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Elkana O. Navigating the "frontal lobe paradox": integrating Real-Life Tasks (RLTs) approach into neuropsychological evaluations. Front Psychol 2024; 15:1394483. [PMID: 38774722 PMCID: PMC11106461 DOI: 10.3389/fpsyg.2024.1394483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/12/2024] [Indexed: 05/24/2024] Open
Affiliation(s)
- Odelia Elkana
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel
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2
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Hernández-Martínez AE, Serrano-Juárez CA, Barrera-Medellín KG, Ramírez-Quiroga CI, Ramírez-Reyes AG, Casarrubias Islas R, Prieto-Corona B. Partial Klüver-Bucy syndrome in a Paediatric patient: A post-neurosurgical and neuropsychological cases. J Neuropsychol 2024; 18 Suppl 1:61-72. [PMID: 37139904 DOI: 10.1111/jnp.12320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 05/05/2023]
Abstract
A variety of cognitive, behavioural, and emotional impairments have been reported in the literature that are associated with the resection of the temporal cortex. Klüver-Bucy syndrome is one infrequently reported disorder in the paediatric population. This paper describes the neuropsychological findings of a female paediatric patient at 7 and 10 years of age with a diagnosis of partial Klüver-Bucy syndrome (pKBS) following total resection of the amygdala and right hippocampus to resect a glioma. The patient presented emotional problems, aggressiveness, hypermetamorphosis, social indifference, and behavioural dysexecutive syndrome, which was found at both 7 and 10 years, but with a decrease in the severity of alterations in attention, impulsivity, hyperactivity, and aggressive behaviour in a second evaluation after she had a neuropsychological intervention. These findings describe the neuropsychological profile of paediatric case with resection of the amygdala and right temporal lobe.
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Affiliation(s)
| | | | | | | | - Alma Griselda Ramírez-Reyes
- Servicio de Neurocirugía, Hospital de Pediatría "Dr. Silvestre Frenk Freund", IMSS, Ciudad de México, Mexico
| | - Roberto Casarrubias Islas
- Servicio de Neurocirugía, Hospital de Pediatría "Dr. Silvestre Frenk Freund", IMSS, Ciudad de México, Mexico
| | - Belén Prieto-Corona
- Residencia en Neuropsicología Clínica, Facultad de Estudios Superiores Iztacala, UNAM, Ciudad de México, Mexico
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3
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Warren S, Drake J, Wu CK. Cognitive Complications of COVID-19 Infection. R I Med J (2013) 2022; 105:27-30. [PMID: 35930487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
SARS-CoV-2 is associated with a post-infectious neurocognitive syndrome characterized by fatigue and deficits in attention, memory, and executive function. As screening cognitive testing generally remains normal, the pathophysiologic basis of these symptoms remains controversial and there is no standardized treatment paradigm. We present a clinical case demonstrative of typical neurocognitive sequelae of SARS-CoV-2 infection, highlighting medical and social factors that may have contributed to the severity of symptoms. We discuss the pathophysiologic evidence for cognitive "brain fog" following COVID-19 infection as well as lifestyle changes and rehabilitation strategies that may improve recovery. As the benefits of pharmacologic therapy remain unproven, we close with a brief discussion of medication options that might be appropriate targets for future clinical trials in the context of rehabilitative treatment.
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Affiliation(s)
- Scott Warren
- Department of Neurology, Brown University, Providence, Rhode Island
| | - Jonathan Drake
- Department of Neurology, Brown University, Providence, Rhode Island
| | - Chuang-Kuo Wu
- Department of Neurology, Brown University, Providence, Rhode Island
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4
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Migliore S, D'Aurizio G, Maffi S, Ceccarelli C, Ristori G, Romano S, Castaldo A, Mariotti C, Curcio G, Squitieri F. Cognitive and behavioral associated changes in manifest Huntington disease: A retrospective cross-sectional study. Brain Behav 2021; 11:e02151. [PMID: 34110097 PMCID: PMC8323039 DOI: 10.1002/brb3.2151] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Behavioral and cognitive changes can be observed across all Huntington disease (HD) stages. Our multicenter and retrospective study investigated the association between cognitive and behavioral scale scores in manifest HD, at three different yearly timepoints. METHODS We analyzed cognitive and behavioral domains by the Unified Huntington's Disease Rating Scale (UHDRS) and by the Problem Behaviors Assessment Short Form (PBA-s), at three different yearly times of life (t0 or baseline, t1 after one year, t2 after two years), in 97 patients with manifest HD (mean age 48.62 ± 13.1), from three ENROLL-HD Centers. In order to test the disease progression, we also examined patients' motor and functional changes by the UHDRS, overtime. RESULTS The severity of apathy and of perseveration/obsession was associated with the severity of the cognitive decline (p < .0001), regardless of the yearly timepoint. The score of irritability significantly and positively correlated with perseveration errors in the verbal fluency test at t0 (r = .34; p = .001), while the psychosis significantly and negatively correlated with the information processing speed at t0 (r = -.21; p = .038) and significantly and positively correlated with perseveration errors in the verbal fluency test at t1 (r = .35; p < .0001). The disease progression was confirmed by the significant worsening of the UHDRS-Total Motor Score (TMS) and of the UHDRS-Total Functional Capacity (TFC) scale score after two-year follow-up (p < .0001). CONCLUSION Although the progression of abnormal behavioral manifestations cannot be predicted in HD, the severity of apathy and perseveration/obsessions are significantly associated with the severity of the cognitive function impairment, thus contributing, together, to the disease development and to patients' loss of independence, in addition to the neurological manifestations. This cognitive-behavior pattern determines a common underlying deficit depending on a dysexecutive syndrome.
