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PubMed2002

Motor and cognitive functions of the ventral premotor cortex.

Recent data show that the ventral premotor cortex in both humans and monkeys has motor and cognitive functions. The cognitive functions include space perception, action understanding and imitation. The data also show a clear functional homology between monkey area F5 and human area 44. Preliminary evidence suggests that the ventral part of the lateral premotor cortex in humans may correspond to monkey area F4. A tentative map of the human lateral premotor areas founded on the reviewed evidence is presented.

Anatomy, Comparative↗

PubMed1990

[Effects of kidney transplantation on cognitive functioning of children].

The purpose of the study was the assessment of cognitive functioning in 20 children (age 4-14 years) with end stage renal disease (ESRD) before and after kidney transplantations by means of an intelligence-test (WISC-R or WPPSI). Research questions were: I. do the test scores of children with ESRD deviate significantly from those of the norm-group before transplantation; 2. do the test scores of children with ESRD increase significantly from pre- to post-transplantation; 3. do the test scores of children with ESRD after transplantation deviate significantly from those of the norm-group. The results show that children with ESRD before transplantation perform significantly more poorly on the verbal part of the WISC-R. After transplantation they show a significant increase on cognitive functioning, mainly in the verbal part of the test. However, kidney transplantation does not cause a complete recovery of cognitive functioning; after transplantation children with ESRD still showed lower scores on several tasks (e.g. tasks concerning concentration).

Adolescent↗

PubMed2003

How "soft" are soft neurological signs? The relationship of subjective neuropsychiatric complaints to cognitive function in systemic lupus erythematosus.

OBJECTIVE: As part of a longitudinal study of cognitive function in systemic lupus erythematosus (SLE), we documented the range and frequency of subjective neurologic and/or psychiatric (NP) complaints in Never-NP-SLE patients, and related these to cognitive function, using the latter as a primary indicator of nervous system involvement. METHODS: Thirty patients with SLE who did not have major neurologic and psychiatric involvement underwent baseline and followup neuropsychological testing roughly 5 years apart. Within 0-13 months prior to retesting, each patient completed a 42 item questionnaire recording NP symptoms. RESULTS: The group as a whole endorsed 26% of symptoms. Fourteen patients labelled high endorsers (> 35% of items) endorsed, on average, 42% of symptoms. There was a significant association between higher item endorsement and lower cognitive function (r = -0.46, p < 0.02) and significantly poorer cognitive performance in the high compared to low endorser groups (t = -3.07, p < 0.005). In addition, a subset of 8 items was endorsed at least twice as often by SLE patients as by patients with rheumatoid arthritis (n = 12) or healthy controls (n = 10). CONCLUSION: These results suggest that "minor" NP symptoms and, in particular, a small subset of subjective complaints may be sufficient to raise suspicion of subclinical nervous system involvement in the absence of clinically evident NP-SLE.

Adult↗

PubMedDate not supplied

[Randomized study of the therapeutic effect of electroconvulsive therapy, uni- or bilateral, on certain cognitive functions in depression, with electroencephalography monitoring. Preliminary results].

Cognitive functions are known to be impaired by ECT. The aim of this study is to differentiate the effects of electroconvulsive therapy on some cognitive functions according to the mode of application of the electrodes. The brief-pulse Thymatron DG apparatus allows to control four electrical parameters and to assess electroencephalographic data. The preliminary sample comprises nine patients suffering of major depressive disorder; they are randomly assigned to the mode of application of the electrodes, bilateral or unilateral to the non dominant hemisphere. Clinical evolution is surveyed by the Montgomery and Asbert Depression Rating Scale. Non mnesic functions are assessed: arousal by CFF (Critical Fusion Frequency), and attentional, motor and decisional abilities by CRT (Choice Reaction Test). Different mnesic function are studied by selective reminding test, cued recall test, block tapping test and picture fragmentation test. After treatment by ECT, verbal mnesic functions assessed by selective reminding test are impaired with the bilateral application. Whereas they are not modified with the unilateral application. The variance of CFF regains a physiological value in the bilateral group, but remains altered in the unilateral.

Adult↗

PubMed1996

Comparison of cognitive function in human and non-human primates.

Fundamental to any comparative study of cognitive function in monkey and man is the demonstration of behavioral homology, viz. that the same cognitive function is being studied in both species. This paper considers a variety of psychological issues that need to be taken into account when attempting to demonstrate behavioural homology. Examples are taken from studies of attentional set-shifting, discrimination reversal learning, spatial working memory and episodic memory. Whilst highlighting the pitfalls to be avoided in the future, these examples also demonstrate the enormous contribution that such studies have had to our understanding of the functions of the temporal lobes and frontal lobes. Moreover, they also illustrate the enormous potential in defining the cognitive functions and dysfunctions of the prefronto-striatal circuitry which underlie so many neurodegenerative and neuropsychiatric disorders.

