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March 1990

Magnetic Resonance Imaging and Clinical Correlates of Intellectual Impairment in Myotonic Dystrophy

Author Affiliations

Section of Neuropathology University of Oklahoma Health Sciences Center 940 Stanton L. Young Blvd Oklahoma City, OK 73190

Arch Neurol. 1990;47(3):253. doi:10.1001/archneur.1990.00530030017005

To the Editor.  —In the May 1989 issue of the Archives, Huber et al1 detailed the results of neuropsychological testing in adults with myotonic dystrophy. According to their findings, depression apparently differentiated myotonic subjects from controls, with the strongest statistical significance. In several previous reports,2-7 we have stressed the characteristic finding of depressive symptomatology in patients with myotonic dystrophy, and have suggested that much of the abnormal "personality" (so prominently described in past reports of these patients8,9) may be the result of chronic depression. In many patients, the symptomatology fulfilled diagnostic criteria for major depressive disorder,10 and this depression responded well to treatment with the tricyclic antidepressant imipramine. As detailed by Huber et al,1 patients with myotonic dystrophy show impairments in a variety of neurophysiological measures of right-hemisphere function. Similar deficits in right-hemisphere cognitive function have been described in otherwise normal individuals as a consequence

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