Ann D. M. Davies

Circadian rest-activity rhythm is altered in Parkinson's disease patients with hallucinations.

The sleep‐wake cycle in Parkinsons Disease (PD) is profoundly disrupted, but less is known about circadian rhythm in PD and its relationship to other important clinical features. This study compared rest‐activity rhythms in healthy older adults and PD patients with and without hallucinations. Twenty‐nine older adults and 50 PD patients (27 with hallucinations, 23 without) were assessed using wrist‐worn actigraphy for 5 days. Disease‐related and cognitive data were also collected. PD patients demonstrated reduced amplitude of activity (F = 12.719, P < 0.01) and increased intradaily variability (F = 22.005, P < 0.001), compared to healthy older adults, independently of age, and cognitive status. Hallucinators showed lower interdaily stability (F = 7.493, P < 0.01) significantly greater activity during “night‐time” (F = 6.080, P < 0.05) and significantly reduced relative amplitude of activity (F = 5.804, P < 0.05) compared to nonhallucinators, independently of clinical factors including motor fluctuations. PD patients with hallucinations display altered rest‐activity rhythm characterized by an unpredictable circadian pattern across days, likely arising from damage to brainstem and hypothalamic sleep centers. Treatment of sleep and rest‐activity rhythm disturbance is an important target in Parkinsons Disease.

Perception and memory for faces in Parkinson's disease

This study investigated face processing abilities in patients with late-onset Parkinsons disease. In the first experiment, the Parkinsons disease patients were impaired on a recognition memory test for unfamiliar faces but showed no deficit relative to controls in recognition memory for words. The Parkinsons disease patients were also impaired at matching different photographs of unfamiliar faces. Experiment 2 revealed that the memory deficit affected recognition of familiar as well as unfamiliar faces and extended the face perception impairment to sex decisions and to the analysis of facial speech. An additional verbal recognition memory test again revealed no significant differences between the performance of the Parkinsons disease and control groups. It is argued that the memory impairment is not accountable for simply in terms of the perceptual deficits, and the problems that the patients experience are discussed in terms of the functional model of face processing put forward by Bruce and Young (Brit. J. Psychol. 77, 305-327, 1986).

Verbal fluency in parkinson's disease

This study compares the performance of Parkinsons disease patients with age-matched controls on semantic and letter-initial verbal fluency tests. An analysis of variance revealed that Parkinsonian patients showed impaired word production. However when the covariates of age, present verbal ability (Mill Hill Synonyms) and severity of depression (Geriatric Depression Screening Scale) were included in an analysis of covariance, the significant effect of Parkinsons disease on verbal fluency disappeared. Instead, age and present verbal ability were revealed to be the significant sources of between subject variation in total verbal fluency performance; results indicated that increased age and lower present verbal ability resulted in poorer performance on the verbal fluency tests. Depression score was not a significant source of between subject variation. The results are discussed in relation to those recently reported by Gurd and Ward (1989).

Impaired recall of verbal material following rupture and repair of an anterior communicating artery aneurysm

Abstract This paper presents a detailed investigation of the memory impairment suffered by a patient, ROB, following the rupture and repair of an anterior communicating artery aneurysm that damaged her left hemisphere. ROB is severely impaired on standard tests of verbal recall such as paired-associate learning and memory for prose passages. Nevertheless she performs normally on both versions of Warringtons (1984) recognition memory test, and on tests that require recall of visuo-spatial material. She also shows no evidence of confabulation. The discrepancy between recall and recognition performance persists even when attempts are made to ensure that the two types of test are equally “difficult” (cf. Calev, 1984). The impairment does not seem to be caused by inappropriate encoding strategies, since recall performance is not improved by imagery instructions or by levels of processing manipulations (Craik&Tulving, 1975). She also performs normally on implicit memory tests regardless of whether they involve...

Assessing caregiving distress: a conceptual analysis and a brief scale.

OBJECTIVES Although it is well known that informal caregiving can have negative outcomes, and is an important factor in institutionalization, there is currently no common model to assess psychological distress in caregivers. In this study, we considered the conceptualization of caregiving distress, and present a five-dimension, 17-item Caregiving Distress Scale (CDS). DESIGN The CDS was developed by administering several scales from the caregiving literature to a sample of 80 Parkinsons disease caregivers longitudinally. METHOD A total of 58 items from published questionnaires were reduced initially by a hierarchical cluster analysis, then by factor analysis. RESULTS This procedure produced five distinctive subscales - relationship distress, emotional burden, care-receiver demands, social impact, and personal cost - that also had high internal reliability. CONCLUSION The CDS is quick to administer and score, and has the potential to be used to profile an individual caregiving situation. Of critical importance for the application of findings from the caregiving literature, the scale can be used to target the type of intervention for the amelioration of caregiving distress.

