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PubMed1989

S-100 protein in cerebrospinal fluid after aneurysmal subarachnoid haemorrhage: relation to functional outcome, late CT and SPECT changes, and signs of higher cortical dysfunction.

The concentration of S-100 protein measured in ventricular cerebrospinal fluid (CSF) from 32 patients with subarachnoid haemorrhage (SAH) during the acute phase was related to features on admission such as the Hunt and Hess neurological scale and the amount of blood at the first computed tomography (CT). The S-100 values were also related to functional outcome assessed by the Glasgow outcome scale (GOS) at 12 months. Twenty-two patients were re-examined more than 2 years after the SAH, and the initial S-100 values were related to signs of structural brain damage at CT and single photon emission computed tomography (SPECT) and to the results of neuropsychological evaluation (NPE). NPE included standardized tests for memory functions, intellectual functions, visuo-spatial abilities, sensory-motor functions, and concept formation. Life-adjustment was assessed by two separate questionnaires. Tests for agnostic dysfunction and the Western aphasia battery test (WABT) were also performed. Patients who were functionally disabled or ultimately died had significantly higher initial CSF concentrations of S-100 protein than patients showing good recovery. Patients with low-attenuated regions and/or increased ventricular size at CT and/or regionally decreased tracer uptake on SPECT had higher S-100 levels during days 2-8 than had patients showing no such changes. Logistic and multiple regression analysis of all characteristics assessed during the acute phase after SAH showed that the CSF S-100 concentration during days 2-8 was the factor best correlated to GOS and findings on CT and/or SPECT. All patients showed varying degrees of cognitive impairment at follow-up. The results of NPE and the WABT were related to outcome assessed by GOS and to increased ventricular size on CT. Women had a stronger feeling of maladjustment, but the scores for life adjustment were otherwise not related to other outcome criteria. It is concluded that the ventricular CSF S-100 concentration during the acute phase after SAH is related not only to the functional outcome as assessed by GOS but also to signs of brain damage seen on late CT and SPECT.

Adult↗
PubMed1995

Timing of operation for ruptured cerebral aneurysm and long-term recovery of cognitive functions.

Advantage and disadvantages of early and late operation for ruptured cerebral aneurysm are controversially evaluated with regard to peri-operative operation outcome and long-term cognitive recovery. In this retrospective analysis 22 patients with early surgery (ES) within three days after subarachnoid haemorrhage (SAH) and 22 patients with late surgery (LS) at least 14 days after SAH were studied. Patients were pair-wise matched by degree of SAH localisation of aneurysm and age at SAH. On average three years after SAH both groups were examined individually with a comprehensive neuropsychological test battery including tests of premorbid intelligence, concept formation, memory, visuomotor speed, aphasia screening, and mood. ES and LS patients were well comparable in terms of years of education and level of premorbid intelligence. There was a clear influence of patients age on fluid intelligence tests, indicating a general change-sensitivity of tests. No influence of degree of SAH and localisation of aneurysm could be detected. There were also no differences between ES and LS patients in neuropsychological tests sensitive to brain damage, suggesting that the decision for early or late surgery for ruptured cerebral aneurysm can be based upon surgical reasons at the time of the SAH.

Adult↗
PubMed1996

Cognitive remediation of persons with severe and persistent mental illness.

There is a vast psychiatric literature describing the nature and degree of cognitive deficits present in persons suffering from severe and persistent mental illness, particularly schizophrenic spectrum disorders. A smaller, more recent literature has emerged addressing non-pharmaceutical interventions developed to remediate those deficits. The Cognitive Remediation Program was developed to remediate cognitive deficits in such areas as the ability to sustain attention and concentration, memory processes, concept formation, organizing visual and auditory stimuli into recognizable patterns, and shifting cognitive sets. The program consists of three fifteen minute intervals or "loops" that each contain a different type of task designed to promote remediation of cognitive deficits. The Program also employs behavioral techniques, using a token economy to aid in shaping behavior and motivating patients. The loops consist of: 1) a group that focuses on training in attention, concentration and cognitive flexibility; 2) a computer group utilizing a combination of game software and programs designed for use with a head injured population; 3) a group promoting the generalization of skills learned in the Program to other social arenas. On a ten week pre- and post-measure, participants improved significantly on both a digits forward and digits backward task, both measures of concentration and attention.

Adult↗
PubMedDate not supplied

Epidemiological aspects of school dropouts in children between 7-15 years in rural Maharashtra.

