Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Trail Making Test”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed1994

Obstetrical complications and trail making deficits discriminate schizophrenics from unaffected siblings and controls.

Numerous studies have reported that both obstetrical complications (OCs) and deficits on the Trail Making Test show elevated prevalences in schizophrenics. Trail Making deficits have also been reported to be more common in schizophrenics' relatives than in controls, suggesting poor Trail Making performance may be a behavioral indicator of a familial risk factor for schizophrenia. Few studies, however, have investigated how these two variables co-vary in samples of schizophrenics and non-schizophrenics. In this study, DSM-III-R diagnoses, OCs noted in birth records, and Trail Making performance were independently assessed in 30 subjects: 9 schizophrenics, 8 of their non-schizophrenic siblings, and 13 comparison subjects with neither a personal nor a family history of schizophrenia. Results supported two key predictions of a two-factor etiologic model of schizophrenia: (a) the combination of perinatal OCs and poor Trail Making performance discriminated schizophrenics extremely well from non-schizophrenics, including their own non-schizophrenic sibs, and (b) perinatal OCs and Trail Making errors manifested a significant inverse association among schizophrenics' non-schizophrenic sibs, but not among other subjects.

Adult↗
PubMedDate not supplied

Hormone therapy, timing of initiation, and cognition in women aged older than 60 years: the REMEMBER pilot study.

OBJECTIVE: The aim of this pilot study was to assess any trends related to the timing of initiation, and duration, of hormone therapy (HT) use on cognitive function to facilitate the design and power calculations for a future large cohort study entitled Research into Memory, Brain function and Estrogen Replacement (REMEMBER). DESIGN: A total of 428 women aged older than 60 years were recruited from a computer-generated random selection of Adelaide households. Demographic and lifestyle characteristics, and HT use history were recorded and confirmed. The Center for Epidemiological Studies-Depression score was used to assess mood. Cognitive tests were administered measuring global cognition (Mini-Mental State Examination), attention and concentration (Trail Making Test Parts A and B), verbal learning and memory (Consortium to Establish a Registry for Alzheimer's Disease [CERAD] word list immediate and delayed recall), and verbal expression (letter fluency [FAS], category fluency [Animals], and the Boston Naming Test [short form]). Analyses were adjusted for age, education, mood, body mass index, smoking, alcohol intake, and history of cerebrovascular disease. HT use was defined as the use of systemic HT for at least 1 year. Early initiation of HT use was defined as commencement of HT before age 56 years for women with a uterus and ovaries, or within 5 years of a hysterectomy and bilateral oophorectomy. Late initiation of HT use was defined as HT commencing after these times. RESULTS: Early initiators of HT performed better than late initiators on the Mini-Mental State Examination (P = 0.04) and were faster than never users on the Trail Making Test Part A (P = 0.02). Women aged 70-79 years who initiated HT early performed better on the FAS test than never users (P = 0.0008). Late initiators performed worse than never users on the Mini-Mental State Examination (P = 0.09), and on the FAS test in the 60-69 year (P = 0.06) and 80 years and older (P = 0.095) age groups. However, late initiators performed better than never users on the FAS test in the 70-79 year age group (P = 0.015). HT users of less than 11 years (P = 0.09), HT users of more than 11 years (P = 0.04), and estrogen-only users (P = 0.024) performed faster than never users on the Trail Making Test Part A. Combined estrogen plus progestin users performed better than never users on the Boston Naming Test short form (P = 0.07). CONCLUSIONS: For some cognitive domains, early initiation of HT from around menopause may be beneficial, and initiation of HT in late menopause may be detrimental. The timing of the initiation of HT seems critical. To fully test these hypotheses and to further examine these trends by route and type of HT regimen in this population, a study size of 2,500 women would be required.

Affect↗
PubMed1992

Methylphenidate as a treatment for depression in acquired immunodeficiency syndrome: an n-of-1 trial.

