Behavioural Neurology The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Amyloid β Enhances Typical Rodent Behavior While It Impairs Contextual Memory Consolidation Wed, 01 Jul 2015 09:32:41 +0000 Alzheimer’s disease (AD) is associated with an early hippocampal dysfunction, which is likely induced by an increase in soluble amyloid beta peptide (Aβ). This hippocampal failure contributes to the initial memory deficits observed both in patients and in AD animal models and possibly to the deterioration in activities of daily living (ADL). One typical rodent behavior that has been proposed as a hippocampus-dependent assessment model of ADL in mice and rats is burrowing. Despite the fact that AD transgenic mice show some evidence of reduced burrowing, it has not been yet determined whether or not Aβ can affect this typical rodent behavior and whether this alteration correlates with the well-known Aβ-induced memory impairment. Thus, the purpose of this study was to test whether or not Aβ affects burrowing while inducing hippocampus-dependent memory impairment. Surprisingly, our results show that intrahippocampal application of Aβ increases burrowing while inducing memory impairment. We consider that this Aβ-induced increase in burrowing might be associated with a mild anxiety state, which was revealed by increased freezing behavior in the open field, and conclude that Aβ-induced hippocampal dysfunction is reflected in the impairment of ADL and memory, through mechanisms yet to be determined. Karla Salgado-Puga, Roberto A. Prado-Alcalá, and Fernando Peña-Ortega Copyright © 2015 Karla Salgado-Puga et al. All rights reserved. Mental Fatigue and Executive Dysfunction in Patients with Cushing’s Syndrome in Remission Sun, 28 Jun 2015 12:02:31 +0000 Patients with Cushing’s syndrome (CS) in remission often suffer from impaired quality of life and cognitive dysfunction. The primary aim was to investigate the occurrence of mental fatigue, characterized by mental exhaustion and long recovery time following mentally strenuous tasks, in patients with CS in remission. The secondary aim was to examine whether the newly developed parts C and D of the trail making test (TMT) are more sensitive, compared to the conventional parts A and B, to evaluate attention and executive function. This was a cross-sectional study including 51 patients with CS in remission and 51 controls. All subjects completed the self-administrated mental fatigue scale (MFS) and performed all four parts of the TMT. The patients had worse outcome on all components of the MFS except for sensitivity to noise. After adjustment for mental fatigue, depression, and anxiety, the patients performed worse only on part D of the TMT (). Mental fatigue is common in patients with CS in remission and can be captured by using the MFS. The most demanding part of the TMT, part D, is more useful to capture cognitive deficits in patients with CS in remission compared to the conventional parts A and B. Eleni Papakokkinou, Birgitta Johansson, Peter Berglund, and Oskar Ragnarsson Copyright © 2015 Eleni Papakokkinou et al. All rights reserved. Mental State Inferences Abilities Contribution to Verbal Irony Comprehension in Older Adults with Mild Cognitive Impairment Thu, 25 Jun 2015 09:41:28 +0000 Objective. The present study examined mentalizing capacities as well as the relative implication of mentalizing in the comprehension of ironic and sincere assertions among 30 older adults with mild cognitive impairment (MCI) and 30 healthy control (HC) subjects. Method. Subjects were administered a task evaluating mentalizing by means of short stories. A verbal irony comprehension task, in which participants had to identify ironic or sincere statements within short stories, was also administered; the design of the task allowed uniform implication of mentalizing across the conditions. Results. Findings indicated that participants with MCI have second-order mentalizing difficulties compared to HC subjects. Moreover, MCI participants were impaired compared to the HC group in identifying ironic or sincere stories, both requiring mental inference capacities. Conclusion. This study suggests that, in individuals with MCI, difficulties in the comprehension of ironic and sincere assertions are closely related to second-order mentalizing deficits. These findings support previous data suggesting a strong relationship between irony comprehension and mentalizing. G. Gaudreau, L. Monetta, J. Macoir, S. Poulin, R. Jr. Laforce, and C. Hudon Copyright © 2015 G. Gaudreau et al. All rights reserved. Higher Body Mass Index Is Associated with Subjective Olfactory Dysfunction Thu, 25 Jun 2015 06:17:35 +0000 Background. Morbidly obese patients demonstrate altered olfactory acuity. There has been no study directly assessing Body Mass Index (BMI) in patients with olfactory dysfunction. Our purpose was to compare BMI in a group of patients with subjective olfactory dysfunction to those without subjective olfactory complaints. Methods. Retrospective matched case-control study. Sixty patients who presented to a tertiary care otolaryngology center with subjective smell dysfunction over one year were identified. Neoplastic and obstructive etiologies were excluded. Demographics, BMI, and smoking status were reviewed. Sixty age, gender, and race matched control patients were selected for comparison. Chi-square testing was used. Results. 