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PubMed2004

Cognitive function before and after surgery in patients with unruptured intracranial aneurysm.

BACKGROUND AND PURPOSE: This prospective study investigated whether surgery for unruptured intracranial aneurysms (UIAs) affects cognitive function and cerebral blood flow (CBF). METHODS: Cognitive tests using the Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale, Rey-Osterrieth Complex Figure test, and CBF measurements using single-photon emission computed tomography were performed before and after surgery for UIAs in 44 patients < or =70 years of age. RESULTS: Group-rate analysis showed the verbal intelligence quotient (IQ), performance IQ, full-scale IQ, and recall trial scores of the Rey-Osterrieth Complex Figure test all increased significantly after surgery, whereas the Wechsler Memory Scale and copy trial scores of the Rey-Osterrieth Complex Figure test were not significantly different. Event-rate analysis demonstrated that no patient showed impaired cognition. There was no significant difference between CBF before and after surgery. CONCLUSIONS: Surgical repair for UIAs does not impair cognition or CBF in patients without postoperative restrictions in lifestyle.

Adult↗

PubMedDate not supplied

[Cognitive function in alcoholics in a double-blind study of piracetam].

The effects of piracetam on cognitive functions have been studied in alcoholic patients. The investigation was carried out on 27 alcoholics who were admitted to hospital with acute withdrawal syndrome. The trial was performed under double-blind condition. Thirteen patients were treated with piracetam and 14 with placebo. The performance of patients treated with piracetam (experimental group) was significantly better at the Block-Design retest, as compared with the control subjects. This was associated with comparatively good perceptual organization, visual motor coordination and abstract reasoning in these patients. Similar kind of performance of these patients has been achieved in the tests used to measure psychomotor speed and attention capacity. Our findings agree well with some observations of the clinicians and may stimulate further research in this field.

Adult↗

PubMed1997

Motor and cognitive function in Lewy body dementia: comparison with Alzheimer's and Parkinson's diseases.

OBJECTIVE: Motor and cognitive function were compared in patients with Lewy body dementia, Parkinson's disease, or Alzheimer's disease, to identify features that may be clinically useful in differentiating Lewy body dementia from Alzheimer's disease and Parkinson's disease. METHODS: A range of neuropsychological function and extrapyrimidal signs (EPS) was assessed in 16 patients with Lewy body dementia, 15 with Parkinson's disease, 25 with Alzheimer's disease, and 22 control subjects. RESULTS: The severity of total motor disability scores increased in the following order: controls approximately = Alzheimer's disease << Parkinson's disease < Lewy body dementia. Compared with patients with Parkinson's disease, patients with Lewy body dementia had greater scores for rigidity and deficits in the finger tapping test, but rest tremor and left/right asymmetry in EPS were more evident in Parkinson's disease. Patients with Lewy body dementia were also less likely to present with left/right asymmetry in EPS at the onset of their parkinsonism. "Sensitivity" to neuroleptic drugs was noted in 33% of patients with Lewy body dementia. Alzheimer's disease and Lewy body dementia groups had greater severity of dementia compared with the Parkinson's disease group and controls. Neuropsychological evaluation disclosed severe but similar degrees of impaired performances in tests of attention (digit span), frontal lobe function (verbal fluency, category, and Nelson card sort test) and motor sequencing in both Lewy body dementia and Alzheimer's disease groups, than Parkinson's disease and controls. In the clock face test, improved performance was noted in the "copy" compared to "draw" part of the test in controls, patients with Alzheimer's disease, and those with Parkinson's disease, but not in the patients with Lewy body dementia, who achieved equally poor scores in both parts of the test. CONCLUSIONS: EPS in Lewy body dementia resemble those seen in idiopathic Parkinson's disease, although less rest tremor and left/right asymmetry but more severe rigidity favours a diagnosis of Lewy body dementia. The unique profile of patients with Lewy body dementia seen in the clock face test suggests that this simple and easy to administer test may be useful in the clinical setting to differentiate Lewy body dementia and Alzheimer's disease.