A study on school dropouts from primary and secondary school children was undertaken in September '91 from 16 schools at the headquarters of 8 Primary Health Centres, where 172 school dropouts were identified. A home visit was paid and information about socio-economic and cultural aspects was collected and a psychological screening was undertaken. Although there was no significant difference in overall dropout rates for both sexes, it increased sharply at 11 years of age in girls. The majority of children dropped out due to financial problems or unsatisfactory scholastic performance, and 142 (82.5%) of the 172 children studied were poor performers in one or more function tests. Maximum difficulty was observed in concept formation 87 (50.5%), followed by numerical ability in 78 (45%). Identification of children with learning difficulties and intervention using special educational methods within the framework of existing network of primary and secondary schools in rural areas is suggested.

Adolescent↗
PubMed2005

Cognitive function in bulbar- and spinal-onset amyotrophic lateral sclerosis. A longitudinal study in 52 patients.

We performed a longitudinal study of frontal and temporal lobe functions in patients with amyotrophic lateral sclerosis (ALS) and compared the evolution of cognitive performance with that of motor deficits in patients with spinal and bulbar-onset of the disease. Fifty two patients suffering from sporadic ALS according to the El Escorial criteria were examined; 37 patients had a spinal, 15 a bulbar onset of the disease. The data profile included examinations at entry (E1), every four months at follow-up (E2, E3, E4) and after 18 months (E5), if possible. Neuropsychological testing covered the domains of executive functions, memory and attentional control. ALS patients showed executive dysfunctions that were most prominently represented by deficits of non-verbal and verbal fluency and concept formation. Memory-related deficits were also present but less expressed. The same held true for phasic and tonic alertness and divided attention. In contrast to motor functions declining concomitantly with disease progression, cognitive deficits appeared in early disease, were essentially present at initial testing and did not substantially decline on follow-up. A subgroup analysis revealed that bulbar-onset ALS patients performed consistently poorer in many cognitive tests than spinal-onset ones with special reference to verbal and non-verbal fluency and interference control. This subgroup difference persisted or even increased throughout follow-up. We conclude that there is a fronto-temporal pattern of cognitive dysfunction in ALS expressing itself early in the course of the disease and mainly with bulbar forms. The cognitive deficits do not progress in synchrony with motor decline, but distinctly more slowly. We suggest that cognitive dysfunctions reflect functional and possibly morphological deficits outside the primary motor system that is specific for the nature and evolution of the disease and might also give clues to etiopathogenesis.

Aged↗
PubMed2001

Mixed state on a sparsely encoded associative memory model.

We analyzed symmetric mixed states corresponding to the so-called concept formation on a sparsely encoded associative memory model with 0-1 neurons. Three types of mixed states--OR, AND, and a majority decision--are described as typical examples. Each element of the OR mixed state is composed of corresponding memory pattern elements by means of the OR operation. The other two types are similarly defined. By analyzing their equilibrium properties through self-consistent signal-to-noise analysis and computer simulation, we found that the storage capacity of the OR mixed state diverges in a sparse limit, but that the other states do not diverge. In addition, we found that the optimal threshold values, which maximize the storage capacity for the memory pattern and the OR mixed state, coincide with each other in the spare limit. We conclude that the OR mixed state is a reasonable representative of mixed state in the sparse limit.

Computer Simulation↗
PubMed2007

Patterns of nonverbal cognitive functioning in young children with autism spectrum disorders.

Previous research demonstrates an uneven pattern of cognitive abilities in children with autism spectrum disorders (ASDs). This study examined whether this uneven pattern exists within the nonverbal domain in young children. We hypothesized relative strengths in perceptual abilities and weaknesses in nonverbal conceptual abilities in preschoolers with ASDs compared to groups with non-autism developmental delays and typical development. Profiles were examined using the Leiter International Performance Scale-Revised. The ASD group displayed clear relative strengths in visuospatial disembedding and detail-focused processing, with relative weaknesses in abstraction and concept formation. This contrasted with patterns of roughly equivalent abilities in both comparison groups. These findings have implications for subsequent development and may represent key features of the cognitive profile of autism.

Autistic Disorder↗
PubMed1988

New perspectives in autism, Part II: The differential diagnosis and neurobiology of autism.

