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PubMed1994

Principal identifying features of the syndrome of nonverbal learning disabilities in children.

The identifying features of the syndrome of nonverbal learning disabilities (NLD) were examined with a view to determining their relative discriminant validity. A stepwise linear discriminant function analysis of children with NLD (n = 29), children with reading and spelling disabilities (Group R-S; n = 27), and a group of nonclinical children (NC; n = 27) on 15 neuropsychological variables yielded a subset of scores on four tests (Target Test; Trail Making Test, Part B; Tactual Performance Test; and Grooved Pegboard Test) that accurately (> 95%) discriminated the NLD group from the R-S and NC subjects. Of the neuropsychological features of NLD described by Rourke (1987, 1988b, 1989), deficits in visual-perceptual-organizational psychomotor coordination and complex tactile-perceptual skills appeared to be most representative (in the sense of most discriminative) of the NDL syndrome in the children examined. These are also the dimensions that are considered to be "primary" in the NLD model (Rourke, 1989). Replication of these results, employing children with other clinical disorders, is necessary.

Child↗

PubMedDate not supplied

Population-based dementia screening program in Kuopio: the effect of education, age, and sex on brief neuropsychological tests.

A neuropsychological screening battery including the Mini-Mental State Examination and four other brief cognitive tests (Russell's Adaptation of the Visual Reproduction Test, Trail Making Test, Verbal Fluency Tests on letters and category, and the Buschke Selective Reminding Test) was administered to a randomly selected population sample of 403 subjects aged 68 to 77 years to evaluate the effect of education, age, and sex on test scores. The difference in neuropsychological screening tests between various education groups (3 years or less, 4 to 6 years, 7 years or more) was statistically highly significant, even after the adjustment for the effect of age. The subscores and total scores were lowest in the minimal education group on every neuropsychological test. Education correlated more strongly than age with all neuropsychological test scores and subscores. The effect of sex on test results was seen only in some subscores of brief neuropsychological tests but not in a single item of the Mini-Mental State Examination. On the basis of our results, the effects of education, age, and sex have to be evaluated before using brief neuropsychological tests in population-based dementia screening.

Age Factors↗

PubMed1997

Barbiturate anticonvulsants: a neuropsychological and quantitative electroencephalographic study.

We studied 11 epileptic children aged 7 to 14 years with quantitative electroencephalographic (EEG) and neuropsychological tests, both on and off the barbiturate anticonvulsants phenobarbital and mephobarbital, comparing them to 13 controls matched for age and IQ who received testing at similar intervals. Neuropsychological tests employed were the Wechsler Intelligence Scale for Children-Revised (WISC-R), Bender-Gestalt, controlled oral word association test (COWAT), selected subtests of the Wechsler Memory Scale-Revised, Purdue Peg Board, Stroop Test, Trail Making Test, Wide Range Achievement Test-Revised, and Achenbach Behavior Rating Scale. There was no difference between on- and off-drug quantitative EEG in percentage power of any frequency band between 0.6 and 32 Hz. Neuropsychological data from all 11 subjects were analyzed with a two-factor analysis of variance with repeated measures on the time factor. The only difference from controls was on the Stroop Test. Parents reported clear behavioral changes in 6 of 11 subjects, but in 4 of these children the behavioral changes were sufficiently mild that parents chose to continue the barbiturate anticonvulsants: irritability, oppositional attitude, and overactivity were described. Mephobarbital was reported by parents to cause less severe problems than phenobarbital in subjects who had taken both barbiturate anticonvulsants. Barbiturate anticonvulsants have no effect on quantitative EEG and limited effects on neuropsychological tests in school-aged children.

Adolescent↗

PubMed2005

Executive functions in autism and Asperger's disorder: flexibility, fluency, and inhibition.

The Color-Word Interference Test, Trail Making Test, Verbal Fluency Test, and Design Fluency Test from the Delis-Kaplan Executive Function System (Delis, Kaplan, & Kramer, 2001) were administered to 12 high-functioning adults and adolescents with autistic disorder or Asperger's disorder. Each test included a switching condition in addition to baseline and/or other executive-function conditions. Participants performed significantly below average on a composite measure of executive functioning adjusted for baseline cognitive ability. Complex verbal tasks that required cognitive switching and initiation of efficient lexical retrieval strategies produced the most consistent deficits, whereas cognitive inhibition was intact. We discuss implications of these findings for understanding the neurocognitive substrates of autistic spectrum disorders.

Adolescent↗

PubMed2005

[Constructional apraxia in patients with closed head injury].