48 out of 60 patients (80%) in the olfactory dysfunction group fell into the overweight or obese categories, compared to 36 out of 60 patients (60%) in the control group. There was a statistically significant difference between the olfactory dysfunction and control groups for this stratified BMI .  Conclusion. This study suggests high BMI is associated with olfactory dysfunction. Prospective clinical research should examine this further to determine if increasing BMI may be a risk factor in olfactory loss and to elucidate what role olfactory loss may play in diet and feeding habits of obese patients. Z. M. Patel, J. M. DelGaudio, and S. K. Wise Copyright © 2015 Z. M. Patel et al. All rights reserved. Ageing and Neurodegenerative Disorders Mon, 22 Jun 2015 06:25:02 +0000 Laura Piccardi, Giuseppe Curcio, Liana Palermo, and Ming-Chyi Pai Copyright © 2015 Laura Piccardi et al. All rights reserved. Sources of Discomfort in Persons with Dementia: Scale and Initial Results Sun, 21 Jun 2015 07:18:22 +0000 The Sources of Discomfort Scale (SODS) assesses discomfort manifestations based on source of discomfort, thus making it both distinct from and complementary to pain assessments for persons with dementia. Sources were categorized as pertaining to physical discomfort, to body position, and to environmental sources. Body position sources of discomfort were related to poor functional status and to pain. The SODS scores were not related to cognitive functioning, and sources of discomfort other than those pertaining to body position were not correlated with pain. This paper demonstrates a direct and enhanced method to detect the manifestations of discomfort separately from pain indicators in a population with advanced dementia. The determination of the source of discomfort has direct implications for intervention. Jiska Cohen-Mansfield, Khin Thein, Marcia S. Marx, Maha Dakheel-Ali, and Barbara Jensen Copyright © 2015 Jiska Cohen-Mansfield et al. All rights reserved. Effects of Different Types of Cognitive Training on Cognitive Function, Brain Structure, and Driving Safety in Senior Daily Drivers: A Pilot Study Tue, 16 Jun 2015 13:58:03 +0000 Background. Increasing proportion of the elderly in the driving population raises the importance of assuring their safety. We explored the effects of three different types of cognitive training on the cognitive function, brain structure, and driving safety of the elderly. Methods. Thirty-seven healthy elderly daily drivers were randomly assigned to one of three training groups: Group V trained in a vehicle with a newly developed onboard cognitive training program, Group P trained with a similar program but on a personal computer, and Group C trained to solve a crossword puzzle. Before and after the 8-week training period, they underwent neuropsychological tests, structural brain magnetic resonance imaging, and driving safety tests. Results. For cognitive function, only Group V showed significant improvements in processing speed and working memory. For driving safety, Group V showed significant improvements both in the driving aptitude test and in the on-road evaluations. Group P showed no significant improvements in either test, and Group C showed significant improvements in the driving aptitude but not in the on-road evaluations. Conclusion. The results support the effectiveness of the onboard training program in enhancing the elderly’s abilities to drive safely and the potential advantages of a multimodal training approach. Takayuki Nozawa, Yasuyuki Taki, Akitake Kanno, Yoritaka Akimoto, Mizuki Ihara, Ryoichi Yokoyama, Yuka Kotozaki, Rui Nouchi, Atsushi Sekiguchi, Hikaru Takeuchi, Carlos Makoto Miyauchi, Takeshi Ogawa, Takakuni Goto, Takashi Sunda, Toshiyuki Shimizu, Eiji Tozuka, Satoru Hirose, Tatsuyoshi Nanbu, and Ryuta Kawashima Copyright © 2015 Takayuki Nozawa et al. All rights reserved. Brain Signals of Face Processing as Revealed by Event-Related Potentials Tue, 16 Jun 2015 12:27:19 +0000 We analyze the functional significance of different event-related potentials (ERPs) as electrophysiological indices of face perception and face recognition, according to cognitive and neurofunctional models of face processing. Initially, the processing of faces seems to be supported by early extrastriate occipital cortices and revealed by modulations of the occipital P1. This early response is thought to reflect the detection of certain primary structural aspects indicating the presence grosso modo of a face within the visual field. The posterior-temporal N170 is more sensitive to the detection of faces as complex-structured stimuli and, therefore, to the presence of its distinctive organizational characteristics prior to within-category identification. In turn, the relatively late and probably more rostrally generated N250r and N400-like responses might respectively indicate processes of access and retrieval of face-related information, which is stored in long-term memory (LTM). New methods of analysis of electrophysiological and neuroanatomical data, namely, dynamic causal modeling, single-trial and time-frequency analyses, are highly recommended to advance in the knowledge of those brain mechanisms concerning face processing. Ela I. Olivares, Jaime Iglesias, Cristina Saavedra, Nelson J. Trujillo-Barreto, and Mitchell Valdés-Sosa Copyright © 2015 Ela I. Olivares et al. All rights reserved. