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PubMed1994

Aniracetam. An overview of its pharmacodynamic and pharmacokinetic properties, and a review of its therapeutic potential in senile cognitive disorders.

Aniracetam is a member of the nootropic class of drugs, which have possible cognition enhancing effects. It appears to positively modulate metabotropic glutamate receptors and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-sensitive glutamate receptors, and may facilitate cholinergic transmission, effects which are possibly related to its mechanism of action. Results from trials in elderly patients with mild to moderate cognitive impairment due to senile dementia of the Alzheimer type suggest that aniracetam may be of benefit, with further trials required to confirm its efficacy profile and to define more precisely those patients most likely to respond to treatment. Aniracetam 1500 mg/day was significantly more effective than placebo in all tests at 4 and 6 months, and in a further 6-month trial was more effective than piracetam 2400 mg/day in 8 of 18 tests. Preliminary evidence in the treatment of patients with cognitive impairment of cerebrovascular origin suggests aniracetam may also be of benefit in this condition. Whilst incidence rates of adverse effects are not yet available, data from trials suggest aniracetam is well tolerated. In particular, aniracetam does not appear to cause increases in liver enzyme levels. The evaluation of drugs for patients with senile cognitive disorders is a difficult area and therapeutic options are currently limited. Preliminary evidence of the potential benefits and good tolerability profile of aniracetam support continued evaluation of its use in patients with mild to moderate senile dementia of the Alzheimer type.

Aged↗
PubMedDate not supplied

[The significance of perinatal alcoholization and its withdrawal in the development of late cognitive disorders in rats].

To study the effect of perinatal alcoholization and its withdrawal on cognitive functions of rats, 25% ethanol solution was administered intragastrically: (1) over the whole period of the rat pregnancy in a dose of 5 g/kg/day; (2) from the Ist day of pregnancy to the 7th day after genera in a dose of 5 g/kg/day; (3) from the Ist day of pregnancy to the 2nd day after genera in a dose of 5 g/kg/day; and then in daily decreased doses (by 1g/kg) to the 7th day. A less pronounced increase in the rat mass and disturbances in maternal behavior (eating up the descendants) was observed for all alcoholization regimes. Alcoholization inhibited the eye opening, but did not affect the body mass increase and elementary inborn reflexes of descendants during the first three weeks of life, whereas in adult male descendants alcoholization deteriorated the ability to training and memory on the "open field" model and bilateral avoidance response. The cognitive disorders in descendants were more pronounced after abrupt withdrawal of ethanol directly after the birth and were minimal after gradual withdrawal of alcohol.

Aging↗
PubMedDate not supplied

[Pharmacologic treatment for cognitive disorders: an update].

Today, the memory is regarded as a network of memories which is sustained by distinct interconnected neuronal pathways. These diverse neuronal pathways are differentially impaired during cerebral ageing. Consequently, according to their molecular and cellular targets, cognitive enhancing therapies will be specifically applied to some neurodegenerative diseases or to age-related cognitive disorders. During recent decades, cognition enhancers have been devised in order to facilitate or to serve as substitutes for the effects of deficient neurotransmitters, particularly acetylcholine. These pharmacological approaches have allowed the proposition of acetylcholinesterase inhibitors and muscarinic agents. At present, these targets remain in progress but research is orientated on the discovery of nicotinic agents and acetylcholine releasers. Simultaneously, intense research activity has been undertaken around the other major systems of neurotransmission and/or neuromodulation such as the glutamatergic, monoaminergic and peptidergic pathways. Although research has always given precedence to symptomatic treatments (cognition enhancers) over organic treatments (neuroprotective agents), those are the subject of intensive research activity as they could be capable of counteracting the neuronal death and decrease of synaptic plasticity that occur during neurodegenerative diseases and ageing, respectively.

Animals↗
PubMed2005

Lifelong endocrine fluctuations and related cognitive disorders.

