Acquired cerebellar lesions in adults and children can lead to the development of a complex behavioural pattern termed 'Cerebellar Cognitive Affective Syndrome' (Schmahmann and Sherman, Brain, 1998; 121: 561-79), which is characterized by reduced cognitive efficiency associated with specific neuropsychological deficits (executive and visuospatial disorders), expressive language disorders (mild agrammatism and anomia) and affective disorders with blunting of affect. It is not known whether a symptomatological picture such as this can also be found in congenital cerebellar malformations. We studied the behavioural developmental profile of 27 patients including children and adults with congenital malformations confined to the cerebellum, the largest studied sample to date. Extensive clinical and neuropsychological investigations highlight the presence of a wide range of disorders supporting the important role played by the cerebellum in the acquisition of higher-order cognitive and affective skills. The type and extent of cerebral reorganization processes in the presence of malformative lesions are difficult to predict and may possibly account for the variability of clinical phenotypes. It is, therefore, more difficult to identify a syndromic picture defined as exactly as is the case with acquired lesions. However, the pattern of deficits that we document is in remarkable agreement with the general profile of the Cerebellar Cognitive Affective Syndrome. Malformations affecting the cerebellar vermis induce affective and social disorders and evolve towards more unfavourable pictures often associated with an autistic symptomatology. Malformations of cerebellar hemispheres are more frequently associated with selective neuropsychological deficits involving mainly executive functions and visuospatial and linguistic abilities. Motor deficits are generally less severe, and tend to improve slowly and progressively, in some cases reaching almost complete functionality. Finally, the overall favourable evolution with an onset of skills in advanced age in a consistent subset of subjects suggests that individual follow-ups should be performed in order to monitor the quality and stability of impairments and acquired abilities over time.
We used human electroencephalogram to study early audiovisual integration of dynamic angry and neutral expressions. An auditory-only condition served as a baseline for the interpretation of integration effects. In the audiovisual conditions, the validity of visual information was manipulated using facial expressions that were either emotionally congruent or incongruent with the vocal expressions. First, we report an N1 suppression effect for angry compared with neutral vocalizations in the auditory-only condition. Second, we confirm early integration of congruent visual and auditory information as indexed by a suppression of the auditory N1 and P2 components in the audiovisual compared with the auditory-only condition. Third, audiovisual N1 suppression was modulated by audiovisual congruency in interaction with emotion: for neutral vocalizations, there was N1 suppression in both the congruent and the incongruent audiovisual conditions. For angry vocalizations, there was N1 suppression only in the congruent but not in the incongruent condition. Extending previous findings of dynamic audiovisual integration, the current results suggest that audiovisual N1 suppression is congruency- and emotion-specific and indicate that dynamic emotional expressions compared with non-emotional expressions are preferentially processed in early audiovisual integration.
Objective: To investigate the presence of syntactic impairments in native language in Parkinson's disease. Methods: Twelve bilingual patients, with Friulian as their first language (L1) and Italian as their second (L2), with Parkinson's disease and 12 normal controls matched for age, sex, and years of schooling, were studied on three syntactic tasks. Results: Patients with Parkinson's disease showed a greater impairment of L1 than L2. Conclusions: These findings provide evidence of greater basal ganglia involvement in the acquisition and further processing of grammar in L1 v L2 possibly due to a major involvement of procedural memory in representing L1 grammar.
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