Biomedical subjects

E Capitani

Publications and source records attributed to E Capitani.

At least 19 recordsLinked to original sources

PubMed2005

Interpretation of a complex picture and its sensitivity to frontal damage: a reappraisal.

A. R. Luria introduced the interpretation of a meaningful picture as a tool for assessing pre-frontal impairment. We gave this test to 196 normal adults, who were asked to communicate what was happening in the portrayed scene (a boy chases a mouse hidden under a cupboard, while three frightened girls assist). The same subjects were given two other frontal tests (verbal fluency on phonemic cue and Trail Making Test (TMT)) and Raven's Matrices. Twenty-three normal subjects (12%) failed to correctly interpret the picture. We also examined 20 patients whose brain lesion encroached upon pre-frontal areas, in order to check if this version of the test could be easily administered to this type of patient, and if its difficulty level was appropriate for avoiding ceiling and floor effects. Twelve patients were unable to interpret the picture (60%). A similar failure rate was observed with the same subjects on verbal fluency and TMT, while Raven's Matrices were less impaired (35%). Some dissociation was found between Picture Interpretation and the TMT. The Italian version of the Picture Interpretation Test is suitable for the examination of pre-frontal patients.

Adult↗

PubMed2005

Temporal gradients for media-mediated memory: Italian norms.

Temporal gradient (TG), i.e., differential recall of recent and old memories, is a well known feature of amnesia. A recent study provided evidence of a classical TG for media-mediated events in elderly healthy people, showing that they recall remote events significantly better than recent ones, while a reverse TG, i.e., better recall of more recent events, was demonstrated in younger normal subjects. In the present study we present normative data which, using the same test, allow evaluation of TG in single cases and their qualification as classical or reverse. The normative procedure was also applied to a small sample of subjects with probable Alzheimer's disease or mild cognitive impairment. Norms for TG may be helpful not only to assess healthy people's performance, but also to judge any apparent TG in pathological subjects.

Aged↗

PubMed2004

Cognitive deterioration in Alzheimer's disease: is the early course predictive of the later stages?

This study investigated the predictive value of the early progression rate of Alzheimer's disease on that of the later stages. We retrospectively evaluated 91 patients affected by possible Alzheimer's disease; the patients had been examined twice with the Milan overall dementia assessment (MODA) scale at an interval of 12 months (53 patients) or 24 months (38 patients). At the first assessment, speed of progression was calculated for each patient dividing the MODA difference from the normality threshold by the time elapsed from the cognitive decline onset. The second assessment of speed of progression was calculated dividing the difference between the two MODA scores by the time elapsed from the first examination. Patients with a slow progression rate in the early stage were unlikely to show a subsequent fast progression rate, and vice versa for patients with a fast early progression. A tool is provided for predicting the speed of cognitive decline of patients from a single MODA assessment. We suggest that, in future clinical trials on Alzheimer's disease, a stratification of participants based on the early rate of cognitive deterioration may be considered.

Age of Onset↗

PubMed2001

Agrammatic Broca's aphasia is not associated with a single pattern of comprehension performance.

One influential hypothesis posits that the brain regions implicated in Broca's aphasia are responsible for specific syntactic operations that are necessary for the comprehension and production of sentences (Grodzinsky, 1986, 1990, in press). The empirical basis of this hypothesis is the claim that Broca's aphasics have no difficulty understanding sentences in the active voice (and other "canonical" sentence types, such as subject relatives and clefts with negative predicates), but perform at chance level with passive voice constructions (and other "noncanonical" sentences such as object-gap relatives and object clefts). In the face of well-established results indicating that Broca's aphasics can exhibit several different performance patterns on these sentence types, Grodzinsky, Piñango, Zurif, and Drai (1999) argued that these conflicting results do not challenge the theory when the data are analyzed appropriately. They carried out a creative statistical analysis of the comprehension performance of published cases of Broca's aphasia and concluded that all of these cases are in agreement with the predicted pattern: chance on passives and 100% correct on actives. Here we show that the statistical reasoning adopted by Grodzinsky et al. (1999) is flawed. We also show that the comprehension performance of a substantial number of the Broca's aphasics in their own sample does not conform to the pattern required. Rather, contrary to these authors' claim, Broca's aphasia is not associated with a consistent pattern of sentence comprehension performance, but allows for a number of distinct patterns in different patients.

Aphasia, Broca↗

PubMed2001

Living musical instruments and inanimate body parts?

