Prosopometamorphopsia is a rare type of visual illusion in which visual perceptual distortion results in an altered perception of faces. We experienced a very rare case of a left-handed patient with prosopometamorphopsia after excision of a brain tumor in the left inferior parietal lobule. The case was a teenage girl found to have a brain tumor in the left parietal lobule on a head MRI scan after a mild head injury. Preoperatively, there were no disturbances in visual acuity, visual field, visual cognition or speech functions. The patient underwent a subtotal resection of the brain tumor, and the diagnosis was diffuse astrocytoma. Postoperatively, she presented prosopometamorphopsia including rotational distortion appearing around the area between the eyebrows and a bilateral periorbital area that changed in size while gazing at a facial picture. A postoperative MRI showed a new infarction in the white matter region under the resection cavity. The right hemisphere is considered to be dominant in face recognition ; however, the lateralization abnormality in this case may have occurred because the patient is left-handed. This case suggests that dysfunctions or functional imbalances between brain regions related to face recognition processing may result in prosopometamorphopsia.

  When Japanese write kana letters, they convert phonemes to kana letters and write them down (e.g., /ka/→か) . When typing kana letters, they romanize the phonemes and type the romanized letters (e.g., /ka/→KA→か) . As kana writing and typing are differently processed as such, the general view is that rehabilitation should be planned specifically for each of these two abilities. However, we experienced a case of chronic aphasia who showed improvement in both writing to dictation of kana letters and typing of aurally presented moras after a newly devised relearning training of phoneme-to-letter conversion.
  The patient was a male in his 40s with cerebral hemorrhage in the left temporoparietal lobe. He showed deficits in writing of hiragana and roman letters to dictation, and in typing of aurally presented moras. On the other hand, he showed good performance in transcribing visually presented kana to roman letters and in typing them. He underwent relearning training, in which auditory presentation of a mora was paired with visual presentation of the corresponding kana letter, wherein a line drawing having the corresponding initial sound of its name was simultaneously presented and he copied the letter repeatedly. It was confirmed in another session that he could name those drawings. He showed improved performance in writing hiragana and roman letters to dictation and typing of aurally presented moras. He commented that he recalled the line drawings used in the training when writing and typing the moras. The visual, semantic, and phonological information involved in the training may have facilitated the relearning of phoneme-to-hiragana conversion, and improved the performance in writing hiragana of aurally presented moras. We concluded that the patient regained typing ability of aurally presented moras not with romanization of the moras but with visualization of the corresponding kana letters.

  The present study investigated the performance of verbal fluency tests conducted repeatedly (5 times in a week×4 or 5 weeks) by two stroke patients with a decline of frontal lobe functions, in terms of time and word frequency information. In both patients, the numbers of total responses increased, while they remained constant in the later evaluation period. The mean word frequency for a test did not much change through the evaluation period, whereas relatively low-frequency words were constantly added in the responses. Both in between-test and within-test timescales, frequency effects that high-frequency words are produced prior to low-frequency words. One patient showed evident changes in the frequency effect toward stronger direction in the late period of the longer timescale. The frequency periods in the shorter timescale and their change in the longer timescale were interpreted in terms of the dynamism between language and executive functions within a verbal fluency test as well as of the recovery of executive functions in the patients.

  This study investigates the word retrieval process in Alzheimerʼs disease (AD) from the viewpoint of cluster formation based on the semantic relationships of words and clarifies the relationship with the semantic processing of words. There were 15 subjects in the mild AD group, 19 subjects in the moderate AD group, and 15 subjects in the control group. We conducted a semantic category fluency task and analyzed cluster formation by semantic association. The number of clusters was significantly lower in the mild AD group than in the control group ; the number of clusters and the cluster size were significantly lower in the moderate AD group than in the mild AD group. The difference between the numbers of retrieval words of the categories was observed only in the moderate AD group, and the semantic similarity for assessing the semantic processing ability of words decreased.
  Given the above findings, we concluded that the retrieval of words using semantic clusters declined in mild AD ; the retrieval of words in adjacent regions sharing a semantic concept also declined in moderate AD. There may be involved a decline in the semantic processing of underlying the word retrieval disorder in AD.

