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1.
Alzheimers Dement ; 20(4): 2353-2363, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38284802

RESUMEN

INTRODUCTION: Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown. METHODS: We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier. RESULTS: Both semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices. DISCUSSION: This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers. HIGHLIGHTS: Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.


Asunto(s)
Afasia Progresiva Primaria , Humanos , Afasia Progresiva Primaria/diagnóstico , Lenguaje , Sustancia Gris , Corteza Cerebral
2.
Alzheimers Dement ; 20(6): 4290-4314, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38696263

RESUMEN

Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.


Asunto(s)
Envejecimiento , Demencia , Países en Desarrollo , Humanos , Demencia/diagnóstico , Demencia/terapia , Demencia/epidemiología , Encéfalo , Congresos como Asunto , Investigación Biomédica
3.
Int J Geriatr Psychiatry ; 36(10): 1576-1587, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33983668

RESUMEN

The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was developed to assess cognitive and behavioural changes in an anterior frontotemporal syndrome (executive functions, language, fluency and behaviour), common in Amyotrophic Lateral Sclerosis (ALS) and also assesses posterior cerebral dysfunction (memory and visuospatial abilities). OBJECTIVES: To validate the ECAS in behavioural variant Frontotemporal Dementia (bvFTD) without ALS, as compared with Alzheimer's disease (AD), against comprehensive neuropsychological assessment. Compare its sensitivity to that of the Addenbrooke's Cognitive Examination (ACE-III) and investigate behavioural changes in both types of dementia. METHODS: Retrospective study of 16 people with bvFTD (without ALS), 32 with AD, and 48 healthy controls completed the ECAS, ACE-III and extensive neuropsychological assessment. RESULTS: The ECAS showed higher sensitivity (94%) and marginally lower specificity (96%) than the ACE-III for both the bvFTD and AD groups. The anterior composite subscore was sensitive for bvFTD (94%), and slightly less so for AD (84%), while the posterior composite subscore was sensitive for AD (97%), and less so for bvFTD (75%). All people with bvFTD that were impaired on the ECAS total and anterior composite scores were also impaired on the anterior function's tests of the neuropsychological assessment. A cut-off of four or more behavioural domains affected differentiated well between the bvFTD and AD groups, while a qualitative analysis of the behavioural interview found different themes between groups. CONCLUSIONS: The ECAS is a valid and sensitive assessment for bvFTD without ALS and for AD. The carer behavioural interview makes it particularly suitable to detect behavioural abnormalities related to frontal lobe disorders.


Asunto(s)
Enfermedad de Alzheimer , Esclerosis Amiotrófica Lateral , Trastornos del Conocimiento , Demencia Frontotemporal , Enfermedad de Alzheimer/diagnóstico , Esclerosis Amiotrófica Lateral/diagnóstico , Cognición , Trastornos del Conocimiento/diagnóstico , Demencia Frontotemporal/diagnóstico , Humanos , Pruebas Neuropsicológicas , Estudios Retrospectivos
4.
J Neurol Neurosurg Psychiatry ; 91(2): 149-157, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31515300

RESUMEN

OBJECTIVE: Approximately 35% of patients with amyotrophic lateral sclerosis (ALS) exhibit mild cognitive deficits in executive functions, language and fluency, without dementia. The precise pathology of these extramotor symptoms has remained unknown. This study aimed to determine the pathological correlate of cognitive impairment in patients with non-demented ALS. METHODS: In-depth neuropathological analysis of 27 patients with non-demented ALS who had undergone cognitive testing (Edinburgh Cognitive and Behaviour ALS Screen (ECAS)) during life. Analysis involved assessing 43 kDa Tar-DNA binding protein (TDP-43) accumulation in brain regions specifically involved in executive functions, language functions and verbal fluency to ascertain whether functional deficits would relate to a specific regional distribution of pathology. RESULTS: All patients with cognitive impairment had TDP-43 pathology in extramotor brain regions (positive predictive value of 100%). The ECAS also predicted TDP-43 pathology with 100% specificity in brain regions associated with executive, language and fluency domains. We also detected a subgroup with no cognitive dysfunction, despite having substantial TDP-43 pathology, so called mismatch cases. CONCLUSIONS: Cognitive impairment as detected by the ECAS is a valid predictor of TDP-43 pathology in non-demented ALS. The profile of mild cognitive deficits specifically predicts regional cerebral involvement. These findings highlight the utility of the ECAS in accurately assessing the pathological burden of disease.


