23rd Annual European International Neuropsychological Society (INS) Conference, July 12-15, 2000, Brussels
Randi Starrfelts poster fik stor opmærk- somhed
Jeg deltog sammen med seks af mine studerende:

Smari Palsson, Haukur Palmason, Barbara Ravnkilde, Lisbet Marstrand og Randi Starrfelt

Starrfelt, R., Gade, A., Gerlach, C., & Udesen, H. (2000). A 2nd case of the 3rd alexia in pure form. Journal of the International Neuropsychological Society, 6, 398.

We present a patient (J.M.) with severe alexia and agraphia in the absence of aphasia, and with intact reading and writing of numbers. J.M., a right_handed 18_year_old man, presented with with alexia and agraphia after concussion. CT and MR were normal. J.M. is impaired in identifying, writing, and copying letters. His reading and writing of numbers are normal, as is his written arithmetic. Object naming is within normal range, and his copying and drawing of figures and objects are good. In a single letter identification task, J.M. was able to identify only 13/29 uppercase letters and 18/29 lowercase letters. He is almost completely unable to read words, and we have not observed any whole_word reading. Rather, J.M. uses a slow and laborious letter_by_letter strategy when trying to read words, including his own name, and misidentification of letters is frequent. His naming to oral spelling is good, as is his oral spelling of dictated words. In writing, letters are partly superimposed on each other, making the words virtually unreadable. There are no obvious spelling errors, but some some letters are poorly formed. By contrast to his reading, J.M. was able to identify written numbers (1_7 digits) quickly and correctly. He is also able to write numbers and perform written calculations without difficulties. This pattern of performance closely resembles that described by Anderson, Damasio, & Damasio. Their patient, presumably the only one on record with this syndrome, had a lesion in Exner's area in the left premotor cortex.

International pris til psykologi- studerende
 
Smari's søn Daniel ved deres "skur" under Hekla sommeren 1999. Hanne og jeg lånte hytten.
En af de islandske psykologistuderende i København, Smari Palsson, fik på konferencen overrakt the Phillip M.Rennick Award. Haukur Palmason, som ligeledes er psykologistuderende, er andenforfatter på det arbejde, som gav prisen for "the best graduate student paper" på the International Neuropsychological Society's 23rd Annual Mid-Year Meeting.

Det prisbelønnede arbejde er Smari Palssons specialeprojekt. Smari og Haukur kom i 1996 til Institut for Psykologi, hvor de er tilmeldt grenspecialiseringen i neuropsykologi. De tog tilbage til Island i 1998 for at gennemføre empiriske specialeprojekter. Begge fik samtidig arbejde ved et genetisk forskningsinstitut, som udfører projekter for deCODE Genetics - det firma, som er ved at kortlægge store dele af den islandske befolknings familiestamtræer og genetik. De muligheder, som det giver, er udnyttet i Smari Palssons arbejde. Formålet er at undersøge, om der hos søskende til patienter med Alzheimers sygdom i familier med demenshistorie er tegn på subtile kognitive defekter.

Arbejdet omfatter indtil nu 73 søskende til patienter og 43 normale kontrolpersoner, som er ægtefæller til patienter. Grupperne er nøje matchede på køn, alder og uddannelse, og alle med kendte forstyrrelser i centralnervesystemet, psykiatriske sygdomme, eller kronisk misbrug af medicin eller alkohol er blevet udelukket fra undersøgelsen. De to grupper er blevet undersøgt med et antal neuropsykologiske tests, som omfattede ialt 27 mål. I den foreløbige opgørelse er der signifikant forskel mellem de to grupper på 7 af de 27 mål - i alle tilfælde mål for hukommelse.

Det ser altså ud til, at søskende til patienter med Alzheimers sygdom har lette eller moderate hukommelses- vanskeligheder, mest tydeligt i verbal hukommelse. Derimod er der ingen tegn på forstyrrelser i andre kognitive domæner som fx. abstrakt tænkning, sprog, koncentration og mental hastighed, eller visuospatiale og konstruktionelle færdigheder.

Hvad er så betydningen af selektive hukommelsesforstyrrelser hos disse søskende? Jo, det er sådan Alzheimers sygdom begynder - selektive vanskeligheder i episodisk hukommelse - og vanskelighederne kunne dermed antyde sygdom i tidlig, præklinisk stadium hos nogle af disse søskende. Betydningen af det islandske fund kan også belyses med et andet fund, som i samme uge i juli 2000 blev præsenteret af en helt tredje specialestuderende ved en konference i Washington DC. Stud.psyk. Nina Sjø præsenterede her resultater fra 1-års opfølgelsen af 29 konsekutive patienter, som efter henvisning til Hukommelsesklinikken på Rigshospitalet viste sig at have selektive forstyrrelser i episodisk hukommelse, men altså ikke var demente og dermed ikke kunne diagnosticeres som tilfælde med Alzheimers sygdom. Gruppen var på forhånd renset for de patienter, hvor der var andre mulige forklaringer på amnesi, fx. alkoholisme, og formålet med den systematiske opfølgning er at undersøge, hvor hurtigt og i hvilken udstrækning de konverterer til demens og Alzheimers sygdom.

