Motoichiro Kato

Errorless and effortful processes involved in the learning of face-name associations by patients with alcoholic Korsakoff's syndrome

In Experiment 1, Korsakoff patients were asked to learn fictitious face-name associations under each of four study conditions that differed from one another in the error and effort required to fulfil the task demands. Recall performance gradually improved over four training sessions and was affected by the error factor. The paired associate and the vanishing cues methods led to superior recall in comparison with the target selection and the initial letter methods, demonstrating an advantage of errorless learning. In contrast, the effort factor was found to have little effect. In Experiment 2, the effectiveness of the vanishing cues method was further examined over five additional training sessions. As indexed by a delayed test, the gradual acquisition of face-name associations was confirmed, but some patients consistently made no correct recall throughout the sessions. The roles of error and effort in the memory rehabilitation of amnesic patients are discussed.

Wisconsin card sorting test in children with temporal lobe epilepsy

To search for the origin of frontal lobe dysfunction identified by the Wisconsin card sorting test (WCST) in temporal lobe epilepsy (TLE) patients, we investigated the WCST performance among 19 children with TLE (with hippocampal atrophy (HA group N=12), without structural lesions (NSL group N=7)), 15 patients with frontal lobe epilepsy (FLE group), and age-matched normal controls (N group). The paired verbal association learning test (PVALT) and Benton visual retention test (BVRT) were also performed. HA group and FLE groups achieved significantly fewer categories and demonstrated more perseverative errors on the WCST than NSL and N groups. In addition, category achievement in WCST showed significant inverse correlation to age at the initial status convulsivus in the HA group (P<0.05). The achievement on PVALT and BVRT did not show any significant differences between HA and FLE groups (P>0.05). Thus, the frontal lobe dysfunction in the HA group is found to exist as early as 7 years old, when they seem to have only a short seizure history or to receive a little electrical interference from the temporal lobe focus to the frontal region. These facts would underscore the importance of prefrontal dysfunction persisting from the early insults and only becoming apparent after maturation of the prefrontal region in patients with mesial TLE.

Corticobasal degeneration presenting with nonfluent primary progressive aphasia: a clinicopathological study

A 62-year-old woman initially presented with slowly progressive nonfluent aphasia with minimal intellectual involvement. Echolalia and personality change were prominent whereas parkinsonian features and signs suggesting parietal lobe dysfunctions were not present. The patients language deficit was consistent with transcortical motor aphasia. She did not manifest extrapyramidal signs. The patient was diagnosed as having Picks disease or frontal lobe dementia. She died at age 65, 2 years and 9 months following disease onset. Neuropathological findings including cytoskeletal abnormalities, however, were clearly distinct from those of classical Picks disease and were consistent with those reported in corticobasal degeneration (CBD). The distribution of her cortical lesions was accentuated in the frontal language-related area. The clinical manifestations in CBD are diverse, and primary progressive nonfluent aphasia should be considered as an initial symptom of CBD. Neuropathological examination of such patients should include cytoskeletal abnormality studies.

Public attitudes towards the mentally ill : A cross-cultural study between Bali and Tokyo

Abstract The present study investigates the differences in public attitudes towards the mentally ill in Bali (Indonesia) and Tokyo (Japan), the former being a non‐industrialized society and the latter an industrialized society in Asia. Seventy‐seven residents of Bali and 66 residents from Tokyo were examined by a devaluation‐discrimination measure and a self‐assessment questionnaire to gauge their reactions to five imaginary case study vignettes consisting of three cases of schizophrenia, one case of a depressive episode, and one case of obsessive–compulsive disorder. Balinese respondents had significantly lower devaluation‐discrimination measure scores, indicating a more favorable global attitude towards persons with a history of psychiatric treatment than did respondents in Tokyo. However, the extent to which people were prejudicial against mental patients in the two societies varied with the kinds of mental disorders, with Balinese having a more positive attitude to schizophrenics but more negative to depressive and obsessive– compulsive patients.

Memory for subject performed tasks in patients with Korsakoff syndrome.

We examined the ability of alcoholic Korsakoff patients to remember verbal and action-related information. Eight Korsakoff patients and eight alcoholic control subjects learned action phrases in either subject-performed tasks (SPTs) or verbal tasks (VTs). Free recall and recognition tests were then administered. Despite the severe anterograde amnesia observed in Korsakoff patients for VTs, their memory performance for SPTs was similarly facilitated over VTs as was the case with alcoholic controls. Domains preserved in this amnesic syndrome may account for the benefit seen when using SPTs in Korsakoff patients. The therapeutic utilization of action events for memory rehabilitation is discussed.

