A neuropsychiatric case of delayed post-hypoxic leukoencephalopathy from opioid intoxication resulting in Anton-Babinski syndrome and quadriplegia.

This is the case of a 26-year-old male who developed Anton Babinski syndrome (ABS), quadriplegia, and delayed post-hypoxic leukoencephalopathy (DPHL) after an opioid overdose. He exhibited cortical blindness, visual anosognosia, and confabulation upon awakening. Several days later, he experienced acute psychosis and agitation.

Skin Biopsy Detection of Phosphorylated α-Synuclein in Patients With Synucleinopathies.

Importance: Finding a reliable diagnostic biomarker for the disorders collectively known as synucleinopathies (Parkinson disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA], and pure autonomic failure [PAF]) is an urgent unmet need. Immunohistochemical detection of cutaneous phosphorylated α-synuclein may be a sensitive and specific clinical test for the diagnosis of synucleinopathies.

Objective: To evaluate the positivity rate of cutaneous α-synuclein deposition in patients with PD, DLB, MSA, and PAF.

Clinical Screening for Posterior Cortical Atrophy.

Background: Posterior cortical atrophy (PCA) is a progressive neurologic syndrome that presents with complex visual deficits. Although PCA is most commonly a form of Alzheimer disease (AD), its early diagnosis is usually delayed due to a lack of understanding for how best to clinically screen for the syndrome.

Objective: To identify neurobehavioral screening tasks for PCA-beyond simple visual constructions-that can be administered in clinic or at bedside.

Impaired visual search in posterior cortical atrophy vs. typical Alzheimer's disease.

Background: Posterior cortical atrophy (PCA) is a neurocognitive disorder characterized by difficulty localizing in space. Recognizing PCA is important because it is usually missed early in its course and may result from a number of neurological disorders other than Alzheimer's disease (AD).

Objective: This study aimed to clarify whether impaired visual search tasks of spatial localization distinguished patients with PCA from those with other more typical dementias as well as from healthy control (HC) subjects.

Benson's Disease or Posterior Cortical Atrophy, Revisited.

Background: D. Frank Benson and colleagues first described the clinical and neuropathological features of posterior cortical atrophy (PCA) from patients in the UCLA Neurobehavior Program.

Objective: We reviewed the Program's subsequent clinical experience with PCA, and its potential for clarifying this relatively rare syndrome in comparison to the accumulated literature on PCA.

Dietary recommendations for patients with dementia.

With the emergence of support for diet in the maintenance of cognition, clinicians have been justifiably eager to promote diet recommendations for their older patients. But popular diets, such as the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), have not been shown to benefit cognition among patients who already have dementia or cognitive decline. In our experience, promoting these restrictive diets can be detrimental to patients with dementia who are already prone to eating disturbance; vulnerable to malnutrition; and, if underweight, demonstrate increased mortality.

Neuropsychiatric Effects on Decision-Making in Early Alzheimer Disease.

Background: Neuropsychiatric symptoms can impact decision-making in patients with Alzheimer disease (AD).

Methods: Using a simple decision-making task, a variant of the ultimatum game (UG) modified to control feelings of unfairness, this study investigated rejection responses among responders to unfair offers. The UG was administered to 11 patients with AD, 10 comparably demented patients with behavioral variant frontotemporal dementia (bvFTD), and 9 healthy controls (HC).

Vicarious Embarrassment or "Fremdscham": Overendorsement in Frontotemporal Dementia.

Objective: The experience of embarrassment signals violations in social norms, and impairment in this social emotion may underlie much of the social dysfunction in behavioral variant frontotemporal dementia (bvFTD). The authors investigated whether impaired self-awareness of embarrassment may distinguish patients with bvFTD early in the course of disease from healthy control subjects (HCs).

Methods: Self-reported embarrassment was examined among 18 patients with early bvFTD and 23 HCs by using the 36-item Embarrassability Scale, which includes items of situations eliciting embarrassment for oneself ("self-embarrassment") and embarrassment for others ("vicarious embarrassment").