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J R Hodges

Publications and source records attributed to J R Hodges.

At least 145 records · Page 8Linked to original sources
PubMed1996

The fractionation of remote memory. Evidence from a longitudinal study of dementia of Alzheimer type.

We studied remote memory, both autobiographical and public, longitudinally over a 1-year period in 24 patients with dementia of Alzheimer type (DAT) and 30 matched controls. Although both public and autobiographical memory were impaired in DAT, public memory deteriorated longitudinally, while autobiographical memory did not. These data support the hypothesis that remote memory may be fractionated and that one important dichotomy is autobiographical memory versus famous person knowledge. A cognitive analysis of famous face and name processing showed evidence of progressive breakdown in the identification of famous faces and names, with preservation of face and name recognition, and face naming. The declining performance on identification appeared to be due primarily to loss of semantic knowledge regarding famous persons, while retrieval a deficit contributed more significantly to the proper name anomia which was over and above the semantic deficit in DAT.

Aged↗
PubMed1996

Executive and mnemonic functions in early Huntington's disease.

Eighteen patients with early Huntington's disease were compared with age- and IQ-matched control volunteers on tests of executive and mnemonic function taken from the Cambridge Neuropsychological Test Automated Battery. Tests of pattern and spatial recognition memory, spatial span, spatial working memory, spatial planning and visual discrimination learning/attentional set shifting were employed. These tests have previously been found to be sensitive to the later stages of Huntington's disease. Patients with early Huntington's disease were found to have a wide range of cognitive impairments encompassing both visuospatial memory and executive functions, a pattern distinct from those seen in other basal ganglia disorders. In contrast to patients with more advanced Huntington's disease, early Huntington's disease patients were not impaired at simple reversal learning, but were impaired at performing an extradimensional shift (EDS). The results will be discussed in relation to the hypothesized neuropathological staging of Huntington's disease and to the anatomical connectivity of the striatum.

Adult↗
PubMed1996

Spectrum of memory dysfunction in degenerative disease.

We have summarized relevant literature on the patterns of memory deficit found in Alzheimer's disease, the focal lobar atrophies (semantic dementia and dementia of frontal type) and three forms of subcortical dementia (progressive supranuclear palsy, Huntington's and Parkinson's disease). We have stressed an approach based on the joint principals of cognitive neuropsychology and applied neuroanatomy. Alzheimer's disease results in a severe deficit in the establishment of new episodic memories which reflects the perihippocampal locus of the early pathology. In semantic dementia, there is profound progressive and relatively pure loss of semantic memory associated with focal left temporal neocortical atrophy. By contrast, in the subcortical dementias the major impairments are in working (immediate) memory and retrieval of information from longer term memory stores, deficits which reflect dysfunction of frontostriatal systems.

Aged↗
PubMed1996

Topographic amnesia: spatial memory disorder, perceptual dysfunction, or category specific semantic memory impairment?

A 60 year old patient, SE, who presented with a severe difficulty in finding his way around previously familiar environments and a mild prosopagnosia is described. SE had herpes simplex encephalitis resulting in selective right temporal lobe damage. He showed normal spatial learning, but was severely imparied in his ability to recognise pictures of buildings and landmarks. The disorder was not confined to the visual modality, but rather involved a loss of knowledge about famous buildings and landmarks when tested from their spoken name. SE was contrasted with a more severely prosopagnosic patient, PHD, who showed normal ability to recognise buildings and landmarks, indicating that recognition of people dissociates from recognition of buildings/landmarks. It is concluded that SE's failure of place knowledge represents a category specific supramodal semantic memory impairment.

Agnosia↗
PubMed1996

Progressive biparietal atrophy: an atypical presentation of Alzheimer's disease.

OBJECTIVES: To define the clinical, neuropsychological, and radiological features of bilateral parietal lobe atrophy. METHODS: Four patients underwent a comprehensive longitudinal neuropsychological assessment, as well as MRI and HMPAO-SPECT. RESULTS: The consistent findings in the patients were early visuospatial problems, agraphia of a predominantly peripheral (or apraxic) type, and difficulty with bimanual tasks, all of which outweighted deficits in memory and language until later in the course of the illness. As the disease progressed, impairments in the phonological aspects of language and in auditory-verbal short term memory were often striking, perhaps reflecting spread from the parietal lobe to perisylvian language areas. Three patients went on to develop a global dementia and fulfilled the criteria for a clinical diagnosis of probable Alzheimer's disease; the fourth patient has only recently been identified. Neuroimaging disclosed bilateral parietal lobe atrophy (MRI) and hypoperfusion (SPECT), which was out of proportion to that seen elsewhere in the brain. One patient has died and had pathologically confirmed Alzheimer's disease with particular concentration in both superior parietal lobes. CONCLUSIONS: Bilateral biparietal atrophy is a recognisable clinical syndrome which can be the presenting feature of Alzheimer's disease. Although the label "posterior cortical atrophy" has been applied to such cases, review of the medical literature suggests that this broad rubric actually consists of two main clinical syndromes with features reflecting involvement of the occipitotemporal (ventral) and biparietal (dorsal) cortical areas respectively.