The clinical spectrum of autism spans a broad range of functions, but the core symptoms remain the same regardless of the intelligence of the child: the autistic type of social deficit that ranges from a lack of inclination to relate to extreme difficulty with the mechanics of social interactions, a global communication deficit that involves both verbal and nonverbal modes, and a severe cognitive deficit involving concept formation (abstraction) that is combined with an exceptional memory for factual information. These symptoms may vary dramatically in severity, but the basic deficits are identifiable regardless of IQ. Under-recognition of autism is a major problem at all IQs, but especially in patients with IQs above 50. No drugs have been found to significantly improve the core deficits in autism. Antipsychotics should be avoided except for short-term use. Antidepressants, anxiolytics, and anticonvulsants are important in the treatment of depression, affective modulation, situation-related stress, and seizures. Intensive social skills training is assuming a prominent role in behavior modification programs, and success with higher-functioning autistic children suggests that outcome can be improved by intensive training. The neurobiology of autism has also undergone dramatic changes. The psychogenic theories of etiology have been completely invalidated. Autism is now considered to be a neurological disorder resulting from an error in brain development. The precise location and nature of this deficit are still being actively debated and investigated. One theory emphasizes a dysfunction of the limbic system that results in an impairment in the acquisition of information. A second theory proposes a primary role for dysfunction of the cortical association network responsible for the processing of information.

Autistic Disorder↗
PubMed1981

Behavior analysis and experimental pharmacology.

This paper provides an introduction to the field of behavioral pharmacology. A brief description of the main characteristics of behavior analysis is followed by a review of the contributions of experimental pharmacology to behavior analysis and vice versa. Finally, a section on new procedures in behavioral pharmacology outlines experimental situations in which complex kinds of behavior can to studied. These include: (a) temporal discrimination; (b) preference to be free and informed; (c) commitment, choice and self-control; and (d) high-order concept formation.

Animals↗
PubMedDate not supplied

Increased cognitive sensitivity to scopolamine with age and a perspective on the scopolamine model.

18 older normal volunteers (mean age = 66.5 +/- 7.9 years) and 46 younger volunteers (mean age = 27.0 +/- 6.1 years) were administered the anticholinergic drug scopolamine (0.5 mg i.v.) followed by a battery of cognitive tests evaluating attention, learning and memory. The older subjects were significantly more impaired than the younger by scopolamine on some tests of learning and memory. This increased sensitivity of the older group to scopolamine is consistent with studies in animals and humans showing decreased cholinergic system function with age. The findings also indicate that age is an important variable to consider in using the scopolamine model of memory impairment. The cognitive impairment caused by scopolamine in younger subjects in this and prior studies is similar to some, but not all aspects of the impairment which occurs in normal aging. Scopolamine also caused impairments on digit span and word fluency tasks, which are not consistent with normal aging changes. In the older group of subjects, scopolamine produced aspects of the cognitive impairment which occurs in AD on tests of episodic memory and learning, vigilance-attention, category retrieval, digit span, and number of intrusions. Other areas of cognition that are of relevance to aging and AD such as psychomotor speed, praxis, concept formation and remote memory were not evaluated in this study. Some of these are being evaluated in ongoing studies, along with additional and more specific tests of retrieval from knowledge memory, implicit memory and attention. The scopolamine model has provided a fruitful pharmacologic starting point for the study of a number of cognitive operations. The idea of dissecting apart aspects of memory systems pharmacologically depends on the availability of neurochemically specific drugs and on the specificity and sensitivity of neuropsychological tests for distinct cognitive operations or domains. Further studies using such tools will aid not only in the understanding of the impairments which occur in aging and in AD, but also of the conceptualization of memory and other cognitive operations and ultimately the physiological mechanisms involved in memory and learning.

Acetylcholine↗
PubMedDate not supplied

Vitamin E deprivation in rats: some behavioral and histochemical observations.

Rats deprived of vitamin E from age of 4 weeks were tested in four independent behavioral experiments and compared with a group fed a control diet. During a 14-minute session in a hole-board, no differences in the level and the course of habituation of parameters of activity and exploration were found. A second group of animals was trained in an automatically controlled six-arm radial tunnel maze. Although no differences were found in various activity measurements, the deprived animals showed a slightly impaired spatial concept formation during 8 acquisition sessions. Testing their relearning ability of the same maze 18 days later, the vitamin E deprived animals showed a significant impairment. In a third experiment, animals were trained 16 days in the same maze configuration and at day 17 they were exposed to the mirror image of the radial maze. Both groups mastered this reversal with an increased level of activity but without differences in patrolling efficiency. In a fourth behavioral experiment, the effects of scopolamine on deprived animals were examined. Compared to the controls, the vitamin E deprived animals were relatively insensitive to the effects of scopolamine. Autofluorescent neuronal lipofuscin accumulation was found especially in the hippocampus (CA3) of vitamin E deprived animals. Based on these results, the usefulness of vitamin E deprivation as an animal model for accelerated normal aging is discussed.

