The Edinburgh cognitive and behavioral amyotrophic lateral sclerosis screen (ECAS):Sensitivity in differentiating between ALS and Alzheimer's disease in a Greek population

International audienceObjectives: (1) Adapt the ECAS into Greek, validate it in ALS patients and compare with the ALS-CBS. (2) Determine the sensitivity and specificity of ECAS in the differentiation between AD and non-demented ALS patients as compared with the ACE-III and mini-ACE. Methods: ALS patients (n = 28) were recruited and AD patients (n = 26) were matched in age, sex, and education with ALS patients (n = 24). The normative data were derived from a random sample of controls (n = 52). Bayes correlation analysis was conducted to examine convergent validity. Bayes t-test was performed to assess between groups’ differences. Receiver operating characteristics (ROC) curve analyses and area under the curve (AUC) were implemented to appraise the sensitivity and specificity in the differentiation between the AD and non-demented ALS patients. Results: The ECAS and its sub-scores in addition to the behavior interview demonstrated robust correlations with the ALS-CBS. Impairment in language and verbal fluency were the most prominent deficits in the ALS patients. The most frequently reported change was apathy. The ROC analysis demonstrated that the ECAS-ALS nonspecific score (comprising memory and visuospatial domains) is the most sensitive and specific in differentiating the AD from ALS patients. The other measures expressed high sensitivity, yet a poor specificity. Conclusions: The ECAS is a multi-purpose screening tool. The ECAS-ALS specific appraises the whole spectrum of the highly prevalent cognitive impairments in ALS. The ECAS-ALS nonspecific (memory and visuospatial) is a sensitive score to detect AD related deficits and is able to differentiate the AD from the non-demented ALS patients better than the ACE-III and mini-ACE

Syntactic predictions and asyntactic comprehension in aphasia: Evidence from scope relations

People with aphasia (PWA) often fail to understand syntactically complex sentences. This phenomenon has been described as asyntactic comprehension and has been explored in various studies cross-linguistically in the past decades. However, until now there has been no consensus among researchers as to the nature of sentence comprehension failures in aphasia. Impaired representations accounts ascribe comprehension deficits to loss of syntactic knowledge, whereas processing/resource reduction accounts assume that PWA are unable to use syntactic knowledge in comprehension due to resource limitation resulting from the brain damage. The aim of this paper is to use independently motivated psycholinguistic models of sentence processing to test a variant of the processing/resource reduction accounts that we dub the Complexity Threshold Hypothesis. According to this hypothesis, PWA are capable of building well-formed syntactic representations, but, because their resources for language processing are limited, their syntactic parser fails when processing complexity exceeds a certain threshold. The source of complexity investigated in the experiments reported in this paper is syntactic prediction. We conducted two experiments involving comprehension of sentences with different types of syntactic dependencies, namely dependencies that do not require syntactic prediction (i.e. unpredictable dependencies in sentences that require Quantifier Raising) and dependencies whose resolution requires syntactic predictions at an early stage of processing based on syntactic cues (i.e. predictable dependencies in movement-derived sentences). In line with the predictions of the Complexity Threshold Hypothesis, the results show that the agrammatic patients that participated in this study had no difficulties comprehending sentences with the former type of dependencies, whereas their comprehension of sentences with the latter type of dependencies was impaired

A biophysical model of decision making in an antisaccade task through variable climbing activity

We present a biophysical model of saccade initiation based on competitive integration of planned and reactive cortical saccade decision signals in the intermediate layer of the superior colliculus. In the model, the variable slopes of the climbing activities of the input cortical decision signals are produced from variability in the conductances of Na+, K+, Ca2+ activated K+, NMDA and GABA currents. These cortical decision signals are integrated in the activities of buildup neurons in the intermediate layer of the superior colliculus, whose activities grow nonlinearly towards a preset criterion level. When the level is crossed, a movement is initiated. The resultant model reproduces the unimodal distributions of saccade reaction times (SRTs) for correct antisaccades and erroneous prosaccades as well as the variability of SRTs (ranging from 80ms to 600ms) and the overall 25% of erroneous prosaccade responses in a large sample of 2006 young men performing an antisaccade task

Why is it difficult to predict language impairment and outcome in patients with aphasia after stroke?

