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PubMed2004

Correlation between cognitive capacity screening examination and cognitive evoked potential in alcohol-dependent patients.

The aim of this study was to verify the significance of cognitive evoked potentials and the correlation between the auditory event-related potential and the Cognitive Capacity Screening Examination (CCSE) in alcohol dependent patients. The P300 studies using an auditory paradigm were performed on 25 alcohol dependent patients, and then the results were compared with score of the CCSE. 1) The latencies of the P300 were significantly prolonged in the patient group compared with the control group, and the scores of CCSE were significantly reduced in the patient group compared with the control group (p < 0.05). 2) There were significant negative correlation between P300 latency and scores of the CCSE (p < 0.05, r= -0.774). 3) There were no significant correlation between P300 latency and the total amount of ethanol ingestion (p > 0.05). 4) There was significant reliability in P300 latency study (alpha=0.9771). These findings suggest that the latency of P300 may be useful as a clinical electrodiagnostic measurement that can objectively reflect cognitive dysfunction in alcohol dependent patients, and it can be used as a quantitative analysis of cognitive dysfunction even for early asymptomatic alcohol dependent patients.

Adult↗
PubMedDate not supplied

Absence of nimodipine premedication effect on memory after electroconvulsive therapy.

While highly efficacious for affective disorders, electroconvulsive therapy (ECT) is sometimes accompanied by troublesome although temporary cognitive dysfunction. We speculated that the efficacy of ECT can be separated from its cognitive dysfunction by administration of nimodipine, a calcium channel blocker that crosses the blood-brain barrier and has prevented electroshock-induced amnesia in animal studies. However, in our single-blind repeated-measures trial on 8 patients, nimodipine 30-60 mg orally 2 h prior to ECT was indistinguishable from placebo in effects on verbal learning and retrograde and anterograde memory during the 2 h after ECT.

Adult↗
PubMed2004

'Chemobrain' in breast carcinoma?: a prologue.

BACKGROUND: Chemotherapy-induced cognitive dysfunction in patients with breast carcinoma has been described previously. However, those studies only assessed patients' postchemotherapy cognitive functioning and were not able to determine the relation between cognitive function and other treatments, such as surgery and radiotherapy, that often precede systemic chemotherapy. METHODS: Eighty-four women with breast carcinoma underwent a comprehensive neuropsychologic evaluation before receiving adjuvant therapy for nonmetastatic primary breast carcinoma. RESULTS: Before the start of systemic therapy, 35% of women in the current cohort exhibited cognitive impairment. Verbal learning (18%) and memory function (25%) were impaired significantly more frequently relative to normative expectations. Although the impairments were not significant in the women who were examined, nonverbal memory (17%), psychomotor processing speed and attention (13%), confrontational naming (13%), visuoconstruction (13%), and upper-extremity fine motor dexterity (12%) were impaired more frequently than was expected. Affective distress was related significantly to cognitive impairment (Pearson chi-square = 9.90; P = 0.002). Given the conservative statistical approach employed, extent of surgery, hormone replacement therapy history, and current menopausal status failed to achieve statistical significance, but these variables did exhibit provocative trends with respect to cognitive impairment. CONCLUSIONS: Cognitive impairment frequently is observed before the administration of systemic chemotherapy. Thus, investigations purporting to measure chemotherapy-induced cognitive dysfunction must employ study designs that incorporate prechemotherapy baseline assessments to accurately detect changes in cognitive function that are attributable to chemotherapy.

Adult↗
PubMed1999

Nutritional status, insulin-like growth factor-1 and quality of life in elderly women with hip fractures.

AIM: To evaluate nutritional status and its relation to cognitive and physical function and quality of life in elderly female patients with hip fractures. METHODS: Nutritional status was assessed in 42 women (80+/-7 years old) using the body mass index (BMI), triceps skin fold, arm muscle circumference and serum levels of insulin-like growth factor (IGF-1) and its binding protein (BP) IGFBP-1. Handgrip strength was measured. The Short Portable Mental Status Questionnaire was used to assess cognitive function and the Nottingham Health Profile to asses quality of life. RESULTS: Low BMI (<== 20) and reduced IGF-1 and IGFBP-1 levels were detected in 50% of the patients. BMI correlated with IGF-1 (p<< 0.02) and with hand grip strength (P<< 0.001). Hand grip strength correlated with arm muscle circumference (P<< 0.05). Cognitive dysfunction was detected in 18% of the patients, and a correlation was found between cognitive function and BMI (P<< 0.01). The Nottingham Health Profile assessment indicated a lower quality of life in underweight patients as compared to others (P<< 0.05). CONCLUSIONS: Half of the elderly women with hip fractures displayed signs of protein-energy malnutrition. Underweight was associated with reduced serum levels of IGF-1, muscle fatigue, cognitive dysfunction and a low quality of life rating, i.e. a cluster of factors which may unfavourably influence the postoperative course in a large proportion of hip fracture patients.