Asunto(s)
Esclerosis Amiotrófica Lateral/metabolismo , Esclerosis Amiotrófica Lateral/psicología , Corteza Cerebral/metabolismo , Disfunción Cognitiva/metabolismo , Proteínas de Unión al ADN/metabolismo , Función Ejecutiva , Trastornos del Lenguaje/metabolismo , Conducta Verbal , Disfunción Cognitiva/complicaciones , Femenino , Humanos , Trastornos del Lenguaje/complicaciones , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas/estadística & datos numéricos
5.
Dement Geriatr Cogn Disord ; 44(3-4): 222-231, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29207387

RESUMEN

BACKGROUND: Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). METHODS: A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. RESULTS: The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; >15 years of education, 62.2 years; p = 0.426). CONCLUSION: The effect of bilingualism is protective against cognitive decline, and lies along a continuum from normal to pathological states. In comparison, the role of years of education is less robust.


Asunto(s)
Disfunción Cognitiva/psicología , Escolaridad , Multilingüismo , Adulto , Edad de Inicio , Anciano , Disfunción Cognitiva/epidemiología , Estudios de Cohortes , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Factores de Riesgo , Factores Socioeconómicos
6.
Alzheimers Dement ; 13(8): 870-884, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28259709

RESUMEN

INTRODUCTION: A classification framework for posterior cortical atrophy (PCA) is proposed to improve the uniformity of definition of the syndrome in a variety of research settings. METHODS: Consensus statements about PCA were developed through a detailed literature review, the formation of an international multidisciplinary working party which convened on four occasions, and a Web-based quantitative survey regarding symptom frequency and the conceptualization of PCA. RESULTS: A three-level classification framework for PCA is described comprising both syndrome- and disease-level descriptions. Classification level 1 (PCA) defines the core clinical, cognitive, and neuroimaging features and exclusion criteria of the clinico-radiological syndrome. Classification level 2 (PCA-pure, PCA-plus) establishes whether, in addition to the core PCA syndrome, the core features of any other neurodegenerative syndromes are present. Classification level 3 (PCA attributable to AD [PCA-AD], Lewy body disease [PCA-LBD], corticobasal degeneration [PCA-CBD], prion disease [PCA-prion]) provides a more formal determination of the underlying cause of the PCA syndrome, based on available pathophysiological biomarker evidence. The issue of additional syndrome-level descriptors is discussed in relation to the challenges of defining stages of syndrome severity and characterizing phenotypic heterogeneity within the PCA spectrum. DISCUSSION: There was strong agreement regarding the definition of the core clinico-radiological syndrome, meaning that the current consensus statement should be regarded as a refinement, development, and extension of previous single-center PCA criteria rather than any wholesale alteration or redescription of the syndrome. The framework and terminology may facilitate the interpretation of research data across studies, be applicable across a broad range of research scenarios (e.g., behavioral interventions, pharmacological trials), and provide a foundation for future collaborative work.


Asunto(s)
Encefalopatías/clasificación , Encéfalo/diagnóstico por imagen , Encefalopatías/diagnóstico por imagen , Encefalopatías/fisiopatología , Encefalopatías/psicología , Humanos
7.
Stroke ; 47(1): 258-61, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26585392

RESUMEN

BACKGROUND AND PURPOSE: Bilingualism has been associated with slower cognitive aging and a later onset of dementia. In this study, we aimed to determine whether bilingualism also influences cognitive outcome after stroke. METHODS: We examined 608 patients with ischemic stroke from a large stroke registry and studied the role of bilingualism in predicting poststroke cognitive impairment in the absence of dementia. RESULTS: A larger proportion of bilinguals had normal cognition compared with monolinguals (40.5% versus 19.6%; P<0.0001), whereas the reverse was noted in patients with cognitive impairment, including vascular dementia and vascular mild cognitive impairment (monolinguals 77.7% versus bilinguals 49.0%; P<0.0009). There were no differences in the frequency of aphasia (monolinguals 11.8% versus bilinguals 10.5%; P=0.354). Bilingualism was found to be an independent predictor of poststroke cognitive impairment. CONCLUSIONS: Our results suggest that bilingualism leads to a better cognitive outcome after stroke, possibly by enhancing cognitive reserve.