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Affiliation(s)
- Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Sabrina Maffi
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Consuelo Ceccarelli
- Italian League for Research on Huntington and Related Diseases (LIRH) Foundation, Rome, Italy
| | - Giovanni Ristori
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Centre for Experimental Neurological Therapies, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Silvia Romano
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Centre for Experimental Neurological Therapies, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Anna Castaldo
- Department of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Caterina Mariotti
- Department of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
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5
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He W, Ji Y, Wei X, Wang F, Xu F, Lu C, Ma Q, Wang K. Eye Movement Technique to Improve Executive Function in Patients With Stroke: A Randomized Controlled Trial. Front Neurol 2021; 12:599850. [PMID: 33776878 PMCID: PMC7988201 DOI: 10.3389/fneur.2021.599850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/17/2021] [Indexed: 12/04/2022] Open
Abstract
Objective: To investigate the efficacy of eye movement technique for the treatment of executive dysfunction of patients with stroke. Methods: This was a prospective, single-blinded, randomized, controlled, single-center clinical trial conducted from June 2018 to December 2019 in patients with stroke. The patients were randomized 1:1 to the routine (conventional management) and eye-move group (routine management plus eye movement technique: 5-min goal management training, 5-min computer-aided working memory, and 10 min of inhibitory control training and set conversion training). The intervention lasted 6 weeks, followed by a 4-week follow-up. The primary endpoint was the Behavioral Assessment of the Dysexecutive Syndrome (BADS) score. The secondary endpoints mainly included the Montreal Cognitive Assessment (MoCA), Wisconsin Card Sorting Test (WCST), and modified Barthel Index (MBI) scores. Results: Sixty-four patients were enrolled (32/group). After the 6-week intervention, the BADS and WCST scores of the eye-move group were significantly improved than those of the routine group (all P < 0.05), but the effects were attenuated in certain subscores after follow-up (all P > 0.05). The MoCA and MBI scores of the eye-move group were significantly higher, and the reaction time was significantly lower than those of the routine group at 4 weeks after the intervention (all P < 0.05). After follow-up, the MBI scores of the eye-move group were still higher than that of the routine group (P < 0.001), but there were no differences for MoCA scores and reaction time (both P > 0.05). Conclusion: The eye movement technique could improve the executive function of patients with stroke. These results have to be confirmed. This was a prospective, single-blinded, randomized, controlled, single-center clinical trial (ChiCTR2000036393). Clinical Trial Registration: [www.chictr.org.cn], identifier [ChiCTR2000036393].
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Affiliation(s)
- Wen He
- Rehabilitation Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Yazheng Ji
- Rehabilitation Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Xiating Wei
- Rehabilitation Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Fan Wang
- Rehabilitation Treatment Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Feng Xu
- Rehabilitation Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Chengyi Lu
- Rehabilitation Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Qianqian Ma
- Rehabilitation Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
| | - Kai Wang
- Rehabilitation Department, Shanghai Fourth Rehabilitation Hospital, Shanghai, China
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6
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Ruiz-Castañeda P, Santiago-Molina E, Aguirre-Loaiza H, Daza González MT. " Cool" and " Hot" Executive Functions in Patients With a Predominance of Negative Schizophrenic Symptoms. Front Psychol 2020; 11:571271. [PMID: 33250814 PMCID: PMC7674804 DOI: 10.3389/fpsyg.2020.571271] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/06/2020] [Indexed: 02/01/2023] Open
Abstract
Background Patients with psychosis often present significant neurocognitive deficits, with executive function deficits (EEFF) being one of the most relevant cognitive impairments with the greatest impact on the functioning of their daily lives. However, although various findings of executive involvement were reported, it is not entirely clear whether there is a differential pattern of involvement according to the clinical symptoms or the deficits occur in all or only in some subcomponents of EEFF. Objective The present study had a double objective: to study the specific deficits in the cool and hot EEFF in a group of psychotic patients with a predominance of negative symptoms; and determine the possible associations between the performance of the patients in the cool an hot EEFF tasks with the negative symptoms, and with the behavioral alterations associated with the dysexecutive syndrome. Method 66 participants, 33 psychotic patients with a predominance of negative symptoms and 33 healthy control subjects matched in gender, age and educational level participated. Both groups were administered 4 cool EEFF tasks (coding/maintenance and updating of information in working memory, ability to change the mental set and planning), and 3 hot EEFF tasks (decision making in situations of uncertainty, recognition of emotions through facial expressions and theory of mind). In the group of patients, the Negative symptoms were evaluated through the Scale for the Evaluation of Negative Symptoms (SANS), and the behavioral alterations associated with dysexecutive syndrome through the subscale of "Executive Dysfunction" of the Frontal Systems Behavior Scale. Results Patients performed worse on three cool EEFF tasks and on two of the hot EEFF tasks. Additionally, we found a correlation between the SANS score and the "executive dysfunction" subscale, with the cold EEFF task that measures planning. Conclusion Our findings showed that in psychotic patients with a predominance of negative symptoms, both, the cognitive (cool) and emotional (hot) components of executive functions are affected. The results reinforce the need for a cognitive rehabilitation treatment of the executive components of the working memory and of those more socio-emotional aspects.
