Neuronal substrates of haptic shape encoding and matching: a functional magnetic resonance imaging study.

We used functional magnetic resonance imaging to differentiate cerebral areas involved in two different dimensions of haptic shape perception: encoding and matching. For this purpose, healthy right-handed subjects were asked to compare pairs of complex 2D geometrical tactile shapes presented in a sequential two-alternative forced-choice task. Shape encoding involved a large sensorimotor network including the primary (SI) and secondary (SII) somatosensory cortex, the anterior part of the intraparietal sulcus (IPA) and of the supramarginal gyrus (SMG), regions previously associated with somatosensory shape perception. Activations were also observed in posterior parietal regions (aSPL), motor and premotor regions (primary motor cortex (MI), ventral premotor cortex, dorsal premotor cortex, supplementary motor area), as well as prefrontal areas (aPFC, VLPFC), parietal-occipital cortex (POC) and cerebellum. We propose that this distributed network reflects construction and maintenance of sensorimotor traces of exploration hand movements during complex shape encoding, and subsequent transformation of these traces into a more abstract shape representation using kinesthetic imagery. Moreover, haptic shape encoding was found to activate the left lateral occipital complex (LOC), thus corroborating the implication of this extrastriate visual area in multisensory shape representation, besides its contribution to visual imagery. Furthermore, left hemisphere predominance was shown during encoding, whereas right hemisphere predominance was associated with the matching process. Activations of SI, MI, PMd and aSPL, which were predominant in the left hemisphere during the encoding, were shifted to the right hemisphere during the matching. In addition, new activations emerged (right dorsolateral pre-frontal cortex, bilateral inferior parietal lobe, right SII) suggesting their specific involvement during 2D geometrical shape matching.

A predicted operon map for Mycobacterium tuberculosis.

The prediction of operons in Mycobacterium tuberculosis (MTB) is a first step toward understanding the regulatory network of this pathogen. Here we apply a statistical model using logistic regression to predict operons in MTB. As predictors, our model incorporates intergenic distance and the correlation of gene expression calculated for adjacent gene pairs from over 474 microarray experiments with MTB RNA. We validate our findings with known examples from the literature and experimentation. From this model, we rank each potential operon pair by the strength of evidence for cotranscription, choose a classification threshold with a true positive rate of over 90% at a false positive rate of 9.1%, and use it to construct an operon map for the MTB genome.

A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis Area and Severity Index, Physician's Global Assessment and Lattice System Physician's Global Assessment.

BACKGROUND: There is a lack of consensus as to the best way of monitoring psoriasis severity in clinical trials. The Psoriasis Area and Severity Index (PASI) is the most frequently used system and the Physician's Global Assessment (PGA) is also often used. However, both instruments have some drawbacks and neither has been fully evaluated in terms of 'validity' and 'reliability' as a psoriasis rating scale. The Lattice System Physician's Global Assessment (LS-PGA) scale has recently been developed to address some disadvantages of the PASI and PGA. OBJECTIVES: To evaluate the inter-rater and intrarater reliability of the PASI, PGA and LS-PGA. METHODS: On the day before the study, 14 dermatologists (raters), with varied experience of assessing psoriasis, received detailed training (2.5 h) on use of the scales. On the study day, each rater evaluated 16 adults with chronic plaque psoriasis in the morning and again in the afternoon. Raters were randomly assigned to assess subjects using the scales in a specific sequence, either PGA, LS-PGA, PASI or PGA, PASI, LS-PGA. Each rater used one sequence in the morning and the other in the afternoon. The primary endpoint was the inter-rater and intrarater reliability as determined by intraclass correlation coefficients (ICCs). RESULTS: All three scales demonstrated 'substantial' (a priori defined as ICC > 80%) intrarater reliability. The inter-rater reliability for each of the PASI and LS-PGA was also 'substantial' and for the PGA was 'moderate' (ICC 75%). CONCLUSIONS: Each one of the three scales provided reproducible psoriasis severity assessments. In terms of both intrarater and inter-rater reliability values, the three scales can be ranked from highest to lowest as follows: PASI, LS-PGA and PGA.