One of the most devastating consequences of stroke is aphasia. Communication problems after stroke can severely impair the patient's quality of life and make even simple everyday tasks challenging. Despite intense research in the field of aphasiology, the type of language impairment has not yet been localized and correlated with brain damage, making it difficult to predict the language outcome for stroke patients with aphasia. Our primary objective is to present the available evidence that highlights the difficulties of predicting language impairment after stroke. The different levels of complexity involved in predicting the lesion site from language impairment and ultimately predicting the long-term outcome in stroke patients with aphasia were explored. Future directions and potential implications for research and clinical practice are highlighted

Verbal memory and sentence comprehension in aphasia: a case series

This case series explores the relationship between verbal memory capacity and sentence comprehension in four patients with aphasia. Two sentence comprehension tasks showed that two patients, P1 and P2, had impaired syntactic comprehension, whereas P3 and P4’s sentence comprehension was intact. The memory assessment tasks showed that P1 and P2 had severely impaired short-term memory, whereas P3 and P4 performed within the normal range in the short-term memory tasks. This finding suggests an association between short-term memory deficit and sentence comprehension difficulties. P1 and P3 exhibited impaired comparable working memory deficits, suggesting a dissociation between working memory and sentence comprehension

Motor neuronopathy with dropped hands and downbeat nystagmus: A distinctive disorder? A case report

BACKGROUND: Eye movements are clinically normal in most patients with motor neuron disorders until late in the disease course. Rare patients are reported to show slow vertical saccades, impaired smooth pursuit, and gaze-evoked nystagmus. We report clinical and oculomotor findings in three patients with motor neuronopathy and downbeat nystagmus, a classic sign of vestibulocerebellar disease. CASE PRESENTATION: All patients had clinical and electrodiagnostic features of anterior horn cell disease. Involvement of finger and wrist extensors predominated, causing finger and wrist drop. Bulbar or respiratory dysfunction did not occur. All three had clinically evident downbeat nystagmus worse on lateral and downgaze, confirmed on eye movement recordings using the magnetic search coil technique in two patients. Additional oculomotor findings included alternating skew deviation and intermittent horizontal saccadic oscillations, in one patient each. One patient had mild cerebellar atrophy, while the other two had no cerebellar or brainstem abnormality on neuroimaging. The disorder is slowly progressive, with survival up to 30 years from the time of onset. CONCLUSION: The combination of motor neuronopathy, characterized by early and prominent wrist and finger extensor weakness, and downbeat nystagmus with or without other cerebellar eye movement abnormalities may represent a novel motor neuron syndrome

No evidence for a saccadic range effect for visually guided and memory-guided saccades in simple saccade-targeting tasks

International audienceSaccades to single targets in peripheral vision are typically characterized by an undershoot bias. Putting this bias to a test, Kapoula [1] used a paradigm in which observers were presented with two different sets of target eccentricities that partially overlapped each other. Her data were suggestive of a saccadic range effect (SRE): There was a tendency for saccades to overshoot close targets and undershoot far targets in a block, suggesting that there was a response bias towards the center of eccentricities in a given block. Our Experiment 1 was a close replication of the original study by Kapoula [1]. In addition, we tested whether the SRE is sensitive to top-down requirements associated with the task, and we also varied the target presentation duration. In Experiments 1 and 2, we expected to replicate the SRE for a visual discrimination task. The simple visual saccade-targeting task in Experiment 3, entailing minimal top-down influence, was expected to elicit a weaker SRE. Voluntary saccades to remembered target locations in Experiment 3 were expected to elicit the strongest SRE. Contrary to these predictions, we did not observe a SRE in any of the tasks. Our findings complement the results reported by Gillen et al. [2] who failed to find the effect in a saccade-targeting task with a very brief target presentation. Together, these results suggest that unlike arm movements, saccadic eye movements are not biased towards making saccades of a constant, optimal amplitude for the task