Longitudinal neuroanatomical and cognitive progression of posterior cortical atrophy

Posterior cortical atrophy is a clinico-radiological syndrome characterized by progressive decline in visual processing and atrophy of posterior brain regions. With the majority of cases attributable to Alzheimer’s disease and recent evidence for genetic risk factors specifically related to posterior cortical atrophy, the syndrome can provide important insights into selective vulnerability and phenotypic diversity. The present study describes the first major longitudinal investigation of posterior cortical atrophy disease progression. Three hundred and sixty-one individuals (117 posterior cortical atrophy, 106 typical Alzheimer’s disease, 138 controls) fulfilling consensus criteria for posterior cortical atrophy-pure and typical Alzheimer’s disease were recruited from three centres in the UK, Spain and USA. Participants underwent up to six annual assessments involving MRI scans and neuropsychological testing. We constructed longitudinal trajectories of regional brain volumes within posterior cortical atrophy and typical Alzheimer’s disease using differential equation models. We compared and contrasted the order in which regional brain volumes become abnormal within posterior cortical atrophy and typical Alzheimer’s disease using event-based models. We also examined trajectories of cognitive decline and the order in which different cognitive tests show abnormality using the same models. Temporally aligned trajectories for eight regions of interest revealed distinct (P5 0.002) patterns of progression in posterior cortical atrophy and typical Alzheimer’s disease. Patients with posterior cortical atrophy showed early occipital and parietal atrophy, with subsequent higher rates of temporal atrophy and ventricular expansion leading to tissue loss of comparable extent later. Hippocampal, entorhinal and frontal regions underwent a lower rate of change and never approached the extent of posterior cortical involvement. Patients with typical Alzheimer’s disease showed early hippocampal atrophy, with subsequent higher rates of temporal atrophy and ventricular expansion. Cognitive models showed tests sensitive to visuospatial dysfunction declined earlier in posterior cortical atrophy than typical Alzheimer’s disease whilst tests sensitive to working memory impairment declined earlier in typical Alzheimer’s disease than posterior cortical atrophy. These findings indicate that posterior cortical atrophy and typical Alzheimer’s disease have distinct sites of onset and different profiles of spatial and temporal progression. The ordering of disease events both motivates investigation of biological factors underpinning phenotypic heterogeneity, and informs the selection of measures for clinical trials in posterior cortical atrophy

Il diritto penale nella prospettiva europea. Quali politiche criminali per quale Europa?

I. Il diritto penale in Europa: le esperienze di ricodificazione di fine secoloSez. 1. L’Europa orientale: la “nuova frontiera” dell’UnioneMARIA VALERIA DEL TUFO, Le riforme penali nei paesi dell’est: uno sguardo di sintesi BERISLAV PAVISIC, Dalla frantumazione di uno Stato ai nuovi sistemi penali: la ex-Jugoslavia HAKAN HAKERI, L’eredità del codice Zanardelli alle porte della nuova Europa: la TurchiaMASSIMO PAPA, Il diritto penale dell’Europa e la presenza delle comunità islamicheSEZ. 2. L’Europa continentale e il mondo anglosassone: riforme realizzate e progettateALBERTO CADOPPI, Civil Law e Common Law: contrapposizione sistemica o culturale?JEAN PRADEL, Il codice penale francese del 1994 GONZALO QUINTERO OLIVARES, L’esperienza della codificazione spagnola dopo sei anni di vigenza del codice penale del 1995 MANFRED MAIWALD, La riforma continua: Germania CARLO FEDERICO GROSSO, Addio al codice Rocco?II. Il diritto penale in Europa: le prospettive di politica criminaleSez. 1. Le politiche criminali dell’Unione e degli Stati tra vecchie e nuove esigenze di tutela: mercato economico e diritti fondamentali MASSIMO PAVARINI, IntroduzioneGIOVANNI FIANDACA, Nuovi orizzonti della tutela della persona LUIS ARROYO ZAPATERO, Immigrazione e lavoro: proposta per un “eurodelitto” di tratta di esseri umani SERGIO SEMINARA, L’evoluzione europea del diritto penale del mercato finanziario nella prospettiva italiana VINCENZO MILITELLO, Criminalità organizzata: politica criminale europea versus tutela nazionale dei diritti fondamentali? SILVIO RIONDATO, Uno sguardo dall’Europa al nuovo diritto penale di guerra statunitense contro il terrorismoSez. 2. Principi generali e modelli di armonizzazioneLORENZO PICOTTI, Diritto penale comunitario e progetto di Costituzione per l’EuropaALESSANDRO BERNARDI, Strategie per l’armonizzazione dei sistemi penali europei JESUS MARÍA SILVA SÁNCHEZ, I principi ispiratori delle proposte di un diritto penale europeo. Un commento criticoKLAUS TIEDEMANN, Diritto penale comune europeo tra realtà e utopiaKLAUS LÜDERSSEN, Europeizzazione del diritto penale e legislazione governativaJOHN A.E. VERVAELE, Il pubblico ministero europeo e lo spazio giudiziario europeo: protezione efficace degli interessi comunitari o inizio di un diritto processuale penale europeo

Eye Movements in Neuropsychological Tasks

This chapter reviews how recording and analysis of eye movements has been applied to understanding cognitive functioning in patients. Measures derived from the performance of instructed eye movement tests such as the anti-saccade and memory-guided saccade tasks have been shown to be associated with cognitive test performance and the early stages of neurodegenerative disorders including Alzheimer’s and Parkinson’s disease. Other research has taken an ecological approach and recorded the uninstructed pattern of saccades made by patients during performance of established neuropsychological tasks. Studies that have analysed the eye movement strategies used in a number of widely used tests are reviewed, including the Corsi Blocks, Tower of London, ‘CANTAB’ Spatial Working Memory and Brixton Spatial Anticipation test. The findings illustrate that eye movements are not purely in the service of vision, but support visuo-spatial working memory and forward action planning. Eye movement tests and measures also have potential for application in the assessment and diagnosis of neurological disease and cognitive impairment. Establishing large scale normative datasets in healthy older adults and use of machine learning multi-variate classifier algorithms may be key to further developing eye tracking applications in neuropsychological assessment