tests able to differentiate between the two stages. CONCLUSION We provide suggestions for suitable visuo-cognitive tests (Corsi Block-Tapping Test, or JLO, ROCF, CDT) to improve diagnostic accuracy. Methodological challenges (e.g., heterogeneity of definitions, tests) are discussed and suggestions for future research are provided. REGISTRATION https://www.crd.york.ac.uk/prospero/, ID: CRD42018088244.
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Affiliation(s)
- Hannah Liebermann-Jordanidis
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Mandy Roheger
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Lukas Boosfeld
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jeremy Franklin
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Sebastiani V, Chiacchiaretta P, Pavone L, Sparano A, Grillea G, Spadone S, Capotosto P, Committeri G, Baldassarre A. Cortical Hyper-Connectivity in a Stroke Patient with Rotated Drawing. Case Rep Neurol 2021; 13:677-686. [PMID: 34899252 PMCID: PMC8613562 DOI: 10.1159/000518844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/29/2021] [Indexed: 11/19/2022] Open
Abstract
In the present case report, we investigated the cortical networks of a patient (DDA) affected by right parietal stroke who showed a constructional phenomenon, in which when coping and recalling from memory a complex figure, the model was reproduced rotated of 90° along the vertical axis. Previous studies suggested that rotation on copy is associated with visuospatial impairments and abnormalities in parietal cortex, whereas rotation on recall might be related to executive deficits and dysfunction of frontal regions. Here, we computed the DDA's resting-state functional connectivity (FC) derived from cortical regions of the dorsal attention (DAN) and the frontal portion of the executive-control network (fECN), which are involved in the control of visuospatial attention and multiple executive functions, respectively. We observed that, as compared to a control group of right stroke patients without drawing rotation, DDA exhibited selective increased FC of the DAN and fECN, but not of task-irrelevant language network, within the undamaged hemisphere. These patterns might reflect a pathological communication in such networks leading to impaired attentional and executive operations required to reproduce the model in the correct orientation. Notably, such enhancement of FC was not detected in a patient with a comparable neuropsychological profile as DDA, yet without rotated drawing, suggesting that network-specific modulations in DDA might be ascribed to the constructional phenomenon of rotated drawing.
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Affiliation(s)
- Valentina Sebastiani
- Department of Neuroscience, Imaging and Clinical Sciences - University of Chieti-Pescara, Chieti, Italy
| | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging and Clinical Sciences - University of Chieti-Pescara, Chieti, Italy
| | - Luigi Pavone
- IRCSS NEUROMED, Mediterranean Neurological Institute, Pozzilli, Italy
| | - Antonio Sparano
- IRCSS NEUROMED, Mediterranean Neurological Institute, Pozzilli, Italy
| | - Giovanni Grillea
- IRCSS NEUROMED, Mediterranean Neurological Institute, Pozzilli, Italy
| | - Sara Spadone
- Department of Neuroscience, Imaging and Clinical Sciences - University of Chieti-Pescara, Chieti, Italy
| | - Paolo Capotosto
- Department of Neuroscience, Imaging and Clinical Sciences - University of Chieti-Pescara, Chieti, Italy
| | - Giorgia Committeri
- Department of Neuroscience, Imaging and Clinical Sciences - University of Chieti-Pescara, Chieti, Italy
| | - Antonello Baldassarre
- Department of Neuroscience, Imaging and Clinical Sciences - University of Chieti-Pescara, Chieti, Italy
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Carson L, Filipowicz A, Anderson B, Danckert J. Representational drawing following brain injury. Neuropsychologia 2019; 133:107154. [PMID: 31398425 DOI: 10.1016/j.neuropsychologia.2019.107154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 11/25/2022]
Abstract
Research has shown that damage to either the left or right hemisphere can lead to deficits in visuoconstructional skills including drawing and figure copying. Nevertheless, research would suggest that the nature of the deficits arising from left and right brain injury are distinct in nature if not severity, with the right hemisphere, and parietal cortex specifically, seen as critical for obtaining accurate spatial relations and the left hemisphere important for effective organisation (i.e., executive function). Much of this work on drawing and figure copying following brain damage has rested on qualitative assessments or crude marking scales with descriptive anchors for what constitutes good or poor performance. We employed quantitative analyses of drawings developed to assess accuracy in novice and expert artists. We analyzed drawings of a cube and a star in 50 patients (23, left brain damaged: LBD; 27 right brain damaged: RBD) who had suffered