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Biomedical subjects

H Spinnler

Publications and source records attributed to H Spinnler.

At least 37 records · Page 2Linked to original sources

Seeing objects smaller than they are: micropsia following right temporo-parietal infarction.

We report the case of an 84-year-old lady who, after a right temporo-parietal infarction, complained of seeing things smaller than she expected. She also related that straight lines appeared distorted and described seeing colours as if they were a badly mixed assemblage of hues. Her visual field was normal except for a transient left field extinction. No spatial neglect emerged. The patient's micropsia remained unchanged during the course of the six month follow-up.

Aged↗

An example of lack of frontal inhibition: the 'utilization behaviour'

The focus of this report is utilization behaviour (UB) conceived as part of the Environmental Dependency Syndrome following frontal damage. An historical sketch is provided on the many conceptualizations of the frontal lobe functions relevant to the understanding of UB. The detailed study of the neuropsychological picture presented by a patient (PG) with massive herpetic damage is then outlined. Emphasis is put on PG's prominent UB as well as on her several dissociations between impaired (as expected) and spared (non expected) cognitive abilities. Such dissociations are discussed with reference to the historical conceptualizations outlined above. The question is raised of whether a great inter-subjects variability of the topo-functional arrangements in the healthy frontal lobes could be the main cause of the variability of symptoms observed in patients with frontal lesions. Copyright 1998 Lippincott-Raven Publishers

Journal Article↗

Variables linked to psychotic symptoms in Alzheimer's disease.

This study is aimed at assessing the prevalence and features of psychotic symptoms in a sample of 180 patients with Alzheimer's disease (AD). Sixty-four patients (35.5% of the sample) showed one or more psychotic symptoms. The presence of these symptoms correlated with the severity of the patients' cognitive impairment, as well as the patients' age at first assessement. Sex, duration of illness, education and familiar history for dementia were not significantly correlated with the psychotic symptoms. Hallucination was the most common symptom (24.4%, of the whole sample), followed by delusion (18.3%) and misperception (11.1%). Visual hallucinations were more frequent than auditory, and, among delusions, persecutory and theft themes were largely prevailing. Misperceptions included television related phenomena and phantom boarder illusions. A follow-up study of 37 patients demonstrated the association between the presence of psychotic symptoms and a steeper slope of cognitive deterioration. Copyright 1998 Lippincott Williams & Wilkins

Journal Article↗

Frontal lobe functioning in man: the riddle revisited.

Forty-eight patients, each with a single frontal lobe lesion, were tested with a battery of 10 of the most widely used neuropsychological tests, comprising five traditional "frontal" tests and five others, for which that claim is not generally made. All correlations among the tests in the group were positive and significant. Moreover, the average correlation between each frontal test and the other tests in the frontal group was found to be higher than the average correlation of the same frontal test with the tests in the other group. A factor analysis of the scores on the five frontal tests yielded a single factor accounting for 53% of the variance. A factor analysis on the entire battery of tests (frontal plus nonfrontal) also yielded a strong general factor; although this accounted for a smaller portion (43%) of the shared variance, and one test (Verbal Span) failed to show a substantial loading on the factor. Neither the results of the present study nor the findings of other researchers argue for the abandonment of the concept of "executive" functioning, mediated by the functioning of the frontal lobes, in favor of a variant of fractionation.

Journal Article↗

Is memory loss without anatomical damage tantamount to a psychogenic deficit? The case of pure retrograde amnesia.

Following a car accident, a patient remained unconscious for approximately 20 min and confused for a few hours. When he could be questioned, he was found to have lost all past memories. The retrograde amnesia covered his whole life and concerned autobiographic events as well as famous facts and encyclopaedic knowledge. It also partially involved the verbal and visual lexicon. Reading, writing and counting were no longer possible. The profound impairment of retrograde memory contrasted with the preservation of anterograde memory, which permitted the patient to reacquire some of the notions he had lost, without, however, recovering the feeling of a personal experience of autobiographical information. Four years later, the retrograde deficit was unmodified, except for what had been relearnt. The search for data in support of an organic or psychological aetiology was negative. No signs of brain damage were apparent at the neurological examination and on CT, MRI and SPECT. On the other hand, there was no evidence of a psychiatric history, psychological stress or emotional precipitants that could substantiate the hypothesis that the patient derived a primary or secondary gain from amnesia. We propose that cases of focal retrograde amnesia, similar to the present one, deserve to be classified separately from organic and psychogenic forms under the label of 'functional' retrograde amnesia, a syndrome in which the threshold of activation of premorbid memories is abnormally raised by the trauma, leaving the encoding and retrieval of new memories unaffected.

Agraphia↗

Comparison of two scoring systems of the Mini-Mental State Examination as a screening test for dementia.

