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To examine prospectively whether high reward experience (the ability to generate positive affect boosts from pleasurable daily events) protects against affective symptoms and whether environmental or genetic risk factors moderate protective effects.At baseline, 498 female twins participated in an experience sampling study measuring reward experience in daily life. They also completed questionnaires on childhood adversity and recent stressful life events (SLE). Affective symptoms were measured at baseline and at four follow-ups using SCL-90 anxiety and depression subscales. Co-twin affective symptoms were used as indicators of genetic risk.Baseline reward experience did not predict follow-up affective symptoms, regardless of level of genetic risk. However, high reward experience was associated with reduced future affective symptoms after previous exposure to childhood adversity or recent SLE.High daily life reward experience increases resilience after environmental adversity; modification of reward experience may constitute a novel area of therapeutic intervention.

High-calorie intake is associated with changes in state body satisfaction, and is moderated by dietary restraint and body mass index. This implies that food intake signals fear of overeating and weight increase in specific populations. Four experiments addressed aspects of this putative relationship by direct manipulation of energy intake and exposure to food cues. This enabled determination of whether digestive or cognitive factors cause changes in body and weight satisfaction. Females were randomly allocated either to food versus non-food conditions, or to low-calorie versus high-calorie food cue exposure. Results: Study 1. Body satisfaction decreased after lunch intake compared to control, an effect more pronounced for overweight than lean participants. Study 2. Consumption of a disguised soup-load increased body satisfaction for overweight but decreased body satisfaction for lean participants; weight satisfaction decreased for lean participants. Study 3. Restrained eaters showed decreased body satisfaction after both cue exposure conditions compared to unrestrained eaters. Restrained eaters showed decreased weight satisfaction after high-calorie, compared to low-calorie exposure, in which weight satisfaction increased. Study 4. Body and weight satisfaction increased in lean unrestrained eaters after both exposure conditions; body and weight satisfaction decreased in overweight restrained eaters after low-calorie exposure and increased after high-calorie exposure. Findings partially support both digestive and cognitive influences on body and weight satisfaction, moderated by body mass index and restraint.

Of 50 consecutive women with partial seizures of temporal lobe origin (temporal lobe epilepsy [TLE]) evaluated for reproductive dysfunction, 28 had menstrual problems. Of those, 19 had reproductive endocrine disorders. Polycystic ovarian syndrome and hypogonadotropic hypogonadism occurred significantly more often in women with TLE than in the general female population. Polycystic ovarian syndrome was associated with predominantly left-sided lateralization of interictal epileptic discharges; hypogonadotropic hypogonadism was more commonly found with right-sided discharges. Hyposexuality occurred more often in women with predominantly right-sided interictal epileptic discharges and was associated with low serum luteinizing hormone levels. There are several possible interpretations: epileptic discharges in medial temporal limbic structures may disrupt hypothalamic regulation of pituitary gonadotropin secretion; anovulatory cycles of reproductive endocrine disorders may promote the development of epileptic discharges; and TLE and some associated reproductive endocrine disorders may represent the parallel effects of prenatal factors common to the development of the brain and the reproductive system.

The lymphocytes from two patients with primary demyelinating diseases showed significant transformation when stimulated by a pure encephalitogenic myelin basic protein. In addition lymphoblasts undergoing mitosis were found in their peripheral blood. Radioimmunoassay did not reveal any antibody to the encephalitogenic protein. Both the patients had atopic histories, and one had a brother with disseminated sclerosis.

Formed auditory hallucinations associated with acquired deafness have seldom been reported in the English literature. In the past year we have had the unusual opportunity of examining two deaf patients whose complaint when first seen was that of hearing music.

An acute confusional state after infarction in the distribution of the right middle cerebral artery has been described. Patient recovery usually is excellent. Some patients, however, do not improve, resulting in a chronic confusional state.

There is an extensive behavioural neurological literature on so-called unilateral attentional disorders, but a striking paucity of papers on global disorders of attention, i.e. confusional states. However, confusional states are distinctive because: (1) they are the most common disturbance of the higher functions in clinical practice, by orders of magnitude; (2) they are the only disturbance of the higher functions from which all normal subjects have suffered; (3) they have characteristic clinical manifestations; (4) they are frequently misdiagnosed as progressive dementias, aphasia, memory disorders, and psychoses; (5) they are the only disturbance of the higher functions that commonly cause patients to produce statements that appear to be extremely witty; (6) they can be readily studied experimentally; (7) they are the most common cause of unconcern with or denial of illness. There are almost certainly several different forms of confusional state depending on the aetiology, the rate of development, the age, and the anatomical systems involved, but little classification has yet been carried on. Confusional states are most simply defined as disorders in which there is a loss of the normal coherence of thought or action. Among the striking clinical features are: (1) failure to pay attention, excessive distractibility, or failure to shift attention; (2) paramnesias, i.e. distortions of memory; (3) reduplicative phenomena, ‘wild’ paraphasias with ‘propagation’ of error, alterations of mood in many different directions; (4) isolated or predominant disturbance of writing (the most common cause of pure agraphia); (5) unconcern with or denial of illness; (6) apparently playful behaviour. While confusional states are usually attributed to ‘global involvement of the brain’ as a result of metabolic or toxic disorder, there are in fact many cases produced by focal infarctions in the right hemisphere, which, in the experience of my department, is one of the commonest effects of cerebrovascular disease. Brief reference is made to the prognosis, and to the theoretical significance for cerebral dominance and the evolutionary development of cerebral dominance in non-human species.

Structural asymmetries between the hemispheres are found in the human brain. Asymmetries in the auditory regions and in the Sylvian fissures are present even in the fetus. The Sylvian asymmetries may have existed in Neanderthal man and are found consistently in some apes. They may relate to right-left differences infunction. Thus, the striking auditory asymmetries could underlie language lateralization. The asymmetries in the frontal and occipital lobes and the lateral ventricles are correlated with hand preference. Anatomical asymmetries may help to explain the range of human talents, recovery from acquired disorders of language function, certain childhood learning disabilities, some dementing illnesses of middle life, and the evidence for behavioral lateralization in nonhuman primates.

Despite repeated assertions by some critics of the impossibility of linking behaviour to study of the brain, there have been major, although not always continuous advances in this field over the past 100 years, some of them based on simple techniques. One example is the study of cerebral dominance, for which it was believed until quite recently that no anatomical basis had been specified. The paper summarizes the findings of striking anatomical asymmetry of the upper surface of the temporal lobe, in an area known to be involved in speech functions. Asymmetries observed in autopsy brains of adults and fetuses, both by gross and by cytoarchitectonic techniques, are reported. By use of radiological methods asymmetries have been shown in the brains and skills of living persons. Asymmetries also appear to be present in the endocasts of skulls of ancient humans, and in nonhuman primates. The distribution of asymmetries is different in left and right handers. The implications of these findings are discussed.

This paper is devoted to a discussion of the mechanism of normal pressure hydrocephalus, and in particular to a consideration of the “total-force” hypothesis. It is shown mathematically on physical grounds that the total-force hypothesis is incapable of accounting even in very simple systems for expansion without increase in pressure or for differential expansion. It is demonstrated that even in such simple systems changes in pressure and differential expansion depend on the structural properties of the walls of the container. It is argued that any theory of the pressure and differential volume changes in a more complex system, such as the ventricles, must take the structural properties of the ventricular walls into consideration.