The first impressions formed by 91 therapists shown silent videorecordings of four patients with idiopathic Parkinson's disease and four with ischaemic heart disease were assessed using visual analogue scales directed at aspects of mood, personality and intellect. Although both patient groups showed no abnormalities in terms of affect, personality and intelligence by standardised psychological tests, the Parkinsonian patients appeared more anxious, hostile, suspicious, unhappy, bored and tense than the cardiac cases; they came across as less intelligent, more introverted and passive, less stable and tough minded; they seemed to enjoy and maintain their part in the conversation less well and relate less to the interviewer and overall they were rated as less likeable. These findings are related to the known effects of speech impairment on impression formation in Parkinson's disease and are discussed in terms of the possible effects on therapeutic relationships and their bearing on diagnosis of psychiatric disturbance in the condition.

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The first impressions formed by 19 senior speech therapy students shown silent video recordings of four patients with idiopathic Parkinson's disease (PD) and four with ischaemic heart disease were measured using visual analogue scales directed at aspects of mood, personality and intellect. Although both patient groups showed no abnormalities in terms of affect, personality and intelligence by standardised psychological tests, the PD patients appeared more anxious, hostile, suspicious, depressed, bored and tense than the controls; they seemd less intelligent, more introverted and passive and looked as if they enjoyed and maintained their part of the conversation less well. They appeared to relate less well to the interviewer although there was no apparent difference in the interviewer's behaviour to the two different disease groups. Overall they were rated as less likeable. The speech therapists' responses did not differ significantly from a previous study of other health professionals. The findings are related to the known effects of speech impairment on impression formation in Parkinson's disease and are discussed in relation to possible effects on therapeutic relationships and management of patients with impaired expressive behaviour.

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Ten patients with Alzheimer-type dementia and nine age-matched normal controls were examined with SPECT, using split-dose 99mTc-labelled exametazime. The baseline condition involved repetition of the word 'yes' or 'no'. The activation condition involved recognition (indicated by a 'yes' or 'no') of words from a previously learned list presented along with distractor words. Patients who performed this task successfully were selected, and efforts were made to match the patients with controls according to their performance on the task, although this was not fully achieved. Uptake of 99mTc-exametazime was estimated at baseline and during the word-recognition task for predetermined regions of interest drawn from a standard neuroanatomical atlas. The baseline task appeared to normalise tracer uptake for frontal, temporal and parietal cortex in the patient group. However, during the recognition task, controls but not patients showed activation effects. These were most prominent in dorsolateral frontal cortex and adjacent anterior cingulate cortex. Among patients, successful performance was correlated with activation of dorsolateral frontal and parietal cortex on the left side. The results confirm the central role of frontal mechanisms in a recognition memory task. The study highlights some of the difficulties of using cognitive challenge tests in clinical groups.