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PubMed2006

A meta-analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer.

Given the improvement in mortality rates associated with breast cancer, the importance of understanding the long-term neuropsychological consequences of chemotherapy is becoming increasingly vital. This study applies meta-analytic techniques to the scant literature on the relationship between contemporary adjuvant chemotherapy treatment for breast cancer and cognitive dysfunction as examined through neuropsychological indices. Seven studies (involving more than 300 participants) were selected from over 200 potential articles, based on three inclusion criteria: presence of breast cancer, administration of chemotherapy treatment, and use of neuropsychological tests. From these, nine treatment-control comparisons were used to generate 129 Hedge's d effect sizes across the cognitive domains of simple attention, working memory short- and long-term memory, speed of processing, language, spatial abilities, and motor function. Small to medium cumulative effect sizes, showing diminished cognitive function for chemotherapy treatment groups compared to control groups, were obtained for each of the eight cognitive domains. Overall, these results suggest that women who undergo adjuvant chemotherapy as treatment for breast cancer may experience subtle yet consequential cognitive decline.

Breast Neoplasms↗
PubMedDate not supplied

Cognitive functioning in chronic fatigue syndrome and depression: a preliminary comparison.

This study used a brief battery of neuropsychological measures to examine the performance of patients with chronic fatigue syndrome (CFS) (N = 16) and patients in a major depressive episode (N = 23). The overall neuropsychological performance of the CFS group was not significantly different from depressed patients, and both groups scored within normal limits on most measures. Variability of neuropsychologic performance was in general unrelated to level of depressive symptoms. The results are discussed in terms of the validity of the cognitive criterion for the CFS diagnosis. Subjective complaints of cognitive dysfunction by CFS patients in light of the lack of objective evidence for the same are considered in terms of a somatic vigilance hypothesis.

Adult↗
PubMed1986

Hearing impairment and cognitive decline in senile dementia of the Alzheimer's type.

Hearing impairment has been hypothesized as contributing to symptoms of dementia. Data from a longitudinal study were analyzed to determine if auditory status predicted cognitive functional decline in senile dementia of the Alzheimer's type (SDAT). As part of a larger study, 156 consecutive SDAT outpatients had received a comprehensive medical evaluation including baseline screening for hearing impairment with the finger friction test and serial assessment of cognitive function with the Mini-Mental State examination. Age and cognitive function at entry to the study were greater among individuals with impaired hearing (N = 36) than with normal hearing (N = 120). The demographic profiles of the impaired and normal hearing groups were otherwise similar, as was the prevalence of depression. Intervening mortality rates were nearly identical. Decline in cognitive function one year later, however, was nearly twice as great in the impaired hearing group, a statistically significant difference (P less than .05, by one-tailed t test) even when controlled for age and initial cognitive function. These results, which need to be verified with sophisticated audiometric techniques, suggest that hearing impairment may be a prognostic indicator for subsequent cognitive dysfunction in SDAT. They are consistent with the hypothesized relationship between hearing impairment and dementia in SDAT as well as alternative hypotheses discussed in the text.

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PubMed1991

Neuroradiological facets of cognitive abnormality in schizophrenia.

Cognitive abnormality has long been regarded as a core feature of schizophrenia, but its nature and etiopathology have been poorly understood. Predicated on new tests that characterize fundamental cognitive impairments, we investigated their relationship to four neuroradiological markers that have been previously implicated in schizophrenia: choroid plexus calcification, cerebellar atrophy, third ventricle enlargement, and pineal calcification. Twenty-three chronic schizophrenic inpatients meeting RDC and DSM-III diagnostic criteria were stabilized on chlorpromazine and assessed independently on a cognitive battery and on CT scan. The results indicated that all four neuroradiological variables were independent of one another and of demographic, historical, and general intellectual measures. The neuroradiological assessments, however, correlated significantly with different cognitive parameters, implying separate pathophysiological bases for distinct profiles of cognitive abnormality. The findings support a "dual-process model" of cognitive dysfunction that posits developmental and arousal-related components which may, more generally, underlie the positive-negative dimension of schizophrenia.

Adult↗
PubMed1991

[Different disciplines, different diagnoses?--A survey among participants of a consensus conference on dementia].

