Time perception in organically healthy and brain damaged subjects

The aims of this study were to investigate whether brain lesions are associated with an impairment of time judgement and whether there is any relationship between alterations of time experience and the side and localization of brain lesions. References were made to the literature dealing with different definitions of the concept of time and the notions derived from time as a categorial entity, such as time experience, time perception and time awareness. To begin with, the philosophical and psychological approach was considered. There upon definitions as given by the natural sciences, conceptual classifications, phenomenological investigations as well as psychopathological considerations were analysed. Furthermore, the literature on disorders of time judgement was reviewed against the background of alterations of time experience in patients with brain lesions. In the present study patients with definite single brain lesions were examined and compared with a group of normal subjects. Three methods for testing time judgement (method of production, method of reproduction and time estimation) were applied to each subject. The results showed that in a substantial proportion of brain-damaged patients a subjective impression of changes in the rate at which time passed was reported, mostly in form of an apparent slowing down. No difference could be demonstrated between left or right cerebral lesions or between different localizations within one hemisphere. On the testing for objective time judgement the brain-damaged patients showed a tendency to under-or overestimation of time intervals, often exceeding the pre-established normal boundaries by far. We observed a certain "vulnerability" of the right hemisphere on the tasks for time judgement, especially in the case of right-sided parieto-occipital lesions.     

Temporal ranges of central nervous processing: clinical evidence

The organization of the time frames for perceiving, generating, and updating information in the CNS has as of yet received little attention despite its elementary character for human behavior. We investigated temporal epochs in perceiving, acting, and updating in patients with anterior and posterior lesions of the left and right hemisphere, in patients with lesions in the left hemisphere without aphasia, and in healthy controls. Three temporal ranges, 30, 300, and 3000 ms, were assessed with different psychophysical paradigms. Prolongation of the temporal perception of order (30 ms) was most pronounced with left posterior lesions, of repetitive action (300 ms) with left anterior lesions, and updating (3000 ms) with left and right anterior lesions. Temporal deficits are group as well as parameter specific. Our results support the notion of coordinated coexistence of different temporal mechanisms.     

Behavioral deficits in groups with cerebral vascular lesions.

Established 3 groups of patients with cerebrovascular disease (right hemisphere, left hemisphere, or generalized involvement) by matching 15 triads for age, sex, education, and duration of diagnosed cerebrovascular disease. Intergroup and intragroup comparisons were made of results on a large battery of measures, including psychometric intelligence, motor strength and speed, psychomotor performance, and sensory functions. Tests given included halstead's finger tapping test, halstead's tactual performance test, and wechsler-bellevue, form i, verbal and performance iq values. Significant differences were found between groups with lateralized lesions, whereas the group with generalized involvement tended to occupy an intermediate position. The group with left cerebral damage had a significantly lower verbal than performance iq, whereas this relationship was reversed in the group with right cerebral damage. Motor, psychomotor, and sensory functions were consistently impaired on the side contralateral to the damage hemisphere for the groups with lateralized lesions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correspondence between Mini-Mult and standard MMPI scale scores in patients with neurological disease.

Explored the possible utility of the Mini-Mult vs the standard MMPI in 18 patients with left hemisphere lesions, 18 with right hemisphere lesions, and 18 non-brain-damaged medical controls. Close correspondence was found between mean Mini-Mult and standard MMPI scale scores for all scales except scale 9. Although all correlations were significant beyond the .01 level, only scales L, K, 1, 2, and 3 reached acceptable levels of equivalence. The Mini-Mult correctly predicted the MMPI high-scale score only 55.5% of the time. It is suggested that the poor predictive value of the Mini-Mult for the individual, despite adequate group prediction, reflects weakness in the test rather than sampling differences due to severity of illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unilateral brain lesions and performance on Russell's version of the Wechsler Memory Scale in an African American population

Studies of patients with unilateral lesions report hemisphere-specific and locus-specific impairments on Russell's (1975) Revision of the Wechsler Memory Scale (RWMS). In the current investigation "race-homogeneous" and "race-comparative" paradigms provide the context in which the generalizability of RWMS findings are examined in a population of African Americans with unilateral lesions. The performances of brain-damaged patients were impaired relative to normal controls on five of the six RWMS measures. However, patients with left and right hemisphere damage in our sample did not differ systematically on RWMS subtests. Likewise, among patients with lesions confined to one of the quadrants in the brain, there were no quadrant group differences in performance on RWMS subtests. But, right posteriors were impaired relative to controls on immediate and delayed VR subtests. The relative merits of the race-comparative and race-homogeneous paradigms are considered in the context of these findings.     