INTRODUCTION: Constructional apraxia is a disorder characterized by an inability to join the elements into a unity. It has not been studied much in patients with closed head injury (CHI). METHODS: Forty-one patients with CHI were examined, of which 11 (26.83%) were with the right-sided, 12 (29.27%) with the left-sided, and 18 (43.90%) with bilateral lesion using the Wechsler Individual Intelligence Test (VITI) - Serbian version, Rey Complex Figure (RCF) test, Trail Making Test - TMT A and B, and the Wisconsin Card Sorting Test (WCST). RESULTS: Intelligence quotient (IQ) was significantly higher in the patients with the right-sided (95.27) and bilateral cerebral lesions (87.56) than in the left-sided (84.42). RCF scores did not show any significant difference regarding the side of the lesion, but was numerically the lowest scores were in patients with bilateral brain damage. Patients with left-sided lesions had the score of 30.63, right-sided of 28.68, and bilateral of 27.39. TMT B showed a significantly lower result in patients with the left-sided (196.50 seconds) and bilateral lesions (192.07 seconds) compared to the right-sided (140.14 seconds). WCST scores were not significantly different regarding the side of the lesion, but the absolute value of the categories was less than expected. CONCLUSION: Constructional apraxia was more frequently present in the patients with CHI than it was previously considered. The use of sensitive tests can show the presence of the disorder mainly in bilateral, but also in unilateral lesions.

Adult↗

PubMed2000

A neuropsychological study of the postpolio syndrome: support for depression without neuropsychological impairment.

OBJECTIVE: This study aimed to examine cognitive functioning in postpolio syndrome (PPS) after controlling for the effects of depression and illness behavior. BACKGROUND: Few studies have investigated the possible cognitive sequelae of PPS, despite widespread documented subjective complaints of "mental fatigue." METHOD: A total of 23 PPS sufferers, 20 polio survivors without PPS, and 22 matched controls were compared using the Beck Depression Inventory-II; the Illness Behaviour Questionnaire; a chronic fatigue syndrome symptom checklist; and several measures of memory, attention, and concentration, including the Brown-Petersen Task, Stroop Test, Austin Maze, California Verbal Learning Test, Trail Making Test, Controlled Oral Word Association Test, and Symbol-Digit Modalities Test. RESULTS: In those participants with a medically confirmed diagnosis of PPS, there was a significantly higher level of depressive and hypochondriacal symptomatology as compared with the other two groups. Nevertheless, no significant differences existed between the three groups on neuropsychological measures. CONCLUSIONS: These results indicate that the attention and memory difficulties reported by PPS sufferers may be linked to the physical or psychological manifestations of the illness rather than to objective decrements in cognitive performance.

Adult↗

PubMed2004

[The cognitive dysfunction in Parkinson's disease].

Parkinson's disease (PD) is a slowly progressive disorder which begins with motor symptoms. Several cognitive deficits can be observed in nondemented patients with PD during their history. The core symptom in the cognitive deficits in PD is the executive dysfunction. Neuropsychological tests such as Wisconsin Card Sorting Test, Trail Making Test are used to measure the degree of this dysfunction. Executive dysfunction is thought related to abnormalities in the dorsolateral prefrontal circuit which largely passes through the caudate nucleus. The dysfunction emerges as the pathology spreads to the nigrocaudate project corresponding to Hoehn & Yahr stage II-III. Effective therapy for cognitive dysfunction in PD remains elusive, however donepezil, Attention Process Training, Music therapy and Transcranial magnetic stimulation have been reported to have partial efficacy.

Cognition Disorders↗

PubMed2005

[Quality of life in patients with obsessive-compulsive disorder: relations with cognitive functions and clinical symptoms].

OBJECTIVE: To compare quality of life in patients with obsessive-compulsive disorder with that in healthy subjects and to relate quality of life to cognitive functions and the severity of clinical symptoms. METHODS: Twenty-three patients who met DSM-IV criteria for obsessive compulsive disorder and 22 healthy subjects were included in the study. Quality of life (Turkish Quality of Life Scale-Brief Form) and cognitive functions were investigated in all subjects. In the patient group the relation of quality of life to the cognitive functions and to the severity of clinical symptoms and in the control group the relation of quality of life to the cognitive functions was investigated. RESULTS: The comparison of quality of life between the patient and control groups showed a significant difference (F= 2.60, p= 0.04). The significant differences between the two groups in psychological and social scores were responsible for the overall significant difference. The scores of quality of life were correlated with the scores of the cognitive tests (Trail Making Test, Auditory Consonant Trigram Test and Digit Span Test) and the severity of obsessive-compulsive symptoms. CONCLUSION: The present study revealed that quality of life is lower in patients with obsessive-compulsive disorder than in healthy subjects and is related to cognitive functions and the severity of obsessive-compulsive symptoms.