Animals↗

PubMed2001

Type 2 diabetes and cognitive function in community-dwelling elderly women.

OBJECTIVE: To examine the relationship of type 2 diabetes to cognitive function in community-dwelling women. RESEARCH DESIGN AND METHODS: From 1995 to 1999, we administered four tests of cognitive function (Telephone Interview of Cognitive Status [TICS], immediate and delayed recall of the East Boston Memory Test, and verbal fluency) by telephone to 2,374 participants (70-78 years of age) of the Nurses' Health Study. Information on diabetes was collected biennially beginning in 1976; 82 women reported type 2 diabetes before their cognitive testing. We used linear and logistic regression models to calculate multivariate-adjusted mean differences in scores and relative risks of a low score (bottom 10% of the distribution) for diabetic women compared with nondiabetic women. RESULTS: After multivariate adjustment, women with type 2 diabetes scored lower on all our cognitive tests than women without diabetes. On the general test of cognition (TICS), the mean difference in score between women with and without diabetes was -0.60 (95% CI -1.18 to -0.03, P = 0.04) and the relative risk of a low TICS score was 1.98 (95% CI 1.06 to 3.69). On a global score combining results of the four tests, the mean for diabetic women was lower than that among women without diabetes (adjusted difference in score -0.73, 95% CI -1.42 to -0.04, P = 0.04), and the relative risk of a low global score was 2.16 (95% CI 1.10 to 4.21). Relative to women without diabetes, longer duration of diabetes was associated with lower scores. Few diabetic women were pharmacologically treated (n = 31), but those taking medication had scores similar to those of women without diabetes. CONCLUSIONS: In these women, diabetes was related to lower scores on several aspects of cognitive function. Longer duration of diabetes may be associated with poorer scores, but hypoglycemic therapy may ameliorate scores.

Aged↗

PubMed1991

Cognitive function after spinal or general anesthesia for transurethral prostatectomy in elderly men.

Cognitive functions in 53 elderly men who underwent a transurethral prostatectomy were assessed pre-operatively and 4 days and 3 months post-operatively. Thirteen patients had a preference for one particular type of anesthesia, and the remaining 40 were randomly allocated to receive either spinal or general anesthesia. Cognitive function was not different between the groups receiving different types of anesthesia at either time point and did not decrease post-operatively. No pre- or perioperative variable could distinguish the subgroup of patients who had a post-operative decrease of 2 points or more on the Mini-Mental State Examination. No difference in post-operative performance was found in the patient groups with pre-operative Mini-Mental State Examination scores above or under their age-specific norm. It is concluded that neither hospitalization nor the two forms of anesthesia investigated cause a decrease in cognitive function in elderly men.

Aged↗

PubMed1995

Cognitive function, thyroid status and postpartum depression.

Impairment of cognitive function can occur with thyroid disorder and also with depression. Since depression occurs in conjunction with postpartum autoimmune thyroiditis, the question arises as to whether any impairment of cognitive function in postpartum women is related to change in thyroid status or to depressed mood. A total of 242 women (110 thyroid antibody-positive and 132 antibody-negative) were assessed at 8, 12, 20 and 28 weeks postpartum in the outpatients of a district general hospital. Thyroid antibody levels (antimicrosomal and antithyroglobulin) were monitored at monthly intervals, together with plasma T3, T4 and thyroid-stimulating hormone. The main outcome measures were Research Diagnostic Criteria for depression, the 17-item Hamilton Depression Rating Scale and the Edinburgh Postnatal Depression Scale, together with reaction time and digit span. Subjects with postnatal depression showed detectable cognitive impairment independent of thyroid antibody status and actual thyroid dysfunction.

Antibodies↗

PubMed1993

Cognitive function during moderate hypoxaemia.

The effect of hypoxaemia (mean SpO2 78%) on cognitive function was measured in two groups of twelve normal subjects. A series of psychometric tests was administered to each subject in the same sequence and consisted of the Reitan trail-making test, a digit symbol substitution test, a visuospatial orientation test and the simple unprepared reaction-time test. Psychomotor performance was assessed in a double-blind manner while the subjects were breathing first air and then either air or a hypoxic mixture. While there was improvement in time for the trail-making test during a repeat study breathing air, there was significant deterioration of time to completion of the test in conditions of hypoxia. A significant learning effect in the orientation test was seen in the control group but this did not occur in hypoxic subjects. Hypoxaemia was shown to cause a significant impairment of simple unprepared reaction time compared with controls. All the changes in cognitive function were small and there were no subjective differences in the air or hypoxic groups. The usefulness of the Reitan trail-making and the simple unprepared reaction-time test in the assessment of psychomotor performance deficit under conditions of hypoxaemia has been demonstrated by this study in normal subjects. It was concluded that a mean oxygen saturation of 78% caused only minor changes in cognitive function in normal subjects.

