Parkinson Disease: Filoteo JV

Price A, Filoteo JV, Maddox WT. · Department of Psychology, Elizabethtown College, Elizabethtown, PA 17022, United States. · Neuropsychologia. · Pubmed #19428385 links to  free full text

Abstract: Measures of explicit rule-based category learning are commonly used in neuropsychological evaluation of individuals with Parkinson's disease (PD) and the pattern of PD performance on these measures tends to be highly varied. We review the neuropsychological literature to clarify the manner in which PD affects the component processes of rule-based category learning and work to identify and resolve discrepancies within this literature. In particular, we address the manner in which PD and its common treatments affect the processes of rule generation, maintenance, shifting and selection. We then integrate the neuropsychological research with relevant neuroimaging and computational modeling evidence to clarify the neurobiological impact of PD on each process. Current evidence indicates that neurochemical changes associated with PD primarily disrupt rule shifting, and may disturb feedback-mediated learning processes that guide rule selection. Although surgical and pharmacological therapies remediate this deficit, it appears that the same treatments may contribute to impaired rule generation, maintenance and selection processes. These data emphasize the importance of distinguishing between the impact of PD and its common treatments when considering the neuropsychological profile of the disease.

Salmon DP, Filoteo JV. · Department of Neurosciences (0948), University of California, San Diego9500 Gilman Drive, La Jolla, CA 92093-0948, USA. · Semin Neurol. · Pubmed #17226737 No free full text.

Abstract: Neuropsychological studies have shown that there are several prominent differences in the patterns of cognitive deficits that occur in neurodegenerative disorders that have their primary etiology in either cortical or subcortical brain dysfunction. Quantitative and qualitative differences are apparent across many cognitive domains, including memory (in all its aspects), attention, executive functions, language and semantic knowledge, and visuospatial abilities. These distinct patterns of deficits have been broadly characterized as forming cortical and subcortical dementia syndromes. Differentiating between cortical and subcortical dementia provides a heuristically useful model for understanding brain-behavior relationships in neurodegenerative diseases and may improve the ability to clinically distinguish among various dementing disorders.

Possin KL, Filoteo JV, Song DD, Salmon DP. · University of California, San Diego, CA, USA. · Neuropsychology. · Pubmed #18763878 No free full text.

Abstract: Working memory maintenance processes for visual-spatial and visual-object information were evaluated in patients with Parkinson's disease (PD). PD patients and controls performed a working memory task with two conditions that differed only in the aspect of the stimuli that the participant was instructed to remember: their locations or shapes. Maintenance processes were investigated by measuring accuracy over 1-s, 5-s, and 10-s delays. Results indicated that patients were impaired in maintaining object information over the delay. In contrast, the patients showed impairment on the spatial condition only when the to-be-remembered stimulus was highly similar in location to the probe, but this impairment was equivalent across the delays, suggesting that this deficit was not due to maintenance impairment. These results suggest that deficits in working memory for spatial and object information are mediated by distinct cognitive processes in nondemented patients with PD and may differ in their pathophysiological basis.

Zizak VS, Filoteo JV, Possin KL, Lucas JA, Rilling LM, Davis JD, Peavy G, Wong A, Salmon DP. · University of California, San Diego, CA 92161, USA. · Cogn Behav Neurol. · Pubmed #16340392 No free full text.

Abstract: OBJECTIVE AND BACKGROUND: Previous studies have shown that patients with frontal-striatal dysfunction demonstrate improved performance on tests of recognition memory relative to free recall memory, suggesting deficits in retrieval processes. Not all studies, however, have indicated that all patients with frontal-striatal dysfunction display this profile. In this study, we examined the ubiquity of this "retrieval deficit" profile in a relatively large sample of patients with Parkinson disease (PD) or Huntington disease (HD). METHODS: Participants included 150 patients with PD and 65 patients with HD. Patients were classified as demonstrating a retrieval deficit or not based on a comparison of their standardized performances on the Recognition Discriminability and Long-Delay Free Recall indices from the California Verbal Learning Test. RESULTS: Results indicated that 1) a retrieval deficit was more prevalent in patients with HD than PD, 2) this group difference emerged only in patients with at least a mild level of global cognitive impairment, and 3) even when the profile did emerge more frequently in patients with HD, it was present in only 44% of the patients. CONCLUSIONS: These findings suggest that not all patient groups with frontal-striatal dysfunction display a retrieval deficit profile, but in groups that do (ie, patients with HD), it is more likely to appear in individuals with greater cognitive impairment.

Possin KL, Filoteo JV, Roesch SC, Zizak V, Rilling LM, Davis JD. · SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA 92109, USA. · J Clin Exp Neuropsychol. · Pubmed #16207620 No free full text.