The difference in validity in detecting dementia of two different scoring systems (age- and education-adjusted versus raw scores) of the Mini-Mental State Examination (MMSE), was assessed in an epidemiological study on the prevalence of dementia. A second, independent, psychometric screening tool, the Milan Overall Dementia Assessment (MODA), was also used. A group of 829 subjects over age 59 took part in the study. Subjects scoring below the cut-off point of the MMSE and/or MODA were clinically evaluated. Clinical diagnoses were adopted as the gold standard. Sensitivity, specificity, positive, and negative predictive values of the two tests were calculated. Our findings show that the correction for age and education of the raw score of the MMSE causes the loss of the mildest demented patients and heavily reduces the sensitivity of the screening test (from 85.7% to 71.4%), while it accounts for a moderate improvement in the specificity (from 90.0% to 96.3%). A possible explanation for this seeming paradox is proposed.

Age Factors↗

Persistent global amnesia following right thalamic stroke: an 11-year longitudinal study.

The 11-year longitudinal study of a right-handed male patient, L. C., who suffered from a severe amnesic syndrome following a softening in the right thalamus, is reported. Memory impairment involving retrograde and long-term anterograde memory, both verbal and spatial, persisted without modification. Investigation revealed some residual implicit learning ability. Positron emission tomography studies in the resting state displayed a bilateral hypometabolism of the mesial frontal lobes. Evidence suggests that a lesion confined to the thalamus may not on its own account for severe amnesia; that involvement of other structures is necessary for severe amnesia to appear; and that a functional investigation should always be included in cases of small thalamic lesions before drawing conclusions about the structures responsible for a given deficit.

Aged↗

Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion.

Patients with defined frontal lobe lesions were assigned to 1 of 2 groups based on whether they showed a behaviorally assessed dysexecutive syndrome or were behaviorally normal. All participants were tested on dual-task performance and on 2 tasks assumed to measure frontal lobe function, the Wisconsin Card Sorting Test and verbal fluency. The dysexecutive group differed significantly from the nondysexecutive in showing impaired capacity for dual-task coordination, but there were no significant differences on the Wisconsin Card Sorting Test and verbal fluency. Results are interpreted in terms of a multicomponent central executive, whose function is linked to, but not coterminous with, the operation of the frontal lobes.

Adult↗

Production, Identification, and Toxicity of (gamma)-Decalactone and 4-Hydroxydecanoic Acid from Sporidiobolus spp.

During the bioconversion of ricinoleic acid to (gamma)-decalactone under controlled pH conditions, Sporidiobolus salmonicolor produced only the lactone form, while Sporidiobolus ruinenii produced both the lactone form and a precursor. By using gas chromatography-mass spectrometry and gas chromatography-Fourier transform infrared analysis techniques, the precursor was identified as 4-hydroxydecanoic acid. The levels of production in the presence of high concentrations of ricinoleic acid methyl ester differed in the two Sporidiobolus species. This difference was due on the one hand to the high sensitivity of S. salmonicolor to the lactone and on the other hand to the high level of 4-hydroxydecanoic acid produced by S. ruinenii. 4-Hydroxydecanoic acid is much less toxic to the microorganisms than the lactone. In contrast to S. ruinenii, S. salmonicolor is not able to catabolize 4-hydroxydecanoic acid.

Journal Article↗

Cognitive modelling of face processing: evidence from Alzheimer patients.

This is a prospective neuropsychological study on face processing in Alzheimer's disease (AD). The aim was to assess the prevalence and the nature of face processing disorders in AD, and at investigating possible inter-test dissociations within the framework of currently used face processing models. A standardized four-test battery of unknown face discrimination and familiar face recognition was given to 30 mildly deteriorated patients with AD. Half of the patients performed below the cut-off in at least one of the tests. Deficits in familiar face recognition tests were more frequently observed than deficits in unknown face discrimination tests. There was no correlation between impairment of face processing and overall cognitive impairment or visual disorders. A multiple single case approach allowed us to elicit statistically warranted double dissociations between tasks assessing unknown face discrimination and tasks assessing familiar face recognition. Moreover, the ability to decide whether or not a stimulus is a face or a non-face has proven to be a non-mandatory step to further process the face stimuli. All together, these findings support the hypothesis that distinct pathways are involved in the processing of unknown and familiar faces, as posited by Bruce and Young [Br. J. Psychol. 77, 305-327, 1986].

Aged↗

Poppelreuter-Ghent's Overlapping Figures Test: its sensitivity to age, and its clinical use.

