Temporal gradient (TG), i.e., differential recallof recent and old memories, is a well known feature ofamnesia. A recent study provided evidence of a classicalTG for media–mediated events in elderly healthy people,showing that they recall remote events significantly betterthan recent ones, while a reverse TG, i.e., better recall ofmore recent events, was demonstrated in younger normalsubjects. In the present study we present normative datawhich, using the same test, allow evaluation of TG in singlecases and their qualification as classical or reverse. Thenormative procedure was also applied to a small sample ofsubjects with probable Alzheimer’s disease or mild cognitiveimpairment. Norms for TG may be helpful not only toassess healthy people’s performance, but also to judge anyapparent TG in pathological subjects.

Picture naming requires early visual analysis, accessing stored structural knowledge, semantic activation, and lexical retrieval. We tested the effect of perceptual, lexical, and semantic variables on the performance of aphasics in picture naming and assessed prevalence of natural categories vs artifact dissociations. Forty-nine aphasics were asked to name 60 pictures, from three natural (animals, fruits, and vegetables) and three artificial categories (tools, furniture, and vehicles). For each item visual (drawing complexity, image agreement), semantic (prototypicality, concept familiarity) and lexical variables (word frequency, name agreement) were available. The effect of these variables showed individual differences; altogether, visual complexity had little influence, whereas lexical and semantic variables were more influential. Name agreement was most important, followed by word frequency. On a multiple single case analysis 10 patients (20%) showed a natural/artificial category dissociation. Five of the six subjects faring better with artifacts were males, and all of four patients faring better with natural categories were females. Interpretations of this finding are discussed.

A group of 51 patients affected by possible semantic memory deficit were given a picture naming task for the purposes of a comparison between six categories, three of Nonliving: nature (tools, furniture, vehicles) and three of a Living nature (animals, fruits, and vegetables). A logistic regression analysis was used for a multiple single case study, where also the items' basic difficulty was included in the model. Besides some patients showing a dissociation between Living and Nonliving categories, other patients showed a liner selectivity on naming, differentiating animals from fruits and vegetables, tools from nonmanipulable: objects, and even vehicles from furniture. These results are examined in the light of current theories of semantic category specificity. (C) 2000 Academic Press.

Fifty-three patients affected by Alzheimer's disease entered a longitudinal survey aimed at studying which factors influence the rate of progression, assessed by means of the Milan Overall Dementia Assessment (MODA). The second examination was carried out, on average, after 16 months from the first assessment. Only age proved to influence the decline rate, which was faster in elders.

We report the neuropsychological findings of two patients (LF and EA) with herpes simplex encephalitis. Both patients presented a greater deficit for living than non-living categories in a number of tasks, although EA was much more impaired than LF. We controlled the several stimulus variables that might affect the performance and could demonstrate that the dissociation was not artifactual. Neither LF nor EA revealed a selective or preferential involvement of perceptual semantic knowledge, and both showed a homogeneous impairment of perceptual and associative encyclopaedic notions. At a second examination, carried out from 1 to 2 years later, LF showed a good recovery, whereas EA's improvement was confined to the non-living categories. The lesion of both patients affected the left temporal pole and the basal neocortical regions of the left temporal lobe. The involvement of limbic areas was more marked in LF, while the Wernicke area and the posterior parts of the middle and inferior temporal gyri were only involved in EA. Besides the basal temporal areas, also the posterior temporal regions are likely to play a role in determining the clinical picture of such patients, and their prospect of recovery.

Objectives– The preferential involvement of living categories in naming impairment is well recognised in Herpes Simplex Encephalitis (HSE). In this paper we describe naming, neuropsychological and neuroradiological findings with seven fresh HSE cases. Material & methods– Patients were given a picture naming task that included 60 items belonging to 6 different categories (three living, i.e. fruits, vegetables and animals and three nonliving, i.e. furniture, vehicles and tools). In the statistical analysis several possible sources of bias as the frequency of the target word, the familiarity with the objects to name, the image complexity and other parameters were taken into account. Results– Four out of seven patients were significantly more impaired with living things. We describe their general cognitive profile and discuss the anatomo‐functional aspects of category dissociation. Conclusion– Language impairment, disproportionately severe for the naming of living exemplars, is frequently observed in HSE, is clinically relevant and should be specifically investigated.

We describe the case of an architect, MF, who in his fifties presented a 10-year progressive cognitive deterioration similar to that recently classified as semantic dementia. For a long period general intelligence, non-lexical aspects of language, memory and pre-semantic stages of visual perception were spared. MF showed a lexical-semantic deficit that was more severe for living things, famous people and architectural knowledge and concerned both visual and encyclopaedic information. Visual and encyclopaedic knowledge about tools, vehicles and furniture was completely spared for a long time. On MRI, our patient presented severe atrophy of the temporal lobes, that most severely affected the right side and also involved basal neocortex, hippocampus and parahippocampal gyri.

Twenty-nine patients affected by motor neuron disease (MND) were investigated with the Raven Progressive Matrices, a test of logical non verbal intelligence, requiring neither motor nor verbal skills. The score distribution of the MND patients did not differ from that of 321 controls. Eleven of these patients were retested after a mean interval of 8.5 months. The resulting differences in the test scores showed that their intellectual performance had not worsened over time. Even allowing for the limitations posed by the use of a single test, these data add to the evidence against systematic cognitive involvement in MND.

