Pseudodementia: A slow death

The clinical term pseudodementia has remained a permanent nosological entity in the literature for over 100 years. Indeed, recognition of the fact that clinical symptoms associated with reversible neuropsychiatric conditions can mimic irreversible disorders was known as early as the middle of the 19th century. The importance of the term lies in the inherent assumption that the presenting dementia is not real, or is at least reversible, and therefore treatable. Nonetheless, there continues to be controversy regarding the validity and appropriate clinical use of the term. This article reviews the evolution and clinical utility of the term pseudodementia and attempts to redirect investigative efforts toward an understanding of the neuroanatomical substrates that underlie depression and cognitive impairment in the elderly. Based on a critical analysis of the relevant literatures, a subcortical-frontal neuroanatomical substrate of late-life depression is supported. Further, the presence of leukoaraiosis, as measured by magnetic resonance imaging, is proposed as a potential neurobiological marker that contributes to the depressed mood, cognitive impairment, and later cognitive deterioration of some elderly depressed.     

Cognitive deficits related to major organ failure: The potential role of neuropsychological testing

Until recently, little attention has been paid to the possibility of cognitive deficits in patients with disease or failure of major organs such as the liver, kidney, or heart. However, there is a growing awareness that major organ failure often has neuropsychological sequelae. These sequelae may at times be quite subtle and not detectable under gross. examination. Nevertheless, even subtle deficits may have a major impact on adherence to medical regimens, psychosocial adjustment, and quality of life of patients. Neuropsychological assessment has a potentially valuable role to play both in research and in clinical work. It can be useful in adding to our knowledge of the cognitive effects of various types, severity and duration of major organ disease, as well as sequelae associated with treatment. It also is a potentially valuable clinical tool for identifying cognitive deficits that will affect the quality of life and probability of survival for organ failure patients.     

Phenotypic and genotypic heterogeneity in gaucher disease: Implications for genetic counseling

Genetic counseling for Gaucher disease is complicated by the vast degree of clinical heterogeneity encountered in the disorder. Recent advances in our understanding of the molecular genetics of Gaucher disease are particularly relevant to genetic counseling. Although the identification of mutations in the glucocerebrosidase gene has enabled genotypic screening of Gaucher patients, the ability to reliably predict patient outcome on the basis of DNA studies is often limited. An appreciation of both the spectrum of clinical manifestations in Gaucher patients and the limitations of the available genotypic information is necessary when counseling patients, families and at-risk individuals.     

Current status of psychological research in organ transplantation

Research addressing the psychological concomitants of organ transplantation is reviewed. Specifically, cognitive, behavioral, and psychosocial correlates of kidney, heart, liver, and bone marrow transplantation in both children and adults are discussed. Despite several conceptual and methodological shortcomings of the psychologically-based research in this area, results seem to indicate that organ transplantation is associated with many psychological issues at pretransplantation, posttransplantation, and follow-up periods. Implications of these general findings for the advancing roles of the health psychologist in organ transplantation are discussed.     

Brain asymmetry and autonomic conditioning: Sensitization control

In the present experiment we report effects of cerebral asymmetry, or laterality, during classical conditioning to facial emotional stimuli. Twenty-five female subjects were presented with slides of a happy face in one visual half-field (VHF), and simultaneously a slide of an angry face in the other VHF, followed by shock as the unconditioned stimulus (UCS). To control for effects of sensitization, a new stimulus, never associated with the UCS, was introduced in the extinction phase. Dependent measures were phasic heart rate responses (HR) and skin conductance responses (SCR). The HR results showed a significant right hemisphere effect for the CS-UCS association, that was not attributable to UCS sensitization. No significant effects were found for the SCRs. The basic HR finding was a right hemisphere superiority for learning of a conditioned association.     

Exploring mechanisms that affect retrograde memory for public events in amnestic mild cognitive impairment: A longitudinal update

Here, we examined mechanisms that affect retrograde memory in amnestic mild cognitive impairment (a-MCI) as a function of longitudinal clinical outcome. 8 a-MCI who converted to Alzheimer's dementia (AD) during the subsequent 3-year follow-up (converter a-MCI) and 10 a-MCI who remained clinically stable during the same period (stable a-MCI) were compared at the baseline evaluation (i.e., when they were diagnosed as a-MCI) using a remote memory questionnaire for public events that allows disentangling the differential contribution of storage and retrieval mechanisms to performance accuracy. Results suggest that deficits in remote memory are primarily explained by impaired retrieval abilities in stable a-MCI and by impaired storage in converter-to-AD a-MCI. This distinction between retrograde amnesia due to defective trace utilisation in stable a-MCI and trace storage in converter a-MCI is consistent with the temporal unfolding of declining anterograde memory over the course of disease progression to AD.     

