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PubMedDate not supplied

Cognitive functioning, weight change and therapy in anorexia nervosa.

Anorexia nervosa is associated with impairments in cognitive function which have been hypothesized to be fundamentally attentional in nature. The current study investigated whether therapy and weight gain affect these impairments. A group of anorexics (N = 12) completed a battery of cognitive performance tasks and self-report measures of psychopathology on three occasions, over the course of 12 weeks of in-patient treatment. A non-clinical control population (N = 17) completed the same measures. The anorexics improved on all measures of psychopathology and affective state as a result of therapy. Anorexics displayed poorer recall, reaction times, and motor speed than the control subjects. Although there was a gain in weight over the course of therapy, there was no corresponding improvement in cognitive performance. Impaired task performance in anorexics was not directly related to their psychopathology or affective state.

Adolescent↗

PubMed2004

Cognitive functioning predicts outpatient service utilization in schizophrenia.

Aim of the study was to evaluate the cognitive and symptom predictors of outpatient service utilization in schizophrenia. The relationships between cognitive functioning (verbal learning and memory, executive functions), symptoms (positive symptoms, negative symptoms), and outpatient service utilization (case management, medication monitoring), were examined in 20 patients receiving outpatient services at a psychosocial clubhouse over a 12-month period. Executive functions, as measured on the Wisconsin Card Sorting Test (WCST), were the only significant predictor of outpatient service utilization, accounting for over 20% of the variance in total outpatient services used, with greater impairment associated with higher service utilization. Specifically, poorer performance on the WCST was associated with delivery of more case management services, but not medication management services. More case management services may be required to compensate for impairments in executive functioning in patients with schizophrenia.

Adult↗

PubMed2001

Cognitive functions of young adults who survived childhood cancer.

Neuropsychological tests were used to determine the cognitive functioning of adult long-term survivors treatedfor childhood cancer Disease onset before the age of 5 was related to lower test scores in intelligence tests, several memory tests, and motor function tests. The cranial irradiated survivors displayed more difficulties, especially in short-term memory tests and the Wechsler Adult Intelligence Scale Digit Symbol Test as compared to nonradiated survivors. No statistically significant differences in test scores were observed between different forms of cancer The results of this study are consistent with the notion that those memory types that demand special attention and motor speed functions are especially vulnerable to cancer and its treatment.

Adolescent↗

PubMed1976

The effect of premenstrual anxiety and depression on cognitive function.

The Depression Adjective Check List, State-Trait Anxiety Inventory, and a battery of factor analytically derived cognitive tests sensitive to anxiety or depression were administered to 50 women between the ages of 30 and 45 during the 4 days prior to the onset of menstruation and again 2 weeks later. Testing sessions were scheduled on the basis of a previously completed Menstrual Distress Questionnaire. There were significant increases in anxiety and depression during the premenstruum. However, no statistically significant differences were found in cognitive test performance, and correlation data failed to support any consistent relationship between premenstrual mood and cognitive function. Moreover, no significant correlations were found between premenstrual complaints on the Menstrual Distress Questionnaire and either cognitive test performance or mood scores obtained during the premenstrual testing sessions. It was concluded that the magnitude of the premenstrual mood change was not great enough to affect intellectual function. Alternative explanations of the absence of decrements in performance are discussed.

Adult↗

PubMedDate not supplied

Triglyceride levels affect cognitive function in noninsulin-dependent diabetics.

Noninsulin-dependent diabetes mellitus (NIDDM) is associated with decrements in several cognitive functions. Among the variables that apparently contribute to the decline in cognitive performance is poor glucose control, as measured by hemoglobin A1c. Elevated levels of triglycerides in diabetics may also contribute to this cognitive decline through the increased incidence of atherosclerosis in these patients. The authors examined the relationship between triglycerides and cognitive performance in 246 NIDDM outpatients, aged 55-74 years. The relationship between triglyceride levels and performance on three cognitive tasks and on a test of reaction time was measured. Elevated levels of triglycerides were associated with significant decrements in performance on the digit symbol substitution test, digit span (backward) test, and on a reaction time measure. High levels of triglycerides, independent of chronic glucose control, appear to contribute to the decreased ability to perform short-term memory tasks in NIDDM.

