[Ready2Transform]

I know Kikki had some powerful links about this prior that are likely on one of these three threads. A quick google and I remember it had to do with frototemporal lobe degeneration. It's still in the news, too, so there's some similarities that are being noticed still.

http://bottomlineinc.com/frontotemporal-degeneration-the-dementia-doctors-mistake-for-a-midlife-crisis/
http://www.healthcentral.com/alzheimers/c/42/136856/frontotemporal/
http://www.dailymail.co.uk/news/article-3513263/Dementia-victims-wrongly-told-s-just-mid-life-crisis.html

[Shocked]

It does occur to me that I missed the tipping point with my H. At some point he peaked at being an adult man than started going the other way. He has digressed to where is maturity level of a 20 year old is. At that age he had married his first wife of four years. He was very unhappy then. I have often thought those are the days he wants the do over for. The adult man he was is the man I miss most and still love. I doubt I will ever see that guy again. That is my heartbreak!!!

[MyBrainIsBroken]

Depression and MLC co-exist and there is a reported connection between depression and dementia.

Don't be so sure you won't see that guy again. MLC takes time but for most it does eventually end and so does the regression.

[Anjae]

There is no definitive knowledge regarding depression leading to a greater risk of Alzheimer's. In papers and classes it is usually said it may/seems, and some patients.

People who have never had MLC or depression have Alzheimer's. And people who have had MLC and/or depression do not have Alzheimer's.

I think most people who have Alzheimer's did not had a MLC. Some may had  suffered from depression, some may not.

It would make sense if depressive episodes increased the risk of Alzheimer's, but no one knows for sure.

[MyBrainIsBroken]

http://www.karger.com/Article/Abstract/22163

http://www.nature.com/nrneurol/journal/v7/n6/abs/nrneurol.2011.60.html

http://archneur.jamanetwork.com/article.aspx?articleid=786350&resultclick=1

http://www.tandfonline.com/doi/abs/10.1046/j.1440-1614.2001.00967.x

http://bjp.rcpsych.org/content/202/5/329.short

http://www.europsy-journal.com/article/S0924-9338(16)01711-9/abstract?cc=y=

[Velika]

Interesting article on connection between migraines and bipolar, depression, and even personality disorder:

http://www.everydayhealth.com/headache-and-migraines/webcasts/migraines-and-mental-illness-whats-the-connection.aspx

My husband started getting severe migraines a few months before bomb drop and continued having them after. He hadn't had migraines prior, although this was also around time he started taking SSRI (Paxil).

[Velika]

Has anyone investigated the ventromedial prefrontal cortex? I came upon this mentioned in a forum on brain damage and sociopathy and looked it up.

I found this very interesting because damage to this specific region of the brain looks a lot like MLC. I'm taking this from Wikipedia (for simplicity's sake) but found other articles on this topic as well that may be of interest. Highlights are my own.

To me, this entire description pretty much provides a unified theory as to what could specifically happen to the brain to cause a MLC. Everything is there.

Decision making
Patients with bilateral lesions of the vmPFC develop severe impairments in personal and social decision-making[4][7] even though most of their intellectual ability is preserved.[7][8] For instance, they have difficulties in choosing between options with uncertain outcomes, whether the uncertainty is in the form of a risk or of an ambiguity.[9] After their lesion, these patients have an impaired capacity to learn from their mistakes, making the same decisions again and again even though they lead to negative consequences. These patients choose alternatives that give immediate rewards, but seem to be blind to the future consequences of their actions.[7] However, the underlying mechanisms of this behaviour are not yet fully understood.[7]

Damage to the ventromedial prefrontal cortex (especially in the right hemisphere) has been connected with deficits in detecting irony, sarcasm, and deception.[10] Subjects with damage in this area have been found to be more easily influenced by misleading advertising.[11] This has been attributed to a disruption of a "false tagging mechanism" which provides doubt and skepticism of new beliefs.