strokes. Our analysis was sensitive to the presence of neglect on the cube (i.e., missing left sided details) with voxel-wise lesion symptom mapping (VLSM) highlighting involvement of expected brain regions (superior temporal and supramarginal gyri). With left-sided omissions removed from analyses, we failed to find any difference between LBD and RBD patients. While the presence of left neglect appeared to exaggerate errors, this was only significant for errors of scale and proportion for the star drawing. VLSM of the distinct error domains demonstrated white matter involvement (and a minor contribution from the right insula) with respect to scale errors of the cube only. Finally, blinded judgements of hemisphere of lesion based on qualitative assessment of the drawings were no better than chance. These results suggest that figure copying is a complex task relying on large scale neural networks involving both hemispheres. Clearly, models of visuoconstructional capacity that emphasise right hemisphere dominance are not entirely accurate.
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Affiliation(s)
- Linda Carson
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Alexandre Filipowicz
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Britt Anderson
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - James Danckert
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
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Senese VP, Zappullo I, Baiano C, Zoccolotti P, Monaco M, Conson M. Identifying neuropsychological predictors of drawing skills in elementary school children. Child Neuropsychol 2019; 26:345-361. [PMID: 31390949 DOI: 10.1080/09297049.2019.1651834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Much evidence indicates that drawing is related to different neuropsychological abilities in children. However, a comprehensive cognitive model of drawing in children is still lacking. Here, we conducted a study on the neuropsychological predictors of drawing in a sample of 142 typically developing elementary school children (M age = 8.8 years; SD = 1.1). Based on a path analysis, we examined the contribution of visual perception (matching geometrical figures), complex spatial abilities (e.g., complex figures identification and mental rotation), visual attention, working memory, verbal and visual-motor skills, as well as of gender, age and socio-economic status, to copying the Rey-Osterrieth Complex Figure (ROCF). Results showed that ROCF copying was influenced in a specific and additive way by visual perception, visual-motor coordination, and verbal abilities as well as age, while it was indirectly related to visual attention, working memory, and to complex spatial abilities. These findings provide the grounds for identifying the neuropsychological bases of drawing in elementary school children.
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Affiliation(s)
- Vincenzo Paolo Senese
- Psychometric Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Isa Zappullo
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Chiara Baiano
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Pierluigi Zoccolotti
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Neuropsychological Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marianna Monaco
- Cognitive-Behavioral School of Psychotherapy "Serapide SPEE", Naples, Italy
| | - Massimiliano Conson
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
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Conson M, Siciliano M, Baiano C, Zappullo I, Senese VP, Santangelo G. Normative data of the Rey-Osterrieth Complex Figure for Italian-speaking elementary school children. Neurol Sci 2019; 40:2045-2050. [PMID: 31111271 DOI: 10.1007/s10072-019-03929-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 05/04/2019] [Accepted: 05/09/2019] [Indexed: 11/30/2022]
Abstract
The Rey-Osterrieth Complex Figure Test (ROCF) is a widely used neuropsychological test for the evaluation of drawing disorders in different clinical populations, and, in particular, in persons with neurodevelopmental disorders. The aim of the present study is to provide normative data for ROCF copying (ROCF-Direct copy) and drawing from memory (ROCF-Immediate recall) in Italian-speaking children. The sample consisted of 348 children (147 males and 199 females), aged 7-11 years, recruited from elementary schools in Southern Italy. Normative data were gathered from 312 participants fulfilling the inclusion criteria, and estimated centiles were obtained according to the LMS method providing normalized growth centile standards. Results showed a significant effect of age on performance in both tasks, with a steady increase of drawing accuracy, whereas participants' gender and mean level of parental education did not exert any significant effect. Thus, normative data were stratified by age, and percentile scores were provided allowing a practical use of the ROCF for the clinical evaluation of drawing abilities in both typical and atypical children.
