Lobe Dysfunction In Patients Research Articles

Association of severe hyposmia and frontal lobe dysfunction in patients with Parkinson's disease

Backgrounds and objectivesSevere hyposmia (SH) is a prodromal symptom of dementia associated with Parkinson's disease (PD) caused by Lewy bodies deposited in the limbic regions that connect the frontal and temporal lobes. We aimed to clarify the association between hyposmia and frontal lobe dysfunction (FLD) among patients with PD. MethodsPatients with PD and Hoehn & Yahr stage 1–3 at on-periods without apparent dementia were screened. FLD was defined as a score of ≤14 on the Frontal Assessment Battery (FAB). SH was defined as an average recognition threshold >4 in the T&T Olfactometer. For each subscore, a recognition score of ≥4 was defined as SH. We examined whether SH and its subscores were associated with FLD and evaluated which FAB subscore might be lower in PD patients with SH using Poisson regression analysis with a robust variance estimator. ResultsWe included 189 patients (median age, 68 years; 107 [57 %] male). FLD was observed in 53 (28 %) patients. Multivariable analysis showed that SH (PR 1.789, 95 % confidence intervals (CI) 1.115–2.872, p = 0.016) was associated with FLD. Regarding odor domains, only SH for fruity smells was associated with FLD (PR 1.970, 95 % CI 1.306–2.972, p = 0.001). Patients with SH had a higher subscore only for FAB-1 (similarity [conceptualization], p = 0.030), indicating linguistically mediated executive dysfunction. ConclusionIn patients with PD, SH is associated with FLD, especially with linguistically mediated executive dysfunction. Particularly, SH for fruity smells may be a sensitive indicator of FLD.

Association of Severe Hyposmia and Frontal Lobe Dysfunction in Patients with Parkinson’s Disease (P4-3.003)

Association of Severe Hyposmia and Frontal Lobe Dysfunction in Patients with Parkinson’s Disease (P4-3.003)

Differences in Frontal Lobe Dysfunction in Patients with Episodic and Chronic Migraine.

Neuroimaging and neuropsychological investigations have indicated that migraineurs exhibit frontal lobe-related cognitive impairment. We investigated whether orbitofrontal and dorsolateral functioning differed between individuals with episodic migraine (EM) and chronic migraine (CM), focusing on orbitofrontal dysfunction because it is implicated in migraine chronification and medication overuse headache (MOH) in migraineurs. This cross-sectional study recruited women with CM with/without MOH (CM + MOH, CM − MOH), EM, and control participants who were matched in terms of age and education. We conducted neuropsychological assessments of frontal lobe function via the Trail Making Test (TMT) A and B, the Wisconsin Card Sorting Test (WCST), and the Iowa Gambling Task (IGT). We enrolled 36 CM (19 CM + MOH, 17 CM − MOH), 30 EM, and 30 control participants. The CM patients performed significantly (p < 0.01) worse on the TMT A and B than the EM patients and the control participants. The WCST also revealed significant differences, with poorer performance in the CM patients versus the EM patients and the control participants. However, the net scores on the IGT did not significantly differ among the three groups. Our findings suggest that the CM patients exhibited frontal lobe dysfunction, and, particularly, dorsolateral dysfunction. However, we found no differences in frontal lobe function according to the presence or absence of MOH.

Moral judgment in patients with idiopathic generalized epilepsy

PurposeThe aim of the current study was to investigate morality while also investigating frontal lobe function with the goal of studying the relationship between frontal lobe and morality in patients with idiopathic generalized epilepsy. MethodA total of 23 right-handed patients with IGE and 25 right-handed healthy participants agreed to participate. Participants made judgments on a series of 50 hypothetical scenarios, which were adapted from a previously published set. The Stroop Test, verbal fluency, Digit Span tests and Wisconsin Card-Sorting Test were used to assess the frontal lobe function. ResultsIGE patients with impaired frontal lobe function choosed more utilitarian options than healthy controls in impersonal dilemmas but not in personal dilemmas. The performance of impersonal judgments were correlated positively with total errors positively and correlated negatively with categories completed. ConclusionsIGE patients with impaired frontal lobe function possessed unusual impersonal moral decision-making and those decisions may be caused more by cognitive impairment than by social-emotional impairment. Correlation analysis indicated that the unusual moral decisions correlated with frontal lobe dysfunction in patients with IGE.

ASSOCIATION OF APATHY WITH FRONTAL LOBE DYSFUNCTION IN AMNESTIC MILD COGNITIVE IMPAIRMENT AND ALZHEIMER'S DISEASE

ObjectiveThe primary aim of this study is to examine an association between apathy and frontal lobe dysfunction in patients with memory problems. We also aimed to look into the association...

