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Biomedical subjects

J DeLuca

Publications and source records attributed to J DeLuca.

At least 55 records · Page 3Linked to original sources
PubMed1997

Cognitive functioning is impaired in patients with chronic fatigue syndrome devoid of psychiatric disease.

OBJECTIVE: To examine the effect of the presence or absence of psychiatric disease on cognitive functioning in chronic fatigue syndrome. METHODS: Thirty six patients with chronic fatigue syndrome and 31 healthy controls who did not exercise regularly were studied. Subgroups within the chronic fatigue syndrome sample were formed based on the presence or absence of comorbid axis I psychiatric disorders. Patients with psychiatric disorders preceding the onset chronic fatigue syndrome were excluded. Subjects were administered a battery of standardised neuropsychological tests as well as a structured psychiatric interview. RESULTS: Patients with chronic fatigue syndrome without psychiatric comorbidity were impaired relative to controls and patients with chronic fatigue syndrome with concurrent psychiatric disease on tests of memory, attention, and information processing. CONCLUSION: Impaired cognition in chronic fatigue syndrome cannot be explained solely by the presence of a psychiatric condition.

Adult↗
PubMed1997

Verbal learning in amnesic anterior communicating artery aneurysm patients and in patients with multiple sclerosis.

The California Verbal Learning Test (CVLT) was used to examine the qualitative, and quantitative aspects of memory in patients with amnesic anterior communicating artery aneurysm (ACoA) and in patients with multiple sclerosis (MS). The results show that both groups were impaired relative to control participants with respect to acquisition of verbal material. The participants with A CoA exhibited a profound loss of information and emitted a significantly greater number of intrusions and false positives than either control participants or participants with MS. The advantages of using both quantitative and qualitative measures of memory in differentiating various clinical populations are discussed.

Journal Article↗
PubMed1997

The effects of fatigue on neuropsychological performance in patients with chronic fatigue syndrome, multiple sclerosis, and depression.

The effects of fatigue on neuropsychological performance were examined in patients with fatiguing illnesses. Repeated testing with the Paced Auditory Serial Addition Test (PASAT; Gronwall, 1977) was employed over the course of a demanding neuropsychological testing session. It was hypothesized that if fatigue affects performance, one would expect to observe "blunting" of the PASAT practice effect. Fifteen of the study participants live with chronic fatigue syndrome (CFS), 15 with multiple sclerosis (MS), 14 with depression (DEP), and 15 are healthy, sedentary controls. Overall PASAT performance was significantly reduced for CFS and DEP participants compared to controls, whereas mean performance did not differ across the three fatiguing illness groups. Degree of improvement across trials (i.e., practice effect) for the groups did not differ from controls'. Neither subjective fatigue or DEP were significantly related to PASAT performance. These findings suggest that fatigue does not universally impair performance during neuropsychological assessment even in groups in which fatigue is a prominent symptom.

Journal Article↗
PubMed1996

Depression in fatiguing illness: comparing patients with chronic fatigue syndrome, multiple sclerosis and depression.

Because depression is commonly observed in the chronic fatigue syndrome (CFS), the present study sought to determine whether the symptom pattern is similar to that seen in clinically depressed subjects (DEP). Individuals with multiple sclerosis (MS) were chosen as an additional comparison group because MS is a fatiguing illness of known organic etiology. The Beck Depression Inventory (BDI) was used to compare categories of depressive symptomatology. Absolute scores on the BDI were higher for the depressed group on mood and self-reproach symptoms, but were not higher than the CFS group on somatic and vegetative items. Analysis of symptoms as a percentage of total BDI score revealed no significant differences in mood or vegetative items among the three groups. The CFS and MS groups exhibited a significantly lower percentage of self-reproach symptoms than DEP, whereas the DEP group showed a lower percentage of somatic symptoms than the CFS and MS groups.

Adult↗
PubMed1996

Cognitive dysfunction following arteriovenous malformation of the vein of Galen: a case analysis.

