Two patients with the syndrome of progressive aphasia without evidence of generalized dementia underwent postmortem neuropathological examinations. In both patients, characteristic changes of Alzheimer's disease, Pick's disease, or Creutzfeldt-Jakob disease were absent. Both patients showed a focal spongiform change involving primarily layer 2 of the left inferior frontal gyrus (and temporal cortex in Patient 1) and a mild astrocytosis in layer 2 and deeper cortical layers. This focal, spongiform cortical degeneration in patients with progressive aphasia does not appear to duplicate any known central nervous system degenerative disease.

The behavioral variant frontotemporal dementia (bvFTD) usually emerges with behavioral changes similar to changes in late-life bipolar disorder (BD) especially in the early stages. According to the literature, a substantial number of bvFTD cases have been misdiagnosed as BD. Since the literature lacks studies comparing differential diagnosis ability of electrophysiological and neuroimaging findings in BD and bvFTD, we aimed to show their classification power using an artificial neural network and genetic algorithm based approach. Eighteen patients with the diagnosis of bvFTD and 20 patients with the diagnosis of late-life BD are included in the study. All patients' clinical magnetic resonance imaging (MRI) scan and electroencephalography recordings were assessed by a double-blind method to make diagnosis from MRI data. Classification of bvFTD and BD from total 38 participants was performed using feature selection and a neural network based on general algorithm. The artificial neural network method classified BD from bvFTD with 76% overall accuracy only by using on EEG power values. The radiological diagnosis classified BD from bvFTD with 79% overall accuracy. When the radiological diagnosis was added to the EEG analysis, the total classification performance raised to 87% overall accuracy. These results suggest that EEG and MRI combination has more powerful classification ability as compared with EEG and MRI alone. The findings may support the utility of neurophysiological and structural neuroimaging assessments for discriminating the 2 pathologies.

We studied three right-handed patients with small, lacunar infarcts localized by CT to the posterior and lateral putamen and the posterior limb of the internal capsule. All had moderate or severe right hemiparesis and mild aphasia that was not characteristic of any traditional aphasia syndrome. Two had mild dysarthria. Aphasic abnormalities included mild, nonfluent, telegraphic speech and mild, fluent aphasia with impaired repetition, naming, and comprehension. All three had severely impaired writing. Unlike previously reported patients with subcortical infarcts, these cases indicate that small lesions limited to the posterior capsuloputaminal area can cause aphasia and agraphia as well as dysarthria.

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OBJECTIVES:The aim of the present study was to examine the impact of 25 Hz high-frequency repetitive transcranial magnetic stimulation (rTMS) on neuropsychological testing in treatmentresistant depression patients who were receiving no other concomitant medications for the treatment. METHODS: A total of 19 patients with treatment-resistant depression and 20 healthy controls were included in the study. A 25 Hz, 1000 pulse stimulation was set at 100% of the motor threshold and delivered 20 times for 2 s with 30 s intervals as 20 sessions to the depression group, and sham treatment was applied to the control group. Brief Psychiatric Rating Scale (BPRS), Stroop task, trail-making test (TMT), and Wisconsin card sorting test (WCST) were performed both before and 3 days after the rTMS treatment. Seventeen-item Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI) were obtained at baseline and after the rTMS treatment, as well. RESULTS: After the rTMS treatment, 52.6% (10 of 19 patients) met the response criteria (>50% improvement in HAMD score), with 5 (26.3%) patients meeting the criteria for remission of depression (HAMD score ≤ 8). None of the patients had a worsened HAMD score at the end of treatment. Reflecting the antidepressant effect of rTMS treatment, the mean BDI score, BPRS score, and Stroop task scores significantly differed following the treatment (p < .001, p < .001, and p = .017, respectively). TMT score difference did not reach statistical significance, whereas WCST scores showed significance in "correct responses" and "perseverative errors" categories (p < .05, and p < .05, respectively). None of the test scores at the end of rTMS treatment showed a significant difference when compared to baseline scores for the control group (p > .05, for all). CONCLUSIONS: Results suggest that rTMS can be used as a beneficial treatment option to ameliorate cognitive functions, especially executive functions. Patients had an improvement in depressive symptoms with the rTMS treatment without any concomitant medication, as well. Therefore, improvement in cognitive performance might be associated with improvement in depressive symptoms. ARTICLE HISTORY