Recent neuroimaging studies have demonstrated that both remembering the past and simulating the future activate a core neural network including the medial temporal lobes. Regions of this network, in particular the medial temporal lobes, are prime sites for amyloid deposition and are structurally and functionally compromised in Alzheimer's disease (AD). While we know some functions of this core network, specifically episodic autobiographical memory, are impaired in AD, no study has examined whether future episodic simulation is similarly impaired. We tested the ability of sixteen AD patients and sixteen age-matched controls to generate past and future autobiographical events using an adapted version of the Autobiographical Interview. Participants also generated five remote autobiographical memories from across the lifespan. Event transcriptions were segmented into distinct details, classified as either internal (episodic) or external (non-episodic). AD patients exhibited deficits in both remembering past events and simulating future events, generating fewer internal and external episodic details than healthy older controls. The internal and external detail scores were strongly correlated across past and future events, providing further evidence of the close linkages between the mental representations of past and future.
When remembering past events or imagining possible future events, older adults generate fewer episodic details than do younger adults. These results support the constructive episodic simulation hypothesis: deficits in retrieving episodic details underlie changes during memory and imagination. To examine the extent of this age-related reduction in specificity, we compared performance on memory and imagination tasks to a picture description task that does not require episodic memory. In two experiments, older adults exhibited comparable specificity reductions across all conditions. These findings emphasize the need to consider age-related changes in imagination and memory in a broader theoretical context.
To date, there have been reports of neurologic manifestations in Covid-19 patients including ischemic strokes, Guillain-Barre Syndrome and anosmia. In this case report, we report a patient who presented with dysosmia, dysgeusia along with monocular peripheral vision loss after being diagnosed with Covid-19.
Background Mobile stroke units ( MSU s) reduce time to intravenous thrombolysis in acute ischemic stroke. Whether this advantage exists in densely populated urban areas with many proximate hospitals is unclear. Methods and Results We evaluated patients from the METRONOME (Metropolitan New York Mobile Stroke) registry with suspected acute ischemic stroke who were transported by a bi‐institutional MSU operating in Manhattan, New York, from October 2016 to September 2017. The comparison group included patients transported to our hospitals via conventional ambulance for acute ischemic stroke during the same hours of MSU operation (Monday to Friday, 9 am to 5 pm) . Our exposure was MSU care, and our primary outcome was dispatch‐to‐thrombolysis time. We estimated mean differences in the primary outcome between both groups, adjusting for clinical, demographic, and geographic factors, including numbers of nearby designated stroke centers and population density. We identified 66 patients treated or transported by MSU and 19 patients transported by conventional ambulance. Patients receiving MSU care had significantly shorter dispatch‐to‐thrombolysis time than patients receiving conventional care (mean: 61.2 versus 91.6 minutes; P =0.001). Compared with patients receiving conventional care, patients receiving MSU care were significantly more likely to be picked up closer to a higher mean number of designated stroke centers in a 2.0‐mile radius (4.8 versus 2.7, P =0.002). In multivariable analysis, MSU care was associated with a mean decrease in dispatch‐to‐thrombolysis time of 29.7 minutes (95% CI , 6.9–52.5) compared with conventional care. Conclusions In a densely populated urban area with a high number of intermediary stroke centers, MSU care was associated with substantially quicker time to thrombolysis compared with conventional ambulance care.
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