People with damage to the ventromedial prefrontal cortex still retain the ability to consciously make moral judgments without error, but only in hypothetical situations presented to them. There is a gap in reasoning when applying the same moral principles to similar situations in their own lives. The result is that people make decisions that are inconsistent with their self professed moral values.[4] People with early damage to the ventromedial prefrontal cortex are more likely to endorse self-serving actions that break moral rules or cause harm to others. This is especially true for patients whose damage occurred the earliest in life.[12]

Emotions and an understanding of social norms are used to provide reasoning of the moral nature on our behaviors, beliefs, and the people around us. The vmPFC works as the neural basis in allowing emotion to influence moral judgement. The trolley dilemma is a classic situation testing emotional involvement in moral judgment. In the trolley dilemma, participants imagine a runaway trolley heading toward five people who will be killed if the trolley is to continue. The participant is to decide whether to allow the trolley to run its course, or to shunt the trolley off to another track where it will only kill one person. Most people choose to throw the switch, concluding that it is moral to save five by sacrificing the life of one. In a variation, there is no switch at hand to shunt the trolley, instead the participant has the option to push someone on the trolley tracks to stop it from moving. Most people are repulsed at the idea of pushing the man to his death, even though outcome is the same as the first dilemma, with five people surviving and one person dying. The more personal nature of pushing someone onto the tracks discourages this response, and the role of emotion is proposed to be the difference in the reasoning. In functional imaging studies, increased activity in the vmPFC is associated with thinking of these personal moral situations, while making harmless decisions does not.[13] Patients with vmPFC lesions made the same decision in non-moral and moral personal dilemmas. Dysfunction of the vmPFC causes failure in using correct moral emotion, which explains why these patients showed less emotional responses when facing these dilemmas.[14]

Regulation of emotion[edit]
The vmPFC plays an important role in regulating and inhibiting our response to emotions. VmPFC seems to use our emotional reactions to model our behavior and control emotional reactions in certain social situations. The inputs of the vmPFC provide it with information from the environment and the plans of the frontal lobe, and its outputs allow the vmPFC to control different physiological responses and behaviors. The role of the vmPFC is especially highlighted in people with damage to this region. A damaged vmPFC causes impairments of behavioral control and decision making, consequences which are rooted in emotional dysregulation. The first and most famous case of someone with defects to this region was Phineas Gage, a railroad construction foreman who in an accident 1848, had his vmPFC bilaterally destroyed. Before his accident, Gage was described as “serious, industrious and energetic. Afterward he became childish, irresponsible, and thoughtless of others.”[15] Another patient with vmPFC damage wasted away his life savings on foolish investments and failed to make appropriate decisions in his personal life. In patients with vmPFC damage, evidence shows that there is a correlation between emotional dysregulation and dysfunction in real world competencies.[15]

The amygdala plays a significant role in instigating the emotional reactions associated with anger and violence. With the vmPFC’s outputs to the amygdala, the vmPFC plays a part in preventing such behavior. Evidence has shown that impulsive murderers have decreased activity in the prefrontal cortex and increased activity in subcortical areas such as the amygdala. This imbalance can enhance actions that are created by negative emotions and limit the ability of the prefrontal cortex to control these emotions. Lower activation in the prefrontal cortex is also correlated with antisocial behavior. The dysfunction of the ventromedial cortex seem to, in part, be caused by lower levels of serotonin release.[15]

The vmPFC also is involved in courage. In experiments with participants allowing snakes to come near or away from them, acts of courage correlated with activation in the vmPFC, specifically the subgenual anterior cingulate cortex.[15][16]

Activation of the vmPFC is associated with successful suppression of emotional responses to a negative emotional signal.[17] Patients with vmPFC lesions show defects both in emotional response and emotion regulation.[8] Their emotional responsivity is generally diminished and they show markedly reduced social emotions such as compassion, shame and guilt. These are emotions that are closely associated with moral values.[8] Patients also exhibit poorly regulated anger and frustration tolerance in certain circumstances.[8]

Patients with focal lesions in the vmPFC show personality changes such as lack of empathy, irresponsibility, and poor decision making. These traits are similar to psychopathic personality traits.[18]

The right half of the ventromedial prefrontal cortex was associated with regulating the interaction of cognition and affect in the production of empathic responses. Hedonic (pleasure) responses were also associations to orbitofrontal cortex activity level by Morten Kringelbach. This finding contributes findings suggesting ventromedial prefrontal cortex being associated with preference judgement, possibly assigning the ventromedial prefrontal cortex a key role in constructing one's self. Studies with Posttraumatic Stress Disorder (PTSD) also supported the idea that the ventromedial prefrontal cortex is an important component for reactivating past emotional associations and events, therefore essentially mediating pathogenesis of PTSD.[19][20] Dysfunction of the vmPFC has also been identified as playing a role in PTSD-affected parents' response to their own children's mental states.[21] Treatments geared to the activation of the ventromedial prefrontal cortex were therefore suggested for individuals and parent-child relationships affected by PTSD. The right half of the ventrolateral prefrontal cortex, being active during emotion regulation, was activated when participants were offered an unfair offer in a scenario. Specific deficits in reversal learning and decision-making have led to the hypothesis that the ventromedial prefrontal cortex is a major locus of dysfunction in the mild stages of the behavioural variant of frontotemporal dementia.[22]