Blood Glucose↗

PubMed2004

Perceived cognitive function is a major determinant of health related quality of life in a non-selected population of patients with coronary artery disease--a principal components analysis.

OBJECTIVE: To assess health related quality of life (HRQL) and explore its underlying structure in a non-selected population of patients with coronary artery disease (CAD). DESIGN, SETTING AND SUBJECTS: HRQL was estimated by the disease specific Cardiac Health Profile (CHP) questionnaire and the EuroQol-VAS (EQ) in 253 consecutive unselected CAD patients in Södertälje, Stockholm County, Sweden. Explorative factor analysis was used to identify independent dimensions of HRQL. Current angina was ranked according to Canadian Cardiovascular Society Classification (CCS). RESULTS: Four independent principal factors representing perceived cognitive, physical, social and emotional functions underlying the patients' HRQL were found. Identical factors were recognized with an alternate technique. The major factor--explaining 43 % of HRQL--was perceived cognitive function reflecting ability to concentrate, activity drive, memory and problem solving. Cognitive function correlated to EQ but not to CCS. Perceived physical function/general health explained 9% of HRQL and was as expected related both to EQ and CCS. Total CHP scores differed significantly to those of healthy controls. CONCLUSIONS: Perceived cognitive function seems to be a major determinant of HRQL in CAD patients. This, in addition to earlier reports of possible prognostic information of reduced cognitive function, would prompt us to propose that HRQL assessments should include questions aimed to assess cognitive function.

Aged↗

PubMed1991

Changes in cognitive functioning associated with normal aging.

The present study explores age-related changes in cognitive functioning in a cohort of 122 healthy elderly volunteer subjects over a 3-year period. The sample was partitioned into four age groups: 57-65, 66-70, 71-75, 76-85 years. The results suggested high stability of factor structure over three testing probes, as well as selective attrition effect with significantly lower performance in those subjects, who dropped out from the study on the tests of verbal memory and mental speed. The results of repeated measures MANOVA on raw scores and univariate ANOVAs on factor scores comparing four age groups at each testing probe revealed a differential pattern of changes in verbal and nonverbal perception/memory versus mental speed/mental flexibility. Implications of these findings in clinical diagnostics were considered.

Journal Article↗

PubMed1991

Selegiline and cognitive function in Parkinson's disease.

Eighteen patients with Parkinson's disease were treated with placebo for 4 weeks and with the MAO-B inhibitor selegiline for 8 weeks without levodopa in a randomized double-blind clinical study. The maximum dose of selegiline was 30 mg/day and the patients' cognitive functions were evaluated before treatment and at week 12 when they were either on 30 mg selegiline or placebo. A series of neuropsychological tests were used to study general cognitive reasoning, memory, visuospatial abilities, attention, cognitive flexibility, motor functions and depression. Specific cognitive effects were not observed. Slight improvement occurred mainly in learning (easy word associations) which may reflect a limited, nonspecific arousal effect.

Adult↗

PubMed2005

Cognitive functioning in patients with schizophrenia and bipolar disorder: a quantitative review.

OBJECTIVE: Evidence suggests that cognitive functioning in bipolar disorder may be impaired even in euthymic states, but it is unclear if the pattern of deficits is similar to the deficits found in schizophrenia. The aim of this study was to review quantitatively the studies on cognitive performance in schizophrenia and bipolar disorder. METHODS: Articles for consideration were identified through a literature search in MEDLINE and PsycLIT in the period between 1985 and October 2004, using the keywords "schizophrenia" combined with "bipolar disorder", or "manic-depress*" or "manic" combined with "cogniti*" or "neuropsycholog*". Thirty-one studies were included that: i) evaluated cognitive performance using standardized and reliable neuropsychological testing procedures; ii) compared adult patients with schizophrenia and with bipolar disorder; iii) reported test scores of both patient groups, or exact p-values, t-values, or F-values; and iv) were published as an original article in a peer-reviewed English language journal. RESULTS: Meta-analyses of all studies indicated that patients with bipolar disorder generally perform better than patients with schizophrenia, but the distribution of effect sizes showed substantial heterogeneity. Results based on a more homogeneous subset of studies that matched patient groups on clinical and demographic characteristics pointed in the same direction, with effect sizes in the moderate range. CONCLUSIONS: Patients with bipolar disorder show better cognitive performance than patients with schizophrenia, even when matched for clinical and demographic characteristics.

