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PubMed1976

A trial use of some of Reitan's neuropsychological tests to assess mild organic complications in psychiatric patients.

Several testing procedures borrowed from Reitan's extensive investigations of impairment in brain function were employed in the present study (Tactual Performance Test, Trail Making Test, Seashore Rhythm Test, Speech Sounds Perception Test, Finger Oscillation Test). These tests were administer to three groups of Ss matched for age, education, and sex distribution. All Ss were 40 years of age or older. The groups were: hospitalized psychiatric patients suspected by their psychiatrists of some degree of organic impairment; hospitalized psychiatric patients not suspected of any organic impairment; and nonhospitalized, apparently normally functioning control Ss. Four months after the beginning of the study, the psychiatrists reevaluated and reclassified the patient Ss and formed new groups of those suspected and not suspected of organic impairment. A comparison of group means that used the original S groups showed that three of nine test scores were nondiscriminating, while the remaining six discriminated the control Ss from the patients, but not the two patient groups from each other. A similar comparison that used the revised patient groups formed from the psychiatrists' re-evaluations after an additional 4 months of observation yielded four test scores that discriminated successfully between the two patient groups: Tactual Performance Test, total time; Trail Making Test, Part A and Part B; and Finger Oscillation Test, right hand. These four test scores predicted the later classification of the patients more accurately than did the psychiatrists' own original evaluations, which would be in keeping with the general function of diagnostic testing, i.e., to provide initial information about patients beyond that which can be obtained from initial psychiatric examination.

Brain Damage, Chronic↗
PubMed1998

Long-term tacrine treatment in three mild Alzheimer patients: effects on nicotinic receptors, cerebral blood flow, glucose metabolism, EEG, and cognitive abilities.

The effect of long-term treatment with tacrine (tetrahydroaminoacridine) was studied in three Alzheimer patients (aged 57, 64, and 68 years) with mild dementia. All three patients had a Mini-Mental State Examination score of 24/30 and carried at least one apolipoprotein E (ApoE) epsilon4 allele. Tacrine was given in doses between 80 and to 160 mg daily for 13-31 months. A lower tacrine concentration was observed generally in cerebrospinal fluid (CSF) compared with plasma. The acetylcholinesterase activity in CSF tended to be increased following longer periods of tacrine treatment, whereas the butyrylcholinesterase activity was decreased. The three patients repeatedly underwent positron emission tomography investigation of cerebral blood flow, nicotinic receptors, cerebral glucose metabolism, and electroencephalogram (EEG) and cognitive tests. Positive influences on these parameters were observed following both short-term and long-term treatment with tacrine. Improvement of nicotinic receptors (measured as 11C-nicotine binding), cerebral blood flow, EEG, and some cognitive tests (trail making test, block design test) occurred earlier after initiation of tacrine treatment compared with the glucose metabolism, which was increased after several months of tacrine treatment. An improvement in attention (trail making test) was observed following tacrine as sign for frontal lobe activation (EEG). The functional effects of tacrine in Alzheimer patients appeared to be related to both dose and length of cholinesterase inhibitor treatment.

Aged↗
PubMed1996

Cyclosporine may affect improvement of cognitive brain function after successful cardiac transplantation.

BACKGROUND: The effects of cardiac transplantation on cognitive brain function are uncertain. METHODS AND RESULTS: We measured cognitive brain function and quality of life in out-of-hospital cardiac transplant candidates (n = 55; ejection fraction, 19.9%; age, 54.8 years [means]). After transplantation, the patients were serially reevaluated at 4 months (n = 25) and at 12 months (n = 19). Brain function was measured objectively by cognitive P300 evoked potentials. Additionally, standard psychometric tests (Trail Making Test A, Mini-Mental State Examination, and Profile of Mood State test) were performed. Cognitive P300 evoked potentials were impaired in cardiac transplant candidates (359 ms, recorded at vertex) compared with 55 age- and sex-matched healthy subjects (345 ms, P < .01). Trail Making Test A was also abnormal (45 versus 31 seconds in 55 healthy subjects, P < .01). After transplantation, P300 measures were normalized at 4 months (345 ms, P < .05 versus before transplantation) but declined again at 12 months (352 ms, P = NS versus before transplantation). Stepwise multiple regression analysis revealed that cumulative cyclosporine dosage was the only predictor of individual cognitive brain function 4 months (753 mg/kg body wt, P < .05) and 12 months (2006 mg/kg body wt, P < .01) after transplantation, respectively. CONCLUSIONS: Objective cognitive P300 auditory evoked potential measurements indicate that cognitive brain function is significantly impaired in patients suffering from stable end-stage heart failure. Successful cardiac transplantation is effective to fully normalize impaired brain function. Subsequent relative long-term decline of cognitive brain function after successful cardiac transplantation is strongly suggested to be related to cumulative cyclosporine neurotoxicity.

