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Objective: Hyperfamiliarity is a phenomenon where new stimuli are perceived as familiar. Previous studies have demonstrated familiarity disorder in mild cognitive impairment (MCI), but mostly from the perspective of a neuropsychological approach, and the exact correlation of MCI aetiologies with the phenomenon remains uncertain. Based on current evidence suggesting a frontal-subcortical pathway contributing to familiarity processing, we hypothesize that individuals with a vascular aetiology of MCI will likely suffer more familiarity deficits. This study aims to examine the real-life hyperfamiliarity symptoms in amnestic versus vascular MCI. Methods: Informants of 11 amnestic and 9 vascular cognitive impairment patients were interviewed about the frequency of hyperfamiliarity symptoms in the previous month. MRI brain images of vascular cognitive impairment patients were analysed as well. Results: Patients with vascular cognitive impairment with no dementia (VCIND) showed a significantly higher frequency of hyperfamiliarity for people but not places or objects. Within VCIND patients, overall basal ganglia hyperintensities, particularly in the putamen, were found to significantly correlate to hyperfamiliarity. Conclusions: Patients with VCIND suffer more real-life hyperfamiliarity during people recognition compared to patients with amnestic mild cognitive impairment (aMCI), despite a comparative global decline in cognitive. This is likely due to impaired memory retrieval and matching processes resulting from subcortical ischaemic lesions.
This chapter presents the case of a 72-year-old man with a 10-year history of Parkinson's disease. He experienced visual hallucinations with preserved insight 2 years previously, subsiding on withdrawal of selegiline. Physical examination revealed a fairly symmetric and moderately severe parkinsonian syndrome, with akinetic-rigid features dominant and little in the way of rest tremor. The initial diagnostic impression was of a dementia syndrome relating to his Parkinson's disease, although the doctor was initially uncomfortable with what he regarded as a normal mini-mental state examination (MMSE) score of 27 out of 30. After 3 and 6 months, repeat MMSE scores were 23 and 25, respectively. Despite some initial diagnostic uncertainty, the patient was commenced on a cholinesterase inhibitor with considerable improvement in his psychotic features and lessening of his periods of confusion. Rationalization of anti-parkinsonian and other medications is an important first step in the management of PD-D.
This paper establishes the existence of the limit as t → ∞ of the distribution of the residual lifetime at time t of a two-unit warm-standby reliability system supported by a single repair facility, conditioned on the event that the system has not been down at any time in (0, t). The conditioned limit distribution is proved to be exponential irrespective of the distributions of the lifetimes and repair times of the individual units, provided that their Laplace transforms are rational functions of their arguments.