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At least 541 records · Page 30Linked to original sources

Piracetam in the treatment of post-concussional syndrome. A double-blind study.

The effect of piracetam, a cyclical derivative of GABA, was compared with that of a placebo in a double-blind study of 60 patients with post-concussional syndrome of 2-12 months' duration. The daily dose of piracetam was 4,800 mg. After 8 weeks of treatment piracetam significantly reduced the occurrence and severity of the following symptoms: vertigo, headache, tiredness, decresed alertness, increased sweating and neurasthenic symptoms. No significant effect was observed on the following symptoms: tremor, orthostatic symptoms, and memory disorders. Side effect were reported by 64% of the patients under piracetam and by 32% under placebo. In the author's opinion, piracetam seems to be a promising new drug for the treatment of post-concussional syndrome.

Brain Concussion↗

Development of an interactive tailored information application to improve patient medication adherence.

Medication adherence is increasingly recognized as an important health care problem. Although various factors have been related to adherence, patients' understanding of their illness and the influence of treatment on it has been shown to affect treatment adherence. Individually tailoring information provided to patients has a greater im-pact on patient behavior than providing generic information. This paper details the development of an interactive software application that provides individually-tailored information to patients treated with cholinesterase inhibitor medications for memory disorders. The application allows clinician input of information on patient level of health literacy and allows patients to choose among multiple questions related to their illness and its treatment. Output then includes answers to questions in Spanish and English at low or high literacy levels. Pilot data show a high degree of acceptability to users and an association with high sustained levels of adherence.

Aged↗

[Neuropsychology of Korsakoff's syndrome].

The main manifestation of Korsakoff's syndrome is a disproportionate impairment in memory in comparison to other cognitive functions. Most prominent is anterograde amnesia for both verbal and nonverbal information. The marked sensitivity to interference is the main characteristic of memory impairment of these patients. Retrograde amnesia is also a typical feature of this disorder. Memory for autobiographical information as well as knowledge of public events and facts are affected and they have a temporal gradient. Confabulations may also occur but they are not specific to Korsakoff's syndrome. Together with the disproportionate deficits in memory that define this disorder, different grades of involvement of other cognitive disorders are observed. The aim of this paper is to review the most important neuropsychological features of Korsakoff's syndrome and to discuss the hypotheses on it.

Cognition Disorders↗

Verbal memory compensation: application to left and right temporal lobe epileptic patients.

This study investigates the compensatory impact of cognitive aids on left and right temporal lobe epileptic patients suffering from verbal memory disorders, who were candidates for surgery. Cognitive aids are defined in the levels-of-processing framework and deal with the depth of encoding, the elaboration of information, and the use of retrieval cues. Results indicate differential compensatory impact for left and right epileptic patients and are discussed according to the HERA model and the compensation framework.

Adult↗

Subjective memory evaluations in patients with focal frontal, diencephalic, and temporal lobe lesion.

This paper examines subjective memory evaluations and their correlates in patients with focal frontal, diencephalic, or temporal lobe lesions. Although all patient groups showed significantly lower subjective memory evaluations than healthy subjects, the temporal lobe group rated themselves significantly lower than the frontal lobe or diencephalic groups despite comparable severity of amnesia, implying more severely impaired 'insight' in the latter two groups. There was a 'temporal gradient' such that patients rated their memory for 'old' (premorbid) items better than their memory for 'new' (recent) or prospective items. As in previous studies, subjective memory evaluations were not correlated with measures of 'objective' anterograde memory performance, but the present study suggests that subjective evaluations are not randomly determined. It seemed to be the site of lesion (frontal and/or diencephalic), rather than underlying aetiology, which produced a particularly severe loss of 'insight'. Whether the earliest remote or autobiographical memories were preserved or not appeared to be an important correlate of current subjective memory evaluations, and patients who had been memory-disordered for longer were more likely to evaluate their memory as poor than those with a more recent onset.

Adult↗

Classification accuracy of the Test of Memory Malingering in persons reporting exposure to environmental and industrial toxins: Results of a known-groups analysis.