Adult↗

PubMed2002

Cognitive function in patients with cerebral arteriovenous malformations after radiosurgery: prospective long-term follow-up.

PURPOSE: To evaluate the long-term cognitive function of patients with cerebral arteriovenous malformations (AVMs) after radiosurgery. METHODS AND MATERIALS: The data of 95 AVM patients were prospectively assessed up to 3 years after radiosurgery. Of these patients, 39 had a follow-up of at least 2 years. Radiosurgery was performed using a modified linear accelerator (minimal doses to the target volume 15-22 Gy, median dose 20). The neuropsychological evaluation included testing of intelligence, attention, and memory. The effect of a preexisting intracranial hemorrhage, as well as AVM occlusion, on cognitive functions was analyzed after 1 and 2 years. RESULTS: No cognitive declines were observed during follow-up. Instead significant improvements occurred in intelligence (1 year, +6.1 IQ points; 2 years, +5.1 IQ points), memory (1 year, +18.3 percentile score; 2 years, +12.2 percentile score), and attention (1 year, +19 percentile score; 2 years, +18 percentile score). Patients without previous intracranial hemorrhage improved more than patients with intracranial hemorrhage, although this difference was not statistically significant. The role of AVM occlusion on cognitive function is not clear at present. CONCLUSION: Radiosurgery does not induce measurable deterioration of cognitive function in patients with cerebral AVMs.

Adult↗

PubMed1983

Association between nutritional status and cognitive functioning in a healthy elderly population.

We evaluated the association between nutritional status and cognitive functioning in 260 noninstitutionalized men and women older than 60 years who had no known physical illnesses and were receiving no medications. Nutritional status was evaluated by three-day food records and also by biochemical determination of blood levels of specific nutrients. Cognitive status was evaluated by the Halstead-Reitan Categories Test (a nonverbal test of abstract thinking ability) and by the Wechsler Memory Test. Subjects with low blood levels of vitamins C or B12 scored worse on both tests. Subjects with low levels of riboflavin or folic acid scored worse on the categories test. These differences remained significant after controlling for age, gender, level of income, and amount of education. "Subclinical" malnutrition may play a small role in the depression of cognitive function detectable in some elderly individuals, or depressed cognitive function may result in reduced nutrient intake.

Aged↗

PubMed1997

Functional outcome following thalamic haemorrhage: relationship between motor and cognitive functions and ADL.

Twenty-two patients with thalamic haemorrhage were examined to investigate the relationship between motor and cognitive function, and activities of daily living (ADL). Patients with unilateral spatial neglect had lower ADL scores on admission than patients without unilateral spatial neglect (Mean: 17.0 and 24.6, respectively; F = 4.38, df = 1, p < 0.05). Unilateral spatial neglect related to feeding, bowel control and transfer in Barthel index on admission. Patients with aphasia on admission had lower ADL at discharge than patients without aphasia on admission (Mean: 57.0 and 84.7, respectively; F = 7.70, df = 1, p < 0.05). Aphasia related to the bathing, toilet, stair climbing, dressing, and ambulation in Barthel index on discharge. There was a significant difference between the severity of paresis in upper and lower limb on admission and ADL at discharge. The two-way repeated measures ANOVA showed a significant difference between severity of paresis in lower limb and ADL improvement. It can be suggested that the most important predictor of outcome was paresis in lower limb, and not aphasia or unilateral spatial neglect.

Activities of Daily Living↗

PubMed1997

[Isolated systolic hypertension and cognitive function in the aged. Experience of the Syst-Eur study].

