Biomedical subjects

T Giovannetti

Publications and source records attributed to T Giovannetti.

6 recordsLinked to original sources

PubMed2001

Anticholinergicity and cognitive processing in chronic schizophrenia.

Patients with chronic schizophrenia suffer from alterations in cholinergic functioning due to several factors, including the disease diathesis and pharmacologic treatments. Acetylcholine-cognition relationships are well explored in normals but are unclear in schizophrenia. Prior work indicated serum anticholinergicity does not cause global cognitive impairment in this group (Tracy et al., 1998a), raising the possibility that anticholinergicity normalizes an abnormal hyperactive cholinergic state. Serum anticholinergic levels were determined in 38 chronic schizophrenia patients using an established radioreceptor assay method. Six cognitive functions associated with cholinergic tone in normals were tested. The potential role of autonomic arousal and cigarette smoking were also assessed as both have been linked to cholinergic functioning. Regression analyses showed measures of inhibitory executive control and effortful memory accounted for a greater proportion of the variance in the anticholinergicity measure compared to the other variables. The data demonstrate a relationship between high anticholinergicity and worse performance on two types of attention-resource demanding cognitive processes and do not support the notion that reduced cholinergic tone normalizes a hyperactive cortical acetylcholine substrate. Relevant neuroanatomic structures and implications for models of cognitive deficits in schizophrenia are discussed.

Acetylcholine↗

PubMed2001

Different underlying mechanisms for deficits in concept formation in dementia.

We investigated the different mechanisms that may underlie deficits in verbal concept formation among patients with Alzheimer's disease (AD) and ischaemic vascular dementia (IVD) associated with periventricular and deep white matter alterations. Concept formation was assessed with the WAIS-R Similarities subtest (SIM). Two types of errors were re-coded from the 0-point responses as scored by the WAIS-R manual. In set errors (e.g., dog-lion "they're alive") were coded when patients reported a very vague superordinate concept for the word pair. Out of set responses (e.g., dog-lion "the lion roars and the dog barks") were coded when a response was clearly out of mental set, i.e., when participants were unable to provide a superordinate concept for the word pair. Between-group comparisons demonstrated no difference in SIM test performance according to the scoring system described in the WAIS-R manual. Nonetheless, AD patients produced a greater proportion of in set errors, while IVD patients produced a greater proportion of out of set errors. Out of set errors were highly associated with measures of executive function, while in set errors were associated with measures related to delayed recognition memory and semantic intrusion errors. We conclude that the underlying deficits that contribute to poor concept formation differ between AD and IVD patients. In IVD impaired concept formation is related to deficits in the executive systems necessary to monitor responses and sustain mental set. In AD, by contrast, the deficit appears to be secondary to impaired verbal response selection.

Journal Article↗

PubMed2000

The role of the dynamic body schema in praxis: evidence from primary progressive apraxia.

On an influential model of limb praxis, ideomotor apraxia results from damage to stored gesture representations or disconnection of representations from sensory input or motor output (Heilman & Gonzalez Rothi, 1993; Gonzalez Rothi et al., 1991). We report data from a patient with progressive ideomotor limb apraxia which cannot be readily accommodated by this model. The patient, BG, is profoundly impaired in gesturing to command, to sight of object, and to imitation, but gestures nearly normally with tool in hand and recognizes gestures relatively well. In addition, performance is profoundly impaired on imitation of meaningless gestures and on tasks requiring spatiomotor transformations of body-position information. We provide evidence that BG's apraxia is largely attributable to impairments external to the stored gesture system in procedures coding the dynamic positions of the body parts of self and others; that is, the body schema. We propose a model of a dynamic, interactive praxis system subserved by posterior parietal cortex in which stored representational elements, when present, provide "top-down" support to spatiomotor procedures computed on-line. In addition to accounting for BG's performance, this model accommodates a common pattern of ideomotor apraxia more readily than competing accounts.

Aged↗

PubMed2000

Visuoconstructional problems in dementia: contribution of executive systems functions.

