A Case of Late-Onset Psychosis: Integrating Neuropsychological and SPECT Data

Cloud, Blaine S.; Carew, Tania Giovannetti; Rothenberg, Howard; Malloy, Paul; Libon, David J.

doi:10.1177/089198879600900308

Cited by 6 publications

(4 citation statements)

References 35 publications

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“…Brain asymmetry within the delusional group was on par with that of normal aging, while those AD patients without delusions showed a relative lack of asymmetry. Cloud et al (1996) found the same pattern of atrophy in a case study of an unusual LOS woman showing phantom boarder syndrome and delusions of suspicion. Their subject showed longstanding delusions of suspicion changing to phantom boarder syndrome after an attempted burglary and progressive executive functioning.…”

Section: Neuropsychological Features and Neuroanatomic Considerationsmentioning

confidence: 61%

Cognitive neuroscience of delusions in aging

Holt¹,

Albert²

2006

Neuropsychiatric Disease and Treatment

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Assessments and clinical understanding of late-onset delusions in the elderly are inconsistent and often incomplete. In this review, we consider the prevalence, neurobehavioral features, and neuroanatomic correlations of delusions in elderly persons -those with documented cognitive decline and those with no evidence of cognitive decline. Both groups exhibit a common phenotype: delusions are either of persecution or of misidentification. Lateonset delusions show a nearly complete absence of the grandiose, mystical, or erotomanic content typical of early onset psychoses. Absent also from both elderly populations are formal thought disorders, thought insertions, and delusions of external control. Neuroimaging and behavioral studies suggest a frontotemporal localization of delusions in the elderly, with right hemispheric lateralization in delusional misidentification and left lateralization in delusions of persecution. We propose that delusions in the elderly reflect a common neuroanatomic and functional phenotype, and we discuss applications of our proposal to diagnosis and treatment.

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Section: Neuropsychological Features and Neuroanatomic Considerationsmentioning

confidence: 61%

Cognitive neuroscience of delusions in aging

Holt¹,

Albert²

2006

Neuropsychiatric Disease and Treatment

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“…A high incidence of Lewy body dementia and argyrophilic grain disease pathology, including deterioration of the frontal and temporal lobes have also been detected in VLOSLP patients (Cloud et al . 1996; Nagao et al . 2014).…”

Section: Discussionmentioning

confidence: 99%

“…One pathological study has associated VLOSLP with ventricular enlargement, generalised atrophy and vascular brain damage (Antonova et al 2004). A high incidence of Lewy body dementia and argyrophilic grain disease pathology, including deterioration of the frontal and temporal lobes have also been detected in VLOSLP patients (Cloud et al 1996;Nagao et al 2014). As Lewy body dementia is also associated with symptoms such as delusions and hallucinations, research comparing VLOSLP with these conditions, perhaps with the aid of neuroimaging or neuropathological data, could be helpful in improving differential diagnosis and understanding pathophysiology.…”

Section: Interpretation Of Findingsmentioning

confidence: 99%

Cognitive impairment and development of dementia in very late-onset schizophrenia-like psychosis: a systematic review

Lam¹,

Kane

2021

Ir. j. psychol. Med.

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Objectives: This study aimed to review the evidence base regarding cognitive impairment and the development of dementia in patients with very late-onset schizophrenia-like psychosis (VLOSLP). Methods: We conducted a systematic literature search of PubMed, PsycINFO and Web of Science according to Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Two reviewers independently screened records first by title and abstract and then by full text, resolving differences after each stage. Selected studies were assessed for quality using the GRADE system, and data on study design, participants, cognitive ability and rates of developing dementia were extracted and synthesised. Results: Seventeen publications were identified for review. They were generally poor in quality and heterogenous in design. VLOSLP patients were found to have impaired global cognition compared to non-psychotic controls, but no difference was found between VLOSLP patients and aged early-onset schizophrenia (EOS) patients. No single cognitive domain was consistently affected. Patients with VLOSLP demonstrated significantly higher rates of dementia diagnosis (ranging from 4.4% over 3 years to 44.4% over 15 years) than controls, but no difference was found between VLOSLP patients and aged EOS patients. Conclusions: VLOSLP may not necessarily predict cognitive decline, but few studies have adequately investigated cohorts on a longitudinal basis. Heterogeneity between and within cohorts and varying selection criteria compromise the clinical generalisability of studies investigating the association between VLOSLP and neurodegenerative disease. Further studies on the clinical presentation, cognitive profile and neuropathology of VLOSLP with comparison to EOS/late-onset schizophrenia (LOS) and neurodegenerative disease are needed to better inform the diagnosis and management of VLOSLP.

