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At least 1,261 records · Page 70Linked to original sources
PubMed1995

Biphasic patterns of memory deficits following moderate-dose partial-brain irradiation: neuropsychologic outcome and proposed mechanisms.

PURPOSE: To identify the longitudinal neurobehavioral characteristics of the early-delayed and late-delayed effects of partial-brain radiotherapy for patients with supratentorial brain tumors with favorable histology. This study improves on previous attempts to identify radiation effects, because of the inclusion of baseline measures and the use of subjects as their own controls. PATIENTS AND METHODS: Ten neuropsychologic domains were measured in 12 patients at baseline (post-surgery and immediately before initiation of radiotherapy), and followed trimonthly for 1 year. Four to six patients were examined at 2 and 3 years postbaseline. RESULTS: Patients were impaired at baseline compared with controls only in visual memory and sentence recall, but demonstrated significant improvement in visual memory by 2 years postbaseline. Speed of processing information also showed a slope of improvement over 2 years. Retrieval from verbal long-term memory was impaired at 1.5 months postcompletion of radiotherapy, but recovered to baseline levels by 1 year. At 2 years postbaseline, long-term memory retrieval demonstrated a decline, but remained unchanged at 3 years. CONCLUSION: Long-term memory appears to be sensitive to the effects of radiotherapy. We confirmed our previous findings of a decrement with rebound during the early-delayed period, and propose that these findings are consistent with demyelination/remyelination. Decrement was observed again at 2 years postbaseline, which suggests that memory retrieval may be the earliest marker of late-delayed effects. These neurocognitive patterns are consistent with leukoencephalopathy. Confirmation of these observations will be possible if neuropsychologic testing with the same sensitivity can be incorporated into national collaborative trials.

Adult↗
PubMed2005

Effect of corticosteroids on short-term and long-term memory.

The effect of acute high-dose glucocorticoid therapy on memory function in patients with acute optic neuritis (n = 9) and multiple sclerosis (n = 21) was studied. All patients had reversible impairment of long-term memory functions, whereas measures of short-term memory, attentional functions, and alertness remained unaffected.

Adolescent↗
PubMed2005

Reduced cerebral blood flow response and compensation among patients with untreated hypertension.

OBJECTIVE: To determine whether memory performance in hypertensive subjects induces diminished parietal and prefrontal blood flow activation relative to normotensive subjects but compensatory amygdala/hippocampal activation. METHODS: Thirty-seven untreated hypertensive subjects and 59 normotensive control subjects performed in two memory and one sensorimotor task while global and regional cerebral blood flow (rCBF) was assessed with [15O]water and PET. Neuropsychological, carotid artery ultrasound, and MRI assessments were obtained. RESULTS: When they were engaged in memory tasks, increases of CBF in hypertensive subjects were less than in normotensive subjects in the posterior parietal area, as expected; blunted responses were also shown within the middle posterior arterial watershed and thalamus. Relative to all other participants, hypertensive subjects that performed relatively well on verbal memory showed an enhanced rCBF response in the right amygdala/hippocampus. Furthermore, hypertensive, but not normotensive, subjects showed task-induced rCBF in the amygdala/hippocampal area that was significantly correlated with task-induced prefrontal rCBF. No confounding influences were identified from carotid artery or MRI measures. CONCLUSIONS: Memory performance in hypertensive individuals is related to a blunted regional cerebral blood flow (rCBF) response, particularly in parietal cortex. Potentially compensatory rCBF responses appear to occur in midbrain and correlate with prefrontal rCBF.

Adaptation, Physiological↗
PubMed2005

The ability of persons with Alzheimer disease (AD) to make a decision about taking an AD treatment.

OBJECTIVE: To examine the severity of impairments in the decision-making abilities (understanding, appreciation, reasoning, and choice) and competency to make a decision to use an Alzheimer disease (AD)-slowing medication in patients with AD and the relationships between these impairments, insight, and overall cognition. METHODS: Semistructured in-home interviews were conducted with 48 patients with very mild to moderate AD and 102 family caregivers of patients with mild to severe AD recruited from the Memory Disorders Clinic of an AD center. The interview measured performance on the decision-making abilities and three expert psychiatrists' judgment of competency based on their independent review of the patient interviews. RESULTS: There was considerable variation in patients' performance on the measures of decision-making abilities. Three expert raters found 19 of 48 (40%) of the subjects competent. Competent patients were more likely to show awareness of their symptoms, prognosis, and diagnosis. A sensitivity analysis suggests that a MMSE score is helpful in discriminating capacity from incapacity only when below 19 or above 23. CONCLUSIONS: Persons with mild to moderate Alzheimer disease (AD) have notable impairments in their ability to make an AD treatment decision, especially persons with moderate AD and persons who lack awareness of symptoms, prognosis, or diagnosis.

