Biomedical subjects

Jelle Jolles

Publications and source records attributed to Jelle Jolles.

At least 19 recordsLinked to original sources

PubMed2003

Is there a side predilection for cerebrovascular disease?

In studies on carotid artery intima-media thickness and stroke, researchers implicitly assume that cerebrovascular abnormalities show a symmetrical distribution. To evaluate whether there is a difference in intima-media thickness between the 2 carotids, we compared left and right common carotid artery intima-media thickness as measured by B-mode ultrasonography in a group of 102 untreated hypertensive patients. This yielded a significant difference between both sides (left, 0.75+/-0.11 mm; right, 0.71+/-0.11 mm; P<0.001). This was associated with a higher cross-sectional area of the intima-media complex and a higher flow velocity at the left side. Arterial diameters, however, were not different. We also assessed whether there is a side preference with respect to cerebrovascular accidents. To this end, we explored our population-based Stroke Registry of 1843 subjects and indeed found a significantly higher incidence of nonlacunar cerebrovascular stroke at the left side, whereas lacunar infarcts were symmetrically distributed. Our findings suggest a predilection for cerebrovascular disease at the left side, which may be related to greater hemodynamic stress and intimal damage in the left carotid artery.

Adult↗

PubMed2003

Deficits of memory, executive functioning and attention following infarction in the thalamus; a study of 22 cases with localised lesions.

The thalamus plays a crucial role in memory, executive functioning and attention. It remains, however, unclear whether thalamic structures have specific roles in each of these functions. We tested 22 cases of thalamic infarction, proven with MR imaging, using experimental and established neuropsychological tests. We performed a lesion-overlap study in standardised stereotactic space of patients sharing a certain deficit, corrected for the lesion distribution of patients without such deficits and determined the regions of interest using an atlas of the human thalamus. We checked for additional, non-thalamic, damage and for deficient comprehension and perception that would preclude interpretation of the results. Non-thalamic damage such as white matter lesions, hippocampal atrophy, sulcal widening and infarctions occur significantly more often in patients aged over 60. The patients with additional damage overlapped to a major degree with those who showed loss of orientation, or lack of comprehension of the test requirements. In the 10 patients judged 'clean', we observed a deficit of episodic long-term memory with relative sparing of intellectual capacities and short-term memory when the mammillo-thalamic tract was damaged. Lesions including the medial dorsal nucleus, midline nuclei and/or intralaminar nuclei accompany executive dysfunctioning. Reduced simple processing speed and attention are associated with age, but not with a particular structure in the thalamus. Complex attention deficits follow damage to the intralaminar nuclei.We conclude that the analysis of structure-function relationships must take into account extra-structure damage which may explain cognitive deficits. Separate thalamic structures are involved in memory, executive functioning and attention.

Adult↗

PubMed2003

Distractor interference in selective reaching: dissociating distance and grouping effects.

In the present experiment, the authors sought to differentiate between a distance and a grouping explanation for the symmetric versus asymmetric patterns of distractor interference in selective reaching. Participants (N = 16) pointed to a green target that appeared either with or without a red distractor. Target-distractor separation was manipulated within an array of 5 closely grouped stimulus boxes, and distractor interference (difference in performance between trials with and trials without a distractor) was measured in reaction time, movement time, percentage errors, and movement endpoints. Small distances (5 mm) between target and distractor yielded a symmetric pattern of interference, whereas large distances (20 mm) yielded an asymmetric pattern, with more interference from near than from far distractors. Those findings support the distance account of distractor interference and refute the grouping account.

Adult↗

PubMed2003

Behavioral problems in dementia: a factor analysis of the neuropsychiatric inventory.

The aim of this study was to detect behavioral subsyndromes of the 12-item Neuropsychiatric Inventory (NPI). Cross-sectional data of 199 patients with dementia living in the community were collected. Principal component analysis (with Varimax rotation) was used for factor analysis. Results showed the presence of three behavioral subsyndromes: mood/apathy, psychosis, and hyperactivity. Anxiety was regarded as a separate symptom. The subsyndrome mood/apathy was the most common, occurring in almost 80% of the patients, versus psychosis and hyperactivity, which occurred in 37 and 60% of the patients, respectively.

