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R Portin

Publications and source records attributed to R Portin.

33 records · Page 2Linked to original sources

Climacteric symptoms do not impair cognitive performances in postmenopause.

OBJECTIVE: To investigate whether information processing and attention performances are affected by climacteric vasomotor symptoms. METHODS: The study group comprised 66 healthy hysterectomized postmenopausal women. The subjects were divided into two subgroups (high symptomatic and low symptomatic) according to the quantity of climacteric vasomotor symptoms. Information processing was examined using CogniSpeed, a reaction time software that separates, for example, pure controlled processing and working memory from perceptual and motor components. Attention was examined by using visual and auditory tasks. The role of climacteric depression as a determinant of cognitive performance was evaluated by the Beck Depression Inventory and dividing subjects according to self-reported climacteric mood symptoms. The effects of serum oestrogen level and ageing on cognitive performances were also studied. RESULTS: Cognitive performances were similar in high symptomatic and low symptomatic women. On the Verification test younger women had shorter reaction times (P = 0.002) and on the Subtraction test they had fewer errors (P = 0.015) than older women. These tests required working memory and decision making. Accuracy in the tests of sustained and auditory attention worsened slightly with age. Cognitive performances neither correlated with scores on the Beck Depression scale nor with serum oestrogen level. Climacteric mood symptoms did not impair cognitive performance. CONCLUSIONS: Despite subjective complaints of memory impairment in association with climacteric vasomotor symptoms, our results did not support a direct cause-and-effect relationship. Thus, the minor deficits found in cognitive processing efficiency seem to be related rather to age than climacteric symptoms.

Aging↗

The progress of cognitive decline in multiple sclerosis. A controlled 3-year follow-up.

The purpose of this study was to illustrate how cognitive functioning evolves over time in patients with multiple sclerosis. We followed the evolution of cognitive performances in two clinically and demographically similar multiple sclerosis groups, the 'cognitively preserved' (n = 20) and the 'cognitively mildly deteriorated' (n = 22), and in healthy controls (n = 34). We conducted the follow-up examination using the Mild Deterioration Battery, the Mini-Mental State Examination, and a set of additional neuropsychological measures after an interval of 3 years. The drop-out rate in our study was only 5%. The 'cognitively preserved' multiple sclerosis group showed substantial neuropsychological stability by performing as well as the controls both at baseline and at follow-up. By contrast, the initially 'cognitively mildly deteriorated' group demonstrated progressive cognitive decline on many neuropsychological tests. The intermediate-length screening battery, the Mild Deterioration Battery, was sensitive to this decline, whereas the briefer Mini-Mental State Examination was not. The progressive cognitive decline could not be predicted from other disease variables. The study demonstrated that intact cognitive functioning in multiple sclerosis may remain stable, whereas incipient cognitive decline seems to be widespread and progressive in nature. Thus, progressive cognitive deterioration should be considered as one of the characteristics of multiple sclerosis.

Adult↗

Language functions in incipient cognitive decline in multiple sclerosis.

Although the mechanisms of cognitive impairment in multiple sclerosis (MS) have been extensively studied, evaluation of language functions has been given little attention. In the present study, we evaluated whether impairment of language functions is associated with cognitive decline in MS. We studied naming, reading, and writing performance of two carefully matched patient groups differing only with respect to cognitive status. In language tasks, the patients with incipient cognitive decline not only demonstrated performance slowness but also made more errors than the patients with preserved cognitive capacity and the healthy controls. The comprehensive naming error analysis revealed that the cognitively deteriorated patients produced error types not present in the other two study groups. Contrary to previous suggestions, the present study indicates that impaired language performances in MS are attributable to mild cognitive deterioration rather than to sensory or motor factors. Thus, assessment of language functions should be included in neuropsychological evaluations of MS patients.

Adult↗

Perceptual priming in Alzheimer's and Parkinson's diseases.