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study Tue, 16 Jun 2015 08:59:08 +0000 Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen’s MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction , favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration. Hellen Livia Drumond Marra, Martin Luiz Myczkowski, Cláudia Maia Memória, Débora Arnaut, Philip Leite Ribeiro, Carlos Gustavo Sardinha Mansur, Rodrigo Lancelote Alberto, Bianca Boura Bellini, Adriano Alves Fernandes da Silva, Gabriel Tortella, Daniel Ciampi de Andrade, Manoel Jacobsen Teixeira, Orestes Vicente Forlenza, and Marco Antonio Marcolin Copyright © 2015 Hellen Livia Drumond Marra et al. All rights reserved. Isoflavone Attenuates the Caspase-1 and Caspase-3 Level in Cell Model of Parkinsonism Tue, 16 Jun 2015 08:45:34 +0000 The study has investigated the effect of isoflavone attenuates the caspase-1 and caspase-3 level in cell model of Parkinsonism. The subjects were PC12 cells. They were randomly divided into six groups: control, MPP+ (250 μmol/L), isoflavone (10 μM), isoflavone (10 μM) + MPP+ (250 μmol/L), Z-YVAD-CHO (10 nM) + MPP+ group, and Z-DEVD-CHO (10 nM) + MPP+ group. Cell viability was measured by MTT methods; the content of tyrosine hydroxylase was measured by immunocytochemistry method of avidinbiotin peroxidase complex; apoptosis ratio was measured by flow cytometry. The results showed that cell viability in the MPP+ group was lower than in all other five groups. There was no difference in cell viability between isoflavone + MPP+ and control group. Optical density of TH positive cells in isoflavone group was higher than in control, isoflavone + MPP+, and MPP+ only groups. The apoptosis ratio in the isoflavone + MPP+ group and control group and the Z-YVAD-CHO + MPP+ and Z-DEVD-CHO + MPP+ group was similar, which was lower than in the MPP+ group. The lowest apoptosis ratio was found in the isoflavone only group. Jian-xin Xu, Hai-ping Song, Qing-Xia Bu, De-Peng Feng, Xiao-Fan Xu, Qian-Ru Sun, and Xue-Li Li Copyright © 2015 Jian-xin Xu et al. All rights reserved. Normal Hearing Ability but Impaired Auditory Selective Attention Associated with Prediction of Response to Donepezil in Patients with Alzheimer’s Disease Tue, 16 Jun 2015 07:49:39 +0000 Background. Alzheimer’s disease (AD) patients have a poor response to the voices of caregivers. After administration of donepezil, caregivers often find that patients respond more frequently, whereas they had previously pretended to be “deaf.” We investigated whether auditory selective attention is associated with response to donepezil. Methods. The subjects were40 AD patients, 20 elderly healthy controls (HCs), and 15 young HCs. Pure tone audiometry was conducted and an original Auditory Selective Attention (ASA) test was performed with a MoCA vigilance test. Reassessment of the AD group was performed after donepezil treatment for 3 months. Results. Hearing level of the AD group was the same as that of the elderly HC group. However, ASA test scores decreased in the AD group and were correlated with the vigilance test scores. Donepezil responders (MMSE 3+) also showed improvement on the ASA test. At baseline, the responders had higher vigilance and lower ASA test scores. Conclusion. Contrary to the common view, AD patients had a similar level of hearing ability to healthy elderly. Auditory attention was impaired in AD patients, which suggests that unnecessary sounds should be avoided in nursing homes. Auditory selective attention is associated with response to donepezil in AD. Yoshitaka Ouchi, Kenichi Meguro, Kyoko Akanuma, Yuriko Kato, and Satoshi Yamaguchi Copyright © 2015 Yoshitaka Ouchi et al. All rights reserved. Personal Strengths and Health Related Quality of Life in Dementia Caregivers from Latin America Tue, 16 Jun 2015 07:17:36 +0000 The research literature has begun to demonstrate associations between personal strengths and enhanced psychosocial functioning of dementia caregivers, but these relationships have not been examined in the context of dementia caregivers in Latin America. The present study examined whether personal strengths, including resilience, optimism, and sense of coherence, were associated with mental and physical health related quality of life (HRQOL) in 130 dementia caregivers in Mexico and Argentina. Structural equation modeling found that the personal strengths collectively accounted for 58.4% of the variance in caregiver mental HRQOL, and resilience, sense of coherence, and optimism each had unique effects. In comparison, the personal strengths together accounted for 8.9% of the variance in caregiver physical HRQOL, and only sense of coherence yielded a unique effect. These results underscore the need to construct and disseminate empirically supported interventions based in part on important personal strengths, particularly sense of coherence, for this underrepresented group. Stephen K. Trapp, Paul B. Perrin, Richa Aggarwal, Silvina Victoria Peralta, Miriam E. Stolfi, Eliana Morelli, Leticia Aracely Peña Obeso, and Juan Carlos Arango-Lasprilla Copyright © 2015 Stephen K. Trapp et al. All rights reserved. The Tree-Drawing Test (Koch’s Baum Test): A Useful Aid to Diagnose Cognitive Impairment Mon, 15 Jun 2015 14:07:12 +0000 Objective. To study the Tree-Drawing Test in a group of demented patients and compare it with a group of mild cognitively impaired patients (MCI) and controls. Methods. Consecutive outpatients were classified as affected by dementia (Alzheimer’s disease (AD), frontotemporal dementia (FTD), and vascular dementia (VD)) or by MCI. Patients and controls underwent the Tree-Drawing Test and MMSE. Results. 