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PubMed1991

Normative data for a brief neuropsychological screening battery. Multicenter AIDS Cohort Study.

This study reports normative data for a group of 733 homosexual/bisexual men stratified by age (range 25 to 54 years) and by education on the following six neuropsychological tests: (1) Digit Span (WAIS-R), (2) Rey Auditory Verbal Learning Test, (3) Symbol Digit Modalities Test, (4) Controlled Oral Word Association Test, (5) Grooved Pegboard, and (6) The Trail Making Test. Analysis demonstrates that both age and education are important determinants of performance for several of these measures.

AIDS Dementia Complex↗
PubMed1999

Vulnerability to emotionally negative stimuli in Parkinson's disease: an investigation using the Emotional Stroop task.

OBJECTIVE: The objective of this study was to determine whether the pathophysiological changes associated with Parkinson's disease (PD) lead to an increased vulnerability to react to negative emotional stimuli and hence to depression. It is hypothesized that nondepressed PD patients will demonstrate, associated with particular PD and/or cognitive variables, vulnerability to the interfering effects of negative words on the Emotional (sad) Stroop task (EST). BACKGROUND: Depression has been reported to occur frequently in PD, but there is controversy regarding its pathophysiology: psychosocial factors versus neurobiologic ones. METHOD: Thirty nondepressed/ nondemented patients with idiopathic PD attending a specialist movement disorders clinic were assessed from their emotional state (Beck's Depression Inventory [BDI], and Hospital Anxiety and Depression Scale) and from their cognitive state (Mini-Mental State Examination, Stroop tasks [including the EST], Modified Card Sorting Test, Word Fluency tasks, Digit Span, and Trail Making tests). In addition, information was gathered on PD-related variables such as severity (Hoehn and Yahr scale), duration of the disease, and type of motor response to dopaminergic drugs. The sample was split into two groups according to the median BDI score to allow for comparisons. One-way ANOVA techniques were used to look for significant differences between variables in the two groups. Bivariate correlations were used to look for significant relationships between variables in each group. RESULTS: The two groups only differed in parameters measuring emotional state. Only the subjects with higher BDI scores showed significant correlations between EST performance and cognitive and PD-related variables. CONCLUSIONS: Those PD patients with more severe forms of illness and a greater level of prefrontal cognitive dysfunction are more vulnerable to the distracting effects of external negative stimuli. According to the cognitive model of depression, this may ultimately lead to the development of clinical depression.

Adult↗
PubMed2006

Intact theory of mind in TBI with behavioural disturbance.

Behavioural disturbance following TBI is common. Theory of mind(ToM) deficits have been noted in autism where difficulties with social interaction and communication are evident. It was hypothesised that TBI patients with behavioural disturbance would show deficits on ToM tasks independent of executive function. Twenty TBI patients with behavioural disturbance and 20 TBI patients without were assessed on verbal (stories) and non-verbal (cartoons) ToM tasks,standard psychometry, and measures of executive function.TBI patients were unimpaired on the ToM tasks. Both groups were unimpaired on standard tests of executive function (verbal fluency and trail making test) but were impaired on the Behavioural Assessment of Dysexecutive Syndrome (BADS). Groups did not differ significantly on these tests. It is concluded that ToM ability does not predict behavioural disturbance and may be independent of executive functioning.

Analysis of Variance↗
PubMed2002

The characteristics of arabic orthography slow its processing.

The present study was designed to evaluate whether the complexity of Arabic orthography increases its perceptual load, thus slowing word identification. Adolescent Arabic speakers who mastered Hebrew as a second language completed oral and visual versions of the Trail Making Test (TMT; J. E. Parington & R. G. Lieter, 1949) in both languages. Oral TMT required declaiming consecutive numbers or alternation between numbers and letters. Visual TMT required connecting Arabic or Indian numbers and alternation between letters and numbers. Performance in Hebrew and Arabic oral TMT did not differ. Performance was significantly slower in Arabic visual TMT. These results indicate that Arabic speakers process Arabic orthography (1st language) slower than Hebrew orthography (2nd language) and suggest that this is due to the complexity of Arabic orthography.

Adolescent↗
PubMed2001

Evidence for cortical "disconnection" as a mechanism of age-related cognitive decline.

