Paul J Eslinger

Publications (30)103.19 Total impact

• Article: Rehabilitation and management of executive function disorders.

  Paul J Eslinger, Claire V Flaherty-Craig, Freeman M Chakara
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  ABSTRACT: Executive function disorders arise from damage to brain areas mediating complex aspects of human behavior, including self-regulation, social cognition, planning, and organization. These functions are especially necessary to everyday adaptation, independence, and productivity. Executive function disorders have multiple causes and are expressed through different patterns of cognitive, emotional, social, and behavioral impairment. Treatment approaches target specific symptoms, especially in attention, working memory, problem solving, social cognition, and self-control of behavior and emotions. Interventions draw upon behavioral training, compensatory processing techniques, self-awareness and metacognitive training, environmental aids, and medications along with family/caregiver education. The evidence base for identifying effective treatments is promising but remains limited with a need to broaden the focus on real world functional outcomes.
  Handbook of Clinical Neurology 01/2013; 110:365-76.
• Source

  Available from: PubMed Central

  Article: Maturational and aging effects on human brain apparent transverse relaxation.

  Jianli Wang, Michele L Shaffer, Paul J Eslinger, Xiaoyu Sun, Christopher W Weitekamp, Megha M Patel, Deborah Dossick, David J Gill, James R Connor, Qing X Yang
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  ABSTRACT: The goal of this study was to address the need for comprehensive reference data regarding maturational and aging effects on regional transverse relaxation rates (R(2)) of the brain in normal humans. Regional R(2)s were measured in twenty-five brain structures from a sample of seventy-seven normal volunteers 9 to 85 years of age. The relationships between regional R(2) and age were determined using generalized additive models, without the constraint of a specified a priori model. Data analysis demonstrated that the brain tissue R(2)-age correlations followed various time courses with both linear and non-linear characteristics depending on the particular brain structure. Most anatomical structures studied exhibited non-linear characteristics, including the amygdala, hippocampus, thalamus, globus pallidus, putamen, caudate nucleus, red nucleus, substantia nigra, orbitofrontal white matter and temporal white matter. Linear trends were detected in occipital white matter and in the genu of corpus callosum. These results indicate the complexity of age-related R(2) changes in the brain while providing normative reference data that can be utilized in clinical examinations and studies utilizing quantitative transverse relaxation.
  PLoS ONE 01/2012; 7(2):e31907. · 4.09 Impact Factor
• Article: Apathy in frontotemporal dementia: behavioral and neuroimaging correlates.

  Paul J Eslinger, Peachie Moore, Shweta Antani, Chivon Anderson, Murray Grossman
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  ABSTRACT: We investigated the occurrence of goal-directed motivational change in the form of apathy in patients with frontotemporal dementia (FTD), particularly those with behavioral variant social and executive deficits (bvFTD). Standardized behavioral inventory was employed to survey and compare apathy ratings from patients and caregivers. In cases of bvFTD, apathy ratings were further related to measures of social cognition, executive function, and atrophy on brain MRI. Results indicated that caregivers rated bvFTD patients as having significantly elevated apathy scores though patient self-ratings were normal. Caregiver and self-ratings of FTD samples with progressive nonfluent aphasia and semantic dementia did not differ from healthy controls and their informants. In the bvFTD sample, caregiver apathy scores were not correlated with general cognitive screening or depression scores, but were significantly correlated with social cognition and executive function measures. Voxel-based morphometry revealed that apathy ratings in bvFTD were related to prominent atrophy in the right caudate (including the ventral striatum), the right temporo-parietal junction, right posterior inferior and middle temporal gyri, and left frontal operculum- anterior insula region. Findings suggest that bvFTD is associated with a significant breakdown in goal-directed motivated behavior involving disruption of cortical-basal ganglia circuits that is also related to social and executive function deficits.
  Behavioural neurology 01/2012; 25(2):127-36. · 1.77 Impact Factor
• Source

  Available from: Am Barrett

  Article: Visual distraction: an altered aiming spatial response in dementia.

