Vessela Stamenova

Brain injury in a forensic psychiatry population

Objectives: The prevalence and profile of adults with a history of traumatic brain injury (TBI) has not been studied in large North American forensic mental health populations. This study investigated how adults with a documented history of TBI differed with the non-TBI forensic population with respect to demographics, psychiatric diagnoses and history of offences. Method: A retrospective chart review of all consecutive admissions to a forensic psychiatry programme in Toronto, Canada was conducted. Information on history of TBI, psychiatric diagnoses, living environments and types of criminal offences were obtained from medical records. Results: History of TBI was ascertained in 23% of 394 eligible patient records. Compared to those without a documented history of TBI, persons with this history were less likely to be diagnosed with schizophrenia but more likely to have alcohol/substance abuse disorder. There were also differences observed with respect to offence profiles. Conclusions: This study provides evidence to support routine screening for a history of TBI in forensic psychiatry.

Associations and dissociations of transitive and intransitive gestures in left and right hemisphere stroke patients.

The study investigated performance on pantomime and imitation of transitive and intransitive gestures in 80 stroke patients, 42 with left (LHD) and 38 with right (RHD) hemisphere damage. Patients were also categorized in two groups based on the time that has elapsed between their stroke and the apraxia assessment: acute-subacute (n=42) and chronic (n=38). In addition, patterns of performance in apraxia were examined. We expected that acute-subacute patients would be more impaired than chronic patients and that LHD patients would be more impaired than RHD patients, relative to controls. The hemisphere prediction was confirmed, replicating previous findings. The frequency of apraxia was also higher in all LHD time post-stroke groups. The most common impairment after LHD was impairment in both pantomime and imitation in both transitive and intransitive gestures. Selective deficits in imitation were more frequent after RHD for transitive gestures but for intransitive gestures they were more frequent after LHD. Patients were more impaired on imitation than pantomime, relative to controls. In addition, after looking at both gesture types concurrently, we have described cases of patients who suffered deficits in pantomime of intransitive gestures with preserved performance on transitive gestures. Such cases show that the right hemisphere may be in some cases critical for the successful pantomime of intransitive gestures and the neural networks subserving them may be distinct. Chronic patients were also less impaired than acute-subacute patients, even though the difference did not reach significance. A longitudinal study is needed to examine the recovery patterns in both LHD and RHD patients.

Limb apraxia in corticobasal syndrome

Corticobasal syndrome (CBS) is a progressive neurodegenerative disorder with asymmetric presentation and course characterized by degeneration of basal ganglia and cortical structures. Limb apraxia is a commonly observed deficit in CBS. Few studies have examined comprehensively the nature of deficits in limb apraxia. The goal of our study was to investigate the severity of deficits in various conceptual and gesture production task modalities. CBS patients were divided in two groups based on the side of brain that was initially affected by the disease. Ten patients with right hemisphere presentation (RHP) and seven with left hemisphere presentation (LHP) were included. The results showed that while selective conceptual tasks deficits were present in both groups, the overall picture suggests preserved conceptual representations of tools and actions in CBS patients with either LHP or RHP. Both groups were impaired relative to controls on gesture production tasks. Performance on transitive gestures was more severely affected in both groups than intransitive gestures. Imitation was more severely affected than pantomime, suggesting deficits in visuomotor transformations. The addition of verbal cuing during concurrent imitation affected only the LHP patients, rendering them more impaired relative to controls in their imitation with verbal cuing as opposed to their imitation only performance. Imitation of non-representational gestures was least accurate and intransitive gestures were most accurate. Patients were more severely impaired relative to controls when holding the object and when they were shown pictures of tools to pantomime.

A Model-Based Approach to Understanding Apraxia in Corticobasal Syndrome

Limb apraxia is a neurological disorder of higher cognitive function characterized by an inability to perform purposeful skilled movements and not attributable to an elementary sensorimotor dysfunction or comprehension difficulty. Corticobasal Syndrome (CBS) is an akinetic rigid syndrome with asymmetric onset and progression with at least one basal ganglia feature (rigidity, limb dystonia or myoclonus) and one cortical feature (limb apraxia, alien hand syndrome or cortical sensory loss). Even though limb apraxia is highly prevalent in CBS (70–80%), very few studies have examined the performance of CBS patients on praxis measures in detail. This review aims to (1) briefly summarize the clinical, neuroanatomical and pathological findings in CBS, (2) briefly outline what limb apraxia is and how it is assessed, (3) to comprehensively review the literature on limb apraxia in CBS to date and (4) to briefly summarize the literature on other forms of apraxia, such as limb-kinetic apraxia and buccofacial apraxia. Overall, the goal of the review is to bring a model-based perspective to the findings available in the literature to date on limb apraxia in CBS.

