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PubMed1999

Cognitive performance after cardiac operation: implications of regression toward the mean.

OBJECTIVE: The purpose of this study was to assess the influence of regression toward the mean on different definitions of cognitive dysfunction after coronary artery bypass graft operation. METHODS: A total of 120 patients who underwent nonemergency coronary bypass operation and who were involved in a randomized trial of an anti-inflammatory agent were assessed prospectively with a battery of 10 psychometric tests covering a variety of cognitive domains. The battery was administered before the operation and 5 days and 3 months after the operation. Data from 2 representative tests, the Rey Auditory Verbal Learning Test and the Trail Making Test (part A), were used. The influence of regression toward the mean on 3 commonly used single-case definitions of cognitive impairment (1 SD method; one-half SD method; 20% method) was analyzed. RESULTS: Group mean performance deteriorated on the Rey Auditory Verbal Learning Test at the discharge assessment (P <.001) and remained below baseline at 3 months (P =.03). Mean performance on the Trail Making Test (part A) showed a near-significant decline at discharge (P =. 06), followed by improvement at 3 months (P <.01). Regression toward the mean was demonstrated on both tests by classifying the preoperative scores into low, moderate, and high-performance categories. Applying the different definitions of dysfunction resulted in substantially larger numbers of patients in the high-performance group being classified as impaired. CONCLUSION: Single-case definitions of cognitive dysfunction are influenced strongly by regression toward the mean. Disproportionate numbers of high-baseline performers are classified as impaired, thereby questioning the validity of established definitions. Group mean analysis with controls is potentially the most reliable method for detecting real change or differences.

Cognition↗
PubMed2004

A longitudinal study of the evolution of cognitive function and affective state in patients with amyotrophic lateral sclerosis.

OBJECTIVES: The study aimed to evaluate cognitive function and emotional reactivity in 18 patients with ALS, compared to 19 matched controls, and assess their evolution over a 12-month period. METHODS: 18 ALS patients and 19 matched controls were included, and assessed at inclusion, six months and twelve months later. Depression was evaluated with the Geriatric Depression Scale, and cognitive function with the Folstein Mini Mental State. A battery of psychometric tests (Wisconsin Card Sorting Test (WCST), the numerical Empan test, the Trail-making test, the Boston Naming Test, the 15-word Rey memory test, the Benton visual retention test and the Raven Progressive Matrix) was used to measure frontal processing and non-frontal function. Emotional reactivity was measured with the film-evoked emotions test. RESULTS: ALS patients were significantly more depressed than controls, as measured on the Geriatric Depression Scale, and depression increased over the study period. There was a very mild defect in cognitive function, and a performance deficit in the Trail-making test, a measure of frontal processing. These deficits, unlike neuromuscular function and depression, did not aggravate over the 12 months of the study. There was no observable change in non-frontal function. Emotional reactivity did not differ significantly between ALS patients and controls. CONCLUSIONS: This study provides further evidence for a mild defect in frontal cognitive processing in ALS patients that evolves only slowly, if at all, with time.

Adolescent↗
PubMed1992

Driving evaluation after traumatic brain injury.

Traumatic closed head injury results in a variety of cognitive and behavioral deficits that may be difficult to assess fully. Adequately evaluating driving safety is a common and important problem for health care professionals. The purpose of this study was to examine the relationship between standardized measures of cognitive function and measures of driving performance in patients with closed head injuries and in their age-matched relative or friend cohorts. Thirteen patients were evaluated. They had each sustained a closed head injury (followed by more than 1 h of coma) 3 to 6 months before testing. Their scores were analyzed along with those of seven cohorts. Assessments of cognitive function and behind-the-wheel driving performance were conducted by examiners blinded to subjects' group membership and medical condition. There was a significant relationship (r = 0.44) between the sum of rated scores of the Tactual Performance Test and Trail Making Test and the global pass/fail ratings of the behind-the-wheel driving test, but it was not related to the driving performance score. The difference between the verbal and performance IQs, and the difference between the block design and other performance tests of the Wechsler Adult Intelligence Scale-Revised were also not significantly related to driving performance. These results suggest that tests of cognitive function alone are not adequate to predict driving performance, and should be used along with standardized driving performance evaluations before recommendations are made.

Adolescent↗
PubMed2003

Executive function in young Colombian adults.