Understanding memory for faces in Parkinson’s disease: the role of configural processing

It has previously been reported that unfamiliar face recognition memory is impaired in Parkinsons disease (PD) [(Dewick, H. C., Hanley, J. R., Davies, A. D. M., Playfer, J. R. & Turnbull, C. J., Perception and memory for faces in Parkinsons disease. Neuropsychologia, 1991, 29, 785-802), (Haeske-Dewick, H. C., Are perception and memory for faces influenced by a specific age at onset factor in Parkinsons disease? Neuropsychologia, 1996, 34, 315-320), (Levin, B. E., Llabre, M. M. & Weiner, W. J., Cognitive impairments associated with early Parkinsons disease. Neurology, 1989, 39, 557-561)]. In the work reported here, we consider the possible mechanisms that might underlie this impairment. 28 PD patients and 28 controls were given a two-part test of recognition memory for words and faces, and two perceptual tests to measure their configural and componential processing ability. We found that PD patients were significantly worse than controls on the recognition memory test for faces, but not when the stimuli were words. In addition, PD patients were significantly impaired relative to controls on the closure test (FCT) used to measure configural processing, but there was no difference between the two groups on a test of componential processing ability. Multiple regression analyses revealed that even after accounting for the influence of age, intelligence and level of depression, configural processing ability was the important predictor of unfamiliar face recognition memory in Parkinsons disease. There was no effect of Parkinsons disease specific variables on either face recognition or FCT performance. In addition, some recently diagnosed patients were poor at face recognition. It is suggested that face configuration skills may be affected very early in the course of Parkinsons disease, and that this may be connected to the fact that considerable nigrostriatal degeneration and alteration in brain neurotransmitter levels occur before the clinical symptoms of PD appear.

THE PERCEPTUAL MAZE TEST IN A NORMAL POPULATION.

This paper describes the performance of a panel of 540 Ss, on a perceptual maze test. Age and sex differences in performance are discussed and the relation of the test scores to other psychological measures is examined.

Remembering and knowing in a patient with preserved recognition and impaired recall

ROB is a patient who has a severe deficit in recalling recently presented verbal material following rupture and repair of an anterior communicating artery aneurysm [Hanley JR, Davies ADM, Downes J, Mayes A. Cognitive Neuropsychology 1994;11:543-78; Hanley JR, Davies ADM. In: Parkin A, editor. Case Studies in the Neuropsychology of Memory. Hillsdale, NJ: Lawrence Erlbaum, 1997. p. 111-26]. Despite this, her performance on tests of recognition memory is comfortably within the normal range. In the present series of experiments, we investigated whether or not ROBs performance on tests of recognition memory might be associated with a disproportionately large number of correct decisions made on the basis of familiarity rather than contextual retrieval [e.g. Mandler G. Psychological Review 1980;87:252-71]. Contrary to this hypothesis, the results showed that ROB made a high proportion of remember decisions relative to know decisions in recognition [cf. Gardiner JM. Memory & Cognition 1988;16:309-13] and produced a high recollection score when conscious recollection and familiarity were placed in opposition to one another [cf. Jacoby LL, Woloshyn V, Kelley C. Journal of Experimental Psychology: General 1989;118:115-25.]. ROBs recognition memory performance therefore appears to be qualitatively as well as quantitatively similar to that found in the normal population. As ROB has suffered damage to both the fornix and the anterior thalamus, the results of the present study are consistent with the claim that damage to the extended hippocampal system has a much more severe effect on recall than on recognition [Aggleton JP, Shaw C. Neuropsychologia 1996;34:51-62; Aggleton JP, Saunders RC. Memory 1997;5:49-71]. The present results provide no support, however, for the additional suggestion [Aggleton JP, Brown MW. Behavioral and Brain Sciences 1999;22:425-56.] that the extended hippocampal system is necessary for recognition memory decisions that are based on contextual retrieval.

The Pre-exposure Technique: A Novel Method for Enhancing the Effects of Imagery in Face-name Association Learning

We report the effects of stimulus pre-exposure in combination with either non-specific or imagery instructions on face-name learning in 15 memory-impaired subjects. Pre-exposure involved viewing the face alone (for 6 seconds) and making various judgements about the person depicted (e.g. honesty), prior to being shown the face-name pair for learning (for 4 seconds). When the face-name pairs were shown for 4 seconds accompanied by non-specific instructions, pre-exposure to the faces alone led to performance levels as good as when face-name pairs were shown for 10 seconds, and significantly greater performance than when the face-name pairs were shown for just 4 seconds. In line with the results of previous studies, imagery was found significantly to enhance face-name association learning, compared to non-specific instructions. However, performance was increased still further by combining imagery with pre-exposure: Under these conditions, subjects were able to remember almostdouble the number of names on the ...

Supporting the Residual Memory of a Korsakoff Patient

The memory functioning of a 31-year-old Korsakoff syndrome patient was assessed in his everyday environment and in the laboratory and a programme devised to support residual memory capacity. The patients wife was used as a monitor of input and retrieval conditions and taught how to seek situations in which her husband would be least impaired. Prompt cards and leaflets were provided for acquaintances in order to reduce the memory demands of the patients environment. Follow-up at 1 year showed that although tested memory functioning deteriorated, the patients memory support system had continued. Additionally, an experiment demonstrated that retrieval could be boosted significantly by presentation of associative cues at storage and retrieval. These findings were used to guide further change in the way the patients wife managed his memory impairments.