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“…To date there are few SPECT studies of a case with psychotic symptoms (e.g. fronto‐temporal degeneration, 11 schizophrenia 5,6 and late‐onset psychosis 12 ). All of these studies demonstrate hypoperfusion in the temporal lobe as our case does.…”

Section: Discussionmentioning

confidence: 99%

A case of psychotic disorder associated with a right temporal lesion: A special reference to magnetic resonance imaging and single photon emission computed tomography findings

Yamakawa

Yokoyama

Shiraishi

et al. 1999

Psychiatry Clin Neurosci

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A number of studies demonstrated a close association between psychotic symptoms and temporal lobe abnormalities. For example, it is well known that psychosis occurs in association with temporal lobe epilepsy, [1][2][3] and recent studies demonstrate morphological and functional abnormalities in the temporal lobe of schizophrenic brains. [4][5][6][7] In addition, there are some reports demonstrating focal temporal lesions such as stroke, 8 trauma 8 as well as brain tumors 9,10 as a causal lesion for psychotic disorder. To our knowledge, however, very few studies of organic psychotic disorder using magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). In this paper we described a patient with psychotic disorder associated with a right temporal lesion with reference to MRI and SPECT findings. CASE REPORTAn 18-year-old, right-handed male was referred to a neurosurgeon because of right-sided facial sensory loss for 5 years. Physical examination on admission revealed abducent palsy, trigeminal palsy and cerebella ataxia on the right side. He had no mental problem except occasional sexual disinhibitory behaviors. There was no family history of any neuropsychiatric disorders. The brain MRI before brain surgery (Fig. 1a,b,c,d) revealed a tumor occupying from the cerebellopontine angle to the right middle cranial fossa and compressing the brainstem and right temporal lobe. The tumor, pathologically diagnosed as trigeminal Schwannoma was almost completely removed Psychiatry and Clinical Neurosciences (1999) AbstractA case of psychotic disorder with a right temporal lesion was reported. The patient, a 19 year old male, who underwent a brain surgery to remove the trigeminal Schwannoma, occupying from the right cerebellopontine angle to the right middle cranial fossa. One year postoperatively, he presented with a psychotic disorder, including auditory hallucinations, delusions of persecution and reference, thought hearing, thought insertion and passive experiences. T1-weighted images on magnetic resonance imaging (MRI) demonstrated a low intensity signal area in the right temporal cortex and white matter. T2-weighted images demonstrated a high intensity signal within the same region. Single photon emission computed tomograghy (SPECT) demonstrated a severe low perfusion corresponding to the region in which the MRI demonstrated the abnormalities. The clinical and neuroimaging studies of this case suggest that psychotic disorder may occur in association with a right temporal lesion and MRI and SPECT are useful to evaluate an organic basis for the psychotic disorder.

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A Case of Late-Onset Psychosis: Integrating Neuropsychological and SPECT Data

Cited by 6 publications

References 35 publications

Cognitive neuroscience of delusions in aging

Cognitive neuroscience of delusions in aging

Cognitive impairment and development of dementia in very late-onset schizophrenia-like psychosis: a systematic review

A case of psychotic disorder associated with a right temporal lesion: A special reference to magnetic resonance imaging and single photon emission computed tomography findings

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