Cardiac disease in intracerebral hematomas

INTRODUCTION AND OBJECTIVE: The Central Nervous System (CNS) plays an essential role in the regulation of the cardiac function. There is strong evidence that many CNS lesions, mainly those of hemorrhagic origin, may induce repolarization abnormalities and enlargement of the QT interval (ECG changes) and several types of arrhythmias. In some cases these changes have been related to sudden death. The imbalance between the sympathetic and parasympathetic systems, favoring the former, seems to be the etiopathogenic factor. MATERIAL AND METHODS: We have carried out a study on thirty-two in-patients suffering from non-severe intracerebral hemorrhage, by means of a Holter ECG examination within the first 72 hours and a second record after two months. We have assessed any significative differences on the ECG findings in relation to the location of the hematoma (left or right hemispheres) and the presence of a personal history of arterial hypertension and/or heart disease. RESULTS: One or more ECG changes were present in 69.2% of the patients and 73% showed one or more rhythm abnormalities. There was a higher incidence of supraventricular arrhythmias associated with the right hemisphere hematomas, with an statistical significance for the atrial extrasystolia. No differences were found between the group with a previous history of hypertension and/or heart disease and the one without these conditions. There were two cases of sudden death, both with left hemisphere hematomas, and in one of them the previous rhythm abnormalities were recorded. CONCLUSIONS: This study corroborates the hypothesis that right hemispheric hematomas induce supraventricular arrhythmias more frequently. The possible association between severe ventricular arrhythmias and sudden death with left-hemisferic hematomas should be studied in a higher number of patients. We recommend monitoring every acute case of intracerebral hematoma when possible.     

Apoptosis signaling by death receptors

How do stimulus size and item number relate to the magnitude and direction of error on center estimation and line cancellation tests? How might this relationship inform theories concerning spatial neglect? These questions were addressed by testing twenty patients with right hemisphere lesions, eleven with left hemisphere lesions and eleven normal control subjects on multiple versions of center estimation and line cancellation tests. Patients who made large errors on these tests also demonstrated an optimal or pivotal stimulus value, i.e., a particular size center estimation test or number of lines on cancellation that either minimized error magnitude relative to other size stimuli (optimal) or marked the boundary between normal and abnormal performance (pivotal). Patients with right hemisphere lesions made increasingly greater errors on the center estimation test as stimuli were both larger and smaller than the optimal value, whereas those with left hemisphere lesions made greater errors as stimuli were smaller than a pivotal value. In normal subjects, the direction of errors on center estimation stimuli shifted from the right of true center to the left as stimuli decreased in size (i.e., the crossover effect). Right hemisphere lesions exaggerated this effect, whereas left hemisphere lesions diminished and possibly reversed the direction of crossover. Error direction did not change as a function of stimulus value on cancellation tests. The demonstration of optimal and pivotal stimulus values indicates that performances on center estimation and cancellation tests in neglect are only relative to the stimuli used. In light of other studies, our findings indicate that patients with spatial neglect grossly overestimate the size of small stimuli and underestimate the size of large stimuli, that crossover represents an "apparent" shift in error direction that actually results from normally occurring errors in size perception, and that the left hemisphere is specialized for one aspect of size estimation, whereas the right performs dual roles.     

Left and right hemisphere contributions to physiognomic and verbal discrimination.