The aim of this article was to observe the correlation between executive function (EF) variables, and to determine the factor structure of the EF in young university students, as mathematical models for supporting its multidimensional structure. Participants were both males and females, aged 16 to 21 years (N = 100) and with normal Full Scale IQ selected in a randomized and representative approach in private universities of Medellín, Colombia. They were students of verbal, visual-spatial, and mathematical careers. An executive function assessment battery was applied and which included: Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) A and B, verbal fluency test (FAS) by phonologic and semantic cues, and Stroop's conflict word/color test. The results were as follows: An orthogonal structure of five factors, which explained 74.9% of the variance, was found. Factor 1 was formed by WCST variables (organization and flexibility), and explained 25.8% of the variance. Errors from the Stroop reading and naming were assigned to factor 2, which explained 17.3% of the variance. Factor 3 was the time for executing Stroop's test, and explained 13.1% of the variance. Factor 4 was TMT A and B (10.1%). Factor 5 was verbal fluency (8.5% of the variance). In conclusion, executive function in young university students was conformed by five orthogonal cognitive dimensions.

Adolescent↗
PubMedDate not supplied

Impaired Trail-Making Test-B performance in patients with acute schizophrenia is related to inefficient sequencing of planning and acting.

In order to investigate the functional basis of the frequently described deficits of schizophrenia patients in Trail Making Test B (TMT-B) performance, the performance process was analyzed based on the interaction of eye and hand movements. In a longitudinal design, 23 acute schizophrenia patients, 17 acute depressive inpatients, and 21 healthy controls were assessed twice within 4 weeks. Computer versions of both TMT-A and TMT-B were used, which require to connect different targets with a cursor, with concurrent infrared oculography. In both TMT-versions, schizophrenia patients demonstrated poorer performance and longer "planning periods"--as defined by fixations outside the cursor area--containing more fixations, which were stable over time. However, these "planning fixations" were only also longer in duration during TMT-B and differed in time and context of their occurrence compared with healthy controls. Schizophrenia patients demonstrated more fixations while the cursor rested between targets. Significant correlations with performance time gave evidence that it is important for short planning periods to be performed parallel to ongoing connection of targets, to obtain a satisfactory result. No relationship between "planning variables" with psychopathology and medication could be found. Accordingly, poorer TMT-B performance in schizophrenia patients was found to be related to insufficient sequencing of planning and acting, which appears to be a trait-like characteristic. Though depressive patients also performed poorer in TMT-B, they did not differ from either of the other groups in the main process variables, which may hint to different underlying causes of the performance deficits in both groups of patients.

Acute Disease↗
PubMed1998

Establishment of normative data on cognitive tests for comparison with athletes sustaining mild head injury.

OBJECTIVE: To provide normal data for comparison with objective measures of an athlete's cognitive ability after mild head injury (MHI). SUBJECTS: Seventy-two Division I college athletes. DESIGN AND SETTING: Athletes were assessed on three test dates (two days apart) in a sports medicine research laboratory. MEASUREMENTS: Normative data were collected on four cognitive tests (Hopkins Verbal Learning Test, Stroop Test, Reitan Trail-Making Tests, and Wechsler Digit Span Tests). RESULTS: A repeated-measures analysis of variance revealed significant learning effects on all tests except the Hopkins Verbal Learning Test. A high correlation was noted between the Stroop and the Trail-Making Tests. CONCLUSIONS: These normative data can be used as comparisions to provide an objective measure of an athlete's cognitive ability following MHI. By adding this test battery to the athlete's other physical and neurologic tests, the decision to return an athlete to competition after MHI can be made with greater confidence and with less risk of reinjury.

Journal Article↗
PubMed1998

Psychologic and neuropsychologic functioning of patients with limited small-cell lung cancer treated with chemotherapy and radiation therapy with or without warfarin: a study by the Cancer and Leukemia Group B.