Aged↗
PubMed2005

Natural history of primary progressive aphasia.

OBJECTIVE: To characterize the natural history of primary progressive aphasia (PPA). METHODS: Forty-nine patients (28 women) with newly diagnosed with PPA presenting to a memory disorders clinic between 1992 and 2001 were prospectively evaluated. RESULTS: Median age at onset was 62 years (range 49 to 73 years) and at first visit was 66 years (52 to 80 years). The median duration of follow-up was 4 years (1 to 11 years). Impairments in activities of daily living developed a median of 6 to 7 (2 to 12) years post onset. Seventy-five percent of patients eventually met clinical diagnostic criteria for frontotemporal dementia (FTD), 14% met diagnostic criteria for dementia with Lewy bodies, and 8% developed signs of corticobasal degeneration; 60% of the patients died after a median course of 7 years (3 to 17 years) at a median age of 71 years (56 to 81 years). Patients showing high Mini-Mental State Examination scores, moderate aphasia, and fluent language at first visit subsequently retained greater autonomy in daily life. CONCLUSIONS: Although activities of daily living are well maintained during the first years of the disease, patients with primary progressive aphasia (PPA) may lose autonomy 6 to 7 years after onset. The majority of patients with PPA in the current study developed frontotemporal dementia.

Activities of Daily Living↗
PubMed2006

Altered hippocampal-prefrontal activation in HIV patients during episodic memory encoding.

OBJECTIVE: To investigate the integrity of hippocampal-prefrontal circuitry during episodic encoding in patients with HIV. METHODS: Functional MRI was used to observe changes in blood oxygenation level-dependent (BOLD) signal in 14 HIV-positive participants and 14 age- and education-matched control subjects while performing an episodic encoding task. Subjects also completed neuropsychological measures of attention and memory. RESULTS: Behavioral results revealed no significant differences in neuropsychological performance. The fMRI results revealed that while both groups recruited brain regions known to be important for successful encoding, including bilateral medial temporal lobes and inferior prefrontal gyri, the HIV group demonstrated significantly reduced signal intensity changes in the right posterior hippocampus, right inferior frontal gyrus, and left lingual gyrus. Additionally, the HIV group exhibited more activity within lateral frontal and posterior parietal regions. CONCLUSIONS: This study demonstrates altered integrity of hippocampal-prefrontal regions during episodic encoding in HIV-positive patients. These results extend previous studies that have documented the effects of HIV on fronto-striatal circuits, and suggest the virus functionally impacts the hippocampal system as well.

Adult↗
PubMed1982

Memory decline in the aged: treatment with lecithin and physostigmine.

Normal aged subjects were given lecithin and placebo for 5 weeks each in a double-blind crossover study. Supraspan tests of memory and learning failed to show any significant changes as a result of these treatments. Addition of a single IV infusion of physostigmine did not improve performance. These findings neither support nor weaken the "cholinergic hypothesis" of cognitive impairment in aging and dementia, but they imply that simple cholinergic hypofunction is unlikely.

Acetylcholine↗
PubMed1988

Cognitive impairment and sensory loss associated with chronic low-level ethylene oxide exposure.

A 29-year-old college graduate worked for 10 years adjacent to an ethylene oxide (EtO) chemical sterilizer. When the sterilizer was closed, levels of EtO in the air around the sterilizer were 4.2 ppm (OSHA maximum level, 1 ppm). Seven years after beginning work with EtO, she experienced impaired memory, increased irritability, clumsiness, and falling. Three years later exposure ceased, and symptoms markedly improved over the next few months, but did not disappear entirely. Neurologic and neuropsychological exams 1 year after exposure ceased demonstrated emotional lability, impaired concentration, cognitive slowing, impaired recent and remote memory, and impaired thermal and vibratory sense in distal limbs. Her pattern of relatively preserved learning and profound forgetting distinguished her from most other subjects with memory disorders. No other causes for the condition were identified.

Adult↗
PubMed1994

Paraneoplastic temporal lobe epilepsy with testicular neoplasm and atypical amnesia.

We report a patient who, at age 38, presented with temporal lobe seizures and an atypical memory disorder 3 years before the discovery of a testicular tumor. Detailed neuropsychological testing revealed a relatively isolated amnestic syndrome. The amnesia was atypical as the patient could retain information for hour-long periods, only to lose it later. Serologic studies revealed the presence of a circulating autoantibody that demonstrated an unusual affinity for the nucleolus of cerebral cortical neurons. Western blot analysis of cortical neurons revealed that this antibody reacted with proteins different from other previously identified paraneoplastic neurologic antigens (Hu, Yo, Ri). We believe this to be a case of paraneoplastic limbic encephalitis secondary to the testicular tumor. This patient presents unique characteristics with respect to the mode of presentation, features of the amnesia, and the presence of a circulating antibody with an unusual reactivity pattern.

