Neuropsychological Profile of a Patient with Acquired Brain Damage Following Vascular Lesion of the Left Anterior Cingulate Cortex

Stroke is a physiological alteration associated with changes in blood flow that can result in sudden-onset cognitive impairment. It has a heterogenous clinical presentation with varying degrees of severity correlated with specific central nervous system zones or areas, and its prognosis is uncertain. This case study describes a 62-year-old male patient with acquired brain damage of the anterior cingulate cortex as a result of an ischemic event in the territory of the left anterior cerebral artery. Cognitive function was assessed using the neuropsychological executive function and frontal lobe test battery (BANFE-2) as well as other neuropsychological tests. The results show a profile of higher mental functions characterized by the presence of dysexecutive syndrome with marked behavioral alteration and diencephalic amnesia. .

Efficacy of Children Neuropsychological and Behavioral Scale in Screening for Autism Spectrum Disorders through a Combination of Developmental Surveillance

Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.

Association between Pre-pregnancy Body Mass Index and Offspring Neuropsychological Development from 1 to 24 Months of Age: A Birth Cohort Study in China

Objective To explore the interactions between pre-pregnancy body mass index(BMI) and age on offspring neuropsychological development from 1 to 24 months in China.Methods In this birth cohort study, a total of 2,253 mother-child pairs were enrolled in Tianjin, China,between July 2015 and May 2018. The China Developmental Scale for Children was used to assess developmental quotient(DQ) of children aged from 1 to 24 months.Results Mixed-models analysis revealed significant age × pre-pregnancy BMI interactions for total DQ and five neurobehavioral domains(gross motor, fine motor, adaptive, language, and social;P < 0.001).Age × pre-pregnancy BMI ≥ 25 kg/m^2 was associated with a negative effect on total DQ and five neurobehavioral domains, as compared to pre-pregnancy BMI < 25 kg/m^2(P < 0.01). Multiple comparisons showed pre-pregnancy BMI ≥ 25 kg/m^2 of mothers had a positive effect on child total DQ at the age of 1 month but a negative effect at 24 months(P < 0.05).Conclusions This study supported the age × pre-pregnancy BMI interaction on offspring neuropsychological development. It also revealed a short-term positive impact of high pre-pregnancy BMI on neuropsychological development at 1 month of age, but a long-term negative effect(from 1 to24 months).

Replace Psychometric Inferences with Direct Brain Measurements: LORETA Reflects Traditional Cerebral Loci for Neuropsychological Tests

Inferences of subtle cerebral injury and dysfunction have been historically dependent upon psychometric tests from which clinical neuropsychological profiles are generated. In addition to being secondary, over-inclusive and crude indicators of cerebral activity, psychometric tests are subject to economic incentives to “re-norm” traditional methods under the pretense of “ensuring” contemporary representations that are sanctioned by regulating organizations dominated by agendas of control over the interpretations of clinicians. The validity of neuropsychological tests is essential for their perspicacious application and interpretations. We measured the quantitative electroen-cephalographic profiles and calculated s-LORETA (standardized Low Resolution Electromagnetic Tomography) profiles in real time for normal men and women while they engaged in both traditional and novel neuropsychological tests that were employed to infer localized brain injury. Conspicuous alterations in source current density within specific frequency bands occurred within various regions of the right prefrontal region during performance of the Category, Design Fluency and Conditioned Spatial Association Test, the prefrontal medial surface during Toe Graphaesthesia, the caudal medial surface during Toe Gnosis, the left temporal region during Speech-Sounds, and within the right retrosplenial-parahippocampal region for Seashore Rhythms. Results supported the well established regional associations with the classic neuropsychological tests, verified the cerebral localization with more recent procedures, and emphasized the utility of modern real-time, direct cerebral imaging procedures.