PURPOSE: The current study assessed the psychologic and neuropsychologic functioning of patients with small-cell lung cancer who were randomized in a large clinical trial to receive intensive doxorubicin, cyclophosphamide, etoposide (ACE)/cisplatin, cyclophosphamide, etoposide (PCE) chemotherapy and radiation therapy (RT) to the primary tumor and prophylactic whole-brain irradiation with (regimen I) or without (regimen II) warfarin. PATIENTS AND METHODS: Patients' emotional states and cognitive functioning were assessed using the Profile of Mood States (POMS) and Trail Making B Test (Trails B), respectively. Two hundred ninety-five patients completed the POMS and Trails B at pretreatment, 224 patients after the completion of the ACE course of chemotherapy (week 9), and 177 patients after the completion of the PCE chemotherapy and RT (week 17). RESULTS: No differences on the POMS or Trails B measures were found between the two treatment arms as predicted, given that the only difference between the two treatment arms was the presence or absence of warfarin. Analysis of the POMS revealed that, overall, mean scores remained stable over the course of treatment; however, women showed a trend toward higher mean scores, which indicated a higher level of distress, compared with men at the pretreatment assessment. Examination of cognitive functioning, measured by the Trails B, revealed improved performance from baseline to post-ACE chemotherapy, which is consistent with a practice effect, but a significant worsening of Trails B scores post-RT compared with the pre-RT assessments, which is consistent with impaired cognitive functioning because of treatment (P < .0001). CONCLUSION: Emotional state, measured by the POMS, did not differ between the groups or change significantly over time in this study of small-cell lung cancer patients treated with a combination of chemotherapy and RT plus or minus warfarin. However, the pattern of relatively stable POMS scores and poorer Trails B performance post-RT suggested that this combination of chemotherapy and RT had a negative impact on cognitive functioning.

Adult↗
PubMedDate not supplied

[Neuropsychological findings in patients with middle temporal lobe epilepsy].

INTRODUCTION: Cognitive dysfunction in mesial temporal lobe epilepsy (MTLE) is still a controversial subject. Since refractory MTLE is considered a surgically remediable syndrome, the neuropsychological assessment to establish the presence of cognitive impairment in the surgical candidate became an important issue, given its possible relevance in predicting outcome after surgery. OBJECTIVE: Our aim was to study the cognitive profile of MTLE patients and to correlate the cognitive status with the presence or absence of hippocampal sclerosis. PATIENTS AND METHODS: Fifty patients with MTLE and 20 control subjects were matched by age and educational level. All subjects were studied with EEG, MRI scan, SPECT, and a comprehensive neuropsychological battery that included measures of language (naming and verbal fluency), visuospatial function (Block Design Test), memory (Signoret Battery), attention (Digit Span and Trail Making Test A) and executive abilities (Trail Making Test B and Wisconsin Card Sorting Test). RESULTS: MTLE patients, particularly those with hippocampal sclerosis, were found to have a considerable lower performance in learning (p < 0.01), naming (p < 0.05), attention (p < 0.05) and executive functions (p < 0.001). Among the MTLE patients a considerable number of subjects showed results within the normal range (n = 27) while others evidenced laterality specific cognitive impairments (n = 13). Material specific memory effects were seen in some patients but not all. CONCLUSIONS: Our results showed the neuropsychological heterogeneity of temporal lobe epilepsy, thus ruling out the existence of a single specific cognitive pattern of impairment in all MTLE patients, and suggesting the need of a thorough pre-surgical neuropsychological evaluation to be used with post-surgical prognosis purposes.

Adult↗
PubMed1999

Bilateral subthalamic or pallidal stimulation for Parkinson's disease affects neither memory nor executive functions: a consecutive series of 62 patients.

There is a renewal of interest in surgical approaches including lesions and deep brain stimulation directed at motor subcorticofrontal loops. Bilateral lesioning presents a far greater risk of adverse effects, especially cognitive impairment. Furthermore, the main advantages of the stimulation procedure over lesioning are adaptability and reversibility of effects. The aim of this study was to assess the influence of bilateral stimulation of the subthalamic nucleus or internal globus pallidus on memory and executive functions in Parkinson's disease. Sixty-two patients were assessed before and after 3 to 6 months of chronic bilateral stimulation of the subthalamic nucleus (n = 49) or internal globus pallidus (n = 13). The neuropsychological tests used were the Mattis Dementia Rating Scale, the Grober and Buschke Verbal Learning Test, the Wisconsin Card Sorting Test, category and literal fluency, graphic and motor series, the Stroop Test, and the Trail Making Test. Mood was evaluated by the Beck Depression Inventory. Only 4 of 25 cognitive variables were affected by deep brain stimulation. Under stimulation, performance improved for Parts A and B of the Trail Making Test, but there was a deterioration in literal and total lexical fluency. There was also a mild but significant improvement in mood. It may therefore be concluded that stimulation of the subthalamic nucleus or internal globus pallidus does not change the overall cognitive performance in Parkinson's disease and does not greatly affect the functioning of subcorticofrontal loops involved in cognition in humans. This relative absence of cognitive impairment in bilateral deep brain stimulation is likely because of the accurate positioning of the electrodes, allowing the effects of stimulation to be confined to sensorimotor circuits.

