Objective: To test the hypothesis that MRI-based measurements of hippocampal volume are related to the risk of future conversion to Alzheimer’s disease (AD) in older patients with a mild cognitive impairment (MCI). Background: Patients who develop AD pass through a transitional state, which can be characterized as MCI. In some patients, however, MCI is a more benign condition, which may not progress to AD or may do so slowly.Patients:— Eighty consecutive patients who met criteria for the diagnosis of MCI were recruited from the Mayo Clinic Alzheimer’s Disease Center/Alzheimer’s Disease Patient Registry. Methods: At entry into the study, each patient received an MRI examination of the head, from which the volumes of both hippocampi were measured. Patients were followed longitudinally with approximately annual clinical/cognitive assessments. The primary endpoint was the crossover of individual MCI patients to the clinical diagnosis of AD during longitudinal clinical follow-up. Results: During the period of longitudinal observation, which averaged 32.6 months, 27 of the 80 MCI patients became demented. Hippocampal atrophy at baseline was associated with crossover from MCI to AD (relative risk [RR], 0.69, p = 0.015). When hippocampal volume was entered into bivariate models—using age, postmenopausal estrogen replacement, standard neuropsychological tests, apolipoprotein E (APOE) genotype, history of ischemic heart disease, and hypertension—the RRs were not substantially different from that found univariately, and the associations between hippocampal volume and crossover remained significant. Conclusion: In older patients with MCI, hippocampal atrophy determined by premorbid MRI-based volume measurements is predictive of subsequent conversion to AD.

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Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment

Dual functional brain asymmetry refers to the notion that in most individuals the left cerebral hemisphere is specialized for language functions, whereas the right cerebral hemisphere is more important than the left for the perception, construction, and recall of stimuli that are difficult to verbalize. In the last twenty years there have been scattered reports of sex differences in degree of hemispheric specialization. This review provides a critical framework within which two related topics are discussed: Do meaningful sex differences in verbal or spatial cerebral lateralization exist? and, if so, Is the brain of one sex more symmetrically organized than the other? Data gathered on right-handed adults are examined from clinical studies of patients with unilateral brain lesions; from dichotic listening, tachistoscopic, and sensorimotor studies of functional asymmetries in non-brain-damaged subjects; from anatomical and electrophysiological investigations, as well as from the developmental literature. Retrospective and descriptive findings predominate over prospective and experimental methodologies. Nevertheless, there is an impressive accummulation of evidence suggesting that the male brain may be more asymmetrically organized than the female brain, both for verbal and nonverbal functions. These trends are rarely found in childhood but are often significant in the mature organism.

Sex differences in human brain asymmetry: a critical survey

Sex-role stereotypes and self-concepts in college students.

BACKGROUND: Older patients are often referred to geriatricians because of complaints of progressive difficulties in walking. The diagnostic and therapeutic approach to these patients is complex. Multiple physiologic subsystems may influence the ability to walk, and no standard criteria are currently available to establish whether these subsystems are functioning within the normal range. To address this lack of knowledge we conducted the InCHIANTI study.



OBJECTIVE: To identify measures that clinicians can use to understand the causes of walking difficulties in older persons.



DESIGN: A population-based study of persons living in the Chianti geographic area (Tuscany, Italy).



PARTICIPANTS: 1453 persons (age-range 20–102 years; 91.6% of the eligible) selected from city registry of Greve in Chianti and Bagno a Ripoli (Tuscany, Italy), using a multistage sampling method.



MEASUREMENTS: Factors that influence walking ability were classified into six main physiologic subsystems: central nervous system, perceptual system, peripheral nervous system, muscles, bone/joints, and energy production/delivery. Measures of the integrity and functioning of each of these proposed subsystems were identified and administered to all participants.



CONCLUSIONS: Data collected in InCHIANTI will be used to identify the main risk factors that influence loss of the ability to walk in older persons, to define physiologic subsystems that are critical for walking, to select the best measures of their integrity, and to establish critical ranges in these measures that are compatible with “normal” walking ability. The final goal is to translate epidemiological research into a geriatric clinical tool that makes possible more precise diagnosis and more effective treatment in patients with walking dysfunction.

Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study.

Cerebral white matter of asymptomatic people frequently exhibits circumscribed areas of hyperintensity on magnetic resonance (MR) images and hypodensity on computed tomography scans. However, behavioral implications of this phenomenon remain unclear. In this meta-analysis, the authors examine cumulative evidence regarding the cognitive sequelae of white matter abnormalities in adults without dementia. The influence of potential moderator variables, such as neuroimaging technique, location of the lesions, rating scale, and demographic characteristics of the sample on the association between the burden of white matter hyperintensities and cognitive performance was also examined. Results indicate that white matter abnormalities observed on MR images are associated with attenuated performance on tasks of processing speed, immediate and delayed memory, executive functions, and indices of global cognitive functioning. There was no significant link between the white matter hyperintensities and psychometric indices of intelligence or fine motor performance.

Eston Jackson Asher

Papers

The Purdue pegboard; norms and studies of reliability and validity.

Introduction to general psychology

Differences in environment: How they affect our behavior.

The psychology of normal people (revised ed.).

Differences between people: How they affect our behavior.