Colored Overlays for Visual Perceptual Deficits in Children with Reading Disability and Attention Deficit/Hyperactivity Disorder: Are They Differentially Effective?

The Transient Channel Deficit (TCD) model of reading disability was evaluated by examining the effects of color overlays on the reading ability of four groups of children (n = 15 each) with reading disability and comorbid conditions involving math and ADHD. These 60 children were evaluated for reading accuracy and rate on measures of word decoding and reading comprehension under three color transparency conditions (blue, red, no overlay). Results indicated that color overlays did not differentially affect the reading performance of individuals with and without reading disabilities. However, blue transparencies significantly improved reading comprehension in all groups, and reduced reading rate. These findings indicate that the TCD model may need to be reexamined. An alternative hypothesis for the observed effects, involving facilitation of attention processes, was posited.     

Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity?

In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and ASD symptoms. OCD patients showed increased ADHD and autism symptom frequencies, OCD + ADHD patients reporting more autism symptoms (particularly attention switching and social skills problems) than OCD − ADHD patients. Attention switching problems were most significant predictors of OC symptom dimensions (except hoarding) and of symptom severity. Hoarding was not associated with elevated autism scale scores, but with inattention. In conclusion, attention switching problems may reflect both symptom overlap and a common etiological factor underlying ASD, ADHD and OCD.     

Adults’ Versus Children’s Perceptions of a Child with Autism or Attention Deficit Hyperactivity Disorder

The present study examined public perceptions toward children with autism or with attention deficit hyperactivity disorder (ADHD). A convenience sample was used consisting of 30 children (7–12-year-olds) and 30 adults. Participants read a stereotyped scenario featuring either a child with autism, a child with ADHD, or a normal child. Child participants were significantly more likely than adults to (a) express dislike/avoidance toward a child described with either stereotypic autistic or ADHD behaviors, and (b) perceive the child with ADHD as unlike themselves. However, child participants and adults were equally likely to see the autistic child as unlike themselves. Reasons for the different perceptions of children and adults may include differences in perceived threat and in categorization.     

The Problem with Using Eye-Gaze to Infer Desire: A Deficit of Cue Inference in Children with Autism Spectrum Disorder?

Children with autism respond atypically to eye-gaze cues, arguably because they fail to understand that eye-gaze conveys mentalistic information. Three experiments investigated whether a difficulty in inferring desire from eye-gaze in autism reflects a failure to understand the mentalistic significance of eye-gaze, an inhibitory deficit or a deficit of cue inference. While there was an inhibitory component to the tasks, children with autism were no more affected by this than controls. In addition, individuals' impairment in inferring desire was not limited to social cues, but was also observed when desire was cued by more general cues. Consequently, children with autism may have a general deficit in using arbitrary cues to make inferences, which impacts particularly on their social development.     

Is Taste Altered in Patients with ALS?

Amyotrophic lateral sclerosis (ALS) is a degenerative neurological disease that affects the motor systems in patients but also may affect some sensory systems. Some ALS patients report taste changes that may decrease their oral intake and nutritional status. This study examined whether focal taste damage occurs in ALS patients compared to age/gender-matched adult healthy controls. An abbreviated Spatial Taste Test was administered to the fungiform and circumvallate papillae. Compared to healthy controls, ALS patients exhibited significantly lower taste intensities across the four basic tastes and significantly lower taste intensities at both the fungiform and vallate papillae, but no significant difference in whole mouth taste intensities. Seven out of nine ALS patients with self reported altered taste had tongue fasciculations, involuntary movements within the tongue dorsum due to lower motor neuron impairment (a common sign of bulbar ALS). Additionally, for patients taking riluzole taste perception at the fungiform papillae appears to be further reduced relative to the vallate papillae. This study suggests ALS decreases taste at both the fungiform and vallate papillae. In addition, riluzole may further damage the chorda tympani. Further studies need to be conducted to examine the etiology for taste loss.     

Hyperphosphatasia With Neurologic Deficit: A Pyridoxine-Responsive Seizure Disorder?

