Biomedical subjects

J Jolles

Publications and source records attributed to J Jolles.

At least 19 recordsLinked to original sources

PubMed2000

Tardive dyskinesia is associated with impaired retrieval from long-term memory: the Curaçao Extrapyramidal Syndromes Study: IV.

Tardive dyskinesia may be associated with cognitive dysfunction. It is not clear whether this dysfunction occurs in the form of a global or specific cognitive deficit. A cross-sectional study was conducted in a well-defined catchment area (Curaçao, The Netherlands Antilles). All schizophrenic inpatients who had been taking neuroleptic medication for at least 3months and who were younger than 65years were included (n=53). Tardive dyskinesia was assessed with the Abnormal Involuntary Movement Scale. The neuropsychological assessment comprised tests of memory, executive function, and speed of information processing. Of the six cognitive measures, only delayed recall was significantly associated with orofacial dyskinesia. Limb-truncal dyskinesia was not associated with any of the cognitive measures. The pattern of memory impairment is consistent with there being a frontal-subcortical disturbance in orofacial dyskinesia. The results underscore the importance of using specific cognitive test procedures in the search for the cognitive correlates of dyskinesia.

Basal Ganglia Diseases↗

PubMed2000

Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study.

Cerebral white matter lesions (WMLs) have been associated with cognitive dysfunction. Whether periventricular or subcortical WMLs relate differently to cognitive function is still uncertain. In addition, it is unclear whether WMLs are related to specific cognitive domains such as memory or psychomotor speed. We examined the relationship between periventricular and subcortical WMLs and cognitive functioning in 1,077 elderly subjects randomly sampled from the general population. Quantification of WMLs was assessed by means of an extensive rating scale on 1.5-T magnetic resonance imaging scans. Cognitive function was assessed by using multiple neuropsychological tests from which we constructed compound scores for psychomotor speed, memory performance, and global cognitive function. When analyzed separately, both periventricular and subcortical WMLs were related to all neuropsychological measures. When periventricular WMLs were analyzed conditional on subcortical WMLs and vice versa, the relationship between periventricular WMLs and global cognitive function remained unaltered whereas the relationship with subcortical WMLs disappeared. Subjects with most severe periventricular WMLs performed nearly 1 SD below average on tasks involving psychomotor speed, and more than 0.5 SD below average for global cognitive function. Tasks that involve speed of cognitive processes appear to be more affected by WMLs than memory tasks.

Aged↗

PubMed2000

Neuropsychology of infarctions in the thalamus: a review.

From a review of the literature on the consequences of thalamic infarctions, it may be concluded that memory problems taking the form of an amnesic syndrome are dependent upon the integrity of the mammillo-thalamic tract (MTT). Memory problems incompatible with an amnesic syndrome however, appear to result from thalamic infarctions involving other areas of the thalamus but which leave MTT intact. In contrast, executive dysfunctions could not be shown so readily to depend upon a single structure of the thalamus. The results indicate that damage to the mediodorsal nucleus of the thalamus, the midline nuclei or the intralaminar nuclei, or a combined lesion of these structures may be responsible for deficits of executive functioning.

Cerebral Infarction↗

PubMed2000

Mild hearing impairment can reduce verbal memory performance in a healthy adult population.

We studied to what extent immediate and delayed recall in an auditory verbal learning paradigm was affected by basic information processing speed (digit copying) and hearing acuity (average hearing acuity at 1, 2 and 4 KHz at the better ear). A group of 453 individuals in the age between 23 and 82 years with no overt hearing pathology was recruited from a larger study of cognitive aging (Maastricht Aging Study, MAAS). After controlling for age, sex, educational level, and processing speed it was found that a mild to moderate hearing loss predicted lower verbal memory performance. Auditory administered verbal memory tests can underestimate true memory performance, particularly in older individuals with unknown hearing status.

Adult↗

PubMed2000

Normal cognitive performance in patients with chronic alcoholism in contrast to patients with Korsakoff's syndrome.

This study investigated which cognitive deficits are associated with chronic alcoholism. Neuropsychological profiles and MRI brain structure volumes of 14 patients with Korsakoff's syndrome, 15 patients with chronic alcoholism, and 16 healthy control subjects were compared. The patients with alcoholism had a normal cognitive performance and normal brain structure volumes. The patients with Korsakoff's syndrome had performance deficits on tests of memory, visuoperceptual, and executive functions, as well as reduced brain structure volumes. The results suggest that the cognitive deficits cannot be ascribed to mere chronic consumption of alcohol. If cognitive deficits are present in patients with chronic alcoholism, this may point to an underlying brain disorder.