778 – Association of apathy with frontal lobe dysfunction in amnestic mild cognitiveimpairment and alzheimer's disease

Objectives The primary aim of this study is to examine an association between apathy and frontal lobe dysfunction in patients with memory problems. We also aimed to look into the association between apathy severity and caregiver burden along with the relationship between apathy and praxis. Methods This was a retrospective cross sectional study. We selected 160 consecutive patients diagnosed with Alzheimer's dementia and Amnestic Mild Cognitive Impairment who had a comprehensive battery of neuropsychological tests and a behaviour rating scale of interest for this study recorded in the database. Correlation between apathy with and without depression were tested against frontal lobe test including Trail making A, Trial making B, Letter Fluency, Ideational Fluency, Category Fluency, Abstract Thinking and Executive functioning subtest of CAMGOG-R. Similarly correlation analysis was also done to look into association between apathy and caregiver burden as well as praxis. Results Statistically significant relationship were found between apathy and executive function scores, ideational fluency scores, abstract thinking and category fluency scores. Relationship between apathy and caregiver burden were highly significant. Further sub analysis, found apathy to be significantly associated with caregiver burden in both AD and aMCI patients. Conclusions Apathy is associated with frontal lobe dysfunction especially impaired executive function and ideational fluency even when controlled for depression. It is highly associated with caregiver burden both in AD & aMCI .Hence early recognition and management of apathy is important in improving the prognosis of patients with AD & aMCI as well as their caregiver.

The Frontal Assessment Battery as a Tool for Evaluation of Frontal Lobe Dysfunction in Patients With Parkinson Disease

Frontal-type cognitive deficits are common in patients with Parkinson disease (PD). The Frontal Assessment Battery (FAB) was developed to assess frontal lobe functions. However, many studies found that it also correlated with a variety of other general neuropsychological tests. To evaluate whether the FAB has an added value over the Mini-Mental State Examination (MMSE) and other bedside neuropsychological tests in reflecting cognitive deficits in patients with PD. Seventy-two consecutive patients with PD underwent cognitive assessment including the FAB, the MMSE, and a variety of other neuropsychological tests. Correlations were examined using the Spearman's r. Highly significant correlations were found between the total FAB score and tests of attention, executive functions, and memory. To evaluate the contribution of the FAB beyond that of the MMSE, partial correlation was used. Analyses revealed that the FAB still correlated with most of the tests. Dividing the patients according to the median MMSE score revealed that the high correlation between the FAB and the MMSE was preserved in the low MMSE group, while in the high MMSE group the correlation was relatively low. In the high MMSE group, the FAB correlated with 11 tests compared to the MMSE that correlated with one (P < .001), while in the low MMSE group the number of correlations was 13 versus 7, respectively (P = .05). In our sample of patients with PD, the FAB correlated with dysfunction in a variety of cognitive domains including attention, memory, and executive functions. The FAB has an added value over the MMSE, particularly among nondemented patients, an advantage that can be used in clinical practice.

Frontal assessment battery scores and non-motor symptoms in parkinsonian disorders

Using data from the PRIAMO study, we investigated non-motor symptoms (NMS) versus frontal lobe dysfunction in patients with idiopathic Parkinson disease (PD); 808 patients with PD and 118 with atypical parkinsonisms (AP) were consecutively enrolled at 55 Centers in Italy. Twelve categories of NMS were investigated. Cognitive impairment was defined as a Mini-Mental Status Evaluation score ≤ 23.8 and frontal lobe dysfunction as a Frontal Assessment Battery (FAB) score ≤ 3.48. Multivariable logistic regression was used to identify predictor of frontal lobe dysfunction in 524 PD patients, and a generalized linear model was used for each of the six FAB items. Not only the total FAB scores but also the single FAB items were lower in AP versus PD (p ≤ 0.005). Age (OR = 1.05), cognitive impairment (OR = 9.54), lack of cardiovascular symptoms (OR = 3.25), attention or memory problems (OR = 0.59) and treatment with L: -DOPA (OR = 5.58) were predictors of frontal lobe dysfunction. MMSE was negatively associated with all FAB items (β ≤ -0.16) and age with all FAB items but prehension behavior (β ≤ -0.01). Previous use of L: -DOPA was negatively associated with verbal fluency (β = -0.32) possibly acting as surrogate marker of disease duration. Cognitive impairment is a predictor of frontal lobe dysfunction. Among NMS, lack of attention or memory problems were negatively associated with frontal impairment. Further studies are nonetheless needed to better identify the predictors of frontal impairment in PD patients.