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Affiliation(s)
- Massimiliano Conson
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy.
| | - Mattia Siciliano
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy.,Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Chiara Baiano
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy
| | - Isa Zappullo
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy
| | - Vincenzo Paolo Senese
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy
| | - Gabriella Santangelo
- Developmental Neuropsychology Laboratory, Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy
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Lo Buono V, Bonanno L, Corallo F, Foti M, Palmeri R, Marra A, Di Lorenzo G, Todaro A, Bramanti P, Bramanti A, Marino S. Qualitative Analysis of Mini Mental State Examination Pentagon in Vascular Dementia and Alzheimer's Disease: A Longitudinal Explorative Study. J Stroke Cerebrovasc Dis 2018; 27:1666-1672. [PMID: 29503167 DOI: 10.1016/j.jstrokecerebrovasdis.2018.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 01/16/2018] [Accepted: 01/23/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Vascular dementia and Alzheimer's disease are the most diffuse forms of dementia. Sometimes, they are difficult to distinguish due to overlaps in symptomatology, pathophysiology, and comorbidity. Visual constructive apraxia is very common in dementia and impairment in these abilities can provide clinical information for differential diagnosis. MATERIALS AND METHODS All patients underwent Mini Mental State Examination (MMSE) at basal visit (T0) and after 1 year (T1). We analyzed differences in Qualitative Scoring Method for the Pentagon Copying Test and we explored the visual constructive apraxia evolution in these 2 types of dementia. RESULTS In intragroup analysis, we found a significant difference in each group between T0 and T1 in MMSE score (P < .001) and total qualitative scores (P < .001). In intergroup analysis, at T0, we found significance difference in total qualitative scores (P < .001), in numbers of angles (P = .005), in distance/intersection (P < .001), in closure/opening (P = .01), in rotation (P < .001), and in closing-in (P < .001). At T1, we found significance difference in total qualitative scores (P < .001), in particular, in numbers of angles (P < .001), in distance/intersection (P < .001), in closure/opening (P < .001), in rotation (P < .001), and in closing-in (P < .001). The total score showed the highest classification accuracy (.90, 95%CI = .81-0.96) in differentiating patients with Alzheimer's disease from patients with vascular dementia. The optimal threshold value was k = 5. with .84 (95%CI = .69-0.93) sensitivity and .81 (95%CI = .64-0.93) specificity. CONCLUSION Patients with vascular dementia showed more accuracy errors and graphic difficulties than patients with Alzheimer's disease. Qualitative analysis of copy provided a sensitive measure of visual constructive abilities in differentiating dementias, underlining a particularly vulnerability of visuoconstructive functions in vascular dementia compared with Alzheimer's disease.
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Affiliation(s)
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | - Maria Foti
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | - Angela Marra
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy; Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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Abstract
Since the classic papers of Kleist, Mayer Gross, and Critchley, constructional apraxia (CA) has been considered to be a typical sign of a parietal lobe lesion, and as a precious tool to appreciate the spatial abilities subserved by this lobe. However, the development of more sophisticated neuropsychologic models and methods of investigation has revealed several problematic aspects. It has become increasingly clear that CA is a heterogeneous construct that can be examined with very different tasks, that are only mildly interconnected, and tap various kinds of visuospatial, perceptual, attentional, planning, and motor mechanisms. On the basis of these considerations, the relationships between parietal lobe functions and constructional activities must be considered, taking into account on the one hand the heterogeneity of the tasks and of the cognitive functions requested by different kinds of constructional activities and, on the other hand, the plurality of functions and of processing streams linking different parts of the parietal lobes to the occipital and frontal lobes.
