A Case of Dysgraphia after Cerebellar Infarction Where Functional NIRS Guided the Task Aimed at Activating the Hypoperfused Region.

BACKGROUND: Linguistic impairment following cerebellar lesions is characterized by a marked cerebellocerebral diaschisis with decreased perfusion in the left cerebral hemisphere. CASE: We report on a 60-year-old right-handed French chef who presented with linguistic deficits following a right cerebellar infarction. Neurolinguistic examinations in the acute phase showed impaired graphomotor planning, especially for kanji (Japanese morphograms). Despite the absence of any structural damage to the supratentorial brain regions, a quantitative 123I-IMP SPECT study revealed a relative hypoperfusion, mainly around the left posterior middle temporal gyrus, considered to be a crossed cerebellar-cerebral diaschisis. We performed functional near-infrared spectroscopy (fNIRS) and observed that a picture card task could increase blood perfusion in the affected area. This task was as follows: once he saw a picture card depicting a dish, the patient had to list the ingredients that make up the dish. For example, he had to name vegetables, meat, and spices upon seeing a "curry" picture card. We added this task to his daily speech-hearing therapy regimen. In the chronic phase, we confirmed symptom amelioration in linguistic performance-paralleled reduction in the level of hypoperfusion on SPECT study. Discussion. This case is the first report of an fNIRS approach used to evaluate evidence-based prospective speech-hearing tasks by observing blood flow to the hypoperfused area of the cerebral cortex surface.

[Improved instrumental activities of daily living in acquired savant syndrome patient after developing interest in drawing].

We performed examinations of a 73-year-old, right-handed man who developed herpes simplex encephalitis, with cognitive dysfunction including severe Wernicke's aphasia. Although he had never previously been interested in arts, use of a coloring book, recommended by his wife, led him to start drawing. A few years after the onset of brain disease, the patient began to copy pictures of landscapes. The lesion was in the left hemisphere and his work showed a strongly realistic tendency, thus we think that this case demonstrated characteristics of acquired savant syndrome. Along with the increase in drawing ability, instrumental activities of daily living (IADL), such as shopping and use of public transport, were also considerably improved in this patient. On the other hand, results of neuropsychological tests, such as the Standard Language Test of Aphasia, were not improved. We concluded that a sense of accomplishment from the drawing activity and communication with supporters might have led to improvement of IADL in this case.

Application of Deep Learning Methods for Pedestrian Collision Detection Using Dashcam Videos.

The goal of this study is to clarify the usefulness of deep learning methods for pedestrian collision detection using dashcam videos for advanced automatic collision notification, focusing on pedestrians, as they make up the highest number of traffic fatalities in Japan. First, we created a dataset for deep learning from dashcam videos. A total of 78 dashcam videos of pedestrian-to-automobile accidents were collected from a video hosting website and from the Japan Automobile Research Institute (JARI). Individual frames were selected from the video data amounting to a total of 1,212 still images, which were added to our dataset with class and location information. This dataset was then divided to create training, validation, and test datasets. Next, deep learning was performed based on the training dataset to learn the features of pedestrian collision images, which are images that capture pedestrian behavior at the time of the collision. Pedestrian collision detection performance of the trained model was evaluated as the percentage of correct predictions of pedestrian collisions in image data according to varied test sets with different combinations of characteristics. Our results for the proposed method show high-precision collision detection for daytime, clear pedestrian wrap trajectory accident data, including accurate detection of pedestrian collision location information. However, nighttime, unclear accident data resulted in false detection or no detection. Reduction of exposure value and resolution was confirmed to reduce detection rate. The results of the present study suggest the possibility of pedestrian collision detection by deep learning using dashcam videos.

The role of movement representation in episodic memory for actions: A study of patients with apraxia.

In attempting to memorize a sentence about an action, such as "Pick up the glass," performing the action (motor encoding) results in better memory performance than simply memorizing the words (verbal encoding). Such enhancement of memory is known as the enactment effect. Several theories have been proposed to explain this phenomenon using concepts such as physical motor information associated with speed, form, amplitude of movement and/or movement representations involved in movement imaging, knowledge on manipulating tools, and spatial relationships in the enactment effect. However, there have been no cognitive neuropsychological studies investigating whether the enactment effect is crucially influenced by physical motor information or movement representations. To clarify this issue, we compared healthy adult control participants with two different types of apraxia patients. One patient with left hemisphere lesions caused by cerebral infarction had a disability involving multiple movement representations. The other patient showed symptoms of corticobasal syndrome and was not able to benefit from feedback on the accuracy of her motor movements during enactment. Participants memorized action sentences via either verbal or motor encoding and responded to recall and recognition tests. Results indicated that the patient with the movement representation deficits exhibited worse memory performance than the other patient or control participants following both verbal and motor encoding. Although the enactment effect was present during recall in both patients, the effect was not observed for recognition in the patient with severe movement representation deficits. These results suggest that movement representations are involved in encoding episodic memories of action. Moreover, the role of movement representations appears to depend on the form of retrieval that is being used.

[Awareness of memory deficit in patients with amnesia].

This study investigated the impaired self-awareness (ISA) of memory deficit in 63 brain injury patients with amnesia. The purpose of this study was (a) to elucidate the relation between degree of ISA and memory deficit measured by several neuropsychological memory tests, (b) to examine the relation between degree of ISA and the post-injury duration, and (c) to investigate the influence of ISA on independent behaviors and occupational outcomes. We measured ISA by using discrepancy methods, which is the difference of the evaluated frequency of the patient's memory problems in daily living as judged by the patients themselves and by their family caregivers. The results showed that the patients underestimated their memory problems more than their caregivers did. Regarding the relationship of ISA and neuropsychological memory tests, performance involving orientation, delayed recall of a story, and abstract figures (Rey Complex Figure Test) were related. Moreover, the degree of ISA influenced independent behavior and occupational outcomes. However, the duration from post-injury did not influence the degree of ISA. These results indicate that not only an approach to enhance neuropsychological memory functions but also an approach to develop an appropriate self-awareness of memory deficit is important for independent living and social reintegration.