On the nature of motor disorders in mentally retarded patients.
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Adult↗
Biomedical subjects
D Grossi
Publications and source records attributed to D Grossi.
A critical review of mental imagery defects.
A critical, clinical review of single-case reports and group studies on visual mental imagery deficits is offered. Neuropsychological findings demonstrate that mental imagery relies upon dissociable processes which are localized in left-hemisphere posterior areas. Imagery defects thus may often be associated with visual recognition and naming impairments. On the other hand, the right hemisphere seems to play an analogous role in imagery and perception. Current theoretical models of imagery do not appear fully capable of accounting for available clinical data.
Attention↗
Exploring visuospatial short-term memory defect in Alzheimer's disease.
The present study aimed at controlling two variables that may affect the visuospatial short-term memory of Alzheimer patients: visuospatial coding efficiency and response modality. Thirty patients affected by Alzheimer-type dementia with relatively spared visuo-perceptual functions were tested under three conditions, all of which employed the same kind of stimuli (visuospatial patterns). At all memory tasks, patients achieved scores significantly lower than those of 30 age- and education-matched normal subjects. Patients did not benefit from longer presentation time, nor did their performance improve with pointing response modality, although they performed perceptual pattern recognition as well as did controls. These data confirm that visuospatial immediate memory capacity is reduced in dementia.
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Agreement in the clinical diagnosis of dementia: evaluation of a case series with mild cognitive impairment.
Interobserver agreement in the clinical diagnosis of dementia among four neurologists was evaluated. The physicians, masked to the original diagnoses, independently reviewed the clinical records of 50 outpatients consulting either the 1st University Neurology Department of Milan or the Neuropsychology Unit of the Medical Center of Veruno (Novara) for suspected cognitive impairment, during a 6-month period. The records contained patients' medical and neurological history, results of neuropsychological testing, laboratory tests, cerebral computed tomography and other investigations. For each patient, the raters had to provide both a diagnosis concerning the presence or absence of dementia and to assign an analytical diagnosis to all the dementia cases. The kappa statistic was used as a measure of interrater reliability. The level of agreement on the primary diagnosis of dementia was moderate (kappa = 0.49); with respect to the nosological diagnoses, the kappa values ranged from 0.16 for depression to 0.80 for multi-infarct dementia.
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Effect of testing procedure on Corsi's block-tapping task in normal subjects and Alzheimer-type dementia.
Corsi's block-tapping task was given to 30 normal subjects and 38 Alzheimer-type demented patients following two different procedures. The first is the most widely standardized (scoring criterion: 3 correct reproductions out of 5 sequences), while the second is more lenient since it does not require subjects to replicate a certain performance three times. Demented patients' scores were lower than those of controls in both conditions, and scores on the two tasks were significantly correlated for patients and controls. However, the requirement of replicating the visuospatial memory performances was more detrimental for demented patients than for controls so the two procedures cannot be considered equivalent.
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Visuospatial imagery in Alzheimer disease.
The purpose of the present study was to investigate the imagery ability of 8 "probable" Alzheimer disease patients using a standard task sensitive to the disruption of the imagery system. These patients were selected based on their good performance on a prerequisite clock-setting task, and with 8 matched control subjects were then required to compare the angles made by the hands on clock faces using only imagined stimuli. There were no significant differences between patients and controls in performance on the clock-imagery task. These data are consistent with models of information processing which postulate the relationships between visual imagery and a short-term memory store and include a central executive system for allocation of cognitive resources.
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"Experimental amnesia" induced by emotional items.
Tulving described an effect of retrograde amnesia in a free-recall task of word lists, produced by inserting items having priority in recall. Other authors confirmed the amnesic effect without giving instructions for priority both in recall and in recognition tasks. The effect was explained by Tulving as a premature termination of encoding processes. The similarity between these experiments and the researches aimed at reproducing amnesia by emotional trauma led us to hypothesize that the two phenomena might be due to the same functional mechanisms. We have organized a free-recall task of word lists into which emotional items were inserted. Our aim was to verify whether with these experimental conditions Tulving's results would be reproduced. The obtained data show amnesic effects in free recall; nevertheless, they do not seem to confirm closely the experimental hypothesis. Lastly, changes in primacy and recency effects produced by emotional items are analyzed.