Aged↗

PubMed2005

Cognitive function, aging, and ethical decisions: recognizing change.

As the population ages, dental and other health care providers will be working with more older adults (and their family members) with changing cognitive status than ever before in history. The intent of this article is to review common cognitive changes in older adults that will undoubtedly be seen in dental practices. Knowledge of the common signs and symptoms of age-related cognitive changes provides a basis on which to identify individuals with undiagnosed cognitive,changes. This article reviews the relationship between cognitive function, aging, and dementia (specifically, mild cognitive impairment and Alzheimer's disease), the role of the dental team in recognizing these conditions, and issues related to obtaining in-formed consent from cognitively impaired patients.

Advance Directives↗

PubMed2003

Clinical recovery in cognitive functioning and self-image among adolescents with major depressive disorder and conduct disorder during psychiatric inpatient care.

This prospective study examined psychosocial and cognitive functioning among adolescents with major depressive disorder and conduct disorder under comprehensive psychiatric inpatient care. Nonverbal and general cognitive performance, self-image, and overall psychosocial functioning improved in both groups. Nevertheless, more changes in self-image and family functioning were found among patients with major depressive disorder. Mental health services should still have the capability of offering long-term residential care for adolescents with the most severe mental disturbance.

Adolescent↗

PubMed1992

Cognitive function and regional cerebral blood flow in Parkinson's disease.

In order to investigate relationships between cognition and regional brain function, we studied 20 non-demented patients with idiopathic Parkinson's disease (PD), 21 mildly demented patients with Alzheimer's disease (AD) and 24 control subjects using cognitive testing and single photon emission computerized tomographic (SPECT) measurements of relative regional cerebral blood flow (rCBF). Neuropsychological tests were grouped into clusters reflecting frontal lobe executive abilities, perseveration, memory and visuospatial ability, with a summary score summarizing performance in all four of these spheres. SPECT imaging utilized the tracer [123I]N-isopropyl-p-iodoamphetamine with a relative measure of regional tracer uptake normalized to occipital radiotracer uptake (rCBF ratios). Patients with PD performed more poorly than controls in all cognitive domains, and were intermediate to AD patients and controls in tests of memory and overall cognitive functioning. Those PD patients who performed most poorly on neuropsychological testing showed lowest rCBF ratios in left and right temporal lobes. Using a stepwise multiple regression procedure, we examined patterns of correlations between cognitive clusters and predictor variables, including rCBF ratios, in the PD patients. We found that while patient age was a strong determinant of performance on the memory cluster and the summary score, dorsolateral frontal lobe perfusion and scores on a depression inventory accounted for a greater proportion of the variance of the frontal lobe and perseveration clusters than did age. These results imply that different neural mechanisms are responsible for the different aspects of cognitive decline seen in PD patients, with overall cognitive function closely related to age and temporal perfusion, while frontal lobe abilities are more linked to frontal perfusion and the presence of depression.

Aged↗

PubMed2006

Formation and validation of a telephone battery to assess cognitive function in acute respiratory distress syndrome survivors.

PURPOSE: Describe initial development and validation of a test battery composed of established instruments designed to detect, via telephone interview, cognitive abnormalities in survivors of acute respiratory distress syndrome. METHODS: Two cross-sectional studies were performed, including the following phases: (1) initial battery construction, (2) feasibility, (3) item reduction, (4) convergent and divergent validity, and (5) telephone administration compared with in-face interviews in a separate population. RESULTS: There was a broad range of cognitive function detected in the derivation population, and all subjects completed the interview. There was convergence of cognitive impairment with moderate/severe anxiety (P = .008), the Sickness Impact Profile Psychosocial Summary Score (mean difference, 15.3; 95% CI, 7.74-22.9; P = .0001), and the mental health domains of the Short Form 36. Subjects with cognitive impairment had no detectable difference in the physical function domains of the Short Form 36. When administered to the validation population, telephone tests of memory, attention, reasoning, and executive functions had good intraclass correlation with the in-face interviews (P < .01). CONCLUSIONS: Detection of cognitive abnormalities in acute respiratory distress syndrome survivors using a telephone-administered test battery derived from standard cognitive tests is feasible and has evidence of construct validity. This battery may be useful as a research tool when in-face interviews are not feasible.

