Depression and cognitive impairment in disability-free early multiple sclerosis

Cognitive and emotional capabilities were evaluated in 73 female patients with stable relapsing-remitting definite, and/or laboratory-supported multiple sclerosis (MS) and were compared with 32 matched healthy controls. Patients were categorized according to their score in the expanded disability status scale (EDSS) to either no (EDSS 0, n = 33) or few clinical signs (EDSS 1-2, n = 40) of MS without physical disability. Patients with EDSS > 0 were characterized by significantly (p < 0.001) higher scores on "von Zerssen's" depression scale, compared to controls. Patients with higher EDSS scores (1-2) showed significantly decreased performance with respect to the total score of Kimura's Recurring-Figures-Test (p < 0.001), in addition. Regarding visuo-constructive functioning, patients with EDSS=0 performed to a significantly lower level (p < 0.001), compared to controls. These results indicate that depression may present as an early sign in MS followed by cognitive impairment, in particular visuo-spatial short-term memory, before physical disability appears. Neuropsychological tests as mentioned here could serve as early diagnostic tools to detect subtle disease progression and to initiate and monitor disease modifying therapies.     

Topiramate in the preventive treatment of episodic migraine: a combined analysis from pilot,double-blind,placebo-controlled trials

The safety and efficacy of medications for preventive treatment of migraine is the subject of current concern and investigation in health care. Two single-center, double-blind, placebo-controlled studies were conducted to evaluate the efficacy and safety of topiramate for migraine prophylaxis. Seventy patients with a diagnosis of migraine were randomly assigned to topiramate-treated and placebo groups. The studies consisted of a 4-week baseline phase, a 6-8 week titration, and 8-12 weeks of maintenance. Topiramate was titrated from an initial dose of 25 mg/day to a target dose of 100 mg BID. The primary efficacy measure, the mean 28-day migraine frequency, was lower in topiramate-treated patients than in the placebo group (3.2 versus 3.8, P=.001). Similarly, topiramate treatment resulted in a significantly greater mean reduction in migraine frequency than did placebo (1.55 versus 0.47, P=.001) and a significantly higher responder rate (35.3% versus 8.3%, P=.008). Paresthesia was the most common side effect reported with topiramate treatment. Other topiramate-associated adverse events included altered taste, memory impairment, diarrhea, and appetite suppression/weight loss. The rates of discontinuation were similar for the topiramate group (n=10) and the placebo group (n=8). These results suggest that topiramate is effective and well tolerated in the preventive treatment of migraine headaches.     

Representing tools: how two non-human primate species distinguish between the functionally relevant and irrelevant features of a tool

Few studies have examined whether non-human tool-users understand the properties that are relevant for a tool's function. We tested cotton-top tamarins (Saguinus oedipus) and rhesus macaques (Macaca mulatta) on an expectancy violation procedure designed to assess whether these species make distinctions between the functionally relevant and irrelevant features of a tool. Subjects watched an experimenter use a tool to push a grape down a ramp, and then were presented with different displays in which the features of the original tool (shape, color, orientation) were selectively varied. Results indicated that both species looked longer when a newly shaped stick acted on the grape than when a newly colored stick performed the same action, suggesting that both species perceive shape as a more salient transformation than color. In contrast, tamarins, but not rhesus, attended to changes in the tool's orientation. We propose that some non-human primates begin with a predisposition to attend to a tool's shape and, with sufficient experience, develop a more sophisticated understanding of the features that are functionally relevant to tools.     

Author Index 106, 2001

Authors Index

Author Index 106, 2001     

The use of bouts and frequencies in the evaluation of hand preferences for a coordinated bimanual task in chimpanzees (Pan troglodytes): an empirical study comparing two different indices of laterality

Hand preferences for a coordinated bimanual task were assessed in 109 chimpanzees (Pan troglodytes). Hand preference was evaluated for 4 test sessions using bouts and frequencies of hand use to compare the sensitivity of each level of analysis in evaluating individual variation in handedness. Overall, significant population-level right-handedness was found using several different measures of hand use. Handedness indices based on bouts and frequencies were highly and significantly correlated. Moreover, hand preferences were consistent across tests despite efforts to situationally bias preference during each test. Taken together, these data do not support the view that bouts are a better level of analysis for evaluating hand preference. The results further suggest that hand preferences for coordinated bimanual actions are not influenced by situational factors and may reflect an inherent specialization of the left hemisphere for motor skill.     