Abstract: This study investigated several constructs of executive functioning in a group of 77 patients with subcortical pathology. Specifically, we examined the validity of categorizing perseverative errors as "recurrent," "stuck-in-set," or "continuous," as proposed by Sandson and Albert (1984). A principal components analysis of 2 measures of recurrent perseveration, 2 measures of stuck-in-set perseveration, and 2 measures of intrusive errors yielded a 2 component solution with stuck-in-set perseverations and intrusive errors loading on Component 1, and recurrent perseverations loading on Component 2. Presence of a continuous perseveration on a graphomotor test was significantly associated with higher factor scores on Component 1, but not Component 2. The stuck-in-set perseveration and intrusion component was associated with the majority of the other neuropsychological tests administered, including tests of executive function and memory. The recurrent perseveration component was not associated with the other measures of cognitive functioning. Presence of a continuous perseveration was associated with executive function but not memory measures. This study provides evidence that recurrent perseverations are distinct from the other types of perseverative and intrusive errors, and that stuck-in-set and intrusive errors are good indicators of general cognitive functioning in patients with subcortical pathology.

Filoteo JV, Rilling LM, Strayer DL. · Psychology Service, Veterans Administration San Diego Healthcare System, California 92161, USA. · Neuropsychology. · Pubmed #11949715 No free full text.

Abstract: Patients with Parkinson's disease (PD) and normal controls (NCs) performed a negative priming task. NCs displayed the normal pattern of negative priming in that relative to a control condition they were slower to identify a target within a stimulus array when it had been a distractor in the previous array. PD patients did not display any evidence of negative priming. In contrast, both PD patients and NCs displayed statistically the same level of spatial priming and response repetition cost. Regression analyses indicated that although symptom severity, symptom characteristics, and global cognitive functioning were not reliable predictors of negative priming or spatial priming in PD patients, greater symptom severity and poorer global cognitive functioning were associated with less response repetition cost. The possible role of the striatum in negative priming, spatial priming, and response repetition cost is discussed.

Filoteo JV, Maddox WT. · Department of Psychology, University of Utah, Salt Lake City 84112, USA. · Neuropsychology. · Pubmed #10353372 No free full text.

Abstract: Parkinson's disease (PD) patients and normal controls (NCs) were administered a series of visual attention tasks. The dimensional integration task required integration of information from 2 stimulus dimensions. The selective attention task required selective attention to 1 stimulus dimension while ignoring the other stimulus dimension. Both integral- and separable-dimension stimuli were examined. A series of quantitative models of attentional processing was applied to each participant's data. The results suggest that (a) PD patients were not impaired in integrating information from 2 stimulus dimensions, (b) PD patients were impaired in selective attention, (c) selective attention deficits in PD patients were not due to perceptual interference, and (d) PD patients were affected by manipulations of stimulus integrality and separability in much the same way as were NCs.

Filoteo JV, Maddox WT, Salmon DP, Song DD. · Department of Psychiatry, University of California, San Diego, CA 92161, USA. · Neuropsychology. · Pubmed #17402818 No free full text.

Abstract: Nondemented patients with Parkinson's disease (PD) are impaired in learning to categorize simple perceptual stimuli when category membership is defined by a nonlinear relationship between stimulus dimensions but not when the relationship is linear (J. V. Filoteo, W. T. Maddox, D. P. Salmon, & D. D. Song, 2005). In the present study, the authors examined whether performance in either of these 2 category learning conditions was predictive of global cognitive decline following a mean of 1.6 years since the time patients were 1st seen. Results indicated that final block accuracy in the nonlinear condition, but not the linear condition, predicted global cognitive decline. Performance on the Wisconsin Card Sorting Test (WCST) did not significantly predict global cognitive decline, although there was a trend for this to be the case. In addition, the association between nonlinear category learning and global cognitive decline was not impacted by patients' performance on the WCST. Results suggest that nonlinear category learning predicts cognitive decline in nondemented patients with PD and that nonlinear category learning and WCST performances may provide independent measures of integrity of the posterior and anterior caudate, respectively.