Visuoconstructional ability was assessed by asking patients diagnosed with Alzheimer's disease (AD), ischaemic vascular dementia (IVD), and Parkinson's disease (PD) and a normal control group (NC) to copy a modification of the Rey-Osterrieth Complex Figure (M-ROCF). The drawings of the NC group were superior to all dementia participants. AD patients generally outperformed IVD and PD patients; however, there were few differences between IVD and PD groups. Nonetheless, the drawings of IVD and PD patients were very fragmented and contained numerous perseverations and omissions. Despite these errors, patients with IVD and PD obtained higher delayed recognition memory scores than AD patients. Correlational analyses among dementia patients between neuropsychological tests and the copy of the M-ROCF found that accurate figure copy was most consistently correlated with tests of working memory, that is, tests requiring patients to monitor their behavior and sustain a complex mental set while performing mental manipulations. By contrast, no relationship between executive function tests related to measures of response selection/inhibition or other domains of neuropsychological functioning was found.

Aged↗

PubMed1998

Declarative and procedural learning, quantitative measures of the hippocampus, and subcortical white alterations in Alzheimer's disease and ischaemic vascular dementia.

This research investigated whether subjects with Alzheimer's disease (AD) and ischaemic vascular dementia (IVD) associated with periventricular and deep white matter alterations can be dissociated on tests of declarative and procedural memory, as well as on MRI indices of white matter alterations and the size of the hippocampal formation. The California Verbal Learning Test (CVLT) and the Pursuit Rotor Learning Tests (PRLT) were used to measure declarative and procedural memory, respectively. Subjects with IVD obtained a higher score on the CVLT recognition discriminability index; however, on the PRLT total time on target, carry-over between trial blocks, and slope calculated for all test trials was low. Subjects with AD exhibited the opposite profile. MRI studies indicated that subjects with IVD had considerably greater white matter alterations, but larger hippocampal formations than subjects with AD. Higher scores on the CVLT recognition discriminability index were correlated with increased size of the body of the hippocampus and parahippocampal gyrus. By contrast, as the severity of white matter alterations increased the slope on the PRLT declined. In sum, subjects with AD and IVD can be dissociated on the basis of differing patterns of impairment on tests of declarative and procedural memory, and MRI indices of white matter alteration and the integrity of the hippocampal formation.

Aged↗

PubMed1998

Awareness of errors in naturalistic action after traumatic brain injury.

A prospective study was performed to develop a method for assessing "on-line" error detection and correction during performance of naturalistic action, to determine whether traumatic brain injury (TBI) affects error detection and correction, and to compare actual task performance with verbal self-ratings of performance. Participants included 18 persons who had sustained severe TBI from 34 to 186 days prior to study and who were comparable to controls in their rate of naturalistic action error, along with 18 control subjects chosen to be demographically comparable to subjects with TBI. Subjects performed two different tests of naturalistic action in which they completed everyday activities (eg, wrapping a gift, making toast) at different levels of complexity, as manipulated by the addition of distractor objects, the number of tasks that had to be completed per trial, and other demands on planning and working memory. Using a specially developed coding system, each error on these tasks was scored as to whether the subject corrected it and whether the subject otherwise demonstrated awareness of the error. Error scores were also compared to subjects' responses to a questionnaire in which they rated their own performance on the most challenging level of the naturalistic action test. In general, subjects with TBI corrected and showed awareness of proportionally fewer of their errors when compared to controls. Qualitative patterns for some error types also differed between groups. Despite making more errors than control subjects on the most challenging task, subjects with TBI did not rate themselves as performing more poorly with respect to its cognitive demands. However, for subjects with TBI, the number of errors was correlated with performance ratings on certain questionnaire items. This study showed that error detection and correction can be reliably measured during naturalistic action and appear to be impaired in severe TBI even when the base rate of error is controlled. TBI may affect error detection and correction by reducing, or impairing the allocation of, attentional resources needed for the simultaneous execution and monitoring of routine action.

Adult↗