Aged↗

PubMed2002

Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age.

In the elderly, cigarette smoking has been related to reduced cognitive performance and moderate alcohol consumption to increased cognitive performance. It is not clear whether these associations also exist in middle age. The authors examined these relations in a population-based cohort study of 1,927 randomly selected, predominantly middle-aged subjects aged 45-70 years at the time of cognitive testing and living in the Netherlands. From 1995 until 2000, an extensive cognitive battery was administered, and compound scores were calculated. Risk factors had been assessed approximately 5 years previously. Multiple linear regression analyses (in which one unit of the cognitive score = one standard deviation) showed that, after the authors adjusted for age, sex, education, alcohol consumption, and cardiovascular risk factors, current smokers had reduced psychomotor speed (beta = -0.159, 95% confidence interval: -0.071, -0.244; p = 0.0003) and reduced cognitive flexibility (beta = -0.133, 95% confidence interval: -0.035, -0.230; p = 0.008) compared with never smokers. This effect was similar to that of being approximately 4 years older. Alcohol consumption was related to increased speed and better flexibility, especially among women who drank 1-4 alcoholic beverages a day. In conclusion, among middle-aged subjects, current smoking was inversely and alcohol consumption positively related to psychomotor speed and cognitive flexibility. This finding suggests that actions to prevent cognitive decline can be taken in middle age.

Age Distribution↗

PubMed2002

Subjective sleep problems in later life as predictors of cognitive decline. Report from the Maastricht Ageing Study (MAAS).

BACKGROUND: Although biological sleep criteria seem to be associated with cognitive changes in older people, it is not clear if subjective sleep parameters are related to cognitive decline in later life. OBJECTIVES: The aim of this study was to determine whether subjective sleep complaints in a population-based sample of 838 middle aged and older adults (>or= 50 years) predicted cognitive decline over a period of 3 years. METHODS: Sleep complaints at baseline, assessed with the subscale Sleep Problems of the Symptoms Checklist-90, were used as a predictor variable. Cognitive performance at follow-up, measured with the Mini Mental Status Examination, was employed as a dependent variable. RESULTS: Controlling for the effects of age, gender, length of follow-up interval, systemic diseases, and cognitive function at baseline, subjective sleep complaints were negatively associated with cognitive performance at follow-up. CONCLUSION: Subjective sleep complaints predict cognitive decline in middle aged and older adults. Mechanisms behind the effect of subjective sleep complaints on cognitive performance are discussed.

Aged↗

PubMed2002

Engaged lifestyle and cognitive function in middle and old-aged, non-demented persons: a reciprocal association?

Some studies have shown that cognitive function is positively affected by an engaged and active lifestyle. However, a recent study found evidence for an opposite causal direction, i.e., persons with good cognitive function more often start to engage in leisure-time activities. Here, we longitudinally examine the causal direction of the association between an engaged lifestyle and cognitive function in middle and old-aged Dutch men and women. The participants in the prospective cohort study "Maastricht Aging Study" (MAAS) were recruited from a register of 15 family practices in the South of the Netherlands. There were 830 non-demented men and women, aged 49 to 81 in 1993-1995 (baseline phase). They were re-examined three years later (follow-up phase). During both phases, all persons reported on their participation in mental, social, and physical activities. Six separate neuropsychological tests, including the Mini-Mental State Examination, were used to define cognitive function at baseline and follow-up. All three activities measured were negatively related to cognitive decline between both phases. Effects were moderate, but consistent. Persons participating in all three activities were particularly protected against longitudinal decline. Furthermore, persons with the best baseline cognitive performance were more likely to increase their number of activities during follow-up compared with persons with the poorest scores. In summary, an engaged lifestyle and cognitive function mutually influence each other in middle and old aged, non-demented persons. This reciprocal association is characterized by simultaneous positive effects of leisure-time activities and good cognitive function on cognitive function and leisure-time activities, respectively. This reciprocal association may create a self-reinforcing, beneficial or adverse life-course in middle and old age.

Age Factors↗

PubMed2002

Cognition and health-related quality of life in a well-defined subgroup of patients with partial epilepsy.