Cagigas XE, Filoteo JV, Stricker JL, Rilling LM, Friedrich FJ. · SDSU/UCSD Joint Doctoral Program in Clinical Psychology, USA. · Brain Cogn. · Pubmed #17049703 links to  free full text

Abstract: Parkinson's disease (PD) patients and healthy controls were administered a flanker task that consisted of the presentation of colored targets and distractors. Participants were required to attend to the center target and identify its color. The stimulus displays were either congruent (i.e., the target and flankers were the same color) or incongruent. The time between the onset of the flanker and the target color (the target onset delay) was either short or long. Results indicated that PD patients and controls did not differ in the magnitude of the flanker effect within individual trials in that both groups demonstrated a typical flanker effect at the short target onset delay and neither group demonstrated a flanker effect at the longer delay. However, when performance was examined on a trial-by-trial basis, PD patients demonstrated a slowing of reaction time relative to controls when having to make the same response across consecutive trials at longer inter-trial intervals when the flankers were incongruent across consecutive trials and the display on the second of two trials was incongruent. These results indicate that PD patients are impaired in inhibiting the distractors over an extended delay and that this deficit may impact motor responding in these patients, suggesting that the basal ganglia contribute to the interface of attention and action.

Filoteo JV, Maddox WT, Ing AD, Song DD. · University of California, San Diego, CA, USA. · Neuropsychologia. · Pubmed #16978666 No free full text.

Abstract: Parkinson's disease (PD) patients and normal controls were tested in three category learning experiments to determine if previously observed rule-based category learning impairments in PD patients were due to deficits in selective attention or working memory. In Experiment 1, optimal categorization required participants to base their decision on a single stimulus dimension and ignore irrelevant variation on another dimension, thus emphasizing selective attention processes. In Experiment 2, optimal categorization required participants to base their decision on both stimulus dimensions using a conjunction of unidimensional decisions. Thus, this task placed less emphasis on selective attention and more on working memory. In Experiment 3, optimal categorization again required participants to base their decision on both stimulus dimensions using a disjunction of two unidimensional decisions in which an additional verbal operation was needed, thereby placing even greater emphasis on working memory. Results indicated that PD patients were impaired in the unidimensional rule-based condition, but not the other two rule-based conditions. These results are consistent with previous studies that demonstrate that PD patients are impaired in learning rule-based categories when selective attention demands are greatest, whereas these patients are normal in learning rule-based tasks when working memory demands are emphasized. Overall, these findings help to delineate the conditions under which PD patients display rule-based category learning deficits.

Possin KL, Cagigas XE, Strayer DL, Filoteo JV. · SDSU/UCSD Joint Doctoral Program in Clinical Psychology, USA. · Percept Mot Skills. · Pubmed #16671622 No free full text.

Abstract: 12 nondemented patients with Parkinson's disease (M age = 67.3) and 12 normal control participants were administered an object-based attention task that enabled examination of both negative and positive priming. Unlike previous studies in which spatial-based attention tasks were used, results of the present study indicated that the patients displayed negative and positive priming not different from those shown by controls. These results suggest that certain object-based attentional processes may not be impaired in patients with Parkinson's disease.

Caligiuri MP, Teulings HL, Filoteo JV, Song D, Lohr JB. · University of California, Department of Psychiatry, 9500 Gilman Drive, La Jolla, CA 29093, USA. · Hum Mov Sci. · Pubmed #16647772 No free full text.

Abstract: Monitoring drug-induced side effects is especially important for patients who undergo treatment with antipsychotic medications, as these drugs often produce extrapyramidal side effects (EPS) resulting in movement abnormalities similar to parkinsonism. Scientists have developed several objective laboratory tests to measure and research drug-induced movement disorders, but equipment and tests are complex and costly and have not become accepted in large-scale, multi-site clinical trials. The goals of this study were to test whether a simple handwriting measure can discriminate between individuals with psychotropic-induced parkinsonism, Parkinson's disease, and healthy individuals, and to examine some of the psychometric properties of the measure. We examined pen movement kinematics during cursive writing of a standard word in 13 patients with idiopathic Parkinson's disease (PD), 10 schizophrenia patients with drug-induced parkinsonism (SZ), and 12 normal healthy control participants (NC). Participants were instructed to write the word "hello" in cursive twice, at three vertical height scales. Software was used for data acquisition and analysis of vertical stroke velocities, velocity scaling, and smoothness. There were four important results from this study: (1) both SZ patients with drug-induced EPS and PD participants exhibited impaired movement velocities and velocity scaling; (2) performance on the velocity scaling measure distinguished drug-induced EPS from normal with 90% accuracy; (3) SZ, but not PD participants displayed abnormalities in movement smoothness; and (4) there was a positive correlation between age and magnitude of the velocity scaling deficit in PD participants. This study demonstrates that kinematic analyses of pen movements during handwriting may be useful in detecting and monitoring subtle changes in motor control related to the adverse effects of psychotropic medications.

Filoteo JV, Maddox WT, Ing AD, Zizak V, Song DD. · Department of Psychology, University of California, San Diego, California, USA. · J Int Neuropsychol Soc. · Pubmed #16212677 No free full text.

