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Biomedical subjects

D C Delis

Publications and source records attributed to D C Delis.

54 records · Page 3Linked to original sources

Are all subcortical dementias alike? Verbal learning and memory in Parkinson's and Huntington's disease patients.

The utility of the concept of 'subcortical dementia' was investigated by comparing the verbal learning and memory abilities of Parkinson's disease (PD) patients with those of Huntington's disease (HD) patients. Many similarities between the PD and HD groups emerged, including impaired immediate memory spans, inconsistency of recall across learning trials, deficient use of a semantic clustering learning strategy, elevated intrusion rates on delayed recall, impaired recognition memory performance, normal retention of information over delay periods, normal vulnerability to proactive or retroactive interference, and normal types of intrusion errors. The HD subjects, however, displayed inferior free recall, deficient improvement across learning trials, abnormal serial position recall effects, higher perseveration rates, and supranormal improvement on recognition testing compared with free recall. Implications of these results for characterizing memory deficits associated with subcortical system dysfunction are discussed.

Adult↗

Block constructions of chronic alcoholic and unilateral brain-damaged patients: a test of the right hemisphere vulnerability hypothesis of alcoholism.

A detailed analysis of the block construction performance of chronic alcoholics, unilateral brain-damaged patients, and normal control subjects was conducted to test two hypotheses: (a) that alcoholics perform similarly to right-hemisphere damaged (RHD) patients but not left-hemisphere damaged (LHD) patients; and (b) that unilateral brain-damaged patients display qualitatively different strategies and errors. Differences in performance without a time limit and broken configuration errors suggest that the alcoholics have not incurred the type of visuospatial impairment characteristic of RHD patients. The LHD and RHD patients showed qualitative differences in their strategies and errors. Implications of the findings for research and clinical assessment of visuospatial dysfunction are discussed.

Journal Article↗

Visuospatial functioning before and after commissurotomy. Disconnection in hierarchical processing.

A patient who underwent complete cerebral commissurotomy was tested before and after surgery on tasks involving drawing and recognition memory for visual hierarchical stimuli. These stimuli consisted of a large, higher-level form constructed from smaller, lower-level forms. Postoperatively, the patient was more accurate in drawing and recognizing higher-level forms relative to lower-level forms when responding with his left hand and primarily right hemisphere, whereas he showed the opposite pattern when responding with his right hand and primarily left hemisphere. Implications of these findings for theories of the cerebral organization of visuospatial processing are discussed.

Adult↗

Visuospatial dysfunction following unilateral brain damage: dissociations in hierarchical and hemispatial analysis.

Unlike the aphasias, visuospatial dysfunction has resisted fractionation into meaningful spared and impaired component functions. In this study, we show that unilateral brain damage results in pronounced dissociations in both hierarchical and hemispatial processing. Patients with left-hemisphere damage showed the greatest impairment in drawing forms at the lower level of hierarchical stimuli presented in right hemispace, whereas patients with right-hemisphere compromise displayed the opposite pattern. We discuss implications of these results for research in visuospatial function and clinical assessment of visuospatial dysfunction.

Aged↗

'Part-whole' processing in unilateral brain-damaged patients: dysfunction of hierarchical organization.

Visuospatial processing in unilateral brain-damaged patients was investigated by aligning two elements along different axes of an equilateral triangle and asking subjects to report the direction the triangle appeared to point when first observed. Left brain-damaged patients were more affected by the alignment than right brain-damaged patients, with controls performing in between the two brain-damaged groups. The implications of these findings for hemispheric differentiation in visuospatial processing are discussed.

Brain↗

Hemispheric specialization of memory for visual hierarchical stimuli.

Unilateral brain-damaged patients and normal control subjects were asked to remember visual hierarchical stimuli consisting of larger forms constructed from smaller forms. The right-hemisphere damaged patients made more errors in remembering the larger forms relative to the smaller forms, whereas the left-hemisphere damaged patients made more errors in remembering the smaller forms relative to the larger forms. These findings are discussed as they relate to hemispheric specialization for visuospatial processing.

Cerebrovascular Disorders↗

Retrieval from semantic memory in Alzheimer-type dementia.