BACKGROUND: Uncontrolled studies report that methylphenidate effectively treats depression in patients with acquired immunodeficiency syndrome (AIDS). Other studies report that methylphenidate improves cognition in patients with dementia stemming from human immunodeficiency virus (HIV). We performed a double-blind, placebo-controlled n-of-1 trial to learn whether methylphenidate was an effective treatment for depression in an outpatient with mild HIV dementia. METHOD: The patient received either placebo or drug in a double-blinded fashion in increasing doses in each of three 2-week phases (A = placebo, B = methylphenidate, C = placebo). Blinded outcomes of depression and cognition were measured initially and twice in each phase. Depression was measured using the Hamilton Rating Scale for Depression (HAM-D) and a mood self-assessment scale. Cognition was measured using the digit span (forward and backward subtest of the Wechsler Adult Intelligence Scale-Revised, Trail-Making Tests A and B, and the Symbol Digit Modalities Test (SDMT). RESULTS: HAM-D scores improved during the methylphenidate phase (initial = 33; A = 23, 25; B = 15, 10; C = 28, 27), as did the subjective mood assessment ratings. Digit span backward scores improved with the drug (initial = 4; A = 4, 3; B = 6, 8; C = 5, 4), as did Trail-Making Test B scores (initial = 125 seconds; A = 133, 103 seconds; B = 86, 82 seconds; C = 88, 96 seconds). Digit span forward, SDMT, and Trail-Making Test A, however, showed no drug-related trend. CONCLUSION: We conclude that methylphenidate was beneficial in the treatment of depression in this patient with AIDS.

AIDS Dementia Complex↗
PubMed2003

WAIS-III processing speed index scores after TBI: the influence of working memory, psychomotor speed and perceptual processing.

This study investigates the extent to which working memory, motor speed and perceptual processing speed influence Wechsler Adult Intelligence Scale-III (WAIS-III) Processing Speed Index (PSI) scores. Sixty-eight adult outpatients with Traumatic Brain Injury (TBI) of varying severity and complete data on all outcome measures were identified. Two cases with outlying values on one outcome measure were omitted from the final sample. Working memory was measured by the Working Memory Index score from the WAIS-III. Motor speed was measured as score on the Halstead-Reitan Finger Oscillation Test (finger tapping) and perceptual processing as score on the Trail Making Test--Part B. In hierarchical multiple regression analyses, working memory accounted for 10% of the variance in PSI scores, whereas motor speed only accounted for 3%. An independent measure of perceptual processing, Trail Making Test--B, accounted for 26% of the variance in WAIS-III PSI scores. The total variance accounted for by the three factors was 56%. Findings confirm that the WAIS-III PSI scores of individuals who have received a TBI reflect perceptual processing speed, with an additional component attributable to working memory. Motor speed made only a small contribution to WAIS-III PSI scores in the present sample.

Adolescent↗
PubMed1978

Screening for cognitive impairment among inpatients.

Screening hospital patients for cognitive impairment is often required for effective treatment planning. Awareness of cognitive deficit is particularly important in working with patients who have drinking problems because of the relationship between alcohol consumption and cognitive impairment. Trail-Making Test is examined as an economic, quick, and accurate indicator of cognitive impairment in non-neurological sample of patients in a Veterans Administration Hospital. Results show that performance discriminates between normal and deficient cognitive function as assessed by established IQ and neuropsychological tests--the Wechsler Bellevue Intelligence Scale and the Halstead Reitan Battery. Nonsignificant correlations with personality variables suggest discriminant validity for the Trail-Making Test as an indicator of cognitive impairment.

Alcoholism↗
PubMed1996

Breathing disorders during sleep and cognitive performance in an older community sample: the EVA Study.

