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Paul J Eslinger

Publications and source records attributed to Paul J Eslinger.

13 recordsLinked to original sources
PubMed2006

Oops! Resolving social dilemmas in frontotemporal dementia.

OBJECTIVES: Our social cognition model posits that social knowledge and executive resources guide interpersonal decision making. We investigated this model by examining the resolution of standardised social dilemmas in patients with a social and executive disorder (SOC/EXEC) caused by frontotemporal dementia (FTD). METHODS: Patients with SOC/EXEC (n = 12) and those with progressive aphasia (APH, n = 14) completed measures requiring resolution of social dilemmas (Guilford's Cartoon Predictions Test), social cognition (theory of mind false belief vignettes and a behavioural rating measure of empathy) and executive measures of cognitive flexibility (Visual Verbal Test). Regression analysis related judgments of social dilemmas to cortical volume using voxel based morphometry of high resolution structural MRI. RESULTS: Patients with SOC/EXEC were impaired in judgments of social dilemmas as well as theory of mind, self-awareness of empathy and cognitive flexibility. Patients with APH were much less impaired in the social and cognitive measures. There were strong correlations among social dilemma, theory of mind and mental flexibility measures in patients with SOC/EXEC, and stepwise regression showed that mental flexibility was most predictive of social dilemma judgments. Social dilemma impairments in the SOC/EXEC sample correlated with cortical atrophy in the orbital frontal, superior temporal, visual association and posterior cingulate regions of the right hemisphere. CONCLUSIONS: Deficits in patients with SOC/EXEC in resolving social dilemmas are related to depleted executive resources and social knowledge that appear to arise from disease that interrupts a right frontal-temporal neural network crucial for mediating social cognition.

Aged↗
PubMed2006

Improving cognition and function through exercise intervention in Alzheimer's disease.

PURPOSE: To analyze the effects of cognition on function and to explore the potential of aerobic exercise for promoting cognitive and functional capacities. DESIGN: Integrative review of literature. METHODS: Studies were selected based on an extensive search of electronic databases and manual cross-referencing for 1980 to 2006, using the combination of key words: Alzheimer's disease (AD), dementia, or cognitive impairment with function or activities of daily living. FINDINGS: Three broad themes were identified from the literature analysis. First, global cognition has mainly been used to examine the effect of cognition on function, indicating an assumption that functional decline progresses in a hierarchical manner in AD. Second, specific cognitive domains affect functional decline in different ways. Executive functioning might have more effect on function than does memory. Third, aerobic exercise might promote cognitive and functional capacities in people with AD by modifying neuropathological changes in the brain. CONCLUSIONS: Specific cognitive domains such as executive functioning are important for understanding function in people with AD and are potentially modifiable by aerobic exercise.

Activities of Daily Living↗
PubMed2005

Unawareness of cognitive deficit (cognitive anosognosia) in probable AD and control subjects.

OBJECTIVE: To develop a quantitative method of assessing cognitive anosognosia in six cognitive and two noncognitive domains. METHODS: Control (n = 32) and probable Alzheimer disease (pAD) (n = 14) subjects self-estimated memory, attention, generative behavior, naming, visuospatial skill, limb praxis, mood, and uncorrected vision, both before and after these abilities were assessed. Based on this estimate and their performance the authors calculated an anosognosia ratio (AR) by dividing the difference between estimated and actual performance by an estimated and actual performance sum. With perfect awareness, AR = 0. Overestimating abilities would yield a positive AR (< or =1); underestimation would yield a negative AR (> or =-1). RESULTS: Relative to controls, pAD subjects demonstrated anosognosia. Pre-testing (off-line), pAD subjects overestimated their visuospatial skill; post-testing (on-line), pAD subjects overestimated their memory. Control subjects also made self-rating errors, underestimating their attention pre-testing and overestimating limb praxis and vision post-testing. CONCLUSIONS: This anosognosia assessment method may allow more detailed examination of distorted self-awareness. These results suggest that screening for anosognosia in probable Alzheimer disease (pAD) should include self-estimates of visuospatial function, and that, in pAD, it may be useful to assess anosognosia for amnesia both before and after memory testing.

Aged↗
PubMed2005

Functional magnetic resonance imaging study of human olfaction and normal aging.

