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PubMed1984

Global appropriateness of pain drawings: blind ratings predict patterns of psychological distress and litigation status.

Previous studies examining pain drawings of low back pain patients have shown conflicting results in predicting elevations of MMPI scores. A study of 82 patients whose drawings were rated only for overall, anatomical appropriateness was conducted using the SCL-90 rather than the MMPI as the psychological assessment instrument. Significant differences were found between appropriate and inappropriate drawings; however, these differences seem to reflect differences in cognitive style of coping with pain as opposed to psychopathology. The implications and limitations of the study are discussed.

Adult↗

PubMed1995

Predictive validity of the Nursing Severity Index in patients with musculoskeletal disease. Nurses of University Hospitals of Cleveland.

Prior studies have not examined the validity of severity of illness instruments in patients at low risk for mortality. We, therefore, examined the predictive validity of a newly developed instrument, the Nursing Severity Index in 5347 adult medical and surgical patients with musculoskeletal diagnoses admitted to an academic medical center in 1985-88. The Index is based on aggregating 34 clinical observations which were recorded by primary nurses during patient care; observations reflect biologic, functional, cognitive and psychosocial abnormalities. Other data, including patient demographic data and outcomes were obtained from hospital data bases. We found that, among all study patients, admission Nursing Severity Index scores were highly related (p < 0.001) to in-hospital death rates-which were 0, 0.4, 0.8, 2.6, 6.7 and 23.5% in six hierarchical strata defined by the Index-and to nursing home discharge rates. In multivariate analyses, adjusting for diagnosis and other important covariates, each strata was associated with a 2.5-fold increased risk of mortality and a 1.6-fold increased risk of nursing home discharge. In addition, the Nursing Severity Index was an independent predictor (p < 0.001) of hospital charges and length of stay. We conclude that the Nursing Severity Index assesses multiple dimensions of illness, can be easily recorded during routine patient care, and accurately predicts hospital outcomes in an important 'low risk' group of patients. The validity of the Nursing Severity Index in other clinical subgroups should be further studied.

Adult↗

PubMed2005

Concurrent administration of coenzyme Q10 and alpha-tocopherol improves learning in aged mice.

The main purpose of this study was to determine whether supplemental intake of coenzyme Q10 (CoQ) (ubiquinone-10) or alpha-tocopherol, either alone or together, could improve brain function of aged mice, as reflected in their cognitive or psychomotor performance. Separate groups of aged mice (24 months) were administered either CoQ (123 mg/kg/day), or alpha-tocopherol acetate (200 mg/kg/day), or both, or the vehicle (soybean oil) via gavage for a period of 14 weeks. Three weeks following the initiation of these treatments, mice were given a battery of age-sensitive behavioral tests for the assessment of learning, recent memory, and psychomotor function. In a test that required the mice to rapidly identify and remember the correct arm of a T-maze, and to respond preemptively in order to avoid an electric shock, the intake of alpha-tocopherol plus CoQ resulted in more rapid learning compared to the control group. Learning was not significantly improved in the mice receiving CoQ or alpha-tocopherol alone. None of the treatments resulted in a significant improvement of psychomotor performance in the old mice. In a separate study, treatment with higher doses of CoQ alone (250 or 500 mg/kg/day) for 14 weeks failed to produce effects comparable to those of the combination of alpha-tocopherol and CoQ. The apparent interaction of CoQ and alpha-tocopherol treatments is consistent with the previous suggestion, based on biochemical studies, that coenzyme Q and alpha-tocopherol act in concert. Overall, the findings suggest that concurrent supplementation of alpha-tocopherol with CoQ is more likely to be effective as a potential treatment for age-related learning deficits than supplementation with CoQ or alpha-tocopherol alone.

Aging↗

PubMed2006

Associative and spatial learning and memory deficits in transgenic mice overexpressing the RNA-binding protein HuD.

