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Dissociations between skill learning and verbal recognition in amnesia and dementia.

Patients with Huntington's disease (HD), patients with alcoholic Korsakoff's syndrome, and normal control subjects were compared on tests of skill learning (mirror reading) and verbal recognition. Like previously reported results, the patients with Korsakoff's syndrome acquired the mirror-reading skill at a normal rate but were severely impaired in their recognition of the words used on the mirror-reading task. In contrast to the amnesic patients, the demented patients with HD were retarded in their ability to acquire this skill but showed normal verbal recognition. Besides emphasizing substantial differences in the anterograde substantial differences in the anterograde memory disorders of these two patient populations, the results suggest that the memory disorder of patients with HD may appear much more severe when recall rather than recognition test paradigms are employed. This failure of recall by the patients with HD may be due to an inability to generate strategies necessary to search their short- and long-term memories.

Alcohol Amnestic Disorder↗

Performance deficit of alpha7 nicotinic receptor knockout mice in a delayed matching-to-place task suggests a mild impairment of working/episodic-like memory.

Patients with schizophrenia exhibit deficits in a range of cognitive functions, particularly working and episodic memory, which are thought to be core features of the disorder. Memory dysfunction in schizophrenia is familial and thus a promising endophenotype for genetic studies. Both human and animal studies suggest a role for the neural nicotinic acid receptor family in cognition and specifically the alpha7-receptor subunit in schizophrenia and its endophenotypes. Consequently, we tested mice lacking the alpha7 subunit of the neural nicotinic receptor (B6.129S7-Chrna7(tm1Bay)/J) in the delayed matching-to-place (DMP) task of the Morris water maze, a measure of working/episodic memory akin to human episodic memory. We report that a minor impairment in alpha7 knockout mice was observed in the DMP task, with knockout mice taking longer to find the hidden platform than their wildtype controls. This suggests a role for the alpha7 subunit in working/episodic memory and a potential role for the alpha7 neural nicotinic receptor gene (CHRNA7) in schizophrenia and its endophenotypes.

Acetylcholine↗

Computer learning by memory-impaired patients: acquisition and retention of complex knowledge.

Several investigators have shown that memory-impaired patients are capable of learning relatively simple information in both the laboratory and everyday life. The present research explored whether patients with memory disorders could also acquire complex knowledge--the domain-specific knowledge needed for operating and interacting with a microcomputer. The results indicated that patients with memory disorders of varying severity could learn to manipulate information on the computer screen, to write, edit and execute simple computer programs, and to perform disk storage and retrieval operations. The learning process, however, was slow relative to controls and the knowledge acquired appeared to be qualitatively different. Theoretical and practical implications of these findings are discussed.

Adult↗

[Cognitive training interventions for normal aging, mild cognitive impairment and Alzheimer's].

BACKGROUND: In the past few years, occupational therapists have been increasingly working with geriatric clients and have used interventions focused on enhancing independance and quality of life. In this area of practice, the cognitive training intervention aimed more specifically at memory disorders, is a promising intervention for the area of aging and occupational therapy. PURPOSE: The aim of this literature review is to present an overview of the fundamentals, objectives and procedures of the cognitive training intervention used with the following populations: aging people presenting a memory disorder associated with normal aging with mild cognitive impairment or with Alzheimer's disease. PRACTICE IMPLICATIONS: A discussion on the cognitive management of memory is presented with respect to the cognitive characteristics of each of these clients.

Aging↗

[A girl with chief compliance of "easy to forget"--cognitive neuropsychological evaluations and cerebral blood flow].

Cognitive-neuropsychological evaluations were performed on a 12-year-old girl with memory disorder to study the higher brain function of this patient. The cerebral blood flow (r-CBF) was also studied. The results showed that the auditory-verbal memory of this patient were impaired. The regional cerebral blood flow was reduced in the left hippocampus which reportedly cause memory disorder. The disturbance of visual cognition and disability of construction in this patient seem to be related to reduced cerebral blood flow in the left parietal region.