The Relationships between Cognitive Neuropsychological State, Oxidative Stress and Genotoxicity in Radiology Staff

Imbalance between the production and removal of reactive oxygen species (ROS) has been used for characterizing Oxidative stress. Extra amount of ROS are hazardous and can lead damages to the cells resulting in harsh diseases. For cancer, diabetes, psychological disorders and age-related disorders, latent of ROS in induction of alteration and DNA harm is a critical factor. Regarding these finding, the current research was planned to test the relationship between cognitive neuropsychological state and oxidative markers and genotoxicity in radiology staff. Total Number of 47 radiology staff, working in the radiology center of a referral University Hospital in Shiraz, were invited in the study. The participants were occupationally exposed to low-dose ionizing radiation (x-ray) for more than 2 years. Psychological disorder was analyzed by SCL-90-R. In the plasma, lipid peroxidation, DNA harm, catalase, superoxide dismutase, myeloperoxidase, and glutathione peroxidase activity were calculated. Associations between parameters were measured by using Pearson correlation coefficient and multivariate linear regression analyses. As a result, there was a positive considerable connection between catalase and paranoid ideation, Obsessive-Compulsive, Anxiety and total. Furthermore, the correlation between psychoticism, Interpersonal Sensitivity, Paranoid Ideation and DNA damage was positive. There were positive relationships between superoxide dismutase and psychomotor speed, initiative/energy, selective attention and verbal memory. So, there were significant relationships among interpersonal sensitivity, somatization, depression and gender. But, there were no major relationships among psychological distress, history workers and oxidative stress. In so many words, Oxidative stress and genotoxicity result in psychological disorders in radiology staff. So, radiology staff should have more attention, as they suffered from some psychological disorders.

Absence of Quantitative Improvement in Neuropsychological Profiles in Patients Who Exhibit Moderate Brain Impairment: Comparisons of Cross-Sectional and Longitudinal Data (1 through 4 Years Post-Injury)

A total of 127 adult patients who had sustained an impact of significant mechanical energy to their skulls during motor vehicle incidents were given thorough neuropsychological, cognitive and personality assessments between 0.5 years and 4 years after the event. Cross-sectional analysis indicated no statistically significant objective changes in patients as a function of yearly intervals. However there was strong evidence of significant deterioration of neuropsychological proficiency and efficiency between 0.3 to 1.0 years after the injury. A subset (n = 20) of patients who displayed moderately severe neuropsychological impairment when assessed about 1 year after the injury showed no statistically significant changes when reassessed about 1.5 years later (2.5 years after the brain trauma). These results challenge the traditional concept of “recovery” following a traumatic brain injury and indicate that insidious processes that adversely affect neurocognitive capacity may emerge 0.5 years after the trauma. Post-hoc analysis indicated that the occurrence of unconsciousness or its duration at the time of the injury minimally affected the magnitude of subsequent indices of neuropsychological impairment but influenced the incidence of electroencephalographic theta activity during the years following the injury.

A Survey on Neuropsychological State, Oxidative Stress and Hematological Parameters in Coke Oven Workers

Coke oven factories are one of the main emitting sources of polycyclic aromatic hydrocarbons (PAH)s which have been identified as highly carcinogenic chemicals by IARC. Induction of oxidative stress and following disrupting pathways has been repeatedly reported in subjects exposed to PAHs. This study was performed to monitor the oxidative stress markers, hematological and biochemical parameters, and psychological states in coke oven workers. 100 male subjects were included in this comparative cross-sectional study. At first 50 male workers who were 22 - 63 and worked in the steel factory located in South-East of Iran were contained. Control subjects were chosen from Esfahan, in the factory’s neighborhood, consisting of 50 office workers without any background of occupational exposure to metals. The blood levels of hematological factors and oxidative stress were measured. In order to compare data, two-sample t test was applied. In order to measure the correlation between variables, Pearson correlation coefficient was applied. The mean level of total antioxidant capacity, hemoglobin (Hb), mean corpuscular hemoglobin concentration (MCHC), and hematocrit were significantly lower in the workers in association with increased lipid per oxidation (LPO). A positive correlation existed between work history, hyper thyroids (r2 = 0.288, p = 0.01), and endocrine disorders (r2 = 0.309, p = 0.028). Occupational exposure of coke oven workers to PAHs can induce oxidative stress and consequent metabolic and neuropsychological disorders. When workers take daily shower and use protective tools, absorption of toxic elements would decrease so that reaching them to the body can be suitably limited.

