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PubMed2005

Anterior and non-anterior ruptured aneurysms: memory and frontal lobe function performance following coiling.

Our aim was to compare memory and frontal function performance between two groups of patients treated with Guglielmi detachable coil (GDC) following intracranial ruptured aneurysm. The subgroups drawn following the localization of the aneurysm consisted of 19 patients presenting with anterior communicating artery aneurysms and 16 patients exhibiting middle cerebral artery and posterior communicating artery aneurysms. The 35 patients and 35 normal controls were administered extensive neuropsychological assessment. Additionally, a scale of qualitative changes of mood was presented to the patients and patients' relatives. The patients showed a better general performance on memory compared with the executive function performance, which was similarly impaired in both groups. We suggest that executive functions are more vulnerable to differently located lesions than memory functions.

Adult↗

PubMed2006

Decreased activation of anterior cingulate cortex in the working memory of the elderly.

We examined aging effects on activation in the anterior cingulate cortex during a verbal working memory using functional magnetic resonance imaging. Ten young (mean age 25 years) and 10 elderly (mean age 69 years) healthy adults performed the reading span test in which performance reflects individual differences in verbal working memory. We found an age-related difference in executive function in the prefrontal cortex; younger participants showed significant anterior cingulate cortex activation whereas the elderly did not. We found that the anterior cingulate cortex plays a critical role in executive function related to working memory. We found that behavioral deficits in verbal working memory because of aging result from the deterioration of cognitive control owing to decreased activation of the anterior cingulate cortex.

Adult↗

PubMed2006

Cognitive and emotion recognition deficits in obsessive-compulsive disorder.

Previous investigations have demonstrated impaired recognition of facial affect and cognitive dysfunction in several psychiatric disorders. The specificity of these deficits is still debated. The aim of this study was to investigate the deficits in emotion recognition and cognition in obsessive-compulsive disorder (OCD). Forty patients with OCD (DSM-IV, 16 women, 34.7+/-10.4 years) and 40 healthy volunteers (16 women, 34.7+/-8.7 years) were compared. All participants underwent a computerized neuropsychological test battery (Gur, R.C., Erwin, R.J., Gur, R.E., Zwil, A.S., Heimberg, C., Kraemer, H.C., 1992. Facial emotion discrimination II. Behavioral findings in depression. Psychiatry Research 42, 241-251; Gur, R.C., Ragland, J.D., Moberg, P.J., Turner, T.H., Bilker, W.B., Kohler, C., Siegel, S.J., Gur, R.E., 2001. Computerized neurocognitive scanning: I. Methodology and validation in healthy people. Neuropsychopharmacology 25, 766-776). A German version of the Penn Facial Emotion Acuity Test, the Facial Emotion Intensity Differentiation, including happy, sad and neutral faces, and the Facial Memory Test were administered. Executive functions were assessed by a computerized version of the Wisconsin Card Sorting Test and attention was evaluated using the Continuous Performance Test. OCD patients performed more poorly than healthy controls in facial memory tests (especially delayed), as well as in attention and executive functions. The only significant difference between the groups in emotion processing was poorer recognition of sad female faces in patients, who misperceived neutral faces as sad. The results point to memory and executive deficits in addition to a "negative" bias in emotion recognition in OCD patients.

Adult↗

PubMedDate not supplied

First symptoms--frontotemporal dementia versus Alzheimer's disease.

Frontotemporal dementia (FTD) is often misdiagnosed as Alzheimer's disease (AD). We hypothesized that the first symptoms associated with FTD would be different from those seen in AD and that the first symptoms in FTD would reflect loss of function in the frontal region with the greatest degree of degeneration. The objective of the study was to compare the earliest symptoms in patients with FTD and AD, and to delineate the symptoms that were associated with right, left or bilateral frontotemporal degeneration in FTD. The first symptoms in 52 FTD and 101 AD patients were determined in retrospect. Based on functional imaging studies, the FTD patients were divided into those with predominantly bilateral (n = 15), left-sided (n = 19) and right-sided (n = 18) patterns of atrophy. The results showed that disinhibition, social awkwardness, passivity and loss of executive function were more common in FTD, while memory loss was more common in AD. Disinhibition was greatest in the asymmetric right-sided group, language dysfunction was commonest in the asymmetric left-sided group and loss of executive function was most frequent in the bilateral group. In summary, different first symptoms appeared in FTD and AD, which may help distinguish between the diseases. The anatomic site for FTD largely determined the kind of first symptoms.