Serum inflammatory proteins and frontal lobe dysfunction in patients with cardiovascular risk factors

Recent studies have shown that the levels of circulating inflammatory markers are associated with cognitive decline and cerebral small-vessel disease. Frontal lobe dysfunction is believed to be a relatively characteristic neuropsychological symptom in vascular cognitive impairment caused by cerebral small-vessel disease. The purpose of this study was to investigate whether the levels of serum inflammatory markers are associated with frontal lobe dysfunction, particularly executive dysfunction. Between January 2003 and September 2007, 388 patients who had one or more atherosclerotic risk factors and subsequently underwent brain MRI and neuropsychological testing including mini-mental state examination (MMSE), frontal assessment battery (FAB), and modified Stroop test were enrolled in this study. We evaluated the effect of serum levels of inflammatory markers and white matter lesions on frontal lobe function. The FAB score was negatively correlated with serum inflammatory marker levels (hsCRP; r = -0.170, IL-6; r = -0.143, IL-18; r = -0.175) and white matter lesions. In the modified Stroop test, interference measure was positively correlated with the levels of hsCRP (r = -0.198), and IL-18 (r = -0.152), and white matter lesions. However, the MMSE score was not correlated with either inflammatory marker levels. The association between hsCRP and FAB score or interference measure remained significant when controlling for other confounding factors and MRI findings. The circulating level of hsCRP is associated with frontal lobe dysfunction in patients with cardiovascular risk factors independent of white matter lesions in brain MRI.

Frontal lobe dysfunction in patients with chronic migraine: a clinical–neuropsychological study

Neuropsychological tests have demonstrated a frontal lobe dysfunction in several psychiatric and neurological disorders. Our purpose was to examine whether similar functional differences would be found in patients with chronic migraine. The Gambling Task (GT), the Tower of Hanoi-3 (TOH-3) and the Object Alternation Test (OAT) were administered to 23 female patients previously treated for chronic migraine and to 23 healthy women who were similar to the patients in age and educational level, and the mean test scores of the two groups were compared (Student's t and Pearson correlation coefficient). The patient group scored significantly higher than the controls on the TOH-3 and, especially, the OAT. In the patients, no significant relationship was found between the neuropsychological test scores and those for the Minnesota Multiple Personality Inventory (MMPI), the Spielberg State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In conclusion, the data suggest a relation between chronic headache and dorsolateral function (as tested by the TOH-3) and orbitofrontal function (as tested by the OAT). The decision-making function related to ventromedial prefrontal cortex (tested by the GT) did not show a statistically significant difference between patients and controls. These neuropsychological findings seem to be partly independent of the patient's psychological traits and psychiatric disorders.

Influence of the levodopa on frontal lobe dysfunction in patients with de novo Parkinson's disease

We investigated the efficacy of the levodopa ( l-dopa) on cognitive function in patients with de novo Parkinson's disease (PD) using the event-related potential (ERP) measure and neuropsychological test batteries. We studied 20 PD patients who had never received anti-Parkinson medications. The ERP with auditory oddball P3 paradigm and neuropsychological tests such as Mini-Mental State Examination (MMSE), New Modified Wisconsin Card Sorting Test (WCST) and Trail Making Test were repeated in the patients before and after administration of levodopa plus benserazide daily 300 mg. For the ERP's components, reference-independent measures of global field power (GFP) were determined, and P3 GFP peak, peak latency and topography were assessed. After administration of levodopa, the patients revealed significant increase of the achieved categories and decrease of preservation errors in the WSCT, shortening of time in Trail Making Test although MMSE score showed no significant difference. The P3 GFP peak attenuated although there were no differences in peak latency or on scalp topography. These findings suggest that levodopa affect on the neural circuit connects frontal cortex with the striatum and normalizes its function, and it causes decrease of P3 GFP peak reflecting appropriate resource allocation. In addition, P3 GFP might be a more appropriate indicator than psychological tests.

58. Parietal lobe dysfunction in patients with severe borderline personality disorder

58. Parietal lobe dysfunction in patients with severe borderline personality disorder

Pre- and postoperative auditory event-related potentials in temporal lobe epilepsy.

We studied auditory event-related potentials (ERPs) in 11 surgically treated patients with intractable temporal lobe epilepsy (TLE) pre- and postoperatively. ERPs through sphenoidal electrodes (Sp1-T3, Sp2-T4) provided clinically relevant and correctly lateralizing electrophysiologic evidence of temporal lobe dysfunction in 9 of 11 patients, confirmed by EEGs, electrocorticograms, neuroradiologic, and neuropsychological results, and clinical follow-up. Lateralizing asymmetries were noted in P300 amplitude, but latencies were prolonged bilaterally. Sphenoidal ERPs might serve as a new functional indicator of temporal lobe dysfunction in patients evaluated for epilepsy surgery.