The relative contributions of the right- and left-temporal lobes in rapid recognition of faces and letters were studied in patients with anterior right- or left-temporal lobe excisions and a matched control group. On the basis of findings in patients with unilateral and bilateral brain damage, it was hypothesized that left hemisphere damage would not change the reaction time of letters analyzed by the right hemisphere and that right hemisphere damage would not change the reaction time of faces analyzed by the left hemisphere. The hypothesis was supported for letters but not for faces. Patients in the right-temporal group, particularly those with large hippocampal removals, were slow to recognize faces in both visual fields. Two possible explanations for the findings with faces are explored: One holds that right hemisphere mechanisms are involved even when a face is presented to the left hemisphere for rapid recognition; the other holds that specialized encoding is carried out by the right hemisphere during learning, with the encoded template then being used by each hemisphere independently. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

ILAE-defined epilepsy syndromes in children: correlation with quantitative MRI

PURPOSE: The role of quantitative magnetic resonance imaging (MRI) in evaluation of childhood epilepsy remains poorly defined, with minimal published data. Previous work from our center questioned the specificity of hippocampal asymmetry (HA) in an outpatient group whose epilepsy was defined by using clinical and interictal data only. By using childhood volunteer controls and defining epilepsy syndromes using video-EEG monitoring, we readdressed the utility of HA in differentiating mesial temporal lobe epilepsy (MTLE) from other partial and generalized epileptic syndromes in children. METHODS: Seventy children were enrolled; entry criteria were age younger than 18 years with predominant seizure type recorded on video-EEG telemetry with volumetric MRI in all cases. Thirty healthy child volunteers had volumetric MRI. Epilepsy syndrome classification was according to ILAE. RESULTS: Control data revealed symmetric hippocampi, mean smaller/larger ratio of 0.96 (0.95-0.97, 95% CI) with no gender or right/left predominance. Overall 23% of patients had significant HA. Mean hippocampal ratio for MTLE was 0.78 (95% CI, 0.70-0.86), significantly lower than controls and from all other epilepsy syndromes. HA was highly specific (85%) to the syndrome of MTLE. Other potential epileptogenic lesions were found in 27 (39%) patients, lowest yield in frontal and mesial temporal syndromes. Dual pathology was present in 10% of patients. There was no significant association between HA and risk factors. CONCLUSIONS: In this study, we found that HA in children with a well-defined epilepsy syndrome is highly sensitive and specific for MTLE. Whether this will correlate with surgical outcome, as in adults, is the subject of ongoing study.     

Anosognosia for motor impairment following left brain damage.

Anosognosia for motor impairment has been linked to lesions of the right hemisphere. However, left hemisphere damaged patients have often been excluded from investigation because of their associated language deficits. In this study we assessed anosognosia for motor disorders in a group of left hemisphere damaged patients using 2 tools that assess the presence of unawareness—a structured interview that is a common method of assessment of anosognosia in clinical settings, and a new tool, the Visual-Analogue Test for Anosognosia for Motor Impairment (VATAm; Della Sala, Cocchini, Beschin, & Cameron, in press). The structured interview relies heavily on language and enquires about general motor ability whereas the VATAm is less dependent on language abilities and enquires about specific motor tasks. Results suggest that the frequency of anosognosia in left brain damaged patients may have been underestimated due to methodological reasons, and that anosognosia for motor impairment can also be associated with lesions of the left hemisphere. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cytochrome P450 2E1 mRNA in the rat prostate: detection and quantitation by competitive reverse transcription and polymerase chain reaction

Conventional balloon angioplasty treatment of aorto-ostial stenoses in native coronary arteries and saphenous vein grafts is associated with a low primary success rate, a high complication rate and a high incidence of restenosis. The short-term outcome of Palmaz-Schatz stent implantation in aorto-ostial lesions was compared with that of balloon angioplasty. Thirteen patients underwent stent implantation for 13 de novo lesions (four in the left main coronary trunk, two in the right coronary artery, seven in the vein graft) between January 1994 and December 1995. Fourteen patients underwent balloon angioplasty for 14 de novo lesions (five in the left main coronary trunk, four in the right coronary artery, five in the vein graft between January 1986 and April 1992. Both groups had similar clinical characteristics. Initial success was obtained in all patients in the stent group, compared with 71% of the balloon angioplasty group. Insufficient dilation was the main cause for such failure in the balloon angioplasty group. Baseline reference diameters were similar (3.40 +/- 0.65 mm in the stent group vs 3.36 +/- 0.42 mm in the balloon angioplasty group) and there was no difference in baseline minimal luminal diameter (1.41 +/- 0.74 vs 1.08 +/- 0.56 mm). Minimal luminal diameter was significantly greater in the stent group than in the balloon angioplasty group at both post-procedure and follow-up examinations (post: 3.36 +/- 0.58 vs 2.69 +/- 0.45 mm, p < 0.01; follow-up: 2.33 +/- 0.96 vs 1.52 +/- 0.68 mm, p < 0.05). There was no subacute occlusion in either group. The overall angiographic restenosis rate (> 50% stenosis) was lower in the stent group (17%) than in the balloon angioplasty group: the restenosis rates of native lesions were 0% in the stent group and 40% in the balloon angioplasty group; those of saphenous vein graft lesions were 33% in the stent group and 50% in the balloon angioplasty group. Although the number of patients was limited, these results suggest that Palmaz-Schatz stent implantation may be a safe and effective strategy for treating aorto-ostial lesions in both native coronary arteries and saphenous vein grafts.     

