Communication disorders after decline in sub-cortical aphasia: the role of fronto-sub-cortical disconnection?

INTRODUCTION: Pragmatic analysis of Language difficulties examines the pertinence and adaptation of the spoken Language which can be disturbed even when phonologic, syntactic and semantic functions, taken separately, appear normal. Disorders of pragmatic Language function remain poorly explored and the few published papers in adult neuropsychology have been devoted to patients with traumatic frontal lesions. METHODS: In the present study we report the case of a patient admitted for right hemiplegia with "dissident" aphasia related to a capsulo-lenticular hematoma. Aphasic disorders progressively improved but with the occurrence of speech disorders which were assessed by pragmatic indices. RESULTS: There was no difference between free and directed interview with the exception for the non-contingencies which were significantly more frequent in the directed interview. As compared with the spoken Language of a normal individual, highly significant differences were noted for incoherent lexical proximities, non-contingencies and markers of difficulty. DISCUSSION: and conclusion. For some Authors, the pragmatic speech disorders observed in this patient during the directed interview are linked to abnormal executive functions, also noted in the patient. The difficulties to adjust to speech constraints of the interview context could be related to a fronto-subcortical disconnection resulting in this patient to the left capsulo-lenticular lesion.     

Brief Report: Do the Nature of Communication Impairments in Autism Spectrum Disorders Relate to the Broader Autism Phenotype in Parents?

Extensive empirical evidence indicates that the lesser variant of Autism Spectrum Disorders (ASD) involves a communication impairment that is similar to, but milder than, the deficit in clinical ASD. This research explored the relationship between the broader autism phenotype (BAP) among parents, an index of genetic liability for ASD, and proband communication difficulties. ASD probands with at least one BAP parent (identified using the Autism Spectrum Quotient) had greater structural and pragmatic language difficulties (assessed using the Children’s Communication Checklist-2) than ASD probands with no BAP parent. This finding provides support for the position that genetic liability for ASD is associated with increased communication difficulties across structural and pragmatic domains.     

Part of the problem or part of the solution? Communication assessments of Aboriginal children residing in remote communities using videoconferencing

The current article describes the results, inter-scorer reliability, and potential sources of bias in conducting speech-language assessments with Aboriginal children in remote Ontario communities using videoconferencing. A main focus of this pilot study was to examine scoring bias, an issue that might arise with videoconferencing for any population but that could potentially interact with test and cultural bias to negatively affect the diagnosis of Aboriginal children. Assessments were administered by a remote-site speech-language pathologist (SLP), while an on-site SLP served as an assistant. Responses were scored simultaneously by both SLPs and the results and their degree of correspondence were compared. Percentage agreement ranged from 96-100% for language tests and from 66-100% for the articulation measure. Results suggest that videoconferencing can be an effective complement to service provision when procedures are organized so as to minimize bias in test administration and in the interpretation of test performance.     

Is Nonverbal Communication Disrupted in Interactions Involving Patients With Schizophrenia?

Background: Nonverbal communication is a critical feature of successful social interaction and interpersonal rapport. Social exclusion is a feature of schizophrenia. This experimental study investigated if the undisclosed presence of a patient with schizophrenia in interaction changes nonverbal communication (ie, speaker gesture and listener nodding). Method: 3D motion-capture techniques recorded 20 patient (1 patient, 2 healthy participants) and 20 control (3 healthy participants) interactions. Participants rated their experience of rapport with each interacting partner. Patients’ symptoms, social cognition, and executive functioning were assessed. Four hypotheses were tested: (1) Compared to controls, patients display less speaking gestures and listener nods. (2) Patients’ increased symptom severity and poorer social cognition are associated with patients’ reduced gesture and nods. (3) Patients’ partners compensate for patients’ reduced nonverbal behavior by gesturing more when speaking and nodding more when listening. (4) Patients’ reduced nonverbal behavior, increased symptom severity, and poorer social cognition are associated with others experiencing poorer rapport with the patient. Results: Patients gestured less when speaking. Patients with more negative symptoms nodded less as listeners, while their partners appeared to compensate by gesturing more as speakers. Patients with more negative symptoms also gestured more when speaking, which, alongside increased negative symptoms and poorer social cognition, was associated with others experiencing poorer patient rapport. Conclusions: Patients’ symptoms are associated with the nonverbal behavior of patients and their partners. Patients’ increased negative symptoms and gesture use are associated with poorer interpersonal rapport. This study provides specific evidence about how negative symptoms impact patients’ social interactions.Key words: schizophrenia, nonverbal communication, rap port, symptoms, social exclusion     

Age and education effects on adults’ performance on the Brazilian version of the Montreal Communication Evaluation Battery

Background: Socio-demographic features such as age and education are the strongest influences on cognitive and communicative performance in every culture. However, there are few neuropsychological tests adapted to Brazilian society, culture, and language, especially for evaluating the communication of individuals with right hemisphere damage.

