Neuropsychological Sequelae of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A Critical Review

Neuropsychologists are increasingly involved in surgical candidacy evaluations and postoperative neurobehavioral assessments of patients with movement disorders, most notably those with disease (PD). We review here the initial studies regarding neuropsychological outcomes of deep brain stimulation (DBS) within the subthalamic nucleus (STN) for treatment of PD. Overall, these initial investigations provide preliminary support for the cognitive and neurobehavioral safety of STN DBS. Improvements in self-reported symptoms of depression and diminished verbal fluency were the most common findings, whereas changes in global cognitive abilities, memory, attention, and frontal/executive functions were inconsistent and most often described as nominal and/or transient. The generalizability of this literature is hindered by several methodological limitations, including small samples and the absence of appropriate control participants. The clinical and theoretical implications of these initial studies are highlighted and recommendations are offered to guide future research.     

Accuracy and precision of binocular 3-D motion perception

In principle, information for 3-D motion perception is provided by the differences in position and motion between left- and right-eye images of the world. It is known that observers can precisely judge between different 3-D motion trajectories, but the accuracy of binocular 3-D motion perception has not been studied. The authors measured the accuracy of 3-D motion perception. In 4 different tasks, observers were inaccurate, overestimating trajectory angle, despite consistently choosing similar angles (high precision). Errors did not vary consistently with target distance, as would be expected had inaccuracy been due to misestimates of viewing distance. Observers appeared to rely strongly on the lateral position of the target, almost to the exclusion of the use of depth information. For the present tasks, these data suggest that neither an accurate estimate of 3-D motion direction nor one of passing distance can be obtained using only binocular cues to motion in depth. ((c) 2003 APA, all rights reserved)     

Opposed left and right brain hemisphere contributions to sexual drive: a multiple lesion case analysis

Brain topographical studies of normal men have have shown that sexual excitation is asymmetric in the brain hemispheres. Group studies of patients with unilateral epileptic foci and other studies of patients with unilateral brain lesions have come to the same conclusion. The present study reviewed previously published single case reports of patients with frank hypo or hypersexuality subsequent to a unilateral brain lesion. Hyposexual patients tended to have left hemisphere lesions (primarily of the temporal lobe), and hypersexual patients tended to have right hemisphere lesions (primarily of the temporal lobe) (p < 0.05). We interpret this double dissociation as part of a more general phenomenon of psychic tone similarly dissociated with regard to hemispheric control, including mood, psychomotor baseline, speech rate, and even immunity. The behavioral significance of this psychic tone is to modulate approach versus avoidance behavior.     

Bouts of responding from variable-interval reinforcement of lever pressing by rats

Four rats obtained food pellets by lever pressing. A variable-interval reinforcement schedule assigned reinforcers on average every 2 min during one block of 20 sessions and on average every 8 min during another block. Also, at each variable-interval duration, a block of sessions was conducted with a schedule that imposed a variable-ratio 4 response requirement after each variable interval (i.e., a tandem variable-time variable-ratio 4 schedule). The total rate of lever pressing increased as a function of the rate of reinforcement and as a result of imposing the variable-ratio requirement. Analysis of log survivor plots of interresponse times indicated that lever pressing occurred in bouts that were separated by pauses. Increasing the rate of reinforcement increased total response rate by increasing the rate of initiating bouts and, less reliably, by lengthening bouts. Imposing the variable-ratio component increased response rate mainly by lengthening bouts. This pattern of results is similar to that reported previously with key poking as the response. Also, response rates within bouts were relatively insensitive to either variable.     

Changing perspectives on frontotemporal dementia: A review

This article examines the evolution in understanding of frontotemporal dementia (FTD) during the last four decades. A central theme is the recognition of heterogeneity. Originally construed as a disorder of behaviour and executive impairment, FTD is now known also to be associated with alterations in language, conceptual knowledge and praxis. An absence of neurological signs is the hallmark of many FTD patients, but there is also an established association with motor neurone disease (MND), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). FTD is commonly defined as an early onset dementia, yet about a quarter of patients present after the age of 65. The underlying pathological protein is tau, TDP-43 or more rarely fused-in-sarcoma (FUS). Distinct genetic mutations have been identified in familial FTD. There are predictable relationships between clinical phenotype, pathological substrate and genetic mutation. For example, a circumscribed semantic disorder predicts TDP-43 pathology, and speech or limb apraxia tau pathology. The co-occurrence of MND predicts TDP-43 pathology, and PSP and CBD tau pathology. FUS pathology is associated with very youthful onset, stereotyped behaviours and caudate atrophy. Non-fluent aphasia is linked to progranulin (GRN) mutations and MND and psychosis to repeat expansions in the C9orf72 gene. Despite striking worldwide consensus in findings there remain some issues of contention, largely related to the classification of FTD and its sub-variants. Understanding the diverse nature of FTD is crucial for effective diagnosis, management and the development of targeted therapies.     

Defensive pessimism and precautionary action during the COVID pandemic

The purpose of this research was to test, in the context of the COVID-19 pandemic, the hypothesis that individuals who use defensive pessimism as a strategy to manage anxiety are likely to act to prevent or mitigate negative outcomes. Across three crowd-sourced samples (Total N = 1416), defensive pessimism was correlated with self-reports of more precautionary behavior (Studies 1, 2, & 3) and fewer COVID-positive results (Study 3).     

A Two-Year Longitudinal Study of Neuropsychological and Cognitive Performance in Relation to Behavioral Problems and Competencies in Elementary School Children

Despite interest in early neuropsychological status as a possible contributor to children's behavioral development, prospective longitudinal investigations of neuropsychological measures in relation to later behavioral outcomes in childhood are few. A 2-year longitudinal study in a nonselected childhood sample is reported. The study tested the influence of early neuropsychological performance (verbal fluency, mental inhibitory control, and visual spatial ability) on later childhood behavioral problems and social competency. Regular education children (n = 235) were assessed at three time points 1 year apart. To control for autocorrelation of outcome measures, Time 1 behavior was partialed while testing the effects of Time 1 neuropsychological scores on Time 3 outcome. To control for autocorrelation of neuropsychological scores, Time 2 scores were partialed while testing the predictive effect of Time 1 scores on Time 3 outcome. Both sets of regression models suggested modest but statistically significant effects for inhibitory control and verbal fluency, but not IQ, reading, or visual spatial ability, on behavioral outcome. Study results are consistent with a modest causal effect of selected neuropsychological skills on later behavioral adjustment. The findings support theories that implicate subtle neuropsychological dysfunction in the development of behavioral problems in childhood.