OBJECTIVES: To determine whether poor cognitive performance was associated with symptoms related to the sleep apnea syndrome, snoring, and breathing stoppage during sleep. DESIGN: Cross-sectional analysis of data collected at baseline in the EVA Study, a 4-year cohort study. SETTING: The city of Nantes in western France. SAMPLE: A total of 1389 persons, aged 60 to 70 years, recruited from the electoral rolls of the city of Nantes. MEASUREMENTS: Demographic characteristics and data on drug use and tobacco and alcohol consumption were collected using a standardized questionnaire. Weight and height were measured. Individuals completed a previously validated sleep questionnaire about nocturnal sleep characteristics, snoring, breathing stoppage during sleep, and day-time sleepiness. Trained psychologists administered eight neuropsychological tests: The Mini-Mental State Examination, Trail Making Test, Digit Symbol Substitution Test of the WAIS-Revised, Benton Visual Retention Test, Paced Auditory Serial-Addition Task, Auditory Verbal Learning Test, Raven Progressive Matrices, and Word Fluency Test. Depressive symptomatology was assessed by the Center for Epidemiologic Studies-Depression scale. MAIN RESULTS: In this older sample, 49.5% of subjects reported snoring, and 10.8% reported breathing stoppage during sleep. Both respiratory disorders were associated significantly with male gender and high body mass index. In men, prevalence of snoring was increased significantly in those with alcohol consumption greater than 40 mL per day. Breathing stoppage during sleep was associated with depressive symptoms in women. Logistic regression models adjusted for age, gender, educational level, tobacco status and alcohol consumption, depressive symptomatology, and number of medications found that both snoring and breathing stoppage were associated with low scores (< or = 10th percentile) in tests requiring visual attention skills, the Trail Making Test (OR = 2.14, 95% CI = 1.24-3.69 and OR = 1.88, 95% CI = 1.04-3.39, respectively), and the Digit Symbol Substitution Test (OR = 1.80, 95% CI = 1.09-2.99 and OR = 1.58, 95% CI = .87-2.89, respectively). These relationships were significant only when either snoring or breathing stoppage was associated with daytime sleepiness. CONCLUSIONS: This cross-sectional analysis suggested that in community-dwelling individuals 60 to 70 years of age, snoring and breathing stoppage during sleep associated with daytime sleepiness were risk factors for low cognitive performance in tests requiring visual attention skills.

Age Factors↗
PubMed2001

Verb comprehension in frontotemporal degeneration: the role of grammatical, semantic and executive components.

Verb comprehension has been associated with the left frontal cortex, but assessments of verb comprehension in frontotemporal degeneration (FTD) have been rare. This study assessed word-picture matching for verbs and nouns under two conditions: alone (baseline) and during concurrent performance of a secondary task. In addition, we correlated FTD patients' verb comprehension with their performance on measures of executive resources and language. We found that FTD patients were significantly less accurate and required significantly longer to make word-picture matching decisions about verbs compared with nouns at baseline. During concurrent performance of a secondary task, accuracy decreased and response latencies became prolonged for nouns to the point that these measures equaled the performance with verbs at baseline. Verb comprehension accuracy was significantly correlated with the performance on executive measures such as category naming fluency, the Stroop test, and the Trail Making Test Part B (Trails B test). Assessment of FTD patient subgroups revealed distinct profiles of performance, suggesting that several factors contribute to verb comprehension in FTD. Verb comprehension in FTD patients with a dysexecutive syndrome (EXEC, n = 10) was sensitive to concurrent performance of a secondary task, and their verb comprehension accuracy correlated with the time required to complete executive measures such as the Stroop test and the Trails B test. This suggested a relationship between impaired verb comprehension and limited information-processing speed in EXEC patients. Verb comprehension in patients with a progressive non-fluent aphasia (PNFA, n = 7) was not selectively influenced by executive resources. Instead, verb comprehension accuracy in PNFA was significantly correlated with sentence comprehension accuracy, suggesting that grammatical aspects of verbs play a crucial role in their verb comprehension difficulty. Although we studied only a small number of patients with semantic dementia (SD, n = 4), we observed significant verb comprehension difficulty that was minimally influenced by executive resources and was unrelated to sentence comprehension. It is possible that impaired verb comprehension in SD is related in part to the degradation of semantic feature knowledge.

Adult↗
PubMed1989

Feedback EEG in the detection of subclinical hepatic encephalopathy: a preliminary report.

