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.     

Unique Aspects of Adolescent Sexual Victimization Experiences

This study explored females' adolescent experiences with sexual aggression using event-level data. A community sample of women, ages 18 to 30 years ( N = 319), were interviewed regarding their most recent unwanted sexual experience. Incidents were categorized as occurring during adolescence (ages 14 to 17) or adulthood (after age 18). Preliminary statistical comparison of adolescent and adult incidents revealed differences in perpetrators, type of aggression, preceding activities, and location of assault. Qualitative analytic techniques were then used to identify the contexts in which adolescent victimization occurred, as well as the factors contributing to adolescent vulnerability. Four contexts in which adolescents were sexually victimized emerged: Within Intimate Relationships, At Parties/Social Gatherings, Abuse by Authority Figures, and While Alone With a Friend. Thematic analysis revealed that inexperience with sex and dating, lack of guardianship, substance use, social and relationship concerns, and powerlessness contributed to adolescent vulnerability within these contexts.     

Neurobiological Markers of Illness Onset in Psychosis and Schizophrenia: The Search for a Moving Target

In this review, we describe neuropsychological and brain imaging findings in the early stages of psychosis and schizophrenia. We focus on recent clinical high-risk studies and consider whether the evidence supports these as ‘endophenotypes’ of a vulnerability to the illness or as ‘biomarkers’ of illness onset and transition. The findings suggest that there are a number of processes at psychosis onset that may represent biomarkers of incipient illness. These neurobiological indices particularly implicate the integrity of frontal and temporal cortices, which may or may not be related to the genetics of psychosis (i.e. potential ‘endophenotypes’). However, these brain regions are dynamically changing during normal maturation, meaning that any putative neurobiological markers identified at the earliest stages of illness may be relatively unstable. We suggest that, while such measures may be readily identified as potential neurobiological markers of established illness, they are inconsistent at (or around) the time of illness onset when assessed cross-sectionally. Instead, identification of more valid risk markers may require longitudinal assessment to ascertain normal or abnormal trajectories of neurodevelopment. Accordingly, we assert that the current conceptualisations of potential biomarkers and/or ‘endophenotypes’ for schizophrenia may need to be reconsidered in the context of normal and abnormal brain maturational processes at the time of onset of psychotic disorders.     

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.     

Effects of similarity of location and temporal intensity pattern of conditioned and unconditioned stimuli on the acquisition of conditioned suppresion in rats.

This article two studies that examined the effect of similarity of location and temporal intensity patterns of the conditioned stimulus (CS) and the unconditioned stimulus (UCS) on the acquision of conditioned suppression. Experiment 1 showed that greater suppression occurs during a stimulus generalization test when the tested stimulus has a location and temporal intensity pattern that is similar to the previously presented UCS. Experiment 2 showed that conditioned suppression is acquired more rapidly if the CS and UCS have similar locations and temporal intensity patterns. These similarity factors were interpreted as forms of event covariation, which aided in associative formation. Several applications of these data are discussed.     

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.