This report describes the case of a 4 1/2-year-old female with developmental delay and tonic-clonic seizures, persistently elevated serum alkaline phosphatase activity, and low serum pyridoxal 5'-phosphate. Born at term to consanguineous parents, she was dysmorphic and delayed at 5 months. At 11 months, seizures and microcephaly were evident but skeletal and cerebral imaging, karyotyping, and genetic metabolic tests were unremarkable. Serum alkaline phosphatase activity, however, was elevated (1.3 +/- 0.6 times greater than the upper limit of normal) on seven occasions between 5 months and 4(1/2) years of age. Hyperphosphatasia with neurologic deficit (MIM #239300), a rare autosomal recessive disorder, was diagnosed. The low serum levels of pyridoxal 5'-phosphate (6 nmol/L; normal >20 nmol/L) prompted a pyridoxine challenge. A clinically significant but paradoxical response was observed. On electroencephalography, diffuse delta slow waves (1-2 Hz) were observed, suggestive of stage 3 or 4 slow-wave sleep. With daily administration of 100 mg pyridoxine and withdrawal of phenobarbital, seizures were not evident. We suggest that serum alkaline phosphatase should be measured in cases of seizures with paradoxical electroencephalographic response to pyridoxine. Conversely, pyridoxine challenge should be considered in cases of hyperphosphatasia with seizures and neurologic deficit.     

Constructional Apraxia in Left Brain-Damaged Patients: A Planning Disorder?

The aim of the present study was to verify the hypothesis advanced by Hécaen and Assal (1970), that the presence of landmarks can improve the copying performance of left brain-damaged patients, while leaving unchanged that of right brain-damaged patients. Sixty-two control subjects and 196 brain-damaged patients with lesions restricted to the right (N = 84) or to the left (N = 112) cerebral hemisphere were given two tests of copying drawings. In the first task the patients were asked to directly copy a drawing; to perform the second test they were given guiding landmarks. On both tests no difference was found between the performance of the two hemispheric groups. Right-sided patients used a lower number of guiding landmarks, but this occurred only on the half of the drawings contralateral to the side of the lesion and was apparently due to unilateral spatial neglect.     

Motor imagery difficulties in children with Cerebral Palsy: A specific or general deficit?

AimThe aim of this study was to examine the specificity of motor imagery (MI) difficulties in children with CP.MethodPerformance of 22 children with CP was compared to a gender and age matched control group. MI ability was measured with the Hand Laterality Judgment (HLJ) task, examining specifically the direction of rotation (DOR) effect, and the Praxis Imagery Questionnaire (PIQ).ResultsIn the back view condition of the HLJ task both groups used MI, as evidenced by longer response times for lateral compared with medial rotational angles. In the palm view condition children with CP did not show an effect of DOR, unlike controls. Error scores did not differ between groups. Both groups performed well on the PIQ, with no significant difference between them in response pattern.Conclusion and implicationThe present study suggests that children with CP show deficits on tasks that trigger implicit use of MI, whereas explicit MI ability was relatively preserved, as assessed using the PIQ. These results suggest that employing more explicit methods of MI training may well be more suitable for children with CP in rehabilitation of motor function.     

Subthalamic stimulation in Parkinson disease: with or without anesthesia?

OBJECTIVE: To study the effects of general anesthesia on the postoperative outcome of patients with Parkinson disease (PD) who underwent surgery using bilateral placement of stimulating electrodes within the subthalamic nucleus (STN). DESIGN: Retrospective analysis. SETTING: H?pital de la Salpêtrière, Paris, France. PATIENTS: Fifteen PD patients who underwent bilateral implantation of electrodes within the STN received general anesthesia because of severe anxiety, poorly tolerated off-period dystonia, or respiratory difficulties. These patients were compared with 15 patients matched for age, disease duration, and parkinsonian motor disability who underwent the same neurosurgical procedure under local anesthesia. MAIN OUTCOME MEASURE: Motor disability scores. RESULTS: After surgery, the severity of parkinsonian motor disability was markedly improved in both groups of patients. Compared with patients who were under local anesthesia during the operation, the residual parkinsonian motor score under stimulation (with ["on"] or without ["off"] levodopa) and the intensity of stimulation were higher in patients who were under general anesthesia during the operation. CONCLUSIONS: Although the improvement of parkinsonian motor disability is greater in PD patients who receive local anesthesia during surgery, general anesthesia can be performed in patients unable to tolerate prolonged states without levodopa.