Affect↗
PubMed1988

Neuropsychological impairment in Wilson's disease.

To examine the neuropsychological deficits of patients with Wilson's disease (WD), 19 neurologically impaired patients with WD were administered the Wechsler Adult Intelligence Scale (revised), Wechsler Memory Scale, Dementia Rating Scale, Wisconsin Card Sorting Test, Boston Naming Test, Trail Making Test, and Animal Naming Test. Their test scores were compared with those of 12 neurologically asymptomatic patients with WD and 15 normal controls. The neurologically impaired patients scored lower than did the control group on the Performance IQ, Full-Scale IQ, Dementia Rating Scale, and Trail Making Test, and they scored lower on the Wechsler Memory Scale than did both the asymptomatic and control groups. The major areas of deficit for the neurologically impaired WD group were in motor and memory functioning. Computed tomographic and neurologic examinations of the neurologically impaired patients with WD generally reflected abnormalities of the basal ganglia.

Adolescent↗
PubMed2000

Comparison of the Trail Making and Color Trails Tests in a Chinese context: a preliminary report.

The Color Trails Test developed as a culturally fair analogue of the Trail Making Test, was used to examine the relationship between the two tests with 35 undergraduate Chinese in Hong Kong recruited as the subjects. The scores on these two tests of the 12 men and 23 women were significantly correlated .71. The equivalence of the Trail Making and Color Trails Tests when applied to Chinese in Hong Kong was discussed.

Adult↗
PubMed2000

Are trail making and color trails tests of equivalent constructs?

The Color Trails Test (CTT) was developed as a culturally fair analogue of the Trail Making Test (TMT). This study examined the equivalence of these two tests for Chinese individuals in Hong Kong. One hundred and eight Chinese people volunteered for this study, and were classified into four groups according to their age and level of education. Their performance on these two tests was compared. The findings suggested that age and level of education indeed played significant roles in their performance on these two tests. Strong correlations (r = 0.72) were only observed between scores on Part B of the TMT and Part 2 of the CTT when the participants were older and had higher levels of education. This suggests that the equivalent construct of the Trail Making and Color Trails Tests can only be examined and established within specific age and education parameters.

Adolescent↗
PubMed1986

Classification rates obtained with "standard" cut-off scores on selected neuropsychological measures.

Examined in a normal sample (N = 365) the number of subjects was classified as impaired on several commonly used neuropsychological tests (Seashore Rhythm Test, Trail Making Test, Finger Tapping Test, and Grooved Pegboard Test) in reference to conventional cut-off scores. The sample was stratified on the basis of age, sex, and education. For the sample as a whole, the percentage of subjects classified as impaired ranged from 15.6 to 80. In some subgroups on some tests, the percentage so classified was 100. The data were discussed in relation to the need to adjust conventional cut-off scores for the influence of subject variables. In addition, cross-cultural differences on some tests suggested the need for local or national normative studies.

Adolescent↗
PubMed2001

Dietary protein, carbohydrate, and fat enhance memory performance in the healthy elderly.

BACKGROUND: Dietary carbohydrates can improve memory. Whether these effects are related to elevations in blood glucose or to energy ingestion is unknown. OBJECTIVES: Our objectives were to determine 1) the influence of isoenergetic protein-, carbohydrate-, and fat-containing drinks on cognitive performance and 2) whether the time period after ingestion affects cognition. DESIGN: After fasting overnight, 11 men and 11 women aged 61-79 y consumed either a 300-mL drink containing 774 kJ as pure protein (whey), carbohydrate (glucose), or fat (safflower oil) or a nonenergy placebo on 4 separate mornings. Cognitive tests were administered 15 and 60 min after ingestion of the drinks. Plasma glucose and serum insulin concentrations were measured. RESULTS: Only the carbohydrate drink increased blood glucose (P < 0.0001). Compared with the placebo, all 3 macronutrients improved delayed paragraph recall (PR) (P < 0.001) and improved or tended to improve immediate PR (P < 0.04) 15 min after ingestion. Beneficial effects on other cognitive tests were confined to one or more of the macronutrients: carbohydrate improved Trail Making Test (Trails) performance at 60 min (P = 0.02) and tended to improve Trails at 15 min (P = 0.04) and PR at 60 min in men, carbohydrate and fat improved or tended to improve performance on Trails at 15 and 60 min in subjects with poor baseline scores (r > -0.41, P < 0.03), fat tended to improve attention at 60 min (P < 0.05), and protein reduced the rate of forgetting on the PR at 15 min (P = 0.002). CONCLUSIONS: Energy intake from protein, carbohydrate, or fat can enhance memory independently of elevations in blood glucose. Each macronutrient may also exert unique effects on cognition.

