A new clinical tool for assessing numerical abilities in neurological diseases: numerical activities of daily living

The aim of this study was to build an instrument, the numerical activities of daily living (NADL), designed to identify the specific impairments in numerical functions that may cause problems in everyday life. These impairments go beyond what can be inferred from the available scales evaluating activities of daily living in general, and are not adequately captured by measures of the general deterioration of cognitive functions as assessed by standard clinical instruments like the MMSE and MoCA. We assessed a control group (n = 148) and a patient group affected by a wide variety of neurological conditions (n = 175), with NADL along with IADL, MMSE, and MoCA. The NADL battery was found to have satisfactory construct validity and reliability, across a wide age range. This enabled us to calculate appropriate criteria for impairment that took into account age and education. It was found that neurological patients tended to overestimate their abilities as compared to the judgment made by their caregivers, assessed with objective tests of numerical abilities

現代朝鮮語の特殊助詞‘-도’について

Objective: Here we report an investigation on the accuracy of the b Test, a measure to identify malingering of cognitive symptoms, in detecting malingerers of mild cognitive impairment. Method: Three groups of participants, patients with Mild Neurocognitive Disorder (n=21), healthy elders (controls, n=21) and healthy elders instructed to simulate mild cognitive disorder (malingerers, n=21) were administered two background neuropsychological tests (MMSE, FAB) as well as the b Test. Results: Malingerers performed significantly worse on all error scores as compared to patients and controls, and scored poorly than controls, but comparably to patients, on the time score. Patients scored significantly worse than controls on all scores, but both groups showed the same pattern of more omission than commission errors. By contrast, malingerers exhibited the opposite pattern with more commission errors than omission errors. Machine Learning models achieve an overall accuracy higher than 90% in distinguishing patients from malingerers on the basis of b Test results alone. Conclusions: our findings suggest that b Test error scores accurately distinguish patients with Mild Neurocognitive Disorder from malingerers and may complement other validated procedures such as the Medical Symptom Validity Test

Combined duloxetine and benzodiazepine-induced visual hallucinations in prodromal dementia with Lewy bodies

Objective: We describe a patient with prodromal dementia with Lewy bodies (DLB) presenting with drug-induced visual hallucinations (VHs). Case report: A 78-year-old woman complained of daytime recurrent VHs characterized by seeing her face and arms covered in fur and viewing moustaches on her daughter's face. VHs started a few days after the beginning of a combination therapy with duloxetine and lorazepam and ceased within 24 h after their discontinuation. Nonamnestic mild cognitive impairment with profound visual perception deficits and very mild extrapyramidal signs, with abnormal brain DaTscan single photon emission tomography, were present. Three years later, cognitive and neurological follow-up assessments supported the diagnosis of DLB. Conclusion: Perturbation of cerebral serotonergic tone induced by duloxetine, associated with reduced attentional control due to benzodiazepine use, may be the physiopathological substrate of transient VHs in prodromal DL