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PubMed1991

Depression and memory in major depressive disorder.

The relationship between memory function and depression was examined in 23 patients who met DSM-III criteria for major depression. All patients were unmedicated at the time of examination, which included the Wechsler Memory Scale, Minnesota Multiphasic Personality Inventory-Depression Scale (MMPI-D), and Hamilton Depression Rating Scale (HDRS). Consistent with previous studies, there was no relationship between the MMPI-D and any of the Wechsler Memory Scale measures. In contrast, poor memory was related to elevated scores on the HDRS. These data indicate that depression does influence memory performance. The most important implication of this study is the need for the use of appropriate measurement instruments in studies of neuropsychological correlates of neuropsychiatric disorders.

Adolescent↗

PubMed2006

Cognitive profile in CADASIL.

BACKGROUND: The spectrum of cognitive alterations associated with CADASIL, a model of pure vascular dementia, has not been thoroughly evaluated. OBJECTIVES: The aims of this study were: (i) to describe the cognitive profile in CADASIL patients according to age; (ii) to compare the profile of patients with dementia with that of patients without dementia; and (iii) to determine the association between alterations in performance in different cognitive domains. METHODS: Forty two consecutive individuals with CADASIL (35-73 years old) were investigated. Cognitive skills were analysed in five domains (executive functions, reasoning, attention, memory, visuospatial abilities) according to age and compared between patients with and without dementia. Associations between cognitive performance and stroke were tested. RESULTS: The youngest patients presented with attention (69%), memory (70%), and executive disturbances (100%). Visuospatial abilities and reasoning deteriorated with age, mainly after the age of 60. About one quarter of patients had dementia, and 75% of these were >60 years of age. Age >60 years was associated with a Rankin score >3 and a significant deficit in all cognitive domains. No association was found between dementia and the number of ischaemic attacks. Episodic memory disorder was characterised by difficulties in retrieval rather than impairment of the encoding process. CONCLUSION: Cognitive decline in CADASIL is dominated by early impairment of executive functions. Skills in other cognitive domains deteriorate with age and are found to be diffusely impaired in patients with dementia. The relative preservation of the encoding process in episodic memory impairment, even in individuals with dementia, is noteworthy.

Adult↗

PubMedDate not supplied

[Daytime consequences of insomnia complaints in the French general population].

