Biomedical subjects

Jeffrey A Wilken

Publications and source records attributed to Jeffrey A Wilken.

6 recordsLinked to original sources

PubMed2006

Initial construct validation of frequently employed ANAM measures through structural equation modeling.

ANAM measures were based on procedures used in both clinical and performance assessment. This paper reviews data from studies designed to delineate specific neurocognitive functions assessed by more commonly used ANAM measures. Data are brought together from both exploratory and confirmatory analyses. Current findings support the use of these measures for assessing aspects of attention, processing efficiency, and working memory. Recommendations for further research include the need for larger samples and the inclusion of specific marker variables.

Cognition Disorders↗

PubMed2006

The use of ANAM to assess the side-effect profiles and efficacy of medication.

Cognition has become increasingly important as an outcome measure in studies of medication. Traditional neuropsychological assessment is limited in its ability to detect subtle, medication-related changes and it is not suitable for the rapid serial assessment required in most clinical trials. Thus, investigators have turned to computerized neuropsychological assessment for its repeatability, sensitivity to subtle cognitive changes, and ease of administration. The automated neuropsychological assessment metrics (ANAM) is one such computerized battery that has been used to measure the effects of numerous CNS-active drugs. This paper is an exhaustive review of studies that have used ANAM to measure cognitive changes associated with pharmacological treatments. The benefits and limitations of using ANAM in clinical trials are discussed.

Brain↗

PubMed2003

A comparison of the effect of diphenhydramine and desloratadine on vigilance and cognitive function during treatment of ragweed-induced allergic rhinitis.

BACKGROUND: Decrements in cognitive performance are associated with the use of sedating antihistamines. Most, but not all, second-generation antihistamines have been found to be nonsedating. OBJECTIVE: To examine the central nervous system (CNS) profile of a new second-generation antihistamine, desloratadine. METHODS: Subjects with ragweed-induced allergic rhinitis (aged 18-60 years) who demonstrated a predetermined severity of symptoms after priming with ragweed pollen in the Environmental Exposure Unit were randomized to receive a single dose of desloratadine, 5 mg; diphenhydramine, 50 mg; or placebo. A comprehensive battery of repeatable, automated neuropsychological tests was administered to subjects before treatment (symptomatic baseline) and 90 minutes after taking study medication. RESULTS: Both desloratadine (P = .04) and diphenhydramine (P < .01) alleviated the symptoms of allergic rhinitis compared with placebo, but treatment with diphenhydramine was associated with clinically meaningful decrements on all vigilance parameters (P < .05 for desloratadine-diphenhydramine contrasts). Also, subjects treated with diphenhydramine performed significantly worse than subjects given desloratadine or placebo across all cognitive domains evaluated. Most effect sizes for the mean desloratadine and diphenhydramine differences were between 0.4 and 0.8 (moderate to high). Stanford Sleepiness Scale scores also indicated significantly more somnolence with diphenhydramine vs desloratadine or placebo (P < .001). There were no significant differences on any of the cognitive parameters between subjects treated with desloratadine and those given placebo. CONCLUSIONS: Desloratadine improved ragweed-induced allergic rhinitis symptoms without adversely affecting performance. Diphenhydramine improved allergic rhinitis symptoms but caused significant decrements in vigilance and cognitive functioning. Thus, efficacy of antihistamine treatment must be balanced against the associated effects on CNS functioning.

Allergens↗

PubMed2002

Decrements in vigilance and cognitive functioning associated with ragweed-induced allergic rhinitis.

BACKGROUND AND OBJECTIVE: The adverse effects of untreated seasonal allergic rhinitis (AR) on performance in the workplace, school, and home are poorly understood. To delineate more clearly the impact and consequences of the disease on performance, the effect of symptomatic AR on vigilance and a wide range of cognitive functions was investigated. METHODS: A battery of automated neuropsychological tests was administered to asymptomatic adult subjects with histories of AR. Subjects were randomized to either a symptomatic or to an asymptomatic group. Subjects in the symptomatic group were exposed to ragweed pollen in a controlled exposure setting until they demonstrated predetermined severities of AR symptoms. Subjects in the asymptomatic group were not exposed to ragweed pollen in the environmental unit and retained a minimum symptom profile. The battery of cognitive measures was re-administered to both groups. RESULTS: AR had major adverse impacts on measures of vigilance. Further, AR adversely affected a broad range of cognitive functions. Specifically, subjects with AR symptoms demonstrated longer response times and decreased efficiency on measures of working memory, psychomotor speed, reasoning/computation, and divided attention as compared with asymptomatic subjects. CONCLUSIONS: In addition to decreased vigilance, AR was associated with decrements in speed and efficiency across several cognitive domains. This is similar to findings in research on medications and medical conditions that cause sedation. Findings may represent a link between AR and poor productivity/personal safety among AR sufferers. This suggests that these results have implications with regard to public health.

Allergens↗

PubMedDate not supplied

Depression and multiple sclerosis: Review of a lethal combination.

Depression is the most frequent psychiatric disorder in multiple sclerosis (MS) patients. The etiology of depression is multifactorial and likely associated with psychosocial stress, focal demyelinating lesions, and immune dysfunction. Proper diagnosis and severity assessment are critical prior to initiation of therapy. Patients with suicidal ideation should be referred for immediate psychiatric consultation and be closely monitored. While more therapeutic trials for depression in MS are needed, MS patients have been shown to respond to current antidepressant medications and psychotherapy. Unfortunately, patients with MS and major depression or suicidal thoughts are often underassessed and therefore not diagnosed. Unlike other aspects of MS, depression is treatable. Early intervention in depression can prevent declines in quality of life and even death from suicide. This article reviews the unique features, assessment, and treatment of depression in MS. MS care providers should vigilantly assess depression and suicide risk in their patients.

Adaptation, Psychological↗

PubMedDate not supplied

Cognitive dysfunction in multiple sclerosis: Assessment, imaging, and risk factors.

Up to 70% of multiple sclerosis (MS) patients experience cognitive dysfunction during the course of their disease. The most often affected domains are attention, memory, and information processing speed. Sequelae of cognitive dysfunction include negative effects on activities of daily living, employment, and relationships. This article reviews cognitive dysfunction in MS and focuses specifically on assessment, imaging, and risk factors. A number of neuropsychological batteries have been developed specifically for assessing cognitive dysfunction in MS patients. Trade-offs in length, administrative support, and efficiency exist between the various batteries. Modern imaging techniques provide a clearer picture of MS-related damage to the central nervous system, which is the major cause of cognitive dysfunction. Additionally, candidate risk factors have been identified that may help predict which patients will develop cognitive dysfunction.

Adult↗