Arteriovenous malformation of the vein of Galen (AMVG) has been associated with poor prognosis secondary to its cerebral steal effect. This report describes the cognitive profile of a 38-year-old man who presented to acute rehabilitation with a congenital vein of Galen malformation. Cognitive and behavioral impairments are described and correlated with neuroanatomic involvement. Physiatrists and allied health care professionals must recognize that with the improvement of neurosurgical technology, AMVG can be associated with favorable short-term rehabilitation outcome. Prospective studies are needed to determine long-term outcome.

Adult↗
PubMed1996

Selective impairment of auditory processing in chronic fatigue syndrome: a comparison with multiple sclerosis and healthy controls.

The most consistent deficit observed in individuals with Chronic Fatigue Syndrome has been in efficiency of information processing. To examine the possibility of a modality-specific impairment, the present study examined subjects with Chronic Fatigue Syndrome, multiple sclerosis, and healthy controls on an auditory-versus visual-paced serial-addition test. 20 subjects with Chronic Fatigue Syndrome, 20 subjects with clinically definite Multiple Sclerosis, and 20 sedentary healthy controls were compared. One-half of the subjects in each group were administered the Paced Auditory Serial Addition Test and the other half were administered the Paced Visual Serial Addition Test. The group with Chronic Fatigue Syndrome was differentially impaired on the auditory relative to the visual processing task. The group with Multiple Sclerosis was equally impaired on both versions of the task. The results are discussed within the framework of Baddeley's model of working memory.

Adult↗
PubMed1996

Cognitive rehabilitation following anterior communicating artery aneurysm bleeding: a case report.

The present case report documents the successful rehabilitation of a severely amnesic anterior communicating artery aneurysm patient. The patient was able to return to his premorbid high-level occupation after significant improvement in executive functioning, moderate improvement in visual memory, modest improvement in immediate verbal memory, and minimal improvement in delayed verbal memory. An interdisciplinary approach to rehabilitation was utilized in conjunction with empirically based intervention strategies. The implications of improved executive functions versus memory functions for successful rehabilitation are discussed.

Adult↗
PubMed1995

Aneurysm of the anterior communicating artery: a review of neuroanatomical and neuropsychological sequelae.

For over 100 years, the study of amnesia in humans has been limited primarily to subjects with either diencephalic or mesial temporal lobe lesions. However, over the last 30 years, it has been reported that individuals who survived aneurysms of the anterior communicating artery (ACoA) often displayed an amnestic syndrome, despite the fact that diencephalic and mesial temporal structures were intact. This article presents a comprehensive review of the ACoA literature concerning the neurobehavioral and neuroanatomical substrates of what has been termed the "ACoA syndrome". Various theoretical models regarding the neural substrates of amnesia are discussed. Possible directions for future research are outlined.

Amnesia↗
PubMed1995

Reducing heterogeneity in chronic fatigue syndrome: a comparison with depression and multiple sclerosis.

Chronic fatigue syndrome (CFS) is a heterogeneous illness characterized by a high prevalence of psychiatric problems. We reasoned that we could reduce heterogeneity by excluding patients with psychiatric problems preceding CFS. We compared the functional status, mood, fatigue level, and psychiatric status of this more homogeneous group of CFS patients with the same parameters in patients with mild multiple sclerosis and in patients with major depression or dysthymia. Patients with CFS and those with multiple sclerosis were similar in terms of level of anger, severity of depression, level of anxiety, and frequency of current psychiatric diagnoses. Patients with CFS resembled depressed patients in having impaired vigor and experiencing substantial fatigue and confusion--problems constituting part of the case definition of CFS. The group with CFS was not psychologically vulnerable before the development of this condition and maintained adequate networks of social support despite disabling illness. Stratification to exclude patients with prior psychiatric disease and those with mild CFS allowed us to define a group of patients with CFS who more resembled patients with mild MS than patients with major depression or dysthymia and thus were more likely to have illness with an infectious or immunologic cause. Use of such a stratification strategy should prove important in testing of the viral/immunologic hypothesis of the etiology of CFS.

Adolescent↗
PubMed1995

Frequency of deviant immunological test values in chronic fatigue syndrome patients.