Adult↗

PubMed1984

Effects induced by vincamine teprosilate on chronic cerebrovascular disease: preliminary results.

A group of 90 patients suffering from chronic cerebrovascular disease (CCVD) were selected on the basis of definite clinical criteria and pretests indicating a well-preserved general level of the higher functions. The purpose was to perform a clinical and neuropsychological assessment of CCVD sufferers during treatment with vincamine teprosilate (Teproside) for 90 days. Each selected patient was submitted to neurological examination and neuropsychological testing before treatment, after 45 days and at the termination of treatment. Neuropsychological examination included the reaction-time task, memory tests, verbal fluency test, trail making test, PM 38, MACL and STAI depression scales. Preliminary results are discussed and compared with previous data reported in the literature.

Aged↗

PubMedDate not supplied

[Frontal lobe dysfunction and depressive state: relation to endogenous character of depression].

A dysfunction of dorsolateral prefrontal cortex (DLPF) in major depression is suggested by functional imagery and comparative neuropsychology. However, assessment of frontal lobe syndrome with DLPF-dependent tests led to controversial results. To clarify these findings, we administered 5 of these tests (Wisconsin Card Sorting Test, Stroop Test, Trail Making Test, Tower of Toronto, verbal fluency) to 16 major depressive subjects and their 16 controls, before and after 21 days of treatment. Furthermore, we tried to assess the prognostic value of frontal lobe dysfunction, and its relation with the endogenous or exogenous nature of the depression on the one hand, the severity of the depression on the other hand. Our results suggest that the presence of a frontal lobe syndrome (defined by impaired performances at 3 tests or more) is only noted in endogenous depression; after treatment, no impairment is detected. No correlation is found with the severity of the depression. Frontal lobe syndrome does not seem to indicate poorer prognosis for current depressive episode.

Adult↗

PubMed2005

Effect of interferon-alpha on cognitive functioning in patients with chronic hepatitis C.

Treatment with interferon-alpha (IFN-alpha) has been shown to adversely affect cognitive functioning in patients with a variety of medical disorders, but information about the effects of IFN-alpha on cognitive functioning in patients with chronic hepatitis C (CHC) is limited. The purpose of this study was to examine the effects of IFN-alpha on neuropsychological test performance in CHC patients. Participants were 30 patients with CHC, 11 who underwent IFN-alpha therapy and 19 who did not. All participants were tested at baseline (i.e., pretreatment) and approximately 6 months later with the Symbol Digit Modalities Test and Trail Making Test. Results revealed that the treatment group performed significantly worse than untreated CHC patients on Part B of the Trail Making Test after approximately 6 months of treatment. No significant group differences were found on Part A of the Trail Making Test or Symbol Digit Modalities Test. Findings suggest that CHC patients undergoing treatment with IFN-alpha may experience reduced abilities to benefit from practice but suffer no decrements in performance after 6 months of treatment. Additional research is needed to replicate these findings and to explore risk factors for susceptibility to IFN-alpha-induced effects.

Antiviral Agents↗

PubMed2004

Is colour vision impairment associated with cognitive impairment in solvent exposed workers?

AIMS: To determine whether acquired colour vision deficits in solvent exposed individuals are associated with cognitive impairment. METHODS: A sample of 82 painters and 38 other subjects were studied. Alcohol, drug, and smoking histories were obtained. Colour vision was tested using the Lanthony D-15-d colour vision test. Cognitive impairment was measured using the Benton visual retention test, Trail making A, and Trail making B tests. Pre-morbid IQ was estimated using the National Adult Reading Test. Solvent exposure in all subjects was estimated using a previously validated, structured subjective assessment methodology. RESULTS: After exclusion of subjects with competing causes of colour vision impairment the final group of men numbered 78. There was a significant association on multiple linear regression between the mean colour confusion index (CCI) and three measures of cognitive impairment, the Benton visual retention test, Trail making A, and Trail making B tests after adjusting for the effects of age (or IQ as appropriate), alcohol, and smoking. CONCLUSION: Acquired colour vision loss is associated with cognitive impairment in solvent exposed workers. However, given the prevalence of acquired colour vision losses in the adult population, colour vision testing is unlikely to be of value as a screening test.

Adult↗

PubMedDate not supplied

Association between attitude toward medication and neurocognitive function in schizophrenia.