118 AD, 19 FTD, 46 VD, and 132 MCI patients and 90 controls were enrolled. AD patients draw trees globally smaller than other patients and controls. FTD patients draw trees with a wider space occupation than AD and MCI patients but smaller than controls as well as VD patients. Trees drawn by MCI patients are intermediate in size between AD patients and controls. The trunk-to-crown ratio of trees drawn by cognitive impaired patients is greater than controls while the tree size-relative-to-page space index is significantly smaller. The tree size-relative-to-page space index of trees drawn by AD patients is smaller than that of the other cognitively impaired patients. Tree height and the trunk-to-crown ratio are independent predictors of cognitive impairment. Conclusions. Trees drawn by cognitively impaired patients are different from those drawn by healthy subjects with a progressive differentiation from mild to more relevant degrees of cognitive impairment. Michelangelo Stanzani Maserati, Corrado Matacena, Luisa Sambati, Federico Oppi, Roberto Poda, Maddalena De Matteis, and Roberto Gallassi Copyright © 2015 Michelangelo Stanzani Maserati et al. All rights reserved. Different Temporal Patterns of Specific and General Autobiographical Memories across the Lifespan in Alzheimer’s Disease Mon, 15 Jun 2015 13:39:22 +0000 We compared specific (i.e., associated with a unique time and space) and general (i.e., extended or repeated events) autobiographical memories (AbM) in Alzheimer’s disease (AD). The comparison aims at investigating the relationship between these two components of AbM across the lifespan and the volume of cerebral regions of interest within the temporal lobe. We hypothesized that the ability to elicit specific memories would correlate with hippocampal volume, whereas evoking general memories would be related to lateral temporal lobe. AbM was assessed using the modified Crovitz test in 18 patients with early AD and 18 matched controls. The proportions of total memories—supposed to reflect the ability to produce general memories—and specific memories retrieved were compared between AD patients and controls. Correlations to MRI volumes of temporal cortex were tested. We found different temporal patterns for specific and general memories in AD patients, with (i) relatively spared general memories, according to a temporal gradient that preserved remote memories, predominantly associated with right lateral temporal cortex volume. (ii) Conversely, the retrieval of specific AbMs was impaired for all life periods and correlated with bilateral hippocampal volumes. Our results highlight a shift from an initially episodic to a semantic nature of AbMs during AD, where the abstracted form of memories remains. Nathalie Philippi, François Rousseau, Vincent Noblet, Anne Botzung, Olivier Després, Benjamin Cretin, Stéphane Kremer, Frédéric Blanc, and Liliann Manning Copyright © 2015 Nathalie Philippi et al. All rights reserved. Are Absence Epilepsy and Nocturnal Frontal Lobe Epilepsy System Epilepsies of the Sleep/Wake System? Sun, 14 Jun 2015 07:11:22 +0000 System epilepsy is an emerging concept interpreting major nonlesional epilepsies as epileptic dysfunctions of physiological systems. I extend here the concept of reflex epilepsy to epilepsies linked to input dependent physiological systems. Experimental and clinical reseach data were collected to create a coherent explanation of underlying pathomechanism in AE and NFLE. We propose that AE should be interpreted as epilepsy linked to the corticothalamic burst-firing mode of NREM sleep, released by evoked vigilance level oscillations characterized by reactive slow wave response. In the genetic variation of NFLE the ascending cholinergic arousal system plays an essential role being in strong relationship with a gain mutation of the nicotinic acethylcholin receptors, rendering the arousal system hyperexcitable. I try to provide a more unitary interpretation for the variable seizure manifestation integrating them as different degree of pathological arosuals and alarm reactions. As a supporting hypothesis the similarity between arousal parasomnias and FNLE is shown, underpinned by overlaping pathomechanism and shared familiarity, but without epileptic features. Lastly we propose that both AE and NFLE are system epilepsies of the sleep-wake system representing epileptic disorders of the antagonistic sleep/arousal network. This interpretation may throw new light on the pathomechanism of AE and NFLE. Péter Halász Copyright © 2015 Péter Halász. All rights reserved. Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis Thu, 04 Jun 2015 09:01:23 +0000 Background. Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS). Purpose. This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI) in MS. Method. 