Lateralization in stroke syndromes as a factor in ambulation

Lateralization should not be ignored in any rehabilitation program for patients with stroke syndromes. Despite the known differences resulting from the localization in the dominant versus the nondominant hemisphere (spatial perception, speech, etc.), practical application of this knowledge in gait training is sparse. The authors looked into different stages of ambulation and the time sequence between these stages and the onset of disease. Standing and walking in parallel bars and outside, as well as elevation activities were given numerical values in an effort to assess abilities quantitatively. The assessment of each patient was recorded graphically (stage of gait against time) and then the different graphs were summated in order to form a common right hemiparetic versus left hemiparetic curve. This study of 236 out of 298 patients (129 left hemiparetics and 107 right ones) showed the following: (1) The right hemiparetics progressed more rapidly in all stages of ambulation, statistically significant figures being obtained for the first two stages; (2) a greater percentage of right versus left hemiparetics reached the assigned levels of ambulation: and (3) 89% out of the 236 patients included in our study were able to ambulate in parallel bars, 81% outside the bars and 38.5% were proficient in stair climbing. Out of the original total number of patients (298), 64% were able able to ambulate outside the bars.     

Electroencephalographic signs of compensatory reactions following stroke with location of the focus in the right and left cerebral hemispheres

The authors studied 41 patients with acute disorders of cerebral circulation, a focus in the right hemisphere and 14 with foci in the left hemisphere. The traits of compensatory reactions were studied according to the background and functional EEG, depending upon the severity, stage, localization and lateralization of focal vascular brain lesions. The authors indicate to a rigidity of clinical and EEG changes in patients with right hemispheric localization of the focus which is explained by the authors by disturbances of the higher cortical functions in these patients.     

Beta(3)-adrenoceptors mediate smooth muscle relaxation in the rat lower oesophageal sphincter

BACKGROUND: The neurological literature concerning disinhibition syndromes and secondary mania has run in parallel to clinical reports of bipolar disorder in old age. METHODS: A critical review was conducted of both the neurological and geriatric psychiatry literature in an attempt to integrate the two streams. RESULTS: Disinhibition syndromes include lateralization to the right hemisphere and localization of lesions to the orbito-frontal and basotemporal cortex involving limbic and frontal connections (orbito-frontal circuit). Mania in old age is associated with late onset, heterogeneous neurological disorders and poor outcome. CONCLUSION: Bipolar disorders in old age may be understood in the context of affective vulnerability influenced by a specific neurobiologic substrate. LIMITATIONS: The clinical literature consists predominantly of small case series and anecdotal reports. CLINICAL RELEVANCE: Improved understanding of these syndromes may elucidate the pathogenesis and etiology of bipolar disorders and the neuropsychiatric syndromes affecting mood, motivation and behavioural disinhibition.     

Does the Clock Drawing Test have focal neuroanatomical correlates?

The Clock Drawing Test (CDT) is widely used in clinical neuropsychological practice. The CDT has been used traditionally as a "parietal lobe" test (e.g., Kaplan, 1988), but most empirical work has focused on its sensitivity and specificity for detecting and differentiating subtypes of dementia. There are surprisingly few studies of its neuroanatomical correlates. The authors investigated the neuroanatomical correlates of the CDT, using 133 patients whose lesions provided effective coverage of most of both hemispheric convexities and underlying white matter. On the CDT, 30 subjects were impaired and 87 were unimpaired (16 were "borderline"). Impairments on the CDT were associated with damage to right parietal cortices (supramarginal gyrus) and left inferior frontal-parietal opercular cortices. Visuospatial errors were predominant in patients with right hemisphere damage, whereas time setting errors were predominant in patients with left hemisphere lesions. These findings provide new empirical evidence regarding the neuroanatomical correlates of the CDT, and together with previous work, support the use of this quick and easily administered test not only as a screening measure but also as a good index of focal brain dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The decoding of emotional concepts in patients with focal cerebral lesions

