Acquired dysgraphia with selective damage to the graphemic buffer: a single case report

We describe one patient with acquired dysgraphia who showed spelling errors (mainly deletions and substitutions), both for words and non-words, across all output modalities (oral and written spelling, and delayed copying). Spelling accuracy was not affected by lexical factors, but was a function of word length. The patient's performance in oral and written tasks suggests the hypothesis of selective damage to the Graphemic Buffer.

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Sommario Viene descritto il caso di una disgrafia acquisita che mostra errori di spelling (soprattutto delezioni e sostituzioni), sia per parole che per non-parole, in tutte le modalità di output (spelling orale e scritto, e copia ritardata). L'accuratezza dello spelling non viene influenzata da fattori lessicali, ma dalla lunghezza dello stimolo. La performance del paziente nei compiti orali e scritti suggerisce l'ipotesi di un danno selettivo del Buffer Grafemico.

     

No effect of orthographic neighbourhood in treatment with two cases of acquired dysgraphia

Background: Studies on the nature of processing within the spelling system have provided evidence for interactivity, where activation between levels of processing flows bidirectionally. In particular, activated letters at the level of the graphemic buffer feed activation back to the lexicon. As a consequence lexical neighbours are activated, which in turn reactivate the graphemic buffer, supporting target selection and leading to an effect of orthographic neighbourhood size in spelling. As a consequence of this feedback, treating words with many neighbours may be more beneficial, and generalisation may be more likely to occur.

Aims: The current study aimed to further examine this interactivity, and in particular the role of orthographic neighbourhood size in both treatment effects and generalisation, in the treatment of two individuals with acquired dysgraphia. Two phases of copy and recall treatment were conducted to investigate if orthographic neighbourhood size modulates treatment effects: in the first phase, treated words had no orthographic neighbours, in the second phase, treated words had many neighbours. Untreated control sets were used to investigate the influence of neighbourhood size on potential generalisation across items.

Main Contribution: Results showed that treated items improved, however neighbourhood size did not significantly influence the size of the treatment effect for either participant, and no clear evidence was found for generalisation to untreated items.

Conclusions: It is argued that (1) the amount of feedback from the buffer to the lexicon was reduced in the participants in this study, and consequently the treated items provide insufficient activation to orthographic neighbours or (2) the effect of feedback from neighbours is small compared to effects of treatment, resulting in similar results for treated words with and without neighbours.

This study informs the relationship between spelling impairment and effects of treatment. Furthermore, the absence of generalisation emphasises the importance of choosing functionally relevant items for treatment.     

Lexical spelling in children and adolescents with specific language impairment: Variations with the writing situation

The goal of this study was to compare the lexical spelling performance of children and adolescents with specific language impairment (SLI) in two contrasting writing situations: a dictation of isolated words (a classic evaluative situation) and a narrative of a personal event (a communicative situation). Twenty-four children with SLI and 48 typically developing children participated in the study, split into two age groups: 7–11 and 12–18 years of age. Although participants with SLI made more spelling errors per word than typically developing participants of the same chronological age, there was a smaller difference between the two groups in the narratives than in the dictations. Two of the findings are particularly noteworthy: (1) Between 12 and 18 years of age, in communicative narration, the number of spelling errors of the SLI group was not different from that of the typically developing group. (2) In communicative narration, the participants with SLI did not make specific spelling errors (phonologically unacceptable), contrary to what was shown in the dictation. From an educational perspective or that of a remediation program, it must be stressed that the communicative narration provides children—and especially adolescents—with SLI an opportunity to demonstrate their improved lexical spelling abilities. Furthermore, the results encourage long-term lexical spelling education, as adolescents with SLI continue to show improvement between 12 and 18 years of age.     

Accessing orthographic representations from speech: The role of left ventral occipitotemporal cortex in spelling

The present fMRI study used a spelling task to investigate the hypothesis that the left ventral occipitotemporal cortex (vOT) hosts neuronal representations of whole written words. Such an orthographic word lexicon is posited by cognitive dual‐route theories of reading and spelling. In the scanner, participants performed a spelling task in which they had to indicate if a visually presented letter is present in the written form of an auditorily presented word. The main experimental manipulation distinguished between an orthographic word spelling condition in which correct spelling decisions had to be based on orthographic whole‐word representations, a word spelling condition in which reliance on orthographic whole‐word representations was optional and a phonological pseudoword spelling condition in which no reliance on such representations was possible. To evaluate spelling‐specific activations the spelling conditions were contrasted with control conditions that also presented auditory words and pseudowords, but participants had to indicate if a visually presented letter corresponded to the gender of the speaker. We identified a left vOT cluster activated for the critical orthographic word spelling condition relative to both the control condition and the phonological pseudoword spelling condition. Our results suggest that activation of left vOT during spelling can be attributed to the retrieval of orthographic whole‐word representations and, thus, support the position that the left vOT potentially represents the neuronal equivalent of the cognitive orthographic word lexicon. Hum Brain Mapp, 36:1393–1406, 2015. © 2014 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.     