Adult↗

PubMed1989

Effects of social drinking and familial alcoholism risk on cognitive functioning: null findings.

The effects of both heavy social drinking and high familial alcoholism risk status on the cognitive performance of college men were examined in this study. A two by three factorial design was employed represented by two social drinking groups (heavy/nonheavy) and three familial risk groups (high, middle, and low). The cognitive performance tasks employed--group embedded figures, revised Beta mazes, mirror tracing, and symbol-digit paired associate learning--had all been previously shown to present difficulties to male alcoholics. No evidence was obtained of a relationship between heavy drinking or familial risk and cognitive functioning, nor a meaningful interaction of these two independent variables. Little evidence was revealed for the "hangover hypothesis" as evidenced by a relationship between drinking behavior within the past week and cognitive performance. The findings are discussed in the context of previous findings in these areas and the general difficulties of interpretation posed in nonexperimental research based on subject variables.

Adolescent↗

PubMed2001

A healthy body, a healthy mind: long-term impact of diet on mood and cognitive function.

Certain dietary risk factors for physical ill health are also risk factors for depression and cognitive impairment. Although cholesterol lowering has been suggested to increase vulnerability to depression, there is better support for an alternative hypothesis that intake of n-3 long-chain polyunsaturated fatty acids can affect mood (and aggression). Possible mechanisms for such effects include modification of neuronal cell membrane fluidity and consequent impact on neurotransmitter function. Stronger evidence exists concerning a role for diet in influencing cognitive impairment and cognitive decline in older age, in particular through its impact on vascular disease. For example, cognitive impairment is associated with atherosclerosis, type 2 diabetes and hypertension, and findings from a broad range of studies show significant relationships between cognitive function and intakes of various nutrients, including long-chain polyunsaturated fatty acids, antioxidant vitamins, and folate and vitamin B12. Further support is provided by data on nutrient status and cognitive function. Almost all this evidence, however, comes from epidemiological and correlational studies. Given the problem of separating cause and effect from such evidence, and the fact that cognitive impairment and cognitive decline (and depression) are very likely to be significant factors contributing to the consumption of a poor diet, greater emphasis should now be placed on conducting intervention studies. An efficient approach to this problem could be to include assessments of mood and cognitive function as outcome measures in studies designed primarily to investigate the impact of dietary interventions on markers of physical health.

Affect↗

PubMed1999

Cognitive functioning in children with typical cri du chat (5p-) syndrome.

This study is the first attempt to assess systematically the cognitive functioning in children diagnosed with typical cri du chat syndrome (CDCS) using neuropsychological test measures. Twenty-six children aged between 6 years 4 months and 15 years 5 months (mean 8 years 3 months) completed a battery of tasks measuring IQ level, receptive and expressive language skills, and articulation. Twenty-four children were in the severe learning-disability range with no specific verbal or performance profile. Using more finely tuned measures of cognition, however, a clear discrepancy in the pattern of language functioning was found with better receptive than expressive language skills. One implication of these findings is that parents and professionals should be more optimistic about the capacities of children with CDCS to understand more complex verbal commands than their expressive language skills would suggest.

Adolescent↗

PubMed1991

Cognitive functioning and positive and negative symptoms in schizophrenia.

The present study examined schizophrenics' performance on a variety of cognitive measures in order to explore the relationship between schizophrenic symptoms and cognitive performance. The Wechsler Adult Intelligence Scale and a battery of neuropsychological tests, developed at the Montreal Neurological Institute, were administered to 38 acutely ill, hospitalized schizophrenics. Patients were diagnosed using DSM III criteria. Negative symptoms were assessed with the SANS and positive symptoms with the SAPS. Both the cognitive tests and the symptom rating scales were re-administered to this sample at a 6 month follow-up period. Analyses revealed that, at both time periods cognitive deficits were more likely to be associated with high negative symptom ratings than with positive symptoms. Only certain tests showed significant improvement at the follow-up period. Furthermore, improved cognitive functioning was related to an improvement in positive, but not negative, symptoms.

