Reduplicative paramnesia after a right frontal lesion.
ABSTRACT To report a case of reduplicative paramnesia after a focal lesion localized in the right frontal subcortical region.
It is suggested that a right frontal subcortical lesion alone may be sufficient to cause cognitive disturbance that can develop into reduplicative paramnesia. Clinical data have been scarce.
We describe the clinical, neuropsychological, and neuroradiologic findings of a 69-year-old man with reduplicative paramnesia after a right frontal subcortical lesion.
Observation and neuropsychological study showed visuospatial impairment, visual-dominant memory disturbance, anosognosia for cognitive disturbance, and mild frontal dysfunction with paranoid personality. Diffusion-weighted magnetic resonance imaging study showed a lesion localized in the right inferior posterior frontal subcortical area, and we could define 5 neural pathways involved with the lesion. We supposed that 4 of these were potentially related to reduplicative paramnesia: the medial inferior component of the superior longitudinal fasciculus and the fronto-occipital fasciculus, which are related to visuospatial processing; the anterior thalamic radiation, which is concerned with memory processes; and the uncinate fasciculus, which may be related to abnormal feelings of hyperfamiliarity.
A localized lesion in the right inferior posterior frontal subcortical area can cause cognitive dysfunction that may develop into reduplicative paramnesia. Paranoid personality and the change of the patient's hospital room might have triggered the reduplicative delusion in this case.
SourceAvailable from: Paolo Bartolomeo[Show abstract] [Hide abstract]
ABSTRACT: The novelist Henry James shared with his brother William, the author of the Principles of Psychology, a deep interest in the ways in which personal identity is built through one's history and experiences. At the end of his life, Henry James suffered a vascular stroke in the right hemisphere and developed a striking identity delusion. He dictated in a perfectly clear and coherent manner two letters as if they were written by Napoleon Bonaparte. He also showed signs of reduplicative paramnesia. Negative symptoms resulting from right hemisphere damage may disrupt the feelings of "warmth and intimacy and immediacy" and the "resemblance among the parts of a continuum of feelings (especially bodily feelings)", which are the foundation of personal identity according to William James. On the other hand, a left hemisphere receiving inadequate input from the damaged right hemisphere may produce positive symptoms such as delusional, confabulatory narratives. Other fragments dictated during Henry James's final disease reveal some form of insight, if partial and disintegrated, into his condition. Thus, even when consciousness is impaired by brain damage, something of its deep nature may persist, as attested by the literary characteristics of the last fragments of the Master.Neurological Sciences 09/2013; 34(11). DOI:10.1007/s10072-013-1546-y · 1.50 Impact Factor
Chapter: Poststroke Aggressiveness[Show abstract] [Hide abstract]
ABSTRACT: http://rd.springer.com/article/10.1007%2F978-1-4471-2428-3_8/lookinside/000.pngNeuropsychiatric symtpoms of cerebrovascular disorders, Edited by Ferro, José M, 01/2013: chapter Postroke Aggressiveness: pages 161-188; , ISBN: 978-1-4471-2428-3
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ABSTRACT: The uncinate fasciculus is a bidirectional, long-range white matter tract that connects lateral orbitofrontal cortex and Brodmann area 10 with the anterior temporal lobes. Although abnormalities in the uncinate fasciculus have been associated with several psychiatric disorders and previous studies suggest it plays a putative role in episodic memory, language and social emotional processing, its exact function is not well understood. In this review we summarize what is currently known about the anatomy of the uncinate, we review its role in psychiatric and neurological illnesses, and we evaluate evidence related to its putative functions. We propose that an overarching role of the uncinate fasciculus is to allow temporal lobe-based mnemonic associations (e.g. an individual's name + face + voice) to modify behaviour through interactions with the lateral orbitofrontal cortex, which provides valence-based biasing of decisions. The bidirectionality of the uncinate fasciculus information flow allows orbital frontal cortex-based reward and punishment history to rapidly modulate temporal lobe-based mnemonic representations. According to this view, disruption of the uncinate may cause problems in the expression of memory to guide decisions and in the acquisition of certain types of learning and memory. Moreover, uncinate perturbation should cause problems that extend beyond memory to include social-emotional problems owing to people and objects being stripped of personal value and emotional history and lacking in higher-level motivational value.Brain 05/2013; DOI:10.1093/brain/awt094 · 10.23 Impact Factor