The impact of deep brain stimulation of the subthalamic nucleus on facial emotion recognition in patients with Parkinson's disease.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is successful in patients with advanced Parkinson's disease (PD) but may worsen cognitive outcome, including facial emotion recognition (FER). Data-analyses on 59 consecutive PD patients with complete pre- and postoperative assessments, using a sensitive FER test, showed no changes in FER 1 year after STN-DBS surgery, both after group and individual analyses. These findings do however not exclude the impact of FER in and on itself on the outcome after STN-DBS.

Coordination and Cognition in Pure Nutritional Wernicke's Encephalopathy with Cerebellar Degeneration after COVID-19 Infection: A Unique Case Report.

BACKGROUND: Alcoholic cerebellar degeneration is a restricted form of cerebellar degeneration, clinically leading to an ataxia of stance and gait and occurring in the context of alcohol misuse in combination with malnutrition and thiamine depletion. However, a similar degeneration may also develop after non-alcoholic malnutrition, but evidence for a lasting ataxia of stance and gait and lasting abnormalities in the cerebellum is lacking in the few patients described with purely nutritional cerebellar degeneration (NCD). METHODS: We present a case of a 46-year-old woman who developed NCD and Wernicke's encephalopathy (WE) due to COVID-19 and protracted vomiting, resulting in thiamine depletion. We present her clinical course over the first 6 months after the diagnosis of NCD and WE, with thorough neuropsychological and neurological examinations, standardized clinical observations, laboratory investigations, and repeated MRIs. RESULTS: We found a persistent ataxia of stance and gait and evidence for an irreversible restricted cerebellar degeneration. However, the initial cognitive impairments resolved. CONCLUSIONS: Our study shows that NCD without involvement of alcohol neurotoxicity and with a characteristic ataxia of stance and gait exists and may be irreversible. We did not find any evidence for lasting cognitive abnormalities or a cerebellar cognitive-affective syndrome (CCAS) in this patient.

The Effect of Deep Brain Stimulation of the Subthalamic Nucleus on Language Function in Parkinson's Disease: A Systematic Review.

Purpose This systematic review focuses on the effect of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) on language function in Parkinson's disease (PD). It fills an important gap in recent reviews by considering other language tasks in addition to verbal fluency. Method We critically and systematically reviewed the literature on studies that investigated the effect of bilateral STN-DBS on language function in PD. All studies included a matched PD control group who were on best medical treatment, with language testing at similar baseline and follow-up intervals as the DBS PD group. Results Thirteen identified studies included a form of a verbal fluency task, seven studies included picture naming, and only two studies included more language-oriented tasks. We found that verbal fluency was negatively affected after DBS, whereas picture naming was unaffected. Studies investigating individual change patterns using reliable change indices showed that individual variability is larger for picture naming than for verbal fluency. Conclusions Verbal fluency is the most frequently investigated aspect of language function. Our analysis showed a pattern of decline in verbal fluency across multiple studies after STN-DBS, whereas picture naming was unaffected. Data on more language-oriented tests in a large DBS sample and best medical treatment control group are sparse. The investigation of language function in PD after DBS requires sensitive language tests (with and without time pressure) and experimental designs as used in the studies reviewed here. Reliable change index statistics are a promising tool for investigating individual differences in performance after DBS. Supplemental Material https://doi.org/10.23641/asha.14794458.

Awake Surgery for a Violin Player: Monitoring Motor and Music Performance, A Case Report.

OBJECTIVE: We report the case of a professional violin player who underwent an awake craniotomy to resect a tumor in the left supplementary motor area, an area involved in motor planning. METHOD: A careful pre- and intraoperative monitoring plan for music performance and complex motor function was established that could be used in combination with cortical stimulation. RESULTS: The patient suffered an epileptic seizure during cortical stimulation. The monitoring of complex motor and musical functions was implemented with the patient playing the violin while the resection was performed. Almost complete resection was achieved with no notable postoperative deficits contributing to functional impairment. CONCLUSIONS: The multidisciplinary approach, involving neurosurgery, neuropsychology, anesthesiology, and clinical neurophysiology, allowed us to successfully cope with the theoretical and practical challenges associated with tailored care for a professional musician. The music and motor monitoring plan is reported in detail to enable other sites to reproduce and adapt it accordingly.