Aged↗
PubMed1995

The Cambridge Neurological Inventory: a clinical instrument for assessment of soft neurological signs in psychiatric patients.

A schedule (the Cambridge Neurological Inventory) has been constructed for standardized neurological assessment of psychiatric patients. Normative data and data resulting from its application to a group of patients with schizophrenia are reported. The instrument is comprehensive, reliable, and easy to administer. In conjunction with other forms of clinical assessment, it may be useful for identifying soft neurological signs and other patterns of neurological impairment relevant to neurobiological localization and prognosis in schizophrenia and other psychiatric disorders.

Adolescent↗
PubMed1995

Is semantic memory consistently impaired early in the course of Alzheimer's disease? Neuroanatomical and diagnostic implications.

To establish whether semantic memory is consistently impaired in patients with very mild dementia of Alzheimer's type (DAT), we assessed episodic and semantic memory in 52 patients with DAT who were divided into three sub-groups according to dementia severity on the Mini-Mental State Examination (minimal > 23, mild 17-23 and moderate < 17) and 24 matched controls. The minimal group showed impairment on the following semantic memory measures: category fluency, naming of line drawings, naming to verbal description, answering semantic feature questions and a non-verbal picture-picture matching task (the Pyramids and Palm Trees Test). The mild and moderate groups showed additional deficits on picture sorting and word-picture matching tests. Within the minimal and mild groups there was, however, considerable heterogeneity. While some patients showed a consistent impairment across all of the semantic memory tests, others were impaired on only on a subset of these tests and a few even performed flawlessly. In contrast, all patients showed a profound deficit in episodic memory: delayed recall of new verbal and non-verbal material appears to be a particularly sensitive marker of early DAT. These data are in keeping with recent neuropathological studies demonstrating that the transentorhinal region is consistently involved at a very early stage. Lesions in this site cause a functional disconnection of the hippocampus, and hence a profound episodic memory disorder. The fact that many, but not all, patients with early disease also show impairment of semantic memory suggests that damage to the transentorhinal region is not sufficient to produce significant disruption of semantic memory. Such disruption reliably occurs, we hypothesize, only when the pathology extends to the temporal neocortex proper.

Aged↗
PubMed1995

Autobiographical memory and executive function in early dementia of Alzheimer type.

We studied executive function and autobiographical memory in a cohort of 33 DAT patients [divided into minimal (MMSE 24-30) and mild (MMSE 17-23) groups] and in 30 normal controls. Autobiographical memory, as assessed by autobiographical fluency and the Autobiographical Memory Interview (AMI), was impaired in DAT patients, even those with minimal disease. There was evidence of a gentle temporal gradient on the incident but not the personal semantic component of the AMI, suggesting that the two components are dissociable. Executive function was assessed by two separate dual performance tasks and letter fluency. Although there was a trend for minimal DAT patients to be impaired on executive tasks, this only reached significance for the mild group. Regression analysis suggested that the divided attention component of working memory was involved in the retrieval of personal semantic autobiographical memory, but verbal fluency was more important in the retrieval of autobiographical incidents. There was thus a dissociation in the type of executive function implicated in different subcomponents of autobiographical memory, arguing for subcomponents within executive function and autobiographical memory. The autobiographical memory deficit in DAT reflects, we argue, both impairment in retrieval processes, linked to executive function, and a loss of memory stores.

Age of Onset↗
PubMed1995

Loss of remote memory: a cognitive neuropsychological perspective.

Recent, cognitively based neuropsychological studies have established that retrograde amnesia is not a single entity. Profound loss of autobiographical memory, with relative sparing of knowledge of word meaning, facts about other people and personal semantic information, may arise from either disruption of thematic retrieval frameworks or a loss of individual memory traces. The opposite pattern of profound loss of general semantic information with preservation of autobiographical memory also occurs. Finer-grained loss of semantic information, involving famous persons or other categories have also been described, providing important clues regarding the representation and organization of such knowledge.

Amnesia, Retrograde↗
PubMed1995

Episodic and semantic memory in Alzheimer's disease and progressive supranuclear palsy: a comparative study.