Electric Stimulation↗
PubMed1997

The psychological and psychiatric effects of rIL-2 therapy: a controlled clinical trial.

It has been suggested that recombinant interleukin-2 (rIL-2) may cause pyschological and psychiatric problems, although the effects of rIL-2 on its own have not been well documented. To evaluate these effects, 17 patients with advanced colorectal cancer took part in a randomised, parallel group study of rIL-2 with chemotherapy (5-fluorouracil and leucovorin) versus chemotherapy alone. Patients were assessed regularly by means of various psychometric tests including the Hospital Anxiety and Depression Scale, the Mood Rating Scale, the Mini-Mental State Examination, the Digit Symbol Substitution Test, the Trail-Making Test and the Benton Revised Visual Retention Test. Rigorous discontinuation criteria were applied to ensure that the effect of time-related variables did not influence the results. Compared with patients who were given chemotherapy alone, patients receiving immunochemotherapy reported reduced energy, impaired confidence, higher depressed mood and more confusion. Immunochemotherapy was rated as more distressing than chemotherapy alone and patients reported a greater incidence of appetite impairment, weight loss, poor concentration and fever. Cognitive assessments indicated that brain dysfunction can be caused by rIL-2. Compared with the control group, patients receiving immunochemotherapy showed significant impairment on Trail Making Test B and the Digit Symbol Substitution Test. One patient developed repeated transient psychotic episodes associated with rIL-2 infusions and another regularly became confused. These effects were not due to sleep deprivation or pyrexia. Treatment with rIL-2 should not be discarded on psychosocial grounds, although in each case the psychological morbidity and adverse effects on quality of life need to be balanced carefully against potential therapeutic benefits.

Antimetabolites, Antineoplastic↗
PubMed2004

Change in cognitive function by glucose tolerance status in older adults: a 4-year prospective study of the Rancho Bernardo study cohort.

BACKGROUND: A few studies have examined change in cognitive performance by diabetes status with disparate results. We examined the 4-year change in cognitive performance among older adults according to glucose tolerance status. METHODS: Three cognitive tests (Mini-Mental State Examination, Verbal Fluency [VF] test, and Trail-Making Test B) were measured 4 years apart in 999 white men and women aged 42 to 89 years, who were enrolled in the Rancho Bernardo Study. Participants were classified with normal (NGT), impaired (IGT) or diabetic glucose tolerance. Sex-specific linear regression models adjusted for age, education, depression score, apolipoprotein E epsilon4 allele, and current estrogen use. We checked for mediation by further adjusting for total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels; blood pressure; glycohemoglobin level; and microalbuminuria, retinopathy, stroke, or coronary heart disease. RESULTS: At baseline, mean cognitive function scores did not differ between glucose tolerance groups. Women with diabetes mellitus had a 4-fold increased risk of a major cognitive decline on the VF test after 4 years compared with nondiabetic women. After multivariate adjustment, VF test scores at follow-up for women were 15.2 +/- 0.6 for those with diabetes, 16.7 +/- 0.4 for those with IGT, and 17.2 +/- 0.2 for those with NGT (P =.007). Glycohemoglobin attenuated this effect, but lipid levels, blood pressure, and microvascular or macrovascular disease did not. Performance on Mini-Mental State Examination and Trail-Making Test B did not differ by baseline glucose status. CONCLUSIONS: Elderly white women with diabetes had a more rapid decline in performance on the VF test compared with women with IGT or NGT. Better glucose control might ameliorate this decline.

Adult↗
PubMed2004

Childhood onset schizophrenia: familial neurocognitive measures.

OBJECTIVE: Early onset disorders may have more salient familial/genetic etiology. Neurocognitive deficits which are seen in families of adult onset schizophrenic patients were examined in healthy family members of patients with childhood-onset schizophrenia (COS). METHODS: Trail Making Tests (TMT) A and B, Wechsler Intelligence Scale-Revised Digit Span and Vocabulary subtests were administered to 67 parents and 24 siblings of patients with childhood-onset schizophrenia and 114 healthy community controls (CC) comparable in sex, age, and educational level. RESULTS: COS siblings performed significantly more poorly than did controls on Trails Making Test B with a trend for poorer performance evident on Trails Making Test A. COS parents performed more poorly than controls only on Trails Making Test A. CONCLUSIONS: Healthy first-degree relatives of COS probands have subtle deficits in tests involving oculomotor/psychomotor speed, working memory and executive function. This provides further support for continuity between COS and later onset schizophrenia and for a familial/genetic factor associated with the illness.