Aged↗

PubMed1996

Cognition and white matter hyperintensities in older depressed patients.

OBJECTIVE: The authors compared amounts of white matter hyperintensity in late- and early-onset depressed patients and never-depressed older subjects, compared neuropsychological function in these groups, and investigated the association between white matter hyperintensities and cognitive function in depression. METHOD: Sixty currently depressed patients whose first depression occurred after age 50 years, 35 depressed patients over age 50 whose first depression occurred before age 35, and 165 nonpsychiatrically ill subjects over age 50 underwent magnetic resonance imaging (MRI) and neuropsychological evaluation. Areas of white matter hyperintensity were measured from MRI images. RESULTS: The late-onset patients had more white matter hyperintensity than either of the other groups. Compared to the nondepressed subjects, the patients had significantly lower scores in the cognitive domains of nonverbal intelligence, nonverbal memory, constructional ability, executive ability, and information processing speed. The cognitive abnormalities were mostly confined to the late-onset patients, and the presence of a large amount of white matter hyperintensity was associated with significantly poorer executive skills. However, most of the scores were not in the significantly impaired range. CONCLUSIONS: Large amounts of white matter hyperintensity are more frequent in patients with late-onsetdepression than in elderly subjects with early-onset or no depression. Both late- and early-onset elderly depressed patients show mild decrements in some "right hemisphere" cognitive skills; the late-onset subjects also show deterioration in information processing speed and executive functions. Patients with large amounts of white matter hyperintensity have significantly poorer executive function.

Age Factors↗

PubMed2004

Neuropsychological functioning in methadone maintenance patients versus abstinent heroin abusers.

Several studies have reported on neuropsychological status as an important contributing variable in drug abuse rehabilitation outcomes. However, few studies have dealt with cognitive impairment in methadone maintenance patients (MMP), despite the fact that methadone is the most frequently used opioid substitution treatment in European countries. The objective of the present study is to contrast the neuropsychological performance of MMP with that of abstinent heroin abusers (AHA). Participants were matched with respect to age, education, pre-morbid IQ, employment status and lifetime drug abuse, and they underwent a set of tests aimed at assessing visuo-spatial attention, processing speed and executive functions. Although processing speed and attention deficits have previously been the focus of studies with MMP, executive functions have not received a similar degree of attention. The purpose of comparing matched MMP and AHA is two-fold: firstly, to test the differential effects of current opioid consumption and past opioid abuse on cognitive-executive performance and secondly, to assess the potential consequences of opioid-related neuropsychological deficits. Results showed a significantly slower performance by MMP on processing speed, visuo-spatial attention, and cognitive flexibility tests (Five Digit Test (FDT) parts 1 and 3; Oral Trails (OT) parts 1, 2; Interference 2-1), and less accuracy in working memory and analogical reasoning tests extracted from the Wechsler Adult Intelligence Scale (WAIS III). Effect sizes for significant comparisons ranged from 0.67 to 1. These results seem to suggest that methadone consumption by itself induces significant cognitive impairments that could compromise drug-treatment outcomes in MMP.

Adult↗

PubMed2005

Circadian preference and cognitive functioning among rehabilitation inpatients.

The influence of circadian preference was examined among 56 morning-oriented rehabilitation inpatients with cognitive (n=28) and noncognitive (n=28) impairments. Each individual was tested twice: morning (preferred time) and evening (nonpreferred time); sessions and test batteries were counterbalanced to control for practice effects. Standard measures assessed attention, language, memory, visuospatial, and executive functions. Persons with cognitive impairment showed disproportionate vulnerability to the effects of circadian preference and time of testing, performing more poorly at nonpreferred than preferred times. Substantial effects (eta2 .12 to .48) were found on tests of executive functioning and tasks incorporating similar higher-order demands (e/g/. complex figure copy). Results are supported by tympanic temperature changes during a vigilance task, and index of cerebral blood flow in response to cognitive challenge. Cognitive reserve theory is suggested as an explanation for the differential effects. These findings may have implications for inpatient therapeutic interventions and discharge planning.