Do high functioning persons with autism present superior spatial abilities?

This series of experiments was aimed at assessing spatial abilities in high functioning individuals with autism (HFA), using a human-size labyrinth. In the context of recent findings that the performance of individuals with HFA was superior to typically developing individuals in several non-social cognitive operations, it was expected that the HFA group would outperform a typically developing comparison group matched on full-scale IQ. Results showed that individuals with autism performed all spatial tasks at a level at least equivalent to the typically developing comparison group. No differences between groups were found in route and survey tasks. Superior performance for individuals with HFA was found in tasks involving maps, in the form of superior accuracy in graphic cued recall of a path, and shorter learning times in a map learning task. We propose that a superior ability to detect [Human Perception and Performance 27 (3) (2001) 719], match [Journal of Child Psychology and Psychiatry 34 (1993) 1351] and reproduce [Journal of Child Psychology and Psychiatry 40 (5) (1999) 743] simple visual elements yields superior performance in tasks relying on the detection and graphic reproduction of the visual elements composing a map. Enhanced discrimination, detection, and memory for visually simple patterns in autism may account for the superior performance of persons with autism on visuo-spatial tasks that heavily involve pattern recognition, either in the form of recognizing and memorizing landmarks or in detecting the similarity between map and landscape features. At a neuro-anatomical level, these findings suggest an intact dorso-lateral pathway, and enhanced performance in non social tasks relying on the infero-temporal pathway.

Performances of patients with a dementia of the Alzheimer type in the Standardized Road-Map test of Direction Sense.

The Standardised Road-Map test of Direction Sense of money (A Standardised Road-Map Test of Direction Sense, Baltimore: Johns Hopkins University Press, 1976) was applied to a group of 14 patients diagnosed with dementia of the Alzheimer type (DAT) and to a group of 14 healthy controls matched in terms of age and education. Subjects were tested with two forms of the Money test. In the first form, the standard procedure was used. It requires patients to perform mental rotations and right or left discrimination. In the second form, the examiner turned the test sheet at each intersection to align the route with the subject. In contrast to the first condition, no mental rotation was necessary to distinguish right from left turns. This procedure has been introduced to investigate the impact of the graphic material in the map display on performance. The subjects were also given a right-left discrimination test. The results show a significant difference between DAT patients and the control group in the original form of the Money test. DAT patients also showed a deficit compared to the control subjects in the modified form of the test. The right-left discrimination test revealed no dysfunction in either group tested on problems referring to their own body parts. The designation of the body parts of somebody facing them was deficient with DAT patients. The capacity of right-left discrimination, at least with respect to parts of their own body, does not play a central role in the poor test performance of the Money test. We conclude that the Money test has a clinical value, but not specifically in the evaluation of right-left discrimination. This test should rather be viewed in terms of mental rotations and limited attention resources in DAT patients.

Prevalence, and intellectual outcome of unilateral focal cortical brain damage as a function of age, sex and aetiology.

Neurologists and neuropsychologists are aware that aging men are more at risk than women for brain damage, principally because of the well known male-predominant risk for cardiovascular disease and related cerebrovascular accidents. However, a disproportion in prevalence of brain damage between the sexes in childhood may be less suspected. Furthermore, sex-specific risk for other aetiologies of brain damage may be little known, whether in the pediatric or adult populations. Proposals of a sex difference in cognitive recovery from brain damage have also been controversial. Six hundred and thirty five "consecutive" cases with cortical focal lesions including cases of all ages and both sexes were reviewed. Aetiology of the lesion was determined for each case as was postlesion IQ. Risk was highly male prevalent in all age groups, with a predominance of cardiovascular aetiology explaining much of the adult male prevalence. However, several other aetiological categories were significantly male prevalent in juveniles (mitotic, traumatic, dysplasic) and adults (mitotic, traumatic). There was no sex difference in outcome (i.e., postlesion IQ) of these cortical brain lesions for the cohort as a whole, after statistical removal of the influence of lesion extent, aetiology and presence of epilepsy. Mechanisms potentially responsible for sex differences in prevalence, aetiology of brain damage, and recovery, are reviewed and discussed.