Adult↗

PubMed1999

A controlled study of temporal lobe structure volumes and P300 responses in schizophrenic patients with persistent auditory hallucinations.

Recent studies of cerebral pathology in patients with schizophrenia have focused on symptomatological and electrophysiological correlates of reduced temporal lobe structure volumes. Volume deficits of the left superior temporal gyrus have been correlated with auditory hallucinations as well as to left-sided P300 amplitude reduction. However, caution is needed to interpret correlational data as evidence of a specific relationship. Therefore, a controlled study was undertaken on schizophrenic patients with and without auditory hallucinations. MRI-defined volumes of the left superior temporal gyrus and other temporal lobe structures were quantified from 3-mm coronal slices in 15 schizophrenic patients with chronic auditory hallucinations (hallucinators), 15 schizophrenic patients without auditory hallucinations (nonhallucinators) and 17 healthy controls. In all subjects a simple oddball paradigm was used to elicit P300 responses at temporal and centro-parietal electrode sites. No evidence was found for volume reductions of temporal lobe structures in the combined patient group compared with controls, or in the hallucinators compared with the nonhallucinators. The patients did show left P300 amplitude reduction compared with controls, particularly in the hallucinator group. Correlations between volumes of left temporal lobe structures and left P300 amplitudes were low and not significant. The results of the present study do not indicate that auditory hallucinations and associated abnormal electrophysiological activity are the consequence of atrophy of localized temporal lobe structures. However, replication in a larger sample of subjects is needed before firm conclusions can be drawn.

Adult↗

PubMed1999

Quantitative analysis of magnetization transfer images of the brain: effect of closed head injury, age and sex on white matter.

Magnetization transfer (MT) imaging has an application in quantitative assessment of cerebral white matter. Previously published postprocessing methods have inherent problems, and therefore a new analysis technique is presented. This technique was found to be more sensitive for white matter changes in patients with a postconcussional syndrome, compared to other methods previously described. Because of the potential application of this technique in longitudinal and group studies, age and sex dependence of the MT ratio (MTR) of white matter were studied. In a group of 51 healthy subjects, a decrease in the mean MTR as well as an increasing distribution width of the MTR was found with increasing age. The mean MTR in males was higher than in females. These results stress the need to take age and sex into account when interpreting MTR data. Magn Reson Med 42:803-806, 1999.

Adult↗

PubMed1999

Medial temporal lobe atrophy and memory dysfunction as predictors for dementia in subjects with mild cognitive impairment.

To determine whether the medial temporal lobe is atrophic in subjects with mild cognitive impairment, and whether atrophy of this structure is a better predictor of dementia than memory dysfunction. Forty-five noninstitutionalized subjects aged 65-85 years were randomly selected from a population based study to obtain a sample with Alzheimer's disease (AD; n = 7), and a clinically nondemented sample (n = 38). Twenty of the latter subjects displayed some cognitive impairment and fulfilled CAMDEX criteria for "minimal dementia." Coronal T1-weighted magnetic resonance imaging was used to visualize the medial temporal lobe. The volume of the parahippocampal gyrus and hippocampus was measured, and medial temporal lobe atrophy was assessed qualitatively. The memory subscore from the CAMCOG was used as a measure of memory functioning. The follow-up period was 3 years. Nine subjects who were diagnosed as being minimally demented at baseline met the criteria for AD during follow-up. At baseline the volume of the parahippocampal gyrus of these subjects was smaller than that of the other subjects with minimal dementia. The memory score was the best predictor of clinical outcome. All medial temporal lobe measures increased the accuracy of prediction compared with only the memory score, by reducing the number of false-negative classifications of dementia. Severe medial temporal lobe atrophy is present even in some subjects with mild cognitive impairment and is an indicator of subsequent AD. The absence of medial temporal lobe atrophy, however, does not exclude the development of dementia. In the majority of subjects memory impairment was a better predictor of dementia than atrophy of the medial temporal lobe. The combination of the two increased predictive accuracy. Nondemented subjects with severe atrophy of the medial temporal lobe could be enrolled in drug trials aimed at slowing the progression of AD.