Activities of Daily Living↗
PubMed2001

Exposure to anaesthetic agents, cognitive functioning and depressive symptomatology in the elderly.

BACKGROUND: Anaesthesia could provoke persistent alterations in specific cognitive domains in the elderly where ageing-related neuronal changes may exacerbate pharmacotoxic effects. AIMS: To evaluate anaesthesia effects on the incidence of cognitive dysfunction after orthopaedic surgery in elderly patients. METHOD: A total of 140 patients over the age of 64 years completed a full range of computerised cognitive tests. The study takes into account effects of pre-operative cognitive dysfunction, depressive symptomatology and ability to perform activities of daily living. RESULTS: Postoperative cognitive decline persisted for up to 3 months in 56% of subjects. Dysfunction was limited to verbal, visuo-spatial and semantic abilities and secondary and implicit memory. Age, low educational level, pre-operative cognitive impairment or depression are risk factors. CONCLUSIONS: Cognitive functions are not equally affected, type of impairment being determined by the risk factors described above and anaesthesia type.

Activities of Daily Living↗
PubMed2004

Cognitive impairment associated with chemotherapy for cancer: report of a workshop.

Cognitive dysfunction may occur in some patients who receive chemotherapy. We provide a summary of an April 2003 workshop on this topic, that included medical oncologists, radiologists, clinical and experimental psychologists, and patient advocates. Current studies indicate that cognitive deficits are often subtle, although they are observed consistently in a proportion of patients, may be durable, and can be disabling. Deficits have been observed in a range of cognitive functions. Underlying mechanisms are unknown, although preliminary studies suggest there may be genetic predisposition and that cognitive impairment may be accompanied by changes in the brain detectable by neuroimaging. The following priorities were established for future research: (1) large-scale clinical studies that use both a longitudinal design and concurrent evaluation of patients with cancer who do not receive chemotherapy-such studies should address the probability and magnitude of cognitive deficits, factors that predict them, and underlying mechanisms; (2) exploration of discrepancies between subjective reports of cognitive dysfunction and the objective results of cognitive testing; (3) studies of cognitive function in patients receiving treatment for diseases other than breast cancer, and in both men and women, to address the hypothesis that underlying mechanisms relate to changes in serum levels of sex hormones and/or to chemotherapy-induced menopause; (4) development of interventions to alleviate these problems; and (5) development of animal models and the use of imaging techniques to address mechanisms that might cause cognitive impairment associated with chemotherapy.

Antineoplastic Agents↗
PubMed2004

Cognitive executive dysfunction in children with mild sleep-disordered breathing.

In children, moderate or severe sleep-disordered breathing (SDB) may impair cognitive executive functions (EFs), including working memory, attention, and mental flexibility. The main objective of this study was to assess EFs in children with mild levels of SDB. Subjects for this descriptive study were 12 children (5 girls, 7 boys) aged 8.0 to 11.9 years (M = 9.0 +/- 0.85) participating in an ongoing study of the effects of adenotonsillectomy on behavior. Each subject had a nocturnal polysomnogram (PSG) and a multiple sleep latency test (MSLT). Mild SDB was considered present if the child's apnea/hypopnea index (AHI) was > or = 1 and < 10. Between MSLT nap attempts, each child completed standardized tests of EFs. The sample showed significant impairment of sustained attention and vigilance on a computerized continuous performance test. Children with low mental flexibility scores on the Children's Category Test (CCT) spent more time in stage 1 sleep (12.2% v. 9.5%, P = 0.028 on PSG) and showed a marginally higher arousal index (9.7 v. 6.5, P = 0.06 on PSG) than children with average or above-average CCT scores. AHI accounted for a significant proportion of the variance in CCT scores when 1 outlier was removed (N = 11, Rsq = 0.67, P = 0.002). Mild levels of SDB and associated sleep architecture disruptions may be associated with impairment of EFs in children.