Amnesia↗
PubMed1995

Verbal memory impairment resulting from hippocampal neuron loss among epileptic patients with structural lesions.

We recently demonstrated statistically significant correlations between presurgical memory impairment and hippocampal volumetric cell densities (in CA3 and the hilar area only) for patients with idiopathic left temporal lobe epilepsy who exhibited marked hippocampal neuron loss. In the present research we determine whether the same relationship exists for patients with structural lesions, in whom hippocampal neuron loss was minimal. Rank-order correlations of verbal memory test results (ie, Long Term Retrieval score of the verbal Selective Reminding Test, Percent Retention index of the Logical Memory subtest of the Wechsler Memory Scale) and hippocampal volumetric cell densities (subfields CA1, CA2, CA3, the hilar area, and the granule layer of area dentata) were computed for 22 patients with structural lesions and medically refractory epilepsy of temporal lobe onset (11 left, 11 right). There were statistically significant correlations between Long Term Retrieval and the volumetric cell density of CA1 (r = 0.62, p < 0.05) and between percent retention and the volumetric cell density of CA2 (r = 0.60, p < 0.05) for patients with left hemisphere lesions. No other correlations were found for patients with left or right temporal lobe lesions.

Adult↗
PubMed1997

ApoE-4 and age at onset of Alzheimer's disease: the NIMH genetics initiative.

OBJECTIVE: To explore the impact of apoE-4 on Alzheimer's disease (AD) and its age at onset. DESIGN: A genetic linkage study using affected relative pairs, predominantly siblings. SETTING: Three academic medical centers ascertained subjects from memory disorder clinics, nursing homes, and the local community. SUBJECTS: 310 families including 679 subjects with AD by NINCDS/ADRDA and/or Khachaturian criteria and 231 unaffected subjects. OUTCOME MEASURE: ApoE genotype. ANALYTIC METHODS: Association, affected pedigree member, sibling pair, and lod score analyses. RESULTS: ApoE-4 was strongly associated with AD in this sample (allele frequency = 0.46 vs. 0.14 in controls, p < 0.000001). Results of lod score, affected pedigree member analysis, and sib-pair analysis also supported apoE-4 as a risk factor for AD. When the sample was stratified on family mean age at onset, the risk conferred by apoE-4 was most marked in the 61 to 65 age group. Individuals with two copies of apoE-4 had a significantly lower age at onset than those with one or no copies (66.4 vs. 72.0, p < 0.001), but individuals with one copy did not differ from those with none. Within families, the individual with the earliest age at onset had, on average, significantly more apoE-4 alleles (p < 0.0001) than the individual with the latest onset. DISCUSSION: This work supports previous reports of an association between apoE-4 and the development of AD and demonstrates that apoE-4 exerts its maximal effect before age 70. These findings have important implications for the potential use of apoE genotyping for diagnosis and prediction of disease. They also underscore the need to identify additional genetic factors involved in AD with onset beyond age 70 years.

Age of Onset↗
PubMed2001

Hypothalamic amnesia with spontaneous confabulations: a clinicopathologic study.

Previous studies demonstrated that patients producing spontaneous confabulations fail to suppress currently irrelevant memory traces and have anterior limbic lesions, particularly involving the orbitofrontal cortex or the basal forebrain. Here, a woman is described who had sarcoidosis damaging the medial hypothalamus and endocrine dysfunction, and a severe memory failure characterized by spontaneous confabulation, disorientation, and severely impaired free recall with preserved recognition. Isolated hypothalamic damage may produce the same type of memory disorder as orbitofrontal damage.

Aged↗
PubMed1982

Neurotransmitter precursors and brain function.

Brain function can be affected by the availability of dietary precursors of neurotransmitters. This occurs because the rate-limiting synthetic enzymes are not "saturated" with substrate under normal circumstances. Tyrosine affects catecholaminergic neurons that fire rapidly, whether in the brain stem to decrease blood pressure in hypertension or in the adrenal gland to increase blood pressure in hypotension, and has been used in the treatment of Parkinson's disease and depression. Choline forms acetylcholine and has been used successfully in the treatment of tardive dyskinesia and memory disorders. Tryptophan, which forms serotonin, has been used for chronic pain therapy, sleep disorders, depression, and appetite control. Although these substances may lack the potency of traditionally used agonists, they offer an increase in specificity because the enzymes necessary to convert them to neurotransmitters are found only in neurons. Precursors are also "physiological"; they are consumed as foods and, therefore, should be relatively safe therapeutic agents.

