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PubMed2025

Relationship Between Cognitive Disorder and First-Line Targeted Therapy for Oncogene Driver-Positive Patients With Non-Small Cell Lung Cancer: Prospective Cohort Study.

BACKGROUND: Previous studies have found and confirmed a correlation between cognitive disorder and chemotherapy. As genetic testing becomes more routine in clinical practice, targeted therapies are increasingly gaining prominence. The relationship between targeted treatment and cognitive function is not yet clear. This study aimed to investigate the correlation between cognitive disorder and targeted treatment by evaluating the changes in cognitive function before and after targeted therapy. OBJECTIVE: This study aims to explore whether targeted therapy affects cognitive function in patients with advanced lung cancer and to explore the association between cognitive function, the inflammatory biomarker C-reactive protein, and psychological stress. METHODS: From the screened cohort of 150 patients with advanced non-small cell lung cancer (NSCLC) with gene mutations, 87 (58%) were rigorously selected for the study. The evaluation instruments used were the Mini-Mental State Examination scale, the Distress Thermometer, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 for assessing quality of life. RESULTS: A significantly lower progression-free survival (PFS) was observed in the group of patients surviving advanced NSCLC with cognitive disorder under targeted therapy in contrast to survivors in the group with no cognitive disorder (hazard ratio=0.347, 95% CI 0.209-0.578; P<.001). Furthermore, the objective response rate and disease control rate for the group with cognitive disorder were noted to be 37.8% and 86.7%, respectively, contrastingly lower than those in the group with no cognitive disorder, recorded at 78.6% and 97.6%, respectively. Significant variances were also noted in the Mini-Mental State Examination scores between patients with and without cognitive disorder both before and after targeted therapy (P<.001 in both cases), with a decreasing trend observed in both groups after targeted therapy. Noteworthy differences were found in quality of life scores both before and after targeted therapy (P<.001 in both cases). In addition, notable disparities were apparent in C-reactive protein levels among the 2 groups before and after treatment (P=.03 and P=.048 for each time point, respectively), with an upward trend observed in both groups after targeted therapy. The multivariate Cox regression analysis demonstrated that cognitive function is an independent risk factor for PFS in patients with NSCLC receiving targeted therapy. CONCLUSIONS: Cognitive disorder may lead to lower quality of life scores and shorter PFS in patients undergoing targeted therapy. Early screening and intervention for such patients could effectively improve clinical outcomes and quality of life.

Humans↗
PubMed1996

[A specific disorder in Kanji writing in a learning disabled child with a visual cognition disorder--a cognitive-neuropsychological and electrophysiological analysis].

We reported a learning disabled child with a specific disorder involving Kanji writing. The patient was a 13-year-old boy. Although he manifested generally normal intellectual ability and his performance on WISC-R indicated that VIQ was 101 and PIQ 84, he could only write approximately 20% of Kanji, which he learned at age 6 to 7. On cognitive-psychological tests, he showed a visual cognition disorder that was different from that in a previously reported case during information processing. Electrophysiologically, he showed a disorder in visual task-relevant potentials. The mechanism underlying this patient appears to be a retrieval disorder for complex graphic forms in addition to a visual cognition disorder because of two reasons. One is that he could distinguish Kanji from similar graphic forms. The other is that he could read Kanji aloud.

Adolescent↗
PubMed1997

Delirium and cognitive disorders after cardiac operations: relationship to pre- and intraoperative quantitative electroencephalogram.

We examined the incidence of delirium and cognitive disorders after cardiac operations and the related risk factors. The value of pre- and intraoperative QEEG was determined. Using the Mini-Mental State Examination and the Saskatoon Delirium Checklist, 321 patients were tested during the immediate postoperative period. Forty-four patients (14%) showed delirium, 68 (23%) cognitive disorders and 26 (9%) both. Significant risk factors for the development of cognitive disorders were age > or = 70 yr, female gender, duration of cardiopulmonary bypass > or = 2.5 h and aorta-cross-clamping > 70 min. Risk factors for delirium were age > or = 70 yr, female gender and Hb < 5 mmol 1(-1) intraoperatively. The preoperative QEEG showed significant differences between the groups with and without a cognitive disorder, while the intraoperative QEEG showed significant differences between the groups with and without delirium. Different risk factors for delirium and cognitive disorders are a possible explanation for the controversies in the literature, where neuropsychologic complications were grouped together. A low intraoperative Hb is an important risk factor for the development of delirium and can be treated. The preoperative QEEG may have prognostic significance in the occurrence of cognitive disorders, while the intraoperative QEEG may have prognostic significance in the occurrence of delirium.