It is hardly known to what extent consensus criteria for dementia are adhered to in clinical practice. An inquiry was held among the participants of the Dutch consensus meeting on dementia to investigate this point. 85 clinicians diagnosed the case descriptions of 10 patients with cognitive dysfunctions. The inquiry was split into two parts, i.e. before and after the meeting. There was no difference between the two parts in the level of consensus. There was not difference between the disciplines in syndrome diagnoses. However, with regard to etiology, significant differences existed between the specialties. Furthermore, the agreement increased with the severity of the cognitive disturbances. In cases where depressive symptoms coexisted, the diagnosis was more often in error. The nature of the diagnoses appeared to be dependent on the discipline of the diagnostician. This study underlines the necessity of a multidisciplinary diagnostic approach based on well accepted criteria.

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PubMed2005

Enhanced hippocampal neurogenesis by intraventricular S100B infusion is associated with improved cognitive recovery after traumatic brain injury.

Evidence of injury-induced neurogenesis in the adult hippocampus suggests that an endogenous repair mechanism exists for cognitive dysfunction following traumatic brain injury (TBI). One factor that may be associated with this restoration is S100B, a neurotrophic/mitogenic protein produced by astrocytes, which has been shown to improve memory function. Therefore, we examined whether an intraventricular S100B infusion enhances neurogenesis within the hippocampus following experimental TBI and whether the biological response can be associated with a measurable cognitive improvement. Following lateral fluid percussion or sham injury in male rats (n = 60), we infused S100B (50 ng/h) or vehicle into the lateral ventricle for 7 days using an osmotic micro-pump. Cell proliferation was assessed by injecting the mitotic marker bromodeoxyuridine (BrdU) on day 2 postinjury. Quantification of BrdU-immunoreactive cells in the dentate gyrus revealed an S100B-enhanced proliferation as assessed on day 5 post-injury (p < 0.05), persisting up to 5 weeks (p < 0.05). Using cell-specific markers, we determined the relative numbers of these progenitor cells that became neurons or glia and found that S100B profoundly increased hippocampal neurogenesis 5 weeks after TBI (p < 0.05). Furthermore, spatial learning ability, as assessed by the Morris water maze on day 30-34 post-injury, revealed an improved cognitive performance after S100B infusion (p < 0.05). Collectively, our findings indicate that an intraventricular S100B infusion induces neurogenesis within the hippocampus, which can be associated with an enhanced cognitive function following experimental TBI. These observations provide compelling evidence for the therapeutic potential of S100B in improving functional recovery following TBI.

Animals↗
PubMed2002

Aspects of neurodegeneration in the canine brain.

The process of neurodegeneration displays some common morphological characteristics, most of which are jointly observed in the brains of most mammalian species. In the canine brain, neurodegeneration is frequently typified by an extensive beta-amyloid (A beta) deposition (mainly of the C-terminal A beta1-42 form) within the neurones and at the synaptic regions, in the early stages of the process. These deposits subsequently appear to give rise to the formation of senile plaques of the diffuse (non-beta-sheet) subtype, which tend to develop spontaneously but rarely proceed to form neuritic plaques. Additional features accompanying neurodegeneration include accumulations of the "aging pigment," lipofuscin, intraneuronal changes in the cytoskeleton, vascular changes in the cerebrum, cortical cerebral atrophy, enlargement of the ventricles and increased concentration of oxidative stress markers, many of which are perceived as cardinal features of extensive dysfunction in the protein turnover network. The involvement of ubiquitin is discrete but consistent in many of these molecular structures and seems to account for some critical aspects of the associated neuropathology. Irrespective of these, though, the degenerated canine brain seems to be devoid of neurofibrillary tangle formation, a manifestation commonly observed in the brain of both aged (cognitively normal) and Alzheimer-affected human subjects. The fact that canines exhibit clear symptoms of an age-related cognitive decline pertains to the concept of A beta playing a central role in age-related cognitive dysfunction and neurodegeneration.

Animals↗
PubMed1987

The Neurobehavioral Cognitive Status Examination: comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population.

