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At least 235 records · Page 13Linked to original sources
PubMed2006

Cognitive function following stroke and vascular cognitive impairment.

PURPOSE OF REVIEW: This review of the cognitive status following stroke and vascular cognitive impairment starts by questioning the concept of vascular dementia and related concepts. Our position is that in many cases these labels promote a superficial conceptualization of an inherently complex and heterogeneous phenomenon hampering a more detailed understanding. RECENT FINDINGS: After stroke or disease of the cerebral vasculature, the cognitive and emotional outcome is dependent on a combination of three factors with the relative importance differing between causes. First, focal damage may lead to selective impairments that are dependent on the localization of the (grey matter) lesion. Second, diffuse neuronal dysfunction produces a more uniform profile of a decrease in mental speed, memory problems, and reduced executive functioning. Third, cognitive outcome is further modulated - notably in terms of severity - by patient variables such as age, sex, premorbid level of functioning, and comorbidity (e.g. hypertension). SUMMARY: The complex character of the cognitive repercussions of stroke can be better harnessed by employing modern neuropsychological assessment procedures. This allows both a detailed categorization of the patients for the selection and effectiveness of therapeutic intervention, as well as the construction of reliable prognostic models.

Brain↗
PubMed2004

Neuroethical considerations: cognitive liberty and converging technologies for improving human cognition.

Developers of NBIC (Nano-Bio-Info-Cogno) technologies face a multitude of obstacles, not the least of which is navigating the public ethics of their applied research. Biotechnologies have received widespread media attention and spawned heated interest in their perceived social implications. Now, in view of the rapidly expanding purview of neuroscience and the growing array of technologic developments capable of affecting or monitoring cognition, the emerging field of neuroethics calls for a consideration of the social and ethical implications of neuroscientific discoveries and trends. To negotiate the complex ethical issues at stake in new and emerging kinds of technologies for improving human cognition, we need to overcome political, disciplinary, and religious sectarianism. We need analytical models that protect values of personhood at the heart of a functional democracy-values that allow, as much as possible, for individual decision-making, despite transformations in our understanding and ability to manipulate cognitive processes. Addressing cognitive enhancement from the legal and ethical notion of "cognitive liberty" provides a powerful tool for assessing and encouraging NBIC developments.

Biomedical Enhancement↗
PubMed2004

Cognition, functional status, education, and the diagnosis of dementia and mild cognitive impairment in Spanish-speaking elderly.

A group of 314 Spanish-speaking elders were classified in 55 participants with mild to moderate dementia, 74 participants with mild cognitive impairment (MCI), and 185 control participants, according to clinical evaluation derived. Sensitivity, specificity, and detection characteristics of frequently cognitive and functional tests were calculated in comparison with the clinical evaluation: Minimental State Examination, Brief Neuropsychological Test Battery, Short Blessed test, Pfeffer Functional Activities Questionnaire, and Blessed Dementia Scale. Influence of education on sensitivity and specificity values varied along the tests. For all the cognitive and functional measures, a great number of MCI participants who fulfilled Mayo's (Mayo's Clinical School) clinical criteria (Petersen et al., 1999) were misclassified as controls and a few were misclassified as demented. Level of education plays a very important role in both cognitive and functional assessment. The cognitive tests that are commonly used to screen demented patients may fail to detect MCI particularly in high-functioning individuals as well as those who are well educated.

Activities of Daily Living↗
PubMed1992

[A multi-stage cognitive training program for improving cognitive functions of chronic alcoholic patients].

In accordance with neuropsychological findings, that chronic alcohol abuse can lead to cognitive impairment, a multi-phased cognitive training program (MKT) developed by Sagstetter was conducted with a group of chronic alcoholic patients. In this article this program is introduced and evaluated with regard to chronic alcoholic patients and their improvement in certain cognitive functions. The study group consisted of 11 chronic alcoholics, who regularly took part in the program. The control group consisted of 11 patients who took part on a behavior therapy program offered by the clinic and had similar social and pathological histories to those of the study group. The two groups were compared with each other with the help of a follow-up study design after approximately seven weeks. The results reveal that this present cognitive training program promotes, above all, cognitive functions such as visual short-time memory, concentration, form perception as well as combination and organisation ability.