HuD is a neuronal specific RNA-binding protein associated with the stabilization of short-lived mRNAs during brain development, nerve regeneration and synaptic plasticity. To investigate the functional significance of this protein in the mature brain, we generated transgenic mice overexpressing HuD in forebrain neurons under the control of the alphaCaMKinII promoter. We have previously shown that one of the targets of HuD, GAP-43 mRNA, was stabilized in neurons in the hippocampus, amygdala and cortex of transgenic mice. Animals from two independent lines expressing different levels of the transgene were subjected to a battery of behavioral tests including contextual fear conditioning and the Morris water maze. Our results show that although HuD is increased after learning and memory, constitutive HuD overexpression impaired the acquisition and retention of both cued and contextual fear and the ability to remember the position of a hidden platform in the Morris water maze. No motor-sensory abnormalities were observed in HuD transgenic mice, suggesting that the poor performance of the mice in these tests reflect a true cognitive impairment. We conclude that posttranscriptional regulation of gene expression by stabilization of specific mRNAs may have to be restricted temporally and spatially for proper acquisition and storage of memories.

Analysis of Variance↗

PubMed2005

Auditory P300 in high-risk, recent-onset and chronic schizophrenia.

BACKGROUND: The present study examined the integrity of the P300 component of the event-related potential (ERP) in patients at high imminent risk for schizophrenia in relation to healthy comparison subjects and patients in the recent-onset and chronic stages of schizophrenia. METHODS: The P300 was recorded by using an auditory oddball task in 10 patients clinically considered at risk of being prodromally symptomatic for schizophrenia, 10 patients with recent-onset schizophrenia, 14 patients with chronic schizophrenia, 14 young healthy comparison subjects, who were age-matched to the high-risk and recent-onset schizophrenia groups, and 14 older healthy comparison subjects, who were age-matched to the chronic schizophrenia group. RESULTS: High-risk subjects displayed smaller than normal P300 amplitudes at the parietal, centroparietal and central scalp locations. The observed P300 amplitude abnormalities in high-risk subjects were severe, being comparable in magnitude to the abnormalities seen in recent-onset and chronic schizophrenia subjects. However, whereas high-risk subjects showed P300 amplitude abnormalities that were bilaterally symmetrical, subjects with recent-onset schizophrenia and, particularly, subjects with chronic schizophrenia exhibited abnormalities that were markedly larger over the left temporal scalp sites. CONCLUSIONS: Patients at high imminent risk for developing a first florid psychotic episode seem to manifest auditory P300 amplitude abnormalities that are similar, but not identical, to those observed in patients in the recent-onset and chronic stages of schizophrenia. These results support the idea that auditory P300 abnormalities in schizophrenia reflect a primary cognitive and pathophysiological feature of the illness.

Adult↗

PubMedDate not supplied

Two factors of experienced deficits in schizophrenia and their relationships with positive, negative, and depressive symptoms.

Eighty inpatients and 20 outpatients with ICD-10 schizophrenia were assessed with the Manchester Scale (MS) and the scale for the assessment of Subjective Experience of Deficits in Schizophrenia (SEDS). A factor analysis on MS scores yielded a three-factor solution: negative symptoms, positive symptoms, and anxious-depressive factor. On the other hand, a factor analysis on SEDS scores provided a seven-factor solution. The first factor, "awareness of social incompetence (ASI)," positively correlated with the anxious-depressive factor. ASI may reflect a negative cognitive attitude of persons who easily become depressive. The second factor, "subjective cognitive disturbance (SCD)," positively correlated with the positive-symptoms factor. SCD might represent a subtle disturbance, which can also produce positive symptoms. We found no factor on SEDS that correlated with the negative-symptoms factor. It was noted that a selection and comparison of items and the cultural background of subjects should be considered.

Adolescent↗

PubMed1995

Patterns of spatial functioning in Turner's syndrome.