The detection, monitoring, and quantification of subclinical hepatic encephalopathy present difficult problems for the clinician caring for patients with liver disease. Traditionally, pencil and paper tests such as signature-writing have been used at the bed-side to measure early encephalopathy. More recently, the Trail-making test has been employed to detect and quantify encephalopathic changes. While the electroencephalogram has provided information about the extent of clinically-obvious encephalopathy, it has only recently proved useful in the detection of subclinical disease. In these cases, evoked potentials and spectral analysis methods have discriminated between 35 and 62% of patients with subclinical hepatic encephalopathy. The present study used the method of feedback electroencephalography to detect and quantify differences in cortical arousal in 5 cirrhotic patients and 5 normal age-matched controls. Subject were also compared with respect to baseline measures of cortical arousal. Finally, arousal during feedback EEG stimulation was correlated with Trail-making test performance. The data revealed that cirrhotic patients can be discriminated from normal controls by baseline (80% detection) and feedback stimulation conditions (100% detection). In addition, feedback EEG reactivity (cortical arousal) was inversely correlated with Trail-making test performance (-0.86, P less than 0.01). The results indicate that simple features of the conventional EEG can reliably discriminate cirrhotic patients from normals. Clinical application of the feedback method in other metabolic encephalopathies, as well as in hypoaroused states secondary to, for example, narcolepsy, is discussed.

Brain↗
PubMed2006

Estrogen, cognitive function and negative symptoms in female schizophrenia.

The aim of this study was to evaluate the relationship of serum reproductive hormone levels with cognitive function and negative symptoms in schizophrenic women during the follicular phase of the menstrual cycle. Thirty-five women with chronic schizophrenia who had minimal positive symptoms participated in this study. We evaluated the correlation of serum reproductive hormone levels with the Scale for the Assessment of Negative Symptoms (SANS) and cognitive function tests such as the Immediate Visual Recognition Scale, Oral Fluency Test, List Recall Scale with List Acquisition Scale, Trail Making Tests A and B, and Digit Symbol Test. The patients were divided into two subgroups (low estradiol group and normal estradiol group) using the normal serum reference range for estradiol. Significant correlation between SANS subcategories, such as Alogia and Attention Impairment, and estradiol were found. Moreover, significant relationships between the estradiol level and the Oral Fluency Test, List Recall Scale with List Acquisition Scale, Trail Making Test B and Digit Symbol Test were observed. In the low estradiol group, the SANS scores, except for Anhedonia-Asociality and Avolition-Apathy, were significantly higher than those in the normal estradiol group. Patients in the low estradiol group had a significantly lower performance in the cognitive function tests, except Visual Recognition Scale, when compared to patients in the normal estradiol group. These results suggest that for schizophrenic women of reproductive age, lower levels of estrogen are associated with more severe negative symptomatology as well as reduced performance in cognitive function, especially verbal performance and executive functioning.

Adult↗
PubMed1979

Sex differences on the Halstead-Reitan Neuropsychological Battery and on other neuropsychological measures.

Evaluated differences in performance between adult males and females with respect to Halstead's Neuropsychological Battery, additional tests employed by Reitan (Trail Making Test, Aphasia Screening Test, Perceptual Examination, dynamometer), and other neuropsychological measures (Seashore Tonal Memory Test, Logical Memory and Visual Reproduction portions of the Wechsler Memory Scale). In evaluating differences, 47 matched pairs of non-neurologic males and females were employed, as well as 47 pairs of neurologic patients. A small number of statistically significant differences were found, all of which favored males. Some of these differences occurred with respect to tasks that have very strong motor components, and these differences were shown to be related to hand size. Others pertained to tasks that have strong visual-spatial components. In general, the differences were less prominent with the neurologic than the non-neurologic samples. The question was raised as to possible over-representation of male-superior components in these tests.

Adolescent↗
PubMed1993

Cognitive function during moderate hypoxaemia.