Adult↗
PubMed1987

Cognitive function, cognitive style and life satisfaction in a 68-year-old male population.

A representative sample of 68-year-old men living in the city of Malmö, Sweden, was examined by means of psychological tests and questionnaires regarding cognitive capacity, cognitive style as an expression of personality, and life satisfaction. Reference values for these parameters are presented, and a continuous cohort increase of verbal ability could be identified in this age group. That the prevalence of cognitive reduction was found to be surprisingly high is tentatively interpreted as reflecting an underdiagnosis of these symptoms as concomitant to other diseases in the general population. Earlier results supporting the concept of terminal decline could not be replicated. The reason for this might be that the present population was somewhat younger than those earlier investigated. Contrary to expectation, life satisfaction did not correlate to either cognitive reduction or cognitive style. It had, however, a positive correlation to measures of fluid intelligence.

Adaptation, Psychological↗
PubMed1999

Arctic cognition: a study of cognitive performance in summer and winter at 69 degrees N.

Evidence has accumulated over the past 15 years that affect in humans is cyclical. In winter there is a tendency to depression, with remission in summer, and this effect is stronger at higher latitudes. In order to determine whether human cognition is similarly rhythmical, this study investigated the cognitive processes of 100 participants living at 69 degrees N. Participants were tested in summer and winter on a range of cognitive tasks, including verbal memory, attention and simple reaction time tasks. The seasonally counterbalanced design and the very northerly latitude of this study provide optimal conditions for detecting impaired cognitive performance in winter, and the conclusion is negative: of five tasks with seasonal effects, four had disadvantages in summer. Like the menstrual cycle, the circannual cycle appears to influence mood but not cognition.

Adolescent↗
PubMed1998

Scopolamine-induced cognitive impairment as a predictor of cognitive decline in healthy elderly volunteers: a 6-year follow-up.

OBJECTIVE: To determine if scopolamine-induced cognitive impairment in healthy elderly people predicts cognitive decline 6 years later. DESIGN: Prospective cohort study. SETTING: Elderly care research unit. PARTICIPANTS: Healthy elderly people who were part of a volunteer panel of research subjects. INTERVENTIONS: Scopolamine 0.2 mg administered subcutaneously at baseline. MAIN OUTCOME MEASURES: Cognitive drug research computerized cognitive testing battery pre- and post-scopolamine, with repeat testing over 6 years later. MAIN RESULTS: 16/24 subjects were retested. Although marked decrements in cognitive functioning were seen with scopolamine, there was little change in performance over 6 years, and no significant association was seen between scopolamine-induced decrement and change over time. CONCLUSIONS: The scopolamine challenge test is not likely to play a role in the preclinical diagnosis of Alzheimer's disease.

Aged↗
PubMed2007

Comparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini-Mental State Exam for the detection of cognitive impairment in nursing home residents.