Retrieval from semantic memory, measured by tasks requiring subjects to name items from a given category, was studied in mild Alzheimer-type dementia (Mild-ATD) subjects, moderate-to-severe Alzheimer-type dementia (MS-ATD) subjects, and normal controls. Semantic retrieval performance was shown to be highly sensitive to both the presence and the severity of ATD. Retrieval from both semantic categories and letter categories showed differences in the rate of production of correct responses between subject groups. These rate differences were not due to differences in accessibility of low-dominance semantic category members or low-frequency letter category members. An increase in errors as well as a decrease in correct responses contributed to the performance deficits of the ATD subjects. Furthermore, the pattern of errors changed from Mild- to MS-ATD. Qualitative as well as quantitative differences were also observed in the performance of Mild- versus MS-ATD groups on a third type of semantic retrieval task--the supermarket task. As performance of the ATD subjects declined on these semantic retrieval tasks, so did their performance on other tasks assessing primarily attention, language, and memory. The findings are discussed in terms of the progressive breakdown in both attentional and semantic memory functions which are associated with ATD.

Aged↗

Buccofacial apraxia without aphasia due to a right parietal lesion.

Buccofacial praxis in right-handers is thought to be mediated by the left hemisphere. We present the case of a right-handed man without family history of sinistrality who exhibited a buccofacial apraxia following a unilateral right parietal infarction. Other findings such as intact language, visuospatial impairment, and hemi-inattention are more characteristic of right posterior lesions.

Apraxias↗

The effect of alcohol abuse on perceptual reference frames.

Visuospatial processing in alcoholics was investigated by aligning two elements along different axes of an equilateral triangle and asking subjects to report the direction the triangle appeared to point when first observed. Alcoholics were not as affected as controls by alignment of the elements. The implications of these findings are discussed.

Adult↗

Processes of verbal memory failure in Alzheimer-type dementia.

Multiple aspects of verbal learning and memory performance in mild as compared to moderate Alzheimer-type dementia (ATD) were studied with the Buschke selective reminding paradigm. Results show that (1) both groups of ATD subjects depend less on long-term memory (LTM) and more on short-term memory (STM) relative to elderly control subjects, (2) mild ATD subjects show less LTM encoding than moderate ATD subjects, (3) moderate ATD subjects retrieve a smaller portion of the items presumed to be encoded into LTM than do mild ATD subjects, and (4) high-imagery words increase LTM encoding and retrieval as compared to low-imagery words for moderate ATD subjects only. These results are explained by the inability of ATD subjects to attend to more than one component of the list-learning task, in conjunction with differences in the deployment of attention between mild and moderate ATD subjects.

Alzheimer Disease↗

The Stroop color-word test: indicator of dementia severity.

The Stroop color-word test was used to examine patterns of cognitive decline in Alzheimer-type dementia (ATD) and non-Alzheimer dementia. Slowing on color naming and word reading was observed, and was greater in moderate than in mild dementia subjects. However, error scores were unrelated to dementia type and severity. The Stroop interference effect, measured with reaction time, was high in individuals with mild ATD and mild non-Alzheimer dementia. In contrast, the more severely impaired ATD subjects showed less Stroop interference effect than mildly impaired subjects when the reaction time was adjusted for color naming performance. These findings are attributed to variation in speed-accuracy tradeoff for the patient groups due to differences in information processing deficits, linguistic impairment, and attitudes to errors. This study demonstrates the importance of partialling out underlying deficits for the understanding of complex cognitive processes in dementia.

Aged↗

Reversed hemispheric organization in a lefthander.

For left-handers, cognitive functions are organized in the brain similarly to right-handers or they are more diffusely represented. In this study, we report a left-handed patient with a focal right temporal-parietal lesion who evidenced a lasting Wernicke's aphasia and visual-spatial functioning typical of a right-hander with left-hemisphere in involvement. The patient's performance on other tasks (e.g. praxis, singing) as well as observed behavioral changes also resembled those of a right-hander with left-hemisphere compromise. This case suggests that it is possible for cognitive functions to be inversely represented in the two hemispheres.

Aged↗

The contribution of the right hemisphere to the organization of paragraphs.

Patients with unilateral right-hemisphere lesions performed significantly worse than normal controls in arranging the mixed-up sentences of stories. This impairment was not restricted to paragraphs conveying primarily spatial information, but occurred on other types of paragraphs as well. Nonspecific deficits of brain injury were ruled out as possible alternative explanations for the patients' difficulty on the task. The organization of language at the paragraph level may depend on right-hemisphere functioning.

Brain Damage, Chronic↗

The breakdown and rehabilitation of visuospatial dysfunction in brain-injured patients.

Neuropsychological studies on visuospatial dysfunction are reviewed and a model is described that characterizes hemispheric specialization of this function. It is proposed that the right hemisphere is dominant for configural processing and the left hemisphere for detail processing. Past efforts of visuospatial rehabilitation, which have focused primarily on one type of impairment, "left-neglect", are discussed. Future directions for rehabilitation of visuospatial dysfunction associated with both right- and left-hemisphere pathology are suggested.

Brain Diseases↗