Studies to determine the validity of the Mini-Mental State Examination (MMSE) and the Cognitive Capacity Screening Examination (CCSE) have indicated unacceptably high false-negative rates for these tests. To determine whether a new examination, the Neurobehavioral Cognitive Status Examination (NCSE), is more sensitive in the detection of cognitive dysfunction, we compared the three examinations in 30 patients with documented brain lesions. The CCSE had a false-negative rate of 53%; the MMSE, of 43%; and the NCSE, of 7%. The sensitivity of the NCSE is derived from two features of its design: the use of independent tests to assess skills within five major areas of cognitive functioning, and the use of graded tasks within each of these cognitive domains.

Adult↗
PubMedDate not supplied

Memory disturbances and temporal lobe epilepsy simulating Alzheimer's disease: a case report.

We report the case of a patient presenting with recurrent transient dyscognitive episodes and memory disturbances, simulating the clinical picture of early Alzheimer's disease (AD). Neuropsychological examination showed only episodic memory impairment without significant progression over time in the absence of any other cognitive dysfunctions; magnetic resonance imaging failed to show selective temporal atrophy. The suspicion that a nocturnal epileptic seizure had occurred arose on the basis of a clinical report of tongue biting and the findings of sharp waves over the temporal region on standard EEG. Thus 600 mg/day of carbamazepine was added to donezepil therapy. Antiepileptic treatment completely reversed the cognitive disturbances. Our observation stresses the possibility that unrecognised epilepsy may present as early AD.

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PubMed1992

Visual event-related P300 potentials in early portosystemic encephalopathy.

Visual event-related P300 potentials, conventional visual evoked potentials, and psychometric tests were applied to patients with noncirrhotic chronic liver disease and to clinically nonencephalopathic and encephalopathic cirrhotics to compare their diagnostic efficacy in detecting early portosystemic encephalopathy (PSE). Sixty-four investigations were performed in 58 patients. The latencies of the P300 parameters were significantly longer in both the encephalopathic and nonencephalopathic cirrhotics than in the noncirrhotics, indicating distinctly abnormal cortical processing of visual stimuli in cirrhotic patients. The visual P300 potentials showed the highest sensitivity and specificity for grade I PSE. Abnormal P300 test results were also found in 78% of the clinically nonencephalopathic cirrhotics, while psychometric tests showed abnormalities in only 41%. The P300 latencies were similar in alcoholic and nonalcoholic cirrhotics. Significant inverse correlations were found between the P300 latencies and measures of quantitative liver function such as galactose-elimination capacity and aminopyrine breath test. It is concluded that visual event-related P300 potentials are a sensitive index of subclinical and grade I PSE. Furthermore, the degree of cognitive dysfunction detected by this method in patients with liver cirrhosis appears to be related to the reduction in hepatic metabolic capacity.

Adult↗
PubMed2005

Decision-making capacity for research participation among individuals in the CATIE schizophrenia trial.

OBJECTIVE: Uncertainty regarding the degree to which persons with schizophrenia may lack decision-making capacity, and what the predictors of capacity may be led us to examine the relationship between psychopathology, neurocognitive functioning, and decision-making capacity in a large sample of persons with schizophrenia at entry into a clinical trial. METHOD: In the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial, a clinical trial sponsored by the National Institute of Mental Health designed to compare the effectiveness of antipsychotic drugs, subjects were administered the MacArthur Competence Assessment Tool-Clinical Research (MacCAT-CR) and had to demonstrate adequate decision-making capacity before randomization. The MacCAT-CR, the Positive and Negative Syndrome Scale (PANSS), and an extensive neurocognitive battery were completed for 1447 study participants. RESULTS: The neurocognitive composite score and all 5 neurocognitive subscores (verbal memory, vigilance, processing speed, reasoning, and working memory) were positive correlates of the MacCAT-CR understanding, appreciation, and reasoning scales at baseline. Higher levels of negative symptoms, but not positive symptoms, were inversely correlated with these three MacCAT-CR scales. Linear regression models of all three MacCAT-CR scales identified working memory as a predictor; negative symptoms made a small contribution to the understanding and appreciation scores. CONCLUSIONS: Negative symptoms and aspects of neurocognitive functioning were correlated with decision-making capacity in this large sample of moderately ill subjects with schizophrenia. In multiple regression models predicting performance on the MacCAT-CR scales, working memory was the only consistent predictor of the components of decision-making capacity. Individuals with schizophrenia who have prominent cognitive dysfunction, especially memory impairment, may warrant particular attention when participating in research.