Learning to read new words in individuals with Down syndrome: Testing the role of phonological knowledge

This study examined the effect of word level phonological knowledge on learning to read new words in Down syndrome compared to typical development. Children were taught to read 12 nonwords, 6 of which were pre-trained on their phonology. The 16 individuals with Down syndrome aged 8–17 years were compared first to a group of 30 typically developing children aged 5–7 years matched for word reading and then to a subgroup of these children matched for decoding. There was a marginally significant effect for individuals with Down syndrome to benefit more from phonological pre-training than typically developing children matched for word reading but when compared to the decoding-matched subgroup, the two groups benefitted equally. We explain these findings in terms of partial decoding attempts being resolved by word level phonological knowledge and conclude that being familiar with the spoken form of a new word may help children when they attempt to read it. This may be particularly important for children with Down syndrome and other groups of children with weak decoding skills.     

Sevoflurane plays a reduced role in cognitive impairment compared with isoflurane: limited effect on fear memory retention

Isoflurane and sevoflurane are both inhalation anesthetics,but in clinical application,sevoflurane has been considered to be less suitable for long-term anesthesia because of its catabolic compounds and potential nephrotoxicity.Nevertheless,recent studies have shown that these two inhalation anesthetics are similar in hepatorenal toxicity,cost,and long-term anesthetic effect.Moreover,sevoflurane possibly has less cognitive impact on young mice.In this study,C57BL/6 mice aged 8–10 weeks were exposed to 1.2%isoflurane or 2.4%sevoflurane for 6 hours.Cognitive function and memory were examined in young mice using the novel object recognition,contextual fear conditioning,and cued-fear extinction tests.Western blot assay was performed to detect expression levels of D1 dopamine receptor,catechol-O-methyltransferase,phospho-glycogen synthase kinase-3β,and total glycogen synthase kinase-3βin the hippocampus.Our results show that impaired performance was not detected in mice exposed to sevoflurane during the novel object recognition test.Contextual memory impairment in the fear conditioning test was shorter in the sevoflurane group than the isoflurane group.Long-term sevoflurane exposure did not affect memory consolidation,while isoflurane led to memory consolidation and reduced retention.Downregulation of hippocampal D1 dopamine receptors and phosphorylated glycogen synthase kinase-3β/total glycogen synthase kinase-3βand upregulation of catechol-O-methyltransferase may be associated with differing memory performance after exposure to isoflurane or sevoflurane.These results confirm that sevoflurane has less effect on cognitive impairment than isoflurane,which may be related to expression of D1 dopamine receptors and catechol-O-methyltransferase and phosphorylation of glycogen synthase kinase-3βin the hippocampus.This study was approved by the Institutional Animal Care and Use Committee,Nanjing University,China on November 20,2017(approval No.20171102).     

The role of cognitive impairment in desire for hastened death: a study of patients with advanced AIDS

To examine the relationship between cognitive impairment and desire for death in patients with advanced AIDS we evaluated 128 patients with advanced AIDS consecutively admitted to three long-term care facilities. Participants completed a clinical assessment that included a self-report measure of desire for hastened death in the medically ill (Schedule of Attitudes toward Hastened Death), three measures of cognitive functioning designed to screen for cognitive impairment (Dementia Rating Scale, Mini-Mental State Exam, HIV Dementia Scale), and other measures of physical and psychological functioning. Participants who were classified as cognitively impaired obtained significantly higher scores on the measure of desire for death than did patients without cognitive impairment. This modest association between cognitive impairment and desire for death remained significant even after controlling for the impact of depression on desire for death. Specific aspect of cognitive functioning such as memory and psychomotor coordination appeared to be more salient than executive functioning or abstract reasoning. Cognitive impairment appears to have a modest, but significant impact on patients' desire for hastened death. Aggressive treatment of cognitive symptoms in the terminally ill is necessary in order to disentangle the various factors that may drive end-of-life treatment decisions.     