We compared 13 patients with dementia of the Alzheimer's type (DAT) and 9 progressive supranuclear palsy (PSP) patients, matched by age, sex, education, and the overall level of cognitive deterioration, measured by using the Dementia Rating Scale, and 12 normal controls. The results of this study confirm that the pattern of cognitive deterioration of PSP patients differs from that of DAT patients. While episodic memory is severely affected early in the course of DAT, it appears to be relatively spared in PSP. In contrast to previous suggestions, we found no evidence for differentially rapid forgetting in DAT, although we did confirm relatively preserved recognition memory in PSP. We had predicted that the performance of the DAT group on tests of semantic memory (the Boston Naming Test, the ADA Synonym Judgement Test, and the Pyramids and Palm Trees Test) would be worse than that of the PSP group. However, there was, in fact, no difference on any of these measures, except that the PSP patients showed a significantly greater deficit on the Synonym Judgement Test. We suggest that the underlying cause of the semantic memory impairment might, however, be different in the two pathologies.

Aged↗
PubMed1995

Progressive prosopagnosia associated with selective right temporal lobe atrophy. A new syndrome?

V.H., a 68-year-old right-handed woman, presented with a progressive deterioration in her ability to recognize faces of familiar people, including friends and relatives. Neuropsychological testing on two occasions separated by 9 months indicated no deterioration in general intellectual ability from estimates of her pre-morbid IQ (in the high average range), and little or no change in memory, language, perceptual or executive functioning. She is severely impaired on tests of face recognition and has shown some deterioration between testing occasions. In contrast, face perception skills, including emotional expression analysis, appear to be intact. Her knowledge of people from names was originally much better than from faces, but clearly declined on follow-up. This progression is discussed in the context of contemporary models of face processing: we suggest that her prosopagnosic deficit began as a modality-specific disorder which has progressed to a cross-modality loss of person-based semantic knowledge. In addition, she shows a striking dissociation between her ability to recognize faces and unique exemplars from other categories, such as buildings and flowers, which confirms the hypothesis that face processing is indeed special. Scanning by SPECT and MRI revealed selective hypoperfusion and atrophy, respectively, of the anterior part of the right temporal lobe. In recent years there have been a number of descriptions of progressive fluent aphasia resulting from atrophy of the left temporal lobe. This case appears to represent a corresponding degenerative process affecting the right temporal lobe.

Aged↗
PubMed1995

The neuropsychological differentiation of patients with very mild Alzheimer's disease and/or major depression.

OBJECTIVE: To evaluate the usefulness of standardized neuropsychological tests in the psychometric differentiation of patients with very mild or mild Alzheimer's Disease (AD) and/or major depression presenting in a tertiary clinic with memory/attention complaints. DESIGN: Controlled prospective clinicoexperimental design. SETTING: Multidisciplinary Memory Clinic at Addenbroke's Hospital, Cambridge, England. PARTICIPANTS: Twenty-four patients with a clinical diagnosis of Alzheimer's disease (12 with major depression and 12 without), 12 patients with major depressive illness but without AD, and 12 healthy control subjects, all matched for age, sex, education levels, and estimates of premorbid intellectual potential. MEASUREMENTS: Mini-Mental State Examination (MMSE), Wechsler's Logical Memory (WLM) and Visual Reproduction (WVR), immediate and delayed reproduction, Wechsler's paired Associate Learning (WPAL), including the Easy and Hard subsets. Warrington's Recognition Memory for Faces (WRMF), Kendrick's Object Learning (KOLT) and Digit Copying (KDCT) Tests. OUTCOME MEASURES: Minimum 2-year follow-up diagnosis. RESULTS: Statistically, patients with very mild AD were distinguished clearly from those without AD on most tests of memory functions. Psychometrically, only KOLT and an index of retention on WLM and WVR were specific enough to avoid false positives, a requirement for second-stage tools. They also proved sensitive enough to suggest their role as first-stage instruments when screening for primary dementia in high-functioning patients scoring above the cut-point on MMSE. CONCLUSIONS: As efforts intensify to develop more powerful means to identify patients with Alzheimer's disease in its earliest stages, inclusion of specialist tests posing greater cognitive challenge than standard mental status scales has been one strategy. Our study explored how some of these neuropsychological tools behave psychometrically when analyzed on a single-case basis, and the results suggest a few are sensitive enough to boost detection above base rates alone while also being specific enough to reduce false alarms. Retention on Wechsler's Logical Memory and Visual Reproduction tasks and scores on Kendrick's Object Learning Test helped decrease the degree of ambiguity when cognitive profiles were used to distinguish depressed patients with Alzheimer disease from those without.

Aged↗
PubMed1994

Remote memory and lexical retrieval in a case of frontal Pick's disease.

