This controlled randomized single-blind study evaluated the effects of cognitive training (CT), compared to active music therapy (AMT) and neuroeducation (NE), on initiative in patients with mild to moderate Alzheimer’s disease (AD). Secondarily, we explored the effects of CT on episodic memory, mood, and social relationships. Thirty-nine AD patients were randomly assigned to CT, AMT, or NE. Each treatment lasted 3 months. Before, at the end, and 3 months after treatment, neuropsychological tests and self-rated scales assessed initiative, episodic memory, depression, anxiety, and social relationships. At the end of the CT, initiative significantly improved, whereas, at the end of AMT and NE, it was unchanged. Episodic memory showed no changes at the end of CT or AMT and a worsening after NE. The rates of the patients with clinically significant improvement of initiative were greater after CT (about 62%) than after AMT (about 8%) or NE (none). At the 3-month follow-up, initiative and episodic memory declined in all patients. Mood and social relationships improved in the three groups, with greater changes after AMT or NE. In patients with mild to moderate AD, CT can improve initiative and stabilize memory, while the non-cognitive treatments can ameliorate the psychosocial aspects. The combining of CT and non-cognitive treatments may have useful clinical implications.

Background and purpose Anterior temporal lobectomy (ATL) within the language-dominant hemisphere can impair naming. This prospective study examined the pre-operative to post-operative course of different language components, clarifying which changes are relevant within the short-term and long-term outcome of language.Methods Patients with drug-resistant temporal lobe epilepsy (TLE) were evaluated using the Token, Boston Naming and Word Fluency tests assessing sentence comprehension and word-finding on visual, semantic or phonemic cues.Results A total of 106 patients were evaluated before and 6 months, 1 and 2 years after ATL; 60 patients were also evaluated after 5 years and 38 controls were assessed at baseline. Seizure outcome was comparable between the left and right TLE patients. Before surgery, naming and word fluency were impaired in the left and right TLE patients, whereas sentence comprehension was normal. After left or right ATL, word fluency progressively improved, naming showed early worsening and late improvement after left ATL and progressive improvement after right ATL, and sentence comprehension did not change. At the 5-year follow-up, naming improvement was clinically significant in 31% and 71% of the left and right TLE patients, respectively. Pre-operative naming, ATL laterality, schooling, and post-operative seizure frequency and number of antiepileptic drugs predicted post-operative naming. Pre-operative word fluency and schooling predicted post-operative word fluency.Conclusions Left or right TLE can impair word-finding but not sentence comprehension. After ATL, word-finding may improve for a long time, depending on TLE laterality, seizure control and mental reserve. These findings may clarify prognosis prior to treatment.

Objective. Theory of mind (ToM), an ability to recognize and understand others' and ones' own affective and epistemic mental states, is considered relevant to the understanding of complex social interactions and may be impaired in patients with focal epilepsy. The purpose of this study was to explore the relationships between ToM and behavioral and affective well-being in patients with temporal lobe epilepsy (TLE).

In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant.We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery.We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia.The key findings are:1) Both left and right TLE patients show decreased left lateralization compared to controls.2) Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.3) Left lateralization correlates with peri-ictal aphasia in left TLE patients.4) Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery.The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients. (C) 2013 The Authors. Published by Elsevier Inc.

Objective. Picture naming and word fluency depend on the integrity of different neural networks including the inferior-lateral temporal, superior parietal and frontal cortices and the ventral visual pathway or the inferior frontal, dorsolateral prefrontal, medial temporal and parietal areas. Although many studies investigated language after epilepsy surgery, scarce attention was given to the postoperative trajectories of different lexical–semantic abilities. This prospective study evaluated the short- and long-term changes of word finding on visual, letter, and category stimuli in patients operated on for drug-resistant temporal lobe epilepsy (TLE).

Although motion is crucial for ecological facial perception, Facial Emotion Recognition (FER) studies mainly used static pictures as stimuli. Recent experiments highlight that motion could improve FER by providing dynamic information, facilitating configural processing and enhancing the perception of change [2]. However, motion may have a generic effect for facial features recognition, rather than a selective facilitation for FER, especially according to new models of face perception [4]. For instance, simple internal characteristics movements, such as eyes looking to the right, may take advantage of a dynamic presentation as well as facial emotion expressions [5]. Previous studies mainly used static [2] or degraded [7] pictures for control tasks, not directly comparing FER to simple physical features recognition. The aim of our work is to explore the role of motion in both emotional and structural facial features recognition.