  Elizabeth E Galletta, Anthony H Lequerica, Scott R Pekrul, Paul J Eslinger, Anna M Barrett
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  ABSTRACT: Healthy individuals demonstrate leftward bias on visuospatial tasks such as line bisection, which has been attributed to right brain dominance. We investigated whether this asymmetry occurred in patients with probable dementia of the Alzheimer type (pAD) which is associated with neurodegenerative changes affecting temporoparietal regions. Subjects with pAD and matched controls performed a line bisection task in near and far space under conditions of no distraction, left-sided visual distraction and right-sided visual distraction. Participants with pAD manifested different motor-preparatory 'aiming' spatial bias than matched controls. There were significantly greater rightward 'aiming' motor-intentional errors both without distraction and with right-sided distraction. 'Aiming' motor-preparatory brain activity may be induced by distraction in pAD subjects as compared to typical visual-motor function in controls.
  Dementia and geriatric cognitive disorders extra. 01/2012; 2(1):229-37.
• Source

  Available from: Michel Thiebaut de Schotten

  Article: Traumatic brain injury and the frontal lobes: what can we gain with diffusion tensor imaging?

  Giuseppe Zappalà, Michel Thiebaut de Schotten, Paul J Eslinger
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  ABSTRACT: Traumatic brain injury (TBI) is a leading cause of death in the young population and long-term disability in relation to pervasive cognitive-behavioural disturbances that follow frontal lobe damage. To date, emphasis has been placed primarily on the clinical correlates of frontal cortex damage, whilst identification of the contribution of subjacent white matter lesion is less clear. Our poor understanding of white matter pathology in TBI is primarily due to the low sensitivity of conventional neuroimaging to identify pathological changes in less severe traumatic injury and the lack of methods to localise white matter pathology onto individual frontal lobe connections. In this paper we focus on the potential contribution of diffusion tensor imaging (DTI) to TBI. Our review of the current literature supports the conclusion that DTI is particularly sensitive to changes in the microstructure of frontal white matter, thus providing a valuable biomarker of the severity of traumatic injury and prognostic indicator of recovery of function. Furthermore we propose an atlas approach to TBI to map white matter lesions onto individual tracts. In the cases presented here we showed a direct correspondence between the clinical manifestations of the patients and the damage to specific white matter tracts. We are confident that in the near future the application of DTI to TBI will improve our understanding of the complex and heterogeneous clinical symptomatology which follows a TBI, especially mild and moderate head injury, which still represents 70-80% of all clinical population.
  Cortex 07/2011; 48(2):156-65. · 6.08 Impact Factor
• Article: Light therapy for seniors in long term care.

  Michael Royer, Noel H Ballentine, Paul J Eslinger, Kevin Houser, Richard Mistrick, Richard Behr, Kirk Rakos
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  ABSTRACT: To investigate the effects of light therapy on cognition, depression, sleep, and circadian rhythms in a general, nonselected population of seniors living in a long term care facility. A double-blind, placebo-controlled trial. The experiment took place at a long term care facility in Pennsylvania. Study participants (15 treatment, 13 placebo) were residents receiving either personal care or skilled nursing care. Treatment consisted of approximately 400 lux of blue light administered for 30 minutes per day, Monday through Friday, for 4 weeks. The placebo was approximately 75 lux of red light generated from the same device. Behavioral assessments were made using the MicroCog Assessment of Cognitive Functioning, Geriatric Depression Scale, and Profile of Mood States. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale. Three of the 4 composite scores from the MicroCog as well as the mean Tension/Anxiety score from the Profile of Mood States showed a significant treatment versus placebo effect. Blue light treatment led to significant cognitive improvements compared with placebo red light and may be a promising environmental intervention to reduce cognitive symptoms in elderly, long-term care residents.
  Journal of the American Medical Directors Association 06/2011; 13(2):100-2. · 4.64 Impact Factor
• Article: Social cognition, executive functioning, and neuroimaging correlates of empathic deficits in frontotemporal dementia.

