Delusional Misidentification: A Clinical, Neuropsychological and Brain Imaging Case Study

Paillère-Martinot, Marie-Laure; Dao-Castellana, M H; Masure, M.C.; Pillon, B.; Martinot, Jean‐Luc

doi:10.1159/000284870

Cited by 38 publications

(12 citation statements)

References 23 publications

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“…Moreover, the presence of a significant impairment in visual-spatial functions and in visual-spatial memory recall is in agreement with previous neuropsychological findings on delusional misidentifications reporting a low efficiency in the complex visuospatial organization tasks and in non-verbal memory [19]. In this context, there is a clear evidence for impaired visuoperceptual functions in the appearance of misidentificative psychotic symptoms in patients affected by Alzheimer's disease [20].…”

Section: Discussionsupporting

confidence: 90%

An unusual delusion of duplication in a patient affected by Dementia with Lewy bodies

et al. 2017

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BackgroundDementia with Lewy bodies (DLB) is the second most frequent diagnosis of progressive degenerative dementia in older people. Delusions are common features in DLB and, among them, Capgras syndrome represents the most frequent disturbance, characterized by the recurrent and transient belief that a familiar person, often a close family member or caregiver, has been replaced by an identical-looking imposter. However, other delusional conditions near to misidentification syndromes can occur in DLB patients and may represent a major psychiatric disorder, although rarely studied systematically.Case presentationWe reported on a female patient affected by DLB who presented with an unusual delusion of duplication. Referring to the female professional caregiver engaged by her relatives for her care, the patient constantly described the presence of two different female persons, with a disorder framed in the context of a delusion of duplication.A brain 99Tc-hexamethylpropyleneamineoxime SPECT was performed showing moderate hypoperfusion in both occipital lobes, and associated with marked decreased perfusion in parieto-fronto-temporal lobes bilaterally.ConclusionsAn occipital hypoperfusion was identified, although in association with a marked global decrease of perfusion in the remaining lobes. The role of posterior lobes is certainly important in all misidentification syndromes where a natural dissociation between recognition and identification is present. Moreover, the concomitant presence of severe attentional and executive deficits evocative for a frontal syndrome and the marked global decrease of perfusion in the remaining lobes at the SPECT scan also suggest a possible dysfunction in an abnormal connectivity between anterior and posterior areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-017-0842-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

An unusual delusion of duplication in a patient affected by Dementia with Lewy bodies

et al. 2017

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“…It has been shown in US clinic samples that a high rate of manic symptoms in adolescentstypically falling short of meeting BD diagnostic criteria due to shorter durationincreases risk for subsequent BD (Birmaher et al, 2009). In addition, subthreshold manic symptoms in adolescents are associated with white-matters microstructure abnormalities in brain regions involved in mood disorders (Paill ere Martinot et al, 2014). However, subthreshold manic symptoms have not been shown to predict later bipolar disorder in a Danish cohort (P€ a€ aren et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Dimensions of manic symptoms in youth: psychosocial impairment and cognitive performance in the IMAGEN sample

Stringaris

Castellanos‐Ryan

Banaschewski

et al. 2014

Child Psychology Psychiatry

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BackgroundIt has been reported that mania may be associated with superior cognitive performance. In this study, we test the hypothesis that manic symptoms in youth separate along two correlated dimensions and that a symptom constellation of high energy and cheerfulness is associated with superior cognitive performance.MethodWe studied 1755 participants of the IMAGEN study, of average age 14.4 years (SD = 0.43), 50.7% girls. Manic symptoms were assessed using the Development and Wellbeing Assessment by interviewing parents and young people. Cognition was assessed using the Wechsler Intelligence Scale For Children (WISC-IV) and a response inhibition task.ResultsManic symptoms in youth formed two correlated dimensions: one termed exuberance, characterized by high energy and cheerfulness and one of undercontrol with distractibility, irritability and risk-taking behavior. Only the undercontrol, but not the exuberant dimension, was independently associated with measures of psychosocial impairment. In multivariate regression models, the exuberant, but not the undercontrolled, dimension was positively and significantly associated with verbal IQ by both parent- and self-report; conversely, the undercontrolled, but not the exuberant, dimension was associated with poor performance in a response inhibition task.ConclusionsOur findings suggest that manic symptoms in youth may form dimensions with distinct correlates. The results are in keeping with previous findings about superior performance associated with mania. Further research is required to study etiological differences between these symptom dimensions and their implications for clinical practice.

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“…In our patient, both electroencephalography and magnetic resonance imaging showed alterations of an organic nature. Although several studies have correlated frontal and subcortical brain lesions with Capgras syndrome,15,16 to date there has been limited investigation of the correlation between specific cerebral areas and this peculiar delusional syndrome. The neuroanatomic investigation, through magnetic resonance imaging, performed on this patient showed hyperintensities in the frontal subcortical white matter and in the semioval centers on both sides, compatible with a picture of gliosis, thus indicating an alteration affecting these areas.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it seems to be related to lesions of bifrontal and right limbic and temporal regions 9. Indeed, magnetic resonance imaging has revealed brain lesions in patients suffering from Capgras syndrome affecting in particular the frontal and subcortical regions 15,16. This delusion could also be due to a disconnection between the frontal lobes and right temporolimbic regions.…”

Section: Introductionmentioning

confidence: 99%

Clinical features and imaging findings in a case of Capgras syndrome

Luca

Bordone²,

Luca³

et al. 2013

NDT

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Capgras syndrome consists of the delusional belief that a person or persons have been replaced by doubles or impostors. It can occur in the context of both psychiatric and organic illness, and seems to be related to lesions of the bifrontal and right limbic and temporal regions. Indeed, magnetic resonance imaging has revealed brain lesions in patients suffering from Capgras syndrome. This case study reports the findings of a thorough diagnostic evaluation in a woman suffering from Capgras syndrome and presenting with the following clinical peculiarities: obsessive modality of presentation of the delusional ideation, intrusiveness of such ideation (that even disturbed her sleep), as well as a sense of alienation and utter disgust towards the double. These characteristics bring to mind the typical aspects of obsessive-compulsive disorder. Neuroanatomic investigation, through magnetic resonance imaging, performed on this patient showed alteration of the bilateral semioval centers, which are brain regions associated with the emotion of disgust and often show alterations in subjects suffering from obsessive-compulsive disorder. Hence, neuroimaging allows researchers to put forward the hypothesis of a common neuroanatomic basis for Capgras syndrome and obsessive-compulsive disorder, at least for cases in which the delusional ideation is associated with deep feelings of disgust and presents with a certain pervasiveness.

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Delusional Misidentification: A Clinical, Neuropsychological and Brain Imaging Case Study

Cited by 38 publications

References 23 publications

An unusual delusion of duplication in a patient affected by Dementia with Lewy bodies

An unusual delusion of duplication in a patient affected by Dementia with Lewy bodies

Dimensions of manic symptoms in youth: psychosocial impairment and cognitive performance in the IMAGEN sample

Clinical features and imaging findings in a case of Capgras syndrome

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