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI. Normalized GM volume (NGMV), normalized WM volume (NWMV), and deep GM structures were calculated from 3D T1-weighted structural brain images. We conducted partial correlations () controlling for demographic and clinical variables. Results. Moderate-to-vigorous physical activity (MVPA) was significantly associated with NGMV (, ), NWMV (, ), hippocampus (, ), thalamus (, ), caudate (, ), putamen (, ), and pallidum (, ) volumes, when controlling for sex, age, clinical course of MS, and Expanded Disability Status Scale score. There were no associations between sedentary and light physical activity with MRI outcomes. Conclusion. Our results provide the first evidence that MVPA is associated with volumes of whole brain GM and WM and deep GM structures that are involved in motor and cognitive functions in MS. Rachel E. Klaren, Elizabeth A. Hubbard, Robert W. Motl, Lara A. Pilutti, Nathan C. Wetter, and Bradley P. Sutton Copyright © 2015 Rachel E. Klaren et al. All rights reserved. Cognitive and Functional Impairment in Stroke Survivors with Basilar Artery Occlusive Disease Wed, 03 Jun 2015 13:30:52 +0000 Background. Despite growing literature on posterior vascular disease, specific information about the cognitive and functional profiles of patients with basilar artery occlusion disease (BAOD) is scarce. The aims of this study were (1) to compare the cognitive statuses of BAOD survivors versus healthy controls and (2) to correlate the functional capacity outcomes with the cognitive profiles of BAOD patients. Methods. Comprehensive cognitive and functional assessments were carried out in 28 patients with BAOD and 27 age- and education level-matched healthy controls. Results. Compared to matched controls, patients presented impairments in selective, sustained, and set-shifting attention, processing speed, visuospatial skills, mental flexibility, and monitoring rules. There were significant deficits in verbal episodic memory (immediate and delayed recall) and visuospatial episodic memory (immediate and delayed recall and recognition). Functional capacity outcomes were significantly related to the cognitive test results. Seventy-five percent of patients had a Modified Rankin Scale score of 0 or 1. Conclusions. Our results indicate good functional outcomes in a selected group of BAOD survivors, despite the presence of subnormal performance on some cognitive tests, including tests of attention, executive function, and long-term memory. Kenia Repiso Campanholo, Adriana Bastos Conforto, Carolina Medeiros Rimkus, and Eliane Correa Miotto Copyright © 2015 Kenia Repiso Campanholo et al. All rights reserved. Physical Feature Encoding and Word Recognition Abilities Are Altered in Children with Intractable Epilepsy: Preliminary Neuromagnetic Evidence Wed, 03 Jun 2015 12:14:12 +0000 Objective evaluation of language function is critical for children with intractable epilepsy under consideration for epilepsy surgery. The purpose of this preliminary study was to evaluate word recognition in children with intractable epilepsy by using magnetoencephalography (MEG). Ten children with intractable epilepsy (M/F 6/4, mean ± SD 13.4 ± 2.2 years) were matched on age and sex to healthy controls. Common nouns were presented simultaneously from visual and auditory sensory inputs in “match” and “mismatch” conditions. Neuromagnetic responses M1, M2, M3, M4, and M5 with latencies of ~100 ms, ~150 ms, ~250 ms, ~350 ms, and ~450 ms, respectively, elicited during the “match” condition were identified. Compared to healthy children, epilepsy patients had both significantly delayed latency of the M1 and reduced amplitudes of M3 and M5 responses. These results provide neurophysiologic evidence of altered word recognition in children with intractable epilepsy. Maria Pardos, Milena Korostenskaja, Jing Xiang, Hisako Fujiwara, Ki H. Lee, Paul S. Horn, Anna Byars, Jennifer Vannest, Yingying Wang, Nat Hemasilpin, and Douglas F. Rose Copyright © 2015 Maria Pardos et al. All rights reserved. Predicting Early Bulbar Decline in Amyotrophic Lateral Sclerosis: A Speech Subsystem Approach Tue, 02 Jun 2015 12:47:56 +0000 Purpose. To develop a predictive model of speech loss in persons with amyotrophic lateral sclerosis (ALS) based on measures of respiratory, phonatory, articulatory, and resonatory functions that were selected using a data-mining approach. Method. Physiologic speech subsystem (respiratory, phonatory, articulatory, and resonatory) functions were evaluated longitudinally in 66 individuals with ALS using multiple instrumentation approaches including acoustic, aerodynamic, nasometeric, and kinematic. The instrumental measures of the subsystem functions were subjected to a principal component analysis and linear mixed effects models to derive a set of comprehensive predictors of bulbar dysfunction. These subsystem predictors were subjected to a Kaplan-Meier analysis to estimate the time until speech loss. Results. For a majority of participants, speech subsystem decline was detectible prior to declines in speech intelligibility and speaking rate. Among all subsystems, the articulatory and phonatory predictors were most responsive to early bulbar deterioration; and the resonatory and respiratory predictors were as responsive to bulbar decline as was speaking rate. Conclusions. The articulatory and phonatory predictors are sensitive indicators of early bulbar decline due to ALS, which has implications for predicting disease onset and progression and clinical management of ALS. Panying Rong, Yana Yunusova, Jun Wang, and Jordan R. Green Copyright © 2015 Panying Rong et al. All rights reserved. Abnormal Olfaction in Parkinson’s Disease Is Related to Faster Disease Progression Tue, 02 Jun 2015 06:50:08 +0000 Introduction. A possible association between olfactory dysfunction and Parkinson’s disease (PD) severity has been a topic of contention for the past 40 years. Conflicting reports may be partially explained by procedural differences in olfactory assessment and motor symptom evaluation. Methods. One hundred and sixty-six nondemented PD patients performed