Does spatial locative comprehension predict landmark-based navigation?

In the present study we investigated the role of spatial locative comprehension in learning and retrieving pathways when landmarks were available and when they were absent in a sample of typically developing 6- to 11-year-old children. Our results show that the more proficient children are in understanding spatial locatives the more they are able to learn pathways, retrieve them after a delay and represent them on a map when landmarks are present in the environment. These findings suggest that spatial language is crucial when individuals rely on sequences of landmarks to drive their navigation towards a given goal but that it is not involved when navigational representations based on the geometrical shape of the environment or the coding of body movements are sufficient for memorizing and recalling short pathways

Treatment satisfaction with botulinum toxin: a comparison between blepharospasm and cervical dystonia

Bernd Leplow, Anna Eggebrecht, Johannes PohlDepartment of Psychology, Martin-Luther-University Halle-Wittenberg, Germany Background: Differential effects of botulinum toxin (BoNT) treatment in cervical dystonia (CD) and blepharospasm (BSP) treatment satisfaction and emotional responses to a life with a disabling condition were investigated. Special interest was drawn to the course within a BoNT treatment cycle and the effects of subjective well-being vs perceived intensity of motor symptoms and quality of life.Methods: A questionnaire was distributed among 372 CD patients and 125 BSP patients, recruited from 13 BoNT centers throughout Germany. Items were related to dystonic symptoms, BoNT treatment responses and treatment satisfaction, quality of life, working situation, and emotional reactions to a life with dystonia.Results: CD patients and BSP patients were widely satisfied with BoNT treatment, but treatment satisfaction worsened significantly within the treatment cycle. Especially CD patients reported that both the dystonic symptoms and the effects of BoNT treatment were influenced by emotional factors. Despite good overall treatment effects, patients from both groups perceived marked persistence of motor symptoms, restrictions of everyday life functions, and reduced quality of life. Functional amelioration of motor symptoms and emotional well-being were only moderately correlated. About 22% of patients from both groups reported mental disorders or emotional disturbances prior to the onset of dystonia.Conclusion: As numerous psychological factors determine perceived outcome, BoNT treatment should be further improved by patient’s education strategies enhancing behavioral self-control. From the patient’s perspective, individual intervals, which may avoid exacerbation between injection points, should be considered. Moreover, patients at risk, with reduced adherence and poor BoNT outcome, should be identified and addressed within psychoeducation.Keywords: cervical dystonia, blepharospasm, botulinum toxin, adherence, treatment satisfactio

Spatial information transfer from virtual to real versions of the Kiel locomotor maze.

The Kiel locomotor maze requires participants to choose five targets from among 20 locations marked by small red lights on the floor of a dimly lit circular environment having four wall-mounted extramaze cues and two intramaze cues at floor level. In the present study, acquisition of the real task was examined in 11-year-old children following prior accurate training in a virtual version, following misleading virtual training, or following no training. The virtual version was displayed on a desk-top computer monitor. Acquisition testing in the real maze was either locomotor or non-locomotor. Good transfer was achieved from virtual to real versions. Children’s exploration of the real maze prior to real maze acquisition training revealed a clear transfer of spatial information previously learned in the virtual version. Children taught the correct target configuration in the simulation made fewer errors and more rapid, confident responses to targets in the real maze than children given no training. However, acquisition was also better following misleading training than no training, suggesting that a non-specific components of performance also transferred. Male superiority was only seen following misleading training, which was interpreted in terms of male superiority in mental rotation. After acquisition, a single probe trial was performed, in which proximal cues and participants’ starting position were rotated, but this had equivalent effects on all groups’ performance. It is clear that transfer of spatial information occurs from the simulated Kiel maze to the real version. This has implications for its use in diagnosis and training