Insomnia is a frequent symptom in the general population; numerous studies have proven this. In the past years, classifications have gradually given more emphasis to daytime repercussions of insomnia and to their consequences on social and cognitive functioning. They are now integrated in the definition of insomnia and are used to quantify its severity. If the daytime consequences of insomnia are well known at the clinical level, there are few epidemiological data on this matter. The aim of this study was to assess the daytime repercussions of insomnia complaints in the general population of France. A representative sample (n=5,622) aged 15 or older was surveyed by telephone with the help of the sleep-EVAL expert system, a computer program specially designed to evaluate sleep disorders and to manage epidemiological investigations. Interviews have been completed for 80.8% of the solicited subjects (n=5,622). The variables considered comprised insomnia and its daytime repercussions on cognitive functioning, affective tone, daytime sleepiness and diurnal fatigue. Insomnia was found in 18.6% of the sample. The prevalence was higher in women (22.4%) than in men (14.5%, p<0.001) with a relative risk of 1.7 (95% confidence interval 1.5 to 2) and was twice more frequent for subjects 65 years of age or older compared to subjects younger than 45 years. Approximately 30% of subjects reporting insomnia had difficulties initiating sleep. Nearly 75% of insomnia complainers reported having a disrupted sleep or waking up too early in the morning and about 40% said they had a non-restorative sleep. Repercussions on daytime functioning were reported by most insomnia subjects (67%). Repercussions on cognitive functioning changed according age, number of insomnia symptoms and the use of a psychotropic medication. A decreased efficiency was more likely to be reported by subjects between 15 and 44 years of age (OR: 2.9), those using a psychotropic (OR: 1.5), those reporting at least three insomnia symptoms (OR: 1.4) and women (OR: 1.4). The highest probability of the appearance of concentration difficulties was found in subjects younger than 65 Years, having a depressive disorder and using a psychotropic (15-44 years: OR 19.1; 45-64 years: OR 46.6). Difficulties maintaining attention were 15 times higher in subjects aged between 45 and 64 who were using a psychotropic and had also a depressive disorder. Memory difficulties were three times more likely to be reported by subjects using a psychotropic. At the affective level, irritability was 10 times more likely to be reported by subjects younger than 65 Years who were also using a psychotropic and had a depressive disorder. Independent of the presence of a mental disorder and the use of a psychotropic, subjects between 15 and 44 Years were five times more likely to be irritable following a bad sleep. Feeling depressed after a bad night's sleep was 18 times more likely to occur in subjects aged between 45 and 64 who were using a psychotropic and had a depressive disorder. Feeling anxious after a bad night's sleep was seven times more likely to occur in subjects with a depressive disorder. Daytime sleepiness was reported by approximately 20% of insomnia subjects. This rate was relatively comparable among gender, age groups, presence/absence of a mental disorder and use or not of a psychotropic. However, taking into account the interaction between age, use of a psychotropic and the presence of a mental disorder, subjects younger than 65 years, using a psychotropic and having a depressive disorder were at least 10 times more likely to report daytime sleepiness. Subjects who were suffering the most diurnal symptoms of insomnia were those younger than 65 years. Several factors can be evoked to explain this fact. These subjects were, for the most part, likelier to have a stricter sleep/wake schedule because of constraints imposed by work, studies, child care, etc. Subjects older than 65 Years were generally retired and therefore less prone to sleepiness and to cognitive difficulties. Insomnia consequences were limited due to their inactivity. Complementary studies should be undertaken to describe the daytime repercussions of insomnia for this specific age group of the general population and to measure these repercussions.

Adolescent↗

PubMed1983

[Comparative study of the effect of lorazepam and tiapride on memorizing capacities of patients over 60 years of age].

Our purpose was to investigate the action on memory disorders of patients over sixty years of age of a well tolerated sedative neuroleptic, tiapride, and of a short-half-life benzodiazepine, lorazepam. Thirty subjects divided into two groups were entered in a three week trial. The product's effect on both anterograde memory and remote memory was assessed by the simple memory test used. Statistical conclusions show that tiapride is very significantly superior to lorazepam in every studied criterion, with disinhibition and stimulation of vigilance. These hypotheses need to be confirmed.

Aged↗

PubMed1988

Neuropsychological effects of brain autograft of adrenal medullary tissue for the treatment of Parkinson's disease.

We describe the pre- and postoperative neuropsychological profiles of seven patients who received an autograft of adrenal medullary tissue to the caudate nucleus for the treatment of Parkinson's Disease (PD). The preoperative neuropsychological evaluations revealed specific cognitive deficits of varying degree. The patients showed frontal lobe-type deficits with alterations in behavioral programming leading to difficulties in the organization of motor sequences and alternating programs. They also showed memory disorders and visuospatial and visuoperceptual deficiences such as a loss of figure-ground perspective and fragmentation. Postoperative evaluations, carried out 3 months after neurosurgery, revealed a significant amelioration of the frontal lobe-type symptoms and visuospatial deficits, as well as an improvement in memory tasks that require an active organization of the response. Immediate and delayed memory difficulties remained unchanged. These observations were compared to neuropsychological data obtained from neurologically intact subjects and from unoperated PD patients. The improvements of the operated PD patients resulted in performance levels close to normal values and clearly distinguishable from those of unoperated PD patients, and were unrelated to improved mood, increased alertness, or sustained attention. Autotransplantation of adrenal medullary tissue to the caudate nucleus of PD patients showing a decreased effective response to L-dopa therapy can partially restore motor functions and frontal-type cognitive symptoms.

