Sebastiano Lorusso

Cognitive impairment in motor neuron disease.

ABSTRACT – A systematic investigation of the cognitive functions of 22 patients affected with motor neuron disease (MND) compared to 36 controls matched for age and education was performed. The MND group showed cognitive performances slightly but significantly lower than the control group; 6 MND patients, however, had decidedly pathological values. Cognitive impairment was stereotyped and global, with sparing of memory. There was no significant difference between patients with isolated involvement of the lower motor neuron and those with associated pyramidal involvement. Our neuropsychological findings are in agreement with previous clinical, neuroradiological and pathological reports indicating extra‐motor cerebral involvement in MND.

Neuropsychological, electroencephalogram and brain computed tomography findings in motor neuron disease.

Thirty-five patients affected with sporadic motor neuron disease (MND) and without clinically evident mental deterioration were systematically investigated by means of neuropsychological tests, quantitative analysis of EEG and brain CT. The MND patients as a group showed a slight but definite and stereotyped cognitive impairment. Temporal slow EEG activity was increased in the whole MND group and posterior background activity was slower in the more cognitively impaired patients. No significant differences were found in CT measurements of brain atrophy between MND and controls.

Epilepsy presenting as memory disturbances.

Summary: Six patients presented with severe adult‐onset memory deficit that was subsequently diagnosed as complex partial epilepsy. In three cases acute amnestic episodes also occurred. The seizures were characterized by short losses of contact and oral automatisms. Interictal EEG showed temporal abnormalities of varying degrees. Formal neuropsychological assessment revealed dissociation between the subjective complaint and the test performances that showed a selective impairment in a few long‐term verbal memory tests. These patients present a characteristic clinical picture of memory disturbance as the prominent feature of partial seizures.

Cognitive effects of valproate

The effects of valproate on cognition are usually considered to be minimal, but few formal neuropsychological studies are available. We studied the psychomotor performances of 20 seizure-free epileptics during fixed valproate monotherapy and after its withdrawal. Our findings suggest some adverse effects of valproate which appear to be completely reversible after withdrawal.

Neuropsychological assessment of mental deterioration: purpose of a brief battery and a probabilistic definition of “normality” and “non‐normality”

ABSTRACT A brief battery for mental deterioration assessment was obtained by Discriminant Analysis techniques from the Mental Deterioration Battery (MDB) (1) and yielded 98 % correct classifications in a sample of 60 subjects (30 pathological and 30 controls). This battery, named Brief Mental Deterioration Battery (BMDB), both quick and easy to administer, is composed of four tests: Reys 15 Words Test, Immediate Visual Memory, Barrage, and Simple Analogies Test. MDB was administered to a further sample of 60 normal subjects and, by multivariate statistical techniques, a probabilistic definition of “normality” and consequently of “non‐normality” was given. When applied to pathological and control groups, this probabilistic dichotomic classification yielded groups almost identical to the previous ones.

Transient Global Amnesia: Neuropsychological Findings after Single and Multiple Attacks

We examined by neuropsychological tests 41 patients who had presented attacks of transient global amnesia (TGA; 31 had single and 10 multiple episodes), comparing them with 41 matched normal controls. Patients with single attacks showed only two impaired memory tasks with respect to controls (immediate and long-term verbal memory), while patients with multiple attacks showed more impaired tasks in memory and visuoperceptual ability. These data confirm that TGA is a benign syndrome, but could leave a few subclinical memory deficits probably exacerbated by repeated attacks.

Withdrawal of phenobarbital and carbamazepine in epileptic patients: a preliminary neuropsychological report.

ABSTRACT We systematically investigated the neuropsychological effects of controlled withdrawal of antiepileptic therapy with a battery of tests exploring intelligence, vigilance, attention, memory and sensori‐motor performance. 16 patients without seizures for at least 2 years, 9 on therapy with phenobarbital (PB) and 7 with carbamazepine (CBZ), were examined 4 times over a period of 21 months. No significant correlation was found between drug levels and performance in the tests. The slight differences found between the PB and CBZ groups at full doses disappeared completely one year after withdrawal.

Cognitive effects of phenytoin during monotherapy and after withdrawal

ABSTRACT— We studied the psychomotor performance of 10 seizure‐free epileptics during a fixed monotherapy with phenytoin and after its withdrawal. Our findings suggests some adverse effects of phenytoin which seem reversible after withdrawal.

Asymptomatic large arachnoid cyst of the middle cranial fossa. A clinical and neuropsychological study

The authors studied a 26-year-old healthy subject in whom a large arachnoid cyst of the right middle cranial fossa was revealed by chance. As there were no subjective or objective neurological findings, we checked the existence of any neuropsychological impairment. In spite of this, the patient obtained a good general performance level and sometimes the hemisphere containing the cyst performed better, in accordance with the patients handedness.

Value of clinical data and neuropsychological measures in probable Alzheimer's disease

We examined retrospectively 60 probable Alzheimers disease (AD) outpatients, 30 with early onset (EOP) and 30 with late onset (LOP), divided into two groups on the basis of illness duration (within 2 years (P<2) and over 2 years (P>2)), compared with 60 normal controls (NC). We employed a battery of neuropsychological tests including the mini mental state examination (MMSE) and our brief mental deterioration battery (BMDB), computerized psychomotor performance tests and staging of functional impairment. EOP were worse than LOP in verbal fluency and in functional impairment, being better only in Reys long-term verbal memory (RLT). P>2 were more compromised than P<2 in functional impairment, MMSE, personal and temporal orientation and RLT. Our BMDB showed the highest accuracy in classifying probably AD patients, whereas, MMSE had a high specificity but poor sensitivity as well as psychomotor performance tasks. In conclusion, AD patients with early onset, having a worse functional impairment, appear to be an eligible group to evaluate possible changes in response to antidementia treatment.