Bipolar Disorder↗

PubMed2005

Stress-induced blood pressure reactivity and cognitive function.

OBJECTIVE: To examine the relation of stress-induced blood pressure (BP) reactivity to cognitive function. METHODS: Ninety-four healthy stroke- and dementia-free middle-aged and older adults (ages 54 to 79; 62% male; 90% white) completed biomedical, psychophysiological, and neuropsychological assessment procedures. RESULTS: After statistical adjustment for age, education, state anxiety, fasting glucose levels, and resting systolic or diastolic BP (depending on the model), greater systolic BP reactivity was associated with decreased performance on Logical Memory-Immediate Recall (r2 = 0.08; p < 0.007), Logical Memory-Delayed Recall (r2 = 0.06; p < 0.02), and Stroop interference scores (r2 = 0.04; p < 0.05). Enhanced diastolic BP reactivity was similarly associated with decreased performance on Logical Memory-Immediate Recall (r2 = 0.06; p < 0.02) and Stroop interference scores (r2 = 0.06; p < 0.02). CONCLUSIONS: Independent of resting clinic blood pressure (BP), systolic and diastolic BP reactivity was associated with diminished performance on tests of immediate and delayed verbal memory and executive function (i.e., response inhibition), accounting for 3 to 8% of the variance in these measures.

Age Factors↗

PubMed1998

Complex partial and secondarily generalized seizure patients: cognitive functioning prior to treatment with antiepileptic medication. VA Epilepsy Cooperative Study 264 Group.

This investigation of cognitive functioning in patients with symptomatic localization-related (partial) epilepsy prior to administration of antiepileptic medication is part of a nationwide prospective, double-blind study of drug efficacy and longitudinal changes in cognition associated with seizure disorders. Recently-diagnosed patients with complex partial or secondarily generalized tonic clonic seizures, equated for age, education and IQ, were compared with normal controls on a battery of neuropsychological tests: verbal and figural memory measures (Rey auditory verbal learning test, Rey Osterrieth complex figure), and a brief behavioral toxicity battery comprising measures of motor function, concentration and mental flexibility (Lafayette grooved pegboard, controlled word association test, Stroop, paced auditory serial addition test [PASAT]). Control subjects perform significantly better than both groups of seizure patients on several measures of motor speed/integration and memory, specifically the pegboard and the RAVLT learning (3-5) and recall trials. Secondarily generalized seizure patients show greatest impairment. They perform significantly worse than patients with complex partial seizures and control subjects on the controlled word association test and the most demanding Stroop color word trial, both measures of concentration and mental flexibility. These findings document deficits in memory as well as concentration and motor function in complex partial and in secondarily generalized seizure patients prior to treatment with antiepileptic medication.

Adult↗

PubMed2004

The early effects of radiotherapy on intellectual and cognitive functioning in patients with frontal brain tumours: the use of a new neuropsychological methodology.

Investigations of the effects of radiation on neuropsychological functions have revealed variable outcomes, ranging from no effect to severe cognitive impairment. However, many of the previous studies have relied on retrospective data or have been limited by methodological problems. In this study, prospective neuropsychological assessments were compared at baseline (after surgery and before radiotherapy) and within 4 months of completion of radiotherapy (except one case), to examine early-delayed effects of radiation on intellectual and cognitive functioning. Sixteen adult patients with either low- or high-grade brain tumours, 15 of whom were treated with radiotherapy, were compared with 8 control participants with nonmalignant brain tumours whom did not undergo radiotherapy. All participants had lesions situated mainly in the frontal lobes. All groups of patients had evidence of intellectual and cognitive impairment at baseline. The low- and high-grade brain tumour groups showed a differential pattern of performance following radiotherapy, with the low-grade tumour group's performance being more competent on all of the five main neuropsychological measures. Their pattern of improvement was very similar to that of the nonmalignant brain tumour group who had not undergone radiotherapy. The present study provides some preliminary information about the neuropsychological deficits associated with primary brain tumours, their severity, and the relationship between neuropsychological functioning and brain tumours and radiotherapy.