The effects of focal brain lesions on the decoding of emotional concepts in facial expressions were investigated. Facial emotions are hierarchically organized patterns comprising (1) structural surface features, (2) discrete (primary) emotional categories and (3) secondary dimensions, such as valence and arousal. Categorical decoding was measured using (1) selection of category labels and selection of the named emotion category; (2) matching one facial expression with two choice expressions. Dimensional decoding was assessed by matching one face with two different expressions with regard to valence or arousal. 70 patients with well documented cerebral lesions and 15 matched hospital controls participated in the study. 27 had left brain damage (LBD; 10 frontal, 10 temporal, 7 parietal); 37 had right brain damage (RBD; 15 frontal, 11 temporal, 11 parietal). Six additional patients had lesions involving both frontal lobes. Right temporal and parietal lesioned patients were markedly impaired in the decoding of primary emotions. The same patients also showed a reduced arousal decoding. In contrast to several patients with frontal and left hemisphere lesions, emotional conceptualization and face discrimination was not independent in these groups. No group differences were observed in valence decoding. However, right frontal lesions appeared to interfere with the discrimination of negative valence. Moreover, a distraction by structural features was noted in RBD when facial identities were varied across stimulus and response pictures in matching tasks with differing conceptual load. Our results suggest that focal brain lesions differentially affect the comprehension of emotional meaning in faces depending on the level of conceptual load and interference of structural surface features.     

Transcranial Doppler ultrasonography and hyperventilation test in assessment of cerebral vasoreactivity after ischemic stroke

In 36 patients 3 month after ischaemic stroke in regions supplied by MCA (Middle Cerebral Artery) physical examination, CT scanning and blood flow velocity recordings in ICA (Internal Carotid Artery) and MCA were performed. In both MCA blood flow velocity was measured in resting state and after 30 sec. of hyperventillation. The control group consisted of 40 healthy volunteers. In the control group blood flow decrease after hyperventillation was nearly equal in both hemispheres (38% in right and 37% in the left hemisphere). In studied group in the symptomatic hemisphere blood flow reduction was 21%. Vasoreactivity in the opposite hemisphere was similar to that in control group (35% decrease). The results suggest that vasoreactivity diminution is a local phenomenon limited to the infarcted area. Hyperventilation test, despite its simplicity, seems to be sufficient for screening vasoreativity.     

Sex differences in the representation of visuospatial functions in the human brain.

Investigated sex differences in the representation of visuospatial functions in the human brain in 20 Ss with right hemisphere stroke and 40 stroke-free control Ss with the Complex Figure Test, Wechsler Adult Intelligence Scale—Revised (WAIS—R) Block Design, and Judgment of Line Orientation. Also, 3 models of sex differences in the representation of visuospatial functions in the human brain were evaluated. The stroke and control groups were composed of equal proportions of men and women. Results suggest that women may be disproportionately impaired in visuospatial functioning relative to men following right hemisphere stroke. It is proposed that visuospatial functions were bilaterally represented in the brains of men, allowing them to rely upon left hemisphere visuospatial systems following right hemisphere stroke, and that these functions were represented in the right hemisphere of women, resulting in their disproportionate impairment despite comparable lesions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of social exclusion in trauma survivors with posttraumatic stress disorder.

Trauma survivors with posttraumatic stress disorder (PTSD) often experience or report social stigmatization and isolation. Williams (2001) provided an experimental paradigm to assess behavioral effects of social exclusion. This paradigm (face-to-face version) has been applied in a 2 × 2 group × experimental condition design. Participants in the PTSD group (N = 16) and the nontraumatized control group (N = 25) were randomly assigned to an exclusion or inclusion condition. The results showed interaction effects for main psychopathological assessments (depression, anxiety, psychoticism) and expected main effects for the majority of outcome measures (psychopathology, well-being, belonging, and meaningful existence). The research concludes that a general assumption of elevated levels of self-perceived social exclusion in PTSD patients has to be considered in terms of differentiated psychopathological effects of exclusion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)