Michon (1985) and Watanabe (2016) proposed a driving model that encompasses the cognitive process of driving, which consists of cognition-prediction-judgment-operation. The model is largely divided into three levels : strategic level ; planning of driving, tactical level ; situation understanding, prediction and judgment, and operation decision, and operational level ; actual driving operation. The higher brain functions involved in each of the above are considered to be executive functions, and functions for recognizing the situation using visual and auditory sensory modalities, focusing attention and distributing attention, and executing the situation. The cognitive load in such driving behavior varies depending on the driving environment. In a comparison of neuropsychological tests between a group of patients with aphasia who could resume driving and a group of patients who did not resume driving, significant differences were found in the MMSE, BIT letter erasure, WAIS arithmetic, BADS zoo map, and modified 6 elements test. These results suggest that language function may influence driving behavior. In the comparison by BDAE, significant differences were found in MMSE, TMT-A and B, and WAIS digit symbol-coding. Although it is possible that the severity of the aphasia may affect the results, further investigation is needed.

  Identifying destructive driving behaviors via empirical on-road assessments can contribute to a heightened comprehension of the underlying mechanisms responsible for hazardous driving among patients with higher brain dysfunction due to brain injury. Concurrently, rehabilitation protocols aimed at restoring driving abilities impaired post-brain injury can concentrate on these areas, elevating the chances of intervention efficacy and potency. This report furnishes a synopsis of the problematic driving practices of individuals with brain injury. It presents the findings of a study by the authors evaluating the extent of difficulty in driving behaviors among this population.

  Our driving school provides driving aptitude testing equipment and actual vehicle evaluations for persons with higher brain dysfunction. Based on our analysis of various cases, we believe that the driving aptitude tester is an evaluation that can play an intermediate role between neuropsychological testing and actual vehicle evaluation. Therefore, for persons with higher brain dysfunction, the validity and reliability of the evaluation can be enhanced by analyzing the relationship between neuropsychological testing, driving aptitude testing equipment, and actual vehicle evaluation, and by considering resumption of driving under multidisciplinary collaboration. In addition, in the actual vehicle instruction for persons with higher brain dysfunction who have decades of driving experience and are assumed to have a certain level of knowledge and skills in driving, experience shows that active learning by questioning using the GROW model as an example is effective in reducing psychological reactance and sustaining the effectiveness of the instruction.

  Several types of visual illusions can occur in Parkinsonʼs disease (PD) . However, the prevalence and types of specific illusions experienced by patients with PD remain unclear. We aimed to investigate the types of illusions. A questionnaire of visual illusions was developed through a literature review in consultation with clinicians and neurologists. Based on the questionnaire, 40 consecutive patients with PD were asked a series of Yes/No questions regarding 19 types of visual illusions since the onset of PD. If participants answered ʻYesʼ, they were then asked to detail their experience (s) . In total, 30 patients with PD had experienced visual illusions since disease onset ; among them. The most commonly observed illusion types were dysmorphopsia, complex visual illusions, metachromatopsia, and diplopia. Other observed illusions included textural illusions, macropsia, micropsia, teleopsia, pelopsia, kinetopsia, akinetopsia, Zeitraffer/Zeitlupen phenomena, tilt illusion, upside-down illusion, and palinopsia. Visual illusions had detrimental effects on the patientsʼ daily lives in some cases. Systematic interviews regarding the incidence and details of visual illusions experienced by patients with PD could offer important information regarding their quality of life.

  Developmental prosopagnosia is a symptom where people cannot even recognize the face of a familiar person despite the absence of problems with their eyesight, intelligence, attention, memory and so on. No organic brain damages or abnormalities on the imaging test were found. We showed three cases of developmental prosopagnosia and compared their facial recognition functions, facial expression recognitions and so on. Furthermore, we conducted interviews on their experiences and feelings that they had had since their childhood. All of the three cases show that the patients still have a lot of difficulties in leading a social life such as the luck of understanding on their workplaces. Therefore, it seems the most important to conduct educational activities to make known the existence of developmental prosopagnosia and make understood inconvenience caused by it.

  Primary progressive aphasia (PPA) is classified according to current diagnostic criteria as nonfluent/agrammatic variant PPA (nfvPPA) , semantic variant PPA (svPPA) , or logopenic variant PPA (lvPPA) . However, some previous cases of PPA did not fulfil any of these criteria. One of the syndromes observed in the cases was progressive word deafness (or progressive auditory agnosia) . The damage in the auditory cortex and/or the acoustic radiation, which are the key parts of the auditory central nervous system, can cause auditory agnosia. Word deafness can be caused when there is damage to the language-dominant hemisphere. Patients with word deafness usually have preserved pure-tone thresholds, whereas their phonological perception of speech sounds is impaired. Because PPA is a syndrome caused by underlying neurodegenerative diseases, the impairment of auditory central nervous system progresses and induces specific auditory symptoms depending on underlying disease. The major auditory processing deficits and auditory symptoms are different among nfvPPA, svPPA, and lvPPA. We summarized the latest findings regarding progressive word deafness. In addition, we mentioned the importance of evaluating speech sound perception, which is fundamental for detecting word deafness in PPA. It is very difficult to accurately evaluate speech sound perception because it can be influenced by language function. As an example of assessment methods, we presented a case in which we attempted to assess basic auditory function and auditory language comprehension using various auditory and linguistic tasks.

  Auditory hallucinations are one of the most common psychiatric syndromes and have been studied mainly in functional psychiatric disorders such as schizophrenia. On the other hand, hallucinations are characteristic of organic mental disorders, and are considered one of the core symptoms of Dementia with Lewy bodies (DLB) . However, auditory hallucinations are not a rare syndrome in DLB, and in our study, one in three DLB patients had auditory hallucinations. The majority of auditory hallucinations in DLB occurred with visual hallucinations, many of which were characterized by “the visual hallucinations spoke to the patients”. Furthermore, factors such as delusions, depression, hearing loss, and women were involved in the development of auditory hallucinations, suggesting that auditory hallucinations in DLB may be caused by a variety of factors, including delusions, depression, hearing loss, and women, acting on the auditory hallucinations.

  Individuals after orbitofrontal/ventromedial prefrontal cortex injury sometimes present both spontaneous confabulation and behavioral changes, such as disinhibition. Why can these two distinctive symptoms coexist? In this paper, we examine the functions of the orbitofrontal/ventromedial prefrontal cortex in terms of value assignment and value judgement, decision making, reality monitoring, and judgement of the situation. We described the possibility that these two symptoms can be explained by both difficulties in value or situational judgment and inability to control untrue statements and inappropriate behaviors.