Adolescent↗

PubMed2003

Cognitive function in schizophrenia. Deficits, functional consequences, and future treatment.

This article has discussed the relationship between cognitive deficits and functional outcome in schizophrenia. This relationship was noted first by Kraepelin and Bleuler at the beginning of the twentieth century. With the introduction of conventional neuroleptics, the focus shifted toward the treatment of positive symptoms. In the past few decades, cognitive dysfunction has been recognized as a fundamental feature of schizophrenia and has been shown repeatedly to have a negative association with functional outcome [6]. Improvement in cognitive functioning became one of the most important clinical targets in the treatment of schizophrenia in the 1990s [82]. Main domains of cognition that are disrupted significantly in schizophrenia include attention, executive function, verbal and visuospatial working memory, and learning and memory. Although conventional antipsychotics are effective in treating positive symptoms, they lack the ability to improve cognitive impairment and produce poor functional outcome. Previous research has shown superior efficacy of atypical antipsychotics on cognitive impairments in schizophrenia compared with conventional antipsychotics. Because the heterogeneity of atypical antipsychotics in their pharmacologic properties, they have differential profiles of cognitive efficacy in patients with schizophrenia. Establishing the cognitive profile of each atypical antipsychotic is an important task. This knowledge can be used to address individual cognitive problems and needs. Because cognitive deficits have been shown to have associations with different aspects of clinical symptoms, limited learning in rehabilitation programs, and functional outcome in schizophrenia, targeting individual cognitive deficits would lead to greater treatment success in terms of clinical and functional outcome. Although atypical antipsychotics have some benefit on cognitive function, further efforts to improve cognitive function are required. Attempts at improving cognition in schizophrenia with specific cognitive enhancers pharmacologically and psychological therapies such as cognitive remediation might lead to better functional outcome in patients with schizophrenia.

Antipsychotic Agents↗

PubMed2005

A pilot study of functional Cognitive Behavioral Therapy (fCBT) for schizophrenia.

BACKGROUND: The feasibility and preliminary efficacy of a novel cognitive behavioral treatment for decreasing psychotic symptoms and improving social functioning was evaluated in a pilot study. This represents the first treatment outcome study of CBT for psychosis with a manualized, active comparison condition. METHODS: Thirty outpatients with schizophrenia or schizoaffective disorder, depressed type with residual psychotic symptoms were randomly assigned to either 16 weekly sessions of functional cognitive behavioral therapy (fCBT) or psychoeducation (PE) with assessments conducted at baseline and post-treatment by blind evaluators. RESULTS: Attrition was only 7% and did not differ between fCBT and PE, indicating good tolerability of both treatments. For this sample with persistent symptoms, between groups effects were not significantly different, but within group effect sizes indicated greater treatment benefit for fCBT on positive symptoms, particularly for the PSYRATS voices subscale. CONCLUSION: The results suggest that fCBT is well tolerated and holds promise for reducing persistent positive symptoms.

Adolescent↗

PubMed2006

Change in cognitive function after chemotherapy: a prospective longitudinal study in breast cancer patients.

Some breast cancer survivors experience cognitive decline following chemotherapy. We prospectively examined changes in cognitive performance among high-risk breast cancer patients who had received high-dose chemotherapy with cyclophosphamide, thiotepa, and carboplatin (CTC group; n = 28) or standard-dose chemotherapy with 5-fluorouracil, epirubicin, and cyclophosphamide (FEC group; n = 39); stage-I breast cancer patients who had received no systemic chemotherapy (no-CT group; n = 57); and healthy control subjects (n = 60). All patients underwent neuropsychologic testing before and 6 months after treatment (12-month interval); control subjects underwent repeated testing over a 6-month interval. No differences in cognitive functioning between the four groups were observed at the first assessment. More of the CTC group than the control subjects experienced a deterioration in cognitive performance over time (25% versus 6.7%; odds ratio [OR] = 5.3, 95% confidence interval [CI] = 1.3 to 21.2, P = .02). No such difference was observed for the FEC or the no-CT groups (FEC versus control: OR = 2.2, 95% CI = 0.5 to 9.1, P = .27; no-CT versus Control: OR = 2.2, 95% CI = 0.6 to 8.0; P = .21). Some cytotoxic treatment for breast cancer affects cognition in a subset of women.

