Completed suicide in a case of clinically diagnosed progressive supranuclear palsy.

We present the clinical history and the cognitive and behavioral presentations of a male patient with suspected progressive supranuclear palsy (PSP) who fatally shot himself in the head. We believe his act of suicide was the consequence of impulsivity, rather than primary depression or mood disturbance. In cases of suspected PSP and other atypical parkinsonisms, health professionals must be aware of neurobehavioral risk factors for suicide attempts and completions to promote patient safety; however, the literature on this topic is sparse. Our case highlights the potentially lethal consequences of impulsivity and other neuropsychiatric symptoms in PSP and related syndromes.

Adjuvant chemotherapy for breast cancer: effects on cerebral white matter seen in diffusion tensor imaging.

PURPOSE: The purpose of this study was to examine the effect of adjuvant chemotherapy on normal-appearing white matter in women with breast cancer. PATIENTS AND METHODS: Ten patients with early-stage breast cancer who were treated with adjuvant chemotherapy and 9 age-, education-, and IQ-matched healthy controls were studied with magnetic resonance imaging. Diffusion tensor imaging was used to calculate fractional anisotropy (FA), a measure of white matter integrity. Measurements were made in the genu and splenium of the corpus callosum. Participants also completed measures of processing speed, depression, and anxiety. RESULTS: Relative to controls, patients had slower processing speed and lower FA in the genu. Processing speed was positively correlated with FA in the genu. CONCLUSION: The results of this pilot study suggest that adjuvant chemotherapy affects normal-appearing white matter in the genu of the corpus callosum and that this is related to the cognitive deficits experienced by patients.

Anterior medial temporal lobe activation during encoding of words: FMRI methods to optimize sensitivity.

The existence of a rostrocaudal gradient of medial temporal lobe (MTL) activation during memory encoding has historically received support from positron emission tomography studies, but less so from functional MRI (FMRI) studies. More recently, FMRI studies have demonstrated that characteristics of the stimuli can affect the location of activation seen in the MTL when those stimuli are encoded. The current study tested the hypothesis that MTL activation during memory encoding is related to the modality of stimulus presentation. Subjects encoded auditorily or visually presented words in an FMRI novelty paradigm. Imaging and analysis parameters were optimized to minimize susceptibility artifact in the anterior MTL. Greater activation was observed in the anterior than posterior MTL for both modalities of stimulus presentation. The results indicate that anterior MTL activation occurred during encoding, independent of stimulus modality and provide support for the hypothesis that verbal-semantic memory processing occurs in anterior MTL. The authors suggest that technical factors are critical for observing the rostrocaudal gradient in MTL memory activation.