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Affiliation(s)
- Pamela Ruiz-Castañeda
- Neuropsychological Evaluation and Rehabilitation Center, University of Almería, Almeria, Spain.,Department of Psychology, University of Almería, Almeria, Spain
| | | | | | - María Teresa Daza González
- Neuropsychological Evaluation and Rehabilitation Center, University of Almería, Almeria, Spain.,Department of Psychology, University of Almería, Almeria, Spain
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7
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Werner-Seidler A, Dahm T, Golden AM, Manly T, Dalgleish T. Personally salient, emotionally negative task contexts provoke goal neglect in depression. Psychol Med 2020; 50:874-880. [PMID: 31057139 PMCID: PMC7168650 DOI: 10.1017/s0033291719000886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 12/18/2018] [Accepted: 04/02/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Goal neglect refers to a dissociation between intended and actual action. Although commonly associated with frontal brain damage, this phenomenon is also characteristic of clinical depression. To date, tests of goal neglect typically require individuals to switch between subtasks populated with neutral stimuli. This study examined the impact of affective and personally salient stimulus contexts on goal neglect in clinical depression. METHODS Participants were randomly allocated to either positively or negatively-valenced versions of the Affective Six Elements Test (A-SET). We hypothesised that depressed individuals (n = 30) would exhibit an overall impairment in A-SET performance by neglecting entire subtasks and allocating suboptimal time to each task, relative to never-depressed peers (n = 30), with effects being strongest for the negatively-valenced version. RESULTS Findings showed that depressed individuals exhibited specific deficits, relative to controls on these measures in the negative A-SET only, with a magnitude comparable to that found in brain injured patients. CONCLUSIONS Individuals with depression are impaired in their ability to monitor performance and implement strategies that are optimal for the purpose of pursuing an overarching goal when the task context is negatively-valenced. Potential mechanisms are discussed.
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Affiliation(s)
- Aliza Werner-Seidler
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Theresa Dahm
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Ann-Marie Golden
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Tom Manly
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
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8
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Liang YY, Wang L, Yang Y, Chen Y, Mok VCT, Ungvari GS, Chu WCW, Kim JS, Tang WK. Association Between Behavioral Dysexecutive Syndrome and the Health-Related Quality of Life Among Stroke Survivors. Front Psychiatry 2020; 11:563930. [PMID: 33101083 PMCID: PMC7506061 DOI: 10.3389/fpsyt.2020.563930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022] Open
Abstract
AIM Behavioral dysexecutive syndrome (BDES) is one common neuropsychiatric comorbidity after stroke. Despite evidences suggesting the adverse effect of BDES on the survivors' outcome, little is known about the association between BDES and the health-related quality of life (HRQoL) among stroke survivors and how BDES impacts the HRQoL. This study aimed to address these questions. METHODS This study included 219 patients with acute ischemic stroke consecutively admitted to a regional hospital in Hong Kong. BDES was defined as a Chinese version of the Dysexecutive Questionnaire (DEX) score of ≥20 assessed at three months after stroke. The HRQoL was assessed with the Chinese version of the Stroke-Specific Quality of Life (SSQoL) questionnaire encompassing 12 domains. Multivariate linear regression models were employed to examine the association between BDES symptoms and the SSQoL total and domain scores. Structural equation model (SEM) was further constructed to delineate the linking pathways linking BDES and the HRQoL. RESULTS The study sample compromised mainly older patients with mild to moderate ischemic stroke. Compared with patients without BDES, those with BDES exhibited poorer performances regarding with the summarized SSQoL (226.2 ± 18.8 vs. 200.3 ± 29.8, p < 0.001) and almost all domains. The BDES symptoms were independently contributed to the whole HRQoL (SSQoL total score) (β = -0.20, p = 0.002), specifically to the domains in personality (β = -0.34, p < 0.001), language (β = -0.22, p = 0.01), and work/productivity (β = -0.32, p < 0.001), after adjusting demographic and clinical characteristics in linear models. The impacts of the BDES symptoms on the HRQoL were mainly explained by the indirect path mediated by depression and anxiety (path coefficient = -0.27, p < 0.05) rather than physical disability, while the resting was elucidated by the path directly linking BDES to the HRQoL (path coefficient = -0.17, p < 0.05). CONCLUSION The present study preliminarily demonstrated a potential association between BDES and a lower level of the HRQoL, predominantly in domains of personality, language, and work/productivityafter acute ischemic stroke. This study also offered insights into the underlying mechanisms linking BDES and the HRQoL, implicating that integrative psychological therapies were urged to achieve better HRQoL after stroke.