In the literature about category effects in semantic memory, body parts and musical instruments are often considered atypical, because in cases with a disproportionate impairment of living categories body parts are relatively spared, while musical instruments are often severely defective. In this study the performance of 57 subjects affected by diseases generally associated with lexical-semantic impairment, for the most part Alzheimer's disease and other forms of cortical degeneration, but also herpetic encephalitis and traumatic brain damage are analyzed. The subjects were given a picture naming task tapping eight categories: three living categories (animals, fruits and vegetables) and three non-living categories (tools, furniture and vehicles), plus body parts and musical instruments. On a preliminary analysis at the group level, body parts were the least impaired category and musical instruments the most severely impaired, the six living and non-living categories being intermediate. However, these differences disappeared after covariance for lexical frequency, name agreement and age of acquisition. The relationship between living categories, non-living categories, musical instruments and body parts was investigated by means of a Lisrel model of Confirmatory Factor Analysis. Two latent variables related to living and non-living categories respectively were defined, and it was found that both body parts and musical instruments were significantly related only with non-living categories. The results showed that the definition of the latent variable expressing the substrate of non-living categories was less satisfactory than that expressing the living categories. On this basis, the conclusions of this study appear statistically definite but their psychological interpretation is less straightforward.

Adolescent↗

PubMed2001

Slowly progressive aphasia: a four-year follow-up study.

This paper reports the long-term follow-up of GC, a patient with primary progressive aphasia of the fluent type. GC presented at onset with an anomia characterized by sparing of first letter knowledge, that applied mainly to proper names and living categories. No semantic deficits were observed in the first stage of the disease, and MRI showed a left temporal lobe atrophy with a gradient from the pole to the posterior regions, the latter being less involved. We now report the clinical evolution of GC from the 2nd to the 4th year of disease. As the disease progressed, the anomia became more severe and the phenomenon of first letter sparing was no longer detectable. Also semantic knowledge was gradually affected and, eventually, was dramatically lost. However, no other cognitive deficits were seen at the last examination. By that time, the temporal atrophy shown by MRI was bilateral, although still more evident on the left side.

Aphasia, Primary Progressive↗

PubMed2000

Wisconsin card sorting test: a new global score, with Italian norms, and its relationship with the Weigl sorting test.

The Wisconsin card sorting test and the Weigl test are two neuropsychological tools widely used in clinical practice to assess frontal lobe functions. In this study we present norms useful for Italian subjects aged from 15 to 85 years, with 5-17 years of education. Concerning the Wisconsin card sorting test, a new measure of global efficiency (global score) is proposed as well as norms for some well known qualitative aspects of the performance, i.e. perseverative responses, failure to maintain the set and non-perseverative errors. In setting normative values, we followed a statistical methodology (equivalent scores) employed in Italy for other neuropsychological tests, in order to favour the possibility of comparison among these tests. A correlation study between the global score of the Wisconsin card sorting test and the score on the Weigl test was carried out and it emerges that some cognitive aspects are not overlapping in these two measures.

Adolescent↗

PubMed2000

Verbal-response and manual-response versions of the Milner Landmark task: normative data.

The paper reports normative data relative to a shortened form of two versions of the Milner Landmark task, involving verbal and manual response, respectively, which have been found to provide crucial information to discriminate perceptual from response bias in unilateral neglect. Normative data based on a large group of subjects were believed to be necessary because the Landmark task is held to be worth further investigation: (a) in comparison with other tasks devised for similar purposes, (b) in elucidating clinico-anatomical correlations, and (c) in planning selective remediation programmes. The results of the investigation provide criteria on the basis of which a patient's bias can be classified as being normal, borderline, or pathological.

Adult↗

PubMed2000

Semantic category dissociations, familiarity and gender.

We carried out four experiments to assess the extent to which familiarity with certain objects in everyday life is related to gender and can account, at least partially, for the semantic category dissociation observed in a few brain-damaged patients. In the first experiment, 210 normal subjects, half males and half females, were given the names of 60 stimuli from the Snodgrass and Vanderwart's set, 30 belonging to living categories and 30 to non-living categories. The task was to rate their familiarity, based on the frequency with which one (i) thinks or speaks of a given item, (ii) sees it represented in the media, and (iii) is confronted with real exemplars. The three indices were highly correlated and their average value was, therefore, used. Females gave higher familiarity ratings to fruit, vegetables and furniture and males to tools. The second experiment was aimed to verify whether the gender difference was responsible for the category dissociation found following brain damage. A male patient with greater impairment for living categories and a female patient with greater impairment for non-living categories were requested to name the same 60 stimuli and their scores were analysed, partialling out the familiarity effect, measured both with the non-gender specific index of Snodgrass and Vanderwart and with the new gender-specific index. In either case, the category dissociation remained significant. To determine if the mean general population familiarity index was valid for the single subject, we studied whether a cohabitant first degree relative was able to predict a normal subject's familiarity better than the population index. Contrary to expectations, the better predictor was the population index. The test-retest reliability of each subject's familiarity ratings was satisfactory, but not higher than the correlation between the personal judgement of each subject and the population index.

