Heart rate variability in post infarction patients.
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Artifacts↗
Biomedical subjects
L Trojano
Publications and source records attributed to L Trojano.
An "ecological" constructional test.
We describe a simple, three-dimensional constructional test (the Box test), which reflects common daily-living activities, to be used for the assessment of constructional disability in elderly brain-lesioned patients. Subjects are required to put as may of 12 objects of varied shape and volume as they can into a box. To carry out the task successfully subjects have to arrange the items according to an efficient constructional strategy. We administered this test to 68 normal subjects and to 50 brain-damaged patients. Analysis indicated the Box test is easy and simple to administer and can be used without difficulty by elderly patients having focal brain damage. Performance correlated well with general intelligence and other bidimensional, conventional constructional tasks. Right or left brain lesions have a similar, significant detrimental effect on performance but probably through different mechanisms.
Activities of Daily Living↗
Selective drawing disorders after right subcortical stroke: a neuropsychological premorbid and follow-up case study.
We report the case of a patient affected by a subcortical lesion of the right non-dominant hemisphere, and demonstrate that he had selective constructional disorders by comparing his post-stroke performances with those assessed 18 months before the stroke. A detailed analysis was made of the visuospatial, perceptual, representational and executive competences involved in drawing tasks at one, two and six months post-stroke. Neuropsychological follow-up revealed the progressive recovery of all visuospatial abilities. This study provides some interpretative elements for constructional disorders and, in particular, for the closing-in phenomenon observed only during the subacute phase.
Aged↗
An Italian kindred with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).
Vascular dementia is usually sporadic and associated with definite risk factors. Several cases also occur in a familial fashion, and may affect middle-aged or even younger subjects. Recently, an autosomal dominant inheritance was demonstrated in two unrelated French families, the members of which were affected by stroke-like episodes culminating in progressive dementia. Genetic linkage analysis assigned the disease locus to chromosome 19q12. We report an additional kindred of Italian origin in which at least 16 subjects presented leukoencephalopathic alterations. Recurrent strokes, psychiatric disturbances, dementia, and in 2 members, tetraplegia and pseudobulbar palsy were the hallmarks of this syndrome. Notably, 5 asymptomatic individuals had neuroradiological signs of leukoencephalopathy. Pathological examination of 1 subject revealed a widespread vasculopathy of the perforating arterioles, characterized by deposition of eosinophilic-congophilic material that did not immunostain with antibodies against prion protein, beta-amyloid, cystatin C, transthyretin, or heat-shock protein 70 and was similar to that described in the French families. Based on the maximum lod score, the most likely location for the disease locus was also mapped to chromosome 19q12, and found to coincide with the CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) locus. The present results confirm the existence of a nosologically distinct, autosomal dominant cerebrovascular disease, presenting with recurrent subcortical ischemic strokes independent of vascular risk factors.
Adult↗
Phonological and lexical coding in verbal short-term memory and learning.
A patient with selective auditory phonological coding defect is described. He also showed a defective auditory verbal short-term memory but could learn lists of words flawlessly, thus closely resembling patients with pure short-term memory defects. We argue that the patient's functional defect could be conceived as a capacity limitation of the phonological short-term store. An experimental evaluation of his verbal short- and long-term memory performances allows a discussion of the interaction of phonological and lexical coding processes in verbal short-term memory and learning.
Adult↗
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↗
Patterns of recovery and change in verbal and nonverbal functions in a case of crossed aphasia: implications for models of functional brain lateralization and localization.
We present a 2-year verbal and nonverbal follow-up of a crossed aphasic patient. The patient had suffered from widespread ischemic damage in the area of right middle cerebral artery, with a parieto-temporal lesion. Three months postonset he showed classical Wernicke's aphasia associated with oral, limb and constructional apraxia and left hemineglect. However, follow-up findings showed a complex, dynamic pattern entirely consistent with cognitive models of language and nonlanguage abilities. Current models of functional brain lateralizations could not satisfactorily account for such longitudinal, fine-grain observations.
Agraphia↗
Pure dysgraphia with relative sparing of lower-case writing.
We describe the cognitive analysis of a patient with acquired pure dysgraphia. She presented a peculiar dissociation between lower- and upper-case handwriting: lower-case writing was relatively spared and showed a significant superiority of words versus nonwords. Upper-case writing and oral spelling did not show lexical effects, but were affected by item length. In all modalities errors consisted mainly of single graphemic substitutions, deletions, insertions and transpositions, resulting in legal or illegal nonwords, and showed a similar distribution across letter positions. These findings were suggestive of an impairment of the graphemic output buffer, which however revealed itself to different degrees in the two handwriting styles.
Aged↗
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.
Aged↗
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.
Aged↗
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.
Aged↗
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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How many alien hand syndromes? Follow-up of a case.
We report the follow-up of a patient affected by a persistent alien left nondominant hand. CT and MRI showed an ischemic lesion localized to the mesial frontal region and involving the supplementary motor area and anterior fibers of the corpus callosum. These findings support theories suggesting a critical role of both these lesions in determining "chronic" forms of alien hand of either upper limb.
Brain Ischemia↗
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↗
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.
Aged↗