This paper presents results from a study of task performance on a variety of spatial tasks in 9-11 year-old children with Turner's Syndrome (T.S.), divided into those with genotype 45XO and those with Mixed genotypes, including isochromosomes of X and mosaicism. There was a significant overall effect of group reflecting impaired spatial cognition in T.S. with greater decrement in the 45XO group. Further investigation of the significant group by task interaction indicated that the group effects appeared on a visuo-perceptual task and on three visuo-constructional tasks but that there were no specific deficits in the T.S. groups on visuo-spatial or tactile-spatial tasks. In T.S., visuo-perceptual and visuo-constructive sub-systems of spatial skill may be more vulnerable than other components of spatial cognition, to the neuro-biological influences which contribute to the disorder. Such dissociation supports theories of modularity in the development of spatial skill. The spatial tasks which create difficulty overlap only partially with those for which there are sex differences amongst normal children and do not represent a simple exaggeration of normal male-female differences.

Child↗

PubMed1975

The relation of visuospatial dysfunction to digit span performance in patients with cerebral lesions.

DSF and DSB performance was compared in hospitalized controls and right and left brain lesion groups dichotomized for the presence or absence of visuospatial deficits. Digit Span performance was also correlated with WAIS Similarities and Block Design and Raven Coloured Progressive Matrices. No differences between groups were observed on DSF. On DSB patients with brain lesions had lower scores than controls and brain-lesioned patients with visuospatial deficits had lower scores than those without. DSB correlated significantly with WAIS Block Design and Raven Coloured Progressive Matrices supporting the hypothesis that visuospatial ability is needed to mediate proper DSB performance. The correlation of DSB with WAIS Similarities, however, lends support to the idea that low DSB may merely reflect severity of cognitive deficit.

Aphasia↗

PubMed2000

No evident neuronal damage after electroconvulsive therapy.

Electroconvulsive therapy (ECT) is regarded as one of the most effective treatments for major depressive disorder but has also been associated with cognitive deficits possibly reflecting brain damage. The aim of this study was therefore to evaluate whether ECT induces cerebral damage as reflected by different biochemical measures. The concentrations in the cerebrospinal fluid (CSF) of three established markers of neuronal/glial degeneration, tau protein (tau), neurofilament (NFL) and S-100 beta protein, were determined in nine patients who fulfilled DSM-IV criteria for major depression. CSF samples were collected before and after a course of six ECT sessions. The CSF/serum (S) albumin ratio reflecting potential blood-brain barrier (BBB) dysfunction was also determined at these time points. The treatment was clinically successful with a significant decline of depressive symptoms in all patients as assessed by the Montgomery-Asberg Rating Scale for Depression. Several patients had signs of BBB dysfunction and/or neuronal damage before the start of treatment. Levels of CSF-tau, CSF-NFL and CSF-S-100 beta levels were not significantly changed by ECT. Also the CSF/S albumin ratio was found to be unchanged after the course of ECT. In conclusion, no biochemical evidence of neuronal/glial damage or BBB dysfunction could be demonstrated following a therapeutic course of ECT.

Adult↗

PubMed2003

Alzheimer's disease proteins in cerebellar and hippocampal synapses during postnatal development and aging of the rat.

Alzheimer's dementia may be considered a synaptic disease of central neurons: the loss of synapses, reflected by early cognitive impairments, precedes the appearance of extra cellular focal deposits of beta-amyloid peptide in the brain of patients. Distinct immunocytochemical patterns of amyloid precursor proteins (APPs) have previously been demonstrated in the synapses by ultrastructural analysis in the cerebellum and hippocampus of adult rats and mice. Now we show that during postnatal development and during aging in these structures, the immunocytochemical expression of APPs increases in the synapses in parallel with the known up-regulation of total APPs brain levels. Interestingly, as shown previously in the adult rodents, the presenilins (PSs) 1 and 2, which intervene in APPs metabolism, exhibit a synaptic distribution pattern similar to that of APPs with parallel quantitative changes throughout life. In the brain tissue, single and double immunocytochemistry at the ultrastructural level shows co-localisation of APPs and PSs in axonal and dendritic synaptic compartments during postnatal synaptogenesis, adulthood and aging. In addition, double-labelling immunocytofluorescence detects these proteins close to synaptophysin at the growth cones of developing cultured neurons. Thusly, the brain expression of APPs and PSs appears to be regulated synchronously during lifespan in the synaptic compartments where the proteins are colocated. This suggests that PS-dependent processing of important synaptic proteins such as APPs could intervene in age-induced adjustments of synaptic relationships between specific types of neurons.

