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Biomedical subjects

G Glosser

Publications and source records attributed to G Glosser.

At least 55 records · Page 3Linked to original sources
PubMed1994

Cross-Cultural Cognitive Examination performance in patients with Parkinson's disease and Alzheimer's disease.

Performance profiles of patients with different dementia syndromes (Alzheimer's disease and Parkinson's disease) were compared with each other and with those of neurologically impaired and healthy individuals without dementia on a new instrument for screening dementia, the Cross-Cultural Cognitive Examination (CCCE). The CCCE measures discriminated reliably between nondemented and demented patients, regardless of etiology. Comparisons between dementia groups found that dementia patients with Parkinson's disease (PD) showed more severe psychomotor slowing and depression, compared with patients with Alzheimer's disease, who showed more impaired recall of recently learned verbal information and verbal abstract reasoning. The CCCE also distinguished between the motor and affective symptoms that are common to all PD patients and the dementia symptoms that occur in some PD patients. These results provide further support for the clinical utility of the CCCE for discriminating dementia from normal cognitive functioning and for initial identification of different dementia syndromes.

Age Factors↗
PubMed1994

Predictors of outcome after anterior temporal lobectomy: the intracarotid amobarbital test.

The intracarotid amobarbital test (IAT) examines hemispheric memory and language. We set out to determine whether memory performance on the IAT correlated with seizure relief after anterior temporal lobectomy in 117 patients with refractory epilepsy. The IAT assessed recognition memory performance for nine items with correction for false-positive recognitions. We then compared performance of one hemisphere with that of the other, defining a correctly lateralized memory deficit as worse performance when using the hemisphere containing the operated temporal lobe than when using the other hemisphere. The analysis included concurrent factors that might also affect outcome, such as age at first risk for epilepsy, presence or absence of tumor, and Full Scale IQ. A discriminant function analysis demonstrated that patients with a correctly lateralized memory deficit on the IAT had an increased probability of being seizure-free following surgery after controlling for other predictors. The performance of the nonoperated temporal lobe related to outcome, although less strongly. The magnitude of the difference in performance between the two hemispheres and the performance of the operated hemisphere did not relate to outcome. Patients who became seizure-free had an earlier age at first risk than did those with persistent seizures, and tumor presence weakly correlated with postoperative outcome. IQ did not correlate with outcome. We conclude that the IAT predicts seizure relief after anterior temporal lobectomy independent of other known risk factors we examined.

Adolescent↗
PubMed1993

Cross-cultural cognitive examination: validation of a dementia screening instrument for neuroepidemiological research.

OBJECTIVE: Validation of a new instrument for screening dementia, the Cross Cultural Cognitive Examination (CCCE), is described. DESIGN: Criterion and concurrent validation and cross-cultural comparison of a new instrument. PARTICIPANTS: All individuals over the age of 40 in a village in southern Guam participated in a door-to-door survey. Alzheimer's and Parkinson's Disease patients and healthy controls aged 40-90 participated in the US mainland study. MEASUREMENTS: The CCCE was administered to all subjects. Effects of age, language, education, and gender on test performances and social-cultural differences were assessed. Concurrent validation of the test with respect to other well accepted screening instruments was determined. RESULTS: High specificity (> 94%) and sensitivity (> 99%) for detecting dementia were found in Guam and US mainland samples, and these were not biased by differences in gender, linguistic preference, education, or cultural background. Sensitivity and specificity of the CCCE matched or exceeded that of already accepted dementia screening instruments. CONCLUSIONS: These validation studies support the usefulness of the CCCE for identifying patients with generalized dementia, rather than focal types of cognitive impairment, quickly and reliably in cross-cultural neuroepidemiological research.

Adult↗
PubMed1992

A comparison of changes in macrolinguistic and microlinguistic aspects of discourse production in normal aging.

Middle-aged and elderly healthy subjects were interviewed informally, and their discourse productions were analyzed to test for age-related changes in language-specific, microlinguistic, and in higher order organizational, macrolinguistic abilities. No significant age differences were found on microlinguistic measures, including syntactic complexity and syntactic and lexical production errors, and there were also no age differences in the use of lexical cohesive ties, such as anaphora. Older subjects, however, obtained significantly lower ratings on a macrolinguistic measure of global thematic coherence. Elderly subjects failed to maintain coherent reference to the general topic of discourse, although they preserved coherent meaning relationships between contiguous utterances. These results are most compatible with the view that age-related performance declines on language tasks primarily reflect changes in macrolinguistic abilities that require integration of linguistic and nonlinguistic cognitive processes, rather than changes in language-specific cognitive processes.

