Limbic lesions in a patient with recurrent mania.
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Bipolar Disorder↗
Biomedical subjects
M L Berthier
Publications and source records attributed to M L Berthier.
Temporal lobe atrophy versus open operculum in Asperger's syndrome.
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Atrophy↗
Anosognosia and major depression in 2 patients with cerebrovascular lesions.
We report 2 patients who developed a neglect syndrome, anosognosia, and major depression immediately after a right hemisphere cerebrovascular lesion. These cases demonstrate that neglect, anosognosia, and major depression may coexist in the same patient, and that the presence of anosognosia does not preclude the patient's recognition of emotional impairment.
Aged↗
Depression and cognitive impairment in Parkinson's disease.
Neuropsychological deficits including cognitive impairment as well as depression are among the most frequent and important mental disorders found in patients with Parkinson's disease (PD). It has never been determined, however, whether there is a specific relationship between cognitive impairment and depression. A consecutive series of patients with PD was therefore examined for the presence of depression and neuropsychological deficits. Severity of depression was found to be the single most important factor associated with the severity of cognitive impairment. When PD patients with major depression were compared with an age and stage-matched group of nondepressed patients with PD using a neuropsychological battery, major depressed patients performed significantly worse than the nondepressed patients on all aspects of neuropsychological function tested. These impairments were most pronounced on frontal lobe tasks.
Cognition↗
Evoked potentials, reaction time and cognitive performance in on and off phases of Parkinson's disease.
Seven patients with Parkinson's disease and severe motor fluctuations were studied with event-related potentials, reaction and movement times and neuropsychological tests while in "off" and "on" phases. While there was a significant decrement in the P300 latency of the event-related potentials and in the duration of movement time in the "on" phase, no significant differences between on and off phases were observed in reaction time and neuropsychological tasks.
Aged↗
Dementia of depression among patients with neurological disorders and functional depression.
Cognitive performance on the Mini-Mental State Examination (MMSE) was assessed in depressed patients (diagnosis of major depression) with cerebrovascular lesions, with Parkinson's disease, or with functional depression (no known brain lesions). Controls for patients with brain lesions or Parkinson's disease were nondepressed patients with the same conditions. Controls for functionally depressed patients were age-matched normal individuals. Depressed patients had significantly lower total MMSE scores than their nondepressed counterparts, but depression did not have an effect on cognitive performance across the three disease groups. The only significant difference between depressed and nondepressed patients shared by all three groups was poorer performance by depressed patients on the delayed-recall task. The findings suggest that major depression may lead to a specific pattern of cognitive deficits independent of coexisting brain pathology.
Brain Damage, Chronic↗
Emotional behavior after a Wada test in a patient with secondary mania.
Soon after treatment of a right basotemporal vascular malformation using an embolization procedure, a 25-year-old patient developed an acute episode of mania. Two months later the patient was still manic, and a second embolization was scheduled. Before it was conducted, a Wada test was carried out to determine speech dominance. No changes in manic symptoms were observed after amytal injections into the left middle cerebral, right frontopolar, or right middle cerebral arteries. This finding suggests that secondary mania may not be the result of "release" of the left hemisphere following a right hemisphere lesion but instead may be related to specific disturbances within the right hemisphere.
Adult↗
Depression in patients with early versus late onset of Parkinson's disease.
We examined correlates of depression in patients whose onset of Parkinson's disease (PD) began before age 55 (early-onset group) compared with patients whose onset was after age 55 (late-onset group). The early-onset group showed a significantly higher frequency of depression than the late-onset group. When both groups were matched for duration of the disease, the early-onset group still showed a significantly higher frequency of depression, whereas tremor, akinesia, and rigidity were significantly more severe in the late-onset group. A stepwise regression analysis showed that in the early-onset group, depression scores were significantly correlated with scores of cognitive impairment and duration of the disease, while in the late-onset group, depression scores were significantly correlated with impairments in activities of daily living. These data suggest that depression in patients with early-onset PD may have a different etiology than in patients with late-onset PD.
Aged↗
Psychic akinesia following bilateral pallidal lesions.
After suffering a carbon monoxide intoxication, a thirty-nine-year-old patient presented a marked behavioral change, with a severe anterograde and retrograde amnesia, extreme placidity, bulimia, and hypersexuality. This picture lasted for twenty days. Placidity and anterograde amnesia persisted, while marked psychic akinesia and abnormal involuntary movements soon appeared. A CT scan disclosed bilateral low density lesions involving the pallidum. The patient showed marked improvement after treatment with bromocriptine.
