['Giving inappropriate and/or misleading answers'; is the era of the Ganser syndrome finally over?]. / Vorbeireden en vorbeigehen: het ganser-syndroom voorbij?

The Ganser syndrome was long regarded as an entity that had as its core symptom 'giving inappropriate and/or misleading answers' to questions. In the literature we found confusion regarding the diagnostic and etiological criteria. We describe the case of an 53-year-old male patient who displayed a number of remarkable symptoms during a delirious episode which ended when the symptoms faded. By reviewing the recent literature, we outline the evolution in the use of the symptom and syndrome diagnosis.

Alcohol-induced hypertension: an important healthcare target in Belgium.

Excessive alcohol intake is one of the leading causes of premature death in Europe and particularly in Belgium. Belgian people are consuming more alcohol per year than the European average. It is well established that excessive alcohol consumption is a significant predictor of the development of hypertension (HTN). Two million adults in Belgium suffer from HTN and this number will increase to three million by 2025. Less than 50% of Belgian people treated for HTN are well-controlled. Alcohol reduction in patients with HTN can significantly lower systolic and diastolic blood pressure. After reviewing the epidemiology of HTN and alcohol disorders in Belgium, this paper will focus on the rationale for alcohol screening and brief intervention in primary care. It will also describe the barriers to alcohol screening, and what could be the benefits of alcohol screening for our healthcare system. The authors believe that early identification through alcohol screening and brief intervention in general practice can help to improve the management of patients with HTN, to reach the targets of the WHO Global Action Plan, i.e., a 25% relative reduction in the risk of premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases. They are also convinced that this would allow achieving major healthcare savings.

Specificity of regions processing biological motion.

Using functional magnetic resonance imaging and point light displays portraying six different human actions, we were able to show that several visual cortical regions, including human MT/V5 complex, posterior inferior temporal gyrus and superior temporal sulcus, are differentially active in the subtraction comparing biological motion to scrambled motion. Comparison of biological motion to three-dimensional rotation (of a human figure), articulated motion and translation suggests that human superior temporal sulcus activity reflects the action portrayed in the biological motion stimuli, whereas posterior inferior temporal gyrus responds to the figure and hMT/V5+ to the complex motion pattern present in biological motion stimuli. These results were confirmed with implied action stimuli.

Cerebral regions processing first- and higher-order motion in an opposed-direction discrimination task.

Using PET, we studied the processing of different types of motion in an opposed-direction discrimination task. We used first-order motion and two types of higher-order motion (presented as moving gratings with stripes defined by flickering texture and kinetic boundaries, respectively). In these experiments, we found that all types of motion activate a common set of cortical regions when comparing a direction discrimination task to a detection of the dimming of the fixation point. This set includes left hV3A, bilateral hMT/V5+ and regions in the middle occipital gyrus, bilateral activations in the posterior and anterior parts of the intraparietal sulcus, bilateral precentral gyrus, medial frontal cortex and regions in the cerebellum. No significant differences were observed between different types of motion, even at low statistical thresholds. From this we conclude that, under our experimental conditions, the same cerebral regions are involved in the processing of first-order and higher-order motion in an opposed-direction discrimination task.

Extracting 3D from motion: differences in human and monkey intraparietal cortex.

We compared three-dimensional structure-from-motion (3D-SFM) processing in awake monkeys and humans using functional magnetic resonance imaging. Occipital and midlevel extrastriate visual areas showed similar activation by 3D-SFM stimuli in both species. In contrast, intraparietal areas showed significant 3D-SFM activation in humans but not in monkeys. This suggests that human intraparietal cortex contains visuospatial processing areas that are not present in monkeys.

Human brain regions involved in heading estimation.

Observer motion in a stationary visual environment results in an optic flow pattern on the retina, which in simple situations can be used to determine the direction of self motion or heading. The present study, using positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), investigated the human cerebral activation pattern, elicited when subjects viewing a ground plane optic flow pattern actively judged heading. Several successive experiments controlled for visual input, visuospatial attention, and motor response effects. Results indicate that the network specifically involved in heading consists of only two motion sensitive areas: human MT/V5+, including an inferior satellite, and dorsal intraparietal sulcus area (DIPSM/L), predominantly in the right hemisphere, plus a dorsal premotor region bilaterally. These results suggest possible homologies with the dorsal part of the medial superior temporal area and area 7a in the monkey.