På Island vil næste trin i det prisbelønnede specialeprojekt være at følge de pårørende med undersøgelser ligesom ved gruppen i København, og undersøgelser af de af deres børn, som er over 40 år gamle, er også startet.

Phillip M.Rennick, som prisen er opkaldt efter, var indtil sin tidlige død midt i 1970'erne professor i psykologi ved Wayne State University i Michigan. Han berømmes i dag ikke blot for sin forskning, men også for sin evne til at inspirere og hjælpe unge studerende til en forskningskarriere i psykologi. Det er en ære for Københavns Universitet og Institut for Psykologi, at en studerende herfra har fået prisen, selv om arbejdet er udført på Island.

Et par billeder fra nattelivet -

Teksten er seriøs nok

Marstrand, L., Gerlach, C., Udesen, H., & Gade, A. (2000). Selective impairment of intermediate vision following stroke in the right occipital lobe. Journal of the International Neuropsychological Society, 6, 381. INTRODUCTION: Recent studies have suggested that intermediate stages (preattentive and grouping processes) in visual processing can be selectively damaged. We present a patient supporting this proposal. CASE HISTORY: The patient H.E., a 58-year-old right-handed woman, suffered from an infarct in the right occipital lobe. Visual field examination showed a left homonymous hemianopia without macular sparing. H.E.'s performance on tests of early vision (Efron Shape Test and VOSP Shape Detection Screening Test) was normal, but her performance on tests using degraded stimuli (Street's Completion Test and VOSP Incomplete Letters) was compromised. On tasks measuring spatial abilities (VOSP Position Discrimination, VOSP Number Location) and visual grouping abilities (perceiving illusory contours) H.E. performed well outside the normal range. Despite marked problems in recognizing degraded pictures H.E. nevertheless performed satisfactorily on easy and difficult object decision tasks and on picture naming suggesting preserved visual knowledge. In addition H.E. also appeared able to perform transformations of orientation. It should be noted, however, that H.E.'s reaction times were abnormally slow on the object decision tasks, the tasks involving transformation of size and orientation and on picture naming. CONCLUSION: H.E.'s early visual abilities are preserved. Also processes related to high-level vision (perceptual differentiation, transformation of orientation) appears to function relatively normally. However, H.E.'s prolonged reaction times and failure to recognize degraded stimuli suggest that the visual information, on which high-level vision is performed, is much reduced. Based on these findings we believe that H.E.'s performance pattern can be accounted for by as a selective impairment of intermediate vision.
Ravnkilde, B., Videbech, P., Gade, A., & Rosenberg, R. (2000). Stroop's test and verbal fluency as measures of frontal lobe function: A PET study. Journal of the International Neuropsychological Society, 6, 379.

Stroop's Test and the Verbal Fluency Test are commonly argued to be measures of the integrity of prefrontal cortex. This assumption has only to some degree been confirmed by lesion studies. In the present study positron emission tomography (PET) was used to further validate Stroop's test and Verbal Fluency as measures of frontal lobe function by implementing both tests as activation paradigms during scanning of normal individuals. 47 normal volunteers (M age 41 +/- 11.7) were scanned with intravenous bolus injections of H2[15O] water. Four scans with a frame of 40 s were completed. Stimuli were presented on a monitor screen outside the scanner and the participants had to respond orally. Activation tasks were Stroop's Test: (1) naming the color of congruent color words, (2) naming the color of incongruent color words, and the Verbal Fluency Test, (3) reading neutral color words, (4) generating as many 'T'-words as possible. Statistics were performed using the Montreal method. The analysis was set up as a cross-validation study. Data presented here are the results of the first analysis of 14 participants. Subtraction of the Stroop tasks (Scan 1 from 2) was found to activate the left anterior cingulate cortex (BA 32, p<.05). When subtracting Scan 3 from 4, Verbal Fluency activated the left dorsolateral prefrontal cortex (BA 9, 45, p<.01), supplementary motor cortex (BA 6, p<.05), anterior cingulate cortex (BA 24, 32, p<.05), and the cerebellum (p<.01). From this first analysis we conclude that both Stroop's test and the Verbal Fluency test with qualifications can be considered tests of frontal lobe function. However, only the Fluency test proved to be a test of specifically prefrontal function.

Barbara Ravnkilde, Anders Gade, Lisbet Marstrand

Konklusion: Et godt og udbytterigt møde både videnskabeligt og socialt !

Næste europæiske INS-konference er i Stokholm 24.-27. august 2002