  Paul J Eslinger, Peachie Moore, Chivon Anderson, Murray Grossman
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  ABSTRACT: The authors investigated aspects of interpersonal sensitivity and perspective-taking in relation to empathy, social cognitions, and executive functioning in 26 frontotemporal dementia (FTD) patients. Behavioral-variant FTD (bvFTD) patients were significantly impaired on caregiver assessments of empathy, although self-ratings were normal. Progressive nonfluent aphasia and semantic-dementia samples were rarely abnormal. In bvFTD, empathy ratings were found to be correlated with social cognition and executive functioning measures, but not depression. Voxel-based morphometry revealed that reduced empathic perspective-taking was related to bifrontal and left anterior temporal atrophy, whereas empathic emotions were related to right medial frontal atrophy. Findings suggest that bvFTD causes multiple types of breakdown in empathy, social cognition, and executive resources, mediated by frontal and temporal disease.
  The Journal of neuropsychiatry and clinical neurosciences 01/2011; 23(1):74-82. · 2.34 Impact Factor
• Article: Olfactory deficit detected by fMRI in early Alzheimer's disease.

  Jianli Wang, Paul J Eslinger, Richard L Doty, Erin K Zimmerman, Robert Grunfeld, Xiaoyu Sun, Mark D Meadowcroft, James R Connor, Joseph L Price, Michael B Smith, Qing X Yang
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  ABSTRACT: Alzheimer's disease (AD) is accompanied by smell dysfunction, as measured by psychophysical tests. Currently, it is unknown whether AD-related alterations in central olfactory system neural activity, as measured by functional magnetic resonance imaging (fMRI), are detectable beyond those observed in healthy elderly. Moreover, it is not known whether such changes are correlated with indices of odor perception and dementia. To investigate these issues, 12 early stage AD patients and 13 nondemented controls underwent fMRI while being exposed to each of three concentrations of lavender oil odorant. All participants were administered the University of Pennsylvania Smell Identification Test (UPSIT), the Mini-Mental State Examination (MMSE), the Mattis Dementia Rating Scale-2 (DRS-2), and the Clinical Dementia Rating Scale (CDR). The blood oxygen level-dependent (BOLD) signal at primary olfactory cortex (POC) was weaker in AD than in HC subjects. At the lowest odorant concentration, the BOLD signals within POC, hippocampus, and insula were significantly correlated with UPSIT, MMSE, DRS-2, and CDR scores. The BOLD signal intensity and activation volume within the POC increased significantly as a function of odorant concentration in the AD group, but not in the control group. These findings demonstrate that olfactory fMRI is sensitive to the AD-related olfactory and cognitive functional decline.
  Brain research 10/2010; 1357:184-94. · 2.46 Impact Factor
• Article: The role of ventral medial prefrontal cortex in social decisions: converging evidence from fMRI and frontotemporal lobar degeneration.

  Murray Grossman, Paul J Eslinger, Vanessa Troiani, Chivon Anderson, Brian Avants, James C Gee, Corey McMillan, Lauren Massimo, Alea Khan, Shweta Antani
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  ABSTRACT: The ventral medial prefrontal cortex (vmPFC) has been implicated in social and affectively influenced decision-making. Disease in this region may have clinical consequences for social judgments in patients with frontotemporal lobar degeneration (FTLD). To test this hypothesis, regional cortical activation was monitored with fMRI while healthy adults judged the acceptability of brief social scenarios such as cutting into a movie ticket line or going through a red light at 2 AM. The scenarios described: (i) a socially neutral condition, (ii) a variant of each scenario containing a negatively valenced feature, and (iii) a variant containing a positively valenced feature. Results revealed that healthy adults activated vmPFC during judgments of negatively valenced scenarios relative to positive scenarios and neutral scenarios. In a comparative behavioral study, the same social decision-making paradigm was administered to patients with a social disorder due to FTLD. Patients differed significantly from healthy controls, specifically showing less sensitivity to negatively valenced features. Comparative anatomical analysis revealed considerable overlap of vmPFC activation in healthy adults and vmPFC cortical atrophy in FTLD patients. These converging results support the role of vmPFC in social decision-making where potentially negative consequences must be considered.
  Neuropsychologia 10/2010; 48(12):3505-12. · 3.64 Impact Factor
• Article: Functional MRI evidence for distinctive binding and consolidation pathways for face-name associations: analysis of activation maps and BOLD response amplitudes.

