Characteristics and reversibility of dementia in Normal Pressure Hydrocephalus

Studies of the cognitive outcome after shunt insertion for treatment of Normal Pressure Hydrocephalus have reported widely mixed results. We prospectively studied performance of 60 patients with Normal Pressure Hydrocephalus on a comprehensive battery of neuropsychological tests before and after shunt surgery to determine which cognitive functions improve with shunt insertion. We also administered a subset of cognitive tests before and after temporary controlled drainage of cerebrospinal fluid to determine if change on this brief subset of tests after drainage could predict which patients would show cognitive improvement three to six months after shunt insertion. There was a significant improvement in learning, retention, and delayed recall of verbal memory three to six months after surgery (using paired t-tests). The majority (74%) of patients showed significant improvement (by at least one standard deviation) on at least one of the memory tests. Absence of improvement on verbal memory after temporary drainage of cerebrospinal fluid had a high negative predictive value for improvement on memory tests at 3-6 months after surgery (96%; p=0.0005). Also, the magnitude of improvement from Baseline to Post-Drainage on few specific tests of learning and recall significantly predicted the magnitude of improvement after shunt surgery on the same tests (r2=0.32-0.58; p=0.04-0.001). Results indicate that testing before and after temporary drainage may be useful in predicting which patients are less likely to improve in memory with shunting.     

Assessment of apathy in neurological patients using the Apathy Motivation Index caregiver version

Apathy is a common, disabling neuropsychiatric syndrome that occurs across many brain disorders and may be associated with diminished motivation in behavioural, cognitive, emotional and social domains. Assessment is complicated by the variability of symptoms across apathy domains and self-report from patients, which can be misleading due to their lack of insight. Independent evaluation by clinicians also has limitations though if it has to be performed with limited time. Caregiver reports are a viable alternative, but current assessments for them either do not distinguish between different apathy domains or are interview-based and take long to administer. In this study, we developed a brief caregiver questionnaire version of the recently developed Apathy Motivation Index (AMI), which is a self-report tool. We confirmed three apathy factors in this new caregiver measure (AMI-CG) that were also present in the AMI: Behavioural Activation, Emotional Sensitivity and Social Motivation. Furthermore, we validated the scores against more extensive caregiver interviews using the established Lillle apathy rating scale as well as patient self-reports of apathy, measures of depression, anhedonia, cognition, activities of daily living and caregiver burden across four different neurological conditions: Parkinson's disease, Alzheimer's disease, subjective cognitive impairment and limbic encephalitis. The AMI-CG showed good internal reliability, external validity and diagnostic accuracy. It also uncovered cases of social apathy overlooked by traditional instruments. Crucially, patients who under-rated their apathy compared to informants were more likely to have difficulties performing everyday activities and to be a greater burden to caregivers. The findings provide evidence for a multidimensional conceptualization of apathy and an instrument for efficient detection of apathy based on caregiver reports for use in clinical practice.     

Is Weiner's attribution‐help model stable across cultures? A test in Brazilian subcultures

The effect of attribution of responsibility on the intention to help is a well‐studied effect. The Weiner model of attribution‐emotion‐help is the main theoretical development to describe the structural relation between these variables. Some research results have suggested that culture influences the relation between model variables. Collectivists tend to show more compassionate emotions independent of attribution of responsibility whereby emotion is no longer a mediator. The present research aims to test the Weiner model in Brazil, a country with established subcultures and clear distinctions in the collectivism–individualism dimension across its regions. An experiment with 1,569 participants from all five Brazilian regions was conducted. Path analysis revealed that more socially oriented participants tended to feel more compassion for the experimental scenario's protagonist, independent of controllability manipulation, decreasing the effect of emotions in the model. These results depict the effect of culture on the model, questioning the stability of the model across cultures.     

The effects of age and emotional valence on recognition memory: An ex‐Gaussian components analysis

The aim of this work was to study the effects of valence and age on visual image recognition memory. The International Affective Picture System (IAPS) battery was used, and response time data were analyzed using analysis of variance, as well as an ex‐Gaussian fit method. Older participants were slower and more variable in their reaction times. Response times were longer for negative valence pictures, however this was statistically significant only for young participants. This suggests that negative emotional valence has a strong effect on recognition memory in young but not in old participants. The τ parameter, often related to attention in the literature, was smaller for young than old participants in an ex‐Gaussian fit. Differences on the τ parameter might suggest poorer attentional performance in old participants.     

The relationship between cognitive inhibition and psychotic symptoms

Cognitive models of schizophrenia have highlighted deficits of inhibitory attentional processes as central to the disorder. This has been investigated using "negative priming" (S. P. Tipper, 1985), with schizophrenia patients showing a reduction of negative priming in a number of studies. This study attempted to replicate these findings, but studied psychotic symptoms rather than the broad diagnostic category of schizophrenia. Psychotic individuals exhibiting positive symptoms were compared with asymptomatic psychiatric patients and with a normal control group. As predicted, the symptomatic group failed to show the usual negative priming effect, which was present in the asymptomatic and normal groups. A modest but significant correlation was found between negative priming and delusions. Neither diagnosis, nor affective or negative symptoms, nor chronicity, nor medication, was related to negative priming. These data replicate previous findings that positive symptoms are related to a reduction in cognitive inhibition, although considerable variability was observed among the psychotic patients.     

Introduction

This is an Introduction to the special issue of Metaphilosophy entitled Philosophy as a Way of Life, giving a brief account of the genesis of the project, an overview of the topic, and a summary of the topics covered in the issue.