OBJECTIVE: To determinate cognitive status and its correlates in older patients with isolated systolic hypertension. METHODS: Syst-Eur is a double-blind placebo-controlled outcome trial conducted in European patients over 60 years of age with isolated systolic hypertension. Moreover, a side-project--the Vascular Dementia Project--is designed to assess cognitive functions and to follow-up their evolution to determine the influence of antihypertensive therapy on vascular dementia incidence. Cognitive functions were evaluated at entry with the MiniMental State Examination (MMSE) in 2250 patients included in Syst-Eur. Cognitive impairment was defined with a MMSE score < or = 23 and led to further evaluation. Baseline blood pressure (BP) was based on the average of six sitting blood pressure readings at three run-in visits 1 month apart. Statistical analysis used Spearman correlation. RESULTS: The MMSE was analysed in 1374 women and 751 men whose mean age was 70 years (range: 60-100). The median level of education expressed as the age at which they stopped their education at school, was 15 years. Baseline blood pressure averaged 173 +/- 10/86 +/- 6 mmHg. Before randomisation in the trial, 899 (40%) patients had received antihypertensive therapy and 602 (27%) had experienced cardiovascular complications. The MMSE-scores ranged from 15 to 30 (median = 29). The maximal score of 30 was reached by 609 (30%) subjects. Among the 59 (3%) patients with a MMSE-score of 23 or less, 5 were considered to be demented according to the DSM IIIR criteria. The MMSE-scores decreased with advancing age in men (r = -0.16; p < 0.001) and women alike (r = -0.24; p < 0.001). In both men and women, they were positively correlated with the level of education (r = 0.30 and 0.32, respectively; p < 0.001). They were negatively correlated with systolic blood pressure (r = 0.10; p < 0.001) and slightly positively correlated with diastolic blood pressure (r = 0.05; p = 0.03). Previously treated patients or patients reporting cardiovascular complications at baseline had lower MMSE-scores than their non-treated counterparts or subjects without cardiovascular complications (median = 28 and 29, respectively, p < 0.003). CONCLUSION: In a European cohort of 2225 patients over 60 years of age with isolated systolic hypertension, the level of cognitive functions evaluated with the MMSE decreases with advancing age or lesser educational level. It also decreases with higher systolic blood pressure or lower diastolic blood pressure. The influence of antihypertensive therapy on cognitive status will be prospectively evaluated in Syst-Eur Vascular Dementia Project.

Aged↗

PubMed2002

Hysterectomy, oophorectomy, and cognitive function in older women.

OBJECTIVES: It has been proposed that estrogen deficiency is a cause of memory loss in postmenopausal women. Bilateral oophorectomy leads to an abrupt decrease in gonadal hormone levels including testosterone. Hysterectomy with ovarian conservation may also lead to a decline in ovarian hormones. This study examines the effects of hysterectomy and oophorectomy on cognitive function in a large sample of older, postmenopausal women with and without current estrogen replacement therapy. DESIGN: Cross-sectional. SETTING: Community-based sample in Southern California. PARTICIPANTS: Subjects were 885 postmenopausal women aged 60 to 89 who were initially enrolled in the Rancho Bernardo Study between 1972 and 1974 and had a follow-up clinic visit in 1988-91. All were Caucasian, middle to upper-middle class, relatively well educated, and ambulatory. MEASUREMENTS: Participants completed 12 standardized tests of cognitive function in 1988-91. Hysterectomy and oophorectomy status were assessed and use of estrogen therapy was also ascertained and validated. RESULTS: Of the 885 women, whose mean age +/- standard deviation was 74.3 +/- 7.5, 225 reported having had a hysterectomy with conservation of one or both ovaries and 190 reported having a hysterectomy with bilateral oophorectomy. Current estrogen use was reported by 35.4%. Among women not using estrogen, there were no significant differences on mean cognitive function scores by hysterectomy and oophorectomy status. Among current estrogen users, after adjustment for age, education, age at menopause, and past estrogen use, those with a hysterectomy and bilateral oophorectomy performed significantly less well on serial sevens and Trails B. These differences, although statistically significant, were small and unlikely to be of clinical significance. No differences in cognitive function were observed between women who had a hysterectomy with ovarian conservation and intact women. CONCLUSIONS: The present study suggests that, overall, there are no long-term effects of hysterectomy and bilateral oophorectomy on cognitive function and does not support the thesis that estrogen deficiency is associated with poor cognitive function in postmenopausal women.

Aged↗

PubMed2003

Impact of antidiabetic medications on physical and cognitive functioning of older Mexican Americans with diabetes mellitus: a population-based cohort study.

PURPOSE: The current study was designed to evaluate the utility of antidiabetic medications in affecting changes in physical and cognitive functioning among older Mexican Americans with diabetes over a 2-year period. METHODS: A longitudinal analysis with repeated measurements between 1999 and 2001 was performed in a cohort of Mexican Americans, 60 or older, in the SALSA Project. Statistical analysis was conducted using a generalized estimating equation. RESULTS: For subjects with diagnosed diabetes </= 5 years (N = 381), there was less decline in physical and cognitive functioning over 2 years among subjects on treatment, compared to those without treatment. For subjects with diagnosed diabetes of 5+ years (N = 337), the effect of antidiabetic medications was more significant in preventing the decline in physical and cognitive functioning (ADL: mean in log scale = -0.10, 95% CI = -0.16, -0.04, 3MS: mean = 6.35, 95% CI = 3.23, 9.48). Combination therapy of antidiabetic agents appeared to be more effective than monotherapy in preventing the decline in physical and cognitive functioning for subjects. CONCLUSIONS: Antidiabetic drugs appear to be useful in alleviating the decline in physical and cognitive functioning among older Mexican Americans with diabetes, especially for those with a longer duration of the disease.