  Melissa Robinson-Long, Paul J Eslinger, Jianli Wang, Mark Meadowcroft, Qing X Yang
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  ABSTRACT: Although some of the anatomical underpinnings of learning and memory systems have been identified, there remains little understanding of how the brain moves from acquiring new information to retaining it. This study was designed to further explore and elucidate the neural mechanisms underlying encoding and memory in a common real-life task, that is, face-name associations. One possible outcome is that the tasks will recruit different neural structures mediating these processes, which can be identified through contrast analysis of activations. Alternatively, it is possible that similar anatomical regions, such as the hippocampus and parahippocampal gyrus, may be involved in both tasks. In that case, analysis of blood oxygenation level dependent (BOLD) amplitude differences between the tasks in those common neural structures may be able to detect whether physiological activation differences occur in encoding versus memory. Five healthy adult participants underwent high-field magnetic resonance imaging (MRI) while learning face-name pairs (encoding phase) and during a multiple-choice recognition task after a brief delay (memory phase). Average activation and BOLD response amplitudes in specific regions of interest and whole-brain activation maps were analyzed. Common activations were observed in the encoding and recognition memory tasks in several regions of interest encompassing the medial temporal and inferior occipital regions. However, higher BOLD response amplitudes occurred in the right fusiform gyrus and the right hippocampus during encoding. In contrast, higher amplitudes were detected in the lingual gyrus bilaterally during recognition memory. Encoding activated distributed prefrontal and temporal cortical regions bilaterally, which mediate attentional, executive, language, and memory systems. Recognition memory recruited a different network of regions encompassing convergence zones in the left prefrontal cortex and the parietal-occipital-temporal region bilaterally, where multimodal visual association, language, memory, and decision-making systems interact. Higher BOLD response amplitudes in the right fusiform gyrus and the right hippocampus during face-name encoding suggest a potentially specific binding pathway where disparate information might be neurally linked. In contrast, the increased BOLD response in the lingual gyrus during recognition memory may indicate a key neural substrate for memory consolidation and long-term knowledge of what is learned. Whole-brain activation maps revealed task-specific differences in areas of the prefrontal, temporal, and occipital-parietal-temporal junctions as well. Findings suggest that there are distinctive anatomical and physiological nodes for face-name learning and memory within large-scale cortical-subcortical networks. Hence, lesions in fairly widespread cerebral regions may potentially disrupt specific binding and/or memory consolidation processes.
  Topics in magnetic resonance imaging: TMRI 10/2009; 20(5):271-8.
• Article: Cerebral plasticity and recovery of function after childhood prefrontal cortex damage.

  Kyle Thompson, Kathleen R Biddle, Melissa Robinson-Long, Jennifer Poger, Jianli Wang, Qing X Yang, Paul J Eslinger
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  ABSTRACT: Recovery of function after early brain injury depends upon both reparative and compensatory processes that are minimally understood. Using functional magnetic resonance imaging (fMRI), this study investigated the reorganization of hemispheric brain activity of a 24 year old male who suffered right prefrontal cortex damage at 7 years of age related to ruptured arteriovenous malformation. His pattern of recovery has been examined and tracked over the past 17 years and evolved from initial significant impairments in executive, spatial and attentional abilities from the brain lesion to remarkable recovery of function. High field fMRI studies were completed with experimental cognitive tasks sensitive to right prefrontal functions, including visuospatial relational reasoning, spatial working memory, go no-go, emotional face recognition, and coin calculation. Results were compared to a matched control group for total hemispheric activity patterns. Results: Analyses revealed that on fMRI activation tasks where the patient scored similar to controls, he activated a broader network of bilateral cortical regions than controls. On tasks where he scored lower than controls, there was under-activation of prefrontal cortical regions in comparison to controls. Recovery of function after prefrontal cortex damage in childhood can occur and be associated with significant functional reorganization of hemispheric activity patterns (i.e. developmental cerebral plasticity). Although not all tasks showed recovery to the same extent in this case, those tasks with the most robust recovery entailed compensatory activation of additional cortical regions on fMRI. Further studies are needed to confirm and extend these findings.
  Developmental neurorehabilitation 01/2009; 12(5):298-312.
• Article: Simulation-based executive cognitive assessment and rehabilitation after traumatic frontal lobe injury: a case report.