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Muramatsu Y, Tokita Y, Mizuno S, Nakamura M. Disparities in visuo-spatial constructive abilities in Williams syndrome patients with typical deletion on chromosome 7q11.23. Brain Dev 2017; 39:145-153. [PMID: 27692871 DOI: 10.1016/j.braindev.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/10/2016] [Accepted: 09/07/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Williams syndrome (WS) is known for its uneven cognitive abilities, especially the difficulty in visuo-spatial cognition, though there are some inter-individual phenotypic differences. It has been proposed that the difficulty in visuo-spatial cognition of WS patients can be attributed to a haploinsufficiency of some genes located on the deleted region in 7q11.23, based on an examination of atypical deletions identified in WS patients with atypical cognitive deficits. According to this hypothesis, the inter-individual differences in visuo-spatial cognitive ability arise from variations in deletion. METHODS We investigated whether there were inter-individual differences in the visuo-spatial constructive abilities of five unrelated WS patients with the typical deletion on chromosome 7q11.23 that includes the candidate genes contributing visuo-spatial difficulty in WS patients. We used tests with three-dimensional factors such as Benton's three-dimensional block construction test, which are considered to be more sensitive than those with only two-dimensional factors. RESULTS There were diverse inter-individual differences in the visuo-spatial constructive abilities among the present participants who shared the same typical genomic deletion of WS. One of the participants showed almost equivalent performances to typically developing adults in those tests. CONCLUSION In the present study, we found a wide range of cognitive abilities in visuo-spatial construction even among the patients with a common deletion pattern of WS. The findings suggest that attributing differences in the phenotypes entirely to genetic factors such as an atypical deletion may not be always correct.
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Affiliation(s)
- Yukako Muramatsu
- Department of Functioning Science, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Aichi, Japan; Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihito Tokita
- Department of Perinatology, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Aichi, Japan
| | - Seiji Mizuno
- Department of Pediatrics, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan
| | - Miho Nakamura
- Department of Functioning Science, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Aichi, Japan.
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Satoh M, Mori C, Matsuda K, Ueda Y, Tabei KI, Kida H, Tomimoto H. Improved Necker Cube Drawing-Based Assessment Battery for Constructional Apraxia: The Mie Constructional Apraxia Scale (MCAS). Dement Geriatr Cogn Dis Extra 2016; 6:424-436. [PMID: 27790241 PMCID: PMC5075750 DOI: 10.1159/000449245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background/Aims Constructional apraxia (CA) is usually diagnosed by having patients draw figures; however, the reported assessments only evaluate the drawn figure. We designed a new assessment battery for CA (the Mie Constructional Apraxia Scale, MCAS) which includes both the shape and drawing process, and investigated its utility against other assessment methods. Methods We designed the MCAS, and evaluated inter- and intrarater reliability. We also investigated the sensitivity, specificity, and positive and negative predictive values in dementia patients, and compared MCAS assessment with other reported batteries in the same subjects. Results Moderate interrater reliability was shown for speech therapists with limited experience. Moderate to substantial intrarater reliability was shown several weeks after initial assessment. When cutoff scores and times were set at 2/3 points and 39/40 s, sensitivity and specificity were 77.1 and 70.4%, respectively, with positive and negative predictive values of 80.0 and 66.7%, respectively. Dementia patients had significantly worse scores and times for Necker cube drawing than an elderly control group on the MCAS, and on other assessments. Conclusions We conclude that the MCAS, which includes both the assessment of the drawn Necker cube shape and the drawing process, is useful for detecting even mild CA.