The neuroprotective effect of vitamin E on chronic sleep deprivation-induced memory impairment: the role of oxidative stress

Sleep deprivation induces oxidative stress and impairs learning and memory processes. Vitamin E, on the other hand, is a strong antioxidant that has neuroprotective effect on the brain. In this study, we examined the potential protective effect of chronic administration of vitamin E on chronic sleep deprivation-induced cognitive impairment. In addition, possible molecular targets for vitamin E effects on chronic sleep deprivation-induced cognitive impairment were determined. Sleep deprivation was induced in rats using modified multiple platform model. Vitamin E (100 mg/kg) was administered to animals by oral gavage. Behavioral study was conducted to test the spatial learning and memory using the radial arm water maze (RAWM). In addition, the hippocampus was dissected out and antioxidant markers including glutathione (GSH), oxidized glutathione (GSSG) and GSH/GSSG, glutathione peroxidase (GPx), catalase, and superoxide dismutase (SOD) were assessed. The results of this project revealed that chronic sleep deprivation impaired both (short- and long-term) memories (P < 0.05), while vitamin E treatment prevented such effect. Additionally, vitamin E normalized chronic sleep deprivation-induced reduction in the hippocampus GSH/GSSG ratio, and activity of catalase, SOD, and GPx. In conclusion, sleep deprivation induces memory impairment, and treatment with vitamin E prevented this impairment probably through its antioxidant action in the hippocampus.     

The role of parental and peer support in adolescents well-being: a comparison of adolescents with and without a visual impairment

In the present study we examined the importance of parental and peer support for well-being of adolescents with and without a visual impairment. The sample included 178 adolescents who are blind or visually impaired and 338 adolescents without visual impairments. Peer and parental support proved to be important for well-being of both adolescents with a visual impairment and sighted adolescents. Whereas in the group of adolescents with a visual impairment, a positive linear relationship exists between peer support and well-being, in the group of adolescents without an impairment well-being appears not be affected by peer support. Parental support is more strongly related to well-being of adolescents without impairments than of adolescents who are blind or visually impaired.     

Risk factors of attempted suicide in the elderly: The role of cognitive impairment

The authors’ aim was to assess the prevalence and importance of dementia and cognitive impairment in relation to suicidal behaviour in elderly psychiatric inpatients. The level of cognitive functioning (according to the Mini Mental State Examination – MMSE) of the elderly suicidal inpatients (N=62) were compared to the general elderly inpatients (N=152). There were significant differences in cognitive functioning between the two groups, in the non-suicidal group the level of cognitive function was significantly lower. However, mild cognitive deficit or mild dementia were registered in 60% of the suicide attempters. The results indicate that not only mood disorders, but other risk factors (especially mild cognitive impairment), have a key role in developing suicidal behaviour in the elderly. Thus, in the treatment and prevention of suicidal behaviour in the elderly, it is important to apply the complex bio-psycho-social model, in which (besides adequate pharmacotherapy) psychotherapeutic approaches and procedures to enhance cognitive functioning are of outstanding significance.     

Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis: a before/after pilot study

Balance impairment in patients with stroke hemiparesis is frequently related to deficits of central integration of afferent inputs (somatosensory, visual, vestibular). Our aim was to evaluate whether balance exercises performed under various sensory input manipulations can improve postural stability and/or walking ability in patients with stroke. Seven chronic hemiparetic subjects were recruited. Patient performance was assessed before, immediately after and one week after treatment (consisting of 20 one-hour daily sessions of several balance exercises) by means of the Sensory Organization Balance Test and the Ten Metre Walking Test. Before treatment, all patients showed balance impairment with difficulty integrating somatosensory information from the lower extremities and excessive reliance upon visual input in standing balance control. After treatment, balance and walking speed significantly increased and this improvement was maintained for one week. These findings indicate that rehabilitation of sensorimotor integration deficits can improve balance in patients with stroke hemiparesis.     

Back to sleep or not: the effect of the supine position on pediatric OSA: Sleeping position in children with OSA

BackgroundIn both adults and children, obstructive sleep apnea (OSA) has significant adverse cardiovascular consequences. In adults, sleeping position has a marked effect on the severity of OSA; however, the limited number of studies conducted in children have reported conflicting findings. We aimed to evaluate the effect of sleeping position on OSA severity and the cardiovascular consequences in preschool-aged children.MethodsThis was a retrospective analysis of children (3–5 years of age) diagnosed with OSA (n = 75) and nonsnoring controls (n = 25). Sleeping position was classified as supine, semi-supine, left lateral, right lateral, prone, and semi-prone by using video recordings during one night of attended polysomnography. OSA severity and cardiovascular parameters were compared between the positions.ResultsAll children spent significantly more sleep time in the supine position than in any other position. The obstructive apnea-hypopnea index was higher in the supine position than in the other sleeping positions during NREM (p < 0.05), higher in the moderate/severe OSA group when sleeping in the supine position than when sleeping in the left and right lateral positions (p < 0.05 for both) and prone position (p = 0.007) during REM. Sympathovagal balance was decreased in children with OSA in the supine and lateral positions (p < 0.05).ConclusionsThis study identified that preschool-aged children, whether nonsnoring controls or children with OSA, predominately sleep in the supine position, and OSA was more severe in the supine position. We suggest that to avoid the supine sleep position, positional therapy has the potential to ameliorate OSA severity, and the known cardiovascular consequences.     

