Ego-syntonic alien hand syndrome after right posterior cerebral artery stroke

The alien hand syndrome classically consists of involuntary movements accompanied by a feeling of foreignness and personification of the affected limb. Autocriticism, in which patients criticize and express astonished frustration with the behavior of the autonomous limb, is a commonly noted feature. Most cases of alien hand are associated with lesions of the supplementary motor areas of the frontal lobes, the corpus callosum, or both. The authors report on a 79-year-old man who sustained a right posterior cerebral artery distribution infarction and developed alien hand syndrome in the absence of callosal involvement. Also unique is that the patient perceived the alien hand as acceptable and positive, not hostile and repugnant. This case suggests not only that the neuroanatomic regions responsible for alien hand syndrome may require re-examination, but also that its definition may need expansion.

Neurobehavioral symptoms and family functioning in traumatically brain-injured adults

Traumatic brain injury (TBI) often results in a myriad of symptoms across physical, cognitive, and neurobehavioral domains. Despite inherent limitations associated with physical or cognitive impairments, the extant literature suggests that neurobehavioral symptoms tend to be the most distressing symptoms for the family and are more strongly related to poor outcome for the patient. The Neuropsychology Behavior and Affect Profile (NBAP) along with the General Functioning subscale of the Family Assessment Device (FAD-GF) and the Perceived Stress Scale were administered to 153 family members of persons who had sustained a TBI. The results provide new normative data and statistical support for the NBAP as a promising measure of neurobehavioral symptomatology following TBI. The correlation of.54 (p <.01) between FAD-GF and Full Scale NBAP scores provides powerful support for the hypothesis that family dysfunction is related to the presence of neurobehavioral symptoms in the patient. NBAP domains of Depression, Inappropriateness, Pragnosia, and Indifference appear most strongly related to family functioning and also bear a significant relationship to caregiver stress level and patient unemployment, whereas injury severity had little impact on either family functioning or neurobehavioral symptoms. The findings reinforce the significance of neurobehavioral symptoms and fortify their proposed link to family dysfunction post-TBI.

Relation of light and exercise to seasonal depressive symptoms: preliminary development of a scale

The palliative effects of exercise on depression are neither generally accepted nor clearly understood. On the contrary, the efficacy of light exposure in the treatment of seasonal depressive symptoms is widely recognized. It is possible that the contradictory findings in the exercise and depression literatures are due to a failure to consider light exposure as a variable. 32 women who regularly exercised were administered a depression inventory and the Seasonal Light Inventory, a new measure composed of two 10-item subscales, Seasonality and Light Exposure. Seasonality assesses fluctuations of mood, appetite, sleep, and other activities occurring at similar times each year, and the Light Exposure subscale measures respondents' estimated exposure to outdoor and bright indoor light. Indeed, those exercisers whose habits exposed them to a relatively large amount of light reported fewer seasonal depressive symptoms than those whose habits exposed them to a relatively small amount of light. The results suggest that the puzzling relationship between exercise and depression might be delineated more clearly by considering light exposure as a confounding variable.