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Biomedical subjects

Anke Bouma

Publications and source records attributed to Anke Bouma.

13 recordsLinked to original sources

Post-treatment intellectual functioning in children treated for acute lymphoblastic leukaemia (ALL) with chemotherapy-only: a prospective, sibling-controlled study.

Intellectual functioning (verbal, performance and full-scale IQ) in 43 children treated for acute lymphoblastic leukaemia (ALL) with chemotherapy-only was evaluated in a nationwide, prospective, sibling-controlled study. Intellectual assessment was performed at diagnosis and repeated shortly after cessation of 2 years treatment, including intrathecal and systemic chemotherapy. Using hierarchical regression analysis, patients' and siblings' (n=27) scores were longitudinally analysed and compared to assess possible changes and differences over time. At both assessments, before and after treatment, the patients showed average scores on intelligence tests compared to population norms. Longitudinal analysis and cross-sectional comparisons revealed no significant differences between patients and controls. Young patients showed a small relative decline, albeit not significant, on performance-IQ compared to healthy siblings. Despite intensive and potentially neurotoxic treatment, no evident negative effects on intelligence were found. However, it cannot be precluded that younger patients are at risk for a small decline in PIQ.

Adolescent↗

Relationships between neuropsychological measures of executive function and behavioral measures of ADHD symptoms and comorbid behavior.

OBJECTIVE: The aim of this study was to examine the relationship between executive functions (EFs), as measured by neuropsychological tests, and symptoms of attention deficit hyperactivity disorder (ADHD) and comorbid behavior, as rated by parents and teachers. As intelligence and language ability are important covariates they were also assessed. METHOD: The sample consisted of 43 children aged 7-11 years who were referred for neuropsychological assessment at a tertiary clinical facility. Most of the children had the diagnosis of ADHD combined or inattentive type. Different aspects of EFs were assessed. RESULTS: EFs were not significantly related to symptoms of ADHD, but only to comorbid symptoms of depression and autistic symptomatology. Language ability rather than EFs best predicted teacher ratings of inattention. CONCLUSIONS: The results of the study do not support the EF theory of ADHD. The importance of screening for comorbid language disorders in children referred for ADHD is emphasized.

Attention Deficit Disorder with Hyperactivity↗

Deviant strategy on The Modified Six Elements Test in patients with schizophrenia.

Impaired executive functioning is found in a considerable proportion of schizophrenia patients. Neuropsychological tests are originally designed to measure the behavior of neurological patients and may therefore miss psychiatry-related cognitive deficits. Qualitative information on tests for executive functioning is important in psychiatric populations. The Modified Six Elements Test (MSET) is a planning test that consists of 6 tasks, for which subjects have limited time and have to obey to switching rules. This study concerns a qualitatively different approach schizophrenia patients use on the MSET, and its relationship with cognitive measures. MSET scores and strategies of schizophrenia patients were compared to those of healthy controls, closed-head-injury patients, and peripheral injury patients. Also, schizophrenia patients and healthy controls were compared on verbal memory and vigilance. Schizophrenia patients finish fewer assignments on the MSET, receive a lower profile score compared to healthy controls, and use a different strategy on the test compared to the other groups. They also perform below healthy controls on the tests for verbal memory and vigilance. Use of the different strategy in schizophrenia patients was related to impaired cognitive functioning. An interesting strategy used by schizophrenia patients on the MSET appears to be indicative of impaired cognitive functioning. This strategy may be a compensatory strategy to spare cognitive resources. It could also be the result of a concrete interpretation of the test instructions.

Adolescent↗

Attention modulates hemispheric differences in functional connectivity: evidence from MEG recordings.

The present study examined intrahemispheric functional connectivity during rest and dichotic listening in 8 male and 9 female healthy young adults measured with magnetoencephalography (MEG). Generalized synchronization within the separate hemispheres was estimated by means of the synchronization likelihood that is sensitive to linear as well as non-linear coupling of MEG signals. We found higher functional intrahemispheric connectivity of frontal and temporal areas within the right as compared to the left hemisphere in the lower and higher theta band during rest and in the lower theta band during dichotic listening. In addition, higher synchronization in the lower theta band correlated with better task performance. In the upper alpha band, hemispheric differences in intrahemispheric connectivity of the frontal regions were found to be modulated by focused attention instructions. That is, attention to the right ear exaggerates the pattern of higher synchronization likelihood for the right frontal region, while attention to the left ear has an opposite effect. We found higher intrahemispheric connectivity in males compared to females as shown by higher synchronization in the lower alpha band. Taken together, our results reflect a physiological basis for functional hemispheric laterality and support the general assumption of sex differences in brain organization. Furthermore, in addition to studies that show that controlled attention processes modulate activation of the frontal areas, our study indicates that attention modulates ipsilateral functional connectivity in the frontal areas. This supports the idea of a supervisory role for the frontal cortex in attention processes.