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Affiliation(s)
- Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Chika Mori
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Kana Matsuda
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Yukito Ueda
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Ken-Ichi Tabei
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hirotaka Kida
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
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Santangelo G, Trojano L, Vitale C, Improta I, Alineri I, Meo R, Bilo L. Cognitive dysfunctions in occipital lobe epilepsy compared to temporal lobe epilepsy. J Neuropsychol 2015; 11:277-290. [DOI: 10.1111/jnp.12085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 07/24/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Gabriella Santangelo
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
- Institute for Diagnosis and Care; ‘Hermitage-Capodimonte’; Naples Italy
| | - Luigi Trojano
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
- Salvatore Maugeri Foundation; IRCCS; Scientific Institute of Telese Terme (BN); Italy
| | - Carmine Vitale
- Institute for Diagnosis and Care; ‘Hermitage-Capodimonte’; Naples Italy
- Deptartment of Motor Sciences and Wellbeing; University of Naples ‘Parthenope’; Naples Italy
| | - Ilaria Improta
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
| | - Irma Alineri
- Department of Psychology; Columbia University; New York New York USA
| | - Roberta Meo
- Neurology Outpatients Service; Naples Local Health Unit; Italy
| | - Leonilda Bilo
- Epilepsy Center; Department of Neuroscience, Reproductive and Odontostomatologic Sciences; University of Naples Federico II; Italy
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Trojano L, Siciliano M, Pedone R, Cristinzio C, Grossi D. Italian normative data for the Battery for Visuospatial Abilities (TERADIC). Neurol Sci 2015; 36:1353-61. [PMID: 25693870 DOI: 10.1007/s10072-015-2114-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/09/2015] [Indexed: 11/24/2022]
Abstract
Battery for Visuospatial Abilities (BVA, known in Italy as TeRaDiC) has been developed to analyse putative basic skills involved in drawing and to plan and monitor outcomes after rehabilitation of visuoconstructional disorders. It encompasses eight tasks assessing both simple "perceptual" abilities, such as line length and line orientation judgments and complex "representational" abilities, such as mental rotation. The aim of present study was to provide normative values for BVA collected in a wide sample of healthy Italian subjects. Three hundred seventeen healthy Italian subjects (173 women and 144 men) of different age classes (age range, 40-95 years) and education level (from primary to university), with a normal score on Mini Mental State Examination, completed BVA/TeRaDiC. Multiple linear regression analysis revealed that age and education significantly influenced performance on most tests of the BVA/TeRaDiC; only line length judgment was not affected by educational level. Gender significantly affected line orientation judgment and mental rotation, with an advantage for males in both tests. From the derived linear equations, a correction grid for adjusting BVA/TeRaDiC raw scores was built. Using a non-parametric technique, inferential cut-off scores were determined and equivalent scores computed. The present study provided Italian normative data for the BVA/TeRaDiC useful for both clinical and research purposes.
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Affiliation(s)
- Luigi Trojano
- Department of Psychology, Neuropsychology Lab, Second University of Naples, Viale Ellittico 31, 81100, Caserta, Italy,
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Likova LT. Temporal evolution of brain reorganization under cross-modal training: Insights into the functional architecture of encoding and retrieval networks. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9394:939417. [PMID: 31423042 PMCID: PMC6697260 DOI: 10.1117/12.2178069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study is based on the recent discovery of massive and well-structured cross-modal memory activation generated in the primary visual cortex (V1) of totally blind people as a result of novel training in drawing without any vision (Likova, 2012). This unexpected functional reorganization of primary visual cortex was obtained after undergoing only a week of training by the novel Cognitive-Kinesthetic Method, and was consistent across pilot groups of different categories of visual deprivation: congenitally blind, late-onset blind and blindfolded (Likova, 2014). These findings led us to implicate V1 as the implementation of the theoretical visuo-spatial 'sketchpad' for working memory in the human brain. Since neither the source nor the subsequent 'recipient' of this non-visual memory information in V1 is known, these results raise a number of important questions about the underlying functional organization of the respective encoding and retrieval networks in the