Speed and context: the effect of a sentence prime on naming speed in children with language impairment

Nineteen pre-school children with language impairment participated in a computerized naming task. The naming procedure involved two conditions, one unprimed where the child had to name a colour picture appearing on the screen as fast as possible and one primed where the picture was preceded by an uncompleted sentence. Response times were significantly shorter in the primed condition compared to the unprimed condition. There was a tendency that the ability to benefit from a semantic-syntactic prime was more closely linked to the participants' results on verbal measures than on non-verbal measures. Naming speed in the primed condition or the unprimed condition was not found to be linked to non-verbal measures including a speed component. Results are discussed in relation to current research, and methodological issues are highlighted.     

The effect of a game training intervention on cognitive functioning and depression symptoms in the elderly with mild cognitive impairment: A randomized controlled trial

ObjectivesThis study aimed to explore whether game training could improve cognitive functioning and depression symptoms in the elderly affected by mild cognitive impairment (MCI).MethodsA non‐blinded randomized controlled trial was conducted. Participants were 72 patients with MCI and depression from a nursing home in Wuhan. Participants were randomized to either the intervention group or the control group (n = 36 each). The intervention group received regular nursing care plus game training for 50 min, three times per week for 8 weeks, whereas the control group received only regular nursing care during the same research period. Cognitive functioning and depression symptoms were tested in both groups at baseline and at the end of the 8‐week intervention. We used the Montreal Cognitive Assessment and the 15‐item Geriatric Depression Scale to assess cognitive functioning and depression symptoms, respectively.ResultsThe 8‐week game training intervention significantly improved the cognitive and depression scores when compared with the control group and baseline scores (p < 0.05). No significant difference was observed in the control group (p > 0.05).ConclusionsOur results suggest that the implementation of game training can improve the cognitive functioning and depression symptoms of the elderly with MCI, indicated that can be widely used.     

Circadian regulation of retinomotor movements: II. The role of GABA in the regulation of cone position

Cone photoreceptor movements in lower vertebrates are regulated by the interaction of the light-dark cycle and an endogenous circadian clock. We have suggested that melatonin and dopamine interact to regulate dark- and light-adaptive movements, respectively, and that melatonin affects cones indirectly by inhibiting dopamine release. In fact, any factor modulating dopaminergic neurons in the retina may have effects on either cone elongation or contraction. We have utilized an in vitro eyecup preparation from the African clawed frog, Xenopus laevis, to evaluate a possible role of the neurotransmitter GABA, which is thought to tonically suppress dopamine release. GABA agonists mimic the effects of darkness and induce cone elongation; the effects of GABA agonists are blocked by dopamine. Muscimol-induced cone elongation occurs at low light intensity but is inhibited by bright light in eyecups prepared from cyclic-light-maintained animals. Although neither melatonin nor muscimol stimulates cone elongation in bright light, simultaneous application of both drugs induces elongation. The GABA antagonist picrotoxin induces cone contraction which is blocked by the dopamine receptor antagonist spiroperidol, which suggests that GABA may affect cone movement in Xenopus by regulating dopamine neurons. Consistent with this, picrotoxin-induced cone contraction is Ca+2 dependent and is blocked by high Mg+2 or the Ca+2 antagonist nifedipine. Pharmacological analysis suggests that the effects of GABA may result from its action at more than one receptor subtype. Our results support the hypothesis that dopamine is part of the light signal for cone contraction and that its suppression is part of the signal for cone elongation.     

The position of the head in space: a kinematic analysis in patients with cervical dystonia treated with botulinum toxin

Many instruments have been employed in recent years in order to quantify the posture and motion of the head in normal and pathological subjects. Evaluations of this type present many difficulties related to the influence of individual and external factors and to the accuracy of the system used. In patients with cervical dystonia (CD) the only rating scales currently used are semi-quantitative and subjective. More precise information on disease severity and response to the treatment is needed. Posture and motion of the head were evaluated by means of ELITE motion analyser (BTS, Milan, Italy) in 6 patients with the left laterocollis form of CD undergoing treatment with botulinum toxin (BTX). The method emerged as very useful for the quantification of the therapeutic response (which was more marked in motion than in posture). We found an inverse relationship between the degree of motion improvement and the restriction of motion before treatment.     