Cerebrovascular Circulation↗

Posttraumatic stress disorder and memory problems after female genital mutilation.

OBJECTIVE: This pilot study investigated the mental health status of women after genital mutilation. Although experts have assumed that circumcised women are more prone to developing psychiatric illnesses than the general population, there has been little research to confirm this claim. It was predicted that female genital mutilation is associated with a high rate of posttraumatic stress disorder (PTSD). METHOD: The psychological impact of female genital mutilation was assessed in 23 circumcised Senegalese women in Dakar. Twenty-four uncircumcised Senegalese women served as comparison subjects. A neuropsychiatric interview and further questionnaires were used to assess traumatization and psychiatric illnesses. RESULTS: The circumcised women showed a significantly higher prevalence of PTSD (30.4%) and other psychiatric syndromes (47.9%) than the uncircumcised women. PTSD was accompanied by memory problems. CONCLUSIONS: Within the circumcised group, a mental health problem exists that may furnish the first evidence of the severe psychological consequences of female genital mutilation.

Adolescent↗

Classification deficits in Alzheimer's disease with special reference to living and nonliving things.

The present study was conducted to assess the hypothesis that visual similarity between exemplars within a semantic category may affect differentially the recognition process of living and nonliving things, according to task demands, in patients with semantic memory disorders. Thirty-nine Alzheimer's patients and 39 normal elderly subjects were presented with a task in which they had to classify pictures and words, depicting either living or nonliving things, at two levels of classification: subordinate (e.g., mammals versus birds or tools versus vehicles) and attribute (e.g., wild versus domestic animals or fast versus slow vehicles). Contrary to previous results (Montañes, Goldblum, & Boller, 1995) in a naming task, but as expected, living things were better classified than nonliving ones by both controls and patients. As expected, classifications at the subordinate level also gave rise to better performance than classifications at the attribute level. Although (and somewhat unexpectedly) no advantage of picture over word classification emerged, some effects consistent with the hypothesis that visual similarity affects picture classification emerged, in particular within a subgroup of patients with predominant verbal deficits and the most severe semantic memory disorders. This subgroup obtained a better score on classification of pictures than of words depicting living items (that share many visual features) when classification is at the subordinate level (for which visual similarity is a reliable clue to classification), but met with major difficulties when classifying those pictures at the attribute level (for which shared visual features are not reliable clues to classification). These results emphasize the fact that some "normal" effects specific to items in living and nonliving categories have to be considered among the factors causing selective category-specific deficits in patients, as well as their relevance in achieving tasks which require either differentiation between competing exemplars in the same semantic category (naming) or detection of resemblance between those exemplars (categorization).

Aged↗

[The clinico-neuropsychological manifestations of arteriovenous malformations of the thalamus].

A comprehensive clinical and neuropsychological study was made of 34 patients with thalamic arteriovenous malformations. In the thalamus. Memory disorders were a common abnormality (in 31 of 34 patients). They were modally nonspecific and depended on the site of arteriovenous malformations. With the prevalent ventricular pattern of hemorrhages, memory disorders were accompanied by disorientation and emotional and volitional impairments. Arteriovenous malformation was removed in 12 patients (on the left side in 7 patients and on the right in 5). After surgery there was virtually progression of memory defects in all patients. Speech disorders combining the specific features of lesions in various cortical regions were detected in 5 of 7 patients with left thalamic arteriovenous malformations.

Adolescent↗

[The clinical neuropsychological aspects in the surgical treatment of arteriovenous malformations of the gyrus cinguli].