The effect of hypoxaemia (mean SpO2 78%) on cognitive function was measured in two groups of twelve normal subjects. A series of psychometric tests was administered to each subject in the same sequence and consisted of the Reitan trail-making test, a digit symbol substitution test, a visuospatial orientation test and the simple unprepared reaction-time test. Psychomotor performance was assessed in a double-blind manner while the subjects were breathing first air and then either air or a hypoxic mixture. While there was improvement in time for the trail-making test during a repeat study breathing air, there was significant deterioration of time to completion of the test in conditions of hypoxia. A significant learning effect in the orientation test was seen in the control group but this did not occur in hypoxic subjects. Hypoxaemia was shown to cause a significant impairment of simple unprepared reaction time compared with controls. All the changes in cognitive function were small and there were no subjective differences in the air or hypoxic groups. The usefulness of the Reitan trail-making and the simple unprepared reaction-time test in the assessment of psychomotor performance deficit under conditions of hypoxaemia has been demonstrated by this study in normal subjects. It was concluded that a mean oxygen saturation of 78% caused only minor changes in cognitive function in normal subjects.

Adult↗
PubMed2005

The pattern of cognitive performance in CADASIL: a monogenic condition leading to subcortical ischemic vascular dementia.

OBJECTIVE: Subcortical ischemic vascular lesions, which are closely related to small vessel disease, are a common substrate of cognitive impairment and dementia. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic variant of small vessel disease resulting from mutations in NOTCH3. Mutation carriers almost invariably develop cognitive deficits and eventually dementia. The current study describes the profile of cognitive abnormalities in CADASIL subjects. METHOD: A cross-sectional study of 65 mutation carriers (mean age=47.3 years, SD=10.5) and 30 matched comparison subjects (mean age=47.2 years, SD=14.0) was conducted. Participants underwent a series of assessments that included ratings of global cognition, the cognitive portion of the Vascular Dementia Assessment Scale, and specific tests of executive function and attention with measures of processing speed and error monitoring. RESULTS: CADASIL subjects had pronounced impairments of the timed measures (Stroop II and III, Trail Making Test, symbol digit, digit cancellation). Measures of error monitoring (Stroop III, Trail Making Test, symbol digit, maze task) were also significantly affected but to a lesser extent. Prominent deficits further included verbal fluency and ideational praxis. Recall, orientation, and receptive language skills were largely preserved. Subgroup analyses indicated a similar profile in subjects with early and advanced impairment of global cognitive performance. CONCLUSIONS: The findings highlight processing speed as the most substantial area of cognitive impairment in CADASIL subjects, with less pronounced yet significant deficits in other aspects of executive performance and attention. This profile of cognitive impairment is present at an early stage and enables the construction of targeted test batteries for clinical trials. It is hypothesized that the profile of dysfunction described here represents the core of the cognitive syndrome associated with small vessel disease and subcortical ischemic vascular lesions.

Attention↗
PubMedDate not supplied

[Dysexecutive syndrome and disorders of motor control in prefrontal mediobasal and cingulate lesions].

Disorders of executive function and motor control are considered to be classical consequences of prefrontal lesions. The aim of this study was to investigate these disorders and their evolution in a series of patients presenting with prefrontal and cingulate lesion following rupture of an anterior communicating artery aneurysm. Twenty one subjects were included, and assessed in the secondary and late post stroke phases. We have used the following tests to assess planning and/or execution time and performance: Trail Making test, Wisconsin Card Sorting Test, London Tower Test, Shopping Test of Martin, sequential gestual test and contradictory responses test from Luria. Correlations between these parameters were used to evaluate subjects strategy. In evaluation of execution time, patients were slower than controls, and the difference was more marked using the Trail Making Test (p < 0.01) and the London Tower Test (p < 0.01). Furthermore, the initiation time was increased in the London Tower Test (p < 0.01), this suggesting that they were slower than impulsive. Groups analysis showed that their performance level was most often similar to that of of controls, even in the secondary phase, with the exception of the number of problems solved whatever number of moves in the London Tower test (p < 0.01) and of the percentage of errors in the sequential motor task (p < 0.03). Similar results were observed in the evaluation of single cases. Correlations between execution time and performance were most often significant and negative, in patients and controls. These results suggest that the management of the speed-accuracy compromise was relatively similar, and that impulsivity, which associates reduction of time to poor performance, was absent or mild. Cingulate, and caudate lesions were identified as the source of most cognitive disorders.