A neuropsychological test battery for Parkinson’s disease

Ringendahl H, Werheid K, Leplow B, Ellgring H, Annecke R, Emmans D. Vorschläge für eine standardisierte psychologische Diagnostik bei Parkinsonpatienten. Nervenarzt. 2000;71(12):946-954.In addition to the motor symptoms of Morbus Parkinson, a number of cognitive and emotional changes take place. The diagnosis of these concomitant symptoms has received increasing attention in research and clinical practice. Global rating scales offer economical advantages but generally do not satisfy the requirements of psychometric criteria, and they do not suffice in light of the multidimensional symptoms of the disease. Based on recent research results, recommendations from the CAPSIT protocol (Core Assessment Program for Surgical Interventional Therapies) for diagnosis of neurosurgically treated Parkinson's patients, and the restraints of everyday clinical work, we propose a standardized neuropsychological diagnostic routine. It includes diagnostic methods that are in use internationally and so timesaving and easily accessible that they can be considered suitable for routine diagnostics. Data comparison among various treatment centers can thus take place more easily. We have included only methods that differentiate well and whose test criteria offer a basis for thorough consultation as well as planning and evaluation of multidimensional therapy.Neben den motorischen Symptomen treten beim Morbus Parkinson eine Reihe kognitiver und emotionaler Veränderungen auf. Die Diagnostik dieser Begleitsymptome hat in den letzten Jahren nicht nur im Bereich der Forschung, sondern auch in der klinischen Praxis zunehmend an Bedeutung gewonnen. Globale Ratingskalen genügen trotz ihrer ökonomischen Vorteile in der Regel nicht den Anforderungen psychometrischer Testgütekriterien und werden der Multidimensionalität der Erkrankung nicht gerecht. Basierend auf dem aktuellen Stand der Forschung, den Empfehlungen des CAPSIT-Protokolls zur Diagnostik neurochirurgisch behandelter Parkinsonpatienten sowie den Erfordernissen der klinischen Praxis wird eine Testbatterie zur standardisierten neuropsychologischen Routinediagnostik vorgeschlagen. Sie umfasst diagnostische Verfahren, die zeitökonomisch, gut zugänglich und international verbreitet sind, um in der Routinediagnostik eingesetzt werden zu können und den Austausch zwischen verschiedenen Zentren zu vereinfachen. Es wurden nur Verfahren berücksichtigt, deren Differenziertheit und Testgüte Grundlage für eine fundierte Beratung sein können sowie solche, die für die Planung und Evaluation einer multidimensionalen Therapie geeignet sind

Prämorbides Intelligenzniveau als Reservefunktion bei neurokognitiven Störungen des Alters

Zu den neurokognitiven Störungen gehören auch altersassoziierte Abbauprozesse kognitiver Funktionen, die sich als leichtes demenzielles Syndrom bzw. leichte kognitive Beeinträchtigung (mild cognitive impairment, MCI) manifestieren können. Mit diesen Abbauprozessen auf der Verhaltensebene sind degenerative Prozesse auf neuronaler Ebene eng verknüpft. Wichtiger Marker der Neurodegeneration sind unteranderem extrazellulare Ablagerungen Beta-Amyloider Plaques. Jedoch wurden trotz hoher Abeta-Pathologie nicht immer entsprechende kognitive Beeinträchtigungen beobachtet. Hier wird seit längerem eine kompensatorische Wirkung der prämorbiden kognitiven Leistungsfähigkeit im Sinne einer Reservefähigkeit diskutiert. In unserer Studie wurden 140 Probanden einem umfangreichen neuropsychologischen Screening unterzogen und Blutkonzentration von Amyloid-beta (As40, As42) bestimmt. Das kognitive Leistungsniveau, insbesondere Leistungen in Lern- und Gedächtnistests, korrelierte hoch mit einer Ratio aus As40 und As42. Diese Ratio wurde schon in anderen Studien als leistungsfähiger Biomarker der Neurodegeneration identifiziert. Bedeutsam war jedoch ein Moderatoreffekt der kognitiven Reservefunktionen, insbesondere geschätzt über das prämorbide Intelligenzniveaus. Es zeigte sich, dass Personen mit niedrigem prämorbiden Niveau bereits bei geringer As40/As42-Konzentration deutliche Gedächtnisdefizite aufweisen. Personen mit höherem prämorbiden Niveau erreichen bei vergleichbaren Konzentrationen altersentsprechende Gedächtnisleistungen. Jedoch treten mit steigenden As-Konzentrationen auch bei diesen Patienten die kognitiven Defizite auf. Unsere Ergebnisse zeigen deutlich das Personen, trotz vorliegender Neuropathologie, normale kognitive Leistungen erbringen können, wenn sie über entsprechende Reservefunktionen zur Kompensation verfügen. Diese Reservefunktionen sind stark vom Bildungsgrad und Intelligenzniveau abhängig. In der Diagnostik und Frühintervention ist auf diese Patienten ein besonderes Augenmerk zurichten, da bereits gering gradige kognitive Veränderungen auf fortgeschrittene neurodegenerative Prozesse hinweisen können