The present study focused on perceptual identification priming (implicit memory) in early stages of dementia by studying demographically and cognitively matched patients with Alzheimer's disease (AD) and Parkinson's disease (PD). The AD and PD groups performed normally on perceptual identification priming, whereas their explicit recognition memory was equally impaired compared to normal controls. These results imply that priming in perceptual identification relies on the perceptual memory system which can resist not only impairments of explicit memory but also widespread cognitive deterioration induced by the neurodegenerative processes in AD or PD.

Adolescent↗

Memory deficits and early cognitive deterioration in MS.

INTRODUCTION: In the present study, the pattern of memory and learning deficits in two cognitively different, but clinically and demographically similar, multiple sclerosis (MS) groups was compared. MATERIAL & METHODS: 23 patients represented the cognitively preserved MS group and 22 patients the MS group with early cognitive decline. A control group of 35 healthy controls was also included. The cognitive status of the subjects was defined using the Mild Deterioration Battery (MDB). Furthermore, all subjects were given a set of memory and learning tests and were instructed to evaluate the frequency of their memory and learning difficulties. The Mini-Mental State Examination (MMSE) was also administered to all subjects. RESULTS: The cognitively deteriorated patients, even those with normal MMSE performance, showed widespread memory and learning deficits, but adequate self-evaluation of their everyday memory and learning difficulties. The preserved group, in turn, performed similarly to the controls. CONCLUSION: Widespread memory and learning deficits are associated with relatively mild cognitive decline in MS. These deficits were observable in the intermediate-length screening battery, the MDB, but not in the MMSE. The present study suggests that the accuracy of patients' own evaluations of their memory and other cognitive problems is superior to the results of very brief screening batteries, like the MMSE. Therefore, brief screening in neuropsychological assessment of MS patients is not recommendable.

Adult↗

Education, gender and cognitive performance in a 62-year-old normal population: results from the Turva Project.

Four WAIS (Wechsler Adult Intelligence Scale) subtests, and tasks of memory and cognitive control were administered to a population sample of 143 men and 179 women. Subjects with a minor advantage in years of education out-performed those with only primary schooling. Gender-related effects were also remarkable. Whereas the general abilities were equal in the genders, women out-performed men on recall of word pairs and objects, on verbal cognitive control and on Digit Symbol. In contrast, men excelled on Trail Making A, and on Block Design. The findings emphasize the need for age norms by gender and education for cognitive tests.

Aging↗

Attention related performance in two cognitively different subgroups of patients with multiple sclerosis.

To evaluate the underlying mechanisms of cognitive decline in multiple sclerosis, two clinically and demographically matched multiple sclerosis groups differing in cognitive status were assessed with attention related tasks. In addition to the attention tests recommended by the Cognitive Function Study Group of the American National Multiple Sclerosis Society, a test of sustained attention was used to evaluate the role of possible fatigue on cognitive performance. The cognitively mildly deteriorated group was slower than the cognitively preserved group and the controls on all tests of attention. The mildly deteriorated group did not, however, consistently differ from the other groups in the error scores of the attention tests. The preserved group exhibited slowness at the end of the visual vigilance test, but no deficits were found on the other attention related tests in this group. It is suggested that dissociable kinds of processing slowness are the origin of the deficits found on the attention tests in the two multiple sclerosis groups. Our preserved group exhibited signs of motor and fatigue related slowness, whereas the mildly deteriorated group also had extensive cognitive slowness. As sensitive indicators of cognitive slowness, attentional tests should be included in evaluation of the cognitive status of patients with multiple sclerosis.

Adult↗

Automatic and controlled information processing in multiple sclerosis.