Adult↗
Differential mood changes following basal ganglia vs thalamic lesions.
Patients with computed tomographic scan-verified unilateral lesions in the basal ganglia or thalamus were examined for the presence of poststroke mood disorders. Patients with left-sided basal ganglia lesions (mainly in the head of the caudate nucleus) showed a significantly higher frequency and severity of depression, as compared with patients with right-sided basal ganglia or thalamic (left- or right-sided) lesions. Results suggest that damage to biogenic amine pathways and/or frontocaudate projections may play an important role in the modulation of mood.
Aphasia↗
Depressive disorders following posterior circulation as compared with middle cerebral artery infarcts.
Patients with cerebrovascular lesions in the posterior circulation territory (PC) were compared with patients having middle cerebral artery territory (MCA) strokes for the presence of mood disorders. Both groups showed a similar profile of clinical symptoms of depression during the acute evaluation in hospital. Patients with posterior circulation lesions involving the brainstem and/or cerebellum demonstrated a significantly lower frequency of depression than patients with MCA lesions or patients with posterior circulation lesions involving the left cerebral hemisphere. Moreover, depression following brainstem and/or cellebellar infarcts was of significantly shorter duration than depression following MCA lesions. These differences in the frequency and duration of depression following brainstem/cerebellar as compared with MCA lesions were not explained by differences in lesion volume, physical impairment, cognitive deficits or quality of social support. They suggest that PC and MCA induced depression may have different aetiologies.
Cerebral Arteries↗
Neuropsychological and neuroradiological correlates in Huntington's disease.
Measurements of cortical and subcortical atrophy were made on CT scans of 34 patients with Huntington's disease. Significant correlations were found between the bicaudate ratio (BCR) and an eye movement scale (r = 0.44, p less than 0.01), and activities of daily living scale (r = 0.57, p less than 0.001) and the Mini-Mental State Exam (r = 0.49, p less than 0.01). No correlations were found between BCR values and severity of chorea or voluntary motor impairment. A detailed neuropsychological evaluation of 18 Huntington's disease patients showed significant correlations between the BCR and Symbol Digit Modalities test (r = 0.65, p less than 0.01), and parts A (r = 0.72, p less than 0.001) and B (r = 0.80, p less than 0.0001) of the Trail Making Test. These data support work in primates that demonstrates the role of the caudate nucleus in cognitive and oculomotor functions, but not in motor control (which is governed by putamino-subthalamic systems). The specific cognitive skills correlated with caudate atrophy in Huntington's disease are those reported in primate work to be served by the frontal-caudate loop system: eye movements, conceptual tracking, set shifting and psychomotor speed.
Adolescent↗
Disconnection syndrome in a right-handed patient with right hemispheric speech dominance.
The callosal disconnection syndrome is characterized by unilateral (left) tactile anomia, unilateral (left) agraphia and unilateral (left) ideomotor apraxia. We report on a right-handed patient, who developed a callosal disconnection syndrome due to the rupture of an anterior communicant aneurysm. As he had right hemisphere dominance for language and praxis, the signs described above were crossed. He also featured a left alien hand sign and motor aprosody. The authors believe this is the first case of callosal disconnection in a right-hander with crossed language and praxis functions.
Adult↗
[Cognitive function in the obsessive-compulsive disorder associated with cerebral lesions].
INTRODUCTION: Although obsessive-compulsive symptoms are uncommon among patients with neurological diseases, structural neuroimaging (CAT or MRI) disclose focal brain lesions in some patients. However, little is know about the clinical phenomenology of obsessive-compulsive symptoms and the cognitive deficits that occur in neurological conditions. OBJECTIVE: To review the cognitive functioning of patients who develop an obsessive-compulsive disorder (OCD) in association with focal brain lesions. DEVELOPMENT: In the present study, the author review recent studies which suggest that OCD associated with brain lesions is relatively similar to idiopathic or 'functional' OCD (i.e., OCD unassociated with gross brain damage). Idiopathic and acquired forms of OCD are clinically heterogeneous. The content of obsessions and compulsions in acquired OCD depends, at least in part, of the causative lesion, whereas the pattern of cognitive deficits is more homogeneous affecting attention, general intelligence, verbal and visuospatial memory, and executive function. CONCLUSION: It is suggested that the study of different subgroups of patients with acquired OCD would detect differences in the phenomenology of obsessions and compulsions as well as in the pattern of cognitive deficits. Moreover, this approach can improve our understanding about the pathophysiological mechanisms underlying idiopathic OCD.
Brain Diseases↗
[Essential tremor of the voice and treatment with gabapentin].
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Acetates↗