Neuropsychological and Electrophysiological Evaluation after Rape: A Case Study of a Teenage Girl

Although rape is an event with a high incidence worldwide, there is currently no single consensus about both the general effects and the diagnosis and treatment of this. To evaluate the consequences of rape, a teenage girl was evaluated at two moments: a month-and-a-half and then a year-and-a-half after being raped. Clinical measurements, neuropsychological testing and electroencephalographic recording (EEG) were conducted in four conditions: eyes closed, eyes open, and during performance of two tasks: Towers of Hanoi and Wisconsin. Observations showed subsyndromal symptoms of post-traumatic stress on the first evaluation, and close-to-normal scores on the neuropsychological and cognitive tests in both assessments. Decreased cortical EEG synchronization, mainly in the fast frequencies and in almost all conditions, was obtained in the second evaluation. The results obtained in this study may indicate an early development in the brain, which is discussed in light of current literature on this topic.

Best early-onset Parkinson dementia predictor using ensemble learning among Parkinson's symptoms,rapid eye movement sleep disorder,and neuropsychological profile

BACKGROUND Despite the frequent progression from Parkinson’s disease(PD)to Parkinson’s disease dementia(PDD),the basis to diagnose early-onset Parkinson dementia(EOPD)in the early stage is still insufficient.AIM To explore the prediction accuracy of sociodemographic factors,Parkinson's motor symptoms,Parkinson’s non-motor symptoms,and rapid eye movement sleep disorder for diagnosing EOPD using PD multicenter registry data.METHODS This study analyzed 342 Parkinson patients(66 EOPD patients and 276 PD patients with normal cognition),younger than 65 years.An EOPD prediction model was developed using a random forest algorithm and the accuracy of the developed model was compared with the naive Bayesian model and discriminant analysis.RESULTS The overall accuracy of the random forest was 89.5%,and was higher than that of discriminant analysis(78.3%)and that of the naive Bayesian model(85.8%).In the random forest model,the Korean Mini Mental State Examination(K-MMSE)score,Korean Montreal Cognitive Assessment(K-MoCA),sum of boxes in Clinical Dementia Rating(CDR),global score of CDR,motor score of Untitled Parkinson’s Disease Rating(UPDRS),and Korean Instrumental Activities of Daily Living(KIADL)score were confirmed as the major variables with high weight for EOPD prediction.Among them,the K-MMSE score was the most important factor in the final model.CONCLUSION It was found that Parkinson-related motor symptoms(e.g.,motor score of UPDRS)and instrumental daily performance(e.g.,K-IADL score)in addition to cognitive screening indicators(e.g.,K-MMSE score and K-MoCA score)were predictors with high accuracy in EOPD prediction.

Regional patterns of atrophy on MRI in Alzheimer’s disease: Neuropsychological features and progression rates in the ADNI cohort

Background: Discrete clinical and pathological subtypes of Alzheimer’s disease (AD) with variable presentations and rates of progression are well known. These subtypes may have specific patterns of regional brain atrophy, which are identifiable on MRI scans. Methods: To examine distinct regions which had distinct underlying patterns of cortical atrophy, factor analytic techniques applied to structural MRI volumetric data from cognitively normal (CN) (n = 202), amnestic mild cognitive impairment (aMCI) (n = 333) or mild AD (n = 146) subjects, in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database was applied. This revealed the existence of two neocortical (NeoC-1 and NeoC-2), and a limbic cluster of atrophic brain regions. The frequency and clinical correlates of these regional patterns of atrophy were evaluated among the three diagnostic groups, and the rates of progression from aMCI to AD, over 24 months were evaluated. Results: Discernable patterns of regional atrophy were observed in about 29% of CN, 55% of aMCI and 83% of AD subjects. Heterogeneity in clinical presentation and APOE ε4 frequency were associated with regional patterns of atrophy on MRI scans. The most rapid progression rates to dementia among aMCI subjects (n = 224), over a 24-month period, were in those with NeoC-1 regional impairment (68.2%), followed by the Limbic regional impairment (48.8%). The same pattern of results was observed when only aMCI amyloid positive subjects were examined. Conclusions: The neuroimaging results closely parallel findings described recently among AD patients with the hippocampal sparing and limbic subtypes of AD neuropathology at autopsy. We conclude that NeoC-1, Limbic and other patterns of MRI atrophy may be useful markers for predicting the rate of progression of aMCI to AD and could have utility selecting individuals at higher risk for progression in clinical trials.