This study used a known-groups design to examine the classification accuracy of the Test of Memory Malingering in detecting cognitive malingering in patients claiming cognitive deficits due to exposure to environmental and industrial toxins. Thirty-three patients who met Slick et al. criteria for Malingered Neurocognitive Dysfunction were compared to 17 toxic exposure patients negative for evidence of malingering, 14 TBI patients and 22 memory disorder patients, both groups without incentive. The original cutoffs (<45) for Trial 2 and Retention demonstrated perfect specificity (0% false positive error rate) and impressive sensitivity (>50%). These findings indicate the TOMM can be used with confidence as an indicator of negative response bias in cases of cognitive deficits attributed to exposure to alleged neurotoxic substances.

Adult↗

Randomized, double-blind, placebo-controlled international clinical trial of the Ampakine CX516 in elderly participants with mild cognitive impairment: a progress report.

This progress report briefly describes the rationale and study design for the first cross-national clinical study of a positive AMPA-type glutamate receptor modulator in subjects with mild cognitive impairment (MCI). The study medication for the double-blind, placebo-controlled trial, the AMPAKINE CX516, represents a novel pharmacological approach to the treatment of memory disorders. Previous preclinical and pilot clinical studies have shown that CX516 has the ability to enhance memory and cognition. Design of the trial, including outcome measures and inclusion criteria, was aided by an international panel of experts in the newly emerging field of MCI.

Aged↗

Memory clinics.

Memory clinics were first described in the 1980s. They have become accepted worldwide as useful vehicles for improving practice in the identification, investigation, and treatment of memory disorders, including dementia. They are provided in various settings, the setting determining clientele and practice. All aim to facilitate referral from GPs, other specialists, or by self referral, in the early stages of impairment, and to avoid the stigma associated with psychiatric services. They bring together professionals with a range of skills for the benefit of patients, carers, and colleagues, and contribute to health promotion, health education, audit, and research, as well as service to patients.

Ambulatory Care↗

Interference effects in chronic alcoholism.

This study investigated underlying mechanisms of the verbal memory disorder associated with chronic alcoholism. Previous investigations have suggested that alcoholics are more vulnerable to interference effects on verbal learning and memory tasks, both with respect to retroactive interference (RI) and proactive interference (PI); this was the hypothesis of the current study. Measures of RI and build-up and release from PI were administered to 31 abstinent male chronic alcoholics and 24 healthy male nonalcoholic control subjects. Alcoholics demonstrated more sensitivity to RI than controls. Additionally, alcoholics displayed a more rapid build-up of PI, although they showed normal release. An increased interference effect was found to be a component of chronic alcoholics' verbal memory impairment and may differentiate chronic alcoholism from other disorders affecting verbal learning and memory.

Adult↗

A novel mutation (L250V) in the presenilin 1 gene in a Japanese familial Alzheimer's disease with myoclonus and generalized convulsion.

This study reports a novel presenilin 1 (PS1) gene mutation in a Japanese family with Alzheimer's disease (AD). Two patients developed progressive memory disorder with disorientation around 50 years of age and showed myoclonus with frequent tonic-clonic seizures several years later. Direct sequencing of the proband's PS1 gene revealed a novel mis-sense mutation (leucine-to-valine at residue 250 (L250V)). This mutation was found in both patients, but not in a normal family member or normal Japanese control subjects. Thus, L250V is a novel PS1 gene mutation responsible for familial AD (FAD) in Japan.

Alzheimer Disease↗

[Forgetting: a product of memory].

If someone asks you what your children talk about at breakfast this morning, it is likely that you not able to tell him. This forgetting will not appear like a mark of memory disorder. But if it concerns a 80 years old people! Over the last decade, it has been claimed that aging induces reduced inhibitory processing and this has been put forward to explain forgetting. However, several experiments have proposed that non inhibitory mechanisms can account for the pattern of results. So, aging doesn't involve inhibitory deficit. Recently, a procedure known as the "retrieval practice paradigm," claimed to give a good measure of inhibitory processing whose goal is to suppress competing traces during an episodic retrieval. In this paradigm, participants study exemplars from taxonomic categories (e.g., fruit-orange, fruit-banana, drink-scotch) and then practice retrieving half of the exemplars from half of the categories by recalling those studied items given a category and letter stem as cue (e.g., fruit-or _). Each item is tested several times. After a delay, subjects are tested on all items. Practice impairs recall of the remaining non practiced exemplars of the practiced categories, phenomenon known as "retrieval-induced forgetting". In the present experiment, we would to determine whether retrieving an item from semantic memory inhibits other concepts that compete with it during retrieval. Indeed, studies of lexical ambiguity resolution provide evidence for inhibition in semantic retrieval. For that, we use homographs because their natural characteristic involves inhibiting one of their two meanings. We expected that if participants practice a word related to a homograph's subordinate meaning, word related to its dominant meaning would need to be inhibited. Results show that old people showed normal levels of inhibition. Moreover, results show an interaction between practiced-unpracticed items and homograph's polarity. These results suggest that a deficit in inhibitory process can not explain forgetting.