Adrenal Medulla↗

PubMed2003

Cognitive screening using a tape recorder: a pilot study.

OBJECTIVES: To determine whether a tape recorder can be used to administer cognitive tests efficiently and yield valid results. DESIGN: Convenience sample. Administration of cognitive test materials by tape recorder and conventional technique. SETTING: Outpatient clinic. PARTICIPANTS: Subjects from memory disorder clinic, hostel accommodation, and community. MEASUREMENTS: Responses to Hopkins Verbal Learning Test-revised, verbal fluency items from the controlled oral word association test, 10-item naming task, a construction task, and speed writing task. RESULTS: Performances on the tape- and clinician-administered battery of tests were highly correlated. Memory impairment was accurately detected using the tape battery. Data from 30 minutes of testing via tape were obtained at the cost to the clinician of 2 to 3 minutes of scoring time. CONCLUSION: Tape-administration of cognitive test material warrants further study as an efficient means of cognitive screening.

Adult↗

PubMed2002

[Posttraumatic stress disorder and trauma memory--a psychobiological perspective].

We postulate that posttraumatic stress disorder is maintained by learnt cortical and subcortical plastic changes. Specifically, we assume that classical conditioning leads to an intense emotional memory of the trauma that is mainly implicit and related to plastic changes in subcortical structures such as the amygdala. At the same time an insufficient explicit trauma memory is formed that manifests itself in insufficient cortical processing of trauma content. This dissociation of implicit and explicit memory prevents the extinction of the emotional response to the trauma and perpetuates the disorder. First empirical results based on this model confirm the main hypotheses.

Amygdala↗

PubMed1996

d-Cycloserine enhances implicit memory in Alzheimer patients.

We tested the ability of d-cycloserine, a partial glycine agonist acting at the N-methyl-D-aspartate (NMDA) receptor complex, to improve implicit memory in Alzheimer patients in a parallel-group, placebo-controlled, double-blind study. One-hundred eight patients with probable Alzheimer's disease of mild to moderate severity received d-cycloserine (5, 15, or 50 mg) or placebo twice daily for 10 weeks. We then evaluated their ability to identify perceptually degraded words, some of which were repeated over multiple trials across 3 days. Implicit memory performance of words repeated across trials was significantly enhanced for the patients who received 15 mg d-cycloserine compared with those who received placebo. These findings support development of NMDA receptor-mediated glutamatergic interventions for the treatment of Alzheimer-related memory disorders.

Aged↗

PubMed1997

Differentiating between demented and psychiatric patients with the Dutch version of the IQCODE.

This study presents psychometric data on the Dutch version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-N). We focused on differentiating between inpatients with dementia or a mood/psychotic disorder. A cutoff point of 3.9 on the IQCODE-N correctly predicted group membership in 87.8% and 78.8% respectively. Internal consistency and principal component analysis suggest that the IQCODE-N measures a unidimensional construct. Correlations with a Dementia Screening Test (r = 0.62), nurses' observations on memory disorders (r = 0.71) and a global assessment of severity of dementia (r = 0.72) support the validity of the informant ratings. Patients' age and level of education did not confound informant ratings. Only a small fraction of the informants could not complete the IQCODE-N, which makes it an easily applicable rating scale for cognitive decline.

Aged↗

PubMed1997

Semantic amnesia without dementia: documentation of a case.

We described the case of a patient affected by a progressive semantic memory disorder associated with prevalent temporal lobe atrophy. This deficit seems to be "pure" in the sense that it has not been found to overlap with other cognitive deficits (intellectual, linguistic, perceptual, visuo-spatial etc.) for a long time. Furthermore, despite his impaired semantic knowledge, the autobiographical memory of the patient was largely intact. This case therefore represents a form of "semantic amnesia" without dementia, and supports the hypothesis that there is a partial distinction between "semantic" and "episodic" memory.

Amnesia↗

PubMed1995

Intraoperative hippocampal cooling and Wada memory testing in the evaluation of amnesia risk following anterior temporal lobectomy.