Correlation of diseased region and area with neglect and other neuropsychological dysfunctions in patients with cerebral infarction

BACKGROUND: Previous studies reported that frontal-temporal-parietal-occipital pathological changes and diseased range in the right cerebral hemisphere were closely correlated with neglect. But studies on the correlation of neglect with diseased region and area in patients who suffer from initial attack of single focus of cerebral infarction (CI) in left and right cerebral hemispheres are few. OBJECTIVE: To observe the status of neglect in patients who suffer from single focus of CI in cerebral hemisphere, and analyze the correlation of neglect with diseased region and area of CI. DESIGN: Case analysis. SETTING: Treatment Center for Cardiocerebrovascular Disease, Second Hospital of Xiamen city; Department of Neurology, First Hospital Affiliated to Baotou Medical College. PARTICIPANTS: All the CI patients hospitalized in the Department of Neurology, First Hospital Affiliated to Baotou Medical College from June 1998 to May 2001 were retrieved. Inclusive criteria: ① Patients who suffered from initial attack of CI, which was confirmed by skull CT or MRI within 24 hours after onset and presented single focus in cerebral hemisphere. ② be conscious and could cooperate in the examination. ③ did not receive formal education, but could do accounts and some simple writing and reading. ④Patients with homonymous hemianopia were excluded through the examination of perimeter. ⑤ Informed consents were obtained from all the patients. Among 67 patients who met the inclusive criteria, 33 suffered from CI in the left cerebral hemisphere and 34 in the right cerebral hemisphere. METHODS: ① Patients received neglect supplement examination and Chinese aphasia examination within 2.5 to 3 months after the attack of CI . The diagnostic criteria of neglect in the tests of line cancellation, line bisection and copying the figures were as follows: In the line cancellation test based on the method of Albert, patients who could not cancel one or more lines were regarded as abnormal. In the line bisection test based on the method of Peter, patients who left deviated 1.16% or right deviated 2.51% were regarded as abnormal. In the test of copying the figures, round-shape, square, cruciform and other shapes were asked to be copied, defect appeared in the figure was regarded as abnormal. The diagnostic criteria of aphasia were according to the diagnostic method of Chinese aphasia examination and type identification flow-sheet of aphasia. Infarct area was calculated based on Palisino formula: infarct area=π/6×the longest diameter of infarct area×the widest diameter of infarct area×the number of CT positive layer. ② Chi-square test was used for comparing the difference of measurement data. MAIN OUTCOME MEASURES: Diseased region and area of CI and their correlations with neglect. RESULTS: Sixty-seven patients were involved in result analysis. ① The correlation of the occurrence of neglect with the diseased regions of CI: Neglect was not found in 33 patients with CI in left cerebral hemisphere, but was found in 7 of 34 patients with CI in right cerebral hemisphere. The diseased regions involved right temporoparietal region, temporal-parietal-occipital region, frontal-temporal-parietal region, frontal-temporal-parietal-occipital region, temporoparietal basal nucleus, basal nucleus and dorsal caudate putamen. ②The correlation of the occurrence of neglect with diseased area: infarct area ≤ 30 cm3 was found in 2 patients with neglect (12.5%), infarct area at 31 to 60 cm3 in 1 patient with neglect (14.3%),infarct area ≥ 61 cm3 in 4 patients with neglect (36.4%). There was no significant difference in infarct area among groups (P > 0.05). CONCLUSION: ① Right cerebral hemisphere takes advantage in spatial attention. ② Neglect is more possibly caused by the combined pathological changes in temporal and parietal lobe. Temporal and parietal lobes may not cause neglect independently, but the occurrence of neglect is not directly correlated with infarct area.