  Usha Satish, Siegfried Streufert, Paul J Eslinger
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  ABSTRACT: To investigate whether identifying specific deficits after brain injury can lead to a more focused and potentially effective cognitive rehabilitation technology. Cognitive simulation assessment was undertaken in a 47-year-old man with trauma-related prefrontal damage and persisting occupational and cognitive-behavioral difficulties at 15 months post brain injury. Results revealed significant difficulties in measured levels of activity, initiative, information utilization, response flexibility, and effective decision-making strategies which accorded well with his real-life complaints despite normal neuropsychological test scores. This profile of findings was then used to design a two-stage intervention program. The first stage focused on participant education and awareness about his simulation-based problem solving difficulties. In the second stage specific goals were formulated to improve problem solving impairments that were then the target of weekly training sessions using pertinent decision-making and problem-solving vignettes. A parallel version of the cognitive simulation assessment was undertaken post-cognitive training (3 months after initial assessment) and revealed significant improvements in targeted executive cognitive-behavioral areas. Results of this cognitive rehabilitation probe supported the feasibility and validity of undertaking a cognitive simulation approach to identify residual executive function deficits after traumatic brain injury, even with a normal neuropsychological test profile. Further studies are needed to establish the reliability, generalizability and maintenance of such gains.
  Disability and Rehabilitation 02/2008; 30(6):468-78. · 1.50 Impact Factor
• Article: Amantadine for adynamic speech: possible benefit for aphasia?

  Anna M Barrett, Paul J Eslinger
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  ABSTRACT: Dopaminergic agents may stimulate behavior and verbal expression after frontal lobe dysfunction. Although amantadine is used in neurorehabilitation of motivational disorders and head injury, it is not commonly prescribed to improve aphasia. This pilot study examined verbal fluency on and off amantadine for nonfluent speech. Four participants undergoing inpatient rehabilitation, meeting criteria for transcortical motor aphasia had stroke (2), stroke postaneurysm surgery (1), or brain tumor resection (1). We administered 100 mg of amantadine twice a day in an open-label, on-off protocol, with multiple assessments per on-off period. Off medication, subjects generated a mean 12.62 of words (abnormally few) on the Controlled Oral Word Association test. On medication, word generation significantly improved to 17.71 words (P = 0.04), although scores remained psychometrically in the abnormal range. Further research on amantadine, specifically for nonfluent speech and nonfluent aphasia, including effects on functional communication and control conditions, may be warranted.
  American Journal of Physical Medicine & Rehabilitation 09/2007; 86(8):605-12. · 1.58 Impact Factor
• Article: Emotional perception deficits in amyotrophic lateral sclerosis.

  Erin K Zimmerman, Paul J Eslinger, Zachary Simmons, Anna M Barrett
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  ABSTRACT: Cognitive deficits associated with frontal lobe dysfunction can occur in amyotrophic lateral sclerosis (ALS), particularly in individuals with bulbar ALS who can also suffer pathologic emotional lability. Because frontal pathophysiology can alter emotional perception, we examined whether emotional perception deficits occur in ALS, and whether they are related to depressive or dementia symptoms. Bulbar ALS participants (n=13) and age-matched healthy normal controls (n=12) completed standardized tests of facial emotional and prosodic recognition, the Geriatric Depression Scale, and the Mini-Mental State Examination. Participants identified the basic emotion (happy, sad, angry, afraid, surprised, disgusted) that matched 39 facial expressions and 28 taped, semantically neutral, intoned sentences. ALS patients performed significantly worse than controls on facial recognition but not on prosodic recognition. Eight of 13 patients (62%) scored below the 95% confidence interval of controls in recognizing facial emotions, and 3 of these patients (23% overall) also scored lower in prosody recognition. Among the 8 patients with emotional perceptual impairment, one-half did not have depressive, or memory or cognitive symptoms on screening, whereas the remainder showed dementia symptoms alone or together with depressive symptoms. Emotional recognition deficits occur in bulbar ALS, particularly with emotional facial expressions, and can arise independent of depressive and dementia symptoms or comorbid with depression and dementia. These findings expand the scope of cognitive dysfunction detected in ALS, and bolsters the view of ALS as a multisystem disorder involving cognitive and also motor deficits.
  Cognitive and Behavioral Neurology 07/2007; 20(2):79-82. · 1.34 Impact Factor
• Article: Oops! Resolving social dilemmas in frontotemporal dementia.