Analysis of Variance↗
PubMed2005

[Effects of thyroid hormone on cognitive function in rats with chronic cerebral ischemia].

OBJECTIVE: To study the characteristics of cognitive dysfunction in rats with chronic cerebral ischemia and the effects of thyroid hormone on the rats' cognitive function. METHODS: Thirty-one male SD rats were randomly allocated into normal control group (n=12), operation group (with bilateral carotid artery ligation and examined 5 weeks later, n=6), acute phase treatment group (APT, with bilateral carotid artery ligation and intragastric administration of thyroid hormone at 20 mg once daily for 5 weeks starting from the day of operation, n=7) and chronic phase treatment group (CPT, with the operation and thyroid hormone administration in an identical manner started from the sixth week following the operation, n=6). Morris water maze test was performed at the end of experiment. One-way ANOVA was used to estimate the differences in the learning and memory functions of the rats using SPSS10.0 for Windows. RESULTS: The average latent period of the operation group was significantly prolonged in comparison with that of the other groups (P<0.05) in spatial orientation test. The probe time (time spent in the quadrant where the platform was once situated) of normal control was much shorter than those of the operation, APT and CPT groups in spatial probe test (P<0.05), and the operation group had the poorest score. The average latent period of the operation and CPT was longer than that of the other groups (P<0.05) in working-memory task (P<0.05), and the operation group again had the poorest score. CONCLUSION: Spatial cognitive function is totally damaged in rats with chronic cerebral ischemia, and learning can not induce the formation long-term memory because of short-term memory damage. Thyroid hormone may lessen but can not fully repair the damage of the cognitive dysfunction resulting from chronic cerebral ischemia, and early intervention with thyroid hormone may be beneficial for chronic cerebral ischemia.

Animals↗
PubMed1993

Cognitive distortions and irrational beliefs in post-traumatic stress, anxiety, and depressive disorders.

This study examined the validity of PTSD by comparing the dysfunctional cognitions found in a PTSD group, a clinical group (anxiety or depression), and a nonclinical group. Subjects completed the Millon Clinical Multiaxial Inventory-II, the Impact of Event Scale, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Cognitive Error Questionnaire, and the Survey of Personal Beliefs. Results revealed that PTSD and clinical groups were significantly more depressed and anxious than nonclinical subjects. Unlike the PTSD group, only the clinical group endorsed more dysfunctional cognitions than the nonclinical group, which supports the uniqueness of the PTSD group as differing cognitively from clinical groups.

Adolescent↗
PubMed2002

Cholinergic dysfunction in cognitive impairments after aneurysmal subarachnoid hemorrhage.

OBJECTIVE: Although cognitive impairments have been observed after subarachnoid hemorrhage (SAH), little is known about their neurobiological bases. To examine cholinergic function in such patients, we used a known test for Alzheimer's disease based on an exaggerated pupil dilation response to a cholinergic antagonist, tropicamide (the tropicamide drop test). METHODS: Seventeen patients who were treated surgically after aneurysmal SAH were divided into two groups on the basis of their scores on the Mini-Mental State Examination (MMSE): Group A (MMSE > or =28) and Group B (MMSE < or =27). The mean interval of time between surgery and administration of the MMSE was 4.7 +/- 2.1 years for Group A and 4.2 +/- 1.3 years for Group B. The tropicamide drop test was performed within 1 month after the MMSE for each patient. After measurement of the baseline pupil diameter (R1, right pupil size: L1, left pupil size), one drop of 0.01% tropicamide was applied to the right eye and physiological saline to the left eye. Pupil diameter (R2, right pupil size; L2, left pupil size) was then remeasured. Data were represented as the dilation ratio of the right pupil (R2/R1) and as the relative dilation ratio of the right pupil to that of the left pupil (R2L1/R1L2). RESULTS: The mean dilation ratio of the right pupil (R2/R1) was higher in Group B (1.13 +/- 0.09) than in Group A (1.07 +/- 0.11), although the difference did not reach statistical significance (P = 0.18). The relative dilation ratio (R2L1/R1L2) was significantly higher in Group B (1.41 +/- 0.36) than in Group A (1.06 +/- 0.20) (P < 0.05). CONCLUSION: We determined cholinergic dysfunction in patients with cognitive impairment after SAH on the basis of the pupillary response to tropicamide. The results provide an insight into the pathophysiology of cognitive impairments after SAH, which might lead to future treatment strategies.