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Affiliation(s)
- Yannis Yan Liang
- Stroke Center and Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Lisha Wang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ying Yang
- Stroke Center and Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yangkun Chen
- Department of Neurology, Dongguan People's Hospital, Dongguan, China
| | - Vincent C T Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Gabor S Ungvari
- University of Notre Dame Australia/Graylands Hospital, Perth, WA, Australia
| | - Winnie C W Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jong S Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Wai-Kwong Tang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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9
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Andriuta D, Roussel M, Barbay M, Despretz-Wannepain S, Godefroy O. Differentiating between Alzheimer's Disease and Vascular Cognitive Impairment: Is the "Memory Versus Executive Function" Contrast Still Relevant? J Alzheimers Dis 2019; 63:625-633. [PMID: 29689726 DOI: 10.3233/jad-171097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The contrast between memory versus executive function impairments is commonly used to differentiate between neurocognitive disorders (NCDs) due to Alzheimer's disease (AD) and vascular cognitive impairment (VCI). We reconsidered this question because of the current use of AD biomarkers and the recent revision of the criteria for AD, VCI, and dysexecutive syndrome. OBJECTIVE To establish and compare the neuropsychological profiles in AD (i.e., with positive CSF biomarkers) and in VCI. METHODS We included 62 patients with mild or major NCDs due to pure AD (with positive CSF biomarker assays), and 174 patients (from the GRECogVASC cohort) with pure VCI. The neuropsychological profiles were compared after stratification for disease severity (mild or major NCD). We defined a memory-executive function index (the mean z score for the third free recall and the delayed free recall in the Free and Cued Selective Reminding Test minus the mean z score for category fluency and the completion time in the Trail Making Test part B) and determined its diagnostic accuracy. RESULTS Compared with VCI patients, patients with AD had significantly greater memory impairments (p = 0.001). Executive function was impaired to a similar extent in the two groups (p = 0.11). Behavioral executive disorders were more prominent in the AD group (p = 0.001). Although the two groups differed significant with regard to the memory-executive function index (p < 0.001), the latter's diagnostic accuracy was only moderate (sensitivity: 63%, specificity: 87%). CONCLUSION Although the contrast between memory and executive function impairments was supported at the group level it does not reliably discriminate between AD and VCI at the individual level.
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Affiliation(s)
- Daniela Andriuta
- Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Hospital, France
| | - Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Hospital, France
| | - Mélanie Barbay
- Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Hospital, France
| | | | - Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Hospital, France
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10
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Endres D, Süß P, Maier SJ, Friedel E, Nickel K, Ziegler C, Fiebich BL, Glocker FX, Stock F, Egger K, Lange T, Dacko M, Venhoff N, Erny D, Doostkam S, Komlosi K, Domschke K, Tebartz van Elst L. New Variant of MELAS Syndrome With Executive Dysfunction, Heteroplasmic Point Mutation in the MT-ND4 Gene (m.12015T>C; p.Leu419Pro) and Comorbid Polyglandular Autoimmune Syndrome Type 2. Front Immunol 2019; 10:412. [PMID: 30949164 PMCID: PMC6437310 DOI: 10.3389/fimmu.2019.00412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 02/15/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Mitochondrial diseases are caused by dysfunctions in mitochondrial metabolic pathways. MELAS syndrome is one of the most frequent mitochondrial disorders; it is characterized by encephalopathy, myopathy, lactic acidosis, and stroke-like episodes. Typically, it is associated with a point mutation with an adenine-to-guanine transition at position 3243 of the mitochondrial DNA (mtDNA; m.3243A>G) in the mitochondrially encoded tRNA leucine 1 (MT-TL1) gene. Other point mutations are possible and the association with polyglandular autoimmune syndrome type 2 has not yet been described. Case presentation: We present the case of a 25-year-old female patient with dysexecutive syndrome, muscular fatigue, and continuous headache. Half a year ago, she fought an infection-triggered Addison crisis. As the disease progressed, she had two epileptic seizures and stroke-like episodes with hemiparesis on the right side. Cerebral magnetic resonance imaging showed a substance defect of the parieto-occipital left side exceeding the vascular territories with a lactate peak. The lactate ischemia test was clearly positive, and a muscle biopsy showed single cytochrome c oxidase-negative muscle fibers. Genetic testing of blood mtDNA revealed a heteroplasmic base exchange mutation in the mitochondrially encoded NADH:ubiquinone oxidoreductase core subunit 4 (MT-ND4) gene (m.12015T>C; p.Leu419Pro; heteroplasmy level in blood 12%, in muscle tissue: 15%). The patient suffered from comorbid autoimmune polyglandular syndrome type 2 with Hashimoto's thyroiditis, Addison's disease, and autoimmune gastritis. In addition, we found increased anti-glutamic acid decarboxylase 65, anti-partial cell, anti-intrinsic factor, and anti-nuclear antibodies. Conclusion: We present an atypical case of MELAS syndrome with predominant symptoms of a dysexecutive syndrome, two stroke-like episodes, and fast-onset fatigue. The symptoms were associated with a not yet described base and aminoacid exchange mutation in the MT-ND4 gene (m.12015T>C to p.Leu419Pro). The resulting changed protein complex in our patient is part of the respiratory chain multicomplex I and might be the reason for the mitochondriopathy. However, different simulations for pathogenetic relevance are contradictory and rather speak for a benign variant. To our knowledge this case report is the first reporting MELAS syndrome with comorbid polyglandular autoimmune syndrome type 2. Screening for autoimmune alterations in those patients is important to prevent damage to end organs.
