Neuropsychological assessment in patients with multiple sclerosis

Multiple Sclerosis (MS) is one of the most common neurological diseases and disabling in young adults, who often have cognitive dysfunction.The authors of this paper proposes to assess neuropsychological functions most affected in a group of MS patients and compares them with a group of healthy people.This study consists of two groups: the group of patients with definite diagnosis of MS (n = 31) and the control group (n = 15). Data collection is done through a questionnaire sociodemographic and clinical data and a battery of neuropsychological assessment (Luria Nebraska Neuropsychological Battery). Data analysis is performed using the program SigmaStat.The results show that the group of MS patients compared with the control group presented a significantly lower performance at various scales, and also indicate that in this patient group, there is no relationship between cognitive functioning and duration of disease (as noted in several studies).This work also indicates a strong diagnostic validity of the Luria Nebraska Neuropsychological Battery, in the differentiation between normal individuals and patients in the neurological point of view (including patients with MS).</jats:p

Dementia in multiple sclerosis: report of a case with cortical grey matter involvement and frontal-type-like clinical features

Background/introductionAlthough multiple sclerosis (MS), a demyelinating disease of unknown aetiology, is primarily a white matter disease, it may also involve the grey matter, a feature not often demonstrated in vivo by means of magnetic resonance imaging (MRI). The involvement of cortical grey matter in MS may account for cognitive dysfunction and behavioural abnormalities.ObjectiveThe purpose of this report is to present the case of a patient with MS and clinical features mimicking dementia of the frontal type due to clear-cut cortical grey matter involvement in the left frontal lobe.Case reportA 55-year-old woman with relapsing remitting MS developed a clinical picture characterized by frontal deficits (e.g. attention, verbal fluency, and speed processing), disinhibition, loss of insight, perseveration, abnormal eating behaviour, agitation, insomnia, and depersonalization phenomena. Neuropsychological evaluation also revealed abnormal performance on the Trail Making and the Stroop tests. Besides typical demyelinating lesions and “black holes”, MRI showed a striking pattern of left frontal opercular involvement including cortical thinning, focal knife-edge appearance of the gyri, and marked gliosis in the adjacent white matter.DiscussionCognitive deficits in MS are typically subcortical, due to the expected predominance of white matter lesions. Nonetheless, the involvement of grey matter structures may contribute to a different pattern of cognitive dysfunction. For example, hippocampal involvement has been linked to memory impairment. This particular case report additionally illustrates how cortical grey matter involvement in the frontal lobe may lead (not unexpectedly) to a clinical condition mostly characterised by frontal deficits and psychiatric symptoms.</jats:sec

Prototype models of opportunity recognition and the decision to launch a new venture: identifying the basic dimensions

Purpose – The purpose of this paper is to obtain evidence concerning the basic dimensions included in cognitive prototypes pertaining to opportunity recognition and decision to launch a new venture; identifying the underlying dimensions of both prototypes – the cognitive frameworks current or nascent entrepreneurs employ in performing these important tasks. Design/methodology/approach – The bi-dimensional models were tested in a sample of 284 founder entrepreneurs, using a 48-item questionnaire. It was used as structural equation confirmatory factor analysis to compare fit indices of uni-dimensional second-order and third-order bi-dimensional models of business opportunity and decision to launch a venture. Findings – Results support the bi-dimensional models and offer support that both prototypes include two basic dimensions. For the business opportunity prototype these are viability and distinctiveness while for the decision to launch a new venture, the basic dimensions are feasibility and motivational aspects. Research limitations/implications – These results help to further clarify the nature of the cognitive frameworks individuals use to identify potential opportunities and reach an initial decision about whether to pursue their development. Uncovering the cognitive functioning of opportunity recognition and decision to exploit it, allow individuals to recognize opportunities easier and successfully; and to make more accurate and effective decisions. Practical implications – Knowing the basic dimensions of opportunity and decision-making prototypes contributes to develop effective skills with respect to business opportunity recognition among students enrolled in entrepreneurship programs. These surveys can be used for self-assessment and also for investors, tutors, and entrepreneurship agents in order to help evaluate features of business opportunities and decision to launch a venture. Originality/value – This study embraces a conceptual contribution, proposing a different model of the business opportunity and decision to exploit prototypes, and it extends Baron and Ensley (2006) previous work, to another important step in the entrepreneurial process – the decision to develop an identified opportunity through the launch of a new venture.info:eu-repo/semantics/publishedVersio

Complicated grief: Is there a place in psychiatry?

