Bilateral pallidotomy for treatment of Parkinson's disease induced corticobulbar syndrome and psychic akinesia avoidable by globus pallidus lesion combined with contralateral stimulation.

Objective: Posteroventral pallidotomy (PVP) has proved to be an effective method for the treatment of Parkinson's disease. However, data on bilateral procedures are still limited. To assess the effects of bilateral globus pallidus (GPi) lesion and to compare it with a combination of unilateral GPi lesion plus contralateral GPi stimulation (PVP+PVS), an open blind randomised trial was designed.

Theory of mind and pragmatic abilities in dementia.

Objective: "Theory of Mind" (ToM) is the capacity to attribute mental states to oneself and to others and to interpret behavior in terms of mental states. Deficits in both ToM and pragmatic abilities have been described in patients with neurologic disorders, such as frontal lobe lesions and right hemisphere strokes, but have not been assessed in demented patients.

Methods: This study examined ToM and pragmatic abilities in a consecutive series of 34 patients with probable Alzheimer disease (AD) using a second-order false belief story, 11 short stories assessing understanding of social situations, and a test of pragmatic abilities assessing both indirect requests and-conversational implications.

Remote memory in Alzheimer's disease.

The authors examined the severity and type of deficits in remote memory in patients with probable Alzheimer's disease (AD). In the first study, 40 AD patients showed significantly more severe deficits on both the free-recall and the recognition sections of the Remote Memory Scale (which measures memory for famous people and well-known events) compared with normal control subjects. In the second study, 25 AD patients showed significantly more deficits on the free-recall section of the Autobiographical Memory Scale compared with normal control subjects.

Explicit and implicit learning in patients with Alzheimer disease and Parkinson disease with dementia.

Objective: To examine the differential impairment of implicit and explicit memory systems in cortical and subcortical dementias.

Background: Whereas verbal priming was reported to be impaired in patients with Alzheimer Disease (AD), patients with Parkinson Disease (PD) may be relatively more impaired on tasks of motor skill learning.

Methods: We examined 15 patients with Alzheimer disease, 10 patients with Parkinson disease and dementia (PD-D), 15 patients with PD but no dementia, and 24 age-comparable normal control subjects with a neuropsychologic battery that included tests of explicit memory (Buschke Selective Reminding Test, Benton Visual Retention Test, Digits Span), and tests of implicit memory (Word-Stem Completion task and the Maze Test).

Neuropsychological correlates of apathy and depression in patients with dementia.

Objective: To investigate the association between apathy and depression, and specific cognitive deficits in AD.

Background: Apathy and depression are frequent behavioral disorders in patients with AD. However, the neuropsychological correlates of these disorders have rarely been examined.

Unilateral radiofrequency lesion versus electrostimulation of posteroventral pallidum: a prospective randomized comparison.

Microelectrode-guided posteroventral pallidotomy (PVP) has shown to be an effective method in the treatment of a group of patients with advanced Parkinson's disease. A nonlesioning approach by means of deep brain electrodes connected to a programmable neuropacemaker has also been used to inhibit the internal segment of globus pallidus (posteroventral stimulation [PVS]) reporting comparable clinical efficacy to the one obtained with the ablative method. Nevertheless, no controlled studies have been performed to compare the efficacy of both procedures.

Prevalence and correlates of the catastrophic reaction in Alzheimer's disease.

We examined the prevalence of the catastrophic reaction (CR) in 146 patients with Alzheimer's disease. Sixteen percent showed a CR during the neuropsychological evaluation. A factor analysis of the CR scale demonstrated an anxious/angry factor that was significantly associated with higher irritability scores and a longer duration of illness, as well as a depressive factor that was significantly associated with more severe cognitive impairments and older age.

Cognitive functions in major depression and Parkinson disease.

Objective: To investigate the importance of major depression in the production of cognitive deficits in patients with Parkinson disease (PD).

Design: A comprehensive neuropsychological and psychiatric assessment was conducted in 19 patients with PD and major depression, 31 patients with PD without depression, 27 patients with major depression but without PD, and 12 age-comparable healthy controls.

Setting: Outpatient clinic.

Prospective longitudinal study of depression and anosognosia in Alzheimer's disease.

Background: The aim was to examine the longitudinal evolution of depression and anosognosia in patients with probable Alzheimer's disease (AD).

Method: Sixty-two of a consecutive series of 116 AD patients that were examined with a structured psychiatric interview had a follow-up evaluation between one and two years after the initial evaluation.

Results: At the initial evaluation 19% of the 62 patients had major depression, 34% had dysthymia, and 47% were not depressed.

Anosognosia and procedural learning in Alzheimer's disease.

Awareness of cognitive deficits may rely on the implicit learning of intellectual limitations, and anosognosia in Alzheimer's disease (AD) may result from deficits in implicit learning. To examine this hypothesis, a consecutive series of 55 patients with probable AD were divided into groups with mild (n = 13), severe (n = 12), or no anosognosia (n = 30) and were assessed with a neuropsychological battery that included tests of declarative and procedural learning. Whereas there were no significant between-group differences in tests of declarative learning (the Buschke Selective Reminding Test and the Benton Visual Retention Test), patients with severe anosognosia showed a significantly worse performance on procedural learning (as measured with the Maze Learning Test) and a test assessing set shifting abilities (the Wisconsin Card Sorting Test) than AD patients without anosognosia.

Neuropsychological and psychiatric differences between Alzheimer's disease and Parkinson's disease with dementia.

Objective: To examine neuropsychological and neuropsychiatric differences between patients with probable Alzheimer's disease and patients with Parkinson's disease and dementia.

Methods: Thirty three patients with probable Alzheimer's disease and 33 patients with Parkinson's disease and dementia were matched for age, sex, and mini mental state examination scores and given a battery of neuropsychological and neuropsychiatric tests.

Results: Patients with Parkinson's disease with dementia had a significantly higher prevalence of major depression than patients with Alzheimer's disease; patients with Alzheimer's disease showed more severe anosognosia and disinhibition than patients with Parkinson's disease.