To investigate the extent and nature of the objective and subjective cognitive deficits and health-related quality of life (HRQOL) in adult outpatients with relatively well-controlled partial epilepsy without symptomatic aetiology, who were on carbamazepine (CBZ) monotherapy. Furthermore, we studied the influence of the epilepsy history and medication on various cognitive functions and the HRQOL. 56 outpatients (29 male, 27 female, mean age 41.3 years) with partial epilepsy were compared with 56 age-, gender-, and education-matched healthy controls. Patients were tested on attention, memory, speed of information processing, and executive functioning. Questionnaires aimed at measuring self-perceived cognitive functioning (CFQ) and HRQOL (SF-36) were administered. Mann Whitney-U tests were used to compare the two groups. Linear regression analysis was performed to identify the epilepsy and medication-related factors that are associated with cognitive functioning and HRQOL. Patients scored lower on measures of attention (P = 0.03), learning (P = 0.02) and speed of information processing (P = 0.00). Mental aspects of HRQOL such as fatigue were lower (P = 0.00), whereas physical functioning was unaffected. These patients also expressed reductions in mental functioning as indicated by a low self-perceived cognitive functioning (P = 0.01). Age at onset, duration of epilepsy, seizure type, seizure frequency, localisation, years on CBZ, and CBZ dosage were not related to cognitive functioning or HRQOL. Patients with partial epilepsy, even when able to maintain regular jobs, have impaired cognition and HRQOL that cannot be attributed to their epilepsy history or CBZ dosage or years of CBZ intake. Therefore, physicians should be more aware of their cognition and HRQOL, in addition to the antiepileptic drug regime.

Adolescent↗

PubMed2002

Atypical cognitive profile in patients with depression after myocardial infarction.

BACKGROUND: We evaluated the cognitive profile of 48 patients with major depression following their first myocardial infarction (MI). METHODS: The cognitive performance of the patients was compared with the performance of 48 non-depressed MI patients and 48 healthy controls. RESULTS: Depressed MI patients performed slower on a simple cognitive speed related measure compared with non-depressed MI patients and healthy controls. Attention and speed-related aspects of cognitive functioning were not affected. Surprisingly, (depressed) MI patients showed even better performances with respect to memory function. LIMITATION: No patients with non-MI-related depression were included. CONCLUSIONS: The cognitive profile of major depression after MI differs from that of non-cardiac-related depressive disorder, as described in the literature. This may reflect a different etiology of post MI depression from non-cardiac-related depression.

Adult↗

PubMed2002

Cognition and health-related quality of life in chronic well-controlled patients with partial epilepsy on carbamazepine monotherapy.

As a group, patients with epilepsy have reduced neuropsychological functioning and health-related quality of life (HRQOL), but the status of these factors is uncertain in seizure-free patients with seizure onset in adulthood on monotherapy. Nevertheless, some of these patients report neuropsychological problems. We hypothesized that subtle impairments in neuropsychological functioning and HRQOL may be underdiagnosed and related to these problems. Sixteen patients with localization-related epilepsy on monotherapy carbamazepine were compared with 16 age-, gender-, and education-matched healthy controls by means of a standardized neuropsychological screening battery, questionnaires about HRQOL (Short-Form Health Survey, SF-36), self-perceived neuropsychological functioning (Cognitive Failure Questionnaire), and mood (Profile of Mood States). No objective impairments in selective attention, memory, and executive functioning were found. However, a lower speed of information processing affecting everyday life functioning was found. Lower levels of self-perceived neuropsychological functioning were reported, whereas HRQOL was unimpaired relative to healthy controls. Physicians should not be reassured when patients receive adequate medication that prevents seizures; careful follow-up of speed of information processing and self-perceived neuropsychological functioning is needed.

Journal Article↗

PubMed2002

Quality of movement as predictor of ADHD: results from a prospective population study in 5- and 6-year-old children.