A model-based approach to long-term recovery of limb apraxia after stroke

Limb apraxia is a disorder affecting performance of gestures on verbal command (pantomime), on imitation, and/or in tool and action recognition. We aimed to examine recovery on tasks assessing both conceptual and production aspects of limb praxis in left (n = 22) and right (n = 15) stroke patients. Patients were assessed longitudinally on four conceptual tasks (action identification, tool naming by action, tool identification, and tool naming) and five production tasks (pantomime, pantomime by picture, concurrent imitation, delayed imitation, and tool use). They were grouped as impaired or not relative to the performance of a control sample (n = 27) and as acute‐subacute (first assessment within 3 months post stroke) or chronic (over 3 months post stroke). Hierarchical linear modeling was used to analyze the data. Acute–subacute and chronic patients had similar average performance. All tasks, except action identification, showed evidence of recovery in both acute and chronic impaired patients. A faster rate of recovery among acute–subacute patients was observed only in the two pantomime tasks (action identification and tool identification were not compared on this factor).

Training recollection in healthy older adults: clear improvements on the training task, but little evidence of transfer

Normal aging holds negative consequences for memory, in particular for the ability to recollect the precise details of an experience. With this in mind, Jennings and Jacoby (2003) developed a recollection training method using a single-probe recognition memory paradigm in which new items (i.e., foils) were repeated during the test phase at increasingly long intervals. In previous reports, this method has appeared to improve older adults’ performance on several non-trained cognitive tasks. We aimed to further examine potential transfer effects of this training paradigm and to determine which cognitive functions might predict training gains. Fifty-one older adults were assigned to either recollection training (n = 30) or an active control condition (n = 21) for six sessions over 2 weeks. Afterward, the recollection training group showed a greatly enhanced ability to reject the repeated foils. Surprisingly, however, the training and the control groups improved to the same degree in recognition accuracy (d′) on their respective training tasks. Further, despite the recollection group’s significant improvement in rejecting the repeated foils, we observed little evidence of transfer to non-trained tasks (including a temporal source memory test). Younger age and higher baseline scores on a measure of global cognitive function (as measured by the Montreal Cognitive Assessment tool) and working memory (as measured by Digit Span Backward) predicted gains made by the recollection training group members.

Limb Apraxia: Types, Neural Correlates, and Implications for Clinical Assessment and Function in Daily Living

Apraxia is a neurological disorder of learned movements that cannot be explained on the basis of deficits in basic sensory or motor functions, verbal comprehension, or recognition of tools or objects [1]. While apraxia frequently arises in concert with other impairments such as ataxia, aphasia, and dementia in conditions such as stroke and Alzheimer’s disease, apraxia can be dissociated from these deficits. Apraxia most often arises from left hemisphere damage (LHD) but can also occur with right hemisphere damage (RHD), with incidences ranging between 28–57 % for LHD and 0–34 % for RHD [2].

The impact of dementia on apraxia and function in daily living

living Richard Painter , Geneviève Desmarais , Vessela Stamenova , Eric A. Roy , Norman W. Park , David A. Gold , Sabrina Lombardi d a Department of Psychology, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ont., Canada N2L 3C5 b Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ont., Canada N2L 3G1 c Graduate Department of Rehabilitation Science, University of Toronto, 500 University Avenue, Toronto, Ont., Canada M5G 1V7 d York University, 4700 Keele Street, Toronto, Ont., Canada M3J 1P3 E-mail address: pain5010@wlu.ca (S. Lombardi)

Gesture imitation in stroke: Analysis of two routes to action

People tend to show the left cheek when posing for a portrait. This effect has been observed in paintings and photographs across a variety of settings, but recent evidence suggests that advertisements do not exhibit this leftward bias, instead demonstrating a rightward bias. McManus and Humphrey demonstrated that leftward biases in portraiture were stronger when the image displayed both a person’s face and body. However, recent studies of posing biases in advertising have only included facial images. The present experiment examines whether the posing bias observed in advertising is dependent on whether a person’s body is visible in the image. The sample of 2613 images was drawn from magazines that were targeted at various audiences. When examining the sex of the model separately, a significant leftward posing bias was shown for female models with the body to the waist included in the image, t(382) = 2.323, p = .021. When images of female models showed the face as well as the body, a leftward bias appeared 44% of the time. For images showing only the model’s face, the leftward bias disappeared. This provides support for McManus and Humphrey’s hypothesis that the presence of the body in the image influences posing bias.

Disentangling indirect (semantic) and direct (visual-motor) routes to action in Corticobasal Syndrome

Neuropsychological correlates of trait impulsiveness, sociotropy and autonomy in healthy college students Ashley E. Sprague , Robert D. Pietrzak , Peter J. Snyder a,b a Department of Psychology, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06447, USA b Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06250-7900, USA E-mail address: rhpietrzak@gmail.com (R.D. Pietrzak)