This study aims to identify the cognitive variables involved in a task of visual recognition of meaningful and meaningless two-dimensional line-drawings of shapes; the Poppelreuter-Ghent Overlapping Figures Test. It was found that the performance of healthy controls was influenced by age and education, but not sex. Age and education adjusted norms are set forth. Meaningful patterns were better recognised than meaningless ones. Number of overlapping patterns, direction, and degree of rotation were among the other variables considered. Only the latter variable significantly influenced the difficulty of the task. The clinical use of this test was verified on clinical populations of patients affected by Alzheimer's disease and right or left hemisphere damage. Left hemisphere damaged patients did not show deficits. Alzheimer and right hemisphere damaged patients were impaired and the degree of rotation significantly influenced their performance. In conclusion, the Poppelreuter-Ghent's Test is a multicomponential task, the visuo-spatial components of which were shown to be the most important.

Journal Article↗

Persistent retrograde, amnesia following a minor trauma.

A 19-year-old man showed dense retrograde amnesia (RA) for autobiographical and public events covering his entire life, following a motor car accident that caused no apparent brain damage. His learning abilities remained excellent and permitted him to recover knowledge of the past, based on information gathered from other people and the media, although he never reacquired the sense of personal experience. At the onset he also showed occasional gaps in his semantic memory, e.g., he failed to recognize a few objects and was unable to provide factual information about sports he had long been playing. Eventually, his amnesia was predominantly restricted to autobiographical events or facts. After 29 months the deficit has remained unchanged. CT, MRI and PET were negative. Psychogenic amnesia was considered, but eventually ruled out for want of any evidence pointing to emotional problems, stressful situations or secondary gains. We posit that for reasons unknown a mild trauma can cause functional inhibition of the access to the engrams that are already stored, leaving intact the ability to encode and retrieve new memories.

Adult↗

The 'Petites Madeleines' phenomenon in two amnesic patients. sudden recovery of forgotten memories.

We report two cases of recovery from retrograde amnesia, which occurred almost suddenly, 1 year and 1 month from onset, respectively. Amnesia followed a left thalamic infarction in one patient and a mild head trauma in the other. Full and permanent recovery occurred within a short time after the spontaneous emergence to consciousness of a single autobiographical event, triggered by the specific experience of a very similar new event. Recovery was limited to retrograde amnesia, leaving unaffected the anterograde deficit present in one of the patients. The nature (psychogenic versus organic) of our patients' memory loss is commented upon in the light of a review of previously reported cases of retrograde amnesia. The transient defect of retrograde memory is discussed in terms of a reversible distortion of the neuronal 'patterned matrices' suggested by Gloor (Brain 1990; 113: 1673-94).

Adult↗

Spared and impaired cognitive abilities after bilateral frontal damage.

We report on a patient (PG) with a severe behavioural disorder following massive bilateral prefrontal damage due to herpetic encephalitis. The lesion involves also the mesial and polar regions of the temporal lobes; the frontal dorso-lateral cortices were relatively spared. The patient's inattentiveness and alternating impulsive and apathetic behaviour led to her social alienation. The only self-motivated activities we observed were those initiated to satisfy her enhanced urge to eat and play games. She did not react to surprise stimuli that consistently elicit a reaction of surprise in healthy people. She also presented "adynamic aphasia" associated with anomia and episodic amnesia. A striking feature of the syndrome was the patient's consistent "utilization behaviour". Her motor behaviour was marked by constant akathisia. She performed surprisingly well on intelligence, "frontal", and visuo-spatial tests. This non-demented patient exhibited a clear dissociation between her relatively spared cognitive abilities and grossly impaired behaviour. In the discussion we explore the extent to which a defect of the supervisory control may be held responsible for the inconsistencies in the patient's coping skill performances.

Adolescent↗

Implicit verbal memory in Alzheimer's disease.

Word stem completion and word identification were used in two repetition priming experiments to evaluate the implicit memory performance of Alzheimer's disease (AD) patients. This issue was also approached using various meta-analyses combining and contrasting previously reported data. While the experimental results suggested that AD patients present preserved repetition priming in both tasks, the meta-analytic approach showed an impairment in stem completion in comparison to word identification. Converging evidence cautiously suggested to accept the results of the meta-analysis. The above dissociation has been interpreted as showing differences in the specific contribution of data- and conceptually-driven processes in the two implicit tasks. A further meta-analysis on the effect of reduced perceptual availability of the study material on the same two tasks indicated that this variable affected repetition priming in word identification more heavily than in stem completion. The impact of such a dissociation on theories of implicit memory is discussed.

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Alzheimer patients show a sensitivity decrement over time on a tonic alertness task.

Tonic alertness was investigated in Alzheimer patients and normal elderly subjects. Sensitivity and criterion shifts were investigated across 45 min of continuous testing using a high event rate test with very low target probability. Alzheimer patients showed a significant sensitivity decrement over time that was unrelated to dementia severity. These results suggest that tonic alertness is impaired by Alzheimer's disease even in its early stages.

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