Torticollis spasmodicus and addiction

From a random sample of 49 patients suffering from torticollis spasmodicus and dependence on alcohol or medicaments, 6 have been selected and are discussed with i view to findings possible mutual influences between the disorders. In particular, premorbid accentuation of personality presented itself as a potential risk factor leading to both tortocollis and alcoholism. In various cases, the patient makes use of alcohol for self-treatment of extrapyramidal-motor symptoms. But such phenomenological developments are preceded by varied constellations of conditions, that have to be taken into account in the treatment.     

The perception of temporal deviations in isochronic patterns

In a study of perceptual synchronization with an isochronic sequence, subjects were given the following task: They heard an isochronic sequence of tones in which the last interval was either correct or too long. Their task was to detect irregularity. The independent variables were the number of tones heard and the time interval between them. The dependent variable was the difference limen (DL) for the detectability of the irregularity. Two experiments were performed in this study, differing in the way in which the trials were blocked: In Experiment 1, stimuli with the same period were presented in blocks, whereas in Experiment 2, the period of the stimulus was randomized. The results show that in Experiment 1 the number of tones in the stimulus did not affect the detectability of the anisochrony. In Experiment 2, the number of the DL was a decreasing function of the number of tones heard. Moreover, the decrease of the DL was larger than one would expect from a simple model of information integration, which assumes that subjects improve their performance by averaging their percepts of the first intervals in the sequence. The difference between this task and experiments on the discrimination of temporal intervals is discussed.     

The effect of early childhood experiences on neurotic disorders in the adult

"Empiricists" and "clinicians", in especial those in the field of psychoanalysis, have reached divergent views on the significance of early childhood experiences for neurotic affections in the adult. The present paper discusses the need to resolve such "apparent" differences. To be effective, models of psychological development should, besides taking into account biological hereditary influences and the psychosocial conditions of childhood, also consider the ongoing perpetualisation of neurotic behavior through social feedback.     

Psychopathologic symptoms in torticollis spasmodicus

The paper presents the results of detailed diagnosis of 51 patients with torticollis spasmodicus. A discussion of the results would seem to indicate the possibility of there being one group with prior neuroses, one group compulsive in nature, and one group whose diminished performance arises from the condition of the brain. Reliable diagnosis is only possible when both mental and physical parameters have been taken into consideration.     

The detectability of local and global displacements in regular rhythmic patterns

Summary The aim of this study is to find out by which mechanism human subjects discriminate a regular sequence of beats from an irregular one. Therefore a detection experiment was conducted in which subjects had to detect one of three different types of displacement within a regular rhythmic pattern. The results are against a theory which assumes that in such a task successive intervals are compared. They are more in favor of a theory that postulates an internal time keeper which is synchronized with the presented pattern.     

Timing precision in continuation and synchronization tapping

 Wing and Kristofferson (1973) have shown that temporal precision in self-paced tapping is limited by variability in a central timekeeper and by variability arising in the peripheral motor system. Here we test an extension of the Wing–Kristofferson model to synchronization with periodic external events that was proposed by Vorberg and Wing (1994). In addition to the timekeeper and motor components, a linear phase correction mechanism is assumed which is triggered by the last or the last two synchronization errors. The model is tested in an experiment that contrasts synchronized and self-paced trapping, with response periods ranging from 200–640 ms. The variances of timekeeper and motor delays and the error correction parameters were estimated from the auto-covariance functions of the inter-response intervals in continuation and the asynchronies in synchronization. Plausible estimates for all parameters were obtained when equal motor variance was assumed for synchronization and continuation. Timekeeper variance increased with metronome period, but more steeply during continuation than during synchronization, suggesting that internal timekeeping processes are stabilized by periodic external signals. First-order error correction became more important as the metronome period increased, whereas the contribution of second-order error correction decreased. It is concluded that the extended two-level model accounts well for both synchronization and continuation performance. Received: 16 November 1998 / Accepted: 21 April 1999     

The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.

Educational objectives: The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.     

Fehldiagnose Aufmerksamkeitsdefizit- und Hyperaktivit?tssyndrom?

Although it is assumed both by healthcare professionals as well as by public opinion that attention deficit hyperactivity disorder (ADHD) is widely overdiagnosed, so far there is little empirical evidence to support this presumption. However, the presented study shows clear evidence for an overdiagnosis of ADHD. Furthermore, the data demonstrate that based on identical symptoms, boys more often receive a diagnosis for ADHD than girls. A false ADHD diagnosis also correlates with a recommendation for medical and psychotherapeutic treatment. One explanation for misdiagnosis is the fact that therapists in the course of diagnosis, as with other everyday decision-making processes, are influenced by heuristics. The most common heuristics that can lead to misdiagnosis are the representativeness heuristic and the availability heuristic. Such mistakes could be avoided by clearly following diagnostic criteria and the use of structural interviews.     

Architecture and organizational principles of Broca's region

Identifying cortical areas for language and speech processing is a prerequisite for cognitive neuroscience and clinical research. Although Broca's region is one of the essential nodes in the language network, its anatomical constituents are ill-defined and multiple definitions of Broca's region exist. Sanides' concept of microstructural gradations interpreted Broca's region as developing from neighboring motor, dorsolateral-prefrontal, and insular cortices. Recent mapping approaches based on cytoarchitecture, transmitter receptor distribution, and connectivity revealed a highly differentiated segregation of this region far beyond Brodmann's classical scheme. This novel segregational concept of structural and functional architecture more adequately reflects the various functions of Broca's region in cognitive and/or linguistic processes.