Antineoplastic Agents↗

PubMed2004

Genetic and neurochemical modulation of prefrontal cognitive functions in children.

OBJECTIVE: The catechol O-methyltransferase (COMT) gene affects how long dopamine acts in the prefrontal cortex. The Methionine polymorphism, which results in a slower breakdown of prefrontal dopamine, is associated with better adult prefrontal cortex function. The authors investigated the relation between the COMT gene polymorphism and cognitive performance in children. METHOD: Children were tested on cognitive tasks that depend on the dorsolateral prefrontal cortex and seem to be sensitive to the level of dopamine there (dots-mixed task), depend on that neural region but appear insensitive to its dopamine content (self-ordered pointing), and depend on other neural systems (recall memory and mental rotation). After data collection, cheek swabs were obtained from all children. DNA was extracted and genotyped for the COMT gene with polymerase chain reaction. RESULTS: Children who were homozygous for the Methionine polymorphism performed significantly better on the dots-mixed task but not on others. CONCLUSIONS: The findings provide an existence proof that genotypic differences can relate to differences in cognitive performance in typically developing children. The authors achieved a level of specificity never previously attempted; the COMT polymorphism was found to be differentially related to performance on tasks linked to the same prefrontal region by whether cognitive requirements of the tasks were sensitive to the level of dopamine found. These results challenge accepted notions that since dopamine is important for some cognitive functions dependent on the prefrontal cortex, it is important for all. The differential sensitivity of distinct cognitive abilities to specific neurotransmitters may make possible targeted pharmacological interventions.

Adolescent↗

PubMed2005

Influence of cognitive functioning on functional status in an older population: 3- and 6-year follow-up of the Maastricht Aging Study.

BACKGROUND: To date, it remains unclear to what extent cognitive competence is related to a change in general functional status in older adults. OBJECTIVES: To evaluate both the cross-sectional and the longitudinal relation between cognitive functioning and functional status. METHODS: Sensorimotor speed, memory, and executive functioning were assessed in a large population of healthy adults aged 60 years and older (n = 485) who participated in the Maastricht Aging Study. Data from the baseline (1993-1995), three-year follow-up, and six-year follow-up were used. Functional status was measured using the SF-36, which was coded into a physical and a mental component summary measure. RESULTS: After adjustment for age, sex, and educational level, a high level of cognitive functioning appeared to be associated with better functional status in the cross-sectional analysis. Longitudinal analyses demonstrated, that cognitive functioning was not a predictor of functional status three or six years later. CONCLUSIONS: Thus while cognitive functioning is useful clinically for predicting the short-term functional status of an older person, it is not useful for predicting that person's long-term (>3 years) functional status and thus the period of validity of the results of these tests in answering such questions is limited.

Aged↗

PubMed2007

Pulsed and continuous wave mobile phone exposure over left versus right hemisphere: effects on human cognitive function.

The possible effects of continuous wave (CW) and pulse modulated (PM) electromagnetic field (EMF) on human cognition was studied in 36 healthy male subjects. They performed cognitive tasks while exposed to CW, PM, and sham EMF. The subjects performed the same tasks twice during each session; once with left-sided and once with right-sided exposure. The EMF conditions were spread across three testing sessions, each session separated by 1 week. The exposed hemisphere, EMF condition, and test order were counterbalanced over all subjects. We employed a double-blind design: both the subject and the experimenter were unaware of the EMF condition. The EMF was created with a signal generator connected via amplifier to a dummy phone antenna, creating a power output distribution similar to the original commercial mobile phone. The EMF had either a continuous power output of 0.25 W (CW) or pulsed power output with a mean of 0.25 W. An additional control group of 16 healthy male volunteers performed the same tasks without any exposure equipment to see if mere presence of the equipment could have affected the subjects' performance. No effects were found between the different EMF conditions, separate hemisphere exposures, or between the control and experimental group. In conclusion, the current results indicate that normal mobile phones have no discernible effect on human cognitive function as measured by behavioral tests.

Adult↗