Journal

The Japanese journal of neuropsychology

[Vol.16 No.2 contents]
Japanese/English

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ArticleTitle Controversies of Neuropsychology: What is the compulsive behavior?
Language J
AuthorList Tatsuo Shimomura
Affiliation Department of rehabilitation, Akita prefectural center of rehabilitation and psychiatric medecine
Publication Japanese Journal of Neuropsychology: 16 (2), 91-98, 2000
Received
Accepted
Abstract Imitation behavior (IB) represents a disinhibitory tendency due to frontal lobe damage. We studied the frequency of IB in 40 patients with the Lund/Manchester criteria of probable FTD, 105 patients with the NINCDS/ADRDA criteria of probable AD, and 80 patients without cognitive impairments as controls. In the present setting, an examiner, seating opposite to a patient, made a series of gestures first without any instruction. If the patient imitated several gestures, the examiner asked him not to do so. After making sure to understanding the instruction, the examiner again made another series of gestures. If the patient did not stop imitating, the patient's behavior was defined as obstinate IB. Otherwise, the behavior was defined as naive IB. 21 patients (26%) of the controls, 38 patients (36%) of the AD group, 14 patients (35%) of the FTD group demonstrated naive IB. On the other hand, obstinate IB appeared exclusively in the FTD group. 14 patients (35%) in the FTD group showed it, and the prevalence significantly differed from that in the AD group (p<0.001, Fisher exact probability test). Therefore, naive IB is not a pathological sign, but is likely to be a style of social behaviour such as an expression of courtesy and the patient-doctor relationship. On the other hand, obstinate IB appeared exclusively in the FTD group. FTD is highly suspected when obstinate IB is elicited in a patient with degenerative dementia in the simple bedside test.
Keywords compulsive behavior, echopraxia, compulsive verbal response, imitation behavior

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