Asunto(s)
Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/psicología , Reserva Cognitiva , Multilingüismo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/psicología , Adulto , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Sistema de Registros , Accidente Cerebrovascular/epidemiología
8.
Dement Geriatr Cogn Disord ; 41(1-2): 9-15, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26473749

RESUMEN

BACKGROUND/AIMS: Early-onset dementia (EOD) is defined as functionally relevant cognitive decline with age of onset at less than 65 years. The aim of this study was to investigate the utility of the recently validated third version of the Addenbrooke's Cognitive Examination (ACE-III) in predicting dementia diagnoses in EOD. METHODS: ACE-III scores of EOD patients were compared to those of healthy controls (HC) and individuals with subjective memory impairment (SMI). RESULTS: The study included 71 EOD patients (Alzheimer's disease, n = 31; primary progressive aphasia, n = 11; behavioural-variant frontotemporal dementia, n = 18, and posterior cortical atrophy, n = 11); there were 28 HC and 15 individuals with SMI. At a cut-off score of 88/100, the ACE-III displayed high sensitivity and specificity in distinguishing EOD from HC (91.5 and 96.4%) and SMI (91.5 and 86.7%). CONCLUSIONS: The ACE-III is a reliable cognitive screening tool in EOD.


Asunto(s)
Enfermedad de Alzheimer/diagnóstico , Pruebas Neuropsicológicas , Anciano , Enfermedad de Alzheimer/clasificación , Enfermedad de Alzheimer/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Neurocognitivos/diagnóstico , Reproducibilidad de los Resultados
9.
Ann Neurol ; 75(6): 959-63, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24890334

RESUMEN

Recent evidence suggests a positive impact of bilingualism on cognition, including later onset of dementia. However, monolinguals and bilinguals might have different baseline cognitive ability. We present the first study examining the effect of bilingualism on later-life cognition controlling for childhood intelligence. We studied 853 participants, first tested in 1947 (age = 11 years), and retested in 2008-2010. Bilinguals performed significantly better than predicted from their baseline cognitive abilities, with strongest effects on general intelligence and reading. Our results suggest a positive effect of bilingualism on later-life cognition, including in those who acquired their second language in adulthood.


Asunto(s)
Envejecimiento/psicología , Cognición/fisiología , Multilingüismo , Conducta Verbal/fisiología , Anciano , Estudios de Cohortes , Femenino , Humanos , Inteligencia , Masculino , Memoria , Pruebas Neuropsicológicas
10.
J Neurol Neurosurg Psychiatry ; 86(11): 1208-15, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25476003

RESUMEN

OBJECTIVES: Executive and behavioural changes are well-recognised in classical amyotrophic lateral sclerosis (ALS), indicating a subclinical behavioural-variant frontotemporal dementia (bvFTD) in some patients. Social cognitive deficits in ALS have been recently described and an impairment was identified on a simple Theory of Mind (ToM) test, which assesses the judgement of the preference of another through direction of eye gaze. The present study further delineated this deficit, by distinguishing between Affective and Cognitive subcomponents, and determining the relationship to behavioural change, levels of empathy and self-awareness. METHODS: The Cognitive-Affective Judgement of Preference Test was administered to 33 patients with ALS and 26 controls. Furthermore, a comprehensive neuropsychological battery and detailed behavioural assessment, with measures of empathy and awareness, were included. RESULTS: Patients with ALS showed a significant impairment in Affective ToM only when compared with healthy controls, with a deficit in 36% of patients; 12% showed an isolated Affective ToM deficit while 24% showed more generic ToM dysfunction. A Cognitive ToM deficit was found in 27% of patients, with 3% showing an isolated Cognitive ToM deficit. The patients with ALS showed reduced empathy (Fantasy scale) and increased behavioural dysfunction with high levels of apathy. In addition, patients with either an Affective and/or Cognitive ToM deficit exhibited poor self-awareness of their performance and abnormalities on verbal fluency, while those with an Affective ToM deficit also displayed higher levels of apathy and a naming deficit. CONCLUSIONS: Dysfunctional ToM is a prominent feature of the cognitive profile of ALS. This specific difficulty in identifying and distinguishing the feelings and thoughts of another from a self-perspective may underpin the social behavioural abnormalities present in some patients with ALS, manifest as apathy and loss of awareness.


