News and Commentary Archive

Explore recent scientific discoveries and news as well as CLBB events, commentary, and press.

Mission

The speed of technology in neuroscience as it impacts ethical and just decisions in the legal system needs to be understood by lawyers, judges, public policy makers, and the general public. The Massachusetts General Hospital Center for Law, Brain, and Behavior is an academic and professional resource for the education, research, and understanding of neuroscience and the law. Read more

Clinical Approach to the Differential Diagnosis Between Behavioral Variant Frontotemporal Dementia and Primary Psychiatric Disorders

By Simon Ducharme, Bruce H. Price, Mykol Larvie, Darin D. Dougherty, and Bradford C. Dickerson | American Journal of Psychiatry | September 1, 2015

Summary:

Frontotemporal dementia (FTD) describes a heterogeneous group of neurodegenerative diseases featuring various combinations of behavioral changes, language abnormalities, social cognitive impairment, and executive function deficits. FTD is divided into two major clinical syndromes: the behavioral variant (bvFTD) (1) and the language variants referred to as primary progressive aphasias (2).

Identifying bvFTD is challenging because symptoms can be subtle in the early stages, and they may combine features that are traditionally within the realm of psychiatry (e.g., personality changes, lack of empathy, compulsions) and others usually seen by neurologists (e.g., aphasia, cognitive impairments). Patients are often first evaluated in general psychiatric settings, and about 50% are initially diagnosed with a primary psychiatric illness (3).

Knowledge about FTD has grown exponentially over the past 10 years, and it is crucial for psychiatrists to include bvFTD as part of their differential diagnosis in a wide range of adult psychiatric disorders. In this article, we review the clinical approach to bvFTD, focusing in particular on the differential diagnosis between bvFTD and primary psychiatric disorders.

Read the full paper here.

In an Iowa courtroom, an astonishing case of sex and Alzheimer’s

By Sarah Kaplan | The Washington Post | April 7, 2015

They started flirting in choir, the vivacious retiree and the grandfatherly politician, both single after the deaths of their longtime spouses. Less than two years later, they were married in the church where they met, surrounded by a gaggle of children and grandchildren and hundreds of guests dancing the polka. It was an unexpected second chance at love for Donna Lou Young and Henry Rayhons, both past 70 at the time of their wedding.

“They were two good people who were good together,” the couple’s pastor recalled.

After a four-year battle with Alzheimer’s, Donna Lou Rayhons died in a nursing home in August, just four days shy of her 79th birthday. A week later, Henry Rayhons was arrested and charged with sexual abuse. State prosecutors accused him of having sex with his wife while she was incapacitated by dementia. Continue reading »

In Alzheimer’s Cases, Financial Ruin and Abuse Are Always Lurking

By Paul Sullivan | January 30, 2015 | The New York Times “Your Money” “Wealth Matters”

Midway through the film “Still Alice,” which tracks the growing grip of Alzheimer’s on a 50-something Columbia University professor, that professor, played by Julianne Moore, stands at a lectern to address an Alzheimer’s conference. She is holding a yellow highlighter and a copy of her speech.

She proceeds to talk about her struggles with the disease and how she never knows what will vanish from her memory and when. It’s a lucid, affecting talk, and the viewer would be hard pressed to know anything was wrong with her, if not for the highlighter. She uses it to track her every word so she doesn’t read the same sentence over and over again.

For anyone who has ever watched a family member disappear into Alzheimer’s, Ms. Moore’s performance is gripping, particularly as her tricks to stall her decline inevitably fail and the later stages of the disease consume her. Yet the movie is also a great vessel to explore many of the financial issues that families need to address when someone is diagnosed with Alzheimer’s or any other disease that causes cognitive impairment.

Continue reading »

When Frontotemporal Dementia Leads to Crime—Prosecution or Protection?

By Jessica Shugart | Alz Forum | January 13, 2015

For some, it starts with stealing candy. For others, it’s a reckless car crash, or a sudden penchant to urinate in public. The type of incident varies, but according to a study published January 5 in JAMA Neurology, more than a third of people with frontotemporal dementia (FTD) act out criminal behaviors. In some cases, the odd conduct is the first clear signal to their loved ones that something is way off. Led by Bruce Miller at the University of California, San Francisco, the study also reported bad behavior in people with Alzheimer’s and Huntington’s diseases; however, those patients’ misconduct tended to surface later in the disease and to a lesser degree than it did in people with FTD. The study raises questions about how the criminal justice system should handle people with FTD and, even more pressingly, concerns about the plight of undiagnosed patients who may be languishing in prisons or on the streets. Continue reading »

Pair allegedly swindled $450,000 meant for cat

John R. Ellement | The Boston Globe | April 17, 2014

Two Brighton roommates allegedly concocted a brazen scheme to bilk an ailing, elderly neighbor of $450,000 by agreeing to use the money to care for the woman’s beloved cat as long as it lived.

But instead of safeguarding the assets for the pet, a tabby named Puddy Cat, the two women are accused of going on a spending spree, buying a $28,000 Mini Cooper car, an iPad, a Vitamix blender, and a Netflix subscription — all while the 74-year-old woman, who suffers from dementia, was in a nursing home. They also siphoned off tens of thousands of dollars in cash, Suffolk Assistant District Attorney Michele Granda said in Suffolk Superior Court Thursday.