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Thomas Benke

Publications and source records attributed to Thomas Benke.

26 records · Page 2Linked to original sources
PubMed2003

The thalamus and basal ganglia: What is exactly where? A reply to 'Neuropsychological consequences of right thalamic injury: case study and review,' MJ Summers, Brain and Cognition 50 (2002).

The present paper re-analyzes anatomical and clinical data of a previous case report (Summer, 2002). In this case study, a patient with severe neuropsychological and behavioral impairments is described and it is claimed that these impairments are causally linked to an right thalamic lesion. A simple method how to perform a lesion analysis is introduced which shows that PD's lesion was a striatocapsular hematoma, and not a thalamic bleeding. The results of this anatomical re-analysis challenge the original behavioral-lesion hypothesis and emphasize the importance to provide appropriate data on brain lesions and clinical findings in neuropsychological case reports.

Basal Ganglia↗
PubMed2003

Dichotic listening performance and frontal lobe function.

In the present paper we report on speech perception in left (n=16) and right (n=10) frontal lobe nonaphasic patients compared with healthy controls (n=26). The patients were inpatients of the University Clinic of Neurology, Innsbruck, Austria, who participated in a prospective neuropsychological study dealing with several aspects of lateralized functioning. The patients were tested with dichotic presentations of consonant-vowel syllables, which allows for specific probing of speech perception in the left and right hemisphere, respectively. The task was to report which syllable they heard best on each trial, emphasizing single answers on each trial. There were 36 dichotic trials with pairs of CV syllables made up of the six stop consonants /p/, /t/, /k/, /b/, /d/, /g/, all paired with the vowel /a/. There were always two different syllables presented on each trial, one in each ear. The results showed significant differences between the left and right lesioned patients in their performance on the dichotic listening test. While the right lesioned patients and the control subjects had a normal and expected right ear advantage, the left lesioned patients performed almost at random with regard to the right and left ear stimulus. The right lesioned patients and the control group showed a right ear advantage of the same magnitude, although the overall performance was somewhat impaired in the right lesioned group compared to the healthy control group. The left lesioned patients showed no ear advantage at all, and particularly their right ear scores were impaired compared to both the control group and the right lesioned patient group. The results are discussed in terms of the role played by the left frontal cortex in speech perception and language asymmetry.

Adult↗
PubMed2003

Medial temporal lobe activation during semantic language processing: fMRI findings in healthy left- and right-handers.

Medial temporal lobe (MTL) areas are well known to serve episodic memory functions; their contribution to semantic memory has been occasionally noticed but not studied in detail. In the present fMRI study, 35 right-handed and 35 left-handed healthy subjects performed a semantic decision paradigm during which subjects heard spoken concrete nouns designating objects and had to decide on whether these objects were available in the supermarket and cost lest then a certain amount of money. The control paradigm consisted of sequences of low and high tones where subjects had to decide whether a sequence contained two high tones. The resulting contrast activation of semantic decision versus tone decision involved neocortical temporal, parietal, and prefrontal areas. Additional significant, bilateral activations in the MTL, the hippocampal formation, and adjacent areas were found. The exact incidence and location of activation was studied in a single-subject analysis for all 70 subjects. At the chosen threshold of P<0.001, 94% of subjects showed activations in the MTL and inferior temporal lobe (ITL). Activations were found along the longitudinal axis of the MTL, including the hippocampal formation and the parahippocampal gyrus. In the ITL, parts of the fusiform and lingual gyri were activated. Activations were similar in right- and left-handers. We conclude from this study that the MTL and parts of the ITL can be added to the areas activated by semantic verbal memory processing.

Acoustic Stimulation↗
PubMed2003

Everyday numerical abilities in Alzheimer's disease.

The present study investigated everyday numerical abilities in a group of 21 patients affected by mild to moderate dementia of Alzheimer's type (DAT). Though patients did not differ from a control group in standard laboratory tests tapping transcoding, number comparison, simple calculation, and estimation, they showed significant difficulties in numerical tasks embedded in an everyday context, such as handling money, a bus schedule, or a television program. Patients' difficulties were attributed to those multiple cognitive demands which are inherent to real situations as compared to well-structured abstract paper-and-pencil tasks. Overall, the study suggests that the examination of numerical abilities in DAT patients should go beyond abstract paper-and-pencil tasks which can only partially reflect the actual numerical skills in DAT and should therefore include also tasks simulating everyday life situations. Assessment of everyday numerical skills may be crucial in planning adequate support for patients, for example in handling money, but also in designing targeted training programs.