The whole-hand point: the structure and function of pointing from a comparative perspective

Pointing by monkeys, apes, and human infants is reviewed and compared. Pointing with the index finger is a species-typical human gesture, although human infants exhibit more whole-hand pointing than is commonly appreciated. Captive monkeys and feral apes have been reported to only rarely "spontaneously" point, although apes in captivity frequently acquire pointing, both with the index finger and with the whole hand, without explicit training. Captive apes exhibit relatively more gaze alternation while pointing than do human infants about 1 year old. Human infants are relatively more vocal while pointing than are captive apes, consistent with paralinguistic use of pointing.     

Gravity biases in a non-human primate?

Pre-school children expect falling objects to travel in a straight line even when there are clear physical mechanisms that deviate the object's path (Hood, 1995). The current study set out to determine whether this expectancy is limited to humans. Cotton-top tamarins (Saguinus oedipus oedipus), a New World monkey species, were tested on Hood's (1995) experimental task where objects are dropped down a chimney connected by an opaque tube to one of three containers. Like human children, there was a significant tendency to search in the container underneath the chimney where the food was dropped on the first trial, even though aligned chimneys and containers were never connected. These search errors suggest that there may be a gravity bias that operates when both primate species fail to understand the constraints operating on object trajectories. Unlike human children however, tamarins were generally more likely to perseverate in making errors even though repeated testing and cost incentives were used.     

Is the inversion effect in rhesus monkeys face-specific?

This study investigated the face inversion effect in rhesus monkeys (Macaca mulatta). Face stimuli consisted of ten black-and-white examples of unfamiliar rhesus monkey faces, brown capuchin faces, and human faces. Two non-face categories included ten examples of automobiles and abstract shapes. All stimuli were presented in a sequential matching-to-sample format using an automated joystick-testing paradigm. Subjects performed significantly better on upright than on inverted presentations of automobiles, rhesus monkey and capuchin faces, but not human faces or abstract shapes. These results are inconsistent with data from humans and chimpanzees that show the inversion effect only for categories of stimuli for which subjects have developed expertise. The inversion effect in rhesus monkeys does not appear to be face-specific, and should therefore not be used as a marker of specialized face processing in this species. Received: 18 November 1998 / Accepted after revision: 9 May 1999     

Mothers’ attuned responses to infant affect expressivity promote earlier achievement of language milestones

To investigate infants’ affective expressivity and maternal attuned responsiveness to infant expressivity in relation to early language achievement, 77 dyads were visited in their homes at 9 and 13 months, and mothers were interviewed about their children’s language between 9 and 21 months. Maternal responses that were attuned to infant affect, by selectively matching either the gradient features or the valence of infants’ affective expressions, were more predictive of children’s language achievement than maternal nonmatching responses; and maternal matching responses at 9 months were more predictive of children’s language achievements than maternal responses at 13 months. Moreover, maternal matching responses at 9 months predicted second-year language achievements over and above infant affect expressivity at 9 and 13 months, and over and above maternal matching responses at 13 months. Infants’ affective expressivity per se was not predictive.     

A Death in the Family: Report of a Single-Session Trauma Group for Nursing Home Residents and Staff

This article describes a single-session trauma-debriefing group conducted at a nursing home following the death of a resident on an outing. The group had as its core an existing weekly therapy group in the facility, with the addition of affected staff, family, and other residents who were on the outing. The treatment illustrates four principles relevant to counseling and psychotherapy in nursing homes: 1) recognition of death; 2) treatment in and of the milieu; 3) flexibility and structure; and 4) dealing with countertransference. Along the way, we see how the residents are capable of giving, and not merely receiving.