A hierarchical model of domains of disablement in the elderly: a longitudinal approach.

PURPOSE: the aims of this paper are to verify that a hierarchical relationship exists between the concepts of Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and mobility and to use this hierarchical model to describe the evolution of disability. METHODS: 3751 elderly community dwellers were followed-up 3 and 5 years after baseline interview. A hierarchic disability scale was computed by summing up the number of domains (ADL, IADL, mobility) in which a subject was dependent. Coefficients of scalability and reproducibility of the scale were computed. The hierarchic scale was used to describe transitions between states at each follow-up. RESULTS: the hierarchical model fitted 99.3% of the subjects at baseline. At each follow-up most transitions were towards contiguous grades of disability in survivors, whatever their age. There was a significant trend towards increasing disability. Death rates were higher in subjects aged 75 and over, whatever their disability level. The patterns of evolution differed according to gender. CONCLUSIONS: the cumulative disability scale can be used to describe the evolution of disability with time in elderly community dwellers.

Analysis of error types in the trial making test evidences an inhibitory deficit in dementia of the Alzheimer type.

Several studies have reported low performances of patients with dementia of the Alzheimer Type (DAT) on the Trial Making Test (TMT), however, these studies were not designed to identify specific operations underlying this impairment. To better understand the attentional disorder in DAT, we analyzed the performances of patients with DAT and matched elderly adults on the TMT, with a detailed analysis of error types. The analysis showed that 67% of patients' errors were related to an inhibitory deficit versus only 24% in normal elderly adults. Therefore, it was suggested that inefficient inhibitory mechanisms are responsible, to a large extent, for the poor TMT performance of patients with DAT, supporting the hypothesis of an inhibitory dysfunction in DAT.

To be or not to be at home? A neuropsychological approach to delusion for place.

A woman, LB, while in recovery from a viral encephalitis, exhibited a delusion for place, which led her to insist that she was at home, in spite of compelling evidence to the contrary. Later, she developed a Capgras syndrome, that is, another misidentification syndrome. The patient was given a detailed neuropsychological evaluation to shed light on the mechanisms underlying her delusional misbelief. Two main deficits were in evidence: (1) a severe visual-spatial impairment, giving the patient a distorted perception of her surroundings; and (2) frontal lobe dysfunction, which played a critical role in her impulsive responses and lack of self-awareness. The pathogenesis of delusion for place and persons if discussed in light of these observations.

Wayfinding in dementia of the Alzheimer type: planning abilities.

This paper reports on wayfinding in dementia, in particular the ability to develop decision plans for solving wayfinding problems in unfamiliar settings. Fourteen patients diagnosed as having mild to moderate dementia of the Alzheimer type (DAT), and 28 normal elderly were asked to reach a destination in a large hospital setting, and to return to the point of departure. Verbalizations of all subjects were recorded, transcribed, and content-analyzed in order to identify the decisions made during the trip and to establish their functional relationships revealing their planning abilities. Results showed that all DAT patients failed to reach the destination and return to the point of departure without errors. Compared to normal elderly subjects, their overall decision plans were poorly structured, indicating basic problem-solving disorders. However, they were able to solve well-defined problems and develop sub-plans in routine situations when the necessary information was readily available. Nondiscriminatory reading of irrelevant information was also observed and tended to interfere with problem-solving.

The dermo-optical perception of color as an information source for blind travelers.