Acoustic Stimulation↗

A comparison of central coherence skills between adolescents with an intellectual disability with and without comorbid autism spectrum disorder.

Central coherence theory hypothesizes individuals with autism process information in a detail-focused fashion. The present study examined whether adolescents with an intellectual disability and comorbid autism spectrum disorder showed a weaker central coherence than age- and IQ-matched controls. The central coherence skills of 43 adolescents from schools for students with severe learning problems were examined with two cognitive tasks. In these two tasks, detail-focused processing is beneficial to global processing to perform the tasks accurately and quickly. The group with autism spectrum disorder performed better than the control group. Adolescents with an intellectual disability and with comorbid autism spectrum disorder have a weaker central coherence than age- and IQ-matched controls. Partial support was also given for variability in weak central coherence within the autism spectrum.

Adolescent↗

Measuring the executive functions in schizophrenia: the voluntary allocation of effort.

INTRODUCTION: Executive functioning reflects not only what a patient does, but also how he does it or whether he does it at all [Lezak MD. The problem of assessing executive functions. Int. J. Psychol. 17 (1982) 281]. Standard test procedures strongly prompt subjects to certain behavior, so that initiative and the amount of voluntary effort one is willing to invest are therefore not being adequately assessed. METHODS: We developed the Cognitive Effort Test (CET); a test for executive functioning specifically aimed at measuring subject's free initiatives, and the amount of effort they invest voluntarily. It is a complex planning task, and performance is being judged by three subscales: Initiative, Planning, and Workload. 36 schizophrenia patients and 30 healthy controls were tested with the CET, and a battery of other cognitive tests (executive functioning, memory, attention and psychomotor speed) was added to investigate construct and divergent validity. Negative symptoms were also recorded (predictive validity). RESULTS: Patients scored below controls on Planning and Workload, but not on Initiative. The CET was significantly related to other tests for cognition but not to negative symptoms. CET Planning and Workload predicted group membership (patients-controls) better than the other tests for executive functioning combined. CONCLUSION: The CET appears to be a clinically useful test that measures an aspect of schizophrenia that is not being assessed by existing tests, presumably the voluntarily allocation of effort.

Adolescent↗

The impact of specific language impairment on working memory in children with ADHD combined subtype.

The objective of this study was to examine the impact of comorbid specific language impairment (SLI) on verbal and spatial working memory in children with DSM-IV combined subtype Attention Deficit Hyperactivity Disorder (ADHD-C). Participants were a clinical sample of 812- to 1212-year-old children diagnosed with ADHD-C. A group of ADHD-C with SLI was compared to a group of ADHD-C without SLI, and a group of normal children, matched on age and nonverbal intelligence. The results show that ADHD-C children with SLI scored significantly lower than those without SLI and normal children, on verbal working memory measures only. Both ADHD groups performed normally on spatial working memory measures. It is concluded that working memory deficits are not a specific characteristic of ADHD but are associated with language impairments. The importance of screening for language disorders in studies of neuropsychological functioning in children with ADHD is emphasized.

Adolescent↗

What is measured by verbal fluency tests in schizophrenia?

INTRODUCTION: Schizophrenia patients perform below the norm on verbal fluency tests. The causes for this are unknown, but defective memory, executive functioning and psychomotor speed may play a role. METHOD: We examined 50 patients with schizophrenia and related disorders, and 25 healthy controls with a cognitive test battery containing tests for verbal memory, executive functioning and psychomotor speed, and a categorical fluency test. RESULTS: Patients obtained significantly lower test results than the controls on most cognitive measures including the verbal fluency test. During the fluency test, they formed as many clusters, and switched as often between clusters as the controls did, but they generated fewer words per cluster. Interestingly, in the control group, fluency performance was predicted by memory and executive functioning, but not by psychomotor speed. In patients, verbal fluency was predicted by psychomotor speed, but not by memory or executive functioning. DISCUSSION: We conclude that psychomotor speed could be a crucial factor in cognition, and its influence on cognitive test performance should be considered in schizophrenia research. Furthermore, these data illustrate the importance of qualitative analysis of cognitive impairments in schizophrenia patients, as traditional cognitive tests often only provide quantitative information.

Adult↗

Do women really have more bilateral language representation than men? A meta-analysis of functional imaging studies.