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Affiliation(s)
- Dominique Endres
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Patrick Süß
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon J Maier
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Evelyn Friedel
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christiane Ziegler
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd L Fiebich
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Franz X Glocker
- Department of Neurology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Friedrich Stock
- Institute of Human Genetics, University Hospital Muenster, Muenster, Germany
| | - Karl Egger
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Lange
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Dacko
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nils Venhoff
- Department of Rheumatology and Clinical Immunology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Daniel Erny
- Institute of Neuropathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Soroush Doostkam
- Institute of Neuropathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katalin Komlosi
- Institute of Human Genetics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Abstract
The aim of this study was to investigate the relation between cognitive and behavioral symptoms of dysexecutive functioning, understood as two aspects of dysexecutive syndrome, in an elderly nonclinical sample. Most previous studies have concentrated on clinical population. However, nonclinical population of elderly adults is, in this context, a group of special interest due to a large body of evidence indicating that executive functions decrease pronouncedly in the course of normal aging. The data were collected from 40 participants aged 67-86 years. None presented symptoms of cognitive disorder or depression or reported psychiatric or neurological problems. The Dysexecutive Questionnaire was used as a measure of behavioral aspect of dysexecutive syndrome. Participants also performed experimental tasks referring to three cognitive aspects of executive functioning (i.e., updating, inhibition, and attentional shifting). Analysis resulted in weak and nonsignificant correlations between cognitive and behavioral aspects of dysexecutive syndrome. Results are discussed in the context of previous research and diagnostic criteria of dysexecutive syndrome.
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12
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Bargiotas I, Moreau A, Vienne A, Bompaire F, Baruteau M, de Laage M, Campos M, Psimaras D, Vayatis N, Labourdette C, Vidal PP, Ricard D, Buffat S. Balance Impairment in Radiation Induced Leukoencephalopathy Patients Is Coupled With Altered Visual Attention in Natural Tasks. Front Neurol 2019; 9:1185. [PMID: 30728804 PMCID: PMC6351469 DOI: 10.3389/fneur.2018.01185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 12/21/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Recent studies have shown that alterations in executive function and attention lead to balance control disturbances. One way of exploring the allocation of attention is to record eye movements. Most experimental data come from a free viewing of static scenes but additional information can be leveraged by recording eye movements during natural tasks. Here, we aimed to provide evidence of a correlation between impaired visual alteration in natural tasks and postural control in patients suffering from Radiation-Induced Leukoencephalopathy (RIL). Methods: The study subjects were nine healthy controls and 10 patients who were diagnosed with RIL at an early stage, with isolated dysexecutive syndrome without clinically detectable gait or posture impairment. We performed a balance evaluation and eye movement recording during an ecological task (reading a recipe while cooking). We calculated a postural score and oculomotor parameters already proposed in the literature. We performed a variable selection using an out-of-bag random permutation and a random forest regression algorithm to find: (i) if visual parameters can predict postural deficit and, (ii) which are the most important of them in this prediction. Results were validated using the leave-one-out cross-validation procedure. Results: Postural scores indeed were found significantly lower in patients with RIL than in healthy controls. Visual parameters were found able to predict the postural score of RIL patients with normalized root mean square error (RMSE) of 0.16. The present analysis showed that horizontal and vertical eye movements, as well as the average duration of the saccades and fixations influenced significantly the prediction of the postural score in RIL patients. While two patients with very low MATTIS-Attention sub score showed the lowest postural scores, no statistically significant relationship was found between the two outcomes. Conclusion: These results highlight the significant relationship between the severity of balance deficits and the visual characteristics in RIL patients. It seems that increased balance impairment is coupled with a reduced focusing capacity in ecological tasks. Balance and eye movement recordings during a natural task could be a useful aspect of multidimensional scoring of the dysexecutive syndrome.