BACKGROUND: Normal aging is accompanied by a decline of cognitive abilities, and executive skills may be affected selectively, but the underlying mechanisms remain obscure and preventive strategies are lacking. It has been suggested that cortical "disconnection" due to the loss of white matter fibers may play an important role. But, to date, there has been no direct demonstration of structural disconnection in humans in vivo. METHODS: The authors used diffusion tensor MRI to look for evidence of ultrastructural changes in cerebral white matter in a group of 20 elderly volunteers with normal conventional MRI scans, and a group of 10 younger controls. The older group also underwent neuropsychological assessment. RESULTS: Diffusional anisotropy, a marker of white matter tract integrity, was reduced in the white matter of older subjects and fell linearly with increasing age in the older group. Mean diffusivity was higher in the older group and increased with age. These changes were maximal in anterior white matter. In the older group, anterior mean diffusivity correlated with executive function assessed by the Trail Making Test. CONCLUSIONS: These findings provide direct evidence that white matter tract disruption occurs in normal aging and would be consistent with the cortical disconnection hypothesis of age-related cognitive decline. Maximal changes in anterior white matter provide a plausible structural basis for selective loss of executive functions. In addition to providing new information about the biological basis of cognitive abilities, diffusion tensor MRI may be a sensitive tool for assessing interventions aimed at preventing cognitive decline.

Adult↗
PubMed2005

Is impairment in set-shifting specific to frontal-lobe dysfunction? Evidence from patients with frontal-lobe or temporal-lobe epilepsy.

Frontal-lobe epilepsy (FLE), temporal-lobe epilepsy (TLE), and matched-control subjects were administered the Trail Making Test (TMT) of the Delis-Kaplan Executive Function System (D-KEFS; Delis et al., 2001), which assesses set-shifting on a visuomotor sequencing task. Results indicated that patients with FLE were impaired in both speed and accuracy on the switching condition relative to patients with TLE and controls. The two patient groups did not differ from controls on the four baseline conditions of the test, which assess visual scanning, motor speed, number sequencing, and letter sequencing. In addition, seizure-related variables (i.e., age of seizure onset, duration of epilepsy, and seizure frequency) failed to correlate with set-shifting performance in patients with FLE. These results suggest that patients with FLE can be reliably distinguished from those with TLE and control subjects on set-shifting as measured by the DKEFS TMT.

Adult↗
PubMed1983

Effects of test anxiety and sex of subject on neuropsychological test performance: Finger Tapping, Trail Making, Digit Span and Digit Symbol tests.

To determine the effects of anxiety and sex on various neuropsychological tests, 28 male and 28 female non-impaired, high and low test-anxious subjects were given the Finger Tapping, Trail Making (Forms A and B), Digit Span, and Digit Symbol tests. Sex significantly affected only the Finger Tapping Test; females made significantly fewer taps. High test-anxious subjects reported an increase in posttest state anxiety. However, test anxiety did not significantly affect performance.

Adolescent↗
PubMed2004

Correlates of anticholinergic activity in patients with dementia and psychosis treated with risperidone or olanzapine.

BACKGROUND: Older individuals with dementia are highly sensitive to the effects of muscarinic receptor blockade. STUDY DESIGN: This was a 6-week multisite, randomized clinical trial. SUBJECTS: Eighty-six patients with probable Alzheimer's disease, vascular dementia, or mixed-etiology dementia (DSM-IV criteria) were randomly assigned to treatment with olanzapine or risperidone. ASSESSMENTS: Anticholinergic activity was measured with a radioreceptor assay, and plasma levels of antipsychotic medications were determined. Primary outcomes were assessed with the Udvalg for Kliniske Undersogelser (UKU) scale and somnolence adverse events; secondary outcome measures included scores on the Neuropsychiatric Inventory (NPI) and other scales. RESULTS: There were no between-treatment differences in the UKU scale or in somnolence adverse events. Statistically significant improvements (p < .001) from baseline were found for the NPI measures, with no between-treatment group differences. Olanzapine was associated with significant increases from baseline in anticholinergic activity, while risperidone was not; the between-treatment group differences were not statistically significant. Increase in anticholinergic activity was associated with an increase in anticholinergic side effects and slower performance on the Trail Making Test Part A. Higher endpoint anticholinergic activity was associated with higher endpoint scores on several items from the NPI, including delusions, anxiety, and aberrant motor behavior. IMPLICATIONS: Efficacious doses of olanzapine increased anticholinergic activity in older patients with dementia, while similarly efficacious doses of risperidone did not. Patients whose anticholinergic activity increased were more likely to experience anticholinergic side effects and to have worsening in certain cognitive domains. These data suggest that certain patients may be vulnerable to the anticholinergic activity associated with antipsychotic treatment.

Antipsychotic Agents↗
PubMed1984

Cognitive functioning in depressed geriatric patients with a history of ECT.