Of 11 immunological tests done on chronic fatigue syndrome patients and on fatigued controls, 3 tests (protein A binding, Raji cell, or C3 or C4 [deviant values in either complement component were counted as positive]) with deviant results discriminated best among the groups. Other tests, including immunoglobulin G subclasses, complement component CH50, interleukin-2, and anticardiolipin antibodies, did not discriminate well among the groups.

Fatigue Syndrome, Chronic↗
PubMed1995

Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression.

To examine the degree and nature of cognitive impairments in chronic fatigue syndrome, a comprehensive neuropsychological battery was given to patients with chronic fatigue syndrome, multiple sclerosis, depressed patients, and healthy controls. The battery included tests of attention and concentration, information processing speed, verbal and visual memory, intellectual ability, and concept formation. Measures of depression and anxiety were also obtained. The chronic fatigue syndrome group did not differ from the depressed group in overall neuropsychological performance, but differed from the multiple sclerosis and control groups. The most significant impairment was in information processing speed in the chronic fatigue syndrome group. Depression and anxiety were not related to neuropsychological performance. The influence of reduced information processing on other areas of cognition is discussed.

Adult↗
PubMed1995

Cardiovascular regulation in multiple sclerosis.

Traditional assessments of autonomic nervous system function have depended on invasive and complex procedures. Vagal power, which is the respiratory component of heart rate variability (HRV) is an alternative and non-invasive measure for indexing autonomic nervous control of the heart. In the current study, 18 multiple sclerosis (MS) and 20 healthy subjects matched with respect to age, education and intelligence served as subjects. The MS group showed significantly lower vagal power during natural and paced breathing than healthy subjects. Importantly, heart rate did not differ between the two groups. If MS patients exhibit abnormalities in mechanisms mediating cardiac parasympathetic control, the impact on quality of life and vulnerability to adverse cardiac events need to be further evaluated. The results of this study may have implications with respect to the feasibility of using HRV as both a diagnostic and prognostic tool for evaluating parasympathetic nervous system dysfunction and in providing valuable information for developing more effective treatment and rehabilitation strategies.

Adult↗
PubMed1994

The nature of memory impairments in multiple sclerosis: acquisition versus retrieval.

The present study was designed to examine whether verbal memory impairment in multiple sclerosis (MS) is attributable to impaired information acquisition or compromised retrieval. Twenty-three MS and 23 control subjects were administered a 10-item verbal list-learning task. Subjects were trained to a specific criterion on the verbal test in order to assure equal information acquisition. Following a 30-min delay, retrieval and recognition performance was evaluated. MS subjects required significantly more trials to reach criterion on the task relative to controls, but the groups did not differ on tests of recall and recognition. Performance was correlated with rate of information processing speed. These results suggest that verbal memory impairment among MS subjects is a consequence of inadequate initial learning and not a function of impaired retrieval.

Adult↗
PubMed1994

Cognitive functioning of patients with chronic fatigue syndrome.

Neuropsychological problems are a distressing and frequent component of the symptom complex associated with chronic fatigue syndrome. Objective assessment of these difficulties is essential to understanding the nature of this illness. Results of the studies discussed in this paper suggest that impaired information processing, rather than primary memory dysfunction, may be at the root of the cognitive problems that afflict so many patients with CFS.

Cognition↗
PubMed1993

Information processing efficiency in chronic fatigue syndrome and multiple sclerosis.