OBJECTIVE: To examine the status of remote memory and lexical retrieval processes in a patient with frontal lobe-type dementia studied serially during an 18-month period. DESIGN: Longitudinal single-case study. SETTING: University hospital. PATIENT: A 67-year-old man presented to the hospital with progressive frontal lobe dysfunction confirmed by neuropsychological testing and single photon emission-computed tomographic scan. Postmortem brain examination demonstrated focal atrophy of the orbitofrontal region of the frontal lobe and medial temporal structures with abundant Pick's bodies and Pick's cells. MAIN OUTCOME MEASURES: Anterograde memory was assessed on a range of free recall and recognition tests using verbal and nonverbal material. Remote memory was assessed by Famous Faces and Famous Events tests and the Crovitz test of remote personal memory. Lexical retrieval was examined using initial-letter and semantic category-based fluency tasks. RESULTS: Initially there was a dissociation between anterograde memory, which was severely impaired, and relatively spared remote memory. Within retrograde memory there was evidence of selective difficulty in retrieving contextually rich and time-specific personal memories and in dating personal and public memories. In contrast, retrieval of names of famous persons and recognition of famous events was relatively normal. As the disease progressed, performance on all remote memory tests worsened, but without a temporally graded pattern. Lexical retrieval was markedly impaired and affected to an equivalent degree performance on initial-letter and category fluency tasks. CONCLUSION: These findings are interpreted in the context of a general retrieval deficit resulting from the interruption of frontostriatal circuits.

Aged↗
PubMed1994

The Dementia Rating Scale in Alzheimer's disease, Huntington's disease and progressive supranuclear palsy.

The Dementia Rating Scale (DRS) comprises a series of five subtests which assess attention, memory, initiation/preservation, construction, and conceptualisation. It can be delivered in full in approximately 30 min, making it a useful test for the detection and estimation of the overall level of dementia. We analysed the pattern of subscale test scores in patients with cortical and subcortical dementias, who were matched for their overall level of dementia on this scale. Patients with dementia of Alzheimer's type were more impaired than patients with Huntington's disease (HD) and progressive supranuclear palsy (PSP) on the memory subtest, whereas patients with HD and PSP were more impaired on the initiation/perseveration subtest. This is evidence in favour of the concept of cortical and subcortical dementias as separate, although overlapping, entities. Qualitative differences in the pattern of cognitive impairment in these disorders can be detected with a brief cognitive status examination.

Aged↗
PubMed1994

The relationship between comprehension and oral reading in progressive fluent aphasia.

The role played by comprehension in oral reading was investigated in three patients with progressive fluent aphasia. For patients J.L. and G.C., there was evidence of a deficit in semantic memory affecting both word production and comprehension. F.M., although equally anomic, had significantly better single-word comprehension than either J.L. or G.C. It was predicted that, for J.L. and G.C., success or failure in word comprehension should show item-specific correspondence with success or failure in reading exception words, but not regular words. This predicted pattern was obtained between word-picture matching tests and reading. For F.M., with only minimal comprehension impairment for the items used, a smaller trend in the same direction was observed. The results are discussed with respect to Patterson and Hodges' hypothesis (Neuropsychologia 30, 1025-1040, 1992) regarding the consequences of impaired semantic memory for the integrity of representations in the phonological output lexicon.

Aphasia↗
PubMed1994

Initial letter and semantic category fluency in Alzheimer's disease, Huntington's disease, and progressive supranuclear palsy.

Ten patients with dementia of Alzheimer's type, 10 patients with progressive supranuclear palsy, and 10 patients with Huntington's disease were compared on two types of verbal fluency task--namely, initial letter fluency and category (semantic) fluency. The groups were carefully matched for overall level of dementia on the dementia rating scale, and were compared with 25 age matched normal controls. The controls found letter fluency more difficult than category fluency, and this relative pattern of performance was repeated in the progressive supranuclear palsy and Huntington's disease groups, although both groups were significantly impaired on both tasks. By contrast, patients with Alzheimer's disease performed just as poorly as the progressive supranuclear palsy and Huntington's disease groups on the category tasks, but were significantly less impaired at letter fluency, performing at near normal levels on this task. From these results, it is suggested that the performances of patients with progressive supranuclear palsy and Huntington's disease relate largely to initiation and retrieval problems secondary to disruption of frontostriatal circuits, whereas in Alzheimer's disease, the poorer performance on category fluency is due principally to the breakdown of semantic knowledge, which probably reflects temporal neocortical involvement.

Adult↗
PubMed1994

Semantic memory and frontal executive function during transient global amnesia.

To assess semantic memory and frontal executive function, two patients underwent neuropsychological testing during transient global amnesia (TGA) and after an interval of 6-8 weeks. In spite of a profound deficit in anterograde verbal and non-verbal memory, semantic memory was normal, as judged by category fluency measures, picture naming, and picture-word and picture-picture matching, and reading ability was normal. Similarly, there were no deficits on a number of tests known to be sensitive to frontal executive dysfunction. A hexamethylpropyleneamine-oxime (HMPAO) single photon emission CT (SPECT) scan, obtained on one patient 24 hours post-TGA, showed focal left temporal lobe hypoperfusion which had resolved three months later. The observed dissociation between episodic and semantic memory is discussed in the light of contemporary cognitive theories of memory organisation.

Aged↗