Abstract: This study examined the impact of irrelevant dimensional variation on rule-based category learning in patients with Parkinson's disease (PD), older controls (OC), and younger controls (YC). Participants were presented with 4-dimensional, binary-valued stimuli and were asked to categorize each into 1 of 2 categories. Category membership was based on the value of a single dimension. Four experimental conditions were administered in which there were zero, 1, 2, or 3 randomly varying irrelevant dimensions. Results indicated that patients with PD were impacted to a greater extent than both the OC and YC participants when the number of randomly varying irrelevant dimensions increased. These results suggest that the degree of working memory and selective attention requirements of a categorization task will impact whether PD patients are impaired in rule-based category learning, and help to clarify recent discrepancies in the literature.

Filoteo JV, Maddox WT, Salmon DP, Song DD. · Department of Psychiatry, University of California, San Diego, CA, USA. · Neuropsychology. · Pubmed #15769205 No free full text.

Abstract: Information-integration category learning was examined in patients with Parkinson's disease (PD) and in healthy control participants in 2 different conditions. In the linear condition, optimal categorization required a nonverbalizable linear integration of information from the 2 stimulus dimensions, whereas in the nonlinear condition, a nonlinear integration of information was required. Each participant completed 600 trials in each condition and was given corrective feedback following each trial. Results indicated that PD patients were not impaired in the linear condition across all trials, whereas the same patients were impaired in the nonlinear condition, but only later in training. The authors conducted model-based analyses to identify participants who used an information-integration approach, and a comparison of the accuracy rates of those individuals further revealed a specific deficit in information-integration category learning in patients with PD. These findings suggest that the striatum may be particularly involved in information-integration category learning when the rule is highly complex.

Ashby FG, Noble S, Filoteo JV, Waldron EM, Ell SW. · Department of Psychology, University of California, Santa Barbara, 93106, USA. · Neuropsychology. · Pubmed #12597080 No free full text.

Abstract: Sixteen patients with Parkinson's disease (PD), 15 older controls (OCs), and 109 younger controls (YCs) were compared in 2 category-learning tasks. Participants attempted to assign colored geometric figures to 1 of 2 categories. In rule-based tasks, category membership was defined by an explicit rule that was easy to verbalize, whereas in information-integration tasks, there was no salient verbal rule and accuracy was maximized only if information from 3 stimulus components was integrated at some predecisional stage. The YCs performed the best on both tasks. The PD patients were highly impaired compared with the OCs, in the rule-based categorization task but were not different from the OCs in the information-integration task. These results support the hypothesis that learning in these 2 tasks is mediated by functionally separate systems.

Stout JC, Wylie SA, Filoteo JV. · Department of Psychology, Indiana University Bloomington, 47405-7007, USA. · Neuropsychology. · Pubmed #11949717 No free full text.

Abstract: This commentary discusses divergent findings in 2 articles published in this issue of Neuropsychology. The studies used negative priming (NP) to probe the associations between basal ganglia function and cognition in Parkinson's disease (PD) and tested different predictions about NP in PD. Different NP tasks were used, and although the subject samples appeared to have similar clinical features, results were quite different. This commentary, written jointly by the authors of the 2 studies (J. V. Filoteo, L. M. Rilling, & D. L. Strayer, 2002; S. A. Wylie & J. C. Stout, 2002), describes a process by which their disparate results may be used to facilitate the design of new studies that may determine how specific features of NP tasks lead to different findings in PD. The results are a more systematic account of how task features, such as specific response demands, interact with the response selection processes that are implemented by the basal ganglia.

Maddox WT, Filoteo JV. · Department of Psychology, University of Texas, Austin 78712, USA. · J Int Neuropsychol Soc. · Pubmed #11575593 No free full text.

Abstract: The contribution of the striatum to category learning was examined by having patients with Parkinson's disease (PD) and matched controls solve categorization problems in which the optimal rule was linear or nonlinear using the perceptual categorization task. Traditional accuracy-based analyses, as well as quantitative model-based analyses were performed. Unlike accuracy-based analyses, the model-based analyses allow one to quantify and separate the effects of categorization rule learning from variability in the trial-by-trial application of the participant's rule. When the categorization rule was linear, PD patients showed no accuracy, categorization rule learning, or rule application variability deficits. Categorization accuracy for the PD patients was associated with their performance on a test believed to be sensitive to frontal lobe functioning. In contrast, when the categorization rule was nonlinear, the PD patients showed accuracy, categorization rule learning, and rule application variability deficits. Furthermore, categorization accuracy was not associated with performance on the test of frontal lobe functioning. Implications for neuropsychological theories of categorization learning are discussed.