Adult↗

PubMed2005

Evidence for a direct association between cortical atrophy and cognitive impairment in relapsing-remitting MS.

Cognitive deficits affecting memory, attention and speed of information processing are common in multiple sclerosis (MS). The mechanisms of cognitive impairment remain unclear. Here, we examined the association between neuropsychological test performance and brain atrophy in a group of mildly disabled patients with relapsing-remitting MS. We applied voxel-based morphometry (SPM2) to investigate the distribution of brain atrophy in relation to cognitive performance. Patients had lower scores than control subjects on tests of memory and executive function, including the PASAT, Digit Span Backward and a test of short-term verbal memory (Memo). Among patients, but not healthy controls, performance on the PASAT, a comprehensive measure of cognitive function and reference task for the cognitive evaluation of MS-patients, correlated with global grey matter volume as well as with grey matter volume in regions associated with working memory and executive function, including bilateral prefrontal cortex, precentral gyrus and superior parietal cortex as well as right cerebellum. Compared to healthy subjects, patients showed a volume reduction in left temporal and prefrontal cortex, recently identified as areas predominantly affected by diffuse brain atrophy in MS. A comparison of low performers in the patient group with their matched control subjects showed more extensive and bilateral temporal and frontal volume reductions as well as bilateral parietal volume loss, compatible with the progression of atrophy found in more advanced MS-patients. These findings indicate that MS-related deficits in cognition are closely associated with cortical atrophy.

Adult↗

PubMed1999

Cognitive deficits and cognitive training in schizophrenic patients: a review.

OBJECTIVE: The aim of this paper is to review the current status of knowledge of cognitive deficits and remediation in patients with schizophrenia. METHOD: Relevant reports were identified by a literature survey. In addition, some outstanding researchers in these areas were asked to add to the identified list relevant literature that was not included. RESULTS: Our review focuses on the cognitive deficits observed in the areas of attention, memory and executive functions. We attempt to classify dysfunctions as vulnerability- or symptom-linked factors, and we discuss the methodological question of a general performance deficit vs. a differential deficit. Furthermore, we briefly delineate how antipsychotics affect cognitive functions. Finally, controlled studies of cognitive training are discussed in more detail. CONCLUSION: The most outstanding cognitive dysfunctions in patients with schizophrenia can be related to the areas of attention, memory and executive functions. Interest in cognitive remediation has to some extent been rekindled in the 1990s. However, few studies on the effects of cognitive training programs have been conducted.

Antipsychotic Agents↗

PubMed2002

Joint attention and set-shifting in young children with autism.

Executive function deficits in autism have been consistently found in many studies, using a wide range of measures, but usually involving older children and adults and those of higher IQ. The interpretation of executive function deficits is difficult because the concept itself is poorly defined (inhibition of prepotent responses, set-shifting, action planning etc.). Analyses have focused mainly on the attention participants pay to physical entities (object handling and problem solving) rather than social ones. The present study investigated whether these two types of attention are linked in autistic development. Fifteen children with autism (mean mental age = 24 months) were compared to 21 normally developing children (mean mental age = 25 months). A strong correlation was found between joint attention and set-shifting in the typically developing children but not those with autism. The results are discussed from a psychopathological perspective on development.

Attention↗

PubMedDate not supplied

A comparison of the Allen Cognitive Level Test and the Wisconsin Card Sorting Test in adults with schizophrenia.