OBJECTIVES: A patient's attitude toward medication is important for medication adherence, which is a key determinant of outcome in schizophrenia. This study examined the association between attitude toward antipsychotic medication and clinical status, particularly neurocognitive function, in patients with schizophrenia. METHOD: Ninety-two patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for schizophrenia participated in this study. The attitudes of the subjects toward medication were evaluated using the Drug Attitude Inventory (DAI). Clinical characteristics, including psychiatric symptoms and side effects of medication were evaluated. Neurocognitive function was measured using the Mini Mental State Examination and a computerized battery consisting of the Digit Span Test, Verbal Learning Test, Continuous Performance Test, Wisconsin Card Sorting Test, Finger Tapping Test, and Trail Making Test, parts A and B. The associations between attitude toward medication and neurocognitive function and clinical characteristics were analyzed. RESULTS: The scores on the DAI were not significantly correlated with the clinical characteristics, such as psychopathology, subjective well-being, or neuroleptic-induced extrapyramidal side effects. Instead, the scores on the DAI were significantly correlated with the learning index and delayed free recall on the Verbal Learning Test, the number of categories completed on the Wisconsin Card Sorting Test, and omission and commission errors on the Continuous Performance Test; the scores were not significantly correlated with measures on the Mini Mental State Examination, Digit Span Test, Finger Tapping Test, or Trail Making Test. CONCLUSIONS: Our findings indicate that a patient's attitude toward medication is associated with neurocognitive function. Specifically, verbal learning memory, executive functioning, and sustained attention were associated with attitude toward medication.

Adolescent↗

PubMedDate not supplied

Neuropsychological screening in the psychiatric emergency room.

In a pilot study, a neuropsychological minibattery of tests consisting of Trail-Making Test A (TMA), Trail-Making Test B (TMB), and the Visual Reproduction subtest (VR) of the Wechsler Memory Scale was administered to patients with common psychiatric diagnoses in a psychiatric emergency room (ER). Patients with adjustment disorders were not distinguishable from normal controls, while patients with affective disorders and schizophrenia were more impaired than both of these samples. It is suggested that this or a similar minibattery of tests can be of use as an adjunct screening device for differential diagnosis of adjustment disorder versus more serious psychopathology in psychiatric ERs.

Adjustment Disorders↗

PubMed2005

Neuropsychological correlates of an attention-related negative component elicited in an auditory oddball paradigm in schizophrenia.

An attention-related, negative component can be detected between the N100 peak and 200 ms after stimulus by subtracting event-related potentials (ERPs) elicited to background tones when subjects ignore tones, from ERPs elicited to background tones when subjects attend to tones to detect target tones in an oddball paradigm. To clarify the cognitive significance of this component in schizophrenia, we examined the correlations of 24 patients between the amplitude and latency of the negative component and results obtained using neuropsychological measurement methods, including the Wisconsin Card Sorting Test, the Trail Making Test, the Verbal Fluency Test and some subtests from the Wechsler Memory Scale. The latency prolongation of the negative component correlated positively with the difference in performance time between parts A and B of the Trail Making Test, which estimates set shift, a frontal-lobe executive function, but not with any other neuropsychological measurements, while the amplitude showed no such correlation. These results suggest that the latency prolongation of the attention-related, negative component induced in an auditory oddball paradigm may serve as an index for frontal dysfunction in schizophrenia.

Acoustic Stimulation↗

PubMed2001

Postural Stability and Neuropsychological Deficits After Concussion in Collegiate Athletes.

OBJECTIVE: Postural stability and neuropsychological testing are gradually becoming integral parts of postconcussion assessment in athletes. Clinicians, however, sometimes question the viability of instituting preseason baseline testing and the value of these results in making return-to-play decisions. Our purpose was to examine the course of recovery on various postural stability and neuropsychological measures after sport-related concussion. A secondary goal was to determine if loss of consciousness and amnesia, both of which are heavily weighted in most of the concussion classification systems, affect the rate of recovery. DESIGN AND SETTING: All subjects underwent a battery of baseline postural stability and neuropsychological tests before the start of their respective seasons. Any athletes subsequently injured were followed up at postinjury days 1, 3, and 5. Matched control subjects were assessed using the same test battery at the same time intervals. SUBJECTS: We studied 36 Division I collegiate athletes who sustained a concussion and 36 matched control subjects. MEASUREMENTS: We assessed postural stability using the Sensory Organization Test on the NeuroCom Smart Balance Master System and the Balance Error Scoring System. Neurocognitive functioning was measured with several neuropsychological tests: Trail-Making Test, Wechsler Digit Span Test, Stroop Color Word Test, and Hopkins Verbal Learning Test. RESULTS: Injured subjects demonstrated postural stability deficits, as measured on both the Sensory Organization Test and Balance Error Scoring System. These deficits were significantly worse than both preseason scores and matched control subjects' scores on postinjury day 1. Only the results on the Trail-Making Test B and Wechsler Digit Span Test Backward resulted in a logical recovery curve that could explain lowered neuropsychological performance due to concussive injury. Significant differences were revealed between the control and injured groups at day 1 postinjury, but a significant decline between baseline and postinjury scores was not demonstrated. Loss of consciousness and amnesia were not associated with increased deficits or slowed recovery on measures of postural stability or neurocognitive functioning. CONCLUSIONS: Athletes with cerebral concussion demonstrated acute balance deficits, which are likely the result of not using information from the vestibular and visual systems effectively. Neurocognitive deficits are more difficult to identify in the acute stages of concussion, although concentration, working memory, immediate memory recall, and rapid visual processing appear to be mildly affected. More research is necessary to determine the best neuropsychological test battery for assessing sport-related concussion.