Adult↗

PubMed2000

Is SIB or BNP better than MMSE in discriminating the cognitive performance of severely impaired elderly patients?

The sensitivity of the Mini Mental State Evaluation (MMSE) in severely impaired patients is reduced by a floor effect and limited score range. The Severe Impairment Battery (SIB) and Preliminary Neuropsychological Battery (BNP) may be valid alternatives. We studied a group of 37 severely compromised elderly inpatients to investigate the usefulness of these two test batteries as alternatives to the MMSE. Both proved reliable, but only the SIB had a wider distribution of results with respect to the MMSE in the lower score range. The BNP, that might be thought easier to perform being a simple verification task, could actually not be completed by the most compromised patients. The SIB seems better able than the MMSE to provide cognitive profile in the three diagnostic categories into which patients were subdivided (Psychogeriatric, Psychorganic, Mentally Retarded). We conclude that it may be useful to test patients with the SIB when they yield a MMSE score lower than 10-12 points.

Journal Article↗

PubMed1999

Gender affects word retrieval of certain categories in semantic fluency tasks.

Recent studies suggest that gender influences phonetically-cued fluency and some semantic memory tasks. In this study we analysed the effect of demographic variables on semantic fluency tasks. The semantic categories considered were: animals, fruits, tools and vehicles. The influence of age and education was common to all the categories considered and seems a general characteristic of the semantic fluency task. Gender had a significant effect only with fruits and tools, but a diverging role: females fared better with fruits and males with tools. We discuss whether the source of the gender effect should be located at the level of the semantic representation of each category or at the level of item recall in the short time (one minute) granted for the task.

Adolescent↗

PubMed1999

The 'preliminary neuropsychological battery'. An instrument to grade the cognitive level of minimally responsive patients.

An early, formalized cognitive evaluation of'minimally responsive' patients could be important in the planning of their care and rehabilitation as well as in providing a realistic prognosis and studying the modality of the cognitive recovery. A short, bedside, neuropsychologically-oriented test-battery, the Preliminary Neuropsychological Battery, a psychometric tool which enables the cognitive evaluation of these patients and of patients unable to give verbal or complex motor answers, has been devised. The BNP was administered to a sample of 40 head-injured patients and to a sample of 34 healthy subjects. The aim was (i) to evaluate its usefulness, and (ii) to study its correlation with cortical functions as assessed by a more extensive battery. The findings suggest that the BNP is useful for assessing the general cognitive level of head-injured post-comatose patients. It was able to detect patients deserving a wider, analytic, neuropsychological assessment. Attentional defects emerged as an important variable determining the BNP score.

Adolescent↗

PubMed1998

A normative study on visual reaction times and two Stroop colour-word tests.

Two-hundred and nine normal subjects underwent a study aimed at providing norms for some attention tests currently used in neuropsychological examination. Norms were calculated taking into account the demographic variables. Our battery included single visuo-manual and go/no-go reaction times, and two versions of the Stroop Colour-Word Test. For the latter test, we employed a traditional version based on card presentation and a new version based on computer-assisted presentation. We evaluated the intercorrelation of the different tests, and studied the statistical regression models in order to adjust the original scores according to age, education and gender. Normative values were calculated following the Equivalent Scores method. The pattern of intercorrelation of our battery and the regression models of the scores are discussed with reference to the literature. The newly developed computer-assisted presentation of the Stroop test offers some advantages over the traditional version, especially with patients affected by spatial disorders.

Adolescent↗

PubMed1998

Phonetically cued word-fluency, gender differences and aging: a reappraisal.

Five-hundred and three normal subjects were given a phonetically cued word-fluency task in order to investigate the controversial issue of the influence of gender and aging on this task. Subjects were requested to say in one minute all the words that occurred to them, beginning with a given letter (F, P and L). Besides the expected significance of education, we observed a female advantage, but not a significant decline in the performance with aging. However, the slope of the line expressing word fluency as a function of age was different between females and males, indicating a greater sensitivity to aging for males. We provide inner and outer tolerance limits for this test in the normal population and give a formula useful for adjusting the raw scores on the basis of gender and education. The results are discussed with reference to previous findings and some hypotheses about the origins of the female advantage in PWF.