Adult↗
PubMed2006

An interactive test of serial behavior: age and practice alter executive function.

We describe an interactive, computer-based test inspired by the Trail Making Test (TMT). In this new test, young (mean age = 20.4 years) and older participants (mean age = 74.9 years) used natural, pointing responses to order series of numbers, letters, or intermixed letters and numbers. This interactive test, which avoids several deficiencies of TMT, assesses participants' baseline speed for detecting and responding to individual items, captures the time for each response, and segregates erroneous responses from correct ones. The inter-response times with intermixed letters and numbers showed that participants did not always switch between the two different ordering tasks, but instead often recall letter-number pairs as single units. An additive factors analysis decomposed test times into functional components, including executive function, which took longer in older participants. With modest practice, both young and older participants sped up their ordering of intermixed numbers and letters, probably reflecting increased automaticity and reduced dependence upon executive function.

Adolescent↗
PubMed1999

Cognitive function and endogenous sex hormones in older women.

OBJECTIVE: To determine if endogenous hormone levels predict cognitive function in older women. DESIGN: A longitudinal, population-based study. SETTING: Rancho Bernardo, California PARTICIPANTS: A total of 393 community-dwelling women aged 55 to 89 years who were not using replacement estrogen. METHODS: Between 1984 and 1987, sera were collected for measurement of total and bioavailable testosterone, total and bioavailable estradiol, and estrone. Between 1988 and 1991, 12 standard neuropsychological tests were administered, including two items from the Blessed Information-Memory-Concentration Test, three measures of retrieval from the Buschke-Fuld Selective Reminding Test, a category fluency test, immediate and delayed recall from the Visual Reproduction Test, the Mini-Mental State Examination (MMSE) with individual analysis of the Serial 7's and the "World" Backwards components, and the Trail-Making Test part B (Trails B). The association between the five hormones and the 12 cognitive function tests was tested in age- and education-adjusted analyses using linear regression, partial correlation, quintile and categorical analyses. RESULTS: Women with better MMSE scores (>23) had significantly higher adjusted mean total and bioavailable testosterone levels (P = .009; P = .02, respectively). Using linear regression, the mean total testosterone was significantly associated with better performance on the World component of the MMSE (b = .12; P = .08). With regard to estrogen, the only statistically significant (P = .02) association was better performance on one test in women with very low levels of estradiol. CONCLUSIONS: In these older women, higher endogenous estrogen levels were not associated with significantly better performance on any cognitive function test. In contrast, higher levels of testosterone predicted better categorical performance on the MMSE and the World component of the MMSE. These novel findings warrant further research.

Age Factors↗
PubMed1988

Neuropsychological performance in psychiatric patients with or without documented brain dysfunction.

The current study examined neuropsychological performance of schizophrenic and depressed patients with and without structural or EEG signs of brain dysfunctioning. The neuropsychological test battery was designed to sample intellectual functioning, psychomotor skills, nonverbal memory, and novel problem solving ability. Patients were classified into four groups: schizophrenics without signs of brain dysfunctioning, schizophrenics with signs of brain dysfunctioning, depressed without signs of brain dysfunctioning, and depressed with signs of brain dysfunctioning. The Trail Making Test--Parts A & B, the difference between these two components of the Trail Making Test, the World Fluency Test and a Laterality Index based on the age scale scores of the WAIS significantly discriminated between patients with and without brain dysfunction. Using these variables and a Linear Discriminant Function Analysis, we found that 84.5% of our subjects could be correctly classified. Substantially fewer patients could be correctly classified with respect to their psychiatric diagnosis (i.e., 66.7% correct classification). In fact, only the PIQ from the WAIS-R showed significant differences between the depressed and schizophrenic subjects. Poor neuropsychological performance was interpreted as showing more than the behavioral disorganization associated with psychiatric states and was felt to be related to the presence of objective signs of brain dysfunctioning.

Adolescent↗
PubMed2006

Comorbid substance abuse and neurocognitive function in recent-onset schizophrenia.