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Affiliation(s)
- Ioannis Bargiotas
- UMR 8257 Cognition and Action Group (CNRS, Service de Santé des Armées, Université Paris Descartes Paris Sorbonne Cité), Paris, France.,CMLA, ENS Cachan, CNRS, Université Paris-Saclay, Cachan, France
| | - Albane Moreau
- Service de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Alienor Vienne
- UMR 8257 Cognition and Action Group (CNRS, Service de Santé des Armées, Université Paris Descartes Paris Sorbonne Cité), Paris, France
| | - Flavie Bompaire
- Service de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France.,OncoNeuroTox Center, Paris, France
| | - Marie Baruteau
- Service de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France.,OncoNeuroTox Center, Paris, France
| | - Marie de Laage
- Service de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Matéo Campos
- Service de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France
| | - Dimitri Psimaras
- Service de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France.,OncoNeuroTox Center, Paris, France
| | - Nicolas Vayatis
- CMLA, ENS Cachan, CNRS, Université Paris-Saclay, Cachan, France
| | | | - Pierre-Paul Vidal
- UMR 8257 Cognition and Action Group (CNRS, Service de Santé des Armées, Université Paris Descartes Paris Sorbonne Cité), Paris, France.,School of Automation, Hangzhou Dianzi University, Zhejiang, China
| | - Damien Ricard
- UMR 8257 Cognition and Action Group (CNRS, Service de Santé des Armées, Université Paris Descartes Paris Sorbonne Cité), Paris, France.,Service de neurologie, Hôpital d'Instruction des Armées Percy, Service de Santé des Armées, Clamart, France.,OncoNeuroTox Center, Paris, France.,Ecole du val de Grâce, Service de Santé des Armées, Paris, France
| | - Stéphane Buffat
- UMR 8257 Cognition and Action Group (CNRS, Service de Santé des Armées, Université Paris Descartes Paris Sorbonne Cité), Paris, France.,OncoNeuroTox Center, Paris, France.,Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
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13
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Simpson JA, Lovecky D, Kogan J, Vetter LA, Yohrling GJ. Survey of the Huntington's Disease Patient and Caregiver Community Reveals Most Impactful Symptoms and Treatment Needs. J Huntingtons Dis 2017; 5:395-403. [PMID: 27983566 DOI: 10.3233/jhd-160228] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In preparation for a meeting with the U.S. Food and Drug Administration (FDA) on Patient-Focused Drug Development in Huntington's disease, the Huntington's Disease Society of America (HDSA) created and distributed two comprehensive surveys on the symptom experience and treatment approaches for Huntington's disease. OBJECTIVE The objective of these surveys was to identify the specific symptoms that most impact the daily lives of individuals with Huntington's disease/Juvenile Huntington's disease (HD/JHD) and their caregivers and to solicit input on the types of treatments desired by HD affected families. The data were shared with the FDA to offer background and insight in preparation for the patient-focused meeting, as well as to ensure representation by the community in a manner that would complement those who attended in person. METHODS Two distinct surveys were created using SurveyMonkey to capture patient and caregiver perspectives on HD symptoms and current treatments. HDSA distributed the surveys to the HD community in August and September 2014 and collected responses through January 2015. RESULTS More than 3,600 responses to the two surveys were received. The data showed that both caregivers and individuals with HD were severely impacted by the cognitive and behavioral symptoms of HD with HD patients reporting problems with executive functioning and cognitive decline as most impactful to them. However, 30 percent of caregivers reported that chorea was the most impactful symptom compared to 17 percent of people with HD. Across all the symptom categories, patients reported a lower occurrence of symptoms than were reported by their caregivers. CONCLUSIONS With only one drug approved for treatment of a symptom of Huntington's disease and no disease modifying treatments available, there is a critical need for new medicines to treat the cognitive, psychiatric and motor symptoms associated with HD. While the surveys did not capture risk/benefit data, the data collected do provide new insights around the different perspectives of patients and caregivers. We believe that industry development of treatments would be well-informed by incorporating the patient community, which is more knowledgeable and engaged than given credit, in consideration of treatment regimens, risk-benefit and priorities for therapeutic development.
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Affiliation(s)
| | - Debra Lovecky
- Huntington's Disease Society of America (HDSA), New York, NY, USA
| | - Jane Kogan
- American Board of Perianesthesia Nursing Certification, Inc., New York, NY, USA
| | - Louise A Vetter
- Huntington's Disease Society of America (HDSA), New York, NY, USA
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14
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Abstract
It is proposed that depending upon the specific pattern of cognitive abilities, each individual lives in an idiosyncratic "cognitive world." Brain pathology can be associated with some disturbed abilities, and frequently experiential changes (i.e., how the world is understood) are observed. Because these patients often are aware of their intellectual changes, they may represent excellent models to illustrate the diversity of cognitive interpretations an individual can have about the surrounding environmental conditions. Four neuropsychology cases are presented to illustrate this point: (a) prosopagnosia associated with spatial agnosia; (b) Gerstmann's syndrome; (c) dysexecutive syndrome due to a head injury; and, (d) patient with Capgras' syndrome associated with a left temporal cyst. It is further emphasized that non-brain damaged people present an enormous-but usually overlooked-dispersion in different cognitive domains, resulting in specific and idiosyncratic patterns of cognitive abilities. It is concluded that the concept of "cognitive world" in neuropsychology can parallel the concept of "perceptual world" introduced by von Uexküll in biology, which assumes that different animal species live in idiosyncratic perceptual worlds, available and knowable by the differences in their sensory system abilities. That is, different individuals live in idiosyncratic cognitive worlds, owing to their differences in cognitive abilities.
