Impaired awareness of movement disorders in Parkinson’s disease

Background

This study analyzed the presence of awareness of movement disorders (dyskinesias and hypokinesias) in 25 patients with Parkinson’s disease (PD) and motor fluctuations (dyskinesias, wearing off, on–off fluctuations). Of the few studies that have dealt with this topic, none have analyzed the differences in the awareness of motor deficits by comparing the on and off states using motor scales and an extensive battery of tests to assess cognitive and behavioral functioning.

Methods

PD patients were compared on three different scales that we have devised to measure awareness of movement disorders: Global Awareness of Movement (GAM) Disorders, dyskinesia/hypo-bradykinesia rating scales.

Results

Data showed that PD patients had greater awareness and psychological suffering in the off state than in the on state. In particular, they were troubled by motor disabilities related to hypokinesias and had mood-related symptoms and a perception of disability in activities of daily living. Interestingly, patients only showed a selective reduction of awareness of movement disorders associated with executive functions and related to dyskinesias in the on state, compared to a preserved awareness of hypokinesias in the off state. On the contrary, no association with executive functions was found in the off state.

Conclusion

Our findings suggest that the dopaminergic overstimulation of mesocorticolimbic pathways may cause a dysfunction of prefrontal–subcortical connections related to the impaired insight.     

On sending artifact in search of artifact: reply to Mcdonald, Harris, and Maher

Two studies are reported that show the McDonald, Harris, and Maher critique of our earlier experiment to be mistaken. In the first study, arousal-induced attention to self was demonstrated in a field setting devoid of any of the artifactual covariates of arousal induction suggested by these researchers. In the second study, a replication of the McDonald et al. experiment was conducted in which a crucial manipulation check that they failed to make was included. This check on the unusualness and embarrassment-producing properties of the manipulations revealed that their study was burdened by the very artifact they claimed might exist in ours. Although their slow-running manipulation was superficially similar to our fast-running manipulation, slow running created self-focus through unusualness and embarrassment, whereas fast running led to self-focus via arousal.     

Nunc pro tunc. The Problem of Retroactive Enactments

In this paper, I present a problem for the realist with respect to the institutional sphere, and suggest a solution. Roughly, the problem lies in a contradiction that arises as soon as institutional contexts are allowed to influence the institutional profile of objects and events not only in the present, but also in the past. If such “retroactive enactments” are effective, in order to avoid contradiction the realist seems to have to accept the unpleasant conclusion that institutions can create a past that has never been present. I will defend a solution which involves a distinction between temporal and atemporal types of institutional kinds that has, I maintain, independent interest.     

Influence of training on maintenance of equilibrium on a tilting platform

To assess the influence of training on the maintenance of equilibrium on a tilting platform, 13 young healthy male athletes aged 19 to 33 years were randomly divided into experimental (n=7) and control (n=6) groups. Two experimental sessions were performed before and after a specific 4-wk. training by the experimental group. Subjects stood upright on a tilting platform. The athletes were asked to maintain the platform as horizontal as possible during a 30-sec. test. The three-dimensional movements of the platform versus the ground were recorded by using a computerized optoelectronic digitiser. The platform plane was calculated and its directrix computed. The area of oscillation and instantaneous angular velocity of the directrix at standardized height were calculated. In both groups the area of oscillation and the angular velocity were reduced in Session 2, but the reduction was significant only in the experimental group. Specific training can significantly improve skill at maintaining equilibrium in young healthy sport performers.     

Attention in athletes of high and low experience engaged in different open skill sports

In this study were examined differences in attentional style of athletes engaged in two open skill sports requiring high reactivity (karate and volleyball) in groups with high or low experience. 42 healthy men, 24 volleyball players, 12 of High Experience (first division Italian League players whose M age was 28 yr. (SD=5) and 12 of Low Experience (prejunior Italian team athletes whose M age was 19 yr. (SD= 2). and 18 karateka, 9 of High Experience (3rd and 4th dan black belt athletes whose M age was 31 yr., SD=5) and 9 of Low Experience (1st and 2nd dan black belt karateka whose M age was 32 yr., SD=5). Tests involved different types of attention: Alert, Go/No-Go, Divided Attention, and Working Memory. For each one, the reaction time (RT), variability, change in RT, and number of errors were analysed. Karateka of High Experience reacted faster than those of Low Experience on the simple RT test, Alert (M RT: 204 vs 237 msec., p< .01), while on the Divided Attention test, the High Experience subjects performed more poorly and committed more errors (M errors: 4.89 vs 1.44, p <.003). Young volleyball players of Low Experience reacted faster than colleagues of High Experience on the Alert (M RT: 187 vs 210 msec., p<.01) and Divided Attention tests (M RT: 590 vs 688 msec., p<.001) but committed more errors (Divided Attention test, M errors: 6.50 vs 3.08, p<.007). For the Divided Attention and Working Memory tests, correlations were positive among errors, RT, and RT variability but only for volleyball athletes of High Experience, suggesting they showed higher attention and stability in complex reactions than the group with Low Experience. No significant correlations were noted for either group of karateka on complex reactions. Results suggested that the attentional resources were engaged in different ways in the two groups of athletes and, in each group, there were differences between persons of High and Low Experience.     

The use of virtual environments for survey spatial ability evaluation in topographical disorientation

Due to their interactivity and to the sense of presence they afford, virtual environments constitute an interesting opportunity to study spatial cognition. In accordance with this perspective, we aimed to introduce a spatial test in virtual simulation in order to investigate the survey spatial ability in patients with topographical disorientation. To do this, we used the "planning in advance task" in a virtual environment that constitutes an effective procedure to experimentally evaluate survey maps. With this procedure we present the single case of a woman, with a right medial temporal lobe lesion, who shows a selective impairment in the acquisition of new spatial relationships. The patient's performance in "planning in advance task" was compared with that of a control group made up of 40 female subjects matched for age and education. Results show how the patient revealed a significantly lower spatial performance when compared to the control group, demonstrating an inability to solve survey-type spatial tasks in complex virtual environments.     

Metaphor comprehension in Alzheimer's disease: novelty matters

The comprehension of non-literal language was investigated in 20 probable Alzheimer's disease (pAD) patients by comparing their performance to that of 20 matched control subjects. pAD patients were unimpaired in the comprehension of conventional metaphors and idioms. However, their performance was significantly lower in the case of non-conventional (novel) metaphor comprehension. This ability was not related to global cognitive deterioration or to deficits in the cognitive domains of attention, memory and language comprehension. On the other hand, the impairment in verbal reasoning appeared to be relevant for both novel and conventional metaphor comprehension. The relationship between novel metaphor comprehension and performance in the visual-spatial planning task of the Behavioral Assessment of the Dysexecutive Syndrome (BADS) suggests that executive impairment, possibly related to prefrontal dysfunction, may be responsible for the pAD patients' poor performance in novel metaphor comprehension. The present findings suggest a role of the prefrontal cortex in novel metaphor comprehension.