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PubMedDate not supplied

Longitudinal progression of subclinical structural brain disease in normal aging.

OBJECTIVE: The authors describe four types of brain structural change in "normal aging:" cortical atrophy, central atrophy, deep white-matter hyperintensities (DWMH), and periventricular hyperintensities (PVH). Cross-sectional investigations have reported that greater volumes of these forms of "subclinical structural brain disease" (SSBD) were found with increasing age. Greater volumes were also associated with poorer cognition, even though subjects performed within the normal range. The natural history of these forms of SSBD and their functional impact are not well established. METHODS: Twenty-nine normal subjects, ages 60-89, were examined longitudinally by volumetric magnetic resonance imagery, with two assessments performed at least 2 years apart; 26 also completed neuropsychological testing to evaluate processing speed, executive functions, language, and other cognitive functions. Associations between structure and function were evaluated with regression models. RESULTS: For most subjects, the volumes for signs of all types of SSBD were found to have increased; for many subjects, increases were small, and a few showed no change or small decreases. PVH and DWMH increases were predicted by baseline cerebrovascular risk factors. Cognitive test performance changed little over time for these normal subjects. CONCLUSIONS: SSBD volumes increased for most subjects over time, with small average increases for most types. Pretreatment cerebrovascular risk factors were associated with greater increases of PVH and DWMH, suggesting that progression of these types of SSBD may be amenable to intervention.

Aged↗

PubMedDate not supplied

['5 digit test': a multilinguistic non-reading alternative to the Stroop test].

INTRODUCTION: The use of digits in groups that may or may not correspond to their arithmetic values (for instance: five twos, that can be easily read as 'two', but must be counted as a 'five') allows us to measure at the same time the 'processing speed' of the subjects and their ability to 'direct' and 'switch' their attentional control. AIMS: The use of this new 'five digit test' (5DT) as a multilingual non-reading alternative to the Stroop test presents a series of advantages: it minimizes the effects of education and social class, allows the testing of much younger students, and allows the testing of some severe clinical cases, who may not be able to read words or name colors. SUBJECTS AND METHODS: Using groups of 20 adults at different age levels (55-64, 65-74, 75+) and groups of 20 and 20 subjects with cerebral-vascular episodes (anterior and posterior) we can estimate the usefulness of this instrument in concrete nosological populations. RESULTS: We find a slowing of production and reorientation times with aging; and a dramatic influence of neurological dysfunctions. CONCLUSIONS: The tests allows a valid exploration of the Stroop effect in prereading and non-reading subjects, even in other languages.

Aged↗

PubMed2004

Dementia screening in light of the diversity of the condition.

Dementia is a general term, not a specific diagnosis. There are many different causes of dementia, and the different etiologies are associated with different neuropsychological profiles. This complicates the problem of dementia screening. Detection of dementing conditions at the earliest possible stage requires batteries of tests, rather than a single test. The cognitive domains that must be addressed include the following: visual and verbal memory, sustained attention and complex attention, working memory, processing speed, reaction time, psychomotor speed and executive function.

Cognition↗

PubMed2005

New ED will feature wired private patient rooms.

Some innovations in your ED may be worth doing, even if you can't guarantee a return on investment. High-tech amenities for patients can be expected to boost satisfaction and increase market share. Recognize that patients may need to take care of real-world responsibilities while in the ED. Accessing test results electronically at the bedside speeds processes and enhances physician-patient relationship.

Emergency Service, Hospital↗

PubMedDate not supplied

[Cognitive impairment in multiple sclerosis].

In this article we present a review of problems associated with cognitive dysfunctions in multiple sclerosis (MS). Neuropsychological investigations demonstrated that cognitive dysfunctions are common in MS patients and affect 40-65% of them. Cognitive deficits were found mainly on measures of memory, attention, information-processing speed, executive functions and abstract reasoning. The differences and degree of cognitive dysfunctions in MS are highlighted and usually related to different clinical appearance (clinical course, duration, disability level, treatment type). Furthermore, we have reviewed published correlations between psychopathological dysfunctions and neuroimaging results (mainly MRI techniques and functional imaging). The results of these correlations showed that an important role in cognitive impairment is related to the total lesion area, the severity of the pathological damage of the normal-appearing brain tissue (NABT), and brain atrophy.

Atrophy↗

PubMed1992

Neurobehavioral recovery.

This review discusses recent programs in early and late neurobehavioral recovery from closed head injury (CHI). The research on early recovery has encompassed the relationship of localized brain lesions to the duration of impaired consciousness and features of posttraumatic amnesia. Of the research on late neurobehavioral outcome of CHI, studies emanating from the Traumatic Coma Data Bank are reviewed in detail, including analysis of acute neurologic indices in relation to recovery of memory, information processing speed, and other cognitive measures. Recent studies concerning the neurobehavioral outcome of CHI in children are discussed as are investigations of behavioral disturbance, psychosocial outcome, and family variables. The review concludes with an assessment of recent studies concerning the efficacy of rehabilitation directed toward the cognitive sequelae of CHI and preliminary trials to evaluate the potential use of psychoactive drugs in the postacute management of head injured patients.