OBJECTIVE: This study examines the relationship among executive function, visuospatial problem solving, and measures of occupational functioning in 33 adult men with schizophrenia or schizoaffective disorder. METHOD: Three measures were administered in a one-time assessment session. The Wisconsin Card Sorting Test (WCST) was used to measure executive functioning, abstract reasoning, and problem-solving abilities. The Allen Cognitive Level (ACL) Test was used to measure learning, problem solving, and visuospatial abilities. The Routine Task Inventory (RTI) measured the level of performance in activities of daily living. RESULTS: Using multiple regression controlling for age, the WCST significantly predicted performance on the ACL the RTI. Perseverative errors on the WCST were negatively correlated with the ACL (r = -.47) and RTI scores (r = -.59). The ACL and RTI were also significantly correlated (r = .67). CONCLUSION: Both the WCST and the ACL are sensitive to similar domains of functioning and are predictive of task performance. The results support the use of the ACL as a quick measure of a person's cognitive and functional abilities.

Adult↗

PubMed1993

Improvement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine.

Cognitive functions and psychopathology were assessed in 36 treatment-refractory schizophrenic patients before initiation of clozapine, and at 6 weeks and 6 months, thereafter. Before treatment, cognitive impairment was found in each measure of memory, attention, and executive function as compared with 26 normal controls. After both 6 weeks and 6 months of treatment, significant improvement occurred in the Controlled Oral Word Association Test, a measure of retrieval from reference memory. Improvement was also noted at 6 months in the Category Instance Generation Test, another measure of retrieval from reference memory, and in some, but not all, tests of executive function, attention, and recall memory. Clozapine treatment also resulted in significant improvement in Brief Psychiatric Rating Scale (BPRS) Total and Positive symptom scores at both 6-week and 6-month assessment points. There was some evidence for a relationship between improvement in psychopathology and cognitive function. The improvement in cognitive function during clozapine treatment could have consequences for capacity to work and social function.

Adult↗

PubMed2000

[Executive cognitive alteration of prefrontal type in patients with mesial temporal lobe epilepsy].

This study examines the performance on executive function--classically considered as purported by the frontal lobes--in patients with temporal lobe epilepsy (TLE). Two groups of patients were evaluated: one consisted of 16 TLE patients and the other comprised 12 patients with primary generalised epilepsy (PGE). The Wisconsin Card Sorting Test (WCST) was used as a measure of executive function. Results demonstrated that performance on the WCST was remarkably defective in the TLE group, showing a pattern suggestive of frontal like executive dysfunction in a 75% of the patients, against the 17% of the PGE group (p < 0.001). Impairment was evident when number of categories achieved (p < 0.05), perseverative errors (p < 0.001) and perseverative responses (p < 0.001) were considered. Clinical and theoretical significance of these findings may reflex the executive dysfunction of the mesial temporal lobe region as part of the temporo-frontal circuit.

Adult↗

PubMed2006

Theory of mind, neurocognition, and functional status in schizotypy.

The present study is the first to concurrently examine social cognition, neurocognition, and social functioning in psychometric schizotypes. Screening of 2108 undergraduates with the Schizotypal Personality Questionnaire-Brief (SPQ-B) identified 52 persons high in schizotypy and 40 persons low in schizotypy. All participants were administered a test battery designed to assess two elements of neurocognition, verbal secondary memory (California Verbal Learning Test) and executive functioning (Wisconsin Card Sorting Test), two elements of social cognition, emotion perception (The Awareness of Social Inference Test-Part 1) and theory of mind (The Awareness of Social Inference Test-Parts 2 and 3), and social functioning (Social Adjustment Scale-Self Report). Although the persons with high schizotypy were impaired in social functioning relative to the persons with low schizotypy, they were not impaired in theory of mind, emotion perception, verbal secondary memory, or executive functioning. Theory of mind and verbal secondary memory were correlated in persons with high schizotypy. The present findings suggest that psychometric schizotypes are not impaired in the domains of social cognition and neurocognition examined.

Adolescent↗

PubMed2004

[Frontal dysexecutive syndromes].

Investigation of executive functions is an approach which began with the early description of behavioral disorders induced by frontal damage. The development of neuropsychology has led to the description of a large variety of cognitive disorders. This type of approach has generated a large number of tests which are still used in clinical practice. More recently, theoretical approaches have proposed an organization of executive processes and have documented the diversity of executive functions and related anatomy. These studies have deeply influenced the clinical approach, the assessment and the diagnosis of executive disorders. For clinical practice, these data favor specific assessment of certain key behavioral and cognitive deficits investigated with a battery of tests.