The capacity for mature defense mechanisms such as intellectualization, compensation, reaction formation, and isolation has been tied to proper functioning of the right ventromedial prefrontal cortex, while more primitive defense mechanisms such as projection, splitting, verbal denial, and fantasy have been found to rely on other regions, primarily in the left hemisphere .[23]

[Shocked]

Interesting!!!! This does sound like MLC. Have you found what might cause lesions in the frontal cortex?

[iamnottheenemy]

The Washington Post had a story yesterday on Robin Williams dying of Lewy body dementia, and I know that he had also spoken openly of his battle with depression. So I started digging around, comparing cases of celebrities who may have been MLCers and exhibited depression and/or dementia in later life. Here's what I compiled:

Celebrities with possible MLC and later dementia

Robin Williams – married to 1st wife ages 27-37. Started affair with the nanny age 35 and married her when she became pregnant. Divorced her at age 49 and remarried a third time before committing suicide at age 63. Diagnosed with Dementia with Lewy bodies.

Otis Chandler – married to 1st wife ages 23-53. Married OW one month after divorce was final. Thrillseeker – crashed a motorcycle at age 68 and a Ferrari at age 61. Diagnosed with Dementia with Lewy bodies.

Casey Kasem – married to 1st wife at age 40; divorced her at age 47 and remarried OW 23 years younger within a year. Diagnosed with Dementia with Lewy bodies.

Charles Bronson – married to first wife ages 28 to 44, 2nd wife 15 years younger 47-69, 3rd wife 77-81. Died of Alzheimer’s.

Ronald Reagan – married to first wife ages 29-38, 2nd wife 10 years younger 41-death. Died of Alzheimer’s.

Abe Burrows – married to first wife ages 28-38; 2nd wife 40-death. Died with dementia.

Norman Rockwell – married to first wife ages 18-36, 2nd wife late 30s-55 (she died), then 3rd wife. He was treated for depression throughout his life & died with dementia.

Peter Falk – married to first wife ages 33-49, remarried within a year to 2nd wife 22 years younger (he was 50 and she was 28) and they were together 33 years. The Daily Telegraph said of Falk and Danese, "Unlike the uxorious Lieutenant Columbo, Falk's relationship with his second wife, the actress Sheralyn Danese, remained unpredictable. So frequent were their numerous break ups and reconciliations that they were known in Hollywood as the 'Fighting Falks'. 'She makes me laugh,' Falk said of his 23-year-old wife, 'but if I had to say what we had in common I guess it would be that we both like the colour blue.” Dementia denied but strongly suspected.

Early signs of dementia (everydayhealth.com and prevention.com):
•   Changes in mood
•   Shift in personality
•   Apathy – loss of interest in former hobbies/activities, friends and family
•   Frequent falling
•   Loss of sense of social norms (stealing, driving violations, and inappropriate interpersonal behaviors, such as sexual comments or actions) as early as 30s-40s – this was the first sign of dementia in 14% of cases in a JAMA study
•   Poor judgment/ineffective decision-making
•   Loss of empathy: If someone who is usually sweet, considerate, and polite starts to say insulting or inappropriate things — and shows no awareness of their inappropriateness or concern or regret about what they’ve said — they could be exhibiting an early sign of dementia. In the early stages of some types of dementia, symptoms can include losing the ability to read social cues and, therefore, the ability to understand why it’s not acceptable to say hurtful things.
•   Lack of embarrassment about situations that should be embarrassing
•   Difficulty with money management
•   Depression – individuals over 50 at the start of a study who showed signs of dementia 7 years later were twice as likely to report having been depressed at the start of the study
•   Changes in food cravings
•   Walking more slowly (due to beta-amyloid buildup)
•   Hoarding/compulsive behavior

[scooter]

OMG my STBEXH has all of those symptons.....What can we do about it?