Adolescent↗
PubMed2001

Association of estrogen levels with neuropsychological performance in women with schizophrenia.

OBJECTIVE: This study sought to determine the relationship of estrogen levels with psychiatric symptoms and neuropsychological function in female patients with schizophrenia. METHOD: Psychiatric symptoms were assessed and average estrogen and progesterone levels from four consecutive weekly blood samples were measured in 22 female inpatients with schizophrenia who were also administered a neuropsychological battery. RESULTS: There were strong positive correlations between average estrogen level and cognitive function, especially measures of global cognitive function, verbal and spatial declarative memory, and perceptual-motor speed. Correlations of hormone levels with psychiatric symptoms were nonsignificant. CONCLUSIONS: Higher estrogen levels in female patients with schizophrenia are associated with better cognitive ability. These results may have implications for potential treatment of cognitive dysfunction with adjunctive estrogen in female patients with schizophrenia.

Adolescent↗
PubMed1995

Event-related auditory evoked potentials and amyotrophic lateral sclerosis.

OBJECTIVE: To study event-related potentials and particularly the P300 wave in a group of patients with amyotrophic lateral sclerosis (ALS), as changes in the P300 wave have been observed in many cases of brain damage-inducing cognitive impairment. DESIGN: Case series. SETTING: University hospital. PATIENTS: Twenty patients with ALS were compared with 20 healthy control subjects, with no significant age range and no significant difference in their education level. MAIN OUTCOME MEASURES: Amplitudes and latencies of long-latency auditory evoked potentials for the N100, P200, N200, and P300 waves were measured in the "odd-ball paradigm." Mental status was assessed by the Similarities subtest of the Wechsler Adult Intelligence Scale and by the Rapid Evaluation of Cognitive Function that allows for a mini-neuropsychological testing. The degree of disability was scored on the ALS Severity Scale, which rates bulbar and spinal functions. RESULTS: The latencies of the N100 and P200 waves did not appear to differ between normal and affected subjects; in contrast, the N200 and P300 latencies were significantly longer in the group with ALS. Sixty percent of the patients had a P300 latency more than 2 SDs above the theoretical norm that was established by the linear curve for control subjects. The N100, P200, N200, and P300 amplitudes showed no significant difference between the control subjects and the group of patients with ALS. There was no significant correlation between the N200 and P300 latencies and the disease duration or between the N200 and P300 latencies and the degree of motor impairment. The scores from the Rapid Evaluation of Cognitive Function were significantly lower in the group of patients with ALS than in the group of control subjects. CONCLUSIONS: A subtle cortical cognitive dysfunction is frequently observed in patients with ALS. These findings point also in the same direction as did previous neuropsychological, histological, and positron emission tomographic studies of ALS. Limb motor deficits and speech difficulties make it difficult to study the time course of changes in intellectual function in patients with ALS by using psychometric methods; thus, in the future, cognitive evoked potentials should constitute a fruitful method of testing cognitive function in patients with ALS to follow up their development over time.

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PubMed2006

Cognitive function in adults with type 2 diabetes and major depression.

The aim of this study was to identify characteristics of neuropsychological functioning among type 2 diabetic adults with and without major depression. Twenty type 2 diabetics with major depression, 20 non-depressed type 2 diabetics and 34 controls without diabetes or depression were compared. A mixed effects repeated measures analysis of covariance indicated significant differences in overall cognitive functioning between diagnostic groups, specifically depressed diabetics demonstrated greater cognitive dysfunction than controls. Further comparisons indicated that depressed diabetics performed significantly worse than non-depressed diabetics in attention/information processing speed. Relative to controls, depressed diabetics performed significantly worse in attention/information processing speed and executive functioning, while there was a trend for non-depressed diabetics to perform worse in executive functioning. These findings suggest that depression negatively impacts cognitive performance among adults with type 2 diabetes, which may have implications for neural circuitry underlying cognitive and mood changes in diabetic patients.