Aged↗

PubMed1999

1998 Curt P. Richter Award. The effect of hormone replacement therapy on cognitive function in elderly women.

Although evidence seems to indicate favorable effects of hormone replacement therapy (HRT) on cognitive functions and mood in elderly healthy and demented women, some questions remain. For instance, the nature of the long term effect of HRT, e.g. in preventing cognitive decline is still unclear. In this respect, the addition of progestagens in combined HRT has been mentioned to oppose some of the beneficial effects of estrogens. The present paper aims to illuminate these questions and presents two studies. In the first study, the long term effects of combined HRT in healthy postmenopausal women was investigated using a parallel groups (HRT-users vs. controls) design. HRT subjects were always tested during the estrogen-progestagen phase. Results indicated that after 6 and 12 months, women in the HRT-treatment group had higher scores on several indicators of the subjective feeling of well being (sleep, physical and psychological complaints) than matched controls, although at baseline both groups were not severely impaired. Effects of HRT on memory functions were seen when HRT treated subjects were compared with their own baseline functioning, but not when compared with controls. Hence, the addition of progestagen did not oppose the effects of estrogens on subjective feelings of well being or on memory. Our second (case-control) study involved women of middle-age who were unaware of the purpose of the experiment. No positive effects of HRT use on subjective scales of well being or on memory were found. However, women with HRT were faster on basic sensorimotor speed tasks as compared with controls. It should be kept in mind that double blind testing in an experimental study is difficult due to withdrawal bleeding and the reduction of flushes. Expectancy effects may have confounded the results of the first study. However, our findings indicate that the use of a particular design and type of memory test can explain the controversial results of studies into the effect of HRT on cognitive function. Furthermore, it was concluded that HRT has a global activating, instead of specific direct effect on cognitive functions.

Affect↗

PubMed1999

Cognition-enhancing properties of subchronic phosphatidylserine (PS) treatment in middle-aged rats: comparison of bovine cortex PS with egg PS and soybean PS.

There are various clinical and non-clinical studies that have indicated that phosphatidylserine (PS) treatment can improve cognitive functions in humans and other animals. However, treatment with PS derived from bovine cortex is not desirable because of possible transfer of infectious diseases. The present study investigated the cognition-enhancing properties of different types of PS in rats. Seventeen-month-old male Fischer 344 rats were treated daily with a dose of 15 mg/kg of PS derived from bovine cortex (BC-PS), soybean (S-PS), egg (E-PS), or vehicle (n = 9 for each group). The effects of treatment were evaluated in three different behavioral tests. An open field test was conducted to examine the effects of treatment on psychomotor behavior. Two other tests (Morris water escape task and two-way active avoidance) assessed treatment effects on the cognitive performance of rats. Treatment with the different forms of PS did not affect the psychomotor or spatial discrimination performance of the rats. In accordance with previous studies, the cognition-enhancing effects of BC-PS were observed in the two-way active avoidance task. It appeared that the cognition-enhancing effects of S-PS were not different from those of BC-PS. The performance of rats treated with E-PS did not deviate from that of vehicle-treated rats. On the basis of the present study, it was concluded that S-PS, but not E-PS, may have comparable effects on cognition when compared with BC-PS.

Animals↗

PubMed1999

Caffeine improves cognitive performance after strenuous physical exercise.

The effects of three carbohydrate electrolyte solutions (CES) containing different amounts of caffeine on cognitive function and the combined effects of these drinks and exercise on cognitive functions were investigated in a double-blind, cross-over study. On five separate occasions, fifteen endurance trained male athletes (23.3 years) received water placebo, CES placebo (68.8 g/l), and three CES drinks containing low, medium and high dosages of caffeine (150, 225 and 320 mg/l). Each occasion, 8 ml/kg of the drink was consumed before -- and 6 ml/kg of the drink was consumed during an all-out 1 hour time trial on a bicycle ergometer. Cognitive (attentional, psychomotor, and memory) tests were carried out immediately before and immediately after exercise. Before exercise, long term memory was improved by CES plus low dose caffeine compared to both placebos. Immediately after exercise, all cognitive functions were improved by CES plus low- and medium-dose caffeine compared to placebo. These results comprise the first practical demonstration of the cognition improving effects of low amounts of caffeine in CES after strenuous physical exercise.

Adult↗

PubMed1999

The behavioural assessment of the dysexecutive syndrome as a tool to assess executive functions in schizophrenia.

