Autonomic and sensory nerve dysfunction in primary biliary cirrhosis

AIM: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC). METHODS: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied. Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD). RESULTS: Fourteen of 24 patients (58%) had at least one abnormal cardiovascular reflex test and thirteen (54%) had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03) and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005; 250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01). CONCLUSION: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty-four-hour HRV analysis is more sensitive than standard cardiovascular tests for detecting of both parasympathetic and sympathetic impairments. Our novel data suggest that hyperaesthesia is a characteristic feature of peripheral sensory neuropathy and might contribute to itching in PBC. Autonomic dysfunction is related to the duration and severity of PBC

Comprehension of wh-questions in a case of mixed dementia

We investigated processing of wh-questions and declarative sentences with differing syntactic complexity in a case of mixed dementia (FA). FA was impaired in her ability to understand syntactically complex declarative sentences and syntactically complex wh-questions beginning with which but not complex who questions. This profile, novel in dementia, is similar to that reported for people with agrammatic aphasia and discerns a ‘‘fault line’’ of the language system along a syntactic/semantic paramete

Comprehension of wh-questions in a case of mixed dementia

We investigated processing of wh-questions and declarative sentences with differing syntactic complexity in a case of mixed dementia (FA). FA was impaired in her ability to understand syntactically complex declarative sentences and syntactically complex wh-questions beginning with which but not complex who questions. This profile, novel in dementia, is similar to that reported for people with agrammatic aphasia and discerns a ‘‘fault line’’ of the language system along a syntactic/semantic paramete

Fluidez verbal semántica y fonológica en una muestra de niños de Argentina

The aim of this work is to obtain data about the evolutionary pattern of performance in verbal fluency tasks for a sample of Argentinean primary school aged children (3rd, 5th y 7th grade) in semantic and phonological verbal fluency tasks. For the semantic fluency task, children were assessed in different categories: animals, fruits and vegetables, and body parts for living things domain, and means of transport, musical instruments and clothes for inanimate objects. For the phonological fluency assessment, children were tested with /f/, /a/and /s/phonemes. Both fluency tasks showed differences between grades, indicating the influence of education. Besides, irrespective of the grade, children performed better on the semantic fluency tasks. Results in the semantic fluency task also showed a better performance for the living things domain over the inanimate objects domain. Further analysis on the results showed that 3rd grade children have the worst performance, compared to 5th and 7th grade children. The results of our work are discussed taking in account cognitive mechanisms, executive functions and semantic memory development.No presente trabalho oferecemos dados de tarefas de fl uência verbal para crianças argentinas de 3°, 5° e 7 ° ano do ensino fundamental. Os participantes foram avaliados com uma tarefa de fl uência semântica, que testou as categorias de animais, frutas e legumes e partes do corpo para o domínio dos seres vivos e meios de transporte, instrumentos musicais e roupas para os objetos inanimados. As crianças também foram avaliadas com uma tarefa de fl uência fonológica que testou os fonemas /f/, /a/ e /s/. Os dados obtidos apontam para diferenças de desempenho entre as tarefas e mostraram um melhor desempenho nas de fl uência semântica. Além disso, nas tarefas de fl uência semântica os participantes tiveram um melhor desempenho no domínio dos seres vivos. Tanto para fl uência semântica quanto fonológica, as diferenças estiveram presentes quando os grupos foram comparados pelo nível de escolaridade, de modo que os alunos de 3° ano se dissociam signifi cativamente dos 5° e 7 ° anos, produzindo menor quantidade de exemplares. Os resultados são discutidos à luz de possíveis diferenças originadas no desenvolvimento cognitivo, as funções executivas e o sistema semântico.El objetivo del presente trabajo es obtener información del patrón evolutivo de desempeño en tareas de fl uidez verbal para una muestra de niños argentinos de nivel primario de 3°, 5° y 7° grado. Se evaluó a los participantes con una tarea de fl uidez semántica, en la que se evaluaron las categorías de animales, frutas y verduras, y partes del cuerpo para el dominio de seres vivos, y medios de transporte, instrumentos musicales y ropa para el de objetos inanimados. Asimismo fueron evaluados con una tarea de fl uidez fonológica en la que se testearon los fonemas /f/, /a/ y /s/. Los datos obtenidos dan cuenta de diferencias de rendimiento entre las tareas de fl uidez con un mejor desempeño en las tareas de fl uidez semántica. Asimismo, en las tareas de fl uidez semántica se observa un mejor rendimiento en el dominio de seres vivos. Las diferencias obtenidas en ambas tareas se identifi can al comparar los grupos según escolaridad, siendo únicamente los niños de 3° grado los que, con menor cantidad de ejemplares recuperados, se disocian signifi cativamente de los de 5° y 7° grado. Estos hallazgos son discutidos a la luz de posibles diferencias en función del desarrollo cognitivo, de las funciones ejecutivas y del sistema semántico.Fil: Fumagalli, Julieta Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Lingüística; ArgentinaFil: Soriano, Federico Gonzalo. Instituto de Neurociencias Cognitiva y Traslacional; ArgentinaFil: Shalóm, Diego Edgar. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Física de Buenos Aires; ArgentinaFil: Barreyro, Juan Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Martínez Cuitiño Carricaburo, María Macarena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentin

Category deficits and paradoxical dissociations in Alzheimer's disease and Herpes Simplex Hencephalitis

Most studies examining category specificity are single-case studies of patients with living or non living deficits. Nevertheless, no explicit or agreed criteria exist for establishing category-specific deficits in single-cases regarding the type of analyses, whether to compare with healthy controls, the number of tasks, or the type of tasks. We examined to groups of patients with neurological pathology frequently accompained with impaired semantic memory (19 patients with Alzheimer disease and 15 with Herpes Simplex Encephalitis). Category knowledge was examined using three tasks (picture naming, naming-to-description and features verification). Both patients groups were compared with aged- and education- matched healthy controls. The profile of each patients was examined for consistency across tasks and across different analyses; however both prove to be inconsistent. One striking findings was the presence of a paradoxical dissociation ( i.e., patients who were impaired on living things on one task and non living things on another task). The findings have significant implication for how we determine category effects and, more generall for the methods use to document double dissociation across individual cases in this literature

LINGUISTIC PERFORMANCE IN TYPICAL COGNITIVE AGING AND DEMENTIA

The paper discusses studies on language in typical cognitive aging and dementia conducted on English language processing. For the most part, the studies on language in aging and dementia presented in the paper have been done with speakers of English. We describe language comprehension and production of two groups— typically aging individuals and individuals with dementia. We provide between- group comparisons with regard to language comprehension and production and point out different levels of impairment affecting comprehension and production. Moreover, taking the findings of the studies into account, which observe language impairments as secondary to motoric, although they may constitute early markers of an undiagnosed condition (Kemper et al. 1995), it is tentatively proposed that content and function words need to be given special attention in analysing language comprehension and language production, respectively. At the same time, cognitive reserve through language learning and in the case of bilingual and multilingual speakers is proposed as a strategy to delay the onset of dementia (De Bot & Maconi, 2005). Finally, we discuss elderspeak and its impact on the quality of life of typically aging individuals and individuals with dementia