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Affiliation(s)
- Alfredo Ardila
- a Communication Sciences and Disorders , Florida International University , Miami , Florida , USA
| | - Monica Rosselli
- b Psychology , Florida Atlantic University , Boca Raton , Florida , USA
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15
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Ferrazzoli D, Ortelli P, Maestri R, Bera R, Giladi N, Ghilardi MF, Pezzoli G, Frazzitta G. Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson's Disease? Front Aging Neurosci 2016; 8:192. [PMID: 27563290 PMCID: PMC4980388 DOI: 10.3389/fnagi.2016.00192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 07/29/2016] [Indexed: 11/22/2022] Open
Abstract
Background: The cognitive status is generally considered as a major determinant of rehabilitation outcome in Parkinson’s disease (PD). No studies about the effect of cognitive impairment on motor rehabilitation outcomes in PD have been performed before. Objective: This study is aimed to evaluate the impact of cognitive decline on rehabilitation outcomes in patients with PD. Methods: We retrospectively identified 485 patients with PD hospitalized for a 4-week Multidisciplinary Intensive Rehabilitation Treatment (MIRT) between January 2014 and September 2015. According to Mini Mental State Examination (MMSE), patients were divided into: group 1—normal cognition (score 27–30), group 2—mild cognitive impairment (score 21–26), group 3—moderate or severe cognitive impairment (score ≤ 20). According to Frontal Assessment Battery (FAB), subjects were divided into patients with normal (score ≥13.8) and pathological (score <13.8) executive functions. The outcome measures were: Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Disability Scale (PDDS), Six Minutes Walking Test (6MWT), Timed Up and Go Test (TUG) and Berg Balance Scale (BBS). Results: All scales had worse values with the increase of cognitive impairment and passing from normal to pathological executive functions. After rehabilitation, all the outcome measures improved in all groups (p < 0.0001). Between groups, the percentage of improvement was significantly different for total UPDRS (p = 0.0009, best improvement in normal MMSE group; p = 0.019, best improvement in normal FAB group), and BBS (p < 0.0001, all pairwise comparisons significant, best improvement in patients with worse MMSE score; p < 0.0001, best improvement in patients with pathological FAB). TUG (p = 0.006) and BBS (p < 0.0001) improved in patients with pathological FAB score, more than in those with normal FAB score. Conclusions: Patients gain benefit in the rehabilitative outcomes, regardless of cognition. Our data suggest that rehabilitation could be effective also in Parkinsonian subjects with cognitive impairment, as well as with dysexecutive syndrome.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti, Italy
| | - Paola Ortelli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti, Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Scientific Institute of Montescano, S. Maugeri Foundation IRCCS Montescano, Italy
| | - Rossana Bera
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti, Italy
| | - Nir Giladi
- Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Centre, Sieratzki Chair in Neurology, Sackler School of Medicine, Sagol School for Neuroscience, Tel-Aviv University Tel-Aviv, Israel
| | - Maria Felice Ghilardi
- Department of Physiology, Pharmacology and Neuroscience, CUNY Medical School New York, NY, USA
| | - Gianni Pezzoli
- Parkinson Institute, Istituti Clinici di Perfezionamento Milano, Italy
| | - Giuseppe Frazzitta
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti, Italy
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16
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Viñas-Jornet M, Esteba-Castillo S, Gabau E, Ribas-Vidal N, Baena N, San J, Ruiz A, Coll MD, Novell R, Guitart M. A common cognitive, psychiatric, and dysmorphic phenotype in carriers of NRXN1 deletion. Mol Genet Genomic Med 2014; 2:512-21. [PMID: 25614873 PMCID: PMC4303221 DOI: 10.1002/mgg3.105] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/04/2014] [Accepted: 07/16/2014] [Indexed: 12/13/2022] Open
Abstract
Deletions in the 2p16.3 region that includes the neurexin (NRXN1) gene are associated with intellectual disability and various psychiatric disorders, in particular, autism and schizophrenia. We present three unrelated patients, two adults and one child, in whom we identified an intragenic 2p16.3 deletion within the NRXN1 gene using an oligonucleotide comparative genomic hybridization array. The three patients presented dual diagnosis that consisted of mild intellectual disability and autism and bipolar disorder. Also, they all shared a dysmorphic phenotype characterized by a long face, deep set eyes, and prominent premaxilla. Genetic analysis of family members showed two inherited deletions. A comprehensive neuropsychological examination of the 2p16.3 deletion carriers revealed the same phenotype, characterized by anxiety disorder, borderline intelligence, and dysexecutive syndrome. The cognitive pattern of dysexecutive syndrome with poor working memory and reduced attention switching, mental flexibility, and verbal fluency was the same than those of the adult probands. We suggest that in addition to intellectual disability and psychiatric disease, NRXN1 deletion is a risk factor for a characteristic cognitive and dysmorphic profile. The new cognitive phenotype found in the 2p16.3 deletion carriers suggests that 2p16.3 deletions might have a wide variable expressivity instead of incomplete penetrance.