Animals↗
PubMed2001

Effects of histidine on working memory deficits induced by the 5-HT1A-receptor agonist 8-OH-DPAT.

We investigated the effects of histidine on spatial memory deficits induced by the 5-HT1A-receptor agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT). Working memory deficits were elicited by 8-OH-DPAT without affecting reference memory. Histidine improved the working memory deficit induced by 8-OH-DPAT at doses causing a significant increase in brain histamine content. This finding suggests that the histaminergic system regulates 8-OH-DPAT-induced working memory deficit.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed2001

Characteristics of learning and memory impairment induced by delta9-tetrahydrocannabinol in rats.

We investigated the characteristics of delta9-tetrahydrocannabinol (THC)-induced impairment of learning and memory using an 8-arm radial maze task, a water maze, a visual discrimination task with 2 figures and a passive avoidance test in rats. THC (6 mg/kg, i.p.) impaired spatial memory in the standard task of the 8-arm radial maze. THC (4-6 mg/kg, i.p.) selectively impaired working memory in a reference and working memory task of the 8-arm radial maze. Even at a dose of 10 mg/kg, THC did not impair spatial memory in the water maze. In addition, THC at a dose of 6 mg/kg, which had inhibitory effects in the 8-arm radial maze, did not affect performance in the visual discrimination task. These results indicate that at low doses (2-6 mg/kg), THC may not produce visual function abnormalities. THC impaired retrieval (6 mg/kg, i.p.) as well as acquisition (10 mg/kg, i.p.) in the passive avoidance test. The consolidation process was also impaired by i.c.v. injection (100 microg), but not i.p. injection (6-10 mg/kg) of THC. These results suggest that THC-induced impairment of spatial memory is based on the selective impairment of working memory through its effects on acquisition and retrieval processes.

Animals↗
PubMed2001

Potential human health effects associated with laboratory exposures to Pfiesteria piscicida.

The adverse human health effects associated with the most prolonged and intense exposure known to Pfiesteria piscicida Steidinger & Burkholder cultures and toxin(s) are described. In December 1993, a patient presented with acute illness to the Memory Disorders Clinic of the Bryan Alzheimer's Disease Research Center at Duke University Medical Center with significant cognitive deficits 2 weeks after ceasing occupational laboratory exposure on the recommendation of the evaluating primary care physician. The clinical and exposure histories of this patient are presented. The comprehensive neurological examination findings are reviewed, with attention to the patient's neuropsychological evaluation. Six-week follow-up data illustrate the course of symptom resolution with exposure cessation. This case is presented in an effort to contribute to the gradually accruing evidence of potential central nervous system sequelae of Pfiesteria exposure. The case is discussed in the context of additional cases evaluated at Duke University Medical Center and the complicated scientific framework in which such evaluations proceed while definitive surrogate or biological markers are awaited.

Cell Culture Techniques↗
PubMed2005

Verbal mistreatment in older adults:a look at persons with Alzheimer's disease and their caregivers in the state of Florida.

PURPOSE: This study examined verbal aggression in a sample of community dwelling older adults with Alzheimer's Disease (AD) using the Risk and Vulnerability model as a means for identifying factors associated with verbal mistreatment in caregiver/patient dyads. DESIGN AND METHODS: Subjects were recruited in the State of Florida through their association with state-funded memory disorder clinics or with local chapters of the Alzheimer's Association. The sample for this analysis consisted of 254 caregivers who completed both a questionnaire and an in-home interview between the years 1998 and 2002. Verbal mistreatment was measured using the verbal aggression sub-scale of the Conflict Tactics Scale and logistic regression analysis was used to examine factors associated with increased risk. RESULTS: Verbal aggression as a conflict resolution style was self reported by 60.1% of caregivers, and was reported as a technique used against them by 74.8% of family members with AD. Logistic regression analysis suggests that factors associated with increased risk for verbal aggression by caregivers included being female, providing care to verbally aggressive elders, caregiver's diminished cognitive status, high levels of psychiatric symptoms, depression, or experiencing a high degree of caregiver hassle. Additionally, a significant interaction effect was found between levels of depression in caregivers and dementia symptoms in elders, as well as between levels of psychiatric symptoms in caregivers, feelings of caregiver hassle, and depression in care recipients and risk for verbal mistreatment. IMPLICATIONS: This study highlights the importance of both risks and vulnerabilities in the outcome of verbal mistreatment, and identifies that in many cases verbal mistreatment may be a reciprocal phenomenain dyads of caregivers and persons with AD.

Journal Article↗