Mild Cognitive Impairment in Parkinson Disease: A Neuropsychological Study of 25 Patients

Parkinson’s disease (PD) is associated with an increased incidence of cognitive impairment and dementia. Population-based cohort of 25 patients with incident PD underwent a large neuropsychological battery. Executive functions were the most affected cognitive domain including particularly initiation, mental flexibility and inhibition. Episodic memory and visuo-spatial functions were less affected. We found that 92% of patients were classified as having Mild Cognitive Impairment (MCI);most of them experienced PD-MCI Single-Domain (17 patients) with disturbances on executive functions. Less frequently, we identified a group of patients with multiple-domain PD-MCI demonstrating deficits on executive functions as well as on episodic memory and/or visuospatial capacities.

Neuropsychological and Neurological Deficits in Obsessive-Compulsive Disorder: The Role of Comorbid Depression

Past research has found a high prevalence of neuropsychological deficits and neurological soft signs in patients with obsessive-compulsive disorder (OCD). A close relationship between OCD and depression has also been indicated in the literature. However, many aspects of this association remain unclear. In this study we compared neuropsychological functioning and neurological soft signs of 46 OCD patients who were off psychotropic medication (21 with significant depressive symptoms and 25 without) with 25 non-patient comparison subjects. The patients were matched to the comparison group with regard to age, sex, education, marital status and handedness. There were significant differences between OCD patients and the non-patient comparison group on neuropsychological functioning but not on neurological soft signs. As far as working memory concerns there was a significant difference between the OCD depressed and non-depressed groups. But we found no evidence that the neuropsychological functions such as cognitive flexibility, problem solving and spatial perception in OCD to be attributable to comorbid depression. The pattern of neuropsychological deficits in this sample of OCD patients is suggestive of orbito-frontal as well as dorsolateral prefrontal cortical dysfunction.

Persistent delayed auditory memory and executive function deficits 5 years after West Nile Virus Encephalitis: A neuropsychological and neuroimaging single case study

There are presently no in-depth published neuropsychological studies of West Nile Virus (WNV) encephalitis patients that have been well-correlated with high resolution structural MRI. In this study a middleaged male who developed West Nile Virus encephalitis five years previously was examined three times over a two year period. We examined him with the Wechsler Adult Intelligence Scales—Fourth Edition and the Wechsler Memory Scale—Fourth Edition (WAIS-IV/WMS-IV) and Advanced Clinical Solutions battery supplemented by tests of attention, executive, motor and sensory functions. Neuroradiological imaging revealed hypodensities within the left hippocampus in the axial and coronal planes with T2-FLAIR MRI. The man was previously high functioning and although he had prior history of well-controlled epilepsy it seems unlikely that the epilepsy could fully account for the neuropathological changes. The patient had previously completed a demanding six year double science degree program before he became ill with WNV and he had been a successful manager and director of a research company. Delayed auditory memory scores were at least two standard deviation units below age expected levels and semantic fluency and Booklet Category Tests of executive function were also in the impaired range. Moreover the illness onset profile of muscle weakness, extreme fatigue, memory complaints as well as inability to carry out research projects involving planning on the job were highly consistent with WNV encephalitis. If the memory and executive function deficits had been premorbid manifestations of epilepsy it is unlikely he would have attained the levels he did educationally and occupationally. This left hippocampal lesion is characteristic of other encephalitic viral infections such as herpes simplex virus. To our knowledge this is the first lateralized WNV encephalitis medial temporal lobe patient in the published literature.