brain. To address these questions, an individual totally blind from birth was given a week of Cognitive-Kinesthetic training, accompanied by functional magnetic resonance imaging (fMRI) both before and just after training, and again after a two-month consolidation period. The results revealed a remarkable temporal sequence of training-based response reorganization in both the hippocampal complex and the temporal-lobe object processing hierarchy over the prolonged consolidation period. In particular, a pattern of profound learning-based transformations in the hippocampus was strongly reflected in V1, with the retrieval function showing massive growth as result of the Cognitive-Kinesthetic memory training and consolidation, while the initially strong hippocampal response during tactile exploration and encoding became non-existent. Furthermore, after training, an alternating patch structure in the form of a cascade of discrete ventral regions underwent radical transformations to reach complete functional specialization in terms of either encoding or retrieval as a function of the stage of learning. Moreover, several distinct patterns of learning-evolution within the patches as a function of their anatomical location, implying a complex reorganization of the object processing sub-networks through the learning period. These first findings of complex patterns of training-based encoding/retrieval reorganization thus have broad implications for a newly emerging view of the perception/memory interactions and their reorganization through the learning process. Note that the temporal evolution of these forms of extended functional reorganization could not be uncovered with conventional assessment paradigms used in the traditional approaches to functional mapping, which may therefore have to be revisited. Moreover, as the present results are obtained in learning under life-long blindness, they imply amodal operations, transcending the usual tight association with visual processing. The present approach of memory drawing training in blindness, has the dual-advantage of being both non-visual and causal intervention, which makes it a promising 'scalpel' to disentangle interactions among diverse cognitive functions.
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Parente A, Giovagnoli AR. Crossed aphasia and preserved visuospatial functions in logopenic variant primary progressive aphasia. J Neurol 2014; 262:216-8. [PMID: 25380584 DOI: 10.1007/s00415-014-7562-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/20/2014] [Accepted: 10/24/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Annalisa Parente
- Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria 11, 20133, Milan, Italy,
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Biesbroek JM, van Zandvoort MJE, Kuijf HJ, Weaver NA, Kappelle LJ, Vos PC, Velthuis BK, Biessels GJ, Postma A. The anatomy of visuospatial construction revealed by lesion-symptom mapping. Neuropsychologia 2014; 62:68-76. [PMID: 25062545 DOI: 10.1016/j.neuropsychologia.2014.07.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 06/09/2014] [Accepted: 07/14/2014] [Indexed: 12/01/2022]
Abstract
Visuospatial construction is a complex cognitive operation that is composed of a purely constructional component (visuoconstruction proper), and visuoperceptive, attentional, and decision-making components. The anatomical correlates of visuospatial construction and its cognitive subcomponents are poorly understood. The purpose of the present study was to determine the anatomical correlates of visuospatial construction by applying lesion-symptom mapping in a cohort of 111 patients with first-ever ischemic stroke. We employed the Rey-Osterrieth Complex Figure (ROCF) copy test and the Judgment of Line Orientation (JLO); both tests measure visuoperception, while only the ROCF has a constructional component. We first performed assumption-free voxel-based lesion-symptom mapping, which revealed large shared right hemispheric correlates for the ROCF and JLO in the frontal lobe, superior temporal lobe, and supramarginal gyrus. These shared anatomical correlates reflect the visuoperceptive component of the ROCF and JLO. Anatomical correlates were discordant in the right superior parietal lobule, and angular and middle occipital gyri: lesions in these regions were associated with poor performance on the ROCF, but not the JLO. Secondly, these findings were reproduced with a region of interest-based analysis that yielded a statistically significant correlation between infarct volume in the right inferior and superior parietal, angular and middle occipital cortices, and poor performance on the ROCF, but not the JLO. This discordance in anatomical correlates of the ROCF and JLO reflects the visuoconstructive component of the ROCF. These findings provide new insights in the anatomical correlates of the visuoperceptive and visuoconstructive components of the ROCF and provide evidence for a crucial role of the right inferior and superior parietal, angular and middle occipital gyri in visuoconstruction proper.