Chronic pain relief after receiving affective touch: A single case report

Affective touch is gentle slow stroking of the skin, which can reduce experimentally induced pain. Our participant, suffering from Parkinson's Disease and chronic pain, received 1 week of non-affective touch and 1 week of affective touch as part of a larger study. Interestingly, after 2 days of receiving affective touch, the participant started to feel less pain. After 7 days, the burning painful sensations fully disappeared. This suggest that affective touch may reduce chronic pain in clinical populations.     

Testing the dopamine overdose hypothesis in action control: A study in people with Parkinson's disease

Prior work on patients with Parkinson's disease (PD) has shown that the administration of dopaminergic medication in the early to intermediate stages of PD benefits (motor) functions associated with the dopamine-depleted dorsal striatal circuitry but may ‘overdose’ and interfere with (cognitive) functions associated with the relatively intact ventral striatal circuitry. The present study aimed to elucidate this so-called dopamine overdose hypothesis for the action control domain. Using a within-subject design in a sample of 13 people with PD, we evaluated the effect of dopaminergic medication on two cognitive processes underlying goal-directed behaviour, namely action selection and initiation through event binding and conflict adaptation. We also investigated whether individual differences in the magnitude of medication effects were associated across these processes. Results showed no indications that dopaminergic medication affects action selection and initiation or conflict adaptation in PD patients. Additionally, we observed no correlations between both cognitive processes nor between individual differences in medication effects. Our findings do not support the notion that dopaminergic medication modulates action control processes, suggesting that the dopamine overdose hypothesis may only apply to a specific set of cognitive processes and should potentially be refined.     

Mechanisms underlying corruption of working memory in Parkinson's disease

Working memory (WM) impairments are reported to occur in patients with Parkinson's disease (PD). However, the mechanisms are unclear. Here, we investigate several putative factors that might drive poor performance, by examining the precision of recall, the order in which items are recalled and whether memories are corrupted by random guessing (attentional lapses). We used two separate tasks that examined the quality of WM recall under different loads and retention periods, as well as a traditional digit span test. Firstly, on a simple measure of WM recall, where patients were asked to reproduce the orientation of a centrally presented arrow, overall recall was not significantly impaired. However, there was some evidence for increased guessing (attentional lapses). On a new analogue version of the Corsi-span task, where participants had to reproduce on a touchscreen the exact spatial pattern of presented stimuli in the order and locations in which they appeared, there was a reduction in the precision of spatial WM at higher loads. This deficit was due to misremembering item order. At the highest load, there was reduced recall precision, whereas increased guessing was only observed at intermediate set sizes. Finally, PD patients had impaired backward, but not forward, digit spans. Overall, these results reveal the task- and load-dependent nature of WM deficits in PD. On simple low-load tasks, attentional lapses predominate, whereas at higher loads, in the spatial domain, the corruption of mnemonic information—both order item and precision—emerge as the main driver of impairment.     

The Transformation of Chinese Cultural Images of the Plague through Chinese Characters,Legends and Folkways1

The human experience of survival from a plague is about distinguishing the sick from the healthy as quickly as possible, establishing a barrier to stop the infection, and protecting healthy people. Nevertheless, the various quarantine rules and the acceptance and compliance of the population are a kind of battle between policy implementers and the public. This paper tries to understand how Chinese cultural attitudes (Henderson, 1984) unconsciously influence the Chinese people to be most cooperative with the strict containment and quarantine measures to confront the COVID-19 pandemic. This article begins with the Chinese characters, exemplified by the four characters of disease and plague, to discuss how the pictograph nature and spatial structural way profoundly shaped the cultural mind. Then, through plague-related Chinese legends, stories and folklore, the paper sets out the Chinese cultural attitudes which are also manifested in the analogical associations between disease, plague and seasons, the balance of the five elements of the universe and ghosts, gods and the government bureaucrats in the Kingdom of the Heaven. All of these approaches are well in line with Jung’s method of associative amplification as a way to locate the archetypal wisdom that assures survival.