BACKGROUND: The function of human olfaction declines with advancing age. An important question centers on whether functional alterations to olfactory brain structures accompany age-related behavioral changes. In the present study, we tested the hypothesis that aged adults have intact though reduced activity in the central olfactory system using functional magnetic resonance imaging (fMRI). METHODS: University of Pennsylvania Smell Identification Test (UPSIT) was used to test the smell function of 11 young (23.9 +/- 1.6 years) and 8 aged (66.4 +/- 4.4 years) healthy participants. Then, the participants received fMRI at 3.0 T with lavender and spearmint as stimulants. After fMRI, the participants provided ratings for the odorants' intensity and pleasantness. RESULTS: The average UPSIT score of the aged adults was 34.1 +/- 1.5, which was significantly lower than that of the young adults (37.3 +/- 1.1) (p =.0004). Both age groups showed significant activation in major olfactory brain structures, including the primary olfactory cortex, entorhinal cortex, hippocampus and parahippocampal cortex, thalamus, hypothalamus, orbitofrontal cortex, and insular cortex and its extension into the inferior lateral frontal region. The aged adults showed less brain activity in olfactory structures (p =.022), consistent with lower ratings of odor intensity and UPSIT scores. Activation intensity in bilateral primary olfactory cortex areas and right insular cortex was also comparatively weaker (p <.019). CONCLUSION: Results demonstrate that significant activation in aged adults can be observed in all the olfactory brain structures that are activated in young adults, but with lower activation volume and intensity. This finding provides a necessary baseline for further investigations in olfaction and aging.

Adult↗
PubMed2005

The moral affiliations of disgust: a functional MRI study.

Recent investigations in cognitive neuroscience have shown that ordinary human behavior is guided by emotions that are uniquely human in their experiential and interpersonal aspects. These "moral emotions" contribute importantly to human social behavior and derive from the neurobehavioral reorganization of the basic plan of emotions that pervade mammalian life. Disgust is one prototypic emotion with multiple domains that include viscerosomatic reaction patterns and subjective experiences linked to (a) the sensory properties of a class of natural stimuli, (b) a set of aversive experiences and (c) a unique mode of experiencing morality. In the current investigation, we tested the hypotheses that (a) the experience of disgust devoid of moral connotations ("pure disgust") can be subjectively and behaviorally differentiated from the experience of disgust disguised in the moral emotion of "indignation" and that (b) pure disgust and indignation may have partially overlapping neural substrates. Thirteen normal adult volunteers were investigated with functional magnetic resonance imaging as they read a series of statements depicting scenarios of pure disgust, indignation, and neutral emotion. After the scanning procedure, they assigned one basic and one moral emotion to each stimulus from an array of six basic and seven moral emotions. Results indicated that (a) emotional stimuli may evoke pure disgust with or without indignation, (b) these different aspects of the experience of disgust could be elicited by a set of written statements, and (c) pure disgust and indignation recruited both overlapping and distinct brain regions, mainly in the frontal and temporal lobes. This work underscores the importance of the prefrontal and orbitofrontal cortices in moral judgment and in the automatic attribution of morality to social events. Human disgust encompasses a variety of emotional experiences that are ingrained in frontal, temporal, and limbic networks.

Adult↗
PubMed2004

Reduction of magnetic field inhomogeneity artifacts in echo planar imaging with SENSE and GESEPI at high field.

Geometric distortion, signal-loss, and image-blurring artifacts in echo planar imaging (EPI) are caused by frequency shifts and T(2)(*) relaxation distortion of the MR signal along the k-space trajectory due to magnetic field inhomogeneities. The EPI geometric-distortion artifact associated with frequency shift can be reduced with parallel imaging techniques such as SENSE, while the signal-loss and blurring artifacts remain. The gradient-echo slice excitation profile imaging (GESEPI) method has been shown to be successful in restoring tissue T(2)(*) relaxation characteristics and is therefore effective in reducing signal-loss and image-blurring artifacts at a cost of increased acquisition time. The SENSE and GESEPI methods are complementary in artifact reduction. Combining these two techniques produces a method capable of reducing all three types of EPI artifacts while maintaining rapid acquisition time.

Artifacts↗
PubMed2004

Developmental outcomes after early prefrontal cortex damage.