A new, short, neuropsychologically oriented test for dementia assessment--the Milan Overall Dementia Assessment (MODA)--is described. Age and education adjusted norms based on 217 healthy controls are given. A validation study on 312 outpatients suspected of dementia (121 with probable Alzheimer's disease) showed that the MODA differentiated patients with cognitive impairment from normal subjects more effectively than did the DSM III-R. The correlation between the MODA and the mini mental state examination was 0.63 in controls and 0.84 in patients with Alzheimer's dementia. The MODA test-retest reliability was 0.83. The test proved to be well suited to longitudinal studies.

We report two head-injured patients whose knowledge of living things was selectively disrupted. Their semantic knowledge was tested with naming and verbal comprehension tasks and a verbal questionnaire. In all of them there was consistent evidence that knowledge of living things was impaired and that of non-living things was relatively preserved. The living things deficit emerged irrespective of whether the question tapped associative or perceptual knowledge or required visual or non visual information. In all tasks the category effect was still significant after the influence on the performance of the following variables was partialled out: word frequency, concept familiarity, prototypicality, name agreement, image agreement and visual complexity. In the verbal questionnaire dissociations were still significant even after adjustment for the difficulty of questions for normals, that had proven greater for living things. Besides diffuse brain damage, both patients presented with a left posterior temporo-parietal lesion.

We found high titers of anti-GM1 antibodies (1/1280 or more) in 3 of 14 consecutive patients (21%) with Guillain-Barré syndrome (GBS) and in 2 additional patients who developed GBS, 10-11 days after starting parenteral treatment with gangliosides. Antibodies were IgG in 4 patients and IgM in one, and they all bound to asialo-GM1, and, in 3, to GD1b as well. Although the clinical features in all the patients with high anti-GM1 titers fulfilled the criteria for the diagnosis of GBS and in 4 of them, proteins but not cells were elevated in cerebrospinal fluid, electrodiagnostic studies in 3 patients showed prominent signs of axonal degeneration, that in one case were confirmed by morphological studies on sural nerve biopsy. No recent antecedent infection was reported by these patients, but in 3, including patients treated with gangliosides, anti-Campylobacter jejuni antibodies were elevated. In 3 patients a consistent decrease in anti-GM1 levels was observed after the acute phase of the disease suggesting that the frequent occurrence of these antibodies in patients with GBS and their frequent association with a prominent axonal impairment may have pathogenetic relevance.

In this paper we consider the serial position curve in immediate verbal free recall. A large literature has argued that two components of the serial position curve, recency and primacy, reflect the functioning respectively of short-term and of long-term memory. However, there are a number of difficulties in interpreting the recency effect as a phenomenon uniquely associated with short-term memory. Moreover, the serial position curve has been used widely for clinical investigations in patients with memory deficits. This is despite the lack of norms for the measures derived from the curve. We present a set of standardised norms based on 321 Italian normal subjects. These norms are shown to be applicable both to an English speaking population, and to three groups of brain damaged-patients, namely Alzheimer's, amnesics, and frontals. The standardised norms offer a clinical and experimental tool which, coupled with a multiple single case approach, allows us to show dissociations and double dissociations among the performance patterns obtained from all three pathological groups. The paper concludes with a discussion of a possible interpretation of the recency effect as a emergent property of all types of memory system, including verbal short-term memory. Taking into account previous literature as well as our own data, the recency effect in immediate verbal free recall is here interpreted in terms of a two-component view of verbal short-term memory.

A battery of 21 standardized neuropsychological tests was used in a retrospective study carried out on 52 mildly demented Alzheimer patients to analyse the relationship between age at onset of disease and the progress of cognitive impairment. Early onset was found to be associated with a more severe impairment. Possible sampling biases are discussed. Forty-seven patients were also tested for hemisphere asymmetry of cognitive impairment with two subsets of tests predominantly tapping left and right hemisphere abilities, respectively. We found a significant predominance of left-sided impairment which was not related to age at onset of disease. Possible relationship of this finding to healthy brain asymmetries is discussed.

This study assessed with a neuropsychological battery the outcome of 27 patients operated on for an aneurysm of the Middle Cerebral Artery a mean of 35 months before, and of 27 patients operated for aneurysms of the Posterior Communicating Artery, a mean of 47 months before. Both groups showed a defective pattern of performance that was related to the hemispheric side of the aneurysm with left-sided patients impaired on naming, verbal fluency and verbal short-term memory and right sided patients on both short-term and long-term spatial memory and discrimination of line orientation. In single cases, the scope of neuropsychological impairment was sometimes wider than that expected only on the basis of the competence of the affected hemisphere.

One hundred and fourteen patients operated on for an intracranial aneurysm were followed up in order to investigate their neuropsychological outcome and to detect if there were any clinical features assessed around the time of operation that had prognostic significance. The neuropsychological examination evaluated language, apraxia, memory, intelligence and spatial ability. In the statistical analysis the overall severity of neuropsychological disorder was studied. "Late surgery timing" had a negative influence upon the neuropsychological outcome. There was not a difference between different aneurysm sites. Several patients with an apparently good clinical outcome showed neuropsychological deficits. Neuropsychological assessment is important in the evaluation of outcome after subarachnoid haemorrhage.