Recent research into the cognitive dysfunctions in schizophrenia has focused on executive deficits. This study investigates performance of patients with schizophrenia on the recently developed Behavourial Assessment of the Dysexecutive Syndrome (BADS). Matched groups of 24 patients with schizophrenia and 17 healthy volunteers were administered the BADS, the Modified Card Sorting Test (MCST), the Tower of London (TOL), a test of general intelligence, and measures of daily functioning. Performance of the schizophrenic group was significantly below that of the control group on the BADS and the MCST, but not on the TOL. The BADS correlated weakly with the MCST. Both tests showed a modest correlation with daily functioning. The BADS appears to offer a useful contribution to the assessment of executive deficits in schizophrenia.

Adult↗

PubMed1999

How ageing and social factors affect memory.

OBJECTIVES: To explore the relationships between lifestyle and memory, and determine whether social factors influence memory. METHODS: the relationship between memory and lifestyle was examined in 497 adults aged 25-80 years, using the Mectamemory in Adulthood questionnaire. We asked about sports activity and perceived activity, participation in voluntary organizations and social contacts. RESULTS: Activity and frequent contact with friends and family were related to higher memory capacity scores. Those with higher capacity scores were also younger, had better health and a stronger internal locus of control. In contrast, people with higher anxiety scores had more symptoms and less education, and were more externally oriented. CONCLUSIONS: people who consider themselves socially and physically active also consider their memory capacity to be good and are less anxious about their memory than less socially and physically active people. Perceived memory change appears to be predominantly influenced by ageing, whereas memory capacity and memory anxiety are more influenced by social factors.

Adult↗

PubMed1999

Cognition after major surgery in the elderly: test performance and complaints.

There is evidence that older people in particular have a higher risk of cognitive dysfunction after surgery under general anaesthesia. We have investigated the severity and character of postoperative cognitive dysfunction after major non-cardiac surgery in patients older than 65 yr. Also, cognitive complaints were studied. Cognitive function was assessed using cognitive tests measuring memory and attention, such as ability to shift between two sequences, ability to ward off distractions, simple cognitive speed and speed of general information processing. These tests were performed before, 1 week (short-term) and 3 months (long-term) after surgery. Cognitive performance of the patients was compared with that of healthy subjects not undergoing surgery who were also subjected to repeated cognitive measurements. After 1 week, patients had a poorer performance on tests measuring simple cognitive speed and speed of general information processing. Three months after surgery, patients and controls showed improved cognitive performance compared with the first measurement. These results suggest that major non-cardiac surgery in older patients causes short-term but not long-term cognitive dysfunction. However, after 6 months, 14 of 48 patients (29%) reported having experienced a decline in cognitive abilities after discharge from hospital. Eight of these 14 patients (17%) were still experiencing these cognitive complaints and reported 'not being the same since the operation'. These findings emphasize that cognitive complaints after major surgery may not reflect actual changes in cognitive performance but may be caused by other factors such as depression or awareness of age-related changes.

Aged↗

PubMed1999

Neuropsychological correlates of a right unilateral lacunar thalamic infarction.

OBJECTIVES: To report on a patient with a lacunar infarction in the right intralaminar nuclei of the thalamus. The role of the thalamic intralaminar nuclei in cognitive function is as yet insufficiently known. The patient described has shown signs of apathy and loss of initiative, in combination with cognitive deficits, which have persisted essentially unaltered up to the present day since an abrupt onset 17 years ago. METHODS: High resolution MRI was performed to show the extent of the lesion; a combination of published and experimental neuropsychological techniques was administered to show the nature of the cognitive defects; Single photon emission computed tomography (SPECT) was employed to obtain a measure of cortical perfusion. RESULTS: Brain MRI disclosed an isolated lacunar infarction in the dorsal caudal intralaminar nuclei of the thalamus. Neuropsychological evaluation indicated problems with attention and concentration, executive disturbances, and memory deficits both in the visual and verbal domains. The memory deficits could not be attributed to problems in the early stages of information processing, and are hence regarded as resulting from a failure of retrieval rather than encoding or storage. Brain SPECT disclosed a hypoperfusion of the right frontal cortex. CONCLUSION: The data indicate that the cognitive profile is the result of a dysfunction of executive functions. This is corroborated by the finding of decreased blood flow in the right frontal cortex, and by evidence from the neuroanatomical literature. Thus the dysexecutive symptoms are thought to be caused by disconnection of the prefrontal cortex from the brainstem activating nuclei through the strategic localisation of the right thalamic infarction.