Adult↗
PubMed1995

Detrimental effects of noise on anaesthetists.

To study the detrimental effects of operating room noise, noise levels in operating rooms were first measured and the average noise level was calculated in Decibels, which was 77.32 dB(A). An audiocassette of 90 min duration was prepared recording the operating room noise. The same audiocassette was used later to expose the 20 anaesthesia residents to the operating room noise in the acoustically treated rooms of audiology department. The noise level during exposure was maintained at 77.32 dB(A). Two cognitive functions, mental efficiency and short-term memory were studied. The tests used were the Trail Making Test and Digit Symbol Test for mental efficiency and the Benton Visual Retention Test for short-term memory. The mean pre-exposure scores for the Trail Making Test, Digit Symbol Test and Benton Visual Retention Test were 22.9 +/- 1.94, 83 +/- 2.62 and 9.55 +/- 0.51 respectively. The mean during-exposure scores were 16.35 +/- 1.39, 74.05 +/- 3.46 and 5.8 +/- 0.41 respectively (P < 0.05). In conclusion, we observed that operating room noise reduced the mental efficiency and short-term memory of anaesthesia residents.

Adult↗
PubMed2002

Cognitive functioning in adults with Attention-Deficit/Hyperactivity Disorder.

OBJECTIVES: Children with Attention-Deficit/Hyperactivity Disorder (ADHD) appear to be deficient in executive control. The purpose of this study was to determine if adults with ADHD are also deficient in executive control. METHOD: The performance of 18 adults with ADHD and 18 control subjects was compared on two tests of executive control, and two control tasks. The executive control tasks used in the study were the Trail Making Test (B), and the Tower of Hanoi. The control tasks used were the Trail Making Test (A), and the Benton Facial Recognition Test. RESULTS: The subjects with ADHD performed more poorly than did the normal controls on the executive control tasks. The subjects with ADHD, however, also performed more poorly on the Trail Making Test (A). CONCLUSIONS: The ADHD subjects showed a deficit in executive control, but this deficit was not confined to the executive control domain.

Adult↗
PubMed2006

Heterogeneity in executive impairment in patients with very mild Alzheimer's disease.

BACKGROUND/AIMS: The presence of executive impairment in mild Alzheimer's disease (AD) has primarily been demonstrated by means of group comparison. Whether executive dysfunction is a common feature of mild AD or only present in a subgroup of patients remains unclear. The aim of this study was to describe the frequency of impairment on a set of internationally well-known executive tests in patients with very mild AD. METHODS: Thirty-six patients with very mild AD (MMSE scores above 23) and 32 healthy control subjects were administered a battery of 7 executive tests: Trail Making part B, Stroop Interference Test, modified Wisconsin Card Sorting Test (WCST), category- and letter-based verbal fluency, a design fluency task and the Similarities subtest from WAIS. Impairment was defined as a score of 2 SD or more below control means. RESULTS: Executive impairment on at least 1 measure was seen in 76% of the patients, and 50% were impaired on 2 or more tests. Trail Making B and Stroop Interference Test were impaired in more than 40%, whereas only few patients were impaired on Similarities, WCST and design fluency. A wide variation of executive test profiles was seen among the patients. CONCLUSION: Executive impairments are common in early AD and not just a feature characteristic of a subgroup of patients. Complex attentional skills are more frequently affected than other executive functions. There is, however, considerable heterogeneity among AD patients in the pattern of executive dysfunction.

Aged↗
PubMed2005

Apolipoprotein E and category fluency: evidence for reduced semantic access in healthy normal controls at risk for developing Alzheimer's disease.