Despite the high prevalence of comorbid substance use disorder (SUD) up to 65% in schizophrenia there is still few knowledge about the influence of substance abuse on neurocognitive function. In a prospective design we recruited 68 patients (aged 18-40 years) diagnosed as recent-onset schizophrenia or schizoaffective disorder consecutively admitted to hospital. The patients received standardized psychopathological evaluation of schizophrenic symptoms [Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS)], depressive symptoms [Montgomery Asberg Depression Rating Scale, (MADRS)] and global ratings [Clinical Global Impressions Scale (CGI), Global Assessment of Functioning Scale (GAF)]. Out of this sample 44 subjects underwent after stabilization (4-6 weeks after admission) neuropsychological investigation focusing on early information processing (Trail-Making-Test A, Digit Span), visuo-spatial ability (Corsi Block Tapping), verbal fluency (Verbal Fluency Test, semantic and letter category), and executive functioning and cognitive flexibility [Trail-Making-Test B, Wisconsin Card Sorting Test (WCST)]. About 36% of patients reported drug abuse [European Addiction Severity Index (EuropASI)] with a high prevalence for cannabis. Compared with nonabusers the sample of substance abusers was younger, predominantly male and had lower socioeconomic status. Attentional impairment according to the SANS subscale was less in abusers than in nonabusers on admission, no other psychopathological differences could be detected. Schizophrenic patients without substance abuse demonstrated significantly better performance only in a few neurocognitive tasks (Verbal Fluency, letter category and at trend level Digit Span, backwards), while there tended to be an advantage for substance abusers in executive functioning (WCST, not significant). These results are consistent with other studies of first-episode patients. The lack of higher cognitive disturbance in young schizophrenic patients with comorbid substance abuse may encourage clinicians to develop integrated treatment programmes using cognitive strategies of drug therapy.

Adult↗
PubMedDate not supplied

[Loss of motivation and frontal dysfunctions in old patients].

UNLABELLED: Loss of motivation and frontal dysfunction are frequent in old people. Motivation refers to what drives acts and relationships. The loss of motivation has some spécific characteristics from depression: loss of sens of meaning, loss of commitment for others, disinterest for daily activities. The frontal function is related to speed of acting, emotional system, anticipating of the future. All these points are altered in demotivated patients. For these reasons we assayed to analyse the possible links between loss of motivation and frontal dysfunctions. METHODS: The focus of this assay was to determine and to precise the functional links between frontal brain and loss of motivation in old people; 45 old patients cared in a day care hospital were proposed to participate to neuropsychologic evaluation. After their agreement and their family acceptation if they were demented, they were assessed by a practitioner, then by 2 different psychologists. They were evaluated for cognition (MMS), depression (Cornell's scale), apathy (Marin's scale), age and scholarships level. In a other time, they were tested with different frontal tests: Trail making A and B, Wisconsin, BREF (frontal battery of psychological tests) ana-lyse concerned speeds, number and natures of errors, habilities for matching categories. Loss of demotivation was scored on EAD scale. Statistical analysis was done with Systat 10 and Statview software. RESULTS: It could be notice the significant negative links between EAD scores and the BREF scales, or with the number of categories found with the Wisconsin test. The more motivated the patients are the best results they have with their frontal tests. There are positive and significant links between EAD score and the number of errors at the Wisconsin test, and especially with repetitive errors either with this test or with BREF test. Repetitive errors and the number of errors, pointing some frontal dysfunctions are associated with a loss of motivation. Considering BREF sub-items, it could be shown the negative links between EAD scores and programmation or inhibition sub-items. All these points persist in a statistical model including pathology, cognitive levels, depression level at the Cornell's scale, age or scholarship level. We do not find a link between EAD scores and the time obtained with the Trail making test. CONCLUSION: Loss of motivation is associated with some frontal impairment responsible for numerous errors in tasks. A good motivation of old people is associated with good frontal habilities especially in complex tasks or in programming capacities of old patients. There is no links between the speeds of tasks and the level of motivation. Motivation could be so related with orbito-frontal brain activities.

Affect↗