the Brief-Smell Identification Test and test scores below the estimated 20th percentile as a function of sex, age, and education (i.e., 80% specificity) were considered demographically abnormal. Patients underwent motor examination after 12 h without antiparkinsonian medication. Results. Eighty-two percent of PD patients had abnormal olfaction. Abnormal performance on the Brief-Smell Identification Test was associated with higher disease severity (i.e., Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III, Freezing of Gait questionnaire, and levodopa equivalent dose), even when disease duration was taken into account. Conclusions. Abnormal olfaction in PD is associated with increased severity and faster disease progression. Sara Cavaco, Alexandra Gonçalves, Alexandre Mendes, Nuno Vila-Chã, Inês Moreira, Joana Fernandes, Joana Damásio, Armando Teixeira-Pinto, and António Bastos Lima Copyright © 2015 Sara Cavaco et al. All rights reserved. Confrontation Naming and Reading Abilities at Primary School: A Longitudinal Study Mon, 01 Jun 2015 13:58:56 +0000 Background. Confrontation naming tasks are useful in the assessment of children with learning and language disorders. Objectives. The aims of this study were (1) providing longitudinal data on confrontation naming; (2) investigating the role of socioeconomic status (SES), intelligence, age, and gender in confrontation naming; (3) identifying relationship between confrontation naming and reading abilities (fluency, accuracy, and comprehension). Method. A five-year longitudinal investigation of confrontation naming (i.e., the Boston Naming Test (BNT)) in a nonclinical sample of Italian primary school children was conducted (), testing them at the end of each school year, to assess nonverbal intelligence, confrontation naming, and reading abilities. Results. Performance on the BNT emerged as a function of IQ and SES. Significant correlations between confrontation naming and reading abilities, especially comprehension, were found; BNT scores correlated better with reading fluency than with reading accuracy. Conclusions. The longitudinal data obtained in this study are discussed with regard to reading abilities, intelligence, age, gender, and socioeconomic status. Chiara Luoni, Umberto Balottin, Laura Rosana, Enrico Savelli, Silvia Salini, and Cristiano Termine Copyright © 2015 Chiara Luoni et al. All rights reserved. A Proposed Neurological Interpretation of Language Evolution Mon, 01 Jun 2015 09:19:50 +0000 Since the very beginning of the aphasia history it has been well established that there are two major aphasic syndromes (Wernicke’s-type and Broca’s-type aphasia); each one of them is related to the disturbance at a specific linguistic level (lexical/semantic and grammatical) and associated with a particular brain damage localization (temporal and frontal-subcortical). It is proposed that three stages in language evolution could be distinguished: (a) primitive communication systems similar to those observed in other animals, including nonhuman primates; (b) initial communication systems using sound combinations (lexicon) but without relationships among the elements (grammar); and (c) advanced communication systems including word-combinations (grammar). It is proposed that grammar probably originated from the internal representation of actions, resulting in the creation of verbs; this is an ability that depends on the so-called Broca’s area and related brain networks. It is suggested that grammar is the basic ability for the development of so-called metacognitive executive functions. It is concluded that while the lexical/semantic language system (vocabulary) probably appeared during human evolution long before the contemporary man (Homo sapiens sapiens), the grammatical language historically represents a recent acquisition and is correlated with the development of complex cognition (metacognitive executive functions). Alfredo Ardila Copyright © 2015 Alfredo Ardila. All rights reserved. Failure to Identify the Left Arcuate Fasciculus at Diffusion Tractography Is a Specific Marker of Language Dysfunction in Pediatric Patients with Polymicrogyria Thu, 28 May 2015 11:34:44 +0000 Background. Polymicrogyric cortex demonstrates interindividual variation with regard to both extent of dyslamination and functional capacity. Given the relationship between laminar structure and white matter fibers, we sought to define the relationship between polymicrogyria (PMG), intrahemispheric association pathways, and network function. Methods. Each arcuate fasciculus (AF) was categorized as present or absent. Language was characterized by a pediatric neurologist. The presence of dysplastic cortex in the expected anatomic locations of Broca’s (BA) and Wernicke’s areas (WA) was evaluated by two pediatric neuroradiologists blinded to DTI and language data. Results. 16 PMG patients and 16 age/gender-matched controls were included. All normative controls had an identifiable left AF. 6/7 PMG patients with dysplastic cortex within BA and/or WA had no left AF; PMG patients without involvement of these regions had a lower frequency of absence of the left AF (). All patients without a left AF had some degree of language impairment. PMG patients without a left AF had a significantly greater frequency of language impairment compared to those PMG patients with a left AF (). Conclusion. In patients with PMG (1) the presence of dysplastic cortex within WA and/or BA is associated with absence of the left AF and (2) absence of the left AF is associated with language impairment. Michael J. Paldino, Kara Hedges, Nadine Gaab, Albert M. Galaburda, and P. Ellen Grant Copyright © 2015 Michael J. Paldino et al. All rights reserved. The Relationship between Gentle Tactile Stimulation on the Fetus and Its Temperament 3 Months after Birth Thu, 28 May 2015 11:31:01 +0000 Objective. The aim of this study was to evaluate the effect of gentle tactile stimulation on the fetus in its temperament 3 months after birth. Method. A total of 302 mother-3-month-infant dyads enrolled the retrospective cohort study. 