Adult↗

Classification accuracy of the test of memory malingering in traumatic brain injury: results of a known-groups analysis.

This study used a known-groups design to determine the classification accuracy of the Test of Memory Malingering (Tombaugh, 1996, 1997) in detecting cognitive malingering in traumatic brain injury (TBI). Forty-one of 161 TBI patients met Slick, Sherman, and Iverson (1999) criteria for Malingered Neurocognitive Dysfunction. Twenty-two no-incentive memory disorder patients were also included. The original cutoffs (<45) for Trial 2 and Retention demonstrated excellent specificity (less than a 5% false positive error rate) and impressive sensitivity (greater than 45%). However, these cutoffs are actually conservative in the context of mild TBI. Over 90% of the non-MND mild TBI sample scored 48 or higher on the Retention Trial and none scored less than 46 while 60% of the MND patients claiming mild TBI were detected at those levels. Trial 1 also demonstrated excellent classification accuracy. Application of these data to clinical practice is discussed.

Adult↗

The carrot and the stick: benefits and barriers in getting a diagnosis.

The goals of this study were to identify the benefits and barriers perceived by family caregivers of persons who have been through a diagnostic assessment for dementia symptoms and to determine which caregivers experience more benefits and barriers associated with assessments. A survey was mailed to caregivers involved in the decision to seek a diagnostic assessment for a family member at a University of Kentucky memory disorders clinic. A total of 528 family caregivers (response rate 71.7%) returned a 4-page survey designed to elicit benefits, barriers, and demographic information. Respondents delayed the diagnostic assessment for an average of 22.4 months after noticing symptoms. Perceived benefits involved confirmation of a medical condition, access to treatment, and help preparing for the caregiving role. Barriers were both emotional and pragmatic in nature. Respondents who were younger, visited the rural assessment clinic, and had less education experienced more barriers. All groups reported receiving the same number of benefits from the assessment. By incorporating these benefits and barriers, interventions can be designed to increase the likelihood of early diagnostic assessments.

Adult↗

Memory and anxiety disorders.

Experimental psychopathologists have identified varying patterns in memory bias in people with depressive and anxiety disorders. Individuals suffering from depression tend to exhibit explicit memory deficits for positively-valanced material, and sometimes exhibit biases for retrieving negative self-relevant information as well. Most studies, however, provide scant evidence for implicit memory biases in depression. In contrast to depression, anxiety disorders are rarely associated with enhanced explicit memory for threat-related information (with the exception of panic disorder). Evidence for implicit memory biases for threat in these syndromes is mixed. After providing an overview of findings on memory abnormalities in depressive and anxiety disorders, data from several new studies bearing on posttraumatic stress disorder (PTSD) in Vietnam combat veterans and in women with histories of childhood sexual abuse are presented. Involving directed forgetting, implicit memory and autobiographical cueing paradigms, these experiments point to a pattern of abnormalities linked to PTSD rather than to trauma per se.

Anxiety↗

Imagery mnemonics and memory remediation.

This paper evaluates the claim that imagery mnemonic techniques are useful in remediation of memory disorders in brain-damaged patients. Clinical research has confirmed that such techniques can lead to improved performance on formal testing in a number of neurologic disease populations and following lesions of either the left or right hemisphere. However, those patients with more severe forms of amnesia and those with medial or bilateral damage do not improve unless the learning task is highly structured. Even among patients who show improvement on formal testing, there is little evidence that they maintain the use of these techniques in similar learning tasks or generalize the use to new learning situations. Imagery mnemonics also appear to be of little practical value in the daily activities that are of most concern to brain-damaged patients themselves. The effectiveness of imagery mnemonics appears to depend upon the patients' motivation and insight rather than upon their intelligence or educational level. Instead of training patients in specific mnemonic techniques, clinicians should promote the development of "meta-cognitive" skills and the acquisition of knowledge about domains of practical significance.

