Neuropsychological assessment in multiple sclerosis: a follow-up study with magnetic resonance imaging.

Nineteen moderately impaired patients with clinically definite multiple sclerosis and an initially relapsing-remitting course were included in a neuropsychological and magnetic resonance imaging (MRI) follow-up study. The average test/re-test interval was about 2 years. The neuropsychological findings were indicative of a very mild overall impairment; the patients, as a group, showed no evidence of cognitive deterioration in the follow-up period. A numerical estimation of the severity of cerebral demyelination shown by MRI did not indicate a significant change. No correlation between cognitive performance variations and MRI changes was found.

Resumption of gainful employment in aphasics: preliminary findings.

We report preliminary data on aphasic patients who, in spite of their language problems, have succeeded in finding a reasonably satisfactory occupational resettlement. Patients who: (a) still had a moderate to sever aphasia, (b) had resumed a gainful employment requiring interpersonal communication, were recalled for a check-up and assessed with: (1) a comprehensive aphasia test: (2) a semistructured interview including detailed questioning about the type and reaction to aphasia, the type of work before the onset of aphasia, the type of current work with particular emphasis on the patients' compensatory mechanisms and emotional reactions. Results comprise 10 cases up to date. One case is described in detail. Findings indicate that the ability to resume a gainful occupation is often greater than could be expected on the sole basis of formal language examination. Findings are discussed from a neuropsychological, social and rehabilitation point of view.

Lateralization of visual attention in patients with classic migraine and unilateral prodromes.

The present study is aimed to investigate whether and how mechanisms of visual attention are changed into conditions of monohemispheric disorders. For this purpose, Posner's paradygm was applied to classic migraine patients with prodromal phenomena localized in one hemisphere. The subjects were examined in acute phase (within 24 h of the episode end) and after a week or more from the episode (interparoxysmal phase). The patients in interparoxysmal phase behaved as normal subjects. In acute phase, we observed a selective involvement of attentional behaviour in migraineurs with left hemispheric symptoms. A possible explanation might be based on the well-known tendency of this hemisphere to prevail in performing attentive tasks.

A case of "crossed aphasia" in which the integrity of the left hemisphere is assessed by MRI.

We describe a 65-year-old right-handed (on the Edinburgh Inventory Test) woman who developed left hemiplegia and language disturbances after right hemisphere lesion. She showed global aphasia and left spatial neglect. To our knowledge, this is the first case of so called "crossed aphasia" in which the integrity of the left hemisphere is assessed by Magnetic Resonance Imaging (MRI). The association of aphasia and neglect is briefly discussed.

Aphasia due to lesions confined to the right hemisphere in right handed patients: a review of the literature including the Italian cases.

We review most of the work published, to our knowledge, between 1880 and 1988 on aphasia due to right cerebral lesions in right-handed patients ("crossed aphasia"). We summarize the 87 cases found in chronological order within defined groups, dealing in greater detail with the less well-known cases in English-language publications and with the cases from other sources that we consider most representative and convincing. The 87 cases fall into three groups on the following criteria: right-handedness (on standardized tests), absence of left-handers in the family, left hemisphere integrity. Group 1 comprises cases that are unreliable because the handedness data are missing and/or because left hemisphere lesions were known to be present or probably were so. Group 2 comprises cases with full clinical data but no formal test of handedness, with familial cases of left-handedness and/or without satisfactory evidence of left hemisphere integrity. Groups 3 comprises the 26 reliable cases, that is those with proven right-handedness, no left-handers in the family and with proven hemisphere integrity. We discuss the implications of these cases.

Neuropsychological assessment in patients with relapsing-remitting multiple sclerosis and mild functional impairment: correlation with magnetic resonance imaging.

Forty one moderately impaired patients with clinically confirmed multiple sclerosis (MS) and a relapsing-remitting course were submitted to a neuropsychological battery and magnetic resonance imaging (MRI) to correlate the neuropsychological performances with the degree of cerebral demyelination. The neuropsychological results were indicative of a very mild overall impairment. The patients were subdivided into two groups (extensive periventricular demyelination or discrete lesions on MRI) and the results of neuropsychological tests compared. Patients with extensive periventricular demyelination had an inferior performance on concept formation, non-verbal reasoning and verbal memory tests.