Adult↗
PubMed2006

Cognitive dietary restraint and cortisol: importance of pervasive concerns with appearance.

The purpose of this study was to elucidate the nature of the relationship between dietary restraint and physiological stress, by investigating which eating and body-related constructs are related to salivary cortisol and to perceived stress. Female undergraduates (N = 170) completed self-report measures on dietary restraint, appearance beliefs, body satisfaction variables, perceived stress, and eating self-efficacy. Participants also provided two saliva samples. The first sample was collected after awakening, and the second was collected 6-8 h later. A factor analysis was performed in order to reduce redundancy in the set of measures surrounding eating and body attitudes, which yielded three factors. The findings indicated that women with stronger beliefs about the importance of their appearance, as well as negative emotions and cognitions surrounding their body image, had higher levels of cortisol in the afternoon. These appearance and body-related constructs were also associated with higher levels of perceived stress. However, perceived stress was not associated with salivary cortisol. There were no significant relationships between any of the eating or psychological variables and morning cortisol levels. These results suggest that dysfunctional cognitions surrounding appearance and body image significantly contribute to the relationship between dietary restraint and elevations in cortisol excretion. Implications for interventions and women's health are discussed.

Adolescent↗
PubMed2003

Effects of the anti-platelet aggregation drug dilazep on cognitive function in Dahl salt-sensitive rats.

Among the consequences of the increasing prolongation of lifespan is a worldwide increase in the number of cases of dementia or impaired cognition. In the present study, to test the hypothesis that mechanisms independent of high blood pressure are involved in maintaining cognitive function, we assessed the effects of long-term dilazep treatment on cognitive dysfunction in normotensive Dahl salt-sensitive (Dahl S) rats fed a low-salt diet, using the standard passive avoidance test. Normotensive Dahl S rats fed a 0.3% NaCl diet were treated for 6 months with low-dose dilazep (2.5 microg/ml in drinking water) or high-dose dilazep (12.5 microg/ml). Systolic blood pressure was within normotensive range throughout the study and did not differ among the experimental groups. The results of the passive avoidance test revealed that dilazep treatment attenuated the decline of latency time relative to that in the untreated control rats (control latency time, 235 s; low-dilazep group, 389 s; high-dilazep group, 397 s), suggesting that the cognitive function of normotensive Dahl S rats was improved by dilazep treatment. This improvement of cognition was associated with significant increases in the number of neuronal cells in the hippocampal region and with an increase in capillary length in dilazep-treated Dahl rats. In addition, the dilazep treatments significantly attenuated arteriolar injury of glomeruli in the kidney. These data suggest that dilazep treatment, through vascular and non-vascular effects, maintains the brain function in Dahl S rats susceptible to vascular injury and organ dysfunction.

Animals↗
PubMed2000

Relationship of behavioral and psychological symptoms to cognitive impairment and functional status in Alzheimer's disease.

OBJECTIVE: This cross-sectional study examined the relationship of behavioral and psychological symptoms to cognitive and functional impairment in Alzheimer's disease (AD). DESIGN: One hundred and fourteen patients were evaluated consecutively at a university-affiliated outpatient memory disorders clinic and diagnosed with possible or probable Alzheimer's disease (AD) according to NINCDS-ADRDA criteria. Subjects were assessed with the Behavioral Pathology in Alzheimer's Disease Scale (BEHAVE-AD), Revised Memory and Behavior Problem Checklist (RMBPC), Blessed Dementia Scale (BDS), and Mini-Mental State Examination (MMSE). RESULTS: Several symptoms of behavioral pathology showed associations with MMSE scores, including activity disturbances, delusions, and hallucinations. After controlling for the variance associated with the MMSE, activity disturbances, diurnal disturbances, delusions, and hallucinations were linked with BDS scores. CONCLUSIONS: The results suggest that some non-cognitive symptoms may be related to the neurobiologic mechanisms underlying the increased cognitive dysfunction in AD. Specific symptoms of behavioral pathology may also impact a patient's ability to perform important self-maintenance behaviors.

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