Adult↗
PubMed1992

Criterion validity of the cross-cultural cognitive examination in Japan.

Criterion validity of a two-stage Cross-Cultural Cognitive Examination (CCCE) designed for epidemiologic use was evaluated in Japanese subjects by comparison with a physician's DSM-III-R diagnosis of dementia and the Hasegawa Dementia Rating Scale (the standard Japanese instrument similar to the Mini-Mental State Exam). We report on 188 subjects tested in three locations in Japan: Tokyo area, Ise, and Osaka. Subjects ranged in age (50-93 years) and education (1-22 years) and included neurology outpatients, community volunteers, and inpatients. The CCCE was 97.4% specific for dementia, with sensitivity of 88%. The correlation with the Hasegawa scale was significant (r(175) = .8230, p less than .0001). Diagnosis using the CCCE showed good validity when compared with Japanese criteria for dementia. If the instrument could be shown to be reliable and more "culture fair" than the currently available tests, it may be useful in cross-cultural epidemiologic studies of dementia.

Aged↗
PubMed1991

Patterns of discourse production among neurological patients with fluent language disorders.

Dissociations between impairments in microlinguistic and macrolinguistic abilities were examined in brain-damaged patients to assess whether these abilities are psychologically and neurologically distinct. The discourse productions of three groups of patients with equally severe fluent language disorders, but varying neuropathology and varying profiles of associated nonlinguistic cognitive impairments, were analyzed. Patients with fluent aphasia secondary to a single left-hemisphere CVA showed the greatest impairment on syntactic and lexical error measures taken to reflect microlinguistic abilities, but normal performance on measures of macrolinguistic organization (i.e., thematic coherence). Patients with probable Alzheimer's Disease were impaired on thematic coherence measures, but not on measures reflecting microlinguistic syntactic and phonological processes. Closed head injury patients whose primary clinical symptom was a fluent language disorder were impaired on both microlinguistic and macrolinguistic measures, which appears to parallel their deficits both in language-specific and in nonspecific, higher-order, diffusely organized cognitive processes.

Adult↗
PubMed1991

Lexical but not semantic priming in Alzheimer's disease.

The hypothesis that patients with Alzheimer's disease (AD) have a disturbance in semantic processing was tested using a new lexical-priming task, threshold oral reading. Healthy elderly controls showed significant effects of priming for word pairs that are associatively related (words that reliably co-occur in word association tests) and for word pairs that are semantically related (high-frequency exemplars that belong to the same superordinate category but are not high-frequency associates). AD patients showed effects of priming for associatively related words but not for word pairs that are related only by shared semantic features. These results are consistent with the hypothesis that semantic processing is impaired in AD and suggest that independent networks of relationships among words and among concepts in semantic memory may be differentially disrupted with various forms of brain damage.

Aged↗
PubMed1991

Idiosyncratic word associations following right hemisphere damage.

Single oral word associations produced by right-hemisphere-damaged (RHD) stroke patients and age-matched healthy controls were analyzed to assess the right-hemisphere contribution to lexical-semantic processes. RHD patients did not differ from normals in terms of response times, in syntactic class of the response word, or in numbers of errors in response to words drawn from different grammatical categories and words differing in imageability/concreteness. Groups also did not differ in the number of high frequency, popular, associations produced. Despite their apparently intact ability to access high-frequency lexical associates, RHD patients, particularly those with frontal-lobe lesions, also sporadically produced lexical responses that were idiosyncratically related or that were totally unrelated to the stimulus word. An attentional disorder is suggested to explain these pragmatically deviant lexical associations.

Analysis of Variance↗
PubMed1990

The continuum of deep/phonological alexia.

Two patients exhibited all the characteristics of deep alexia shortly following brain injury. Both subsequently recovered some reading abilities and evolved to show a pattern of oral reading consistent with phonological alexia. These findings suggest that deep alexia and phonological alexia share common underlying deficits that are mediated by common neurological systems. A two-deficit psycholinguistic model is presented to account for the apparent continuity between deep alexia and phonological alexia.

Adult↗
PubMed1990

Disorders in executive control functions among aphasic and other brain-damaged patients.

Four experimental procedures for assessing disorders of executive control (Nonverbal Continuous Performance, Graphic Pattern Generation, Sequence Generation Test, and Tower of Hanoi) were administered to 22 left-brain-damaged aphasic patients, 19 right-brain-damaged nonaphasic patients, and 49 healthy controls. Aphasic patients with frontal-lobe lesions were significantly more impaired on these tasks than aphasics with retrorolandic or mixed lesions in the left hemisphere. Patients with right-hemisphere lesions, especially those with frontal-lobe lesions, showed even greater impairments on these visual/spatial tasks. The results suggest that aphasics' impairments in executive control are independent of their linguistic and visuospatial deficits and are specific to lesions in left frontal and prefrontal regions. The clinical utility of the experimental procedures is discussed.