Comparative Analysis of Post-Rehabilitation Neuropsychological Profile of a Patient with Susac Syndrome—A Case Report

Susac Syndrome (SS) is an autoimmune disease characterized by the clinical triad of encephalopathy, hearing loss and retinal arterial occlusions, with prevalent structural changes identified on brain magnetic resonance imaging (white matter, corpus callosum, basal ganglia region and the thalamic region extending to the midbrain) in the majority of cases, which lead to cognitive manifestations of which there is a paucity of descriptions in the literature. The objective of this case study is to compare to post-rehabilitation neurocognitive profile of a 29-year-old woman with SS presenting with compromised intellectual and motor skills and cognitive functions, together with neuropsychiatric symptoms. Better performance was found in the neuropsychological assessment, with changes in the structural cerebral network evidenced on Diffusion Tensor Imaging (DTI) performed following the therapeutic and pharmacological intervention.

Neuropsychological and Social Outcome of Patients Sustaining Traumatic Brain Injury in Cotonou

This inaugural study in Benin was aimed at assessing neuropsychological and behavioural problems of patients with traumatic brain injury managed at the Hubert Koutoukou Maga Teaching hospital in Cotonou, and the impact on their standard of leaving. This was a prospective and cross-cutting study with a descriptive and analytical aim. It was carried out from 1 July to 30 October 2018. The study population included patients over 15 years of age who had experienced TBI. A purposive sampling of 585 patients with TBI was done, of which 142 patients could not be reached by phone while. The mean age of patients was 37.16 ± 13.9 years, with extremes ranging from 16 to 87 years. The most frequent complaints were behavioural disorder (79.5%), headache (63.8%) and memory loss (50.4%). The average duration of post traumatic amnesia was 9.08 ± 38.56 days. Sixty-three patients (68.5%) had post-traumatic amnesia that lasted less than 30 minutes and 25 patients (19.2%) had post-traumatic amnesia that lasted over a month. Neuropsychological disorders were more frequent in patients with severe TBI. Attention disorders and difficulties in elaborating strategies were noticed without any statistically significant difference in mild, moderate as well as severe TBI. Nineteen patients lost their job, thus raising the unemployment rate in our sample from 6% to 21%. Among the 100 patients (75%) that recovered their job, 14% had medical follow-up and 10% returned to part-time work. Salary remained unchanged for 61.2% of TBI patients.

Neurological and neuropsychological consequences of electrical and lightning shock： review and theories of causation

Injuries from lightning and electrical injuries involve multiple systems of the body, however neurological symptoms are very widely reported. A disabling neuropsychological syndrome is also noted. This paper presents a comprehensive review of neurological and neuropsychological symptoms. Partial theories of causation for these injuries have been advanced, however, there is no convincing explanation for both delay in onset of symptoms and also the genesis of the neuropsychological syndrome. A theory of causation is proposed which satisfies both these constraints. This theory suggests circulating hormones such as cortisol, together with nitric oxide and oxidant free radicals from glutamatergic hyper-stimulation, act on tissues remote from the injury path including the hippocampus. This theory opens a research path to explore treatment options.

Preoperative and Postoperative Diffusion Tensor Imaging in Patients with Extra-Axial Lesions at the Frontal or Temporal Regions of the Brain and Their Correlations with Neuropsychological Outcomes

The underlying changes in the neuronal connectivity adjacent to brain tumours cannot always be depicted by conventional MR imaging. The hypothesis of this study was that preoperative neuropsychological deficits were associated with impairment of diffusivity in association fibre bundles. Hence, we investigated the potential of combined diffusion tensor imaging (DTI) fibre tracking and fractional anisotropy (FA) values of the fibres to determine changes in association fibres and their correlation to neuropsychological scores. Our study consisted of eighteen patients with extra-axial brain tumours in areas adjacent to the frontal and temporal lobes. They were assessed pre- and postoperatively with DTI and neuropsychological assessments. MR examinations were performed on a 3T-scanner. FA values were calculated for the uncinate fasciculus, arcuate fasciculus, superior fronto-occipital fasciculus, inferior fronto-occipital fasciculus and corticospinal tracts ipsilateral and contralateral to the tumor. These values were compared with neuropsychological scores for language, memory and attention. The analysis revealed marked differences in pre- and post-excision of the tumor in both FA values and neuropsychological scores. Quantitative DTI was able to show significant differences in diffusivity of the association fibres before and after the surgery (P < 0.05). The additional use of DTI-fibre integrity and neuropsychological tests may aid in prognostication and decision making prior to surgery.