Adult↗

PubMed1999

Brain correlates of memory dysfunction in alcoholic Korsakoff's syndrome.

OBJECTIVES: To investigate the relation between anterograde amnesia and atrophy of brain structures involved in memory processing in alcoholic Korsakoff's syndrome. METHODS: The volume of brain structures involved in memory processing was measured with MRI from 13 subjects with Korsakoff's syndrome, 13 subjects with chronic alcoholism without Korsakoff's syndrome, and 13 control subjects. The brain structures analysed were the hippocampus, the parahippocampal gyrus, the mamillary bodies, the third ventricle, and the thalamus. Brain volumes were correlated with the delayed recall of a verbal learning test. RESULTS: Compared with subjects with chronic alcoholism and control subjects, subjects with Korsakoff's syndrome had a reduced volume of the hippocampus, the mamillary bodies, and the thalamus, and enlargement of the third ventricle. The impairment of delayed recall correlated with the volume of the third ventricle (r=-0.55, p=0.05) in the Korsakoff group. CONCLUSIONS: Anterograde amnesia in alcoholic Korsakoff's syndrome is associated with atrophy of the nuclei in the midline of the thalamus, but not with atrophy of the mamillary bodies, the hippocampus, or the parahippocampal gyrus.

Alcoholism↗

PubMed1998

Affected enzyme activities in Alzheimer's disease are sensitive to antemortem hypoxia.

Many enzyme activities in Alzheimer's disease (AD) are changed. Some of these enzyme activities are related to certain neurotransmitter systems. Enzymes in the brain can also be sensitive to antemortem hypoxia. In the present study it was determined if enzyme activities that are altered in AD are also subject to alteration by antemortem hypoxia. As an indicator of antemortem hypoxia brain lactate concentration was used. Enzyme activities measured were those of prolyl endopeptidase (PE), aminopeptidase (AP), phosphatidylinositol (PI) kinase, phosphatidylinositol phosphate kinase, alpha-ketoglutarate dehydrogenase (alpha-KGDH), choline acetyltransferase and beta-glucuronidase. All of these enzyme activities have been measured in AD patients before and several of them have been found to be decreased. In accordance with previous findings, PE, alpha-KGDH and ChAT activities were reduced in AD patients. PI kinase and beta-glucuronidase activities, however, were not reduced, contrary to previous findings. All enzyme activities, except that of beta-glucuronidase, correlated with brain lactate concentration, suggesting that antemortem hypoxia has a major influence on the activity of enzymes in the brain. PE, AP, alpha-KGDH and ChAT activities were still different between AD and control samples when these were matched for lactate concentration. The enzyme activities that were changed in AD were also significantly correlated with lactate concentration, an indicator of antemortem hypoxia, in brain specimens. This suggests that antemortem hypoxia and AD have some factor in common that may be responsible for changes in enzyme activities. Since both PE and alpha-KGDH are known to be sensitive to oxidative stress this factor could be oxidative stress.

Adult↗

PubMed1998

Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction.

BACKGROUND: Long-term postoperative cognitive dysfunction may occur in the elderly. Age may be a risk factor and hypoxaemia and arterial hypotension causative factors. We investigated these hypotheses in an international multicentre study. METHODS: 1218 patients aged at least 60 years completed neuropsychological tests before and 1 week and 3 months after major non-cardiac surgery. We measured oxygen saturation by continuous pulse oximetry before surgery and throughout the day of and the first 3 nights after surgery. We recorded blood pressure every 3 min by oscillometry during the operation and every 15-30 min for the rest of that day and night. We identified postoperative cognitive dysfunction with neuropsychological tests compared with controls recruited from the UK (n=176) and the same countries as study centres (n=145). FINDINGS: Postoperative cognitive dysfunction was present in 266 (25.8% [95% CI 23.1-28.5]) of patients 1 week after surgery and in 94 (9.9% [8.1-12.0]) 3 months after surgery, compared with 3.4% and 2.8%, respectively, of UK controls (p<0.0001 and p=0.0037, respectively). Increasing age and duration of anaesthesia, little education, a second operation, postoperative infections, and respiratory complications were risk factors for early postoperative cognitive dysfunction, but only age was a risk factor for late postoperative cognitive dysfunction. Hypoxaemia and hypotension were not significant risk factors at any time. INTERPRETATION: Our findings have implications for studies of the causes of cognitive decline and, in clinical practice, for the information given to patients before surgery.

Abdomen↗