Asunto(s)
Afecto , Esclerosis Amiotrófica Lateral/psicología , Cognición , Teoría de la Mente , Adulto , Anciano , Anciano de 80 o más Años , Concienciación , Empatía , Femenino , Humanos , Relaciones Interpersonales , Juicio , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Autoimagen , Resultado del Tratamiento
11.
Brain ; 136(Pt 11): 3290-304, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24056536

RESUMEN

Cognitive impairment in amyotrophic lateral sclerosis is characterized by deficits on tests of executive function; however, the contribution of abnormal processing speed is unknown. Methods are confounded by tasks that depend on motor speed in patients with physical disability. Structural and functional magnetic resonance imaging studies have revealed multi-system cerebral involvement, with evidence of reduced white matter volume and integrity in predominant frontotemporal regions. The current study has two aims. First, to investigate whether cognitive impairments in amyotrophic lateral sclerosis are due to executive dysfunction or slowed processing speed using methodology that accommodates motor disability. This is achieved using a dual-task paradigm and tasks that manipulate stimulus presentation times and do not rely on response motor speed. Second, to identify relationships between specific cognitive impairments and the integrity of distinct white matter tracts. Thirty patients with amyotrophic lateral sclerosis and 30 age- and education-matched control subjects were administered an experimental dual-task procedure that combined a visual inspection time task and digit recall. In addition, measures of executive function (including letter fluency) and processing speed (visual inspection time and rapid serial letter identification) were administered. Integrity of white matter tracts was determined using region of interest analyses of diffusion tensor magnetic resonance imaging data. Patients with amyotrophic lateral sclerosis did not show impairments on tests of processing speed, but executive deficits were revealed once visual inspection time was combined with digit recall (dual-task) and in letter fluency. In addition to the corticospinal tracts, significant differences in fractional anisotropy and mean diffusivity were found between groups in a number of prefrontal and temporal white matter tracts including the anterior cingulate, anterior thalamic radiation, uncinate fasciculus and hippocampal portion of the cingulum bundles. Significant differences also emerged in the anterior corona radiata as well as in white matter underlying the superior, medial and inferior frontal gyri and the temporal gyri. Dual-task performance significantly correlated with fractional anisotropy measures in the middle frontal gyrus white matter and anterior corona radiata. Letter fluency indices significantly correlated with fractional anisotropy measures of the inferior frontal gyrus white matter and corpus callosum in addition to the corticospinal tracts and mean diffusivity measures in the white matter of the superior frontal gyrus. The current study demonstrates that cognitive impairment in amyotrophic lateral sclerosis is not due to generic slowing of processing speed. Moreover, different executive deficits are related to distinct prefrontal tract involvement in amyotrophic lateral sclerosis with dual-task impairment associating with dorsolateral prefrontal dysfunction and letter fluency showing greater dependence on inferolateral prefrontal dysfunction.


Asunto(s)
Esclerosis Amiotrófica Lateral/fisiopatología , Trastornos del Conocimiento/fisiopatología , Función Ejecutiva/fisiología , Lóbulo Frontal/fisiopatología , Leucoencefalopatías/fisiopatología , Adulto , Anciano , Esclerosis Amiotrófica Lateral/complicaciones , Esclerosis Amiotrófica Lateral/patología , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/patología , Cuerpo Calloso/patología , Cuerpo Calloso/fisiopatología , Imagen de Difusión Tensora , Femenino , Lóbulo Frontal/patología , Humanos , Leucoencefalopatías/etiología , Leucoencefalopatías/patología , Masculino , Persona de Mediana Edad , Vías Nerviosas/patología , Vías Nerviosas/fisiopatología , Pruebas Neuropsicológicas , Factores de Tiempo
12.
Br J Neurosurg ; 28(6): 755-64, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24881640