Amnesia↗

PubMed2005

Discrepancies between the California Verbal Learning Test: Children's Version and the Children's Category Test after pediatric traumatic brain injury.

One hundred 9-16-year-old children with traumatic brain injury (TBI) completed the California Verbal Learning Test-Children's Version (CVLT-C) and the Children's Category Test (CCT) within 1 year after injury. Performance contrasts between these two instruments that were unusually large (> 16 T score points) were about as common in this clinical sample as in the standardization sample of both instruments. However, relatively poor performance on the CVLT-C as compared to the CCT was associated with prolonged coma and lower scores on the Processing Speed index of the Wechsler Intelligence Scale for Children-Third Edition. It is concluded that a relative weakness on the CVLT-C is more likely to reflect cerebral compromise after pediatric TBI than is a relative weakness on the CCT.

Adolescent↗

PubMed2005

Action (verb) fluency: test-retest reliability, normative standards, and construct validity.

Action (verb) fluency is a newly developed verbal fluency task that requires the examinee to rapidly generate as many verbs (i.e., "things that people do") as possible within 1 min. Existing literature indicates that action fluency may be more sensitive to frontal-basal ganglia loop pathophysiology than traditional noun fluency tasks (e.g., animal fluency), which is consistent with the hypothesized neural dissociation between noun and verb retrieval. In the current study, a series of analyses were undertaken to examine the psychometric properties of action fluency in a sample of 174 younger healthy participants. The first set of analyses describes the development of demographically adjusted normative data for action fluency. Next, a group of hypothesis-driven correlational analyses reveals significant associations between action fluency and putative tests of executive functions, verbal working memory, verbal fluency, and information processing speed, but not between action fluency and tests of learning or constructional praxis. The final set of analyses demonstrates the test-retest stability of the action fluency test and provides standards for determining statistically reliable changes in performance. In sum, this study enhances the potential clinical applicability of action fluency by providing demographically adjusted normative data and demonstrating evidence for its reliability and construct validity.

Adolescent↗

PubMed2005

Executive function as a predictor of inattentive behavior after traumatic brain injury.

Emerging evidence from recent studies using laboratory and naturalistic attention tasks suggests that individuals with traumatic brain injury (TBI) may have a deficit mainly in strategic control of attention. In the present study, we tested the hypothesis that inattentive behavior after TBI could be predicted by performance on psychometric measures of executive function. A group of 37 individuals with moderate to severe TBI were assessed with previously validated naturalistic measures of attention. A battery of neuropsychological tests was also administered to assess various aspects of executive function. Seven measures of executive function and 10 variables reflecting inattentive behavior were combined to form 1 executive and 3 inattentive behavior (IB) composite scores. Three predictors (executive composite, current disability scores, and age) were associated, at the univariate level, with one of the IB composites reflecting frequency and duration of off-task episodes. A stepwise multiple regression procedure indicated that the executive composite was the only significant predictor of the IB composite. Additional post-hoc regression analyses suggested that the relationship was not likely to be mediated by processing speed. The current study supports the hypothesis that executive function, measured by commonly used neuropsychological tests, significantly predicts certain aspects of inattentive behavior in real-world tasks after TBI.

Adolescent↗

PubMed2004

Diagnosis and treatment of temporal lobe epilepsy.

Of the 1,200,000 Americans with partial epilepsy, temporal lobe epilepsy (TLE) occurs in more than 400,000. Temporal lobe seizures are usually stereotypic in their symptoms and duration. A typical sequence is an aura followed by arrest of motor behavior, blank stare, and automatisms. Patients with TLE often show impairments in attention, memory, mental processing speed, executive functions, mood, personality, and drive-related behaviors. Interictal depression occurs in approximately one third of TLE patients. TLE is diagnosed by a history of characteristic partial seizure symptoms. The diagnosis is confirmed by the capture of a typical episode during an electroencephalogram (EEG) or video-EEG, with epileptiform activity over one or both temporal regions. Video-EEG monitoring has revolutionized diagnosis and should be considered in patients in whom diagnosis is uncertain. TLE is treated with medications, resective surgery, and vagus nerve stimulation. Epilepsy surgery should be considered in all patients with refractory partial epilepsy.

Epilepsy, Temporal Lobe↗

PubMed2006

Effects of disorganization on choice reaction time and visual orientation in untreated schizophrenics.

Several preattentive mechanisms have proved to be sensitive markers of clinical change in schizophrenia. Two related studies of visuospatial orientation used cued target detection combined with choice reaction time, short/long preparation, with or without a signal/target interval ("gap"/ "no-gap," to detect attentional disengagement difficulty in schizophrenia). End points were reaction times, alertness scores, attentional cost/benefit, and validity scores. Study 1, in 13 schizophrenics receiving second-generation antipsychotics and 13 controls, found the same impairment of disengagement as with neuroleptics, but intact reaction times and processing speed, with no hemispheric asymmetry. Study 2, in 12 untreated acute schizophrenics and 12 controls, showed slower reaction times, near-zero alertness in the fixation release condition, and impaired valid/invalid discrimination versus Syndrome Scale disorganization subscore (r = -0.81; P < 0.01). Early deficits in the preattentive orientation and visual. Early deficits in the preattentive orientation and visual detection phases are useful for assessing response to psychotropic treatment and establishing clinical correlates in acute schizophrenia.