Cognitive functioning in depressed geriatric patients, some with a history of ECT, was assessed with the Trail Making B test. Depressed patients over the age of 65 who had had at least one prior series of ECT performed more poorly on the test than did older patients with no history of ECT and younger depressed patients regardless of their ECT history. The groups did not differ in severity of depression. Careful assessment of elderly patients' history of ECT will allow for more informed decisions about the current use of ECT and an understanding of the cognitive status of these patients.

Adult↗
PubMed2006

Discrepancy of performance among working memory-related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution.

Working memory performance has been inconsistently reported in autism spectrum disorders (ASD). Several studies in ASD have found normal performance in digit span and poor performance in digit symbol task although these are closely related with working memory. It is assumed that poor performance in digit symbol could be explained by confirmatory behavior, which is induced due to the vague memory representation of number-symbol association. Therefore it was hypothesized that the performance of working memory task, in which vagueness did not cause confirmatory behavior, would be normal in ASD. For this purpose, the Advanced Trail Making Test (ATMT) was used. The performance of digit span, digit symbol and ATMT was compared between ASD and normal control. The digit span, digit symbol and ATMT was given to 16 ASD subjects and 28 IQ-, age- and sex-matched control subjects. The scores of these tasks were compared. A significantly lower score for ASD was found only in digit symbol compared with control subjects. There were no significant difference in digit span and working memory estimated by ATMT. Discrepancy of scores among working memory-related tasks was demonstrated in ASD. Poor digit symbol performance, normal digit span and normal working memory in ATMT implied that ASD subjects would be intact in working memory itself, and that superficial working memory dysfunction might be observed due to confirmatory behavior in digit symbol. Therefore, to evaluate working memory in ASD, tasks that could stimulate psychopathology specific to ASD should be avoided.

Adult↗
PubMed2006

Association between mild anemia and executive function impairment in community-dwelling older women: The Women's Health and Aging Study II.

OBJECTIVES: To evaluate the relationship between mild anemia and executive function in community-dwelling older women. DESIGN: Cross-sectional. SETTING: Community-based. PARTICIPANTS: High-functioning subjects participating in the baseline assessment of the Women's Health and Aging Study (WHAS) II, Baltimore, Maryland, 1994 to 1996. WHAS II eligibility criteria included aged 70 to 80, a Mini-Mental State Examination score of 24 or greater, and absence of advanced disability (difficulty in no more than 1 domain of physical function). Included in this study were 364 subjects with a hemoglobin concentration 10 g/dL or greater and known executive function status. MEASUREMENTS: Trail Making Test (TMT) Parts B and A. Tertiles of time to complete each test were used to define best (bottom), intermediate, and worst (top) performance. Tertiles of the difference TMT-B minus TMT-A were calculated. Anemia defined as hemoglobin concentration less than 12 g/dL. RESULTS: The percentage of subjects in the worst TMT-B, TMT-A, and TMT-B minus TMT-A performance tertile was highest for those with anemia. Prevalent anemia substantially increased the likelihood of performing worst (as opposed to best) on the TMT-B (odds ratio (OR) = 5.2, 95% confidence interval (CI) = 1.3-20.5), TMT-A (OR = 4.8, 95% CI = 1.5-15.6), and TMT-B minus TMT-A (OR = 4.2, 95% CI = 1.0-17.2), even after controlling for age, education, race, prevalent diseases, and relevant physiological and functional parameters. CONCLUSION: This study provides preliminary evidence in support of the hypothesis that mild anemia might be an independent risk factor for executive function impairment in community-dwelling older adults. Whether such an association is causal or noncausal remains to be determined.

Aged↗
PubMed2004

Insulin resistance and executive dysfunction in older persons.

OBJECTIVES: To evaluate the association between insulin resistance (IR) and executive dysfunction in a large, population-based study of older persons without diabetes mellitus (DM) or dementia. DESIGN: Cross-sectional study. SETTING: Outpatient clinic in Greve in Chianti and Bagno a Ripoli, Italy. PARTICIPANTS: A total of 597 subjects aged 65 to 93 without DM or dementia. MEASUREMENTS: Anthropometric measurements; plasma fasting levels of glucose, insulin, cholesterol (total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol), and insulin-like growth factor-1 (IGF-1); homeostasis model assessment (HOMA) to estimate degree of IR; Trail Making Test (TMT) A; TMT-B; TMT-B minus TMT-A (DIFF B-A); and Mini-Mental State Examination (MMSE). RESULTS: IR (HOMA) was associated with longer TMT-B (correlation coefficient (r)=0.11; P=.006) and DIFF B-A times (r=0.10; P=.022). Subjects in the upper tertile of IR were older and had longer TMT-B and DIFF B-A than participants in the lowest tertile. After adjusting for age, sex, and years of formal education, IR was significantly correlated with TMT-A, TMT-B, and DIFF B-A. After adjusting for age, sex, education, body mass index, waist:hip girth ratio, HDL-C, triglycerides, IGF-1, hypertension, drug intake, and physical activity, the results did not significantly change. After introducing MMSE score into the model, IR continued to be an independent determinant of TMT-A (beta=11.005; P=.021), TMT-B (beta=28.379; P<.001), and DIFF B-A (beta=17.374; P=.011). CONCLUSION: IR is independently associated with frontal cortex function evidenced by poor TMT times in older persons without DM or dementia.

