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Journal of Neural Transmission (Vienna,... Aug 2015Anhedonia and abulia are syndromes often presented as components of various psychiatric and neurological disorders, including depression, schizophrenia, stroke, multiple... (Review)
Review
Anhedonia and abulia are syndromes often presented as components of various psychiatric and neurological disorders, including depression, schizophrenia, stroke, multiple sclerosis and brain injury. On the basis of the hypothesis that alterations in the dopaminergic motivational system might be involved in the etiopathogenesis of these clinical phenomena, the antidepressant agomelatine is a highly interesting candidate substance for their treatment because of its indirect dopaminergic effects resulting from its melatoninergic and partial anti-serotoninergic properties. Systematic clinical studies are urgently needed to test the hypothesis that agomelatine might be a clinically useful and versatile anti-anhedonic and/or anti-abulic substance.
Topics: Acetamides; Anhedonia; Humans; Hypnotics and Sedatives; Mood Disorders
PubMed: 24311062
DOI: 10.1007/s00702-013-1126-6 -
Reviews in Neurological Diseases 2011Delirium is sometimes defined as acute onset of either overactivity or underactivity. This article reviews the nature and clinico-anatomical locations of lesions in... (Review)
Review
Delirium is sometimes defined as acute onset of either overactivity or underactivity. This article reviews the nature and clinico-anatomical locations of lesions in patients with reduced activity. The term abulia is used to describe global underactivity. Abulia is customarily explained by interruptions in frontal-subcortical circuitry. These interruptions can occur with lesions in the frontal lobes, caudate nuclei, midbrain, and thalamus. The article describes the anatomy of frontal and subcortical circuits and reviews in detail individual cases and series of patients with reduced initiative and activity who have had localized central nervous system lesions.
Topics: Akinetic Mutism; Animals; Brain; Humans; Motor Activity; Nerve Net; Nervous System Diseases
PubMed: 22249571
DOI: No ID Found -
Child's Nervous System : ChNS :... Aug 2002THALAMUS: The human thalamus is a nuclear complex located in the diencephalon and comprising of four parts (the hypothalamus, the epythalamus, the ventral thalamus, and... (Review)
Review
THALAMUS: The human thalamus is a nuclear complex located in the diencephalon and comprising of four parts (the hypothalamus, the epythalamus, the ventral thalamus, and the dorsal thalamus). The thalamus is a relay centre subserving both sensory and motor mechanisms. Thalamic nuclei (50-60 nuclei) project to one or a few well-defined cortical areas. Multiple cortical areas receive afferents from a single thalamic nucleus and send back information to different thalamic nuclei. The corticofugal projection provides positive feedback to the "correct" input, while at the same time suppressing irrelevant information. Topographical organisation of the thalamic afferents and efferents is contralateral, and the lateralisation of the thalamic functions affects both sensory and motoric aspects. Symptoms of lesions located in the thalamus are closely related to the function of the areas involved. An infarction or haemorrhage thalamic lesion can develop somatosensory disturbances and/or central pain in the opposite hemibody, analgesic or purely algesic thalamic syndrome characterised by contralateral anaesthesia (or hypaesthesia), contralateral weakness, ataxia and, often, persistent spontaneous pain. BASAL GANGLIA: Basal ganglia form a major centre in the complex extrapyramidal motor system, as opposed to the pyramidal motor system (corticobulbar and corticospinal pathways). Basal ganglia are involved in many neuronal pathways having emotional, motivational, associative and cognitive functions as well. The striatum (caudate nucleus, putamen and nucleus accumbens) receive inputs from all cortical areas and, throughout the thalamus, project principally to frontal lobe areas (prefrontal, premotor and supplementary motor areas) which are concerned with motor planning. These circuits: (i) have an important regulatory influence on cortex, providing information for both automatic and voluntary motor responses to the pyramidal system; (ii) play a role in predicting future events, reinforcing wanted behaviour and suppressing unwanted behaviour, and (iii) are involved in shifting attentional sets and in both high-order processes of movement initiation and spatial working memory. Basal ganglia-thalamo-cortical circuits maintain somatotopic organisation of movement-related neurons throughout the circuit. These circuits reveal functional subdivisions of the oculomotor, prefrontal and cingulate circuits, which play an important role in attention, learning and potentiating behaviour-guiding rules. Involvement of the basal ganglia is related to involuntary and stereotyped movements or paucity of movements without involvement of voluntary motor functions, as in Parkinson's disease, Wilson's disease, progressive supranuclear palsy or Huntington's disease. The symptoms differ with the location of the lesion. The commonest disturbances in basal ganglia lesions are abulia (apathy with loss of initiative and of spontaneous thought and emotional responses) and dystonia, which become manifest as behavioural and motor disturbances, respectively.