IntroductionGrief is as normal reactive to a significant personal loss. It is characterized by affective, cognitive, behavioural and physiological symptoms. The grieving process is usually divided in five different stages, but in most cases presents a benign course, with decreased suffering and better adaptation to the new context. However, when high levels of emotional suffering or disability persist over a long time period, it becomes a case of complicated grief (CG), which should be adequately addressed.ObjectivesTo review the characteristics of CG, the evidence that supports it as an individual pathological entity, and its place in current classification systems.MethodsWe performed a bibliographic search in Pubmed and PsychInfo, of articles written in English, Portuguese and Spanish, containing the key words: grief, bereavement, psychiatry, classification.ResultsThe main issue regarding grief is the degree to which it is reasonable to interfere with a usually benign process. Since DSM-III bereavement has been referred to as an adaptive reaction to an important loss, which should not be diagnosed as major depressive disorder or adjustment disorder. However, DSM-5 has stated persistent complex bereavement disorder as an independent entity. In fact, CG fulfils the general criteria of every psychiatric syndrome, namely regarding specific diagnosis criteria, differential diagnosis from depressive disorders and post-traumatic stress disorder, and improvement with adequate treatment.ConclusionIt is important to correctly approach CG, since it presents with characteristic diagnosis features and much improvement may be achieved once adequate treatment is provided.Disclosure of interestThe authors have not supplied their declaration of competing interest.</jats:sec

A case clozapine induced palilalia

IntroductionPalilalia is an acquired speech disorder characterized by involuntary and spontaneous repetition of words or phrases two or more time in a row. Palilalia can occur in a variety of disorders including postencephalic parkinsonism, advanced Parkinson disease, as well as in schizophrenia, and in Gilles de la Tourette syndrome. There is one report of palilalia induced by neuroleptics.AimsTo review the literature related to palilalia. Clinical case: We described a case of a 28 years-old man with refractory schizophrenia that demonstrated palilalia with 300 mg of clozapine.DiscussionIn the patient evaluation we just found unspecific alterations in the electroencephalogram. Palilalia disappeared with lowering doses of clozapine.ConclusionPalilalia can have several causes. The appearance of palilalia induced by clozapine is a rare side effect.</jats:sec

Prototype models of opportunity recognition and the decision to launch a new venture: identifying the basic dimensions

Purpose – The purpose of this paper is to obtain evidence concerning the basic dimensions included in cognitive prototypes pertaining to opportunity recognition and decision to launch a new venture; identifying the underlying dimensions of both prototypes – the cognitive frameworks current or nascent entrepreneurs employ in performing these important tasks. Design/methodology/approach – The bi-dimensional models were tested in a sample of 284 founder entrepreneurs, using a 48-item questionnaire. It was used as structural equation confirmatory factor analysis to compare fit indices of uni-dimensional second-order and third-order bi-dimensional models of business opportunity and decision to launch a venture. Findings – Results support the bi-dimensional models and offer support that both prototypes include two basic dimensions. For the business opportunity prototype these are viability and distinctiveness while for the decision to launch a new venture, the basic dimensions are feasibility and motivational aspects. Research limitations/implications – These results help to further clarify the nature of the cognitive frameworks individuals use to identify potential opportunities and reach an initial decision about whether to pursue their development. Uncovering the cognitive functioning of opportunity recognition and decision to exploit it, allow individuals to recognize opportunities easier and successfully; and to make more accurate and effective decisions. Practical implications – Knowing the basic dimensions of opportunity and decision-making prototypes contributes to develop effective skills with respect to business opportunity recognition among students enrolled in entrepreneurship programs. These surveys can be used for self-assessment and also for investors, tutors, and entrepreneurship agents in order to help evaluate features of business opportunities and decision to launch a venture. Originality/value – This study embraces a conceptual contribution, proposing a different model of the business opportunity and decision to exploit prototypes, and it extends Baron and Ensley (2006) previous work, to another important step in the entrepreneurial process – the decision to develop an identified opportunity through the launch of a new venture.info:eu-repo/semantics/publishedVersio