Cognition↗

PubMed2003

Preoperative and postoperative cognitive functioning in patients with frontal meningiomas.

OBJECT: There is presently no specific information available concerning the nature and course of cognitive deficits caused by intracranial meningiomas. In this prospective study the authors examined the cognitive functioning of patients with frontal meningiomas. METHODS: Fifty-four patients with frontal meningiomas were examined neuropsychologically before and after neurosurgery. The test battery consisted of standardized instruments including those assessing memory, attention, visuoconstructive abilities, and executive functions. The time period between pre-and postoperative assessment ranged from 4 to 9 months. The patients' performance was compared with the results in 54 healthy adults who were also assessed twice by using the same test battery in a period ranging from 4 to 9 months. In addition, the effect on cognition of meningioma lateralization, localization, lesion size, edema, brain compression, time course, and the occurrence of preoperative seizures was analyzed. CONCLUSIONS: Except in the case of working memory, comparisons of pre- and postoperative assessments of cognition revealed no differences in memory, visuoconstructive abilities, or executive functions, although a postoperative improvement in attentional functions was observed. The results of this study indicate that the surgical removal of frontal meningiomas does not impair patients' cognitive functioning. Furthermore, improvements in attentional functions may occur in these patients.

Brain Neoplasms↗

PubMed2004

Contribution to the evaluation of language disturbances in subcortical lesions: a pilot study.

Subcortical structures are in a strategic functional position within the cognitive networks and their lesion can interfere with a great number of functions. In this study, we describe fourteen subjects with exclusively subcortical vascular lesions (eight in the basal ganglia and six in the thalamus) and the interrelation between their language alterations and other cognitive abilities, as attention, memory and frontal executive functions. All patients were evaluated through the following batteries: Boston Diagnostic Aphasia Examination, Boston Naming Test, Token Test, Benton Visual Retention Test, Trail Making, Wisconsin Card Sorting Test and a frontal scripts task. All patients underwent MRI and twelve underwent SPECT. Results show that these patients present impairment in several cognitive domains, especially attention and executive functions. These alterations affect language abilities, and this fact must be considered in the rehabilitation efforts.

Adult↗

PubMed2006

Executive dysfunction is a significant predictor of poor quality of life in children with epilepsy.

PURPOSE: Based on prior research indicating poor health-related quality of life (HRQOL) in children with attention-deficit/hyperactivity disorder, we investigated (1) whether executive functioning deficits were related to poor HRQOL in children with epilepsy, (2) how important these variables were in comparison to known predictors of HRQOL such as neurological factors, and (3) the extent to which clinical-level impairments in executive dysfunction predispose children to low HRQOL. METHOD: Data included scores on the Behavior Rating Inventory of Executive Function (BRIEF) and HRQOL scales (The Impact of Childhood Illness Scale [ICI] and Hague Restrictions in Epilepsy Scale [HARCES]) for 121 children (mean age = 11.9, SD = 3.6) from a tertiary center serving children with severe epilepsy. RESULTS: Correlations between the BRIEF and ICI total and subscore domains (child, parent, family, and treatment) were generally significant and moderate (e.g., r > or = 0.30, p < or = 0.001). BRIEF Global Executive Composite, number of antiepileptic drugs (AEDs), number of prior AEDs, and adaptive level all emerged as significant and unique predictors of HRQOL (R(2)= 0.36, adj. R(2)= 0.33, p < 0.0001). A clinically elevated BRIEF was associated with a twofold risk of low HRQOL (odds ratio = 2.21, p = 0.03). CONCLUSIONS: Executive dysfunction appears to exert a broad adverse influence on HRQOL in children with epilepsy, with clinical-level impairments in executive dysfunction contributing to a twofold increase in the likelihood of poor HRQOL. The constellation of executive dysfunction, low adaptive level, high medication load, and a history of several failed AEDs are risk factors for poor HRQOL in children with epilepsy.

Age Factors↗