Activities of Daily Living↗
PubMed2003

Basal ganglia lesions and the theory of fronto-subcortical loops: neuropsychological findings in two patients with left caudate lesions.

Basal ganglia lesions have a high prevalence for associated behavioural impairments. However, the exact pattern of cognitive impairments and its relationship to individual basal ganglia lesion have rarely been investigated by means of a detailed neuropsychological and lesion study. Furthermore, different mechanisms have been proposed as relevant for the observed cognitive deficits; among these, the hypothesis of fronto-subcortical loops (Alexander et al., 1986) has made predictions regarding the relationship between the damage of particular striato-frontal circuits and the resulting behavioural impairment which await clinical confirmation. We present a study of two subjects who suffered a MRI-documented focal left basal ganglia hematoma. The two patients differed in their lesions; in one patient (PJ) large parts of the caudate nucleus were destroyed whereas in the other (AS) mainly the pallidum and putamen were lesioned and the caudate suffered only minor damage. In the acute phase, the behavioural and neuropsychological abnormalities were similar in both cases and included mainly abulia, an impairment of executive and attentional functions, and a severe amnestic syndrome. After several months many functions were restored in AS, whereas PJ's abilities remained largely defective. Based on these data and on previous case studies several conclusions are drawn. Left caudate lesions induce marked and long-lasting behavioural and neuropsychological impairments comprising predominantly drive, executive control, attention, and memory. The extent of lesion in the head of the caudate nucleus is the critical factor regarding the severity and the outcome of the syndrome, whereas damage to the putamen and pallidum is less crucial for cognitive functions. A subset of behavioural alterations, among them abulia, attentional and frontal-executive dysfunctions, can well be attributed to lesions of the anterior cingulate circuit and the dorsolateral-frontal circuit at the basal ganglia level. Other impairments, most importantly the prominent amnestic syndrome, are more difficult to interpret on the grounds of this hypothesis and may be related to other pathomechanisms.

Basal Ganglia↗
PubMed2002

Persistent cognitive deficits associated with lithium intoxication: a neuropsychological case description.

We present the case of a 51-year-old patient with an acute lithium intoxication associated with several cognitive deficits. During the acute phase of intoxication the patient displayed general psychomotor slowing, dysarthric speech, mood changes, and incoherent discourse. Neuropsychological assessment revealed ideomotor apraxia, profound deficits of visuospatial processing, an impairment of memory and of frontal-executive functions. Other cognitive abilities, such as orientation, spontaneous speech, comprehension, naming, reading, writing, and working memory remained intact. An electroencephalogram revealed diffuse slowing with rhythmic trains, whereas MRI showed no cerebral abnormality. Follow-up examinations at 4 and 14 weeks with lithium levels in the normal range showed substantial recovery of memory abilities and executive functions, whereas praxis and visuoperceptual functions remained impaired, despite the fact that lithium was immediately withdrawn after the intoxication became manifest. We conclude that lithium intoxication may be associated with variable behavioural and cognitive impairments, some of them potentially persistent. Different from other case studies our findings suggest that lithium intoxication may cause a combined, multifocal functional impairment of subcortical and cortical neural mechanisms in both hemispheres.

Antimanic Agents↗
PubMed2002

The neuropsychological assessment of dementia.

It has become standard practice to base the diagnosis of dementia on the combination of neuropsychological and non-behavioral findings. The present article provides a short, clinically oriented synopsis of the targets, investigational procedures, and difficulties of the modern neuropsychological approach to the diagnosis of dementia. Over the years, neuropsychology has developed assessment tools to evaluate the cognitive and behavioral abnormalities of many dementias. Validated tests of memory, language, executive, and other cognitive functions are used to screen for dementia and identifying certain dementia profiles. Behavioral assessment procedures are available for non-cognitive neurodegenerative alterations. At present, problems arise mainly with the behavioral heterogeneity of certain dementia syndromes. Especially problematic are discrimination of age-associated or mild cognitive impairments from incipient dementia and the impact of psychiatric symptoms on cognitive functions. It is concluded that neuropsychology offers a valuable contribution to the diagnosis and differential diagnosis of dementia.

Journal Article↗