Adult↗
Copying procedures in focal brain-damaged patients.
We aimed to ascertain whether non-apraxic, focal brain-damaged patients used abnormal constructional procedures. We tested a series of consecutive patients, classified according to lesion locus and side against a matched sample of normal volunteers. Subjects had to copy the Rey-Osterreith Figure, a complex and structured item that explores copying strategies. We used special testing and scoring methods to analyze different steps of the copy. Unlike the controls, the patients did not choose the central elements of the figure as guiding structures. All patient groups followed an equivalent "pathological", "piecemeal" procedure.
Analysis of Variance↗
Slowly progressive aphasia associated with surface dyslexia.
We report an Italian patient affected by slowly progressive aphasia (SPA) lasting since four years when he first came to our observation. During the successive four years, we documented a progressive language decline resembling transcortical sensory aphasia, associated with a reading disorder corresponding to surface dyslexia, a form extremely rare in patients with native transparent language. His performance at standard intelligence tasks remained in the normal range, without any variation. CT scan showed left temporal atrophy. We emphasize the heterogeneity of the syndrome of SPA and suggest that it can represent one of the pictures of focal cortical degenerative disease, with variable onset, progression, and evolution.
Activities of Daily Living↗
Memory for visuospatial patterns in Alzheimer's disease.
Immediate memory for visuospatial information was assessed in patients affected by Alzheimer-type dementia but with unimpaired visuo-perceptual functions. Patients were given two tasks: one was a traditional visuospatial memory task (Corsi's block tapping test), the second explored specifically immediate memory for visuospatial patterns. The experiment was conducted in two parallel groups of patients in Italy and the United States, each with its own appropriate sample of normal control subjects. Results showed a specific deficit of visual working memory in demented patients, even in a task in which control subjects achieved error-free performance. These data are interpreted in the light of the Working Memory Model, and suggest that in dementia the functions of the Visuospatial Scratchpad, unlike the functions of the verbal subsystems, may be impaired.
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Evaluation of the influence of illiteracy on neuropsychological performances by elderly persons.
The aim of the present study was to verify the role of the primary notions acquired in early school in the formation of a general strategy in elaboration of information. For this purpose we selected a tiny rural village in southern Italy which comprises a substantial number of elderly persons having very little formal schooling. These subjects were screened using a test battery composed of classic neuropsychological tests and reaction-time tests. In the subjects studied we observed a significant correlation between the amount of education and the neuropsychological performances, although no such correlation existed for reaction times. Subjects having little schooling (up to 3 years) performed better than the illiterate persons on the Constructional Apraxia test and on the Raven Matrices. However, the reaction times were similar in these groups. On this basis we claim that reaction-time tests might form a basic tool in evaluating cognitive performances of persons with very little schooling. Further, the primary notions learned during the first few years of schooling induce an improvement in mental strategies that is well-preserved in the normal aging process.
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Impaired drawing from memory in a visual agnosic patient.
A case is reported of an associative visual agnosic patient who could not draw from memory objects he could recognize, even though he could copy drawings flawlessly. His ability to generate mental visual images was found to be spared, as was his ability to operate upon mental images. These data suggest that the patient could generate mental images but could not draw from memory because he did not have access to stored knowledge about pictorial attributes of objects. A similar functional impairment can be found in some other visual agnosic patients and in patients affected by optic aphasia. The present case allows a discussion of relationships among drawing from memory, imagery, and copying procedures.
Adult↗
Short-term memory and verbal learning with auditory phonological coding defect: a neuropsychological case study.
A patient is described with a rarely reported linguistic syndrome: he could repeat words but not nonwords. The patient produced semantic paraphasias in repetition and could read both words and nonwords flawlessly. His basic difficulties were localized in auditory phonological coding, identifying a clinical picture called "phonemic deafness." Short-term memory and verbal learning results suggested that a standard, selective short-term memory defect can be induced by auditory phonological coding deficits as well as by "pure" short-term memory capacity limitation and other phonological deficits. Findings also provided evidence that lexical-semantic code can allow normal verbal learning.