Adult↗

PubMed2006

Emotional and pain-related factors in neuropsychological assessment following mild traumatic brain injury.

A critical issue in the field of clinical neuropsychology is the idea that emotional or pain-related factors may compromise the validity of neuropsychological assessment. In this study, 53 individuals suffering from mild traumatic brain injury related to motor vehicle accident injury completed commonly used measures of emotional and pain-related functioning. A battery of commonly used neuropsychological tests, assessing attention, learning and memory, language, visuospatial and visuomotor functions, speeded processing, fine-motor skill, and symptom validity, was administered concurrently. Findings revealed a significant and negative correlation between anxiety and impaired delayed verbal memory, suggesting that as anxiety increased, delayed verbal memory decreased. The results otherwise provided little support for the idea that emotional or pain-related factors are detrimental to neuropsychological test performance following mild traumatic brain injury.

Accidents, Traffic↗

PubMed2006

A rehabilitative program for central executive deficits after traumatic brain injury.

Deficits affecting Central Executive System (CES) of working memory (WM) are the main neuropsychological outcome after traumatic brain injury (TBI) and can also explain deficits in other domains, like divided attention, executive functions and long-term memory. For this reason we developed a rehabilitative program based on CES functions and we expected to find an improvement in WM as well as in those cognitive functions controlled by the CES. The experimental group was composed by 9 TBIs, selected for WM deficits, whereas the control group was composed by 6 TBIs, without WM deficits, but with speed processing deficits. All patients performed a cognitive training, based on PASAT (Gronwall & Wrightson, 1981)and two new versions of this task. The results showed in the experimental group an improvement in WM and in the cognitive functions controlled by the CES, whereas control patients did not show any improvement after the cognitive training.

Attention↗

PubMedDate not supplied

The Symbol Digit Modalities Test - Oral version: Italian normative data.

In neuropsychological practice, the availability of effective and reliable tests is crucial. The Symbol Digit Modalities Test (SDMT) is widely used because it is easy to administer, reliable and also evaluates information processing speed. We set out to obtain normative data (currently unavailable for the Italian population) for the oral version of this test. Both age and education influenced performance on the SDMT; therefore, correction scores were obtained on the basis of these factors. The cut-off for normality was 34.2. The availability of Italian normative data for the SDMT will allow wider application of this test in clinical practice.

Adult↗

PubMed1991

[The dental profession in The Netherlands before 1865].

The dental profession before 1865 has been described with the help of sources from the 19th century, in combination with prosopographical research. During this period, dentists had no exclusive rights in dentistry: other surgical professions were also involved both with its theory and practice. Their specialised colleagues comprised a group of 137 dentists, largely related to a few Jewish families. This characteristic, underlined by their intensive migration and training within the family, had been responsible for the divergent position of the dentists in Dutch medical legislature of the 19th century. While in the medical profession the organisation and structure (1865) was the first te be revised, followed by a reorganisation of education (1876); in dentistry the recruitment and education had to be reformed (1865-1876) before the building up of a new professional structure. This process speeded up by the rapid mortification of the ancient group of dentists.

History of Dentistry↗

PubMed1990

[Psychophysical prerequisites and mental performance of school children].

By extensive investigations and statistical calculations it is possible to establish the psychophysical prerequisites for performance, which consist of "mental processing speed" and "vegetative reactivity". These can be developed by training and thus contribute to improved mental performance.

Achievement↗

PubMed1989

Central nervous system effects of antihistamines on evoked potentials.

Sedation is the most common side effect of antihistamine therapy. As with many behavioral constructs, attempts at quantification are difficult, and consequently, subjective reports of antihistamine sedation are frequently relied upon. Evoked potential activity is one method to quantitate the brain's response to subtle cognitive change. Evoked potentials are characteristic shifts in the brain's electrical activity that are obtained by time-locking the ongoing EEG to a stimulus over repeated trials. A late positive component of the evoked potential (P3) has been related to various psychologic properties including expectation, selective attention, and information processing speed. Because of this relationship, we employed the latency of the P3 evoked potential to measure the cognitive effects of chlorpheniramine and terfenadine. In healthy young subjects, we observed that terfenadine produces significantly less cognitive slowing of the P3 potential than chlorpheniramine. This finding supports the subjective findings of reduced sedative side effects of terfenadine.

Adult↗

PubMed1989

[Design and application of laser-disk for clinical pulmonary data base system using the personal computer].

A database system is described for managing the information on pulmonary function test (PFT) measured by three different PFT devices. The data is transmitted into a personal computer, FM-11AD2+ (FUJITSU CO., LTD.) with a 20 MB hard disk and a 800 MB laser disk. Multitasking OS, OS-9/6809, is used to operate the software. PFT data of about 15,000 cases may be stored, which can be easily retrieved for research and discussions on a case study. Despite the present limitation of the processing speed and the capacity of the hard disk, this system is useful because it allows to provide reports readily.

Database Management Systems↗