The purpose of this study was to evaluate the kind of slowing of information processing associated with multiple sclerosis and how this possible slowness is related to cognitive deterioration. We selected 45 patients with definitive multiple sclerosis diagnosis and 35 control subjects. Twenty-two patients had mild cognitive deterioration and 23 patients had preserved cognitive capacities, otherwise the groups were matched. Using computerized tests, we investigated three separate stages of information processing: automatic and controlled processing, and motor programming. The results indicate that patients with mild cognitive deterioration are slower than patients with preserved capacities or controls in every stage of processing measured in this study. Additionally, the preserved patients showed signs of mild slowing in automatic visual processing. These results show that, in multiple sclerosis patients, widespread information processing slowness is associated with multiple sclerosis-related cognitive deterioration. This study emphasizes the importance of studying subgroups rather than cognitively heterogeneous patient samples and, furthermore, the need to divide information processing into different stages is indicated.

Adult↗

Slowing of information processing in Parkinson's disease.

In this study, we criticize the notion of bradyphrenia and argue that "slowness of thought" in Parkinson's disease (PD) must be analyzed as slowness of different information-processing stages and that unselected patients should not be used in experimental studies. We selected 32 patients with a long history of PD and 50 control subjects. Sixteen patients had mild cognitive deterioration (not dementia) and 16 patients had preserved cognitive capacities; otherwise the groups were matched. By using computerized tests, we investigated three separate stages: automatic and controlled processing and motor programming. The results indicate that patients with mild cognitive deterioration are slower than patients with preserved cognitive capacities or controls in automatic visual and in controlled processing but not in motor programming. We conclude that the slowing of controlled processing reflects the disruption of central neural networks, that a long history of PD does not necessitate cognitive slowing, and that PD is not a neuropsychologically serviceable category.

Aged↗

Quality of life and cognitive performance after carotid endarterectomy during long-term follow-up.

The quality of life and the cognitive performance of patients with extracranial carotid stenosis were investigated 8-11 years after treatment in 18 non-operatively treated patients and 44 patients treated with carotid endarterectomy. The cognitive performance was compared with data on a normal control group. Cognitive performance was assessed with neuropsychological tests and the quality of life by personal interview based on a questionnaire. Most of the carotid stenosis patients recovered well both subjectively and cognitively regardless of the type of treatment. Only the subgroup operated twice was subjectively worse compared to the other groups. Even 10 years later the cognitive performance of carotid stenosis patients was remarkably close to normal.

Aged↗

Senile dementia of the Alzheimer type treated with aniracetam: a new nootropic agent.

Forty-four patients with senile dementia of the Alzheimer type were randomly allocated into double-blind treatment with either aniracetam (RO 13-5057) 1 g or placebo daily for 3 months. Neurological examinations were made before and after treatment and psychometric tests were performed before and after 1 month's and after 3 month's treatment. Treatment was interrupted due to occurrence of confusion in four cases in the aniracetam group and in one case in the placebo group. During treatment, an improvement was seen in several cognitive tests, especially those associated with memory, but this improvement occurred in the placebo as well as in the aniracetam-treated group. In clinical evaluation no difference was seen in efficacy between the two treatment groups.

Aged↗

The effect of deprenyl (selegiline) on cognition and emotion in parkinsonian patients undergoing long-term levodopa treatment.

The effects of deprenyl on memory, other cognitive functions, vigilance and emotional processes were investigated in seven parkinsonian patients undergoing long-term levodopa treatment. The patients were selected on the basis of their cognitive impairment, observed during a follow-up study of 8-10 years. Four of the patients had progressive dementia and three did not. After deprenyl treatment lasting 4 weeks, there were two patterns of responses. Patients with slow progressive dementia failed to respond to treatment, whereas patients without progressive impairment tended to show improvement in memory and motor speed; the former group also showed more emotional changes than the latter. Typical responses in all patients treated with deprenyl were: increased arousal, paradoxical spells of tiredness, deterioration in vigilance and in set shifting, but improvement of parkinsonian disability. These preliminary findings indicate that there is a dissociation between pure motor responses and cognitive as well as other behavioural responses to deprenyl. It is probable that although enhanced availability of dopamine by MAO-B inhibition partly explains the present neuropsychological findings, also other brain mechanisms are involved.

Aged↗