Adolescent↗

PubMed2002

Long-term effects of breast-feeding in a national birth cohort: educational attainment and midlife cognitive function.

OBJECTIVE: A recent meta-analysis showed that breast-feeding confers a 3.2 point increment in cognitive function through adolescence. Little is known, however, about possible longer-term effects of breast-feeding. We investigated the effect of breast-feeding on educational attainment, and on a range of cognitive skills in midlife, in the British 1946 birth cohort. DESIGN: Regression analyses were used to test the association between breast-feeding, likelihood of obtaining advanced educational qualifications by age 26 years, and three cognitive test scores at age 53 years: i.e. reading ability (NART), timed visual search and verbal memory. These associations were then adjusted for social confounding variables and for cognitive ability at age 15 years. SETTING AND SUBJECTS: One thousand seven hundred and thirty-nine male and female participants in the MRC National Survey of Health and Development, also known as the British 1946 birth cohort, distributed throughout England, Wales and Scotland. RESULTS: Breast-feeding was significantly and positively associated with educational attainment, an effect that was independent of early social background, but largely accounted for by cognitive ability at age 15 years. Breast-feeding was significantly and positively associated with the NART at 53 years, an effect that was independent of early social background, educational attainment and adult social class, but, again, largely accounted for by cognitive ability at 15 years. There was no independent effect of breast-feeding on timed visual search or verbal memory at 53 years. CONCLUSION: The benefit of breast-feeding has long-term potential impact across the life course through its influence on childhood cognition and educational attainment.

Adolescent↗

PubMed1995

A double-blind cross-over placebo-controlled trial of the effects of bromocriptine on psychomotor function, cognition, and mood in de novo patients with Parkinson's disease.

The effects of bromocriptine on potentially dissociable functions were investigated in this double-blind placebo-controlled trial in previously untreated Parkinsonian patients. Bromocriptine-induced reductions in response time were independent of variations in the complexity of the cognitive or motor programming components of reaction time tasks. These results suggest that bromocriptime speeds up response initiation, and it may also improve some "early" visual processes. No clear-cut verbal memory, visuospatial or general intellectual changes were produced by bromocriptine; however, further evaluation of the effects of bromocriptine on "executive" cognitive functions is clearly required. Psychiatric distress was significantly reduced when the active drug was administered. While mood improvements could not be statistically dissociated from motor improvements, review of the literature suggested that decreased emotional distress may have arisen through bromocriptine's action on neural circuits modulating mood. Some clinical implications of bromocriptine's effect on mood are mentioned.

Journal Article↗

PubMedDate not supplied

Cognitive function in elderly non-insulin-dependent diabetic patients before and after inpatient treatment for metabolic control.

Cognitive function was measured before and after inpatient treatment for metabolic control in 20 elderly patients with non-insulin-dependent diabetes mellitus (NIDDM). Another 20 patients still on the waiting list for this treatment, served as a control group. Glycosylated hemoglobin decreased in both groups. Psychomotor speed and concentration improved only after inpatient treatment (p < 0.01; p < 0.05, respectively). Improved performance was maintained and even enhanced 6 weeks after discharge from inpatient treatment. Performance in concentration tasks correlated with glycosylated hemoglobin (p < 0.05). It is concluded that cognitive deficits in elderly NIDDM patients can be reduced by inpatient treatment, although the benefit of glycemic control was not clearly demonstrated in this study.

Aged↗

PubMedDate not supplied

Impact of carotid endarterectomy upon cognitive functioning. A systematic review of the literature.

