Should a diagnosis of Alzheimer's disease be disclosed?

There is evidence that some health practitioners may be reluctant to disclose a diagnosis of Alzheimer's disease (AD) to patients. However, this reluctance towards disclosure may not be in accordance with patient expectation. This study examined the attitudes of 100 undergraduate psychology students towards disclosure practices in relation to AD, before and after exposure to AD education. After AD education, 93% of participants indicated a desire to be informed of a diagnosis of AD, and 95% of participants were in favour of telling a close relative a diagnosis of AD. Results are discussed in terms of the relationship between age and attitudes towards AD diagnosis. It is concluded that the high rate of support for disclosure of AD diagnoses to patients among younger adults may reflect a change in the information preferences of patients brought about by a shift away from a patriarchal medical model, toward a more autonomous model of health.     

Should sluggish cognitive tempo symptoms be included in the diagnosis of attention-deficit/hyperactivity disorder?

OBJECTIVE: To determine the impact of including sluggish cognitive tempo items on the factor and latent class structure of attention-deficit/hyperactivity disorder (ADHD) subtypes in boys and girls. METHOD: Parent report of two sluggish cognitive tempo items on a population-based sample of 1430 female twins and 1414 male twins were analyzed along with parent report of the 18 DSM-IV ADHD items using principal components analysis and latent class analysis. RESULTS: The inclusion of the two sluggish cognitive tempo items resulted in distinct factor structures for boys and girls. For boys there were separate inattentive, hyperactive/impulsive, and sluggish factors. For girls there were separate inattentive/sluggish, hyperactive, and impulsive factors. In contrast, sluggish cognitive tempo items had minimal impact on the latent class structure of ADHD for both boys and girls. CONCLUSIONS: The inclusion of sluggish cognitive tempo items markedly changed ADHD symptom associations for boys and girls in a factor analytic framework. In contrast, latent class subtyping of ADHD shows limited impact of the inclusion of sluggish cognitive tempo items, emphasizing the very different assumptions about underlying continua of behavior rather than discrete classes that distinguish the two approaches.     

Should the Study of Homo sapiens be Part of Cognitive Science?

Beller, Bender, and Medin argue that a reconciliation between anthropology and cognitive science seems unlikely. We disagree. In our view, Beller et al.'s view of the scope of what anthropology can offer cognitive science is too narrow. In focusing on anthropology's role in elucidating cultural particulars, they downplay the fact that anthropology can reveal both variation and universals in human cognition, and is in a unique position to do so relative to the other subfields of cognitive science. Indeed, without cross-cultural research, the universality of any aspect of human cognition cannot truly be established. Therefore, if the goal of cognitive science is to understand the cognitive capacities of our species as a whole, then it cannot do without anthropology. We briefly review a growing body of anthropological work aimed at answering questions about human cognition and offer suggestions for future work.     

Should the parameters of a BCI translation algorithm be continually adapted?

People with or without motor disabilities can learn to control sensorimotor rhythms (SMRs) recorded from the scalp to move a computer cursor in one or more dimensions or can use the P300 event-related potential as a control signal to make discrete selections. Data collected from individuals using an SMR-based or P300-based BCI were evaluated offline to estimate the impact on performance of continually adapting the parameters of the translation algorithm during BCI operation. The performance of the SMR-based BCI was enhanced by adaptive updating of the feature weights or adaptive normalization of the features. In contrast, P300 performance did not benefit from either of these procedures.     

Is the immobility of advanced dementia a form of lorazepam-responsive catatonia?

Patients with end-stage dementia typically are very immobilized. Could this state actually be a form of lorazepam-responsive catatonia? Catatonia has been documented following cerebrovascular accidents, head injury, HIV encephalitis, brain tumors, and multiple sclerosis. Identified anatomical substrates include frontal lobes, parietal lobes, limbic system, diencephalon, and basal ganglia. Given that Alzheimer's disease, vascular dementia, Lewy body dementia, corticobasal degeneration, frontotemporal dementia, and Parkinsonian dementia often have degeneration in some of the same areas, dramatic awakenings might be possible by giving lorazepam challenges to locked-in dementia patients. If even a small percentage were lorazepam responders, the impact worldwide would be tremendous. Serious consideration should be given to undertaking large-scale clinical trials.     

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.