Journal Article↗

PubMed2003

Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain: a randomized controlled trial.

CONTEXT: 1',1'dimethylheptyl-Delta8-tetrahydrocannabinol-11-oic acid (CT-3), a potent analog of THC-11-oic acid, produces marked antiallodynic and analgesic effects in animals without evoking the typical effects described in models of cannabinoids. Therefore, CT-3 may be an effective analgesic for poorly controlled resistant neuropathic pain. OBJECTIVE: To examine the analgesic efficacy and safety of CT-3 in chronic neuropathic pain in humans. DESIGN AND SETTING: Randomized, placebo-controlled, double-blind crossover trial conducted in Germany from May-September 2002. PARTICIPANTS: Twenty-one patients (8 women and 13 men) aged 29 to 65 years (mean, 51 years) who had a clinical presentation and examination consistent with chronic neuropathic pain (for at least 6 months) with hyperalgesia (n = 21) and allodynia (n = 7). INTERVENTIONS: Patients were randomized to two 7-day treatment orders in a crossover design. Two daily doses of CT-3 (four 10-mg capsules per day) or identical placebo capsules were given during the first 4 days and 8 capsules per day were given in 2 daily doses in the following 3 days. After a washout and baseline period of 1 week each, patients crossed over to the second 7-day treatment period. MAIN OUTCOME MEASURES: Visual analog scale (VAS) and verbal rating scale scores for pain; vital sign, hematologic and blood chemistry, and electrocardiogram measurements; scores on the Trail-Making Test and the Addiction Research Center Inventory-Marijuana scale; and adverse effects. RESULTS: The mean differences over time for the VAS values in the CT-3-placebo sequence measured 3 hours after intake of study drug differed significantly from those in the placebo-CT-3 sequence (mean [SD], -11.54 [14.16] vs 9.86 [21.43]; P =.02). Eight hours after intake of the drug, the pain scale differences between groups were less marked. No dose response was observed. Adverse effects, mainly transient dry mouth and tiredness, were reported significantly more often during CT-3 treatment (mean [SD] difference, -0.67 [0.50] for CT-3-placebo sequence vs 0.10 [0.74] for placebo-CT-3 sequence; P =.02). There were no significant differences with respect to vital signs, blood tests, electrocardiogram, Trail-Making Test, and Addiction Research Center Inventory-Marijuana scale. No carryover or period effects were observed except on the Trail-Making Test. CONCLUSIONS: In this preliminary study, CT-3 was effective in reducing chronic neuropathic pain compared with placebo. No major adverse effects were observed.

Adult↗

PubMed1997

Performance on tests sensitive to impaired executive ability in schizophrenia, mania and well controls: acute and subacute phases.

AIMS: To compare the performance of schizophrenia, mania and well control groups on tests sensitive to impaired executive ability, and to assess the within-group stability of these measures across the acute and subacute phases of psychoses. METHOD: Recently admitted patients with schizophrenia (n = 36), mania (n = 18) and a well control group (n = 20) were assessed on two occasions separated by 4 weeks. Tests included: the Controlled Oral Word Association Test, the Stroop Test, the Wisconsin Card Sort Test, and the Trail Making Test. RESULTS: The two patient groups were significantly impaired on the Stroop Test at both time points compared to the control group. Significant group differences were also found for the Trail Making Test at Time 1 and for the Wisconsin Card Sort Test at Time 2. When controlled for practice effect, significant improvements over time were found on the Stroop and Trail Making tests in schizophrenia group and on WCST Categories Achieved in the mania group. DISCUSSION: Compared to controls, the patient groups were impaired on measures related to executive ability. The pattern of improvement on test scores between the acute and subacute phases differed between patients with schizophrenia versus patients with mania.

Acute Disease↗