The aim of this review is to examine the relationship between endocrine fluctuation and cognitive functioning. A plethora of in vitro and in vivo studies has demonstrated the neuroprotective role of estrogens and their impact on the neurotransmitter systems implicated in cognition. Recent hormonal replacement therapy (HRT) trials in non-demented post-menopausal women suggest a temporary positive effect (notably on verbal memory), and four recent meta-analyses converge to suggest a possible protective effect in relation to Alzheimer's disease (reducing risk by 29 to 44%). However, data from the only large randomised controlled trial published to date, the Women's Health Initiative Memory Study, did not confirm these observations and have even suggested an increase in dementia risk for women using HRT compared to controls. Several methodological differences between observation studies and controlled trials with regard to patient group, type, timing and duration of HRT, cognitive measures and analyses, are discussed to explain these discrepancies. The association between hormonal serum level and cognitive functioning remains controversial suggesting high inter-individual vulnerability in risk. Moreover, research on the impact of endocrine functioning on cognition during the female reproductive cycle suggests life-long fluctuations in vulnerability. Etiological models taking into account the interaction of clinical, reproductive, and menstrual events throughout life may provide a more valid approach in understanding the effects of steroids on the brain and in determining sub-groups at heightened risk. Cognitive disorders in the elderly are more likely be related to cumulated lifelong exposure to steroids, rather than to a specific exposure to a given steroid. Multifactorial models based on an exhaustive view of all hormonal events throughout reproductive life together with other risk factors (notably genetic risk factors related to estrogen receptor polymorphisms) should be explored to clarify the role of hormonal risk factors, or protective factors for cognitive dysfunction and dementia.

Aging↗
PubMed1986

Schizophrenic patients and their parents. A multimethod design and the findings from an illustrative empirical study of cognitive disorders and communication deviances.

The research design and main findings from a multimethod research project, in which cognitive disorders in schizophrenic patients and communication deviances in their parents were examined, are presented. Non-paranoid schizophrenics manifested cognitive disturbances on a majority of the variables examined, while paranoid schizophrenics did not. Likewise, parents of non-paranoid schizophrenics revealed significantly more communication deviance than parents of paranoid schizophrenics as well as the control groups (normal and "neurotics"). Egocentrism appeared to be a prominent characteristic of the communication of non-paranoid schizophrenics' parents. Conspicuous among the cognitive deficits in their offspring were attentional disturbances. Support for the existence of a link between the parents' communication and the offsprings' cognitive functioning was found by correlation- and regression analyses.

Adult↗
PubMed2002

Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain.

PURPOSE: Analysis of the feasibility and effect of hyperbaric oxygen treatment (HBO) on cognitive functioning in patients with cognitive disorders after irradiation of the brain. PATIENTS AND METHOD: Seven patients with cognitive impairment after brain irradiation, with an interval of at least 1.5 years after treatment, were treated with 30 sessions of HBO in a phase I-II study. A comprehensive neuropsychological test battery was performed before treatment, at 3 and 6 months thereafter. Patients were randomized into an immediate treatment group and a delayed treatment group. The delayed group had a second neuropsychological test at 3 months without treatment in that period and started HBO thereafter. RESULTS: All eligible patients completed the HBO treatment and the extensive neuropsychological testing. One out of seven patients had a meaningful improvement in neuropsychological functioning. At 3 months there was a small, but not significant benefit in neuropsychological performance for the group with HBO compared to the group without HBO treatment. Six out of seven patients eventually showed improvement after HBO in one to nine (median 2.5) of the 31 tests, although without statistical significance. CONCLUSION: HBO treatment was feasible and resulted in a meaningful improvement of cognitive functioning in one out of seven patients. Overall there was a small but not significant improvement.

Adolescent↗
PubMedDate not supplied

[Test computer systems in the diagnosis of cognitive disorders as observed in the syndrome of attention deficiency with hyperactivity in children].

The instrumental methods of evaluation of the cognitive ability of child by means of test computer systems open up real opportunities for the objective and thorough examination of main processes of the cognitive ability. An objective quantitation of the cognitive sphere makes it possible to prognosticate the intellectual development of child and to use such methods not only in the diagnosis and prevention but also in the correction of cognitive disorders.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

[Computed tomographic correlates of the cognitive disorders in Parkinson disease].

There were observed of 88 patients with Parkinson's disease. According to data of computer tomography 3 groups of patients were determined: with external type of cerebral atrophy (CA) mainly, with internal type of CA mainly and combined type too. Neuropsychologic study revealed differences among CA types both in degree of manifestation and in character of alteration of high mental functions. Together with neuropsychologic symptoms of the damages of mediobasal structures which were quite characteristic for this disease, there were also revealed the damages of convex cortical areas of frontal, parietal and temporal lobes. Pathologic inertia, inactivity of remembering and impairment of the processes of generalization were found more frequently at internal type of CA. Meanwhile at external CA type both difficulties of learning and disorders of motor programs' control were observed. The obvious correlations were also established between the degree of cognitive alterations and a presence of CA. Moreover, CA type had certain influence mainly on the structure but not on the manifestation of the cognitive disorders.

Aged↗
PubMed2000

Comorbidity of mild cognitive disorder and depression--a neuropsychological analysis.

