Developmental syndrome of the angular gyrus.
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Adult↗
Biomedical subjects
D F Benson
Publications and source records attributed to D F Benson.
The effects of prefrontal leucotomy on visuoperceptive and visuoconstructive tests.
Visuoperceptive and visuoconstructive tests were administered to three groups of schizophrenics who had undergone bilateral prefrontal leucotomy approximately 25 years earlier. A nonoperated schizophrenic patient group and a normal subject group served as controls for the effects of schizophrenic symptomatology and for age and education. The results demonstrated that orbital frontal white matter lesions do not disturb simple perceptions and constructions. The nonoperated schizophrenics had significant problems on many of the tests. Only one test, the WAIS Picture Arrangement, revealed deficits in all patient groups, including the good recovery leucotomized patients. This suggests impairment in the higher-order control and organization of perceptual material which may be secondary to orbital frontal white matter lesions or reflect aspects of the underlying schizophrenic disorder.
Frontal Lobe↗
Parkinsonian dementia: cortical or subcortical?
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Alzheimer Disease↗
The fluorodeoxyglucose 18F scan in Alzheimer's disease and multi-infarct dementia.
Patients with Alzheimer's disease and multi-infarct dementia were studied with scans using fluorodeoxyglucose tagged with fluorine 18. The rates of glucose metabolism were calculated. Patients with Alzheimer's dementia showed decreased metabolism in all areas of the brain but with preferential sparing of the primary motor and sensory cortex. Patients with multi-infarct dementia also had global reductions in glucose metabolic rates when compared with normal control subjects, but the areas of hypometabolism were focal and asymmetric.
Aged↗
The involvement of orbitofrontal cerebrum in cognitive tasks.
Although the frontal lobes are frequently associated with high-level cognitive functions, patients with significant frontal damage often maintain normal "intelligence". While recent research has clarified some aspects of this enigma, specific questions remain concerning the nature of the deficit in these patients and its relation to lesion localization within the frontal lobes. A group of psychiatric patients who had undergone prefrontal leucotomy 25 years earlier and whose frontal lesions were bilateral and maximal orbitofrontally were evaluated. Sixteen leucotomized schizophrenics, divided into three groups based upon recovery after psychosurgery, were compared to two control groups: (1) non-leucotomized chronic schizophrenics; (2) normal subjects. Four tests were administered: Wechsler Adult Intelligence Scale, Wisconsin Card Sorting test, Visual Metaphor test, and the Visual Verbal test of abstraction. The results suggest that orbitofrontal pathology does cause impaired performance on certain cognitive tests, which appeared independent of IQ measures.
Cognition↗
Comparison of metabolic rates, language, and memory in subcortical aphasias.
Four patients with subcortical lesions and either aphasia or amnesia were compared to four patients with cortical lesions and aphasia. Each patient had [18F] fluorodeoxyglucose positron-emission computed tomography, language, and memory evaluations. Marked metabolic depression was found in the thalamus and caudate in all patients. The subcortical patients had only mild left-cortical changes, while the cortical patients showed marked cortical metabolic changes in the left hemisphere. Language changes were mild in the subcortical patients, while moderate to severe in the cortical patients. All patients showed severe verbal memory dysfunction. The only common abnormalities in the two groups were metabolic changes in the thalamus and severity of verbal memory dysfunction. These findings suggest a relationship between verbal memory and thalamic function.
Adult↗
The human Klüver-Bucy syndrome.
Twelve patients with the Klüver-Bucy syndrome (KBS) are described. The syndrome occurred in head trauma, Alzheimer's disease, Pick's disease, and following herpes encephalitis. KBS was transient after head trauma but was a persistent feature of the postencephalitic syndrome. In all cases KBS was combined with aphasia, amnesia, or dementia. Human KBS resembles the monkey syndrome, but in humans there is a more elaborate complex of behavioral disturbances. The behavioral manifestations are produced by bilateral temporal lobe dysfunction. Partial expression of the syndrome may have localizing validity.
Adult↗
Subcortical dementia: a clinical approach.
At present there is no specific treatment for cortical dementia. On the other hand, many of the disorders listed as subcortical dementia will respond, at least to some degree, to appropriate treatment; some can be completely reversed. Dementia is a serious disability, and discovery of those demented individuals who may respond to treatment is of obvious importance. It would appear that many, possibly a majority of demented patients, have a disorder other than Alzheimer or Pick varieties of cortical dementia. It can be hoped that many individuals currently diagnosed as ASD, primary dementia, senile dementia, or OBS and relegated to a custodial or nursing-home existence would respond to treatment sufficiently to enjoy a better existence in their remaining years. The strongest tool in the physician's diagnostic armamentarium for discerning such individuals is the clinical examination outlined here. The clinical pictures of the cortical and the subcortical types of dementia are often sharply different and offer a promising lead for the management of dementia.
Aged↗
Mutism: loss of neocortical and limbic vocalization.
A patient with complete mutism of 5 years duration was studied to determine the cause of the defective phonation. The patient had neurological findings indicative of pseudobulbar palsy, but he had lost emotional vocalization and emotional facial expression, as well as propositional speech. Phylogenetic, ontogenetic, and anatomic evidence indicates that propositional speech and volitional facial movements are mediated by corticobulbar tracts descending from neocortical areas, whereas emotional vocalization and emotional facial expression are dependent on intact limbic system connections. The findings suggest that the patient's impaired faciovocal expression was the result of lesions involving both limbic system and descending neocortical connections.