BACKGROUND AND PURPOSE: The extent to which carotid endarterectomy (CEA) influences cognitive functioning has been the subject of a number of studies often with conflicting conclusions. This paper systematically reviews the literature in an attempt to clarify this issue. RESULTS: Although the majority of studies (16/28) reported an improvement in cognition after surgery, a substantial minority (12/28) found no change. Studies before 1984 tended to report an improvement, while later studies tended to report no change in cognition. Cognitive improvement was also more likely the longer the time interval between CEA and assessment. The studies were found to differ on many methodological factors, e.g. sample size, type of patient and control group, severity and side of carotid stenosis, the range of cognitive tests and timing of postoperative assessment. CONCLUSION: Given the conflicting findings, and the methodological issues, it is not possible to draw a clear conclusion regarding the impact of carotid endarterectomy upon cognition. Future research which pays attention to these methodological factors is needed in order to adequately resolve the current debate.

Carotid Arteries↗

PubMed2005

Effect of 902 MHz mobile phone transmission on cognitive function in children.

We examine whether a standard mobile exposure at 902 MHz has a significant effect on cognitive function in 18 children 10-12 years of age. These were in a single group in which each child was given a single training session and then three test sessions in a randomized, three-way crossover design, using the cognitive drug research (CDR) cognitive assessment system. Exposures were 0, 0.025, or 0.25 W from a standard Nokia 3110 mobile phone handset mounted on a plastic headset in normal use position. The results of testing showed that the baseline (0 W) performance for the reaction time measurements was considerably slower than for the comparable measures in adult. There was a tendency for reaction time to be shorter during exposure to radiation than in the sham (baseline) condition, an effect that was most marked for simple reaction time. However, no effects reached statistical significance after Bonferroni correction. Therefore, we conclude that this study on 18 children did not replicate our earlier finding in adults that exposure to microwave radiation was associated with a reduction in reaction time. It should be noted that the present study investigated the effects of radiation from a GSM handset, whereas in our previous study the effect on reaction time was observed only with a more powerful analogue handset.

Body Burden↗

PubMed2006

Dopaminergic enhancement of cognitive function.

The ascending dopamine system of the mammalian brain has been associated with motor, mnemonic and goal-directed or reward-related behaviour. The most progress in understanding the cortical mechanisms of dopaminergic modulation of function has been made with regards to short-term mnemonic (or working memory) function. Research in experimental animals strongly suggests that stimulation of dopamine D1 receptors in the prefrontal cortex can ameliorate spatial working memory related cognitive deficits, and may even enhance cognitive function in healthy animals. Research in humans has not been able to clearly replicate these findings, partly due to the lack of available agents that can safely be used. Low doses of dopamine D2 receptor agonists such as bromocriptine and pergolide may be able to enhance working memory and executive functions, but these effects may be dependent on the nature of the tasks used and the baseline performance levels of the subjects. Thus, the effects of dopaminergic cognitive enhancers may not be simple, or uniform across subjects. Systematic studies in humans carefully controlling task parameters are needed in order to specify the potential cognitive processes open to enhancement with dopaminergics. However, since the DA receptor subtypes in different brain regions appear to differentially influence similar functions, carefully defining the cognitive processes to be tested against potential therapeutics is an equally important goal. Studies in patients groups using selective dopaminergics are rather restricted, but show promise for designing large-scale clinical trials into the cognitive enhancing properties of potential therapeutic agents that act through the dopamine system.

Animals↗

PubMed1995

Cognitive functioning in Lesch-Nyhan syndrome.

The present study represents the first effort to assess systematically the cognitive functioning of a population of individuals with Lesch-Nyhan syndrome using standardized psychometric instruments. Seven residents from a special hospital setting participated. They ranged in age from 10 years 1 month to 22 years 3 months (mean 13 years 7 months). Using the Stanford-Binet Intelligence Scale: IV, scores in each of the four domains assessed by this battery (Verbal Reasoning, Abstract/Visual Reasoning, Quantitative and Short-Term Memory), as well as the general composite score, ranged from moderately mentally retarded to low average. Areas of weakness included attention, the manipulation of complex visual images, the comprehension of complex or lengthy speech, mathematical ability, and multi-step reasoning.

Adolescent↗