Aging↗
PubMed1992

Information processing in the separated hemispheres of callosotomy patients: does the analytic-holistic dichotomy hold?

The characterization of the left and right cerebral hemispheres as analytic and holistic, respectively, was evaluated with callosotomy patients. This distinction was operationalized by reference to the work of Garner, Kemler Nelson, and their colleagues on separable (analytic) and integral (holistic) dimensions of cognition. In one experiment, patients were asked to make similarity judgments when faced with triads of stimuli such that one pair matched on a criterial attribute (analytic) and another pair showed a family resemblance (holistic). The right hemisphere showed a stronger bias to judge on the basis of the criterial attribute. In a second experiment, each hemisphere was engaged separately in a concept formation task. Depending on the exemplars in a particular set, analytic or holistic processing was seen in either hemisphere. However, the left hemisphere was more likely to engage in analytic processing. The results suggest that both hemispheres are capable of either type of processing and may use either mode, depending on the nature of the task and stimulus material. Thus, the analytic/holistic distinction may not provide a simple, generalizable description of information processing differences between the two hemispheres.

Adult↗
PubMed2004

Anxious-depression in boys: an evaluation of executive functioning.

The effects of anxiety and depression on frontal lobe functioning were tested in two groups of 9-11-year-old boys. Participants were screened for handedness, health, intelligence and classified as anxious-depressed or non-anxious, non-depressed based on scores from the A-State scale of the State-Trait Anxiety Inventory for Children and the Child Depression Inventory. Previous research in our laboratory has indicated that boys high in anxious-depression may have neuropsychological deficits [e.g., Emerson, C. S., Harrison, D. W., & Everhart, D. E. (1999). Investigation of receptive affective prosodic ability in school-aged boys with and without depression. Neuropsychiatry, Neuropsychology and Behavioral Neurology, 12(2), 102-109; Emerson, C. S., Harrison, D. W., Everhart, D. E., & Williamson, J. B. (2001). Grip strength asymmetry in depressed boys. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 14(2), 130-134]. In order to assess the effects of anxious-depression on cerebral functioning performance on the Trail Making Test (Forms A and B) and on the Concept Formation subtest of the Woodcock Johnson was compared between groups. As predicted, anxious-depressed boys demonstrated deficits in sequencing, alternation, and problem-solving tasks as evidenced by longer completion times and significantly more errors on the tests. These results provide supportive evidence for deficits in frontal lobe functioning.

Anxiety Disorders↗
PubMed2005

Executive function deficits in early Alzheimer's disease and their relations with episodic memory.

Previous research suggests that patients with Alzheimer's disease (AD) are impaired on executive function early in the course of disease, but negative findings were reported. To evaluate the performance on executive tasks in early AD and to determine the involvement of memory on the outcome of executive tasks. Thirty-six AD patients were divided into two subgroups on the basis of the MMSE: very mild and mild. The comparison with 17 normal controls shows that very mild AD patients had deficits on visuospatial short-term memory, episodic memory, flexibility and self-monitoring abilities, concept formation and reasoning. The mild AD patients showed additional deficits on the Similarities test. Episodic memory and executive deficits occur in the very early stage of AD and precede impairment in constructional praxis, language and sustained attention. With the progression of the disease, additional deficit is observed in abstract thinking. In mild AD, memory failure is also related to executive impairment.

Aged↗
PubMed2006

Baseline cognitive function predicts rate of decline in basic-care abilities of individuals with dementia of the Alzheimer's type.