RESUMEN

The cerebellar cognitive affective syndrome (CCAS) was first described by Schmahmann and Sherman as a constellation of symptoms including dysexecutive syndrome, spatial cognitive deficit, linguistic deficits and behavioural abnormalities in patients with a lesion in the cerebellum with otherwise normal brain. Neurosurgical patients with cerebellar tumours constitute one of the cohorts in which the CCAS has been described. In this paper, we present a critical review of the literature of this syndrome in neurosurgical patients. Thereafter, we present a prospective clinical study of 10 patients who underwent posterior fossa tumour resection and had a detailed post-operative neuropsychological, neuropsychiatric and neuroradiological assessment. Because our findings revealed a large number of perioperative neuroradiological confounding variables, we reviewed the neuroimaging of a further 20 patients to determine their prevalence. Our literature review revealed that study design, methodological quality and sometimes both diagnostic criteria and findings were inconsistent. The neuroimaging study (pre-operative, n = 10; post-operative, n = 10) showed very frequent neuroradiological confounding complications (e.g. hydrocephalus; brainstem compression; supratentorial lesions and post-operative subdural hygroma); the impact of such features had largely been ignored in the literature. Findings from our clinical study showed various degree of deficits in neuropsychological testing (n = 1, memory; n = 3, verbal fluency; n = 3, attention; n = 2, spatial cognition deficits; and n = 1, behavioural changes), but no patient had full-blown features of CCAS. Our study, although limited, finds no robust evidence of the CCAS following surgery. This and our literature review highlight a need for guidelines regarding study design and methodology when attempting to evaluate neurosurgical cases with regard to the potential CCAS.


Asunto(s)
Enfermedades Cerebelosas/diagnóstico , Trastornos del Conocimiento/diagnóstico , Neoplasias Infratentoriales/cirugía , Complicaciones Posoperatorias/diagnóstico , Adulto , Anciano , Enfermedades Cerebelosas/etiología , Trastornos del Conocimiento/etiología , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Infratentoriales/complicaciones , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Adulto Joven
13.
Healthcare (Basel) ; 12(7)2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38610141

RESUMEN

BACKGROUND: A body of research from around the world has reported positive effects of bilingualism on cognitive ageing and dementia. However, little is known about whether foreign language learning could be applied as an intervention for people already living with dementia. Yet, before it is possible to determine the efficacy of language courses as an intervention for people living with dementia (PLWD), it is necessary to establish whether such an intervention is feasible. Our study explored this possibility. METHODS: We conducted an exploratory study to examine the feasibility and tolerability of 2-week Italian beginner courses for PLWD in early stages and their family carers in two Scottish Dementia Resource Centres (DRCs). The courses were delivered by trained tutors from Lingo Flamingo, a social enterprise specialising in language teaching for older learners and learners with dementia. Twelve PLWD and seven carers participated in the study. Focus groups preceded and followed the courses. Additional post-course open interviews with the DRC managers were conducted, with a follow-up via telephone approximately one year later. RESULTS: Qualitative content analysis resulted in 12 themes, 5 reflected in the interview schedule and 7 arising from the focus groups and interviews. Overall, the courses were perceived positively by PLWD, carers, and DRC managers, although a few logistically and linguistically challenging aspects were also mentioned. The courses were found to positively impact both the individual by increasing self-esteem and producing a sense of accomplishment as well as the group by creating a sense of community. Notably, no adverse effects (in particular no confusion or frustration) were reported. CONCLUSION: The positive outcomes of our study open a novel avenue for future research to explore foreign language training in dementia as an intervention and its implications.