Aging↗

PubMed2001

Good tolerability equals good results: the patient's perspective.

Although conventional antipsychotics are useful for the treatment of schizophrenia, many patients discontinue taking them within a few months. As well as the positive influence of a good doctor-patient relationship, evidence suggests that the patient's initial subjective experience during antipsychotic therapy is a major predictor of compliance. In addition to motor symptoms, conventional antipsychotics can cause significant adverse effects on drive, emotion and cognition, which are reflected in patients complaining of a reduced quality of life, although may not be detected by objective examination. This syndrome, which is similar to the negative symptoms of schizophrenia, is known by numerous terms including 'pharmacogenic depression' and 'pharmacogenic anhedonia'. The introduction of atypical antipsychotics broadened the criteria for effective antipsychotic treatment to include the subjective assessment of improvement in patients' quality of life. The previous lack of interest in this domain may have been due to the inability to improve it with conventional agents and the misconception that schizophrenic patients were unable to subjectively evaluate their quality of life. However, numerous studies have shown that 63-95% of patients in remission are able to self-rate their affective state of well being or quality of life. Atypical antipsychotics are superior to conventional antipsychotics in improving quality of life and reducing the stigma of schizophrenia, particularly from the patient's perspective and are strong reasons for the widespread use of these drugs.

Antipsychotic Agents↗

PubMed1997

Language development in children with congenital strokes.

The congenital lesion population provides an excellent forum to investigate the issues of innate specialization and plasticity. Effects of early lesions on left and right hemisphere function reflect both the cognitive process under study and biological/neurological factors of lesion parameters and hemispheric maturation rates. In general, toddlers with both congenital left and right lesions show mild to moderate delays in language acquisition. School-age children with left hemisphere lesions have more problems with language and language-based academic skills than those with right hemisphere lesions, but the problems are subtle and do occur in both groups. This pattern stands in sharp contrast with the adult, who shows striking language deficits with acquired lesions only in the left perisylvian region. Thus, there is evidence in these studies of the immature nervous system for both innate specialization and plasticity, as well as a right hemisphere contribution to language acquisition and verbal cognition.

Adult↗

PubMed1996

Verbal fluency in schizophrenia: relationship with executive function, semantic memory and clinical alogia.

To examine whether poor verbal fluency in schizophrenia represents a degraded semantic store or inefficient access to a normal semantic store, 25 normal volunteers and 50 DSM-III-R schizophrenic patients, matched for age, sex and IQ, were recruited. Although schizophrenic patients were impaired on both letter and category fluency, they showed a normal pattern of output in that category was superior to letter fluency, and an improvement in category fluency when a cueing technique was employed (Randolph et al. 1993). These results resemble those found in disorders of frontostriatal systems (Parkinson's and Huntington's disease) and suggest that poor verbal fluency in schizophrenia is because of inefficient access to semantic store. A measure of improvement with cueing was directly related to performance on the Stroop executive task. Of all symptom measures derived from SANS and Manchester Scales, only alogia was related to verbal fluency in that superior improvement correlated inversely with the degree of alogia. It is suggested that both alogia and poor verbal fluency are mediated by the same underlying cognitive abnormality that reflects frontostriatal dysfunction.

Adult↗

PubMed2001

Theory of mind impairments in schizophrenia: symptomatology, severity and specificity.