OBJECTIVE: To compare the cognitive performance of subjects with chronic fatigue syndrome (CFS), multiple sclerosis (MS), and healthy controls. All subjects were matched for age, education, and verbal intelligence, as previous neuropsychological studies of CFS had not used appropriate control groups. DESIGN: Case-control design. All subjects were given a neuropsychological battery and the test scores were compared among the groups. SETTING: Subjects with CFS and subjects with MS were recruited from private and institutional practice and from the community. Healthy subjects were recruited from the community. PATIENTS/OTHER PARTICIPANTS: Twelve subjects (all female) with CFS participated in the study. Chronic fatigue syndrome was diagnosed in these patients in accordance with the requirements outlined by the Centers for Disease Control as modified subsequently to not exclude patients with concurrent depression and/or anxiety. All subjects with CFS were referred for a neuropsychological examination to assess persistent cognitive complaints. Eleven subjects (10 female, one male) with the diagnosis of clinically stable MS were chosen from clinics and the community because of complaints of mild to moderate cognitive impairment. The subjects with MS and 11 healthy volunteers (10 female, one male) were matched to the group with CFS by age, education, and estimated verbal intelligence (based on the Vocabulary subtest of the Wechsler Adult Intelligence Scale-Revised). The subjects with MS had a mean Kurtzke Expanded Disability Status Scale score of 4.95 (SD, 1.95; range, 2.0 to 7.5). As a result of the matching procedure, there were no differences among the three groups in age (F[2,31] = 0.32), education (F[2,31] = 0.80), and verbal intelligence (F[2,31] = 0.31). INTERVENTIONS: None. MAIN OUTCOME MEASURES: These measures included the Beck Depression Inventory (BDI), the Paced Auditory Serial Addition Test (PASAT), Digit Span Test, and the Similarities Test of Verbal Abstract Reasoning. RESULTS: The mean number of correctly identified responses collapsed across the four PASAT trials was significantly different across groups (F[2,31] = 4.03; P < .05). While the CFS and MS groups did not differ from each other, subjects with CFS (SEM, 124.2 +/- 6.4) and subjects with MS (SEM, 112.9 +/- 10.9) scored significantly below controls (SEM, 146.4 +/- 6.4) (Fisher's Protected Least Significant Difference test; P < .05). There were significant differences among the three groups on mean Digit Span Test performance (F[2,31] = 5.5; P < .01). While the CFS and MS group did not differ significantly from each other, only the CFS group was significantly lower than control (Fisher's Protected Least Significant Difference test; P < .05). Mean performance on the Similarities test did not differ among the three groups (F = 0.58). In addition, there were significant differences among the three groups in mean BDI scores (F[2,31] = 7.6; P < .01). The CFS and MS groups did not differ significantly from each other, and both groups showed a statistically significantly elevated mean BDI score relative to the control group (Fisher's Protected Least Significant Difference test; P < .05). No significant correlations were found between BDI scores and PASAT total scores (CFS, r = -.21; MS, r = .13; control, r = .27), or between BDI and Digit Span Test (CFS, r = -.32; MS, r = -.40; control, r = -.19). Results of the PASAT and Digit Span Test were significantly correlated in the CFS group (r = .71; P < .01), but not in the MS (r = .06) or control groups (r = .49). CONCLUSIONS: These results indicate that subjects with CSF and subjects with MS show significant impairment on a test of complex concentration when compared with appropriate controls. The data suggest that subjects with CFS and subjects with MS have difficulty on tasks that require the simultaneous processing of complex cognitive information. Selective impairment in information processing efficiency may lie at the

Adult↗
PubMed1993

The neuropsychology of post-polio fatigue.

To test the hypothesis that post-polio fatigue and its concomitant cognitive deficits are associated with an impairment of attention and not of higher-level cognitive processes, six carefully screened polio survivors were administered a battery of neuropsychological tests. Only subjects reporting severe fatigue, and not those with mild fatigue, demonstrated clinically significant deficits on all tests of attention, concentration, and information processing speed while showing no impairments of cognitive ability or verbal memory. These findings suggest that an impaired ability to maintain attention and rapidly process complex information appears to be a characteristic in polio survivors reporting severe fatigue, because these deficits were documented even when their subjective rating of fatigue was low. This finding supports the hypothesis that a polio-related impairment of selective attention underlies polio survivors' subjective experience of fatigue and cognitive problems.

Adult↗
PubMed1993

Predicting neurobehavioral patterns following anterior communicating artery aneurysm.

This multiple case report presents two groups of survivors from aneurysms of the anterior communicating artery (ACoA); amnesic and non-amnesics, to examine the similarities and differences in neuropsychological profiles. All six patients were consecutive admissions to acute inpatient rehabilitation, and exhibited generally intact attention, concentration and intellectual ability. Confabulation and personality changes were observed only among the amnesic ACoA patients. However, difficulties in concept formation and perseverative responding was observed in all subjects. A neurobehavioral hypothesis addressing the underlying mechanism of the main features of the "ACoA syndrome" is presented.

Adult↗