The effects of motor neurone disease on language: further evidence

It might sound surprising that Motor Neurone Disease (MND), regarded still by many as the very example of a neurodegenerative disease affecting selectively the motor system and sparing the sensory functions as well as cognition, can have a significant influence on language. In this article we hope to demonstrate that language dysfunction is not only a pronounced and well documented symptom in some MND patients but also that the study of language in MND can address interesting theoretical questions about the representation of language and conceptual knowledge in the brain. After a brief introduction delineating clinical and pathological features of the disease we discuss the evidence available in the literature for language dysfunction in MND. We then present linguistic data from our own study of seven patients with MND/dementia/aphasia syndrome focusing on the dissociation between noun and verb processing. To illustrate the clinical, neuropsychological and linguistic aspects of MND we describe in more detail the patient E.N., a pathologically confirmed case of MND/dementia. Finally, we attempt to characterise the nature of the linguistic impairment in MND in the light of current debates about the mechanisms underlying noun/verb dissociation.     

Is a picture worth a thousand words? Evidence from concept definitions by patients with semantic dementia

Nine patients with semantic dementia (the temporal lobe variant of frontotemporal dementia) were asked to define concrete concepts either from presentation of a picture of the object or from its spoken name. As expected, the patients with the most severe semantic impairment produced the least detailed definitions, and the quality of the definitions overall was significantly related to concept familiarity. Further analyses of the definitions were designed to assess two key theoretical aspects of semantic organization. (i) Do objects and their corresponding names activate conceptual information in two neuroanatomically separable (modality-specific) semantic systems? If so, then-apart from any expected commonality in performance attributable to factors such as concept familiarity-one would not predict striking item-specific similarities in a patient's picture- and word-elicited definitions. (ii) Do sensory/perceptual features and more associative/functional attributes of conceptual knowledge form two neuroanatomically separable subsystems? If so, then one would predict significant dissociations in the prominence of these two types of information in the patients' definitions. The results lead us to favor a model of the semantic system that is divided by attribute type but not by modality.     

Attenuation of Hippocampal 11beta-Hydroxysteroid Dehydrogenase Type 1 by Chronic Psychosocial Stress in the Tree Shrew

11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD-1) catalyses the interconversion of active cortisol and corticosterone with inert cortisone and 11-dehydrocorticosterone, thus regulating glucocorticoid access to intracellular receptors. In rats, chronic glucocorticoid excess or stress increases 11beta-HSD-1 in the hippocampus, producing suggestions that it may attenuate the deleterious effects of chronic glucocorticoid excess. However, 11beta-HSD-1 predominantly catalyses 11beta-reduction in the intact liver and hippocampal cells, thus regenerating active glucocorticoids from inert substrate. We studied 11beta-HSD activity in the tissues of male tree shrews following 28 days of sustained psychosocial stress or exogenous administration of cortisol. In the hippocampus, chronic psychosocial stress attenuated 11-HSD-1 activity (69 +/- 9% of control), whereas cortisol alone had no effect. In the liver, both chronic stress and cortisol administration decreased 11beta-HSD-1 activity (47 +/- 11% and 49 +/- 4% fall, resp.). Attenuation of 11beta-HSD-1 within tissues may reflect a homeostatic mechanism designed to minimise the adverse effects of prolonged stress and/or glucocorticoid excess.     

APPLICATION OF CONTENT VALIDITY METHODS TO THE DEVELOPMENT OF A JOB-RELATED PERFORMANCE RATING CRITERION

This study demonstrated the use of quantitative content validity procedures in the development of a job-related behavioral rating scale criterion for entry-level psychiatric aides. Work behavior items were developed by staff from 6 state psychiatric hospitals, placed in a content validity questionnaire using the Lawshe format, and given to a representative sample of 38 aides and supervisors. Seventy-eight of 83 items were found to be significantly job-relevant using the computation procedures of both Lawshe and Aiken. After the significant items were grouped into 4 categories with high interjudge agreement and placed in a rating scale format, ratings were obtained on 72 psychiatric aides from 4 hospitals. Items in the 4 categories were found to be internally consistent using coefficient alpha. Significant but low concurrent validities were established for 2 verbal ability selection tests using the rating criterion. The validities found were interpreted to be especially significant when the factors of low selection ratio, restriction in range, and limited rater training were considered.     

Factors influencing failure to show for a family evaluation

Abstract

An important issue in clinical practice concerns clients' failure to keep their initial evaluation appointments, which has been termed defection (Shapiro and Budman, 1973). Research findings and clinical impressions suggest that client defection can be related to three sets of factors: actuarial variables, client psychological and motivational variables, and client-clinician interaction prior to the initial appointment (Rubinstein and Lorr, 1956; Garfield, 1971). Among the actuarial variables, the following have been suggested as being related to clients' defection: referral source, distance client must travel for the appointment, client socioeconomic status (SES), and waiting time (Brill and Storow, 1960; Raynes and Warren, 1971; Lorion, 1973).     

Reviews

Lois Raynor: The Adopted Child Comes of Age. National Institute of Social Services Library No. 36, 1980. George Allen and Unwin. Paperback, [euro]5.50.

W.R. Bion: The Long Weekend. Fleetwood Press, 1982 [euro]9.00.     

Acquiring a Novel Coordination Skill without Practicing the Correct Motor Commands

There is evidence that experience of the sensory consequences, in the absence of practice of the required motor commands, is sufficient to learn new bimanual coordination patterns. This was shown through improvements of an incongruent group who practiced a desired 30° phase offset between the limbs while 1 limb was weighted such that the desired phase relation was achieved when synchronous motor commands were sent to the limbs (P. Atchy-Delama, P. G. Zanone, C. E. Peper, & P. J. Beek, 2005). In addition to testing a similar incongruent and congruent group (i.e., no weight), the authors extended this experiment by removing visual feedback during practice and by including an auditory modeling and passive guidance group. All groups showed improvement, except for the modeling group. The passive guidance group made more errors in posttests than the congruent and incongruent groups. Only the congruent group increased the amount of time around 30° after practice. Active experience of the sensory consequences combined with practice sending appropriate motor commands is the most effective method for learning, even though strategic improvements can be attained without experience of the latter.