Mild cognitive impairment is found in many cases of depression, and it is mostly assumed to improve during the time course of depression remission. Recent data question the reversibility of low cognitive test performance in depression. The aim of this study is to determine the degree of reversibility and the proportion of patients who will not demonstrate reversibility of cognitive dysfunction. Consecutive inpatients suffering from depression (N=102) were investigated and N=82 matched control subjects. N=57 of the patients were diagnosed as major depression according to DSM-IV. A total of N=67 could be retested after remission of depression (N=32 of the patients with major depression) and a matched control group (N=62). Neuropsychological tests were applied in a test session which avoids the effects of fatigue in the patients by the short duration of strenuous tests. For most neuropsychological tests an impaired performance in the depressed patients was found. About one third of the depression subjects performed at an impaired level in tests of averbal memory and verbal fluency (below 5th percentile). In the follow-up investigation, a slight improvement in performance could be assessed for both the depression and the control group, which was, however, attributed to a general test training effect. No normalization of cognitive test performance was found in spite of complete recovery of the affective symptoms. No correlation between the duration of the disease before the index episode or number of episodes and cognitive deficits could be found. The data of the neuropsychological deficits of depressed patients, which are stable in the time course of the affective disorder, may indicate that these patients may suffer from comorbidity of both depression and mild cognitive disorder. The findings are discussed as 1) indicating only a minor impact of the depressed mood on the cognitive performance and 2) they are consistent with a role of brain lesions which have been reported in several studies in a subgroup of depression.

Cognition Disorders↗
PubMedDate not supplied

[Cognitive disorders in patients with chronic renal insufficiency].

The paper presents examination results of patients with chronic renal failure. The aim of the study was to estimate the cognitive disorder profile in patients with renal failure before and after the introduction of hemodialysis. The sample consisted of 10 patients with terminal renal failure, 20 patients admitted to chronic hemodialysis programme and 20 healthy volunteers. General intellectual performance, attention, perception, memory and speech were evaluated by standard neuropsychological tests. Results have shown that patients with terminal renal failure have pronounced impairment of all mentioned functions. Some of those functions have been significantly improved after introduction of hemodialysis (visual-spatial abilities, verbal learning, temporal and spatial orientation and speech understanding). Partial recovery was reflected in domain of general intellectual performance, writing and mental manipulation, whereas pronunciation and attention maintenance disorders remained.

Adult↗
PubMed2004

ABT-089: pharmacological properties of a neuronal nicotinic acetylcholine receptor agonist for the potential treatment of cognitive disorders.

ABT-089 [2-methyl-3-(2-(S)-pyrrolidinylmethoxy)pyridine dihydrochloride salt] is a selective neuronal nicotinic receptor (NNR) modulator with cognitive enhancing properties in animal models of cognitive functioning. Amongst NNR subtypes, ABT-089 shows selectivity for the cytisine binding site on the alpha4beta2 receptor subtype as compared to the alpha-bungarotoxin (alpha-BgT) binding sites on the alpha7 and alpha1beta1deltagamma receptor subtypes. In functional in vitro electrophysiological and cation flux assays, ABT-089 displays differential activity including agonism, partial agonism and antagonism depending upon the NNR subtype and assay. ABT-089 is as potent and efficacious as (-)-nicotine at evoking acetylcholine (ACh) release from hippocampal synaptosomes. Furthermore, ABT-089 is neuroprotective against excitotoxic glutamate insults, with even greater potency seen after chronic treatment. Similarly, ABT-089 is effective in models of cognitive functioning, including enhancement of baseline functioning as well as improvement of impaired cognitive functioning seen following septal lesioning and natural aging. In neuroprotective assays the compound is most potent by chronic administration. In stark contrast to the positive effects in the cognitive models, ABT-089 shows little propensity to induce adverse effects such as ataxia, hypothermia, seizures, cardiovascular or gastrointestinal side effects. Together these data suggest that ABT-089 is a NNR modulator with the potential for treating cognitive disorders with markedly limited adverse cardiovascular and gastrointestinal side effects.

Animals↗
PubMed2005

[Acute and chronic cognitive disorders caused by cannabis use].

Cannabis is currently the most commonly used illegal psychoactive substance amongst young people aged between 15 and 24, and it seems that 5% of this age group is addicted to it. Many research teams focused particularly on the cognitive disorders caused by cannabis use. Amongst the cognitive functions considered, memory-related, attention-related, psychomotor and motivation-related functions were proved deteriorated by acute and chronic cannabis use; a very important point, especially among teenagers, as possible alteration at the social and academic level could be the outcome. However studies on long-term and persistent cognitive effects haven't provided convergent conclusions. Methodological differences could partly affect these observations. Therefore it seems necessary to develop studies with larger samples.

Adolescent↗