Aged↗
PubMed1982

Correlations between psychopathology, psychological test results and computerized tomography changes in senile dementia.

This study is an investigation of the relationship between morphological, neuropsychological, and clinical measurements, all presumably contributing to an expert's diagnosis of senile dementia. Morphological assessment was carried out by linear measurements taken from the photographs of the CT scanners display. The battery of tests comprised instruments able to evaluate performance (WAIS, Benton test, d2 test, Trail Making test) as well as personality (FPI) from a quantitative point of view. For clinical assessment the Assessment Scale for Gerontopsychiatry (AGP) was used. A group of 39 patients suffering from mild to severe dementia was studied. The results show strong correlations between some sub-tests of the WAIS and certain CT measurements but fail to show comparable features in using the full scale IQ. The other cognitive tests did not work as well in detecting brain atrophy. Surprisingly, the personality inventory (FPI) showed some correlations with brain atrophy. A number of correlations between morphological and clinical variables were found as well, consistent with well-known clinical experience. Topographical features will be discussed supporting the view that cerebral lesions in the progress of senile dementia take the form of distinct patterns.

Affect↗
PubMed1995

[Effect of modafinil in narcoleptic patients. Electrophysiologic and psychometric studies].

Clinical efficiency of Modafinil was clearly demonstrated in narcoleptic patients but only a few electrophysiological studies were carried out to confirm these observations. Since Modafinil did not change the propensy to fall asleep, the aim of this work was to study maintenance of wakefulness and performance levels in treated narcoleptic patients. Of the 16 treated patients, 12 responded as expected to Modafinil. These 12 patients were studied. After a one night polysomnography, electrophysiological tests included: baseline spectral analysis, maintenance of wakefulness tests carried out respectively eyes open in diffused light and eyes closed in darkness during which sleep latency, duration of test and changes in the theta/alpha ratio were measured. Psychometric performances were evaluated using verbal or non verbal tests: visual and auditory reaction time tests. Trail Making Test, Stroop, verbal Fluency and WAIS-R. Modafinil improved the ability of narcoleptic patients to remain awake only when the situation or the environmental conditions were favorable. Some psychometric performances also trended towards on improvement.

Adult↗
PubMed2001

Cardiopulmonary bypass affects cognitive brain function after coronary artery bypass grafting.

BACKGROUND: The causes for cognitive impairment after coronary artery bypass grafting (CABG) have long been a topic for debate. METHODS: We prospectively followed 308 consecutive, unselected survivors of CABG at our institution. In addition to determination of clinical measurements, cognitive brain function was measured objectively by P300 auditory-evoked potentials before CABG, at 7-day and at 4-month follow-up. Standard psychometric tests (Trail Making Test A, Mini Mental State Examination) were also performed. RESULTS: At 7-day follow-up cognitive P300 auditory-evoked potentials were significantly impaired compared with preoperative levels (peak latencies: 376 +/- 40 ms versus 366 +/- 37 ms, p = 0.0001). P300 measurements were almost normalized at 4-month follow-up (peak latencies: 369 +/- 33 ms, p = NS versus preoperative). Standard psychometric tests failed to detect this subclinical cognitive impairment. Multiple regression analysis revealed that use of cardiopulmonary bypass was the only independent predictor of impaired cognitive brain function at 7-day (p < 0.0001) and 4-month follow-up (p = 0.0008). The presence of diabetes mellitus (p = 0.0135) or concomitant repair of significant carotid artery stenosis (p = 0.0049) was predictive of late improvement of cognitive brain function at 4-month follow-up. CONCLUSIONS: Objective cognitive P300 auditory-evoked potential measurements demonstrate that the use of cardiopulmonary bypass is the only predictor of short- and long-term cognitive brain dysfunction after CABG. Interestingly, the presence of diabetes mellitus and concomitant repair of a significant carotid artery stenosis were predictive for long-term cognitive benefit.

Aged↗