14.
Curr Opin Neurol ; 26(6): 671-7, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24184973

RESUMEN

PURPOSE OF REVIEW: Within the last decade, the neurobiology of action processing has moved from an obscure topic of specialist interest to one of the most popular themes in modern neuroscience. However, the wealth of literature and the diversity of approaches and theoretical models can make the field complex and, at times, bewildering. This review presents the main currents of research, examining their theoretical underpinnings in an interdisciplinary context. RECENT FINDINGS: The presence of specific deficits in verb and action processing has been documented in a wide range of neurodegenerative diseases, including parkinsonian syndromes and motor neuron disease. Interestingly, most of these disorders affect the motor system, suggesting a systematic relationship between motor functions and their cognitive and linguistic representations. Action processing has been explored with a whole spectrum of methodologies, from neuroimaging to transcranial and intracranial stimulation. The findings have been integrated with other influential concepts and theories, including mirror neurons and embodied cognition. SUMMARY: Converging evidence from patient and imaging studies links the concepts of actions and their processing with the execution of actions through the motor system. The theory of embodied cognition remains influential as well as controversial. However, the points of criticism have changed, reflecting recent paradigm shifts.


Asunto(s)
Encéfalo/patología , Trastornos del Conocimiento/etiología , Trastornos del Lenguaje/etiología , Enfermedades Neurodegenerativas/complicaciones , Semántica , Encéfalo/fisiopatología , Humanos , Enfermedades Neurodegenerativas/patología , Neuroimagen , Pruebas Neuropsicológicas
15.
J Magn Reson Imaging ; 38(5): 1140-5, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23450730

RESUMEN

PURPOSE: To investigate brain-wide white matter structural changes associated with amyotrophic lateral sclerosis (ALS) using an automatic single seed point tractography-based segmentation method, probabilistic neighborhood tractography (PNT), which provides quantitative measures of both tract integrity and shape. MATERIALS AND METHODS: Diffusion MRI data were acquired from 30 patients with ALS (ALS Functional Rating Scale-Revised score > 20) and 30 matched controls. PNT was used to segment 12 major projection, commissural and association fibers, and assess differences in how the shape of an individual subject's tract compares to that of a predefined reference tract, in addition to providing tract-average mean diffusivity (〈D〉) and fractional anisotropy (FA) data. RESULTS: Across all 12 tracts, group-averaged 〈D〉 was larger, while group-averaged FA was equal to or smaller in value for patients than controls. These differences were significant for right cingulum 〈D〉, and left and right corticospinal tract (CST) 〈D〉 and FA (P-values 6 × 10(-5) to 0.03). Tract shape modeling indicated that there were significantly greater topological differences from the reference tract in left and right CST, and right uncinate fasciculus (P-values 0.02 to 0.04) for patients than controls. The rate of disease progression was significantly negatively correlated with bilateral CST FA (P-values 0.01 to 0.02). CONCLUSION: ALS, although particularly affecting CST, is associated with subtle changes in white matter tract integrity and shape in several other major fibers within the brain. Correlations between CST integrity and disease progression rate suggest that quantitative tractography may provide useful biomarkers of disease evolution in ALS.


Asunto(s)
Algoritmos , Esclerosis Amiotrófica Lateral/patología , Encéfalo/patología , Imagen de Difusión Tensora/métodos , Interpretación de Imagen Asistida por Computador/métodos , Fibras Nerviosas Mielínicas/patología , Reconocimiento de Normas Patrones Automatizadas/métodos , Adulto , Anciano , Simulación por Computador , Interpretación Estadística de Datos , Femenino , Humanos , Aumento de la Imagen/métodos , Masculino , Persona de Mediana Edad , Modelos Anatómicos , Modelos Neurológicos , Modelos Estadísticos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
16.
J Neurol Neurosurg Psychiatry ; 83(4): 405-10, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22019546

RESUMEN

INTRODUCTION: There are no well-established criteria for patients with corticobasal syndrome. The authors have attempted to clarify this area by comparing and applying three sets of well-known criteria (from Toronto, the Mayo Clinic and Cambridge). PATIENT AND METHODS: The authors first compared the three criteria for overlap and differences, and then applied them to a group of 40 consecutive patients (22 men, mean age 67 years) with focal cortical syndrome characterised by apraxia and Parkinsonism, at both the early stages and later in their illness. RESULTS: Despite an overall similarity, there were major differences in the criteria which affect their applicability. Cognitive impairment was ubiquitous even at presentation, with speech and language impairment the commonest feature. Some classic features, alien limb and myoclonus, were present in a minority only even late in their course. The three criteria were equally applicable to patients with advanced disease (Toronto 92.5%, Cambridge 90% and Mayo 87.5%). Thirty patients (75%) satisfied all three criteria. Using this group as a 'gold standard', 73.3% fulfilled the Cambridge criteria at presentation compared with 46.7% and 36.7% for the Toronto and Mayo Clinic criteria, respectively. Concordance between criteria was poor. CONCLUSION: Cognitive impairment, especially language impairment, was prominent from onset of disease. The Cambridge criteria apply to a higher proportion of cases at an early stage of corticobasal syndrome. The authors suggest a minor modification to capture the high prevalence of aphasia.