Aims: This study was designed to describe age and education effects on the communicative performance of non-brain-damaged Brazilian adults on the Brazilian Montreal Communication Evaluation Battery (MAC Battery), which was created to evaluate components of communication usually overlooked by aphasia tests.

Methods & Procedures: The sample was composed of 240 adults, divided into two education and three age groups. The influence of these variables on the Brazilian MAC Battery performance was assessed.

Outcomes & Results: Communicative performance is influenced by educational level. Age also partially impacts performance, but to a lesser degree, and there is an interaction between these factors in five tasks.

Conclusions: These results are important for the use of this protocol with patients with neurological disorders since education and age will have to be taken into consideration.     

Dancing in the dark?

Alzheimer’s disease (AD) is a genetically complex and heterogeneous disorder. Recent estimates suggest that possibly over 70% of the genetic variance for the disease remains unaccounted for by apolipoprotein E (APOE) and the three known early-onset AD genes (APP, PSEN1, PSEN2). Specifically, one recent segregation analysis predicted the existence of up to four additional susceptibility genes having a similar or greater effect than APOE. However, most of the nearly three dozen putative AD loci proposed to date have only been inconsistently replicated in follow up analyses and more studies are necessary to distinguish false-positive findings from genuine signals. Novel AD genes will not only provide valuable clues for the development of novel therapeutic approaches, but will also allow the development of new genetic risk-rofiling strategies that are an essential prerequisite for early prediction/prevention of this devastating disease. In this review, we will present a brief overview of analytic tools in complex disease genetics, as well as a summary of recent linkage and association findings indicating the existence of novel late-onset AD genes on chromosomes 12, 10, and 9.     

What's in the literature?

The neuromuscular literature over the past 3 months has been diverse, including useful information on the epidemiology of several disorders. Our understanding of the genetics of amyotrophic lateral sclerosis continues to grow, and in the process, it makes the distinction between familial and sporadic forms of the disorder increasingly murky. Some interesting articles about peripheral neuropathy provide insight into relationships with diabetes and with Parkinson disease and summarize the state of knowledge of the increasingly complex topic of hereditary neuropathies in children. Epidemiology and electrodiagnosis of lateral femoral cutaneous neuropathy is nicely discussed in 2 articles. Several muscle diseases, including Pompe disease, sporadic inclusion body myositis, and the congenital myopathies, receive attention in articles that provide very useful information for the clinician, and there is a treatment-oriented article on dystrophinopathies, which makes for excellent reading. There are also discussions of several uncommon disorders, including a mitochondrial myopathy, periodic paralysis, and congenital myasthenic syndromes, which are helpful in providing information to clinicians who may see such disorders only infrequently.     

Changes in the Expression of Genes of the Glutamate Transporter and Subunits of the NMDA and AMPA Receptors in the Rat Amygdala in the Lithium–Pilocarpine Model of Epilepsy

The molecular changes in the glutamatergic system of the rat amygdala were studied during the latent phase of the lithium–pilocarpine model of temporal lobe epilepsy in order to identify the potential involvement of these changes in epileptogenesis. The real-time PCR method was used to evaluate the mRNA expression of the NMDA and AMPA receptor subunits, as well as the excitatory amino acid transporter-2 (EAAT2) in the basolateral nucleus of the amygdala 7 days after the seizures caused by administration of pilocarpine. The results of the experiments were as follows: (1) an increase in the expression ratio of the GluN2a/GluN2b NMDA receptor subunits with an unchanged expression level of the GluN1 subunit; (2) increased expression of the GluA2 subunit of AMPA receptors with the invariance of GluA1, and (3) enhanced expression of the EAAT2. According to literature data, the expression of the same genes decreased in the hippocampus in the same model of epilepsy. Neurodegeneration was reported in both brain regions. The opposite changes in the expression of the glutamatergic system genes in the hippocampus and amygdala during the latent period of the lithium–pilocarpine model suggest the occurrence of factors that can both contribute to and hinder epileptogenesis.     

