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      Dementia due to Meningovascular Syphilis in Medial Temporal Lobe and Cognitive Rehabilitation

      case-report

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          Abstract

          The temporal lobe is essential in saving declarative memory and plays an important role along with the cerebral neocortex in creating and maintaining long-term memory. Damage to the temporal lobe is expected to result in cognitive impairment or dementia, which has characteristic symptoms such as cognitive and behavioral dysfunction and decreasing self-reliance in activities of daily living. We report on a patient, who suffered from dementia due to meningovascular syphilis affecting the medial temporal lobe, and on the outcome of cognitive rehabilitation.

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          Ventral and dorsal pathways for language.

          Dorothee Saur, Björn Kreher, Susanne Schnell … (2008)
          Built on an analogy between the visual and auditory systems, the following dual stream model for language processing was suggested recently: a dorsal stream is involved in mapping sound to articulation, and a ventral stream in mapping sound to meaning. The goal of the study presented here was to test the neuroanatomical basis of this model. Combining functional magnetic resonance imaging (fMRI) with a novel diffusion tensor imaging (DTI)-based tractography method we were able to identify the most probable anatomical pathways connecting brain regions activated during two prototypical language tasks. Sublexical repetition of speech is subserved by a dorsal pathway, connecting the superior temporal lobe and premotor cortices in the frontal lobe via the arcuate and superior longitudinal fascicle. In contrast, higher-level language comprehension is mediated by a ventral pathway connecting the middle temporal lobe and the ventrolateral prefrontal cortex via the extreme capsule. Thus, according to our findings, the function of the dorsal route, traditionally considered to be the major language pathway, is mainly restricted to sensory-motor mapping of sound to articulation, whereas linguistic processing of sound to meaning requires temporofrontal interaction transmitted via the ventral route.
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            Cerebellar neurocognition: insights into the bottom of the brain.

            Hyo Jung De Smet, P. P. Niu, Philippe F Paquier … (2008)
            The traditional view on the core functions of the cerebellum consists of the regulation of motor coordination, balance and motor speech. However, during the past decades results from neuroanatomical, neuroimaging and clinical studies have substantially extended the functional role of the cerebellum to cognitive and affective regulation. Neuroanatomical studies convincingly showed cerebellar connectivity with associative areas of the cerebral cortex involved in higher cognitive functioning, while functional neuroimaging provided evidence of cerebellar activation during a variety of cognitive tasks. In addition, more systematic neuropsychological research performed in patients with cerebellar lesions and the development of more sensitive neuropsychological tests allowed clinicians to identify significant cognitive and affective disturbances following cerebellar damage. In this review, an overview is presented of the cerebellar role in a variety of cognitive processes, such as executive functioning, memory, learning, attention, visuo-spatial regulation, language and behavioral-affective modulation. In addition, recent evidence with regard to cerebellar induced clinical entities such as the cerebellar cognitive affective syndrome (CCAS) and the posterior fossa syndrome (PFS), will be discussed. Although extensive research has substantially broadened the insights in the cognitive and affective role of the cerebellum, the precise nature of the cerebellar contribution to cognitive and affective regulation is not yet clear. In this review experimental and clinical data will be discussed that substantiate the presumed neurobiological mechanisms underlying the cognitive and affective modulatory role of the cerebellum.
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              Prefrontal and medial temporal lobe activity at encoding predicts temporal context memory.

              Charan Ranganath, Emily Jenkins (2010)
              One of the defining features of episodic long-term memory is that it includes information about the temporal context in which an event occurred. Little is known about the regions that support the encoding of temporal information in the human brain, although previous work has suggested a role for the lateral prefrontal cortex (PFC) and medial temporal lobes (MTL). Here we used event-related fMRI to examine the relationship between activity at encoding and subsequent memory for temporal context. Participants were scanned while performing a serial order working memory task with pictures of common objects and were later tested for temporal memory at two different timescales. In the coarse temporal memory test, participants viewed one object from each trial and indicated approximately when during the course of the experiment it had appeared. In the fine temporal memory test, participants were shown the remaining objects from each trial and asked to recall the order in which they had been originally presented. Activity in the parahippocampal cortex predicted subsequent fine temporal accuracy, whereas coarse temporal accuracy was predicted by activity in several regions of the PFC, as well as in the hippocampus. Additional multivoxel pattern analyses revealed evidence implicating the rostrolateral PFC in the representation of time-varying contextual states in a manner similar to that proposed by computational theories of temporal context memory. These results highlight MTL and PFC contributions to temporal memory at the time of encoding and suggest a particular role for the rostrolateral PFC in encoding coarse temporal context.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Rehabil Med
                Journal ID (iso-abbrev): Ann Rehabil Med
                Journal ID (publisher-id): ARM
                Title: Annals of Rehabilitation Medicine
                Publisher: Korean Academy of Rehabilitation Medicine
                ISSN (Print): 2234-0645
                ISSN (Electronic): 2234-0653
                Publication date (Print): June 2012
                Publication date (Electronic): 30 June 2012
                Volume: 36
                Issue: 3
                Pages: 423-427
                Affiliations
                Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Anyang 431-070, Korea.
                Author notes
                Corresponding author: Suk Hoon Ohn. Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, 896, Pyeongchon-dong, Dongan-gu, Anyang 431-070, Korea. Tel: +82-31-380-3860, Fax: +82-31-380-3864, myeom@ 123456korea.com , ohnsh@ 123456hallym.ac.kr
                Article
                DOI: 10.5535/arm.2012.36.3.423
                PMC ID: 3400886
                PubMed ID: 22837982
                SO-VID: 0a9cdd9b-1e11-448a-9d8f-2e211ab4aae7
                Copyright © Copyright © 2012 by Korean Academy of Rehabilitation Medicine
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 June 2011
                Date accepted : 15 September 2011
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
                Keywords: meningovascular syphilis,dementia,cognitive rehabilitation
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: meningovascular syphilis, dementia, cognitive rehabilitation

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