Asunto(s)
Enfermedades de los Ganglios Basales/diagnóstico , Anciano , Fenómeno de la Extremidad Ajena/diagnóstico , Enfermedad de Alzheimer/diagnóstico , Afasia/diagnóstico , Apraxias/diagnóstico , Enfermedades de los Ganglios Basales/mortalidad , Enfermedades de los Ganglios Basales/patología , Trastornos del Conocimiento/diagnóstico , Diagnóstico Diferencial , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Trastornos del Movimiento/diagnóstico , Mioclonía/diagnóstico , Enfermedad de Parkinson/diagnóstico , Tasa de Supervivencia , Síndrome
17.
Br J Psychiatry ; 200(4): 342-3, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22403087

RESUMEN

A masked analysis of videotaped assessments of people at high genetic risk of schizophrenia revealed that those who subsequently went on to develop schizophrenia used significantly more second-person pronouns. This was evident before diagnosis, at two separate assessments approximately 18 months apart. This supports the view that people who go on to develop schizophrenia may have an abnormality in the deictic frame of interpersonal communication - that is, the distinction between concepts being self-generated or from elsewhere may be blurred prior to the onset of a diagnosis of schizophrenia.


Asunto(s)
Lenguaje , Esquizofrenia/diagnóstico , Estudios de Casos y Controles , Humanos , Pruebas Neuropsicológicas , Estudios Prospectivos , Esquizofrenia/genética , Grabación de Cinta de Video , Adulto Joven
18.
Behav Brain Sci ; 35(5): 280-1, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22929865

RESUMEN

Frost's claim that universal models of reading require linguistically diverse data is relevant and justified. We support it with evidence demonstrating the extent of the bias towards some Indo-European languages and alphabetic scripts in scientific literature. However, some of his examples are incorrect, and he neglects the complex interaction of writing system and language structure with history and cultural environment.


Asunto(s)
Encéfalo/fisiología , Modelos Neurológicos , Lectura , Reconocimiento en Psicología/fisiología , Semántica , Humanos
20.
Dement Geriatr Cogn Disord ; 31(4): 254-8, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21474935

RESUMEN

INTRODUCTION: The motor features of corticobasal syndrome (CBS) are well recognized but the fact that many, if not all, affected patients develop cognitive impairment is still underrecognized. The dementia of CBS overlaps most with a language variant of frontotemporal dementia: progressive nonfluent aphasia (PNFA). The aim of this study was to determine the usefulness of Addenbrooke's Cognitive Examination-Revised (ACE-R) in the evaluation of CBS and to document similarities and differences between CBS and PNFA. MATERIALS AND METHODS: Patients with well-defined CBS or PNFA from two tertiary referral centers were selected along with matched controls. RESULTS: Twenty-one patients with CBS, 23 patients with PNFA and 47 age- and education- matched controls were included. Both CBS and PNFA groups showed substantial impairment on the ACE-R (f = 17.3-80.2, p < 0.001) and were significantly impaired in all domains (p < 0.001). The only significant difference between CBS and PNFA was in the visuospatial domain (p < 0.009), being worse in CBS. Using a cutoff of 88/89 out of 100, 90% of CBS and 82.6% of PNFA patients were impaired. At this cutoff of 88/89, ACE-R in CBS had sensitivity and specificity values of 91 and 98%, respectively.


Asunto(s)
Trastornos del Conocimiento/diagnóstico , Degeneración Lobar Frontotemporal/diagnóstico , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Pruebas Neuropsicológicas/normas , Anciano , Afasia/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
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