Distinct roles in vivo for the ubiquitin-proteasome system and the autophagy-lysosomal pathway in the degradation of α-synuclein

Increased intracellular levels of α-synuclein are implicated in Parkinson's disease and related disorders and may be caused by alterations in the ubiquitin-proteasome system (UPS) or the autophagy-lysosomal pathway (ALP). A critical question remains how α-synuclein is degraded by neurons in vivo. To address this, our study uses α-synuclein transgenic mice, expressing human α-synuclein or α-synuclein-eGFP under the (h)PDGF-β promoter, in combination with in vivo pharmacologic and multiphoton imaging strategies to systematically test degradation pathways in the living mouse brain. We demonstrate that the UPS is the main degradation pathway for α-synuclein under normal conditions in vivo while with increased α-synuclein burden the ALP is recruited. Moreover, we report alterations of the UPS in α-synuclein transgenic mice and age dependence to the role of the UPS in α-synuclein degradation. In addition, we provide evidence that the UPS and ALP might be functionally connected such that impairment of one can upregulate the other. These results provide a novel link between the UPS, the ALP, and α-synuclein pathology and may have important implications for future therapeutics targeting degradation pathways.     

Can a cutaneous-muscular biopsy be helpful in the diagnosis of vasculitis in the stroke?

Vasculitis includes a heterogeneous group of multisystemic disorders characterized pathologically by inflammation of blood vessels. The diagnosis of vasculitis is difficult and more often than not, it is made indirectly after eliminating other causes of the stroke. Vasculitis is an infrequent disorder and a rare cause of the stroke. This is a case report of a 41-year-old man who had the first-ever stroke with vasculitis diagnosed histologically in a cutaneous-muscular biopsy from the place not changed by the disease. After corticosteroid therapy the hemiparesis disappeared. The patient has continued the treatment with immunosuppressive drugs.     

Is epilepsy in the elderly overlooked? An investigation in a home for the aged

The symptoms of epileptic seizures in old patients differ from those in younger patients. Therefore, these seizures may be misinterpreted as symptoms of other "typical" diseases in old people. In an old people's home, we assessed whether a standardized questionnaire is able to reveal undiagnosed epilepsy in the elderly. Reported sudden falls, loss of consciousness, and cramps were the criteria for further diagnostic procedures. We found epilepsy in 11 of 389 study participants. In four of them (1% of the total sample), the epilepsy was newly diagnosed; five more cases remained unclear. Therefore, the total number of epileptic patients might have been even higher. Most of the reported sudden falls and unconsciousness (89%) were due to internal medical or other neurological or orthopaedic causes. Once these have been excluded, the diagnosis of epilepsy should be considered. The results of our pilot study suggest that epilepsy in old people's homes is often unrecognised. Early diagnosis and treatment of epilepsy in the elderly is important to improve prognosis and social consequences for affected persons.     

Is the midbrain involved in the manifestation of gait disturbance in idiopathic normal-pressure hydrocephalus?

Gait disturbance is the most common symptom in idiopathic normal-pressure hydrocephalus (iNPH). However, its pathophysiology in iNPH has not been clarified. Some researchers have hypothesized that the mesencephalic locomotor region, which is a functionally defined area in the brainstem playing an important role in locomotion, is involved in the development of gait disturbance in iNPH. The purpose of the study was to investigate whether the midbrain is involved in the manifestation of gait disturbance in iNPH. Twenty-one iNPH patients who showed clinical improvements after shunt surgery were studied. Brain magnetic resonance imaging (MRI) was performed and clinical symptoms were assessed before and 1 year after surgery. Gait disturbance was assessed by the Timed Up and Go test and gait subcategory of the iNPH Grading Scale, a validated assessment tool for iNPH symptoms. Anteroposterior, left-to-right diameter and cross-sectional areas of the midbrain were measured at the inferior collicular level of axial images in MRI. The diameters and cross-sectional area of the midbrain at baseline did not show significant correlation with gait assessments at baseline (Spearman’s correlation). The midbrain measurement did not show significant difference between the baseline and postoperative values (paired t test), and its change rates did not show significant correlation with the change (rates) of the gait assessments. In this study there were no findings to suggest involvement of the midbrain in the manifestation of gait disturbance in iNPH. The hypothesis that the mesencephalic locomotor region is involved in the manifestation of gait disturbance in iNPH needs to be reconsidered.     

Kainate receptors in the CA2 region of the hippocampus

<正>The hippocampus is involved in important brain functions such as learning and memory,spatial navigation,fear processing,and social behavior(Dudek et al,2016).The most prominent areas of the hippocampus are typically denoted as the dentate gyrus and the three areas of the cornu ammonis(CA1,CA2,and CA3).Discovered by Lorente de Nó(1934),the CA2 region of the hippocampus is a relatively small area interposed between CA3 and CA1 that forms the nexus linking the input of the entorhinal corte...     

Astrocytes dynamically regulate the blood-brain barrier in the healthy brain

<正>The blood-brain barrier (BBB)(discovered and defined by Max Lewandowsky and Lina Stern,and not,as it is universally,and yet erroneously believed,by Paul E hrlich (Verkhratsky a nd Pivoriunas,2023)) that separates the nervous system from the circulation is evolutionarily conserved from arthropods to man.