OBJECTIVE: To compare the diagnostic accuracy of an outcome measurement scale of the Minimum Data Set of the Resident Assessment Instrument for nursing homes (MDS/RAI-NH), the Cognitive Performance Scale (CPS) and the Mini-Mental State Exam (MMSE) for the detection of cognitive impairment. The Cambridge Examination for Mental Disorders of the Elderly--Revised (CAMDEX-R) was used as the reference standard. STUDY DESIGN AND SETTING: This study was part of a larger prospective study (QUALIDEM) involving a diagnostic procedure and two-year follow-up on the quality of primary care for demented patients. CAMDEX-R and MDS/RAI-NH were administered to 198 residents, aged 65 or more, living in 42 low and high care institutions for aged people. MAIN OUTCOME MEASURES: Indicators of diagnostic accuracy: sensitivity, specificity, predictive values, likelihood ratios, odds ratio and area under receiver operating characteristics curve (AUC). RESULTS: The CAMDEX-based prevalence of cognitive impairment was 75%. The diagnostic values of a CPS score of two or more for the detection of cognitive impairment were: sensitivity = 0.81; specificity = 0.80; PPV = 0.92; NPV = 0.57. The diagnostic values of a MMSE score of less than or equal 23 were: sensitivity = 0.97; specificity = 0.59; PPV = 0.88; NPV = 0.85. For CPS, the area under the receiver operating characteristic (ROC) curve was 0.87 (95% CI, 0.81-0.91), and not significantly different (p = 0.63) from the MMSE score, 0.88 (0.83-0.93). CONCLUSIONS: CPS and MMSE demonstrated similar performance to detect cognitive impairment in nursing home residents.

Aged↗
PubMed2000

Cognitive neuropharmacology: new perspectives for the pharmacology of cognition.

Taking its roots both in neuropharmacology and in cognitive science, cognitive neuropharmacology is an emerging approach in the field of psychopharmacology. It attempts to use theoretical knowledge to understand the biochemical bases of cognition and the mode of action of the commonly used drugs and to find new brain-targeted therapeutics. The aim of the present article is to throw up the main characteristics of this way of research. It is defined in comparison with its neighbouring approaches and by presenting its own rationale. Its particular methods mainly concern the animal modelling of the highest human cognitive functions and the original means of intra-cerebral drug administration. Finally, we present an illustrative example of a study in cognitive neuropharmacology and propose further perspectives.

Animals↗
PubMed1993

Emotion and two kinds of meaning: cognitive therapy and applied cognitive science.

The clinical cognitive approach assumes that emotional reactions are mediated through the meanings given to events. Cognitive therapy aims to change emotion by changing meanings. It focuses on specific level meanings, evaluating the truth value of particular beliefs. Bower's science-driven associative network theory of cognition and emotion is also primarily concerned with specific meanings. This focus on meaning at a specific level causes problems, e.g. the contrasts between 'intellectual' and 'emotional' belief, between 'cold' and 'hot' cognition, and between explicit and intuitive knowledge. These problems are resolved in the Interacting Cognitive Subsystems (ICS) approach. ICS distinguishes between a specific and a more holistic, intuitive, level of meaning. In contrast to alternative approaches, ICS suggest that holistic level meanings are of primary importance in emotion production. Representations at this level consist of schematic mental models, encoding high-order inter-relationships and prototypical patterns extracted from life experience. The ICS approach to meaning is described and its implications for understanding and treating emotional disorders discussed, together with relevant empirical findings. ICS suggests a therapeutic focus on holistic rather than specific meanings, a role for 'non-evidential' interventions, such as guided imagery, and a rational basis for certain experiential therapies.

Adaptation, Psychological↗
PubMed1995

Cognitive bias in panic disorder patients and changes after cognitive-behavioral treatments.

The aim of this study was to investigate cognitive biases in panic disorder patients via a questionnaire originally developed by Clark and co-workers [Clark, Salkovskis, Gelder, Koehler, Martin, Anastasiades, Hackman, Middleton & Jeavons, (1988). In Hand, I. & Wittchen, H.-U. (Eds) Panic and Phobias 2] to assess interpretations of ambiguous internal (bodily sensations) and external events. The results showed that, compared to normal controls, panic disorder patients interpreted bodily sensations in a more threatening fashion, while there was no difference concerning external events. Cognitive-behavioral treatments normalized this bias, and Cognitive Behavior Therapy and Applied Relaxation were equally effective in this respect. Moreover, compared to panicking patients, panic-free patients had reduced their cognitive threat bias at post-treatment and follow-up to a significantly larger extent. The results support the cognitive theory of panic disorder.

