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Ratings of personality change in patients being evaluated for memory disorders.

Caregivers of 35 mildly to moderately memory-impaired patients rated current and premorbid personalities with the NEO Personality Inventory. We then examined changes in the five domains of personality tapped by the NEO. There were significant changes in four of the five domains of normal personality functioning toward less conscientiousness, lower extraversion, higher neuroticism, and lower openness. The difference toward lower agreeableness was not significant when controlling for multiple comparisons. Spearman rank correlation coefficients indicated that changes in conscientiousness and vulnerability were not related to rated premorbid personality patterns and thus appear to describe shifts for all patients evaluated for memory disorders. These data suggest that personality inventories may be helpful in characterizing caregivers' observations of memory-impaired patients and thus represent a critical source of information for the clinician in charge of care.

Adult

Memory disorders associated with Huntington's disease: verbal recall, verbal recognition and procedural memory.

Two experiments were conducted to evaluate the hypothesis that the memory disorders of Huntington's Disease (HD) patients are characterized by deficiencies in both retrieval mechanisms and the acquisition of procedural (skill-based) information. In the first study, verbal recall and recognition tests were administered to HD patients, amnesics and normal control (NC) subjects. Although the two patient groups were impaired relative to NC subjects on both recall and recognition of word lists, the performance of the HD patients was superior to that of the amnesics on the recognition test. In the second experiment early HD (EHD), advanced HD (AHD), amnesic and NC subjects were compared in the acquisition of the 'Tower of Hanoi' puzzle. Both the NC subjects and EHD patients acquired the solution of this puzzle after repeated trials, whereas the AHD and amnesic patients evidenced little improvement. However, on a recognition test assessing memory for facts about the puzzle, both the EHD and AHD patients were superior to the amnesic subjects. These results are consistent with the retrieval hypothesis but are equivocal with regard to the HD patients' proposed deficit in skill learning. Since the 'Tower' puzzle may rely heavily on both problem solving and skill learning capabilities, it may be of limited value in searching for double dissociations between patient groups and the acquisition of skill-based and data-based knowledge.

Adult

MR signal abnormalities in memory disorder and dementia.

MR imaging of the brain, performed in 86 normal subjects and 113 patients with objective memory disorder or dementia, demonstrated white- and gray-matter areas of high signal intensity on long TR images (short and long TE). Hyperintensities were analyzed with respect to size (on a scale of 0-3) and location: lesions were periventricular, subcortical, or cortical. The patients with memory disorder and dementia were categorized as having probable/possible Alzheimer disease, a combination of Alzheimer disease and multiinfarct cognitive disorder, or multiinfarct cognitive disorder alone on the basis of clinically determined Hachinski ischemic scores. Significant correlations were found between age and scores for periventricular lesions (r = .40, p less than .0005) and subcortical lesions (r = .39, p less than .0005) in normal subjects. Correlations were also found between the Hachinski ischemic score and scores for periventricular lesions (r = .21, p less than .01), subcortical lesions (r = .27, p less than .0002), and cortical lesions (r = .32, p less than .0005) in subjects with memory disorder/dementia. Comparing multiinfarct cognitive disorder, Alzheimer disease, and normal groups, the mean scores for periventricular lesions were 12.0 +/- 4.6, 7.6 +/- 4.8, and 3.4 +/- 2.6, while mean scores for subcortical lesions were 10.8 +/- 12.2, 4.1 +/- 6.4, and 0.8 +/- 1.2, respectively. Periventricular lesions were present in 99-100% of patients with Alzheimer disease and multiinfarct cognitive disorder. On the other hand, subcortical lesions, which were identified in 100% of patients with multiinfarct cognitive disorder, were present in only about half of the patients with Alzheimer disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

The clinical aspects of memory disorders: contributions from experimental studies of amnesia and dementia.

Many of the standardized memory tests employed by clinical neuropsychologists fail to demonstrate important differences in the memory disorders of amnesic and demented patients. To exemplify this heterogeneity of amnesic symptoms, the anterograde and retrograde amnesias of patients with Huntington's Disease (HD) and of patients with alcoholic Korsakoff's syndrome are compared. While both patient groups have similar MQs, they differ dramatically in their recall and recognition memory and in their ability to acquire procedural (rule-based) information. The Korsakoff patients are impaired in both recall and recognition memory but are able to acquire and retain mirror reading skills. In contrast, the patients with HD are impaired in their acquisition of procedural knowledge and in verbal recall although their recognition memory approaches normality. The importance of such information for the assessment of the patients' memory disorders is discussed.

Alcohol Amnestic Disorder

Age-related disruption of classical conditioning: a model systems approach to memory disorders.