Activities of Daily Living↗

PubMed1996

[Evaluation of cognitive functions after anesthesia with propofol].

OBJECTIVES: To assess the disturbances and delay of recovery of cognitive functions following propofol anaesthesia, and to evaluate a series of simple cognitive recovery tests. STUDY DESIGN: Prospective comparative non randomized clinical study. PATIENTS: Two groups of non premedicated patients, of ASA physical class 1 and 2 were studied. The control group (n = 11) included patients undergoing gastric fibroscopy under local anaesthesia. The propofol group (n = 22) consisted of patients scheduled for coloscopy under propofol anaesthesia. METHODS: The gastric fibroscopy was performed under local anaesthesia with lidocaine and the coloscopy under general anaesthesia with propofol as the sole anaesthetic. Five cognitive tests, designed to assess short-term memory, delayed memory, the ability to plan complex tasks, attention, and language comprehension were conducted the day before, and 1 hour, 3 hours and 6 hours after the endoscopy. RESULTS: The cognitive functions remained significantly depressed for at least 3 hours after anaesthesia, and recovered fully about 6 hours after the cessation of propofol administration. The capacity for planning was the most heavily affected. CONCLUSIONS: Complete recovery can be evaluated by simple cognitive tests, which showed that cognitive functions are impaired over a longer period than psychomotor functions. Oral instructions may therefore not be fully understood by the patient within 3 hours after anaesthesia, emphasizing the importance of written instructions and the essential role played by a well-informed accompanying person.

Adolescent↗

PubMed1995

Education and change in cognitive function. The Epidemiologic Catchment Area Study.

The association between educational attainment and decline in cognitive function over an interval of 1 year was examined for 14,883 subjects 18 years and older in the National Institute of Mental Health Epidemiologic Catchment Area Study. Cognitive function was assessed at both time points by the Mini-Mental State Examination (MMSE); cognitive decline was coded as a dichotomous variable and was defined as 1 if the subject's score had declined 3 or more points from the baseline MMSE score at the 1-year follow-up interview and as 0 otherwise. The association between educational attainment and decline in cognitive function over 1 year was examined in logistic regression models that were stratified by age group (< 65 years, > or = 65 years) and by baseline MMSE level (MMSE > 23, MMSE < or = 23). Covariates included age, baseline MMSE score, ethnicity, residence, lifetime diagnosis of abuse of alcohol or other drugs, and gender. In those with baseline MMSE > 23, education was a significant predictor of cognitive decline, not only in the elderly but also in younger subjects. Among those with baseline MMSE < or = 23, education was not a significant predictor of cognitive decline. The fact that education provides protection against cognitive decline even in those younger than 65 years, in whom the prevalence and incidence of dementia are very low, would seem to indicate that education or its correlates provides protection against processes other than dementia that might produce a decline in test performance in young persons.

Adolescent↗

PubMed2001

Virtual reality in the assessment of selected cognitive function after brain injury.

OBJECTIVE: To assess selected cognitive functions of persons with traumatic brain injury using a computer-simulated virtual reality environment. STUDY DESIGN: A computer-simulated virtual kitchen was used to assess the ability of 30 patients with brain injury and 30 volunteers without brain injury to process and sequence information. The overall assessment score was based on the number of correct responses and the time needed to complete daily living tasks. Identical daily living tasks were tested and scored in participants with and without brain injury. Each subject was evaluated twice within 7 to 10 days. A total of 30 tasks were categorized as follows: information processing, problem solving, logical sequencing, and speed of responding. RESULTS: Persons with brain injuries consistently demonstrated a significant decrease in the ability to process information (P = 0.04-0.01), identify logical sequencing (P = 0.04-0.01), and complete the overall assessment (P < 0.01), compared with volunteers without brain injury. The time needed to process tasks, representing speed of cognitive responding, was also significantly different between the two groups (P < 0.01). CONCLUSION: A computer-generated virtual reality environment represents a reproducible tool to assess selected cognitive functions and can be used as a supplement to traditional rehabilitation assessment in persons with acquired brain injury.

Activities of Daily Living↗