1,720,966 research outputs found
Combined duloxetine and benzodiazepine-induced visual hallucinations in prodromal dementia with Lewy bodies
No full textObjective: We describe a patient with prodromal dementia with Lewy bodies (DLB) presenting with drug-induced visual hallucinations (VHs). Case report: A 78-year-old woman complained of daytime recurrent VHs characterized by seeing her face and arms covered in fur and viewing moustaches on her daughter's face. VHs started a few days after the beginning of a combination therapy with duloxetine and lorazepam and ceased within 24 h after their discontinuation. Nonamnestic mild cognitive impairment with profound visual perception deficits and very mild extrapyramidal signs, with abnormal brain DaTscan single photon emission tomography, were present. Three years later, cognitive and neurological follow-up assessments supported the diagnosis of DLB. Conclusion: Perturbation of cerebral serotonergic tone induced by duloxetine, associated with reduced attentional control due to benzodiazepine use, may be the physiopathological substrate of transient VHs in prodromal DL
Impulse control disorders in frontotemporal dementia: spectrum of symptoms and response to treatment.
No full textCognitive improvement after cranioplasty: A possible volume transmission-related effect.
No full textEffects of Lexical–Semantic Treatment on Memory in Early Alzheimer Disease: An Observer-Blinded Randomized Controlled Trial
No full textBackground. Episodic memory and semantic abilities deteriorate early in Alzheimer disease (AD). Since the cognitive system includes interconnected and reciprocally influenced neuronal networks, the authors hypothesized that stimulation of lexical–semantic abilities may benefit semantically structured episodic memory. Objective. To investigate the effects of lexical–semantic stimulation (LSS) on verbal communication and episodic memory in early AD. Methods. Forty AD participants were randomized to LSS or unstructured cognitive stimulation (UCS) as control condition. Treatments lasted 3 months, 2 sections a week. The primary outcome measures were the Mini Mental State Examination (MMSE), Boston Naming Test (BNT), Verbal Naming Test (VNT), Phonemic and Semantic Fluency, Story Recall, and Rey Auditory Verbal Learning (RAVL). Secondary outcome measures were neuropsychological tests assessing cognitive functions not stimulated by the intervention, such as attention, executive functions, and visual–spatial abilities, and the instrumental activities of daily living scale. A 6-month follow-up assessment was administered to the LSS group. Results. LSS treatment yielded significant improvements of the MMSE, BNT, VNT, Brief Story Recall, and RAVL delayed recall mean scores. Among secondary outcome measures, only working memory and the speed of a task assessing executive functions (Stroop test) improved after LSS. Unstructured cognitive stimulation intervention did not improve any cognitive domain. Six months after LSS discontinuation, the MMSE mean score remains significantly higher than the baseline value. Conclusion. LSS treatment may improve episodic memory in AD patients and may be regarded as a clinical option to counteract the cognitive decline typical of the disease
Clinical and cognitive correlates of visual hallucinations in dementia with Lewy bodies
No full textBACKGROUND: The presence of recurrent complex visual hallucinations (VHs) is a core feature of dementia with Lewy bodies (DLB). The aim of this study was to investigate which clinical and neuropsychological characteristics are associated with VHs and their predictive value over a 1 year follow-up.
METHODS: 81 DLB patients, 41 with (VH+) and 36 without (VH-) VHs, and 45 patients with Alzheimer's disease (AD), were enrolled. All participants underwent extensive neuropsychological testing. Visual-spatial and perceptual abilities were evaluated with the Visual and Object Space Perception (VOSP) battery. Fluctuations in attention, rapid eye movement sleep behaviour disorder (RBD) symptoms, extrapyramidal signs and behavioural disturbances were studied with dedicated clinical scales.
RESULTS: The presence of VHs was associated with older age and later disease onset, but not with disease duration or with fluctuations, RBD or parkinsonism severity. Cognitive correlates of VHs were deficits in visual attention (digit cancellation: p<0.005) and executive functions (clock drawing: p<0.05; digit span forward: p<0.05) on a background of a slightly worse global cognitive performance (Mini-Mental State Examination: p=0.05). Visual-perceptual and visual-spatial deficits were significantly worse in DLB than in AD patients (VOSP subtests scores 1, 6, 7 and 8) but were not different in DLB VH+ and VH-, except for subtest 6. Poor performance in the visual attention task was an independent predictor of VHs.
DISCUSSION: Impairment of visual-spatial and perceptual abilities in DLB represents a disease related cognitive signature, independent of the presence of VHs, for which it may represent a predisposing condition. Visual attention, instead, is the main cognitive determinant for the genesis of VHs
Simple motor stereotypies are not specific features of behavioural frontotemporal dementia.
No full textSimple motor stereotypies are not specific features of behavioural frontotemporal dementia
No full textCase series evidence for improvement of executive functions after late cranioplasty
No full textCraniectomy, used to relieve refractory intracranial pressure in traumatic brain injury (TBI), may cause cognitive deficits which could be improved by skull breach repair. This paper studied whether late cranioplasty improves a specific pattern of cognitive functions. Design: A case series of five TBI patients with craniectomy undergoing late cranioplasty (median interval time: 14 months, range: 12-36). Methods: Longitudinal neuropsychological and brain MRI assessments 1 week before cranioplasty and 3 months later. Results: After cranioplasty, mean score of the verbal fluency test improved compared to pre-cranioplasty (p = 0.02). Similarly, significant improvements after cranioplasty were observed in other tests scores exploring executive functions, such as working memory (p = 0.03) and speed of attention (p = 0.04), independently from the size and site of cranioplasty. Conclusions: The cognitive improvement induced by cranioplasty, even when performed after a long interval from craniectomy, may be due to the restoration of physiological cerebrospinal fluid circulation which, in turn, allows an efficient brain volume transmission signal circulation. The restoration of this essential way of signal communication seems to affect large-scale neuronal networks responsible for the executive function
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