Sex differences in cognition are consistently reported, men excelling in most visuospatial tasks and women in certain verbal tasks. It has been hypothesized that these sex differences in cognition results from a more bilateral pattern of language representation in women than in men. This bilateral pattern of language representation in women is thought to interfere with visuospatial functions in the right hemisphere. To test whether language representation is indeed more bilateral in the female than in the male brain, a meta-analysis was performed on studies that assessed language activity with functional imaging in healthy men and women. Effect sizes were weighted for sample size and the meta-analytic method was applied to obtain a combined effect size. Fourteen studies were included, providing data on 377 men and 442 women. Meta-analysis yielded a mean weighted effect d of 0.21 with a 95% confidence interval of -0.05 to 0.48, indicating no significant difference in language lateralization between men and women. This implies that the putative sex difference in language lateralization may be absent at the population level, or may be observed only with some, as yet not defined, language tasks. It is therefore not likely that differences in language lateralization underlie the general sex differences in cognitive performance, and the neuronal basis for these cognitive sex differences remains elusive.

Brain↗

Age effects in identifying and localising dichotic stimuli: a corpus callosum deficit?

In the present study, dichotic listening performance of 31 older adults was compared with performance of 25 younger adults under free and focused attention conditions. In addition to an age-related general decrease in performance, we observed in the focused attention condition increased asymmetry in the elderly group: the decrease of recall performance was stronger for the left ear (LE) then for the right ear (RE), while the increase of localisation errors were greater for the RE than for LE. Identifying and localising digits appear to be different process mediated predominantly by the left and right hemisphere, respectively. Since age-related reduced performance is strongest for the ear ipsilateral to the hemisphere dominant to that particular function, these finding may be ascribed to decline of corpus callosum functioning resulting in decrease interhemispheric interaction rather than to a selective decline of right hemisphere functions.

Acoustic Stimulation↗

Effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type.

OBJECTIVE: The aim of this study was to examine the effects of transcutaneous electrical nerve stimulation (TENS) on cognition, behavior, and the rest-activity rhythm in children with attention deficit hyperactivity disorder, combined type (ADHD-CT). METHODS: Twenty-two children diagnosed with ADHD-CT received TENS treatment during 6 weeks, 2 times 30 min a day. Neuropsychological tests were administered to assess cognition, parent/teacher behavioral rating scales were used to measure behavior, and actigraphy was used to assess the rest-activity rhythm. RESULTS: TENS appeared to have a moderate beneficial influence on cognitive functions that load particularly on executive function. There was also improvement in behavior as measured by parent/teacher behavioral rating scales. Moreover, motor restlessness during sleep and motor activity during the day decreased by TENS. CONCLUSIONS: The effects of TENS in children with ADHD are modest but encouraging and warrant further research.

Adolescent↗

[The diagnostic value of drawing a clock in geriatrics].

In this study the Clock Drawing Test (CDT) is used in a geriatric department to search for dementia in a population with somatic disorders (N=236). The demented group (N=113) has significant lower scores on every item and on the total score of the scoring method, compared to the non-demented group (N=123). A factor analysis of the scoring method shows that the fourteen items can be grouped into the three groups "contour", "digits", and "hands". A logistic regression shows that "hands" is the most discriminating, although this effect is moderate (sensitivity 59.3%, specificity 75.6%). Considering however that the CDT, compared to other screening tasks, appeals to an unique combination of cognitive functions, including visual semantic memory, working memory, visuospatial skills, attention and executive functions, it can be concluded that this test can contribute to the diagnoses of dementia, besides the traditionally used instruments.

Aged↗

Pain assessment in patients with possible vascular dementia.

PREVIOUS studies comparing Alzheimer's disease (AD) patients with the normal elderly suggest that AD patients experience less pain. In the present study, pain reporting in 20 patients with possible vascular dementia (VaD) was compared to 20 nondemented elderly who had comparable pain conditions. It was hypothesized that, due to de-afferentiation, the possible VaD patients would experience more pain than the cognitively intact elderly. Pain assessment was conducted using three visual analogue scales, (1) the Coloured Analogue Scale (CAS) for Pain Intensity, (2) the CAS for Pain Affect, and (3) the Faces Pain Scale (FPS); a verbal pain questionnaire, Number of Words Chosen--Affective (NWC-A) of the McGill Pain Questionnaire; and an observation scale, the Checklist of Nonverbal Pain Indicators (CNPI). Results showed a significant increase in the scores on the CAS for Pain Affect and the FPS in the demented patients compared to the control group. There was a tendency for an increase in scores on the CNPI in the VaD group. These results suggest that patients with possible VaD suffer more pain than healthy elderly without cognitive impairment.

Aged↗