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Cognitive functioning in children and adolescents with multiple sclerosis.

OBJECTIVE: To examine cognitive functioning in children with multiple sclerosis (MS). METHODS: The authors examined the neuropsychological profile of 37 children with a diagnosis of clinically definite MS and assessed the associations between cognitive function and clinical features. RESULTS: Of 37 children and adolescents evaluated, 35% demonstrated significant cognitive impairment. Cognitive functioning was strongly related to several clinical variables, including current Expanded Disability Status Scale, total number of relapses, and total disease length. The consequences of MS adversely affected academic functioning in over a third of the children. CONCLUSIONS: Cognitive deficits occur in children with multiple sclerosis. Comprehensive treatment planning should involve recognition that they may require academic accommodations for their education.

Activities of Daily Living↗

[Neuropsychology of eating disorders: a systematic review of the literature].

BACKGROUND: The pathophysiology of eating disorders is still unknown, with many factors possibly involved. The existence of a central nervous system (CNS) dysfunction is being investigated with particular interest. One of the most employed strategies to reach this goal is the evaluation of cognitive functioning of patients with eating disorders with neuropsychological tests. OBJECTIVE: To evaluate the current knowledge about the neuropsychology of ED. METHODS: We performed a review of several data bases (including MedLINE, PsychoINFO, LILACS and Cochrane Data Bank), using terms related to main theme of interest. The review comprised articles published up to January, 2004. RESULTS: Anorexia Nervosa (AN) was the most studied ED from the neuropsychological point-of-view, with studies tending to elicit attentive, visuo-spatial, and visuo-constructive deficits among such patients. On the other side, patients with Bulimia Nervosa (BN) exhibited deficits in the selective aspects of attention and in executive functions. As yet, there is no study covering the neuropsychological aspects of binge-eating disorder. After successful treatment, individuals show improvement of some cognitive deficits, while other seem to persist. CONCLUSIONS: The ED are possibly associated with a certain degree of neuropsychological dysfunction, even though there is no consensus with regard to which function is particularly impaired. The fact that some cognitive dysfunction tend to disappear after treatment argues in favor of the hypothesis that these are functional deficits. Other deficits, however, tend to persist, suggesting that they may precede the development of eating disorders or even contribute to their development or to a worse prognosis. The study of the neuropsychological aspects of ED may help tailoring more selective therapeutic approaches to patients suffering from these disorders.

Cognition Disorders↗

[Speech disorders in tumors of the left frontal lobe].

The paper deals with a description of speech activity or dynamic aphasia seen in 9 patients with tumors of the left frontal lobe. A weakening of volition to speech was combined with disorders of naming, verbal memory, logic thinking. All these disturbances were accompanied by general motor inhibition. Among the 9 studied patients in 8 cases the focus of lesion was situated on the medial surface of the hemisphere, corresponding to the supplementary Penfield speech zone.

Adult↗

[Non-linguistic cognitive symptoms of cerebral stroke].

BACKGROUND: Cognitive symptoms are common after stroke, but doctors' knowledge about such symptoms seems sparse. METHODS: We review the literature and present our own clinical experience on selected cognitive losses after stroke. RESULTS AND INTERPRETATION: The most common non-linguistic cognitive symptoms are neglect (hemi-inattention), visuospatial problems (difficulties in putting elements together or to perform spatial tasks), and apraxia (difficulties in performing voluntary, purposeful tasks due to mistakes in the choice and order of motor elements). More than half of patients suffer from such symptoms in the acute phase of stroke and approximately one in four has long-lasting problems. Knowledge about these symptoms is essential for effective rehabilitation, good information to the patient and his caregivers, and for prognostic purposes. Full evaluation of cognitive losses requires a neuropsychological examination, but thorough observation of the patient combined with simple pen-and-paper tests can be very helpful.

Agnosia↗

[Associative processes disorders in schizophrenia].

This paper tries to approach and systematize knowledge about the character of associative process disorders in schizophrenia. In considering schizophrenia as an illness composed of various symptoms which may lead to different clinical progress, the paper is mainly focused on disorganization of thinking and, consequently, speaking and communication disorders. Authors reviewed various concept of pathogenesis and course of associative process disorders in schizophrenic patients. Special attention was paid to a connectionist model of disturbed associations. This model originates from cognitive psychology and assumes that concepts are represented as networks in the mental lexicon. Following from this model, a hypothesis was presented, claiming that disturbed associations in schizophrenia may be related to abnormalities in semantic networks. Results of research, supporting this hypothesis, were referred. Moreover, authors tried to describe the relationship between associative processes disorders in schizophrenia and abnormalities in neurophysiological (event--related potentials) and neuropathological (MRI) examinations. At least hypotheses describing the role of neurotransmission disorders was presented.

Cognition Disorders↗

[Rehabilitation in old age: a neuropsychological perspective].

We are revising some programs of cerebral activation in elderly people. The application criteria from a neuropsychological perspective are proposed. A change about the rehabilitation of all types of brain injuries and its prevention is needed in the professional's attitude.

Aged↗