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Affiliation(s)
- Marina Viñas-Jornet
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain ; Unitat de Biologia Cellular, Facultat de Biociències, Universitat Autònoma de Barcelona Bellaterra, Spain
| | - Susanna Esteba-Castillo
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Elisabeth Gabau
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
| | - Núria Ribas-Vidal
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Neus Baena
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
| | - Joan San
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Anna Ruiz
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
| | - Maria Dolors Coll
- Unitat de Biologia Cellular, Facultat de Biociències, Universitat Autònoma de Barcelona Bellaterra, Spain
| | - Ramon Novell
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Miriam Guitart
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
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17
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Ceravolo R, Pagni C, Tognoni G, Bonuccelli U. The epidemiology and clinical manifestations of dysexecutive syndrome in Parkinson's disease. Front Neurol 2012; 3:159. [PMID: 23162529 PMCID: PMC3497716 DOI: 10.3389/fneur.2012.00159] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 10/21/2012] [Indexed: 11/13/2022] Open
Abstract
This mini-review summarizes the evidence of the cognitive and behavioral features of dysexecutive syndrome in Parkinson’s disease (PD). Deficits in response inhibition, set-shifting, mental flexibility, and strategy have been frequently described from the earliest stages of PD, although there are inconsistencies in study findings due to the complexity of the executive function (EF) construct and methodological limitations. Behavioral disorders of PD, e.g., apathy, distractibility, perseverative behavior, and impulse-control disorders, may be viewed as the other side of dysexecutive syndrome. Despite the interrelationship between the cognitive and behavioral domains, some reports reveal that the two syndromes may be dissociated, suggesting that both aspects must be clinically assessed. EFs are widely associated with the prefrontal areas, although dysexecutive syndrome may be observed in patients with damage to other brain regions. EFs drive numerous abilities essential to daily life, such as prospective remembering and language comprehension, which may be impaired in PD subjects. Considering the impact of dysexecutive syndrome on independence and quality of life, early detection of executive impairment is crucial in the management of PD.
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18
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Duarte NA, Woods SP, Rooney A, Atkinson JH, Grant I. Working memory deficits affect risky decision-making in methamphetamine users with attention-deficit/hyperactivity disorder. J Psychiatr Res 2012; 46:492-9. [PMID: 22305489 PMCID: PMC3307875 DOI: 10.1016/j.jpsychires.2012.01.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 12/19/2011] [Accepted: 01/05/2012] [Indexed: 10/14/2022]
Abstract
Methamphetamine (MA) use and Attention-Deficit/Hyperactivity Disorder (ADHD) commonly co-occur and are independently associated with dysregulation of frontostriatal loops and risky decision-making; however, whether their comorbidity exacerbates risky decision-making is not known. This study evaluated 23 participants with histories of MA dependence and ADHD (MA+ADHD+), 25 subjects with MA dependence alone (MA+ADHD-), and 22 healthy adults (MA-ADHD-), who completed the Iowa Gambling Task (IGT) as part of a larger neuropsychiatric research evaluation. Results showed a significant interaction between ADHD, MA, and working memory, such that individuals with working memory deficits in the MA+ADHD+ cohort demonstrated the strongest propensity to select cards from "disadvantageous" versus "advantageous" decks on the IGT. This effect was not better explained by other psychiatric, substance use, neuromedical, or cognitive factors. Findings suggest that working memory deficits may moderate the expression of risky decision-making in MA users with ADHD.
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Affiliation(s)
| | | | | | - J. Hampton Atkinson
- Department of Psychiatry, University of California, San Diego,Psychiatry Service VA San Diego Healthcare System
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego
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Riveros R, Chabriat H, Flores R, Alvarez G, Slachevsky A. Effects of donepezil on behavioral manifestations of thalamic infarction: a single-case observation. Front Neurol 2011; 2:16. [PMID: 21472029 PMCID: PMC3066464 DOI: 10.3389/fneur.2011.00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 03/07/2011] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the effect of donepezil for the treatment of cognitive and behavioral disorders associated with thalamic lesions in a 45-year-old male who suffered an infarct in the left thalamus. BACKGROUND Recent studies suggest that donepezil may improve executive functions impairments due to subcortical ischemic lesions. METHOD The effects of donepezil were analyzed in a single-case of thalamic infarction with cognitive and behavioral alterations in an open label study. RESULTS Significant behavioral modifications related to improved performances in executive functions were observed with the treatment. CONCLUSION The results suggest that donepezil may have significant effect on executive functions that can alter behavioral outcomes after thalamic infarctions.
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Affiliation(s)
- Rodrigo Riveros
- Cognitive Neurology and Dementia Unit, Neurology Service, El Salvador Hospital Santiago, Chile
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