The effect of retrieval instructions on false recognition: exploring the nature of the gist memory impairment in amnesia

In previous studies, we found that amnesic patients show reduced levels of false recognition in a converging semantic associates paradigm. This finding was interpreted as reflecting an impairment in amnesia in the ability to form, retain and/or retrieve a well-organized representation of the semantic ‘gist’ of studied items. To further explore the nature of amnesics’ impairment in gist memory, the current study compared performance in two retrieval conditions. In a standard retrieval condition, participants were asked to endorse on a recognition test only items that had appeared on the study list. In a meaning retrieval condition, participants were asked to endorse any item that shared the meaning of studied items. Meaning retrieval instructions failed to eliminate the reduction in false recognition in amnesia. These results suggest that amnesics’ impairment in gist memory is not attributable to a failure to access well-formed gist representations when given item-specific retrieval cues. Rather, it suggests that amnesic patients are impaired in their ability to encode, store, or maintain strong gist information.     

The role of school connectedness and maladaptive cognitions in the association between stress and Internet addiction: A serial mediation model

Purpose: To explore the mediating effect of school interest and maladaptive cognitions in the relationship between stress and Internet addiction. Design and Methods: A total of 2271 high school students were recruited from a Chinese high school. Serial mediation model was used. Results: School interest and maladaptive cognitions had 0.03 and 0.13 indirect effects in the association between stress and Internet addiction, and accounting for 7.9% and 34.2% of the total effect, respectively. The serial indirect effect of school interest and maladaptive cognition was 0.05, accounting for 13.2% of the total effect. Practice Implications: The present study highlights the need of reducing stress and increasing school interest among high school students to prevent and intervene the occurrence of Internet addiction.     

The role of parietal cortex in overimitation: a study with fNIRS

Previous studies have shown right parietal activation in response to observing irrational actions. Behavioral studies show that people sometimes imitate irrational actions, a phenomenon called overimitation. However, limitations on movement in functional magnetic resonance imaging (fMRI) mean that the neural basis of overimitation has not been studied. To address this, our study employed a less restrictive neuroimaging technique, functional near-infrared spectroscopy (fNIRS). Measurements were taken while participants observed either rational or irrational movements before performing movements on a computerized puzzle task. Observing irrational actions produced greater activation in right anterior inferior parietal lobule (aIPL), replicating results from the fMRI literature. This is a proof of principle that fNIRS can be used as an alternative to fMRI in social cognition experiments, and that parietal cortex has a core role in responding to irrational actions.     

The auditory oddball paradigm in patients with vascular cognitive impairment: a prolonged latency of the N2 complex

OBJECTIVE: The event-related potential (ERP) evoked by the auditory oddball paradigm has been investigated mainly in patients with Alzheimer's disease and in patients with different causes of subcortical dementia. Subcortical ischemic vascular disease (SIVD) seems to be an important cause of vascular cognitive impairment (VCI) frequently not fulfilling the criteria for dementia. Recognition of VCI is needed in order to provide adequate care and therapy. The aim of this study was to investigate the diagnostic value of the different elements of this response (N(1), N(2) complex and P(3) latencies) in a group of elderly patients with VCI caused by SIVD. METHODS: The study population consisted of patients with a clinical and neuropsychological diagnosis of VCI caused by SIVD (n = 38) and healthy control subjects (n = 53) aged 60 years or older. The mean Mini Mental State Examination score of both groups was 27.6, and the mean HIV Dementia Scale score was 6.1 in the patient group and 12.3 in the control group. In all subjects, the ERP was recorded under standardized conditions, and the latencies and amplitudes of N(1), N(2) and P(3) were analyzed by two clinical neurophysiologists in consensus. Both were blinded to the diagnosis. RESULTS: The N(2) latency was significantly longer in patients with VCI than in age-matched controls, whereas the latencies of the P(3) and N(1) were not significantly different. The peak-to-peak amplitude of the N(2) complex to the P(3) wave was significantly lower in the patient group. White matter abnormalities on MRI were not significantly correlated with the N(2) latency. CONCLUSION: Our findings suggest that the latency of the N(2) complex is prolonged and the peak-to-peak amplitude of the N(2) complex to the P(3) wave is lowered in patients with VCI caused by SIVD.