Dermo-optical color perception refers to a person's ability to distinguish color surfaces through "skin perception" without the use of sight. The aims of this study were (1) to assess prior research findings which apparently demonstrated the existence of dermo-optical color perception and (2) to explore the possibilities of using color to indicate reference points for blind travellers. Three experiments were conducted with 20 congenitally blind subjects and a sighted blindfolded control group matched on age, sex, and education. In Exp. 1 on a discrimination task subjects were asked if two boards were of the same color and on a pairing task were asked to match a colored board with one among a set of three boards having the same color. In Exp. 2 the discrimination task was identical to that in Exp. 1, but instead of using boards perceived through haptic exploration, we used colored cubicles in which the whole body would be exposed to the color. In Exp. 3 subjects were asked to walk along the corridor of a labyrinthine set-up and to identify any changes of color they could perceive. The experiments were designed to provide measures of reliability of subjects' responses. Analysis showed little or no support for the ability to perceive color by dermo-optical means. The comparisons of the blind and the sighted control groups were nonsignificant. On the basis of our findings, the use of color to help blind travellers has to be rejected. The paper concludes with a discussion suggesting reasons for the contradictory results emerging from studies on dermo-optical color perception.

Maternal and neonatal outcome in pregnancies with no risk factors.

Between November 1979 and April 1984, 790 consecutive pregnant women who considered themselves as having a "normal" pregnancy were followed in private practice from 9 weeks' gestation until 6 weeks post partum. The women had no pre-existing disease or problem classified as a risk to the pregnancy at the time of their first visit, had a singleton pregnancy and gave birth at Notre-Dame Hospital, Montreal. Maternal complications occurred during the course of pregnancy in 181 women (23%). Complications were mostly related to obstetric conditions (10%), such as preterm labour, intrauterine growth retardation (IUGR) and antepartum hemorrhage, or to medical conditions (12%), the most prevalent of which was hypertension (77% of medical conditions). Neonatal complications occurred in 183 infants (23%). The corrected perinatal death rate was 2.5 per 1000. Prematurity, IUGR and dysmaturity/postmaturity accounted for nearly half of the complications. Hyperbilirubinemia occurred in 7% of the cases. Among women without any maternal complications during pregnancy, the frequency rate of neonatal complications was 19%, compared with 23% among the entire group of 790 women. Our results suggest that the absence of maternal complications does not protect the infant from a neonatal complication. Further refinement is needed to identify markers of obstetric, medical and neonatal complications in pregnancies with no risk factors.

A prospective study of blood pressure in pregnancy: prediction of preeclampsia.

A prospective study of blood pressure recording was conducted in 1000 patients, at each antenatal visit, with the use of an automatic random-zero sphygmomanometer. In 46 patients, among 808 primigravid women, who developed preeclampsia, the diastolic and mean blood pressures were significantly elevated compared to values at the first antenatal visit (p less than 0.01, 9 to 12 weeks). This difference was sustained throughout pregnancy until delivery by at least 10 mm Hg as compared to pressures in the normotensive group. Sensitivity for predicting preeclampsia early in pregnancy with an elevated blood pressure measurement (130 to 135/80 to 85 mm Hg) ranged from 16% to 57% while specificity ranged from 75% to 98%. The results substantiate an early vasospasm (9 to 12 weeks) in those women destined to develop preeclampsia.

[Prospective study of arterial pressure during pregnancy. Prediction of hypertensive complications]. / Etude prospective de la tension artérielle au cours de la grossesse. Prédiction des complications hypertensives.

A prospective study of measure of blood pressure was conducted in 366 pregnant women at each antenatal visit, using an automatic random-zéro sphygmomanometer. In fourteen patients, among 244 primigravidae, who developed preeclampsia, systolic and diastolic arterial blood pressures were already significantly elevated by 13-16 weeks of pregnancy. This difference was sustained throughout until delivery. In addition, the systolic and diastolic arterial blood pressure, in those women destined to develop preeclampsia, did not show a dip between 13-20 weeks as in the normotensive group. There was no difference in arterial blood pressure during pregnancy between primigravidae and multigravidae who remained normotensive.