The aims of this prospective study were (1) to examine whether quantitative and/or qualitative aspects of motor performance in 5- to 6-year-old children can predict attention-deficit-hyperactivity disorder (ADHD) 18 months later; (2) to investigate whether this relation is also present in oppositional defiant disorder and conduct disorder (ODD/CD). Quantitative and qualitative aspects of motor performance were tested in a selected community sample (n=401; 232 males, 169 females; mean age 6 years 4 months, SD 6 months, range 5 years 4 months to 7 years 11 months) using the Maastricht Motor Test. Eighteen months later, standardized psychiatric information was obtained with the Amsterdam Diagnostic Interview for Children and Adolescents: 35 children were classified as having ADHD, and 92 children as having ODD/CD. Weighted analyses were used in logistic regression analyses to investigate predictive values. Unlike quantitative aspects of motor performance, qualitative aspects were predictive of ADHD. Motor performance was not predictive of ODD/CD.

Attention Deficit Disorder with Hyperactivity↗

PubMed2002

Neurocognitive performance of 5- and 6-year-old children who met criteria for attention deficit/hyperactivity disorder at 18 months follow-up: results from a prospective population study.

The aim of this prospective study was to examine whether neurocognitive performance of children aged 5-6 years distinguished children who were later diagnosed with attention deficit/hyperactivity disorder(ADHD) or "borderline ADHD" from children without ADHD after adjustment for behavioral measures and to examine the influence of comorbid psychopathology. Out of a general population of 1,317 children, 366 children were selected on the basis of their scores on the Child Behavior Checklist (CBCL). Eighteen months later, the parents were interviewed using a standardized child psychiatric interview: 33 children were classified as ADHD and 75 children as borderline ADHD, and there were 258 children without ADHD. Children with rated ADHD were significantly impaired on measures of visuomotor ability and working memory compared to children without ADHD after adjustment for CBCL results. The performance of borderline ADHD children was in between that of children with and without ADHD. In addition, 4 groups of children were analyzed: 9 ADHD, 24 ADHD with comorbid oppositional defiant disorder/conduct disorder (ODD/CD), 59 ODD/CD, and 274 controls. Children with rated comorbid ADHD and ODD/CD performed significantly worse on these tasks compared to children with rated ODD/CD and control children while they did not differ from ADHD children. Our results imply that neurocognitive measures can contribute to the early identification of ADHD with and without comorbid ODD/CD.

Attention Deficit Disorder with Hyperactivity↗

PubMed2002

A longitudinal community study: do psychosocial risk factors and child behavior checklist scores at 5 years of age predict psychiatric diagnoses at a later age?

OBJECTIVE: To examine the extent to which certain risk factors in 5- to 6-year-old children predict later psychopathology in a population-based sample of children from the province of Limburg in the south of the Netherlands. METHOD: Of the 2,290 children of interest, 1,317 children were screened with the Child Behavior Checklist (CBCL) and psychosocial risk factors for these children were collected. On the basis of the CBCL ratings, 403 children participated in the second stage in which, 1.5 years later, standardized child psychiatric information was obtained. Weighted logistic regression analyses were used to investigate predictors of psychopathology. RESULTS: In separate analyses of specific types of child psychopathology, different risk factors emerged as significant. Low-level parental occupation and having foreign-born parents were predictive of conduct disorders, and living in a single-parent family and a having a life event were the most important predictors of mood and anxiety disorders. Furthermore, CBCL-based ratings at 5 to 6 years of age corresponded well with interview-defined diagnoses 1.5 years later. CONCLUSIONS: Investigation of psychosocial risk factors and CBCL scores at the age of 5 to 6 years could be helpful in predicting child psychopathology and could help identify children at risk, in order to provide them with timely attention.

Adolescent↗

PubMed2002

Are cognitive impairments associated with sensitivity to stress in schizophrenia? An experience sampling study.

OBJECTIVE: Patients with a diagnosis of schizophrenia display cognitive impairments and abnormal sensitivity to stress. However, little is known about the relationship between these two endophenotypes. METHOD: Neuropsychological tests were administered to 42 patients with schizophrenia or other psychosis to assess cognitive functioning, and the experience sampling method (a structured diary technique assessing current context and mood in daily life) was used to assess 1) appraised subjective stress related to daily events and activities and 2) emotional reaction to these daily life stressors. RESULTS: Multilevel random regression analyses showed that in some instances, cognitive functioning did not alter emotional reaction to stress. In other instances, an inverse relationship was found, indicating that a better performance on neuropsychological tests was related to greater emotional reaction to stress. CONCLUSIONS: The results indicate that emotional reaction to stress in the daily lives of patients with schizophrenia may not be a consequence of cognitive impairments and that the two mechanisms may act through different pathways. Such pathways may be related to the extremes of clinical outcome that have been observed in schizophrenia: an episodic, reactive, good outcome and a more chronic form characterized by high levels of negative symptoms and cognitive impairments.