Humans↗

[Neuropsychological and scintigraphic aspects of frontotemporal dementia preceding amyotrophic lateral sclerosis].

Between 1993 and 2001, we observed fifteen patients (ten men and five women, mean age 63 years) with frontotemporal dementia (FTD) which preceded signs of amyotrophic lateral sclerosis (ALS) which developed 21 months later. Mean disease duration in the fourteen deceased patients was 38 months. FTD associated with ALS is characterized by rapid course, predominance of disinhibited forms (orbito-basal), presence of aphasia with neologisms, and semantic memory disorders. Performed in all patients, single-photon emission computed tomography demonstrated a bifrontal pattern of low uptake, sometimes associated with low uptake in the anterior temporal region. In one patient, neuropathology revealed neuron atrophy and loss in the frontotemporal region, the anterior horns, and the hypoglossal nucleus. Ubiquitin-positive inclusions were visible in the dentate gyrus of the hippocampus and in the anterior horns. The dementia/ALS association is classically described is uncommon. It belongs to the FTD group since the Lund and Manchester consensus. Approximately 15 p.100 of patient with FTD can be expected to develop ALS. About 250 cases have been reported in the literature, half of them in the Pacific area where the incidence of ALS is high (55/100,000 inhabitants versus 1/100,000 in the rest of the world). Intermediary forms of FTD, semantic dementia, and progressive non-fluent aphasia are discussed since several cases of non-fluent progressive aphasia associated with ALS are reported in the literature. The links between these two degenerative diseases are discussed.

Aged↗

Cortical deafness to dissonance.

Ordinary listeners, including infants, easily distinguish consonant from dissonant pitch combinations and consider the former more pleasant than the latter. The preference for consonance over dissonance was tested in a patient, I.R., who suffers from music perception and memory disorders as a result of bilateral lesions to the auditory cortex. In Experiment 1, I.R. was found to be unable to distinguish consonant from dissonant versions of musical excerpts taken from the classical repertoire by rating their pleasantness. I.R.'s indifference to dissonance was not due to a loss of all affective responses to music, however, since she rated the same excerpts as happy or sad, as normal controls do. In Experiment 2, I.R.'s lack of responsiveness to varying degrees of dissonance was replicated with chord sequences which had been used in a previous study using PET, in examining emotional responses to dissonance. A CT scan of I.R.'s brain was co-registered with the PET activation data from normal volunteers. Comparison of I.R.'s scan with the PET data revealed that the damaged areas overlapped with the regions identified to be involved in the perceptual analysis of the musical input, but not with the paralimbic regions involved in affective responses. Taken together, the findings suggest that dissonance may be computed bilaterally in the superior temporal gyri by specialized mechanisms prior to its emotional interpretation.

Adult↗

Executive dysfunction can explain word-list learning disability in very mild Alzheimer's disease: the Tajiri project.

Elderly people with questionable dementia (i.e. a Clinical Dementia Rating (CDR) of 0.5) have been focused on as representing the borderline zone condition between healthy people and dementia patients. Many of them are known to have pathologic traits of very mild Alzheimer's disease (AD). Although they present mild memory disorder, the underlying mechanism has not been fully investigated. Herein is reported the mechanism of learning disability in very mild AD. Eighty-six CDR 0.5 participants and 101 age- and education-matched healthy controls (CDR 0) were randomly selected from a community in the town of Tajiri, Miyagi Prefecture. The word-recall task of the Alzheimer Disease Assessment Scale-Japanese (i.e. learning and recall of 10 words) was administered. The numbers of words recalled in each trial and those never recalled throughout the trials were compared for the two CDR groups. The serial-position function was depicted for three parts (i.e. primary, middle, and recency). The CDR 0.5 group recalled significantly fewer words than the CDR 0 group. The number of never-recalled words was greater in the CDR 0.5 group. A remarkable difference was found in the middle part of the word list. The number of never-recalled words of the CDR 0.5 group was greater in the middle part. The large number of never-recalled words accounted for the poor learning performance of very mild AD participants. The results suggested that very mild AD participants have difficulty in learning and retaining words in the middle part of the word-list because of a functional decline of the central executive system.

Aged↗