The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study.

Patients with multiple sclerosis (MS) often suffer from psychological distress and cognitive dysfunctioning. These factors negatively impact the health-related quality of life. Only recently behavioral therapeutic approaches are being used to treat psychological distress in MS. The aim of the present pilot study was not only to investigate the effectiveness of mindfulness-based stress reduction (MBSR) on psychological distress but also to explore whether it can improve cognitive functioning among patients with MS. Outpatients of the MS Center of the Radboud University Medical Center (Radboudumc) were invited to participate in an MBSR training. Psychological and cognitive measures were administered pre- and post-intervention. Twenty-five MS patients completed the MBSR training and psychological measures, of which 16 patients completed the cognitive tests. Significant improvements were found in depressive symptoms, quality of life, fatigue, mindfulness skills, and self-compassion. Of the cognitive tests, performance on a visual spatial processing test significantly improved after the intervention. Overall, this pilot study showed promising results of the effects of MBSR on reducing psychological distress, and it suggests MBSR might improve cognitive functioning in MS patients. Future randomized controlled trials should be conducted to confirm the possible effectiveness of MBSR-and its long-term effects-on psychological and cognitive functioning in MS patients.

Memory worries and self-reported daily forgetfulness: a psychometric evaluation of the Dutch translation of the Multifactorial Memory Questionnaire.

The expression of memory worries and the self-reporting of daily forgetfulness easily spark discussion among sufferers and their family or friends about what is normal or abnormal forgetfulness. One way to investigate whether the reporting of forgetfulness might be excessive is to use a standardized memory questionnaire--for instance, the Multifactorial Memory Questionnaire (MMQ). The MMQ measures worries, daily forgetfulness, and memory strategy use. In this study we present a psychometric evaluation of the Dutch translation of the MMQ and provide normative data to determine the significance of individual differences in subtest scores. In addition, clinical examples are given of the use and interpretation of percentile norms and single-case statistics.

Neural correlates of syntactic ambiguity in sentence comprehension for low and high span readers.

Syntactically ambiguous sentences have been found to be difficult to process, in particular, for individuals with low working memory capacity. The current study used fMRI to investigate the neural basis of this effect in the processing of written sentences. Participants with high and low working memory capacity read sentences with either a short or long region of temporary syntactic ambiguity while being scanned. A distributed left-dominant network in the peri-sylvian region was identified to support sentence processing in the critical region of the sentence. Within this network, only the superior portion of Broca's area (BA 44) and a parietal region showed an activation increase as a function of the length of the syntactically ambiguous region in the sentence. Furthermore, it was only the BA 44 region that exhibited an interaction of working memory span, length of the syntactic ambiguity, and sentence complexity. In this area, the activation increase for syntactically more complex sentences became only significant under longer regions of ambiguity, and for low span readers only. This finding suggests that neural activity in BA 44 increases during sentence comprehension when processing demands increase, be it due to syntactic processing demands or by an interaction with the individually available working memory capacity.

Intersentential syntactic context effects on comprehension: the role of working memory.

The study investigated the influence of a syntactically biasing context sentence on the processing of syntactically complex object-first relative clauses and even more complex object-first complement clauses in readers with individual differences in working memory. Behavioral as well as brain responses (event-related potentials, ERPs) were recorded from two groups of participants with either a high or a low working memory span. The behavioral data taken from a post-sentence comprehension question task indicate an intersentential syntactic contextual influence on the comprehension of object-first relative clauses for low span readers, but not for high span readers. The on-line ERP measures taken at the disambiguating item revealed for the high span readers a main effect of structure (subject- versus object-first) i.e., a P600, independent of context. Low span readers, in contrast, did not show any P600 structure effect. Thus, the combined data indicate a differential context effect on sentence comprehension in low and high span readers. High span readers parse the incoming information independent of intersentential context, whereas low span readers use the intersentential context off-line.