Clinical and neuropsychological studies of the outcomes of surgical treatment in patients with arteriovenous malformations (AVM) of the gyrus cinguli were conducted. Preoperative examination revealed predominantly memory disorders in 38 cases. Of them 5 cases had amnestic disturbances similar to those of the Korsakoff syndrome. Autonomic and epileptic seizures were not common. Thirty eight patients underwent surgery. Memory deterioration was recorded in 23 cases postoperatively. Three patients developed a "new" Korsakoff syndrome. The rate of deterioration of memory disorders showed a clear correlation with the extent of gyrus cinguli destruction and degree of corpus callosum integration to AVM nidus. The qualitative analysis of amnestic syndromes demonstrated that the majority of patients developed pre- and postoperative disorders of trace selectivity, the insight incontinence of the story essence accompanied by diminished critical attitude towards their condition. This pattern of defects was similar to the clinical features of the amnestic syndrome in patients with frontal lobe lesions. Combined damage of frontal lobes and their connections (with gyrus cinguli in this case) is of great importance in the formation of a clinical picture in man. The findings should be taken into consideration when surgical policy is to be analyzed.

Adolescent↗

Practitioner review: verbal working memory development and its disorders.

Working memory refers to the systems responsible for the temporary storage and manipulation of information during the performance of cognitive tasks. There is a good deal of evidence that verbal short-term memory functions as a working memory system. We review advances in our understanding of the nature and limitations of verbal short-term memory and the reasons for its development with age, and go on to consider the common association between impairments of verbal short-term memory and other impairments of cognitive development. We conclude by considering the relationship between short-term memory development and cognitive development.

Adolescent↗

[Hypoxia and memory. Specific features of nootropic agents effects and their use].

Hypoxia and hypoxic adaptation are powerful factors of controlling memory and behavior processes. Acute hypoxia exerts a differential impact on different deficits of mnestic and cognitive functions. Instrumental reflexes of active and passive avoidance, negative learning, behavior with a change in the stereotype of learning are more greatly damaged. Memory with spatial and visual differentiation and their rearrangement change to a lesser extent and conditional reflexes are not deranged. In this contract, altitude hypoxic adaptation enhances information fixation and increases the degree and duration of retention of temporary relations. Nootropic agents with an antihypoxic action exert a marked effect on hypoxia-induced cognitive and memory disorders and the magnitude of this effect depends on the ration of proper nootropic to antihypoxic components in the spectrum of the drugs' pharmacological activity. The agents that combine a prevailing antiamnestic effect and a marked and moderate antihypoxic action (mexidole, nooglutil, pyracetam, beglymin, etc.) are most effective in eliminating different hypoxia-induced cognitive and memory disorders, nootropic drugs that have a pronounced antiamnestic activity (centrophenoxine, etc.) and no antihypoxic component also restore the main types of mnestic disorders after hypoxia, but to a lesser extent.

Adaptation, Psychological↗

Suspected dementia: evaluation of 323 consecutive referrals.

A neurological outpatient department studied 323 consecutive referrals for suspected dementia: 135 (41.8%) were not demented. Of the patients 12.1% had diffuse cognitive disorder; 10.2% circumscribed memory disorder; 0.9% other circumscribed cognitive disorder, 14.2% psychiatric disorder, and 4.3% were judged to be normal. Of the nondemented, 44.1% had a potentially treatable cause for their cognitive symptoms; in 27.4% it was depression. The total of demented patients was 188 (58.2%): 38.8% had primary degenerative dementia; 37.2% vascular dementia including combined degenerative and vascular dementia; and 23.4% had a specific cause. Patients with specific cause were significantly younger than those with other causes of dementia. A potentially treatable cause was found in 10.7% of all demented patients, the most common being metabolic disorders, meningioma, hydrocephalus, subdural haematoma, and depressive pseudodementia.

Adult↗

Corticosteroid receptors: a dynamic interplay between protein folding and homeostatic control. Possible implications in psychiatric disorders.