Two groups of non-demented individuals, who differed on genetic risk for Alzheimer's disease (AD) based on their apolipoprotein E (APOE) genotype, were tested on a category fluency task. Twenty varepsilon4 carriers and twenty varepsilon4 non-carriers were tape recorded while saying animal names for ten minutes. Five measures were examined: total names generated; total clusters; mean cluster size; mean within-cluster retrieval time; and mean between-cluster retrieval time. Groups were matched on age and education and scored as normal on a battery of psychometric tests. The varepsilon4 carriers generated significantly fewer names and clusters, and took significantly longer to access clusters, when compared to the varepsilon4 non-carriers. No group differences were found for cluster size or within-cluster retrieval times. We previously reported [Rosen, V. M., Bergeson, J. L., Putnam, K., Harwell, A., Sunderland, T. (2002). Working memory and apolipoprotein E: What's the connection? Neuropsychologia 40, 2226-2233] that the varepsilon4 carriers in the present study scored significantly lower than the varepsilon4 non-carriers on a measure of working memory/attentional capacity [Operation Span Task, see Turner, M. L., Engle, R. W. (1989). Is working memory capacity task dependent? Journal of Memory and Language 28, 127-154]. In the present study, a significant negative relationship found between span performance and between-cluster retrieval times suggested that reduced attentional capacity may have negatively impacted semantic access for the varepsilon4 carriers. Finally, we found significant relationships between a Trail Making Test [Reitan, R. M. (1992). Trail Making Test, manual for administration and scoring. Tucson, AZ: Reitan Neuropsychology Laboratory] "switch" measure (Form B-Form A) and three of the five fluency measures. The findings suggested that the varepsilon4 carrier's reduced attentional capacity may have interfered with their covertly shifting attention among subcategories in the fluency task, resulting in fewer names and clusters generated and longer times to access clusters.

Aged↗
PubMed2000

[Neuropsychological pattern of cognitive impairment in Alzheimer type dementia and vascular dementia].

BACKGROUND: Cummings et al, 1987, hypothesized that Alzheimer dementia type (ADT) patients would present poorer performances than vascular dementia (VD) patients on the neuropsychological tests that mainly involve cortical neurological structures, and that VD would perform worse on tests that mainly involve subcortical structures. The main purpose of the research was to identify a cognitive impairment pattern that discriminates the type of dementia in the initial stages. METHOD: Two groups of patients, one affected by mild ADT (n = 30) and the other by multi-infarct dementia (VD, n = 30) were given a neuropsychological battery. The battery was composed by Temporal Orientation (Benton et al.); Vocabulary, Similarities, Digits, Coding and Kohs (WAIS) of Wechsler; the Colour-Form Test of Weigh; the Trail Making Test (A and B) (Halstead-Reitan Neuropsychological Battery); Tapping (McQuarrie); Logical Memory, Visual Memory and Paired Association (Wechsler Memory Scale) of Wechsler; Delayed Memory (Russell). The two groups were similar in age and socio-cultural features. The z-score and its statistical significance on the Mann-Whitney test were made and we performed an exploratory discriminant analysis to the classification. RESULTS: In general, results were poorer in the ADT group. But we detected no significant differences in the tests, although some test (Immediate Visual Memory and Kohs' Blocks) almost reached significance. The discriminant analysis reached a classification of the 67% of the subjects into the ADT group and the 70% of the subjects into the VD group. CONCLUSIONS: In the initial stages of dementia it is difficult to differentiate between a cortical pattern of cognitive impairment in ADT and a subcortical pattern in VD, a distinction that the other researchers have reported. When complex tests were used the performance depended on the coordination of multiple related systems. These findings are in agreement with the holistic models of higher mental functions.

Aged↗
PubMed2006

The Val66Met polymorphism of the brain-derived neurotrophic factor gene is associated with risk for psychosis: evidence from a family-based association study.

Schizophrenia (SZ) is a prevalent and severe mental disorder. One of the most favored hypotheses for the etiology of SZ is the neurodevelopmental hypothesis. Brain-derived neurotrophic factor (BDNF), a member of the neurotrophin growth factor family, promotes the development, regeneration, and survival of neurons and has been linked to the neuropathology of SZ. The present study tested, in a sample of 94 nuclear families, the hypothesis that the BDNF gene Val66Met polymorphism is associated to SZ and its psychopathologic phenotype using a multidimensional symptom approach. Furthermore, considering a reported reduction of BDNF in the frontal cortex of patients with SZ, we studied the relationship between this polymorphism and prefrontal function. The transmission disequilibrium test (TDT) showed a preferential transmission of allele Val from heterozygous parents to the affected offspring (P = 0.002), suggesting a possible role of this gene in the vulnerability to SZ spectrum disorders. The findings remained essentially unchanged when the analysis was restricted to the subgroup of patients with SZ (P = 0.009) and when a multidimensional approach to the diagnosis was used. Quantitative transmission disequilibrium test (QTDT) analyses did not demonstrate a significant association between the prefrontal tests assessed (Wisconsin Card Sorting Test and Trail Making Test) and the transmission of the BDNF alleles. Our finding suggests that the investigated BDNF polymorphism plays an important role in the phenotype of psychosis, but not in the performance of tests of prefrontal cognitive functions analyzed in these patients.

Adult↗