Adolescent↗

PubMed1998

Picture naming and progression of Alzheimer's disease: an analysis of error types.

Seven patients affected by Dementia of the Alzheimer Type (DAT) took part in a longitudinal study aimed at assessing the qualitative and quantitative evolution of picture naming impairment. The follow-up lasted 6-36 months and the patients were examined at intervals of 6 months or longer. We found that the absolute number of lexical-semantic errors tended to be constant or to rise slightly until an advanced stage of DAT severity was reached. However, the proportion of errors of the lexical-semantic type in relation to the overall number of errors showed a decline as the disease progressed, with empty and unrelated responses being increasingly observed. Visual errors were generally a minority; they were produced in different proportions for each patient but did not vary greatly over time. For the observed patients, the proportion of lexical and semantic errors was inversely related to the overall naming performance, following a negative logarithmic function. This finding was replicated analysing cross-sectional data from another 24 DAT patients who were given the same naming task.

Aged↗

PubMed1998

Semantic category dissociations in naming: is there a gender effect in Alzheimer's disease?

Several studies on picture naming in Alzheimer's disease have reported inconsistent findings regarding semantic category dissociation. To clarify this point, 26 patients suffering from dementia of the Alzheimer's type (DAT) were given a naming task, based on 60 black and white drawings, which allowed us to take into account several variables that might influence performance, notably word frequency, stimulus familiarity and prototypicality, name and image agreement and visual complexity. On a raw analysis, DAT patients as a group gave a lower performance with stimuli of Living Categories (LC) than with stimuli of Non-Living Categories (NLC), but when all the confounding factors were taken into account the category effect disappeared. Nevertheless, with a multiple single case approach, some patients presented a true dissociation: 11 were significantly better with Non-Living stimuli, and 3 with Living stimuli. In order to find what factors were involved in determining this distribution, we took the distribution of asymmetry indices of each patient, and plotted the individual category effect against the level of the general performance. In our sample, the distribution of asymmetry indices was skewed, and included a definite cluster of male subjects who were better at performing with Non-Living stimuli. Multivariate analysis suggested that the greater discrepancy shown by male patients was due to a protection acting on Non-Living stimuli rather than to a selective hampering of Living stimuli. The greater personal experience of males with Non-Living things could explain the relative preservation of these in male DAT subjects.

Aged↗

PubMed1998

Proper name anomia: a case with sparing of the first-letter knowledge.

In this article we describe the case of GC, a woman affected by severe proper name anomia due to progressive brain atrophy that mainly affected the left temporal pole. Proper name comprehension and semantic knowledge about the people she was unable to name were normal. GC showed a sparing of initial letter knowledge of proper names, while other phonological characteristics were not equally available. At a later stage of her illness, the naming impairment began to affect common names as well as proper names, though at a lesser extent. Whereas there was no category effect between names of animate and inanimate stimuli, we observed a relative sparing of first letter knowledge selectively for animate categories, although less marked than with proper names. This case is discussed within the theoretical framework of two-stage models of name production. Knowledge of the initial letter of proper names supports the psychological reality of the "phonological address" as a preliminary stage of the production of this class of names. Moreover, the qualitative similarity between errors observed with proper names and with names of animate objects suggests that the production of names belonging to these classes may conform, at least in part, to analogous algorithms.

Anomia↗

PubMed1998

Neuropsychological outcome of operated cerebral aneurysms: prognostic factors on 148 patients.

OBJECTIVES: To analyse prognostic factors in patients operated upon for cerebral aneurysms. A previous investigation by our group showed that patients operated later than 10 days after bleeding have a worse neuropsychological prognosis, but the number of patients operated upon within 3 days was not sufficient. Here, a new sample of patients with early surgery is included in the analyses. MATERIAL AND METHODS: Patients numbered 148 (65 with ACoA, 39 with MCA, and 44 with PCoA aneurysms): 56 were operated within 3 days, 44 within 4-10 days, and 48 after at least 10 days from bleeding. A standardized battery of 13 neuropsychological tests was adopted: we considered both the number of defective scores and the average performance. RESULTS: Patients operated later than 10 days after bleeding had a worse prognosis than the 2 groups with early and intermediate surgery, which were not different. Aneurysm site was not relevant. Old age and low education were associated with a worse prognosis. Hunt and Hess scores at operation and post operation were also predictive of the outcome. CONCLUSION: On the whole, patients operated upon later than 10 days after bleeding have a less favourable prognosis than those with earlier operation timing.

Adolescent↗