76 mothers had regular gentle tactile stimulation on the fetus in their pregnancy; 62 mothers had irregular tactile stimulation on the fetus, and the rest of 164 mothers who had no tactile stimulation served as nonexposure group. Temperament was assessed using the EITS (a nine-dimensional scale of temperament). Results. Significant difference in temperament type was found among infants in 3 groups at 3 months of age. In the regular practice group, the babies with easy type temperament accounted for 73.7%, which was higher than that in irregular practice group (53.2%, ) and that in the control group (42.1%, ). Compared to infants in no practice group, the infants who had received regular gentle tactile stimulation before birth were lower in negative mood () while higher in adaptability (), approach (), and persistence (), respectively. Conclusion. Regular gentle tactile stimulation on fetus may promote the formation of easy type infant temperament. Zhe-Wei Wang, Jing Hua, and Yu-Hong Xu Copyright © 2015 Zhe-Wei Wang et al. All rights reserved. Detecting Migraine in Patients with Mild Traumatic Brain Injury Using Three Different Headache Measures Wed, 27 May 2015 11:07:54 +0000 Posttraumatic migraine may represent an important subtype of headache among the traumatic brain injury (TBI) population and is associated with increased recovery times. However, it is underdiagnosed in patients with mild traumatic brain injury (mTBI). This study examined the effectiveness of the self-administered Nine-Item Screener (Nine-Item Screener-SA), the Headache Impact Test- 6 (HIT-6), the 3-Item Migraine Screener, and the Rivermead Post-Concussion Questionnaire (RPQ) at discriminating between mTBI patients with (n = 23) and without (n = 20) migraines. The Nine-Item Screener demonstrated significant differences between migraine patients with and without migraine on nearly every question, especially on Question 9 (disability), sensitivity: 0.95 and specificity: 0.65 (95% CI, 0.64–0.90). The HIT-6 demonstrated significant differences between migraine and no-migraine patients on disability and pain severity, with disability having a sensitivity of 0.70 and specificity of 0.75 (95% CI, 0.54–0.83). Only Question 3 of the 3-Item ID Migraine Screener (photosensitivity) showed significant differences between migraine and no-migraine patients, sensitivity: 0.84 and specificity: 0.55 (CI, 0.52–0.82). The RPQ did not reveal greater symptoms in migraine patients compared with those without. Among headache measures, the Nine-Item Screener-SA best differentiated between mTBI patients with and without migraine. Disability may best identify migraine sufferers among the TBI population. Kirsten Anderson, Simon Tinawi, Julie Lamoureux, Mitra Feyz, and Elaine de Guise Copyright © 2015 Kirsten Anderson et al. All rights reserved. Attentional Control and Intelligence: MRI Orbital Frontal Gray Matter and Neuropsychological Correlates Tue, 26 May 2015 11:49:00 +0000 Attentional control is a key function of working memory that is hypothesized to play an important role in psychometric intelligence. To test the neuropsychological underpinnings of this hypothesis, we examined full-scale IQ, as measured by the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), and attentional control, as measured by Trails B response time and Wisconsin Card Sorting (WCS) test perseverative errors in 78 healthy participants, 25 of whom also had available magnetic resonance imaging (MRI) gray matter volume studies of the orbital frontal cortex (OFC) parcellated into three regions: gyrus rectus, middle orbital gyrus, and lateral orbital gyrus. Hierarchical regression indicated that Trails B response time specifically explained 15.13% to 19.18% of the variation in IQ and WCS perseverative errors accounted for an additional 8.12% to 11.29% of the variance. Full-scale IQ correlated very strongly with right middle orbital gyrus gray matter volume (, ), as did Trails B response time with left middle orbital gyrus gray matter volume (, ). Trails B response time and right middle orbital gyrus gray matter volume jointly accounted for approximately 32.95% to 54.82% of the variance in IQ scores. These results provided evidence of the unique contributions of attentional control and OFC gray matter to intelligence. Paul G. Nestor, Motoaki Nakamura, Margaret Niznikiewicz, James J. Levitt, Dominick T. Newell, Martha E. Shenton, and Robert W. McCarley Copyright © 2015 Paul G. Nestor et al. All rights reserved. Behavioural and Cognitive-Behavioural Treatments of Parasomnias Mon, 25 May 2015 06:50:53 +0000 Parasomnias are unpleasant or undesirable behaviours or experiences that occur predominantly during or within close proximity to sleep. Pharmacological treatments of parasomnias are available, but their efficacy is established only for few disorders. Furthermore, most of these