Decline in basic self-care abilities is an important risk factor for institutionalization in individuals with dementia. The ability to predict such decline would be of clinical importance in working with families of dementia patients. Research has suggested that cognitive decline may precede loss of functional capacity. This paper utilized a large sample of probable Alzheimer's disease patients (N=150) who were evaluated longitudinally to assess the pattern of neuropsychological functioning predictive of rapid decline in self-care. The findings indicated that despite initial equality of Lawton Physical Self-Maintenance (PSM) scores, patients showing rapid decline of PSM function displayed significantly more impaired performance on neuropsychological measures at diagnosis. They also exhibited a statistically significant difference in the pattern of scores from patients who remained stable. The pattern of the rapid declining group included more severe impairment in visual spatial skills, processing speed, and concept formation. Difficulties in using individual patients' cognitive profiles to make predictions about future rate of PSM decline are discussed.

Activities of Daily Living↗
PubMed2005

Decision-making: Context matters.

Research and theory in human decision-making has increasingly stressed the importance of the context in which the problem is embedded. This emphasis is consistent with that supported by research of behavior analysts on natural concept formation and in problem solving, as well as in the study of choice. We present data on reasoning problems that further support the role of context in decision-making.

Cognition↗
PubMed2005

Executive dysfunction in early stages of Huntington's disease is associated with striatal and insular atrophy: a neuropsychological and voxel-based morphometric study.

BACKGROUND: Huntington's disease (HD) is characterized by a progressive multisystem neuronal atrophy in the brain. Apart from motor signs, cognitive symptoms, particularly executive dysfunctions, are proposed to be recognizable in early stages of disease. The aim of the present study was to clarify if cognitive dysfunction in early stages of HD is correlated with loco-regional structural changes in 3D-MRI. METHODS: Twenty-five patients with genetically confirmed HD in early clinical stages were included in the study and underwent neuropsychological testing, i.e., the executive tasks Tower of Hanoi (ToH), Stroop Colour Word Interference Test (STROOP), and modified Wisconsin Card Sorting Test (mWCST). High-resolution volume-rendering MRI scans (MP-RAGE) were acquired on a 1.5 T scanner in all patients and were analyzed by statistical parametric mapping and voxel-based morphometry (VBM) in comparison to an age-matched control group. RESULTS: Group analysis of HD patients demonstrated robust regional decreases of gray matter volumes (p<0.05, corrected for multiple comparisons) in the caudate and the putamen bilaterally with a global maximum at Talairach coordinates 11/4/11 (Z-score=7.06). Executive dysfunction was significantly correlated with the areas of highest significant differences out of VBM results which were located bilaterally in the caudate (ToH: r=0.647, p<0.001; STROOP: r=0.503, p<0.01; mWCST: r=0.452, p<0.05). Moreover, subgroup analyses revealed marked insular atrophy (Talairach coordinates 43/-3/1; Z-score=5.64) in HD patients who performed worse in the single executive tasks. CONCLUSION: Two aspects were most remarkable in this correlational study: (i) striatal atrophy in HD patients in early stages plays an important role not only in impaired motor control but also in executive dysfunction, and (ii) extrastriatal cortical areas, i.e., the insular lobe, seem to be involved in executive dysfunction as assessed by neuropsychological tests requiring for planning and problem solving, stimulus response selectivity and concept formation.

Adult↗
PubMed2004

Cognitive and motor functioning in a patient with selective infarction of the left basal ganglia: evidence for decreased non-routine response selection and performance.

Focal damage to the basal ganglia is relatively rare, and little is known about the cognitive effects of damage to specific basal ganglia structures. A 28-year-old, highly educated male (patient RI) sustained a unilateral left ischemic infarction involving primarily the putamen and secondarily the head of the caudate and the anterior internal capsule. Two detailed neuropsychological assessments, at 3 and 16 months post-infarction, revealed that a majority of cognitive abilities were spared. RI's general intelligence, simple attention, concept formation, cognitive flexibility, and explicit memory were unaffected. Select cognitive abilities were affected, and these appeared to be related to direct involvement of the putamen and/or to indirect disruption of circuits between the basal ganglia and frontal lobes. Consistent with involvement of the left putamen, RI showed micrographia with his right hand. Interestingly, his micrographia was context-dependent, appearing only when verbal expression was involved (e.g., present when writing spontaneously, but not when copying sentences or when drawing). Evidence of disruption to frontal systems included variably decreased sustained attention, mildly decreased ability to generate words and to generate ideas, and significantly impaired abstraction ability in both verbal and visual modalities. Although there are several possible interpretations for these findings, this pattern of cognitive and motor functioning is consistent with neuroimaging research suggesting that the frontal/subcortical circuit between the putamen and frontal motor areas plays a role in non-routine response selection and performance.

Adult↗