OBJECTIVE: To determine the efficacy of memory testing following localized thermal inactivation (cooling) of the hippocampus during epilepsy surgery to assess risk for postoperative memory decline. DESIGN: Memory was assessed after intraoperative thermal inactivation of the hippocampus and during the Wada procedure to help determine the clinical utility of each procedure. SETTING: A university hospital, comprehensive epilepsy surgery program. PATIENTS: Individuals undergoing unilateral temporal lobectomy for relief of intractable seizures. PROCEDURE: After temporal tip resection, iced liquid was irrigated into the temporal horn of the lateral ventricle until the hippocampus was "cooled." MAIN OUTCOME MEASURES: Multiple neuropsychological measures of learning and memory. RESULTS: Wada memory testing suggested risk for memory impairment in 15 patients while cooling indicated risk in only five patients. Predictions arising from the two procedures were concordant in 13 patients and discordant in 12 patients. Among the 12 inconsistent predictions, hippocampal cooling suggested adequate contralateral memory support in 11 (92%) of 12 patients, and none of these 11 patients had a postoperative anterograde amnesia. CONCLUSION: Intraoperative hippocampal cooling may be useful in determining the risk of postoperative memory disorder among selected patients undergoing epilepsy surgery.

Adult↗

PubMed1977

Dysphoria and impaired mentation in young physicians.

A syndrome of dysphoria and impaired mentation afflicting young physicians is described. Complaints involve a perceived inability to remember recently read medical literature and a perceived lack of ability and "memory lapses" in the clinical care of patients. This syndrome occurs at a time when the young physicians' professional role is in transition and when he has just assumed increased clinical responsibilities. Resolution of the syndrome may be facilitated by a suggested protocol.

Adult↗

PubMed1996

Negative transactivation of cAMP response element by familial Alzheimer's mutants of APP.

In familial Alzheimer's disease (FAD), missense point mutations V642I/F/G, which co-segregate with the disease phenotype, have been discovered in amyloid precursor APP695. Here, we report that three FAD mutants (FAD-APPs) negatively regulated the transcriptional activity of cAMP response element (CRE) by a G(o)-dependent mechanism, but expression of wildtype APP695 had no effect on CRE. Experiments with various Galpha(s) chimeras demonstrated that Phe-APP coupled selectively to the C-terminus of Galpha(0). Again, wild-type APP695 had no effect on its C-terminus. These data indicate that FAD-APPs are gain-of-function mutants of APP695 that negatively regulate the CRE activity through G(o). This negative transactivation of CRE is the first biochemically analyzed signal evoked by the three FAD-APPs, but not by wild-type APP695, in a whole-cell system. We discuss the significance of constitutive CRE suppression by FAD-APPs, which is potentially relevant to synaptic malplasticity or memory disorders.

Alzheimer Disease↗

PubMed2000

Does longer-term memory storage never become overloaded, and would such overload cause Alzheimer's disease and other dementia?

According to an uncritically accepted axiom, the human brain's capacity for longer-term memory storage is never overloaded. This viewpoint is shown to be contrary to all evidence and beyond reasonable credibility. The entire currently obtainable evidence for or against overload comes via the presence or absence of its manifestation in behaviour. This manifestation would be as an incurable, deteriorating, specific form of memory disorder, associated with old age and consequent to increased data-inputting and reductions of brain capacity. There is in fact such a disorder, namely Alzheimer's disease and other dementia. This relationship provides elegant explanations for various peculiar findings, without encountering any counter-evidence. The premorbid accumulation of tangles in the hippocampus is explained via an integration of existing hippocampus theories. Long-term low doses of drugs that reduce memory formation could prevent or delay dementia. TV-watching, videos, and some memory-enhancing nootropic drugs could increase risk.

Alzheimer Disease↗

PubMed1987

Effects of dehydroepiandrosterone and its sulfate on brain tissue in culture and on memory in mice.