Adult↗

PubMed2002

Brain lesions in patients visiting a memory clinic with postconcussional sequelae after mild to moderate brain injury.

Postconcussional disorder after a relatively mild head injury is common. Although a partial organic etiology is presumed, little imaging evidence exists for this assumption. In this study, patients with mild to moderate brain injury (median Glasgow Coma Scale score of 14) had more parenchymal brain lesions than control subjects (P=0.02). Additionally, the authors investigated the potential of quantifying brain injury by the magnetization transfer ratio (MTR). The curve amplitude of the MTR histogram was used as a measure of normal white matter. Patients had a lower curve amplitude than control subjects (P=0.008). This study provides evidence of persistent traumatic brain alterations in patients who sustained a relatively mild traumatic brain injury.

Adult↗

PubMed2002

Atypical brain activation of reading processes in children with developmental dyslexia.

Brain activation differences of reading-related processes between dyslexic and normal reading children were localized with functional magnetic resonance imaging (MRI). The children performed tasks that varied in visuospatial, orthographic, phonologic, and semantic processing demands. Enhanced activation of the left extrastriate cortex was found during all tasks in the dyslexic group. During orthographic processing, dyslexic children predominantly showed activation in the right prefrontal cortex, as also occurred during the visuo-spatial task. Normal readers also showed activation in the left prefrontal cortex. Dyslexic readers showed less activation of both the temporal and the prefrontal cortex during phonologic processing. The results suggest that dyslexic readers fail to use brain areas that are normally specialized in language processing, but rather use areas that underlie visuospatial processing.

Brain↗

PubMed2002

Selective reaching: evidence for multiple frames of reference.

Students participated in 3 experiments investigating the use of environment- and action-centered reference frames in selective reaching. They pointed to a green target appearing either with or without a red distractor. Target-distractor distance was manipulated, and distractor interference (difference between distractor trials and no-distractor trials) was measured in reaction time, movement time, and movement endpoint. Target-distractor distance determined the dominant frame of reference. Small distances evoked an environment-centered framework that encoded targets within an external context. Large distances evoked an action-centered framework that encoded targets relative to the start position of the hand. Results support the hypothesis that the brain represents spatial information in multiple frames of reference, with the dominant frame of reference being dependent on the task demands.

Adolescent↗

PubMed2002

Regional frontal cortical volumes decrease differentially in aging: an MRI study to compare volumetric approaches and voxel-based morphometry.

Recent neuroimaging studies suggest that the frontal lobes are the part of the brain most profoundly affected by the aging process. The present study investigated whether subregions within the frontal cortex show different patterns of brain aging. Magnetic resonance images of 57 healthy participants between 21 and 81 years old were used to measure regional frontal gray matter volumes in three ways: a manual tracing method, a semiautomatic "Talairach boxes" volumetric method, and voxel-based morphometry. Seven regions within each hemisphere were manually traced: precentral gyrus, inferior frontal gyrus, dorsolateral frontal cortex, ventral medial region, lateral orbital region, anterior cingulate, and frontal pole. With the semiautomatic approach, four regions were measured: lateral, orbital, and medial frontal regions and frontal pole. Advancing age was strongly associated with decreases in the volume of the whole frontal cortex. Differential age effects on the volumes of frontal subregions were dependent on the method applied. According to the manual approach, age-related volume decreases were strongest in the lateral and orbital frontal gray matter. The semiautomatic and voxel-based analyses found that age effects were most prominent within the lateral frontal and cingulate regions. Overall, it was concluded that although semiautomated and voxel-based methods can provide a reasonable estimate of regional brain volume, they cannot serve as a substitute for manual volumetry.

Adult↗