The model systems approach to the neurobiology of memory involves studying a well characterized learned response in a relatively simple and well controlled preparation. The best characterized mammalian model system is classical conditioning of the rabbit's eyeblink response. Using this preparation, significant progress has been made toward understanding the neurobiological systems and mechanisms involved in elaboration of the conditioned response. Using a well characterized model system such as classical eyeblink conditioning, it should be possible to both characterize the changes in learning and memory that accompany aging and to investigate their neural substrates. Our strategy for using the conditioned eyeblink preparation for studying age-related memory deficits is four-fold and includes investigating conditioning deficits in: (1) humans across the life span, (2) rabbits across the life span, (3) Alzheimer's disease patients, and (4) rabbits with aluminum-induced neurofibrillary degeneration. In this paper, we present exemplary data from each of these lines of research. If similar deficits occur in each of these groups, it may be possible to begin to form hypotheses about the neurobiology of age-related memory disorders.

Aging

The role of diencephalic pathology in human memory disorder. Evidence from a penetrating paranasal brain injury.

A patient (B.J.) is reported who developed severe memory impairment following a penetrating brain injury caused by a snooker cue which entered through his left nostril into the basal regions of the brain. Initially, his memory disorder had the clinical features of a dense amnesic syndrome, with both anterograde and retrograde amnesia, but B.J. subsequently showed significant recovery of memory function. Formal memory testing was carried out 21 months after injury. This demonstrated marked verbal memory impairment, as severe as that seen in patients with the amnesic syndrome. On nonverbal memory tests, his impairment was relatively mild and patchy. His retrograde amnesia had regressed mainly to affect a 6 month period before the injury. On other cognitive tasks, he performed at an average or above average level, and there was no neuropsychological evidence of frontal lobe dysfunction. Neuroradiological investigations at various stages after his injury failed to demonstrate a lesion in any of the thalamic nuclei. Magnetic resonance imaging showed a lesion in the hypothalamus in the region of the mamillary bodies. Our study demonstrates that marked, relatively focal, memory disorder after diencephalic injury can occur without direct pathology to the body of the thalamus. It also indicates that structures in or adjacent to the hypothalamus, such as the mamillary bodies, may play a more important role in human memory functioning than has hitherto been considered.

Adult

[Drug evaluation of huperzine A in the treatment of senile memory disorders].

Huperzine A is an alkaloid which was first isolated from Huperzia serrata (Thumb) Trev by Zhejiang Academy of Medical Sciences and Shanghai Institute of Materia Medica, Chinese Academy of Sciences. It exhibits a significant anticholinesterase activity and has been used on myasthenia gravis patients. The therapeutic effects were studied by random, match and double-blind method on 56 patients of multi-infarct dementia or senile dementia and 104 patients of senile and presenile simple memory disorders. The curative effects were evaluated by Wechsler memory scale. The im dose for multi-infarct dementia was 0.05 mg bid for 4 wk, whereas that for senile and presenile simple memory disorders was 0.03 mg bid for 2 wk. Saline was used on control group. The result showed that the curative effect of huperzine A was significant. Only a few patients felt slight dizziness and this did not affect the therapeutic effects.

Aged

Long-term retention of computer learning by patients with memory disorders.

Previous research has demonstrated that patients with memory disorders resulting from closed-head injury can acquire the complex knowledge and skills necessary for the use of a microcomputer. The present paper extends the generality of those findings by showing that (1) amnesic patients with other etiologies could similarly learn how to operate a computer and (2) the knowledge and skills acquired were retained over intervals of up to 9 months.

Adult

[Memory disorders in lesions of the thalamus in man].

Isolated memory disorders occur after bilateral involvement of thalamus. Anterograde amnesia is not complete; retrograde amnesia is always severe. Four groups of thalamic nuclei may be affected: anterior nuclei; midline nuclei, medialis dorsalis nuclei; intralaminar nuclei. A pathophysiologic interpretation is proposed. Three kinds of memory processes may be involved: consolidating process that leads to the formation of memory traces (anterior nuclei, midline nuclei); retrieving process that leads to the activation of memory traces (intralaminar nuclei); temporal organizing process that regards ancient et recent memory traces (medialis dorsalis nuclei).

Amnesia

Age-dependent alterations in hippocampal synaptic plasticity: relation to memory disorders.

In this paper, we review the evidence indicating that the common disturbance in recent memory associated with aging is a consequence of functional and structural impairment in the hippocampal formation. In the Fischer 344 rat, an experimental model of the human age-related memory disorder was developed. The majority of aged rats of this strain show impaired performance in the 8-arm radial maze in a manner typical of young rats with bilateral hippocampal lesions. Aged animals also exhibit rapid decay of LTP and slower kindling of the perforant path-dentate synapse. Furthermore, quantitative morphometric analysis of the hippocampal synaptic architecture revealed that aged, memory-impaired rats had a specific loss of perforated axospinous synapses in the middle third of the dentate gyrus molecular layer; the extent of loss was directly related to the degree of memory dysfunction. Most important was the fact that the electrophysiological and morphological abnormalities did not appear in equally old animals with good memory.