BACKGROUND: Several studies have examined the ability of schizophrenic patients to represent mental states ('theory of mind': ToM). There is consensus that some patients have impaired ToM, but there is disagreement about the relation between ToM and symptomatology, and about the severity and specificity of the deficit. METHODS: Two first-order and one second-order false belief tests of ToM were given to groups of schizophrenic patients and psychiatric and normal controls. The relation between ToM and symptomatology was explored using regression and symptom subgroup analyses. Severity was investigated by using the same task methodology as in autism research, to enable direct comparison with that disorder. Specificity was investigated using matched control tasks which were as difficult as the ToM tasks, but did not require ToM. RESULTS: Symptom subgroup analysis showed that schizophrenic patients with behavioural signs were impaired relative to controls on ToM, and that remitted patients and a single case with passivity symptoms performed as well as controls. Regression analysis showed that ratings of behavioural signs predicted impaired ToM in schizophrenia. There was weak evidence that a subgroup with paranoid symptoms had ToM impairments, although these were associated with low IQ. Schizophrenic patients only showed ToM deficits on the second-order task. No impairments appeared on the matched control tasks which did not require ToM. CONCLUSIONS: There is a clear association between ToM impairment and behavioural signs in schizophrenia. Deficits in paranoid patients are harder to detect with current tasks and may be compensated for by IQ-dependent problem-solving skills. ToM impairments in schizophrenia are less severe than in autism, but are specific and not a reflection of general cognitive deficits.

Adolescent↗

PubMed1999

Converging evidence for a cognitive anomaly in early psychopathology.

Subcomponents of the N200 component of the event-related brain potential believed to be differentially sensitive to involuntary and voluntary cognitive processes were examined. Nonpatients (N = 131) identified initially by the Chapman and Depue research scales and classified later on the basis of diagnostic symptom clusters and family psychiatric history provided converging evidence for an intact mismatch negativity subcomponent. In contrast, the N2b subcomponent distinguished several groups of subjects. Results suggested abnormal voluntary cognitive processing, perhaps reflecting compensatory efforts in subjects at risk for or manifesting psychopathology, particularly those showing negative symptoms.

Adolescent↗

PubMed1995

Semantic relations and Alzheimer's disease: an early and disproportionate deficit in functional knowledge.

This experiment explored knowledge of four types of semantic relations (superordinate category, part, property, and function) in Alzheimer's disease (AD) subjects and age- and education-matched controls. Moderate AD subjects showed the greatest disruption on functional relations, intermediate disruption on part and property relations, and the least disruption on category relations; mild AD subjects showed a similar pattern but significant deficits only on functions. We suggest that the disproportionate deficit on functions reflects a greater cognitive complexity of functions than other semantic relations that renders them more vulnerable either to disrupted processing or to structural degradation of the network of associations among semantic concepts.

Aged↗

PubMed1993

Interference effects in the Stroop and Simon paradigms.

The possibility that Stroop and Simon effects reflect the same cognitive processes was tested in 3 experiments with 62 adult Ss. The words LEFT and RIGHT were shown left and right of screen center. Similar levels of interference were found for a Simon task (keypress to meaning of word) and a spatial Stroop task (name its location). A reverse Simon task (keypress to word location) showed minimal interference from the irrelevant word, but in a reverse spatial Stroop task (read the word aloud) interference from the irrelevant location was sizable. This poses difficulty for translational accounts of Stroop interference. Presenting LEFT and RIGHT laterally balanced by a color-name foil yielded a Simon effect inconsistent with an orienting response hypothesis. With bilateral stimuli in a reverse Simon task, interference was marked, supporting an integrative account of Stroop and Simon effects in terms of cognitive activation and the salience of irrelevant stimuli.

Adult↗

PubMed1998

Attention and memory dysfunction in posttraumatic stress disorder.

Attention and memory performances were studied in Persian Gulf War veterans with and without posttraumatic stress disorder (PTSD) diagnoses. Veterans diagnosed with PTSD showed relative performance deficiencies on tasks of sustained attention, mental manipulation, initial acquisition of information, and retroactive interference. Their performances were also characterized by errors of commission and intrusion. The tendency toward response disinhibition and intrusion on cognitive tasks was correlated positively with reexperiencing symptoms and negatively with avoidance-numbing symptoms. These cognitive deficit patterns are consistent with models of PTSD that emphasize the role of hyperarousal and implicate dysfunction of frontal-subcortical systems. Results suggest that intrusion of traumatic memories in PTSD may not be limited to trauma-related cognitions but instead reflects a more general pattern of disinhibition.

Adult↗