Adult↗
Visual associative agnosia and optic aphasia. A single case study and a review of the syndromes.
The case is presented of a patient who showed visual naming disturbances caused by a left occipital infarction. His performance on tests of visual naming, of recognition not requiring a verbal response, and of verbal-visual matching demonstrated a wide range of qualitatively different errors, including complete inability to recognize the object, access to partial semantic knowledge, and mere name finding difficulty. On the basis of the present case and of a review of the recent literature, the clinical distinction between visual associative agnosia and optic aphasia and the relation of these disorders with the anatomical site of lesion are discussed.
Agnosia↗
Glycosaminoglycan polysulfate in the treatment of old age dementias.
1. In a multicenter, placebo-controlled, double-blind clinical trial in 155 elderly patients with cognitive decline, glycosaminoglycan polysulfate was found to be a therapeutically effective agent in the treatment of old age dementias. 2. Treatment with glycosaminoglycan polysulfate in the daily dosage of 600 LRU, administered on the basis of a divided dosage schedule for 12 weeks, was significantly superior to an inactive placebo on several outcome measures including the Wechsler Memory Scale-Russell Revision (Easy Paired Associates Learning and Immediate Visual Reproduction), Mini Mental State Examination, the Sandoz Clinical Assessment Geriatric (Cognitive Dysfunction and Depression), Hachinski Dementia Scale, Brief Psychiatric Rating Scale (Confusion and Depressive Withdrawal) and Global Improvement Scale of the Clinical Global Impression. 3. Adverse effects with glycosaminoglycan polysulfate were few and mild. The drug was equally well tolerated and equally effective in the two major dementias of old age, i.e., primary degenerative and multi-infarct. The number of abnormal laboratory test readings remained essentially unchanged from pre-treatment to post-treatment.
Activities of Daily Living↗
Apperceptive and associative forms of prosopagnosia.
Three prosopagnosic patients were given four face tests, two perceptual (an unknown face identification test and an age estimation test) and two also implying memory (a familiarity check test and a famous face recognition test). The patients' performance was assessed with reference to the score distribution of the normal population. A patient was found to fail both perceptual and mnestic tests, without any noticeable difference between them. Also the second patient had poor scores on both kinds of tests, but his impairment was significantly greater on the perceptual ones. The third patient, on the contrary, showed no perceptual deficit and only failed the mnestic tests. His inability to recognize the individuality of an item among members of the same category was strictly confined to faces and never present for other classes of stimuli (cars, coins, personal belongings). This finding is supportive of the thesis that in a few patients the deficit underlying prosopagnosia is face specific.
Adult↗
Urinary 6-sulphatoxymelatonin, an index of pineal function in the rat.
The objective of this study was to apply the radioimmunoassay for 6-sulphatoxymelatonin (aMT6s) to rat urine, and use it to study the source of aMT6s. The radioimmunoassay was found to have acceptable within- and between-assay variation, excellent specificity, and good parallelism between the standard and unknown. Because urine is highly contaminated we assessed whether preliminary purification was required and established that it was unnecessary. Using this assay a 24-hr rhythm in 6-sulphatoxymelatonin output was seen in pools of urine harvested at 3-hr intervals from Wistar rats on LD 12:12. The nocturnal rise in aMT6s was abolished by constant light. In contrast pinealectomy lowered aMT6s output significantly throughout both dark and light. This study confirms previous studies indicating that the pineal is the major source of 6-sulphatoxymelatonin. It is concluded that urinary 6-sulphatoxymelatonin as measured by radioimmunoassay is a valid measure of pineal gland activity in the rat.
Animals↗
Mixed transcortical aphasia: clinical features and neuroanatomical correlates. A possible role of the right hemisphere.
This paper reports the clinical features of 2 patients affected by mixed transcortical aphasia. Both of them had extensive damage of the left hemisphere. Cerebral blood flow measurement showed a marked decrease in left-hemisphere flow. In particular, speech areas were found to be morphologically and functionally damaged. The present findings, together with a critical review of the literature, served as a starting point for a discussion of linguistic features, diagnostic criteria and classical neuroanatomical interpretation of mixed transcortical aphasia. The possible contribution of the right hemisphere in determining this aphasic syndrome is suggested.
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