Low concentrations of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) enhanced neuronal and glial survival and/or differentiation in dissociated cultures of 14-day mouse embryo brain. Posttrial intracisternal injection into the brains of mice undergoing active avoidance training alleviated amnesia and enhanced long-term memory. By minimizing degenerative changes in injured nerve tissue and facilitating plastic changes, DHEA and DHEAS may be of use in treatment of neurodegenerative and memory disorders in man.

Animals↗

PubMed1991

[The concept of amnesia and quantitative assessment of amnesic disorders].

This article presents first a short historical overview of the different viewpoints concerning psychiatric approaches to define the concept "amnesia" (Ribot, Korsakow, K. Schneider, Bleuler, Bonhoeffer et al.). A generally accepted result is the differentiation between retrograde and anterograde amnesia. Research work of the last two decades has focussed on the experimental investigation of anterograde amnesia, the so-called amnesic syndrome. In this context four main factors responsible for memory performance are distinguished: encoding, retrieval, forgetting and interference. One of the main results of neuropsychological research in amnesia consists in having discovered a set of symptoms or features common to most if not all forms of amnesia. These features appear regardless of etiology and locus of lesion. This set or features is described in detail in the paper. On the basis of these amnesic features a clinical test was developed, the Berliner Amnesie Test (BAT). This standardized test can be used for the assessment from mild up to severe memory disorders.

Alzheimer Disease↗

PubMed1996

Late cognitive and behavioural improvement following treatment of disabling orthopaedic complications of a severe closed head injury.

Interactions of physical, emotional, cognitive and behavioural impairments after severe closed head injury (CHI) remain poorly understood. A 47-year-old man was referred to our department 13 months after a severe CHI. He demonstrated severe left hemiplegia and disabling orthopaedic complications (left hip infectious arthritis, after surgical treatment for heterotopic ossification). His hip was blocked and extremely painful. He was totally dependent for daily-life activities (Functional Independence Measure (FIM) score = 18). Moreover he exhibited severe cognitive and behavioural troubles, which had been stable for many months beforehand, e.g. complete disorientation for time and place, major memory disorders, agitation, anxiety, depression, irritability, disinhibition, aggressiveness and lack of initiative. Pain disappeared within a few weeks after treatment. Progressively, functional improvement occurred (sitting position, transfers, walking between parallel bars). The FIM score increased to 63. Aggressiveness, irritability and agitation disappeared. Surprisingly, neuropsychological assessment demonstrated parallel improvement of cognitive functions, especially in regard to orientation, and to a lesser degree attention and memory. Such an observation should encourage use of active treatment of physical disabilities, even in patients presenting with an apparently poor cognitive prognosis at a late stage of severe CHI.

Cognition Disorders↗

PubMed1999

Task decomposition analysis of intertrial free recall performance on the Rey Auditory Verbal Learning Test in normal aging and Alzheimer's disease.

Task decomposition provides supplementary data that complement traditionally computed performance indexes of multi-trial list learning. Both traditional and decomposition approaches can be combined to permit a thorough assessment of multiple aspects of learning and memory in patients with memory impairment. We applied task decomposition to investigate the relative roles of acquisition and consolidation in mediating the multi-trial learning deficit in patients with Alzheimer's disease. This goal was accomplished by decomposing recall performance across the five study-and-test trials of the Rey Auditory Verbal Learning Tests into measures that presumably tap intertrial acquisition and intertrial consolidation. As compared to matched controls, patients diagnosed with mild Alzheimer's disease showed lower gained access across trials, indicating that Alzheimer's disease impairs the ability to produce a stable memory representation of new material in long-term memory. Additionally, patients with Alzheimer's disease manifested higher lost access, which suggests that deficient consolidation leading to rapid intertrial forgetting also contributes to their poor learning. We argue that analytically decomposing learning curves will help both in uncovering the cognitive processes that underlie disease-related learning deficits in persons with memory disorders and can help to characterize potential areas for remediation.

Aged↗