Adult↗
PubMed1995

Assessment of cognitive variable relevant to cognitive behavioral perspectives on anorexia nervosa and bulimia nervosa.

Several cognitive behavioral writers have described cognitions regarding food, eating, and body weight as central to the psychopathology of anorexia and bulimia. However, only preliminary efforts have been undertaken to develop valid and reliable assessment methodologies for these cognitions. This paper reviews the current status of self-report questionnaires, thought-sampling procedures, and methods from cognitive psychology as applied to the assessment of eating disorder cognitions.

Anorexia Nervosa↗
PubMed1996

Neuronal mechanisms mediating drug-induced cognition enhancement: cognitive activity as a necessary intervening variable.

The conceptual foundations of a research aimed at the determination of potential neuronal, neuropharmacological, and behavioral/cognitive mechanisms mediating drug-induced cognition enhancement are discussed. The available evidence justifies a focus on attentional processes as a target for drug-induced cognition enhancement. Neuropharmacological mechanisms that may mediate drug-induced enhancement of attentional functions are proposed to interact necessarily with attention-associated neuronal activity. The elements of a transsynaptic approach to increase the excitability of basal forebrain cholinergic neurons and hence, attentional functions are discussed. Experimental tests of this hypothesis require the demonstration of interactions between cognition-induced increases in the activity of cortical cholinergic afferents and the effects of putative cognition enhancers. The available data illustrate that the effects of benzodiazepine receptor (BZR) agonists and inverse agonists on cortical acetylcholine (ACh) efflux interact with the state of activity in this system. The feasibility, potential heuristic power, and the experimental and conceptual problems of studies attempting to simultaneously assess drug effects on behavioral/cognitive abilities, ACh efflux, and neuronal activity have been revealed by an experiment intended to correlate performance in a task measuring sustained attention with medial prefrontal ACh efflux and medial prefrontal single-unit activity. The rational development of a psychopharmacology of cognition enhancers requires a union among behavioral/cognitive pharmacology, neuropharmacological and electrophysiological approaches.

Acetylcholine↗
PubMed2006

Explicit and implicit cognition: a preliminary test of a dual-process theory of cognitive vulnerability to depression.

Two studies were conducted to test a dual-process theory of cognitive vulnerability to depression. According to this theory, implicit and explicit cognitive processes have differential effects on depressive reactions to stressful life events. Implicit processes are hypothesized to be critical in determining an individual's immediate affective reaction to stress whereas explicit cognitions are thought to be more involved in long-term depressive reactions. Consistent with hypotheses, the results of study 1 (cross-sectional; N=237) showed that implicit, but not explicit, cognitions predicted immediate affective reactions to a lab stressor. Study 2 (longitudinal; N=251) also supported the dual-process model of cognitive vulnerability to depression. Results showed that both the implicit and explicit measures interacted with life stress to predict prospective changes in depressive symptoms, respectively. However, when both implicit and explicit predictors were entered into a regression equation simultaneously, only the explicit measure interacted with stress to remain a unique predictor of depressive symptoms over the five-week prospective interval.

Adolescent↗
PubMed2005

Hormone replacement therapy and cognitive performance in postmenopausal women--a review by cognitive domain.

Laboratory, animal and neuroimaging evidences suggest that hormone replacement therapy (HRT) may be beneficial to human cognition. This systematic review includes 26 studies on the association between HRT and cognition and 17 studies on HRT and risk of dementia. It was hypothesised that HRT would have a positive association with cognitive speed and verbal memory and possibly visual memory but not with executive functioning, and would be associated with a decreased risk of dementia. Evidence for HRT's neuroenhancing and neuroprotective properties was also evaluated. There was significant statistical and clinical heterogeneity among studies precluding meta-analysis. Results showed no consistent relationship between HRT and performance in any cognitive domain. Cross-sectional studies tended to report more positive results than longitudinal studies and randomised-controlled trials, particularly in the areas of verbal memory and executive functioning. HRT was associated with decreased risk of dementia in observational studies, but with increased risk in one randomised-controlled trial. Cognitive improvement or maintenance are not secondary benefits of HRT.