Aging

An outline for the analysis of dementia. The memory disorder of Huntingtons disease.

Methods have been developed for assessing the cognitive parameters contributing to a memory disorder. Our findings suggest that individuals with Huntington disease have impairments in the encoding of new information and the consistent retrieval from storage of learned material. Their difficulties lie particularly in the realm of episodic memory.

Adult

Remediation of memory disorders: experimental evaluation of the spaced-retrieval technique.

Research concerning remediation of memory disorders has frequently been concerned with mnemonic techniques that demand a great deal of elaborative and effortful processing. The present study examines a relatively simple technique, known as spaced retrieval, in which patients are taught to retrieve information at increasingly long temporal intervals after initial presentation. Results indicated that the spaced-retrieval technique aided patients' learning of new information. There was also evidence of learning to learn: Two of the four patients who were studied learned to use the technique in the absence of explicit cues from the experimenter. Issues pertaining to the possible usefulness of spaced retrieval in everyday life are discussed.

Adult

Low diagnostic yield in a memory disorders clinic.

A review of the first 144 patients to attend a Memory Disorders Clinic found not one case of treatable dementia. The use of a routine comprehensive battery of investigations was not supported: however, computerized tomographic brain scans and electroencephalograms were moderately useful in diagnosing dementia. Clinical features and historical data did not discriminate early- from late-onset Alzheimer's disease or Alzheimer's disease from multi-infarct dementia.

Activities of Daily Living

[Memory disorders at different stages of development of temporal lobe astrocytoma].

Mnemonic disorders were investigated in 42 patients with astrocytomas of the temporal lobes. Mnemonic disorders examined at different disease stages were found to be related to the side and intralobular localization of tumors. In tumors of the mediobasal and neocortical structures of the temporal lobes, the irritative syndromes and memory loss symptoms were distinguished. Hypotheses of memory disorders seen in patients with those lesions are presented.

Adult

[Memory disorders in epileptic children with temporal psychomotor seizures].

The authors demonstrate the results of experimental psychological examination of memory in 57 patients with epilepsy in psychomotor temporal seizures. It was possible to show that in such cases there was a total decline of short-time memory. In bilateral foci and a long-term development of the disease there was a formation of an amnestic syndrome. The most distinct changes were seen in a delayed reproduction. In an electrostimulation of the structures of the temporal lobe by means of implanted electrodes the experiments displayed an intactness of direct reproduction during a stimulation of the neocortex, a moderate decrease in a stimulation of the hypocampus and a grave -- when stimulating the amygdalar complex.

Amygdala

[Memory disorders in parkinsonism patients].

The experience of memory and retention weaknesses in Parkinsonian patients led us to question if these are only due to age-specific deteriorations, and if these weaknesses change during the L-Dopa therapy of the underlying disease. For this reason 30 Parkinsonian patients and 30 normal subjects of a matched control group took part in five different tests of retention and memory: digit span (Wechsler), visual retention test (Benton), Wechsler Memory Scale (subtests 4 and 7), delayed recall (Williams). The results (including some further samples of the test literature) gave some evidence of test-material-specific weaknesses in Parkinsonian patients: especially such memory decay as is dependent on the interval of retention. An organic deterioration of the intermediate term memory is suggested. This result could not be fully explained by known psychological or neurological characteristics of the underlying disease.

Age Factors

Memory complaints, memory disorders and focus localization in patients with partial epilepsy.

Our study aimed at analysing effects of epileptic foci on memory function in patients with partial epilepsy. Twenty-eight patients with spontaneous memory complaints and psychometrically established memory disorders were assessed by 21-channel electroencephalography recorded both during cognitive testing and during 99mTc-HMPAO single photon emission computed tomography (SPECT). Computed tomography (CT) was performed on the same day. None of the epilepsy-related factors (seizure type, seizure frequency, type of epilepsy, age at onset of the seizures, type of antiepileptic treatment) could be related directly to severity or type of memory impairment (classified into the categories 'global', 'verbal' and 'non-verbal'). Remarkably, this study found no significant relationship between EEG focus localization and severity of measured memory impairment. Most areas with hypoperfusion on the SPECT were found in the group with global (severe) amnesia, typically with a right frontal localization. Abnormalities on CT were predominantly found in the same group, however, with a right-sided parietal localization. An unanticipated finding was that the majority of temporal CT and SPECT lesions were found in the group with relatively better memory performance.

Adult