Adult↗
PubMed1995

Memory dysfunction and autonomic neuropathy in non-insulin-dependent (type 2) diabetic patients.

Considering the nervous system as a unit, it might be expected that diabetic patients with autonomic neuropathy could have a central abnormality expressed as cognitive dysfunction. To determine whether autonomic neuropathy is independently associated with cognitive dysfunction, we studied a cross-section of 20 non-insulin-dependent diabetic patients with autonomic neuropathy (14 males and six females; age (mean) = 60 + or - 1 years); 29 non-insulin-dependent diabetic patients without autonomic neuropathy (14 males and 15 females; age = 59 + or - 1 years) and 34 non-diabetic patients (10 males and 24 females; age = 58 + or - 1 years), matched by age, education and duration of disease. Cognitive function was evaluated by tests of immediate, recent and remote memory: verbal (digit span; word span) and visual (recognition of towers and famous faces). Diabetic patients with autonomic neuropathy scored (median) lower in visual memory tests than diabetic patients without autonomic neuropathy and controls (towers immediate = 5 versus 7 and 6; towers recent = 4 versus 6 and 6; faces = 16 versus 18 and 18; respectively; Kruskal-Wallis; P < 0.05). There was no difference in verbal memory performance (Kruskal-Wallis; P > 0.05). Entering age, education, duration of disease and fasting plasma glucose in a stepwise multiple regression, the performance in these tests remained associated with autonomic neuropathy (towers immediate, P = 0.0054, partial r2 = 0.166; towers recent, P = 0.0076, partial r2 = 0.163). Scores in visual tests correlated negatively with the number of abnormal cardiovascular tests (faces, r = -0.25; towers recent, r = -0.24; Spearman; P < 0.05). Decreased visual cognitive function in non-insulin-dependent diabetic patients is associated with the presence and degree of autonomic neuropathy.

Adult↗
PubMed2000

Dysfunction of the auditory cortex persists in infants with certain cleft types.

Language and learning disabilities occur in almost half of individuals with oral clefts. The characteristics of these cognitive dysfunctions vary according to the cleft type, and the mechanisms underlying the relation between cleft type, cognitive dysfunction, and cleft-caused middle-ear disease are unknown. This study investigates preattentive auditory discrimination, which plays a significant role in language acquisition and usage, in infants with different cleft types. A mismatch negativity (MMN) component of brain evoked potentials, which indexes preconscious sound discrimination, and brain responses to rare sine-wave tones were recorded in 12 healthy infants and 32 infants with oral clefts at the ages of 0 and 6 months. Infants with clefts were subdivided into two categories: those with cleft lip and palate (CLP) (n=11 at birth, n=6 at the age of 6 months) and those with cleft palate only (CPO) (n=17 at birth, n=8 at the age of 6 months). At both ages, brain responses to rare sounds tended to be smaller in both cleft subgroups than in healthy peers. However, in the latency range of 300 to 500 ms, the MMN was significantly smaller in infants with CPO. In infants with CLP, the MMN was comparable to that of healthy infants. Differences in auditory discrimination between infants with CLP and CPO, as reflected by MMN, were detectable at birth and persisted into later infancy. This pattern parallels known behavioural differences between children with these cleft types. Brain responses to rare sounds, in contrast, had no differentiative power with respect to the cleft type.

Auditory Cortex↗
PubMed1997

Spouse-aided therapy with depressed patients.

Twenty-three non-maritally distressed depressed patients who were married or cohabitating were randomly assigned to either individual behavioral-cognitive therapy or spouse-aided treatment. Both treatment conditions focused on depressed mood, behavioral activity, and dysfunctional cognitions, the difference being that in the spouse-aided treatment the partner was involved in all aspects of treatment, whereas in the individual condition the partner was not involved. MANOVAs revealed that treatment led to statistically significant improvement on depressed mood, behavioral activity, and dysfunctional cognitions. Treatment did not affect relationship variables (marital satisfaction, communication, and expressed emotion) for both spouses. Spouse-aided therapy was as effective as individual cognitive-behavior therapy.

Adolescent↗
PubMed1994

Restoration of hypoglycaemia awareness in patients with long-duration insulin-dependent diabetes.