Neuropsychological features of progranulin-associated frontotemporal dementia: a nested case-control study

The distinction between sporadic and genetic behavioural-variant frontotemporal dementia(bvFTD)regarding some neuropsychological(NP)features remains challenging.Specifically,progranulin(GRN)-associated bvFTD frequently presents with early episodic memory impairment and some degree of parietal dysfunction which are supporters of Alzheimer’s disease(AD)diagnosis.In this context,we aimed to characterize the NP profile of GRN-bvFTD as compared to sporadic-bvFTD and AD in patients with mild dementia(Mini-Mental State Examination score≥17 and Clinical Dementia Rating Scale score≤1.We identified 21 patients at Centro Hospitalar e Universitário de Coimbra,Portugal with GRN mutations belonging to fifteen different families.As our focus was bvFTD variants,FTD-related aphasic forms(3 patients)were excluded.The remaining 18 GRN-bvFTD were further matched with 18 sporadic-bvFTD and 18 AD patients according to disease staging,age and education.All patients completed the Mini-Mental State Examination,Montreal Cognitive Assessment(MoCA)and a comprehensive NP assessment battery.Results were converted into z-scores.Differences between groups in individual NP measures and NP domains were assessed through non-parametric tests(Kruskal-Wallis test analysis)and eta squared(ŋ2)was calculated as a measure of effect size.Group comparisons show that GRN patients have worse performances on verbal retrieval processes(P=0.039,ŋ2=0.110)and visuoconstructive abilities(P=0.039,ŋ2=0.190)than sporadic bvFTD forms.When compared to AD,GRN patients present a higher impairment in frontal(P=0.001,ŋ2=0.211)and parietal(P=0.041,ŋ2=0.129)measures and a better performance in memory tasks(P=0.020,ŋ2=0.120).Sporadic-bvFTD forms are worse than AD in frontal measures(P=0.032,ŋ2=0.200),being better in both memory(P=0.010,ŋ2=0.131)and visuospatial skills(P=0.023,ŋ2=0.231).Considering these results,we conclude that GRN-bvFTD patients present a NP profile that associates the typical patterns of FTD and AD deficits.This is particularly expressive in visuoconstructive abilities,which was the more discriminative feature between groups,followed by episodic verbal memory.This study was approved by the Institutional Ethics Committee of Centro Hospitalar e Universitário de Coimbra,Portugal(CE-029/2019)on June 24,2019.

Cognitive Effects of Late Life Depression: Review of Neuropsychological Findings

Normal aging and depression both slow information processing speed which leads to poorer attentional control, shallower inhibition monitoring, poorer encoding, poorer updating of short term memory, and subsequent poorer learning, set-shifting, error monitoring, inhibition control, and cognitive planning. A combination of aging and depression amplifies these cognitive effects. Deterioration in frontal brain functioning in normal aging is irreversible, but altering of frontal brain function due to depression may be reversible. Since the symptoms are indistinguishable, it is difficult to separate effects of depression and aging with use of neuropsychological tests, even when premorbid history is known. Statistical group effects show more severe cognitive effects in late life depression than in normal aging or depression in younger persons, but no particular cognitive markers of depression in older subjects have been identified. Attention and inhibition are closely related, but their relationship needs to be studied further. It is not clear, whether a problem with inhibition of irrelevant stimuli occurs because of attentional deficits due to late life depression, or if it is a primary consequence of the depression. Further studies on the relationship between inhibition, attention and processing speed involving homogeneous depressed and non-depressed groups of different age may help disentangle this relationship.