  Paul J Eslinger, Peachie Moore, Vanessa Troiani, Shweta Antani, Katy Cross, Shaleigh Kwok, Murray Grossman
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  ABSTRACT: Our social cognition model posits that social knowledge and executive resources guide interpersonal decision making. We investigated this model by examining the resolution of standardised social dilemmas in patients with a social and executive disorder (SOC/EXEC) caused by frontotemporal dementia (FTD). Patients with SOC/EXEC (n = 12) and those with progressive aphasia (APH, n = 14) completed measures requiring resolution of social dilemmas (Guilford's Cartoon Predictions Test), social cognition (theory of mind false belief vignettes and a behavioural rating measure of empathy) and executive measures of cognitive flexibility (Visual Verbal Test). Regression analysis related judgments of social dilemmas to cortical volume using voxel based morphometry of high resolution structural MRI. Patients with SOC/EXEC were impaired in judgments of social dilemmas as well as theory of mind, self-awareness of empathy and cognitive flexibility. Patients with APH were much less impaired in the social and cognitive measures. There were strong correlations among social dilemma, theory of mind and mental flexibility measures in patients with SOC/EXEC, and stepwise regression showed that mental flexibility was most predictive of social dilemma judgments. Social dilemma impairments in the SOC/EXEC sample correlated with cortical atrophy in the orbital frontal, superior temporal, visual association and posterior cingulate regions of the right hemisphere. Deficits in patients with SOC/EXEC in resolving social dilemmas are related to depleted executive resources and social knowledge that appear to arise from disease that interrupts a right frontal-temporal neural network crucial for mediating social cognition.
  Journal of neurology, neurosurgery, and psychiatry 06/2007; 78(5):457-60. · 4.87 Impact Factor
• Article: Integrative study of cognitive, social, and emotional processes in clinical neuroscience.

  Paul J Eslinger, Daniel Tranel
  Cognitive and Behavioral Neurology 04/2005; 18(1):1-4. · 1.34 Impact Factor
• Source

  Available from: Ricardo de Oliveira

  Article: The moral affiliations of disgust: a functional MRI study.

  Jorge Moll, Ricardo de Oliveira-Souza, Fernanda Tovar Moll, Fátima Azevedo Ignácio, Ivanei E Bramati, Egas M Caparelli-Dáquer, Paul J Eslinger
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  ABSTRACT: Recent investigations in cognitive neuroscience have shown that ordinary human behavior is guided by emotions that are uniquely human in their experiential and interpersonal aspects. These "moral emotions" contribute importantly to human social behavior and derive from the neurobehavioral reorganization of the basic plan of emotions that pervade mammalian life. Disgust is one prototypic emotion with multiple domains that include viscerosomatic reaction patterns and subjective experiences linked to (a) the sensory properties of a class of natural stimuli, (b) a set of aversive experiences and (c) a unique mode of experiencing morality. In the current investigation, we tested the hypotheses that (a) the experience of disgust devoid of moral connotations ("pure disgust") can be subjectively and behaviorally differentiated from the experience of disgust disguised in the moral emotion of "indignation" and that (b) pure disgust and indignation may have partially overlapping neural substrates. Thirteen normal adult volunteers were investigated with functional magnetic resonance imaging as they read a series of statements depicting scenarios of pure disgust, indignation, and neutral emotion. After the scanning procedure, they assigned one basic and one moral emotion to each stimulus from an array of six basic and seven moral emotions. Results indicated that (a) emotional stimuli may evoke pure disgust with or without indignation, (b) these different aspects of the experience of disgust could be elicited by a set of written statements, and (c) pure disgust and indignation recruited both overlapping and distinct brain regions, mainly in the frontal and temporal lobes. This work underscores the importance of the prefrontal and orbitofrontal cortices in moral judgment and in the automatic attribution of morality to social events. Human disgust encompasses a variety of emotional experiences that are ingrained in frontal, temporal, and limbic networks.
  Cognitive and Behavioral Neurology 04/2005; 18(1):68-78. · 1.34 Impact Factor
• Article: Functional magnetic resonance imaging study of human olfaction and normal aging.