Brain↗
PubMed2006

Cognitive impairment but preservation of sexual dimorphism in cognitive abilities in chronic schizophrenia.

Neurocognitive impairment in schizophrenia is well established, though sex differences on cognitive tasks have produced equivocal findings. The present study was designed to examine performance of schizophrenia patients on a sexually dimorphic cognitive battery. The cognitive battery comprising tests of spatial (mental rotation, computerized version of the Benton Judgment of Line Orientation) and verbal abilities (phonological and semantic fluency) was administered to men (n = 22) and women (n = 21) with schizophrenia and healthy controls (n = 21 men and 21 women). A series of multivariate analyses showed that the patient group performed worse than controls on all the cognitive tasks. Cognitive sexual dimorphism on all spatial tasks favoring men and verbal tasks favoring women remained. Within the patient sample, correlational data demonstrated that earlier age at onset of illness related to poorer spatial performance. It is concluded that normal sexual dimorphism is undisturbed on both spatial and verbal tasks by the schizophrenia disease process.

Adolescent↗
PubMed1999

The role of norepinephrine in the pathophysiology of cognitive disorders: potential applications to the treatment of cognitive dysfunction in schizophrenia and Alzheimer's disease.

The role of noradrenergic neurotransmission in normal cognitive functions has been extensively investigated, however, the involvement of noradrenergic functions in the cognitive impairment associated with schizophrenia and Alzheimer's disease has not been as intensively considered. The limited ability of atypical antipsychotics to treat the cognitive impairment of schizophrenia, and cholinomimetics to treat the cognitive impairment of Alzheimer's disease, may be related to the influence of a multiplicity of neurotransmitter abnormalities including noradrenergic dysfunction, which these treatments do not address. The evidence of noradrenergic dysfunction occurring concomitantly with dopamine dysfunction in schizophrenia and acetylcholine dysfunction in Alzheimer's disease supports therapeutic approaches using noradrenergic drugs in combination with neuroleptics and cholinesterase inhibitors, respectively, to enhance the treatment of cognitive impairment. Given the results of animal and human studies, it appears that alpha-2A agonists may be the optimal choice for this purpose.

Adrenergic alpha-2 Receptor Agonists↗
PubMedDate not supplied

Exploring cognitive complaints in schizophrenia: the subjective scale to investigate cognition in schizophrenia.

While it has become commonplace to test the various components of memory in schizophrenia with paper-and-pencil or in-lab tasks, very little data exist on the subjective complaints of patients regarding their memory. Few instruments have been designed to collect systematically the complaints of patients with schizophrenia. We present a work in progress on the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS), a 21-item, Likert-type scale that is simple and easy to use. It allows a quantitative approach to the subjective and cognitive dimensions of schizophrenia. Stip constructed the scale based on a questionnaire covering several cognitive domains: memory (working memory, explicit long-term memory), attention (divided, distractibility, alertness, sustained), language, and praxia. We evaluated the psychometric properties of the SSTICS in a population of 114 French-speaking patients in Montreal. Patients were recruited in the community and assessed with the Structured Clinical Interview for DSM-III-R (SCID), the Positive and Negative Syndrome Scale (PANSS), and the Extrapyramidal Symptoms Rating Scale (ESRS). Cognition was measured using the Rey Auditory Verbal Learning Test (RAVLT) (long-term memory), Controlled Oral Word Association Test (verbal fluency), and Trails A and B. Preliminary analyses showed very good internal consistency for the global score (alpha=0.88), and alphas varying from 0.57 to 0.72 for the subscales. Stability over time was very good. The principal components analysis accounted for a multiple structure. Correlations between subjective scores and objective cognitive assessment were significant for several domains. Validation of the SSTICS needs to be completed through further exploration of the factorial structure and testing of the English version.

Adult↗