Topics: Basal Ganglia; Brain Mapping; Humans; Motor Activity; Movement; Movement Disorders; Neural Pathways; Neurons, Afferent; Neurons, Efferent; Parkinson Disease; Psychomotor Performance; Thalamus
PubMed: 12192499
DOI: 10.1007/s00381-002-0604-1 -
American Journal of Physical Medicine &... Aug 2018
Topics: Apathy; Caudate Nucleus; Diffusion Tensor Imaging; Humans; Male; Middle Aged; Prefrontal Cortex; Stroke
PubMed: 29303792
DOI: 10.1097/PHM.0000000000000884 -
Journal of Alzheimer's Disease : JAD 2015Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive language impairment. The three variants of PPA include the...
BACKGROUND AND OBJECTIVE
Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive language impairment. The three variants of PPA include the nonfluent/agrammatic, semantic, and logopenic types. The goal of this report is to describe two patients with a loss of speech initiation that was associated with bilateral medial frontal atrophy.
METHODS AND RESULTS
Two patients with progressive speech deficits were evaluated and their examinations revealed a paucity of spontaneous speech; however their naming, repetition, reading, and writing were all normal. The patients had no evidence of agrammatism or apraxia of speech but did have impaired speech fluency. In addition to impaired production of propositional spontaneous speech, these patients had impaired production of automatic speech (e.g., reciting the Lord's Prayer) and singing. Structural brain imaging revealed bilateral medial frontal atrophy in both patients.
CONCLUSION
These patients' language deficits are consistent with a PPA, but they are in the pattern of a dynamic aphasia. Whereas the signs-symptoms of dynamic aphasia have been previously described, to our knowledge these are the first cases associated with predominantly bilateral medial frontal atrophy that impaired both propositional and automatic speech. Thus, this profile may represent a new variant of PPA.
Topics: Aged; Aphasia, Primary Progressive; Atrophy; Female; Frontal Lobe; Humans; Male; Mental Status Schedule; Middle Aged; Speech
PubMed: 25854928
DOI: 10.3233/JAD-142112 -
Handbook of Clinical Neurology 2019The frontal lobes contain a complex set of diverse anatomic regions that form multiple distinct, complex networks with cortical and subcortical regions. Damage to these... (Review)
Review
The frontal lobes contain a complex set of diverse anatomic regions that form multiple distinct, complex networks with cortical and subcortical regions. Damage to these cortical-subcortical networks can have dramatic behavioral consequences, ranging from apathy to impairments in executive functioning. This chapter provides a brief overview of the common syndromes caused by damage to the mediodorsal and dorsolateral prefrontal circuits, followed by a more detailed review of the syndrome-sometimes referred to as pseudopsychopathy or acquired sociopathy-associated with damage to the ventromedial prefrontal circuit.
Topics: Agnosia; Apathy; Emotions; Executive Function; Frontal Lobe; Frontotemporal Dementia; Humans; Motivation; Nerve Net; Neuropsychological Tests
PubMed: 31590727
DOI: 10.1016/B978-0-12-804281-6.00008-2 -
Neurologic Clinics Feb 2016Frontotemporal dementia (FTD) is a not-uncommon explanation for progressive cognitive deficit in patients who often have a genetic susceptibility for such a... (Review)
Review
Frontotemporal dementia (FTD) is a not-uncommon explanation for progressive cognitive deficit in patients who often have a genetic susceptibility for such a neurodegenerative process. However, FTD does not seem to identify one particular pathogenetic mechanism but rather a spectrum of pathologies with particular predilection for the frontal and temporal lobes of the brain. There have been various subcategorizations of this form of dementia that have a tendency to be of earlier onset than typical Alzheimer disease and heralded by behavioral or communication manifestations. There is a behavioral variant and a language variant, referred to as primary progressive aphasia.
Topics: Aphasia, Primary Progressive; Brain; Frontotemporal Dementia; Humans; Neuropsychological Tests
PubMed: 26613998
DOI: 10.1016/j.ncl.2015.08.007 -
Movement Disorders : Official Journal... Sep 2002Abulia is the relatively uncommon yet debilitating lack of spontaneous, goal-directed behaviour that is seen predominantly with lesions of the basal ganglia and the...
Abulia is the relatively uncommon yet debilitating lack of spontaneous, goal-directed behaviour that is seen predominantly with lesions of the basal ganglia and the frontal lobes. We sought to confirm the existence of abulia as an entity recognized by clinicians, to generate a set of items characteristic of the condition, and to see how clinicians differentiate between overlapping disorders. The Delphi technique was used to survey consultant neurologists and psychiatrists at three hospitals in London. The study consisted of two phases: semi- structured interviews of a small group of neurologists and psychiatrists, followed by a survey of a larger group of consultants using postal questionnaires. Both neurologists and psychiatrists recognized abulia to be a distinct clinical entity but its status as a syndrome was unclear. Features such as difficulty in initiating and sustaining spontaneous movements and reduction in emotional responsiveness, spontaneous speech, and social interaction were identified as being characteristic of abulia. The information generated by this study may help to develop a working classification for disorders of diminished drive and motivation, and instruments for clinical assessment and decision making.
Topics: Basal Ganglia; Delphi Technique; Frontal Lobe; Goals; Humans; Mental Disorders; United Kingdom
PubMed: 12360558
DOI: 10.1002/mds.10194