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Affiliation(s)
- J Matthijs Biesbroek
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands.
| | | | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nick A Weaver
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands
| | - L Jaap Kappelle
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands
| | - Pieter C Vos
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Birgitta K Velthuis
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands
| | - Albert Postma
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, The Netherlands
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Roth HL, Bauer RM, Crucian GP, Heilman KM. Frontal-executive constructional apraxia: when delayed recall is better than copying. Neurocase 2014; 20:283-95. [PMID: 23581561 DOI: 10.1080/13554794.2013.770879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED In assessments of visuospatial function and memory, patients are often required to copy a figure and later to reproduce that figure from memory. Whereas most people perform better on a copying task than when drawing from memory, in this study we describe an unusual pattern of performance in which patients are better at drawing from memory than copying. Consecutive patients in a neurocognitive disorders clinic were given a battery of clinical cognitive tests that included copying a figure of intersecting pentagons and then drawing the figure from memory. Patterns of drawing performance at the two time points were compared to the profile of other cognitive deficits. RESULTS A subgroup of four patients with frontal dysfunction showed marked improvement in drawings at a delay compared to copying. Prior studies have indicated that most patients have declines in drawing performance at a delay. The unusual pattern of better performance at a delay compared to an initial copy occurred in patients with frontal dysfunction. These patients' visuoconstructive deficit and subsequent improvement could be related to either a failure to disengage when a model is present, to memory consolidation with increased reliance on top-down processing in the delay condition, or to relative preservation of global versus local aspects of a stimulus in memory. The addition of a task to assess drawing after a delay to a standard clinical screening battery such as the Mini-Mental Status Examination (MMSE) provides the opportunity to evaluate this phenomenon that may be indicative of frontal-executive dysfunction.
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Affiliation(s)
- Heidi L Roth
- a Department of Neurology , University of North Carolina , Chapel Hill , NC , USA
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Cognitive profile of patients with rotated drawing at copy or recall: A controlled group study. Brain Cogn 2014; 85:286-90. [DOI: 10.1016/j.bandc.2014.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 01/08/2014] [Accepted: 01/13/2014] [Indexed: 11/18/2022]
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Abstract
Closing-in (CI) refers to copying drawings near to or superimposed on the original model, and is often observed in Alzheimer's disease (AD) patients. Contrasting hypotheses have been suggested to explain CI, but no prospective study has directly verified these interpretations. We evaluated the role of frontal/executive versus visuo-spatial impairments in a prospective sample of AD patients, and also explored whether different types of CI are related to specific neuropsychological tasks. We enrolled 64 AD patients who underwent copying tasks and an extensive neuropsychological assessment of visuo-spatial and visuo-constructional skills, frontal/executive abilities and anterograde memory. AD patients with CI showed more severe impairment on frontal/executive functions than AD patients without CI. Moreover, the tendency to produce copies superimposed on the model was selectively associated with poor inhibitory control for irrelevant responses. On this basis, we suggest that different CI phenomena could be ascribed to distinctive frontal/executive defects.
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Neuropsychological profile of adult patients with nonsymptomatic occipital lobe epilepsies. J Neurol 2012; 260:445-53. [DOI: 10.1007/s00415-012-6650-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 07/12/2012] [Accepted: 08/03/2012] [Indexed: 11/08/2022]
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Makuuchi M. fMRI studies on drawing revealed two new neural correlates that coincide with the language network. Cortex 2010; 46:268-9. [DOI: 10.1016/j.cortex.2009.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Revised: 08/21/2008] [Accepted: 02/16/2009] [Indexed: 11/29/2022]
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Heart rate variability and drawing impairment in hypoxemic COPD. Brain Cogn 2009; 70:163-70. [DOI: 10.1016/j.bandc.2009.01.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 01/23/2009] [Accepted: 01/28/2009] [Indexed: 12/30/2022]
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