Bulbar Palsy, Progressive↗
Angular gyrus syndrome simulating Alzheimer's disease.
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Aged↗
Visual recognition through kinaesthetic mediation.
A case is reported in which mercury intoxication produced visual symptoms with an unusual compensation. The similarity of this patient to Schn., a much reported neuropsychiatric case, was striking and prompted correlation of the two cases. Experimental psychological studies performed on the present case provide a basis for an understanding of both cases.
Adult↗
Evidence for the involvement of orbitofrontal cortex in memory functions: an interference effect.
Although it is frequently stated that the frontal lobes play a significant role in memory function, research proof has been ambiguous at best. This problem was addressed by administering a variety of memory tests to 16 schizophrenic patients who had undergone prefrontal leucotomy approximately 25 years earlier. The 16 were divided into three groups on the basis of recovery after surgery. Two comparison groups were established to control for psychiatric symptomatology, years of institutionalization, age, and years of education. The results demonstrate that large bilateral orbitofrontal lesions may not result in amnesia; in fact, the nonoperated schizophrenic control group performed the most poorly. Proactive interference was demonstrated, however, resulting in significant impairment for all patients with prefrontal lobe damage despite normal scores on commonly used memory tests. Ability to maintain consistent and directed attention and to overcome interference is proposed as a role of the frontal lobes in memory function.
Amnesia, Retrograde↗
Motor abilities after frontal leukotomy.
The effect of bilateral frontal leukotomy on motor function was evaluated by neurologic examination, tests of praxis, and appropriate neuropsychologic tests administered to five groups of subjects. Postleukotomy schizophrenic patients were subdivided into three degrees of recovery. Two nonleukotomized groups served as controls for effects of schizophrenia, age, and education. The results indicate that the size of the bifrontal damage was not significant in the response to the motor tests, whereas the severity of schizophrenia clearly affected results. As tested, bilateral orbitofrontal white matter lesions did not disturb motor competency.
Brain Diseases↗
Dementia in the elderly: the silent epidemic.
The graying of America will be accompanied by an epidemic of major proportions--dementia or intellectual impairment--that will have an impact on all aspects of the helath care system, particularly on the institutional component of the long-term care system. Health professionals; federal, state, and local health planners; families; and others must recognize that many ameliorable or curable physical and emotional diseases in the elderly are associated with intellectual impairment that may be difficult to distinguish from irreversible brain disease of the Alzheimer type. We present information on the cause, physiopathologic mechanism, clinical presentation, appropriate laboratory studies, and anticipated outcomes in the various forms of intellectual impairment found in the elderly. Important new developments will occur in the next decade that will address the cause, pathogenesis, further refinement of laboratory investigation, and specific therapeutic intervention in dementia.
Aged↗
Frontal leukotomy size and hemispheric asymmetries on computerized tomographic scans of schizophrenics with variable recovery. Northampton Veterans Administration study.
The computerized tomographic (CT) scans of 17 schizophrenic men who had had bilateral prefrontal leukotomy performed 25 years earlier were examined to determine the relationship among leukotomy site, size, hemispheric asymmetries, and recovery. Six cases of good recovery (GR), five of moderate recovery (MR), and six of no recovery (NR) were studied; 16 of 17 patients were right-handed. Results showed that the GR cases had significantly larger lesions in the low orbitofrontal region (especially on the left) than did the other MR and NR cases. Also, five of six of the GR cases had significantly greater lesion size asymmetry in the low orbitofrontal region and overall than did the other MR and NR cases. There was no consistent asymmetry of lesion size (larger right or left) that was associated with recovery. Significant differences were observed in the hemispheric asymmetries of the right-handed schizophrenics vs normal subjects. Only half the cases had the expected increased left occipital width, and half had unexpected equal or increased right occipital widths. All of the GR cases had either an increased left or right occipital width; none had equal widths. Additional observation of long-standing leukotomy sites on CT scans in schizophrenia cases is recommended.
Aged↗
The long-term effects of prefrontal leukotomy.
To explore the long-term effects of bilateral prefrontal destruction, 16 schizophrenics who had undergone prefrontal leukotomy approximately 25 years earlier were studied by neurologic examination, psychiatric outcome, EEG, computerized tomography (CT), and a battery of neuropsychological tests. Five nonleukotomized chronic schizophrenics and five age-matched normal subjects served as controls. We report details on the subjects, outline the test procedures, and offer an overview of the long-term residua. In general, the larger the frontal lesion demonstrated by CT, particularly if asymmetric, the better the psychiatric outcome and the better the performance on psychological testing, but there was no correlation between frontal lesion size and either neurological or EEG abnormality.
Brain Diseases↗
Depression in aphasic patients: frequency, severity, and clinical-pathological correlations.
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Activities of Daily Living↗
Long-term effects of prefrontal leucotomy--an overview of neuropsychologic residuals.
A battery of neuropsychologic tests was administered to 16 schizophrenics who had undergone prefrontal leucotomy approximately 25 years earlier. The 16 were divided into three groups based on their recovery after surgery. Five non-leucotomized chronic schizophrenics and five normal subjects served as controls. This paper presents a description of the subject population, a listing of the neuropsychologic battery administered, as well as main results from each major psychologic function tested. This information serves as an introduction and an overview for later detailed results.
Adult↗