The incidence of clinically apparent asymmetric
profiles of neuropsychological deficits in Alzheimer's
disease (AD) patients similar to those reported in the
PET literature is currently unclear. This study investigated
lateral neuropsychological asymmetry using principal component
factor analysis in a sample of 153 patients diagnosed with
probable AD. Using factor scores, patients were classified
into groups exhibiting asymmetric or symmetric profiles
of neuropsychological deficits. In the analysis of lateral
asymmetry, 27.5% of patients were classified as asymmetric
(10% verbally and 17% visuospatially). Consistent with
reports of continued asymmetry beyond the mild dementia
stage, asymmetry was exhibited in the mild, moderate, and
severely demented groups. These findings of neuropsychological
asymmetry across stages of dementia are consistent with
the picture of significant neuropsychological heterogeneity
in AD that has been emerging in the decade. (JINS,
1997, 3, 420–427.)
Isolated symmetric damage to the amygdala and their cortical connections occurred in an individual following cancer treatment. The lesions were imaged after reversal of hyponatremia. The patient displayed marked behavioral changes including visual agnosia, hypersexuality, hyperorality, a tendency to react to every visual stimulus, and memory deficits. The cluster of neurobehavioral symptoms is similar to previously reported accounts of Klüver-Bucy syndrome and suggests the importance of bilateral amygdala involvement in these behavioral changes.
The authors report the assessment of 2 patients on interferon alpha (IFN-alpha) therapy for chronic myelogenous leukemia who developed manic symptoms long after IFN-alpha therapy had been initiated. These cases suggest that chronic IFN-alpha therapy may be associated with vulnerability for developing overt psychiatric symptoms, particularly in cases where the patient is experiencing psychosocial stress, and that the current definition of persistent adverse effects of IFN-alpha should be broadened to include the occurrence of manic episodes.
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