Yes/no reversals as neurobehavioral sequela: a disorder of language, praxis, or inhibitory control?
This study identifies a linguistic phenomenon suggestive of damage to fronto-subcortical circuitry. Our objective was to determine the occurrence and neuroradiological/neurobehavioral correlates of yes/no reversals in corticobasal degeneration (CBD), and document occurrence of reversals in other neurological conditions. In a prospective study, we evaluated 34 CBD patients using a neuropsychologic battery and magnetic resonance imaging. Patients were subdivided into two groups: those with (n = 11) and without (n = 23) yes/no reversals. In a retrospective study conducted during the period of 1991-2001, we identified 33 patients for whom yes/no reversals occurred to compare correlates with prospective study findings. In the prospective study, 11 patients (32.3%) had yes/no reversals. Significant between-group differences were found in scores of lexical fluency (P = 0.02) and prehension (P = 0.03). Prehension scores correlated with facial praxis (P < 0.0001) and upper limb praxis scores (P < 0.0001) in the yes/no reversal group only. In the retrospective study, nine CBD patients and 24 non-CBD patients had yes/no reversals, with damage to fronto-subcortical areas present in all patients. Results suggest an association with deficits in mental flexibility and inhibitory control. High within-group correlations of lexical fluency and prehension with praxis scores suggest a relationship of yes/no reversals with multiple factors.
Frattali
C
C
Department, W G Magnuson Clinical Center, NIH, Bethesda, MD 20892-1604, USA. carol_frattali@nih.gov
Duffy
J R
JR
Litvan
I
I
Patsalides
A D
AD
Grafman
J
J
D000368:Aged; D000369:Aged, 80 and over; D001479:Basal Ganglia / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007806:Language Disorders / Q000473:pathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000473:pathology / Q000523:psychology; D009433:Neural Inhibition / Q000502:physiology; D019636:Neurodegenerative Diseases / Q000473:pathology* / Q000523:psychology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012189:Retrospective Studies