We treated a male patient in his 60s who developed a dressing disorder. The patient had problems in dressing himself in a front-fronted open shirt, such as incorrect threading of the sleeves on the left and right sides, misalignment of the sleeve holes and the hand that threads the sleeves, and incorrect buttoning. In particular, the patient often did not notice the left-right sleeve threading error, and his awareness of the importance of dressing was also noticeably impaired ; however, he had no problems dressing others and performing other activities of daily living. Neuropsychological findings included decreased visual working memory, distributive attention, and compositional deficits. In addition, the left and right hands of the user made the mistake in tasks that required simultaneous correspondence between the targetʼs and the userʼs left and right hands, such as gesture imitation and auditory body part indication tasks. In addition, in a task in which participants were asked to correctly arrange 10 segmented photographs of the process of wearing a shirt with a front opening, they were able to correctly arrange the photographs taken from the front, but not those taken from the back. Once the patient was able to correctly arrange the photos taken from the back, he was able to correctly put on his front-front open shirt.

  We report a case whose initial symptom of left-hand diagonistic dyspraxia changed, during the course of the disease, to right-hand compulsive manipulation of tools. The patient, a right-handed man in the late seventies, suffered a second cerebral infarction 5 days after his first cerebral infarction. A brain MRI demonstrated lesions in the left medial frontal lobe, including the supplementary motor area, as well as the genu and body of the corpus callosum. The patient presented with diagonistic dyspraxia in the left hand which interrupted his right-hand action for approximately six months. Subsequently, as the diagonistic dyspraxia disappeared, right-hand compulsive manipulation of tools became apparent instead. This is the first report in which involuntary action following focal brain damage switched from the left to the right hand. We speculate that functional reorganization of the supplementary motor area in action control contributed to the appearance of the right-hand compulsive manipulation of tools, which was initially hidden under the left-hand diagonistic dyspraxia. We further suggest that an environmental setting using visual stimuli may be an effective approach for alleviating compulsive manipulation of tools.

  Classifiers, being sometimes referred as numeral classifier in Japanese, are morphemes that co-occur with nouns and represent subjective semantic attributes of corresponding nouns. They represent subjective categorization. Examining classifier use and comprehension could reveal changes in subjective categorization for patients with Alzheimerʼs disease (AD).
  【Classifier Production Test】We performed a classifier production test (SALA PR 28) with 39 patients with AD and 21 control participants. In this test, the subjects were required to describe the names and numbers of drawn objects, along with appropriate corresponding classifiers. Many of the subjects also performed noun and verb similarity judgment tasks (SALA VC 16/VC 17). Our results showed that patients with AD misused classifiers more often than the control participants in the PR28, i.e., they frequently showed correct naming with a wrong classifier, being significantly related to the misevaluation for dissimilar pairs of the VC 16/VC 17 task.
  【Classifier Comprehension Test】We performed a classifier comprehension test (SALA AC 9) with 26 patients with AD and 16 control participants. In this test, the subjects were asked to select a corresponding alternative to a given classifier among four choices. Many of the subjects also performed noun and verb similarity judgment tasks (SALA VC 16/VC 17) We observed that patients with AD made more errors in the AC9 test, which was more obvious in those with lower MMSE scores. An analysis of error patterns suggests that their responses were affected by similarities among the four choices.
  【Conclusions】Since classifiers represent subjective categorization, the results of this study suggest that patients with AD are categorizing objects differently from controls. On the other hand, most errors in the noun and verb similarity judgment tasks (SALA VC 16/VC 17) are excessive associations between the given dissimilar words, such as, “everyone should wear a suit to go to a hotel, so suit and hotel are similar”, which could be resulted from the profile shift to the given words.
  Patients with AD would recognize every word and every object from a viewpoint that deviated from the standard semantic range, which will lead them to adopt uncommon categorization.

  This study aimed to investigate the effects of line-break position on the omissions of letters at the beginning of lines on the neglected side and eye movements in patients with left unilateral spatial neglect. Five right-handed patients (two males and three females) with left unilateral spatial neglect caused by right hemisphere damage and 18 right-handed neurologically healthy adults (controls, 11 males and seven females) participated in this study. We asked the participants to read aloud 12 texts containing 48 line breaks. We controlled the positions of line breaks so that 24 lines started with the beginning of a word (word boundary condition) and 24 lines started in the middle of a word (non-word boundary condition).
  Three of the five patients omitted letters or words at the beginning of the lines, demonstrating left neglect dyslexia. For the patients with left unilateral spatial neglect, regardless of whether or not they showed left neglect dyslexia, the landing location of return sweeps (leftward eye movements from the end of lines) was far from the beginning of the line. In patients with left neglect dyslexia, we observed omissions of letters and words at the beginning of lines more in the word boundary condition than in the non-word boundary condition. Moreover, the leftmost fixation location of the leftward eye movement was farther from the beginning of the line in the word boundary condition than in the non-word boundary condition. There was a correspondence between the difference in the rate of omissions of letters at the beginning of lines and the eye movements under the word boundary and non-word boundary conditions.

  We reported a right-handed female in her 40ʼs presenting with difficulty to release her unintended left-hand grasp on objects following cerebral infarction of the right medial frontal lobe. She was unable to voluntarily release objects after grasping them with her left hand in bimanual movements. She could overcome this symptom by stimulating the dorsal surface of the left hand, mentally focusing on the idea of letting go, or internally ordering the left hand to release. Brain MRI showed cerebral infarctions in the right medial prefrontal area, pre-supplementary motor area, supplementary motor area, cingulate gyrus and corpus callosum. This symptom is partially comparable with diagonistic dyspraxia defined as abnormal motor behavior of the left hand triggered by voluntary activities of the right hand, and was interpreted as a release phenomenon of the learned praxis of the left hand due to damage to genu and body of the corpus callosum. We presumed that external stimulation to the left hand and/or concentration of attention on the left hand movement may facilitate lessening of this abnormal grasping phenomenon.

  In this study, analyses of clinical background factors and neuropsychological assessments such as Wechsler Adult Intelligence Scale (WAIS) -III scores and Neuropsychiatric Inventory (NPI) scores have been conducted for 86 consultation cases (among which 70 were home dwellers, 15 were facility dwellers, and one was unknown) with the chief complaint of social behavioral disorders. Since the analyses showed the decline in the cognitive function for the half of the subjects, the importance of an appropriate dealing method following the assessment of the background cognitive function has been suggested. Also, discriminant analysis with problematic symptoms and NPI items as its explanatory variables and their dwelling, home or facility, as its objective variable showed that standardized discriminant coefficients was highest for “night-time behavioral disturbances” followed in order by “gambling,” “anorexia,” “over-eating/drinking” and “disinhibition” ; and the higher percentage of the subjects showed these problems among the facility dwellers. The canonical correlation coefficient was 0.694 (Wilksʼλ＝0.52, P＜0.001) , and its significant effectiveness was confirmed for the discrimination. The percentage of correct discrimination after cross-validation was 90.2%.