Adult↗
PubMed1994

[Cognition disorders related to psychotropic treatments].

Evaluation of cognitive disorders induced by treatment with psychotropic drugs is complex due to the involvement of several factors that can intervene in the pathogenesis and the evaluation of these disorders. Nevertheless, studies are numerous in the field, and we present the main reports. Most studies evaluating the influence of psychotropic drugs in healthy subjects indicate the existence of cognitive changes. On the contrary, aside from the effect of tranquillizers, and the sedative effect and/or the anticholinergic action of certain psychotropic drugs, in treated patients the individual responsibility of these drugs in cognitive disorders appears to have been often overestimated.

Antidepressive Agents↗
PubMedDate not supplied

Cognitive-disorder diagnoses in inpatient psychosomatic-medicine consultations: associations with age and length of stay.

Authors reviewed consecutive charts of 155 cognitive-disorder patients from a psychosomatic medicine service in 2001, analyzing factors of age, cognitive-disorder diagnosis, and length of stay. Mean length of stay for this cohort exceeded the typical hospital length of stay, and decreased with age. Increased age was associated with a decreased probability of a delirium-only diagnosis, and was strongly associated with an increased probability of a dementia diagnosis. Among those with dementia, the probability of having an additional diagnosis of delirium was unrelated to age. The case-mix of cognitive disorders differs with age, whereas cognitive disorders are associated with increased length of stay for adult patients of all ages.

Adolescent↗
PubMed2006

Neglect and prism adaptation: a new therapeutic tool for spatial cognition disorders.

PURPOSE: A large proportion of right-hemisphere stroke patients show unilateral neglect, a neurological deficit of perception, attention, representation, and/or performing actions within their left-sided space, inducing many functional debilitating effects on everyday life, and responsible for poor functional recovery and ability to benefit from treatment. This spatial cognition disorder affects the orientation of behaviour with a shift of proprioceptive representations toward the lesion side. METHODS: This shift can be reduced after a prism adaptation period to a right lateral displacement of visual field (induced by a simple target-pointing task with base-left wedge prisms). The modification of visuo-motor or sensory-motor correspondences induced by prism adaptation involves improvement of different symptoms of neglect. RESULTS: Classical visuo-motor tests could be improved for at least 2h after adaptation, but also non-motor and non-visual tasks. In addition, cross-modal effects have been described (tactile extinction and dichotic listening), mental imagery tasks (geographic map, number bisection) and even visuo-constructive disorders. These cognitive effects are shown to result from indirect bottom-up effects of the deeper, adaptive realignment component of the reaction to prisms. Lesion studies and functional imaging data evoke a cerebello-cortical network in which each structure plays a specific role and not all structures are crucial for adaptation ability. CONCLUSIONS: These cognitive effects of prism adaptation suggest that prism adaptation does not act specifically on the ipsilesional bias characteristic of unilateral neglect but rehabilitates more generally the visuo-spatial functions attributed to the right cortical hemisphere. These results reinforce the idea that the process of prism adaptation may activate brain functions related to multisensory integration and higher spatial representations and show a generalization at a functional level. Prism adaptation therefore appears as a new powerful therapeutic tool for spatial cognition disorders.

Adaptation, Physiological↗
PubMed2004

[Cognitive disorders and dementias in the private practice of specialists: pilot study of a self-assessment survey].

OBJECTIVES: To know about the features of cognitive disorders and dementias in the private practice of specialists and these doctor's skills on that area. METHOD: In this pilot study, self-assessment questionnaires were delivered to neurologists of São Paulo State and 196 (22.8%) were respondents. RESULTS: Many neurologists are involved, besides the private practice, with teaching (61.5%) and/or research (59.5%) activities. Most of them assessed as not good the training on cognitive disorders and dementias they had had during both the graduate (77.3%) and residence (63.1%) courses; nevertheless 60.8% self rated their knowledge on that subject as satisfactory and 83.0% declared their interest on it as at least equal to other areas. The most frequent cognitive complaints occurring as primary reason for appointment are memory loss (73.0%) and attention/concentration deficits (48.0%). Dementia of Alzheimer type (54.9%) and vascular dementia (23.0%) are the most frequent ones in the neurologist private practice. CONCLUSION: Cognitive disorders and dementias represent a significant proportion in the neurological private practice. Although they had not had a good training on the area of cognitive disorders and dementias, the respondent neurologists demonstrated great interest on it.