The neuropsychological bases of cognitive, social, and moral development are minimally understood, with a seemingly wide chasm between developmental theories and brain maturation models. As one approach to bridging ideas in these areas, we review 10 cases of early prefrontal cortex damage from the clinical literature, highlighting overall clinical profiles and real life developmental outcomes. Based on these cases, there is preliminary evidence to support distinctive developmental differences after: (1) dorsolateral, (2) mesial, and (3) orbital-polar prefrontal lesions, for more profound impairments after bilateral damage, and possibly for recovery differences after very early vs. later childhood lesion onset. Further case and group studies are needed to confirm reliable effects of specific lesion locations, the influence of age of lesion onset, and related experiential and treatment variables in determining adult outcomes. Rather than a single underlying deficit associated with early prefrontal cortex damage, we interpret the findings to suggest that it is the altered integration and interplay of cognitive, emotional, self-regulatory, and executive/metacognitive deficits that contribute to diverse developmental frontal lobe syndromes. The findings support the fundamental importance of prefrontal cortex maturation in protracted cognitive, social-emotional, and moral development.

Adolescent↗
PubMed2003

Morals and the human brain: a working model.

Morality has been at the center of informal talks and metaphysical discussions since the beginning of history. Recently, converging lines of evidence from evolutionary biology, neuroscience and experimental psychology have shown that morality is grounded in the brain. This article reviews the main lines of investigation indicating that moral behavior is a product of evolutionary pressures that shaped the neurobehavioral processes related to the selective perception of social cues, the experience of moral emotions and the adaptation of behavioral responses to the social milieu. These processes draw upon specific cortical-subcortical loops that organize social cognition, emotion and motivation into uniquely human forms of experience and behavior. We put forth a model of brain-behavior relationships underlying moral reasoning and emotion that accommodates the impairments of moral behavior observed in neuropsychiatric disorders. This model provides a framework for empirical testing with current methods of neurobehavioral analysis.

Brain↗
PubMed2002

The neural correlates of moral sensitivity: a functional magnetic resonance imaging investigation of basic and moral emotions.

Humans are endowed with a natural sense of fairness that permeates social perceptions and interactions. This moral stance is so ubiquitous that we may not notice it as a fundamental component of daily decision making and in the workings of many legal, political, and social systems. Emotion plays a pivotal role in moral experience by assigning human values to events, objects, and actions. Although the brain correlates of basic emotions have been explored, the neural organization of "moral emotions" in the human brain remains poorly understood. Using functional magnetic resonance imaging and a passive visual task, we show that both basic and moral emotions activate the amygdala, thalamus, and upper midbrain. The orbital and medial prefrontal cortex and the superior temporal sulcus are also recruited by viewing scenes evocative of moral emotions. Our results indicate that the orbital and medial sectors of the prefrontal cortex and the superior temporal sulcus region, which are critical regions for social behavior and perception, play a central role in moral appraisals. We suggest that the automatic tagging of ordinary social events with moral values may be an important mechanism for implicit social behaviors in humans.

Adult↗
PubMed2002

Empathy and social-emotional factors in recovery from stroke.

There is growing interest in evaluating the social and emotional effects of stroke, with the aim of improving recovery and outcome. Recent investigations indicate that post-stroke depression and social impairment are cross-cultural consequences that affect between one-third and two-thirds of patients. These conditions appear to be undertreated, even though studies confirm measurable benefits of medical and caregiver education interventions. A further improvement in outcome can be expected from the comprehensive recognition and management of other social and emotional alterations that encompass emotion-related communication disorders, reduced emotional arousal, initiation and expression, and impaired social cognition, empathy and related interpersonal competencies.

Empathy↗
PubMedDate not supplied

Changes in Mini-Mental State Exam in community-dwelling older persons over 6 years: relationship to health and neuropsychological measures.

Although cognitive screening test scores change with advanced age, the significance of these changes (particularly decline in score) needs to be defined in terms of general health and neuropsychological functioning. Such analysis was undertaken in a subgroup of 287 healthy older men (mean age at baseline = 70.7 years) from the Western Collaborative Group Study, an ongoing cardiovascular and aging research project. Time from baseline to follow-up study averaged 6.0 years (SD = 0.5 years). Mini-Mental State Examination (MMSE) scores indicated that 15% of participants declined by three or more points (a 1+ standard deviation change among all change scores), 5% of participants improved by three or more points, and 80% of the sample remained within two points of their initial score. In health terms, decliners were significantly older, less active at follow-up, rated their health more poorly, and reported more depressive symptoms than non-decliners. Decliners also performed more poorly on several neuropsychological tests administered at follow-up. Results suggest that a decline of three or more points on the MMSE in community-dwelling, older persons without acute illness may signify important changes in health and cognition.

Adult↗