Glucocorticoids are key elements in the maintenance of an organism's homeostasis, a dynamic balance that is constantly challenged by internal and external stressors. Chronic exposure to elevated glucocorticoids may induce profound effects on an individual's physical and mental well-being. Therefore, a complex neuroendocrine system, the limbic-hypothalamo-pituitary-adrenocortical (LHPA) axis, exists to regulate glucocorticoid homeostasis. Dysregulation of the LHPA axis has been linked to numerous psychiatric disorders, including eating disorders, anxiety, depression, posttraumatic stress disorder, memory impairment, neurodegenerative disorders, and even Alzheimer disease. At a molecular level, the actions of glucocorticoids are mediated by two different cytoplasmic receptors, the mineralocorticoid receptor and the glucocorticoid receptor. These corticosteroid receptors are heteromeric complexes found in dynamic association with a still growing number of chaperone proteins and other factors mediating their actions. Because this dynamic association is extremely sensitive to changes in cellular environment, energy, and metabolic state, we hypothesize that these corticosteroid receptors act as "sensor" signal transducers critical for homeostasis. In this review, we focus on the interplay among protein folding, transport, and function of the corticosteroid receptors at the cellular level, which provides a foundation for understanding the pathogenesis of glucocorticoid resistance or hypersensitivity, causing imbalances in the LHPA axis, and possibly triggering psychiatric disorders.

Animals↗

Different components in word-list forgetting of pure amnesics, degenerative demented and healthy subjects.

This study investigated the contribution of different components of the serial position curve to the accelerated forgetting rate displayed by amnesic and degenerative demented patients in word-list recall. For this purpose, we analyzed immediate and 15 min delayed recall performances on Rey's 15-word learning task of 16 pure amnesic, 15 Alzheimer's demented and 81 healthy subjects. Results documented that in all groups most forgetting occurred at the expense of terminal items of the word list. Nevertheless, both amnesic and demented patients showed a disproportionately larger memory loss on the recent part of the serial position curve than healthy subjects. Finally, amnesics (but not AD patients) suffered from a significantly larger forgetting rate for primacy items than normal controls. These data demonstrate that a critical deficit in memory disordered patients is represented by a failure in transferring information from a transitory memory status to a more durable storing condition. At least in amnesic patients, our results also suggest "true" long-term forgetting, presumably due to decay or to the intervening inaccessibility of previously stored memory representations.

Adult↗

Progress and controversies in neuropsychology of memory.

In the first part of this paper we discuss some of the most important areas of progress and of controversy in the field of memory functions and of memory impairment. Three main issues are taken separately into account: (1) the fractionation of memory into a number of sub-systems and the relationships existing among these subsystems; (2) the main theories of amnesia and the mechanisms underlying memory disorders; (3) the main anatomoclinical forms of amnesia and the brain structures subserving various components of the amnesic syndrome. In the second part we shift from the basic research to the clinically oriented investigations, reporting the results of two studies that we have recently conducted on some aspects of memory disorders in dementia. In the first study we have shown that severity and qualitative aspects of amnesia can be used to distinguish the two most frequent clinical forms of dementia, namely the dementia of the Alzheimer's type (DAT) from the vascular forms of dementia. In the second study we have demonstrated that a fine grained analysis of memory impairment can help improving the most difficult differential diagnosis in this field, namely the distinction between DAT and depressive pseudo-dementia.

Alzheimer Disease↗

[Memory in multiple sclerosis: review of performance and relationship with clinical variables and neuroimaging].

INTRODUCTION: Neuropsychological studies in multiple sclerosis (MS) mainly have centred on the study of memory disorder. DEVELOPMENT: The prevalence of memory deficits in MS population is around 40-60%. These deficits could be sum up in an impaired immediate memory, a learning capacity lower than normal controls subjects and a worse long term memory. The results of the reviewed studies about the relationship between performance in memory tasks and clinical variables, show that physical disability and depressive symptoms do not influence this performance. Whilst, years of evolution and, mainly, disease course are related to a worse performance in memory tasks. In structural neuroimaging studies (CT and MRI) it is considered that ventricular dilatation and the total lesion load are predictor variables of MS patients performance in different memory tasks. CONCLUSION: This paper reviews several studies relative to amnesic function in subjects suffering from MS, emphasizing the most relevant contributions of the present neuropsychological literature.

Brain↗