Adult↗
PubMedDate not supplied

ICD-10 mild cognitive disorder following meningitis due to neurosarcoidosis.

We report the case of a patient referred to our department with the diagnosis of conversion disorder, who ultimately proved to have neurosarcoidosis presenting with mild cognitive disorder. Despite the criticism of mild cognitive disorder as a diagnostic entity, our patient met the criteria for it. The reported case exemplifies the difficulties in classifying mild cognitive deficits in patients suffering from brain diseases without major morphological damage.

Adult↗
PubMed2005

[Cognitive disorders appearing before the age of 65 in patients of the Alzheimer Centre of the VU Medical Centre: diagnoses and clinical characteristics].

OBJECTIVE: To obtain a profile of the causes and clinical characteristics of cognitive disorders in patients referred to a memory clinic before the age of 65 years. DESIGN: Retrospective case-note study. METHOD: Data were collected from 127 subjects with objective cognitive disorders who visited the Alzheimer Centre of the VU Medical Centre in Amsterdam, the Netherlands, in the period from 1 January 2001 to 31 December 2003 with an onset of complaints before the age of 65. Besides the diagnoses, we investigated the clinical presentations, the occurrence of cardiovascular risk factors, the family history, and the presence of noncognitive neurological signs. RESULTS: The most common causes of cognitive decline under the age of 65 were Alzheimer's disease (46%) and frontotemporal dementia (23%). Vascular dementia was seen in 5% and dementia with Lewy bodies in 2%; 9% had mild cognitive impairment but no dementia. Hypertension and a positive family history for dementia were each present in 40% of the patients. Non-cognitive neurological abnormalities were found only in cases of non-Alzheimer dementia. During the period under investigation, the number of patients with objective cognitive disorders increased more than did the number without a cognitive disorder. CONCLUSION: Within the population of a memory clinic, Alzheimer's disease was the most frequent cause of cognitive decline under the age of 65, followed by frontotemporal dementia. The distribution differed from causes of dementia at an older age, where vascular dementia had the second place.

Adolescent↗
PubMed1995

ICD-10 mild cognitive disorder: epidemiological evidence on its validity.

Criteria for the diagnosis of ICD-10 Mild Cognitive Disorder (MCD) were applied to a sample of 897 community dwelling elderly participants. Criterion A (the presence of a physical disorder) was met by 44%, Criterion B (report of a cognitive disorder) by 17%, Criterion C (an abnormality in quantified cognitive assessments) by 60%, and Criterion D (exclusion on basis of dementia and other conditions) by 74%. A total of 36 cases (4%) met all four criteria. Correlations between Criteria A and B, and B and C were weak (r = 0.18), and the correlation between Criteria A and C was almost zero (r = 0.02). This suggests that no syndrome exists. Membership of MCD was predicted by a report that memory or intelligence interfered with daily life but not by performance on cognitive tests or by a report of physical illness. Cases of MCD had higher anxiety, depression and neuroticism scores than normal elderly, but did not differ substantially on tests of cognitive functioning. These findings call into question the validity of the ICD-10 diagnosis of MCD.

Activities of Daily Living↗
PubMedDate not supplied

[The Clock Test: drawing a clock for detection of cognitive disorders in geriatric patients].

Patients of a geriatric hospital (n = 263; 145 women, 118 men) had the task of drawing a clock and indicating a given time by the placements of hands. Errors were classified hierarchically by using a five-category-panel based on defined criteria. Its use as a "first-line" screening test for cognitive disorders in old age was evaluated. Retest- (r = 0.89) and interrater- correlations (r = 0.81) were satisfying. The results of this "clock drawing test" were compared both to the outcome in the Abbreviated Mental Test (AMT) and to the general judgment of the patients' cognitive status, based on the history, the report of informants, on clinical observation and examination. Patients with faultless clock drawings performed well in the AMT. However, prediction of the outcome in the AMT gradually became impossible with poorer performance in the clock drawing test, resulting in a low specificity (0.74) for a normal AMT. Specificity of the clock drawing test increased (0.79) for the general judgment of cognitive disorder, with sensitivity remaining constant (0.84). Sudden onset of cognitive disorder (most commonly confusion) in case of acute disease was discovered by the clock drawing test. Focusing on all patients without apparent cognitive disorder and with normal AMT-result, the subgroup of patients with faultless clock drawings was significantly younger (t = 5.0); p < 0.001). It is suggested to use the clock drawing test in addition to conventional psychometric screening tests because it requires visuospatial skills and conceptual thinking in addition to mere mnestic and verbal qualities.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