  We reported two cases in which the form of jargon temporarily metamorphosed with changes in emotions. Case 1 was a woman with Alzheimerʼs disease in her 80ʼs. She had severe aphasia and was emotionally unstable and angered easily becoming furious. Her speech and utterance was a neologistic jargon when she was calm, but when she became excited, angered, and furious, her neologisms increased and postpositional particles tended to drop out of her speech and were at times completely omitted. I.e., her utterance transitioned reversibly between a neologistic jargon and an undifferentiated jargon as her emotions changed. Case 2 was a woman in her 80ʼs who suffered from a left thalamic hemorrhage and presented with severe aphasia with general cognitive decline. Her speech consisted of typical semantic jargon usually free of phonological errors. However, when absorbed in what she was talking about, and becoming excited during a conversation, neologisms started cropping up in her speech. As she continued her conversations, eventually tiring, she began talking less, and the neologisms disappeared. This process showed that her utterance transitioned reversibly between a semantic jargon and a neologistic jargon in response to her emotional changes and fatigue. We reported these two cases and examined the changes in jargon speech as related to the emotions exhibited in these two cases.

  We investigated factors related to the appearance of alien hand syndrome (AHS) based on the results of a multifaceted assessment in a patient with a posterior variant type of AHS. Our patient was a right-handed woman in her 60s with cerebral infarction in the right frontal lobe, the right parietal lobe including the postcentral gyrus, and the right temporal lobe. She presented the following symptoms : left superficial and deep sensory disturbance, left upper limb ataxia, left hemiplegia, and abnormal involuntary movements in her left hand. Regarding her left upper limb, she stated that her left hand felt as if it belonged to somebody else and that it moved without her intentions. We compared the results of the visual analog scale of her AHS with the scores of motor paralysis, sensory disturbance, and ataxia. Patient, relief of motor paralysis and improvement of the AHS were observed simultaneously. On the other hand, although her AHS had improved, sensory disturbance and ataxia remained with little improvement. Based on these results, we consider that our patientʼs AHS had improved because of relieved voluntary movement, which led to the recognition of self-ownership of her hand.

  In order to understand the current status of support for persons and children with neurocognitive disorders, a questionnaire survey was conducted. The questionnaires were distributed to designated specific consultation support service providers and designated consultation support service providers for children with disabilities in Tokyo and Shiga prefecture. In both communities, the percentage of persons and children with neurocognitive disorders among their service users was less than 5 %, and approximately one quarter of them were undiagnosed. Also, providers with no consultation experience for these persons or children accounted for approximately half of the responded providers, which indicates these consultations are concentrated in certain providers. There were, however, some cases where services were not used despite the existing needs. The reported difficulties included “self- and/or family membersʼawareness of the neurocognitive disorders,” “mismatch between needs and services,” “relationships with other users and care staff members,” and“lack of service providers equipped to deal with persons and children with these disorders.”
  As consideration and measures to overcome these difficulties, “consideration for communication”, “utilization of specialized institutions such as medical institutions” and “information sharing with related organizations”, etc. were mentioned. The development and expansion of a system that encourages providers with these support experiences to build up successful example cases with other local providers to improve the skills of consultation support specialists are needed.

  The purpose of this study was to evaluate the short-term effectiveness of an aphasia day care service (hereafter referred to as “day care for aphasia (DCFA) ”) . An aphasic patient with good cognitive function who used DCFA for the first time was the subject of the study. The study design was for a singlecase experimental study, and consisted of an A-B-Aʼ design with a baseline period, an intervention period, and an intervention removal period. The outcome measures were the Communicative Confidence Rating Scale for Aphasia, the Life Stage Aphasia Quality of Life Scale-11, language function, pragmatic communication skills, and social participation. The results of the study showed that statistically there was a significant improvement in psychosocial performance and a clear improvement in pragmatic communication skills during the intervention period compared to the baseline period. However, there was an overall decrease in performance in the intervention removal period compared to the intervention period. Although there is room for further research, we were able to obtain preliminary data on the effectiveness of DCFA on psychosocial aspects and pragmatic communication skills.