  Jianli Wang, Paul J Eslinger, Michael B Smith, Qing X Yang
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  ABSTRACT: The function of human olfaction declines with advancing age. An important question centers on whether functional alterations to olfactory brain structures accompany age-related behavioral changes. In the present study, we tested the hypothesis that aged adults have intact though reduced activity in the central olfactory system using functional magnetic resonance imaging (fMRI). University of Pennsylvania Smell Identification Test (UPSIT) was used to test the smell function of 11 young (23.9 +/- 1.6 years) and 8 aged (66.4 +/- 4.4 years) healthy participants. Then, the participants received fMRI at 3.0 T with lavender and spearmint as stimulants. After fMRI, the participants provided ratings for the odorants' intensity and pleasantness. The average UPSIT score of the aged adults was 34.1 +/- 1.5, which was significantly lower than that of the young adults (37.3 +/- 1.1) (p =.0004). Both age groups showed significant activation in major olfactory brain structures, including the primary olfactory cortex, entorhinal cortex, hippocampus and parahippocampal cortex, thalamus, hypothalamus, orbitofrontal cortex, and insular cortex and its extension into the inferior lateral frontal region. The aged adults showed less brain activity in olfactory structures (p =.022), consistent with lower ratings of odor intensity and UPSIT scores. Activation intensity in bilateral primary olfactory cortex areas and right insular cortex was also comparatively weaker (p <.019). Results demonstrate that significant activation in aged adults can be observed in all the olfactory brain structures that are activated in young adults, but with lower activation volume and intensity. This finding provides a necessary baseline for further investigations in olfaction and aging.
  The Journals of Gerontology Series A Biological Sciences and Medical Sciences 04/2005; 60(4):510-4. · 4.60 Impact Factor
• Article: Unawareness of cognitive deficit (cognitive anosognosia) in probable AD and control subjects.

  Anna M Barrett, Paul J Eslinger, Noel H Ballentine, Kenneth M Heilman
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  ABSTRACT: To develop a quantitative method of assessing cognitive anosognosia in six cognitive and two noncognitive domains. Control (n = 32) and probable Alzheimer disease (pAD) (n = 14) subjects self-estimated memory, attention, generative behavior, naming, visuospatial skill, limb praxis, mood, and uncorrected vision, both before and after these abilities were assessed. Based on this estimate and their performance the authors calculated an anosognosia ratio (AR) by dividing the difference between estimated and actual performance by an estimated and actual performance sum. With perfect awareness, AR = 0. Overestimating abilities would yield a positive AR (< or =1); underestimation would yield a negative AR (> or =-1). Relative to controls, pAD subjects demonstrated anosognosia. Pre-testing (off-line), pAD subjects overestimated their visuospatial skill; post-testing (on-line), pAD subjects overestimated their memory. Control subjects also made self-rating errors, underestimating their attention pre-testing and overestimating limb praxis and vision post-testing. This anosognosia assessment method may allow more detailed examination of distorted self-awareness. These results suggest that screening for anosognosia in probable Alzheimer disease (pAD) should include self-estimates of visuospatial function, and that, in pAD, it may be useful to assess anosognosia for amnesia both before and after memory testing.
  Neurology 03/2005; 64(4):693-9. · 8.31 Impact Factor
• Source

  Available from: Mark Meadowcroft

  Article: Reduction of magnetic field inhomogeneity artifacts in echo planar imaging with SENSE and GESEPI at high field.

  Qing X Yang, Jianli Wang, Michael B Smith, Mark Meadowcroft, Xiaoyu Sun, Paul J Eslinger, Xavier Golay
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  ABSTRACT: Geometric distortion, signal-loss, and image-blurring artifacts in echo planar imaging (EPI) are caused by frequency shifts and T(2)(*) relaxation distortion of the MR signal along the k-space trajectory due to magnetic field inhomogeneities. The EPI geometric-distortion artifact associated with frequency shift can be reduced with parallel imaging techniques such as SENSE, while the signal-loss and blurring artifacts remain. The gradient-echo slice excitation profile imaging (GESEPI) method has been shown to be successful in restoring tissue T(2)(*) relaxation characteristics and is therefore effective in reducing signal-loss and image-blurring artifacts at a cost of increased acquisition time. The SENSE and GESEPI methods are complementary in artifact reduction. Combining these two techniques produces a method capable of reducing all three types of EPI artifacts while maintaining rapid acquisition time.
  Magnetic Resonance in Medicine 01/2005; 52(6):1418-23. · 2.96 Impact Factor