The Influence of Behavioral and Psychological Symptoms of Dementia on the Autonomic Nervous System

Stress is one of the most potent of many factors that can cause expression of behavioral and psychological symptoms of dementia (BPSD). Stress can also increase autonomic nervous activity. This study aimed to examine the relationships between BPSD and autonomic function in the elderly with dementia. We recruited 35 participants diagnosed with dementia from nearby geriatric health service facilities. The Neuropsychiatric Inventory was used for the evaluation of BPSD, and a TAS 9 VIEW (manufactured by YKC) was used for the heart rate variability analysis to measure autonomic nervous system activity. We constructed a model in which the autonomic nervous system comprised a category and performed a structural equation modeling analysis to calculate the standardization coefficient and correlation coefficient for each factor. The results showed that the influence of BPSD resulted in suppression of sympathetic and enhancement of parasympathetic nervous system activity.

Differences of Neglect in Peripersonal Space and Extrapersonal Space in a Patient with Unilateral Spatial Neglect

Unilateral spatial neglect (USN) is characterized by neglect in peripersonal and extrapersonal space, the disparity of which is unknown. We assessed these forms of neglect in a patient with USN. We promoted sight scanning in extrapersonal space and used an eye camera to measure gaze movement. We found left-sided sight scanning in peripersonal space, but right-side-biased sight scanning in extrapersonal space. Additionally, line of sight was corrected when the patient was instructed to look left in extrapersonal space and to focus the line of sight at the center. Gaze measurement thus helped to assess disparities in spatial neglect in USN.

Head Position of Patients with Right Hemisphere Damage during a Visual Search Task in a Large Field

Spatial neglect syndrome with cerebral lesions is characterized by the ina-bility to orient, report, or respond to relevant visual stimuli contralateral to the lesions. In this study, we investigated the pattern of horizontal visual search in a large space;this search was performed by patients with right hemisphere damage caused by cerebrovascular disease. The neck rotation angle and search time in each increment were continuously recorded during the task, and quantitative data of the measurements were collected. Head position during the visual search task in a large space (%) was then calculated. We set angular bands in increments of 5 degrees from the midline on the left and right sides, and calculated the total search time in each angular band. In patients with unilateral spatial neglect (USN), the search time in the angular band of 5 - 9 on the right side was significantly longer (with USN 16.7%, without USN 4.5%, t = 2.52, df = 16, p < 0.05). Furthermore, in patients with neglect in the leftmost end area in a large space, the search time was significantly shorter in the angular band of 1 - 4 degrees to the left (with neglect 13.1%, without neglect 23.7%, t = 2.13, df = 16, p < 0.05), and tended to be long in the angular band of 5 - 9 to the right. The neck rotation angle and pattern during the search task in a large field deviated slightly to the right, and the search time slightly to the left was short. We believe that these results support the rightward deviation of the search pattern and frame of USN patients.

Utility of Tracing as a Memory Storage Method

Although many studies have explored the utility of tracing as a rehabilitation approach for patients with aphasia and alexia and for Japanese patients with various disabilities, this may be the first study to demonstrate the superiority of tracing over copying for enhancing long-term memory. We investigated the utility of tracing as a memory storage method. Young and elderly participants learned a figure from the Rey-Osterrieth complex figure test by copying or tracing its outline. They were asked to reproduce the figure after 3 min and 3 days. Although the copying group performed better than the tracing group in immediate recall after 3 min, the performance of the tracing and copying groups after 3 days was similar. Among younger participants, the tracing group achieved higher scores than the copying group after 3 days;however, the difference was not statistically significant. Copying as a learning strategy has a substantial temporal gradient of memory loss;tracing may be more appropriate for improving long-term memory. This result could have considerable practical usefulness, e.g., among professionals who provide memory training for the elderly. Tracing, which uses visuomotor memory, is acquired earlier than transcription. Tracing may be effective for rehabilitation because it is a developmentally appropriate approach to early instruction.

A Study on Visual Search during the Trail Making Test: Analysis Using an Eye Tracker

The Trail Making Test A (TMT-A) is a task related to visual search. Therefore, performance in the TMT-A has a high possibility of being influenced by visual information, such as the arrangement of numbers. The purpose of this study was to measure eye movements during the TMT-A using an eye tracker, to analyze differences in enforcement and trace execution, and to examine appropriate inspection drawings as visual search tasks. Study 1 was performed in 14 young healthy subjects and Study 2 was performed in 6 young healthy subjects. The English and Japanese versions of the TMT-A were administered as usual and the subjects performed the traces in a sitting position. The eye movements of the subjects were measured during the task. We analyzed the combined motion angles of both eyes. We compared the average values (30 Hz/s) of movement in the horizontal (X-axis) and vertical (Y-axis) directions during the normal administration of the English and Japanese version of the TMT-A. We also compared the traces performed by the subjects. There were no differences in tracing or enforcement in the English version of the TMT-A. Especially in the vertical visualization operation, it was shown that the normal enforcement was fewer than the tracing, and almost no up-to-down search was performed. In contrast, the subjects performed visual searches in all directions during the Japanese version of the TMT-A.