disorders tend spontaneously to remit with development. Nonpharmacological treatments therefore represent valid therapeutic choices. This paper reviews behavioural and cognitive-behavioural managements employed for parasomnias. Referring to the ICSD-3 nosology we consider, respectively, NREM parasomnias, REM parasomnias, and other parasomnias. Although the efficacy of some of these treatments is proved, in other cases their clinical evidence cannot be provided because of the small size of the samples. Due to the rarity of some parasomnias, further multicentric researches are needed in order to offer a more complete account of behavioural and cognitive-behavioural treatments efficacy. Andrea Galbiati, Fabrizio Rinaldi, Enrico Giora, Luigi Ferini-Strambi, and Sara Marelli Copyright © 2015 Andrea Galbiati et al. All rights reserved. Patterns of Objective and Subjective Burden of Informal Caregivers in Multiple Sclerosis Wed, 20 May 2015 09:42:42 +0000 Background. Home care for patients with Multiple Sclerosis (MS) relies largely on informal caregivers (ICs). Methods. We assessed ICs objective burden (Resource Utilization in Dementia measuring informal care time (ICT)) and ICs subjective burden (Zarit Burden Inventory (ZBI)). Results. ICs () were spouses (70%), mean age 52 years, assisting disabled patients with a mean EDSS (Expanded Disability Status Scale) of 5.5, with executive dysfunction (mean DEX (Dysexecutive questionnaire) of 25) and a duration of MS ranging from 1 to 44 years. Objective burden was high (mean ICT = 6.5 hours/day), mostly consisting of supervision time. Subjective burden was moderate (mean ZBI = 27.3). Multivariate analyses showed that both burdens were positively correlated with higher levels of EDSS and DEX, whereas coresidency and IC’s female gender correlated with objective burden only and IC’s poor mental health status with subjective burden only. When considering MS aggressiveness, it appeared that both burdens were not correlated with a higher duration of MS but rather increased for patients with severe and early dysexecutive function and for patients classified as fast progressors according to the Multiple Sclerosis Severity Score. Conclusion. Evaluation of MS disability course and IC’s personal situation is crucial to understand the burden process and to implement adequate interventions in MS. E. Bayen, C. Papeix, P. Pradat-Diehl, C. Lubetzki, and M. E. Joël Copyright © 2015 E. Bayen et al. All rights reserved. Chronotypes in Patients with Epilepsy: Does the Type of Epilepsy Make a Difference? Wed, 20 May 2015 06:32:03 +0000 Circadian rhythms govern all biological functions. Circadian misalignment has a major impact on health. Late chronotype is a risk factor for circadian misalignment which in turn can affect the control of seizures in epilepsy patients. We compared a group of 87 confirmed epilepsy patients regardless of subtypes with age- and sex-matched healthy controls. We compared generalized epilepsy patients with localization related epilepsy patients and with healthy controls. We found that primary generalized epilepsy patients were 5 times more likely to have a late chronotype than healthy controls. We did not find any significant differences between localization related epilepsy patients and healthy controls or between the overall epilepsy cohort and healthy controls. Generalized epilepsy patients are more likely to be evening types as compared to those with focal epilepsy or subjects without epilepsy. Epilepsy patients do not experience the same age related increase in morningness as do age-matched healthy controls. This is important in regard to timing of AED, identifying and preventing sleep deprivation, and integrating chronotype evaluations and chronotherapy in comprehensive epilepsy care. Further studies, using objective phase markers or the impact of chronotherapy on seizure control, are necessary. Hallie Kendis, Kelly Baron, Stephan U. Schuele, Bhavita Patel, and Hrayr Attarian Copyright © 2015 Hallie Kendis et al. All rights reserved. Self-Reported ADHD Symptoms and Interhemispheric Interaction in Adults: A Dimensional Approach Tue, 19 May 2015 13:28:09 +0000 The present study applied the dimensional approach to test whether self-reported symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in adults are associated with the speed of interhemispheric interaction. A sample of first grade students () completed Conners’ Adult ADHD Rating Scales and letter matching reaction time tasks. In the tasks, participants had to match a single target letter displayed below the fixation cross, either on left or right visual field, with one of two letters displayed above the fixation cross, one letter on each visual field. For each task, identical letters were presented either within the same visual field (within hemisphere condition) or across visual fields (across hemisphere condition). Interhemispheric interaction was indexed as the difference in mean reaction time between within and across hemisphere conditions. Comorbid problems such as depression, anxiety, and stress may affect task performance and are controlled for in this study. Findings indicated that self-reported ADHD symptomology, especially hyperactivity, in the presence of stress was weakly but significantly associated with fast interhemispheric interaction. Saleh M. H. Mohamed, Norbert A. Börger, Reint H. Geuze, and Jaap J. van der Meere Copyright © 2015 Saleh M. H. Mohamed et al. All rights reserved.