Adult↗
PubMed1989

Linguistic and nonlinguistic impairments in writing: a comparison of patients with focal and multifocal CNS disorders.

The hypothesis that the language disorder in Alzheimer's disease (AD) depends on degenerative brain changes in classical left-hemisphere language zones was tested by comparing the written language performances of a group of AD patients with mild-moderate dementia and left-hemisphere stroke patients with equally severe naming and auditory comprehension deficits who were in varying stages of recovery from Wernicke's aphasia. The results indicated significant qualitative group differences in performances between tasks and in errors within tasks. The findings are consistent with hypothesized disruption of more diffusely organized neurolinguistic systems in AD. The hypothesis that the language disorder in AD represents an exaggeration of the pattern of language change in normal aging was also examined by comparing the performances of AD patients to the changes that occur with very advanced normal aging. The data indicate convergence between AD and very elderly healthy subjects in some aspects of written language production.

Aged↗
PubMed1988

Variations in aphasic language behaviors.

This study reports intraindividual variations in the semantic and syntactic complexity of language and in the linguistic errors produced by mildly and moderately impaired aphasic and nonneurologically impaired control subjects in different communication contexts. Aphasic patients, compared to control subjects, evidenced as many, if not more, linguistic variations in response to changing communication requirements. In conditions that restricted visual contact between speaker and listener, aphasic patients produced fewer communicative gestures and more complex verbalizations. Verbal complexity and language errors also varied significantly with different contents of communication. Measures of verbal complexity and errors in verbal communications were found to vary independently across different communication contexts, contents, and tasks. These findings demonstrate that despite their linguistic impairments, aphasic patients show appropriate and predictable linguistic changes in response to nonlinguistic social contextual variables.

Adult↗
PubMed1986

Communicative gestures in aphasia.

Gestural communications of 10 mild and moderate aphasics and five controls were examined in two conditions: Face-to-face informal dyadic conversation and restricted visual access between speaker and listener. Gestural production was significantly reduced with restriction of visual access, supporting the posited communicative function of the hand and arm gestures investigated in this study. No differences were found between aphasic and control subjects in the rate of gestural communication in the natural condition of face-to-face interaction. Moderate aphasics, however, were found to produce proportionally fewer of the complex semantic modifying and relational communicative gestures and more nonspecific, nonconsensually shared, unclear gestures. Gestural complexity was significantly negatively correlated with measures of linguistic impairment for the aphasics. The relationship between the frequency and complexity of communicative gestures and concurrent verbalizations was also examined. The findings of this study provide confirmation for the view that there is an identifiable class of gestures utilized by aphasics for communication, aphasics are impaired in their gestural communicative competence in natural conditions of communication, and the quality of aphasics' gestural communications parallels changes in their verbal communication patterns.

Adult↗
PubMed1985

Physicians' and families' perspectives on the medical management of dementia.

The role of physicians in the long-term management of patients with the primary diagnosis of progressive dementia was investigated by surveying the opinions of 57 physicians and 47 family members. Respondents were asked to evaluate the difficulty and helpfulness of various activities physicians perform in the diagnosis, treatment, and management of patients with dementia. Both physicians and families rated the diagnostic services provided by physicians very highly. Although families found physicians' explanations of the diagnosis and prognosis extremely helpful, physicians reported this as an area of difficulty. Physicians and families expressed considerable frustration with the limited medical treatments and interventions for the relief of symptoms associated with dementia. Despite the acknowledged sensitivity of physicians to the social-psychological consequences of dementia, physicians were found to be least helpful in addressing these issues, either directly or through referral to allied health and social services. This study outlines areas of physician education that need improvement and calls for development of an interdisciplinary network of services for the biopsychosocial management of dementia.

Alzheimer Disease↗
PubMed1982

Memory decline in the aged: treatment with lecithin and physostigmine.

Normal aged subjects were given lecithin and placebo for 5 weeks each in a double-blind crossover study. Supraspan tests of memory and learning failed to show any significant changes as a result of these treatments. Addition of a single IV infusion of physostigmine did not improve performance. These findings neither support nor weaken the "cholinergic hypothesis" of cognitive impairment in aging and dementia, but they imply that simple cholinergic hypofunction is unlikely.

Acetylcholine↗