Hypoglycaemia without warning is a dangerous complication of insulin-dependent diabetes mellitus and it limits the use of intensified insulin therapy to reduce chronic diabetic complications. To investigate the possibility of restoring awareness; symptomatic, cognitive, and hormonal responses to controlled hypoglycaemia were studied in insulin-dependent diabetic patients with long disease duration (6 with good glycaemic control and 6 with poor control) before and after hypoglycaemia avoidance. At the start of the study, all had loss of hypoglycaemia awareness. Responses to the initial challenge were small (pooled area under curve [AUC] adrenaline 5.75 [SE 0.07] nmol/L per 260 min, pooled AUC symptom score 80 [1.3]) and only started when plasma glucose was significantly lower than the 2.8 (0.1) mmol/L at which cognitive function deteriorated. After 4.1 (1.1) months' scrupulous hypoglycaemia avoidance, hormone and symptom responses to the challenge were increased (AUC adrenaline 15.9 [0.1] nmol/L per 260 min, p = 0.01; AUC symptom score 275 [7], p < 0.001), starting at plasma glucose concentrations significantly higher than that causing cognitive dysfunction. Glycosylated haemoglobin did not deteriorate significantly. We conclude that the normal hierarchy of subjective awareness before cognitive dysfunction during hypoglycaemia can be restored by avoiding hypoglycaemia. This is independent of disease duration or initial metabolic control.

Adult↗
PubMed1996

Delirium and right-hemisphere dysfunction in cognitively impaired older persons.

Cognitive impairment has been repeatedly shown to be a delirium risk factor. Much indirect evidence suggests that right-hemisphere dysfunction plays a particularly important role. This retrospective, case-controlled study, from a 148-patient memory loss clinic database, compared neuropsychological measures of hemispheric function in cognitively impaired elderly veterans with and without a history of delirium. Eleven study subjects had a history compatible with DSM-III-R criteria for delirium. Controls selected from the same database had no known history of delirium and were matched for Mini-Mental State Examination scores and Geriatric Depression Scale scores. Compared to the controls, subjects with a history of delirium had significantly lower scores on Object Assembly and Visual Reproduction (p < .05), tests that are predominantly right-hemisphere dependent. There were no significant differences in left-hemisphere measures. It is concluded that right-hemisphere dysfunction may prove to be an important risk factor for delirium.

Aged↗
PubMed2006

Neuropsychological impairment in obsessive-compulsive disorder--improvement over the course of cognitive behavioral treatment.

A large body of studies demonstrates mild cognitive dysfunction in patients with Obsessive Compulsive Disorder (OCD). Few trials have investigated whether this dysfunction can be improved by treatment. Thirty unmedicated inpatients with OCD were administered a comprehensive neuropsychological test battery before and after 12 weeks of cognitive behavioral therapy (CBT). Thirty-nine carefully matched healthy controls were tested twice within the same interval. At baseline, patients exhibited significant impairments on several tests which normalized at follow-up. A significant group x time interaction was found for tests of nonverbal memory, set shifting and flexible, self guided behavior. Major responders improved significantly more than minor responders on the Rey-Osterrieth Figure immediate and delayed recall. Results suggest that cognitive dysfunction in OCD can improve in the course of treatment. We hypothesize that particularly cognitive behavioral treatment enables OCD patients to think and act in a more flexible way that helps them to develop more effective cognitive strategies.

Adult↗
PubMed1988

Behavioral effects of developmental lead exposure in rhesus monkeys.

Postnatal lead exposure has been found to cause long-term learning and memory deficits in monkeys. Pulse-chronic exposure, consisting of acute high-level exposure followed by chronic lower-level exposure, has been particularly effective in causing these impairments. We investigated possible antecedents of lead-induced cognitive dysfunction by evaluating the behavioral effects of pulse-chronic lead exposure in rhesus monkeys during the first 6 months of postnatal life. Blood lead concentrations in the monkeys reached a peak of 55.8 +/- 7.8 ug/dl during week 5 after birth and then averaged between 33.1 and 42.9 ug/dl during the rest of the first 6 months after birth. Zinc protoporphyrin levels were increased by lead exposure, but hematocrits were unaffected. Significant lead-related effects were detected on a visual exploration test and a neonatal behavioral assessment battery. Lead-treated monkeys exhibited decreased looking behavior on the visual exploration test and decreased muscle tonus and increased arousal or agitation on the behavioral assessment battery. No effects were seen on a Piagetian object permanence task and no toxic effects on health or growth were detected. In addition to providing indices of behavioral dysfunction during postnatal lead exposure, performance on these early behavioral tests may predict later lead-induced cognitive dysfunction.

Animals↗