Magnetoencephalography study of right parietal lobe dysfunction of the evoked mirror neuron system in antipsychotic-free schizophrenia.

Introduction Patients with schizophrenia commonly exhibit deficits of non-verbal communication in social contexts, which may be related to cognitive dysfunction that impairs recognition of biological motion. Although perception of biological motion is known to be mediated by the mirror neuron system, there have been few empirical studies of this system in patients with schizophrenia. Methods Using magnetoencephalography, we examined whether antipsychotic-free schizophrenia patients displayed mirror neuron system dysfunction during observation of biological motion (jaw movement of another individual). Results Compared with normal controls, the patients with schizophrenia had fewer components of both the waveform and equivalent current dipole, suggesting aberrant brain activity resulting from dysfunction of the right inferior parietal cortex. They also lacked the changes of alpha band and gamma band oscillation seen in normal controls, and had weaker phase-locking factors and gamma-synchronization predominantly in right parietal cortex. Conclusions Our findings demonstrate that untreated patients with schizophrenia exhibit aberrant mirror neuron system function based on the right inferior parietal cortex, which is characterized by dysfunction of gamma-synchronization in the right parietal lobe during observation of biological motion.

Outcome of schizophrenia in a non-industrialized society: Comparative study between Bali and Tokyo

Objective: The aim of the present study was to contrast the outcome of schizophrenic patients between Bali and Tokyo, the former being a non‐industrialized society and the latter an industrialized society in Asia. Method: A total of 51 Balinese schizophrenics and 40 schizophrenics in Tokyo were evaluated by five outcome measures at a 5‐year follow‐up. Results: No significant difference was found in the mean scores of the Positive and Negative Syndrome Scale, Egumas Social Adjustment Scale and the re‐admission rates between the subjects in the two sites. The cumulative length of stay in hospital during the 5‐year period was significantly shorter in Bali. The percentage of subjects on psychiatric medication at the follow‐up was significantly lower in Bali than that in Tokyo. Conclusion: Although the clinical outcome of schizophrenics in Bali was not superior to that in Tokyo, the subjects in Bali tended to be able to live in society without neuroleptic medication.

Apolipoprotein E ε4 allele distribution in Wernicke-Korsakoff syndrome with or without global intellectual deficits

SummaryRecent genetic studies show that the apolipoprotein E (ApoE) ɛ4 allele is a risk factor for Alzheimers disease (AD). Whether this allele is associated with other dementing diseases is the next important question. The information could provide a clue to the pathogenetic role of ApoE. In the present study, patients with Wernicke-Korsakoff syndrome (WKS) of alcoholic etiology were divided into two groups according to the severity of intellectual deficits, i.e., those of “classical” Korsakoff patients with preserved intellectual function other than amnesia and those with global intellectual deficits. Genotyping showed that the frequency of ApoE ɛ4 allele was significantly higher in the patients with global deficits, suggesting the involvement of this allele in the intellectual decline of WKS. In contrast, distributions of other two markers, α1-antichymotrypsin and presenilin-1, did not differ between the two groups. These results added further support to the notion that the consequence of acute insult to the brain is influenced by the ApoE genotype, and suggested ApoEs role in the development of a certain group of “alcoholic dementia.”

Dry eye and Meige's syndrome

AIMS To determine the relation between dry eye and Meige’s syndrome. METHODS 325 patients with dry eye were divided into those responsive to topical and other forms of treatment (n=276) and those who were not (n=49). A neuropsychiatric examination was performed to check for Meige’s syndrome in the latter group. RESULTS Twenty eight (57%) of the treatment unresponsive patients were diagnosed with Meige’s syndrome. CONCLUSIONS There is a subgroup of patients with dry eye who do not respond to simple therapy. More than half of these patients have Meige’s syndrome and need psychiatric, as well as ophthalmic, care.

Activation of right insular cortex during imaginary speech articulation.

Human speech articulation is a complex process controlled by a form of ‘programming’ implemented in the brain. Analysis of speech articulation using neuroimaging techniques is difficult, however, because motor noise is time-locked to the articulatory events. The current magnetoencephalography study, in which 12 participants were required to imagine vocalizing a phonogram after a visual cue, was designed to visualize the prearticulatory ‘automatic’ processes corresponding to the motor initiation. Magnetic activity correlating with the preparation for articulation occurred in the insular cortices at about 160u2009ms after the visual cue, and had a relative dominance in the right hemisphere. This suggests that motor control of speech proceeds from the insular regions, although the ‘automatic’ nature of our task might have led to the observed right-sided dominance.