Adult↗
PubMed1999

Neuropsychological functioning among non-psychotic siblings and parents of schizophrenic patients

Several studies have shown subtle neuropsychological deficits in healthy relatives of schizophrenic patients. However, older relatives and parents have been less frequently assessed than younger adult relatives and siblings. Furthermore, some areas of neuropsychological functioning such as memory and learning have been little studied. Thirty-seven 22-70-year-old non-psychotic parents and siblings of schizophrenic patients were compared to 37 healthy control subjects on a battery of neuropsychological tests (Trail Making, parts A and B, verbal fluency, Wisconsin Card Sorting Test, and four subtests of the Wechsler Memory Scale-Revised: logical memory, design reproduction, verbal paired associates and digit span). Relatives did not differ from control subjects on Wisconsin Card Sorting Test performance and on visual memory, but were significantly impaired on verbal fluency; more subtle deficits were found on Trail Making, part B, digit span and paired associates. A higher proportion of relatives than control subjects showed impairment on verbal fluency and verbal memory. These neuropsychological weaknesseswere present as much in siblings as in parents of schizophrenic patients, and age did not cancel differences between relatives and control subjects. Thus, these subtle deficits seem to be potential phenotypic markers of schizophrenia.

Journal Article↗
PubMed1998

Alcohol, intelligence and violent crime in young males.

Research has demonstrated a relationship between alcohol and violent behavior, but proof of a causal connection remains elusive. A recent review concluded that the key task that remained was to identify sub-groups of the population for which alcohol promotes violence. Because alcohol might induce violence by causing cognitive disruption (e.g., misunderstood communication), less intelligent persons could be vulnerable because they start out closer to the lower limit of comprehension. Our objective is to investigate the effect of lower intelligence on the alcohol/violence relationship. This analysis uses data from the Buffalo Longitudinal Study of Young Men to investigate this hypothesis. Males, 16 to 19 years of age (N = 596), were selected from Buffalo, NY, by random digit dialing. High-risk males were oversampled. Two interviews were conducted 18 months apart, including drinking, criminal offenses, and psychological traits. Verbal intelligence was measured by the Ammons Quick Test and visual-motor intelligence by the Trail Making Test. An analysis of covariance was conducted with wave 2 average alcohol consumption and both measures of intelligence as independent variables, violent offending as the dependent variable, and race, wave 1 alcohol and wave 1 violence as covariates. Results show a positive main effect of wave 2 alcohol consumption, but also interactions with both verbal and visual-motor intelligence. These interactions indicate that the prevalence of violence increases significantly at low intelligence and high alcohol consumption levels. A parallel analysis with nonviolent offending as the dependent variable failed to find significant interactions. The combination of heavy drinking and lower intelligence is associated with a synergistic surge of violent behavior.

Adolescent↗
PubMed2002

Caudate nucleus volumes and genetic determinants of homocysteine metabolism in the prediction of psychomotor speed in older persons with depression.

OBJECTIVE: The authors sought to determine whether caudate nucleus volumes or specific genotypes predict psychomotor slowing in older persons with depression. METHOD: Forty-seven persons with depression (mean age=51.8 years, SD=12.4) and 20 healthy volunteers (mean age=56.1 years, SD=9.8) underwent clinical assessments, a neuropsychological test of psychomotor speed (part A of the Trail Making Test), high-resolution magnetic resonance imaging scans, and genotyping for the apolipoprotein E epsilon4 allele and a mutation of the methylenetetrahydrofolate reductase enzyme. RESULTS: Multivariate analyses revealed that psychomotor speed was uniquely predicted by age, a diagnosis of depression, right caudate nucleus volume, and mutation of the methylenetetrahydrofolate reductase enzyme. CONCLUSIONS: Psychomotor slowing, a key clinical and cognitive phenomenon in older persons with depression, is predicted by reduced caudate nucleus volumes and genetic determinants of homocysteine metabolism.

Adult↗
PubMed1989

Psychomotor performance and counterregulatory responses during mild hypoglycemia in healthy volunteers.

The effect of mild hypoglycemia on psychomotor performance and counterregulatory responses was studied among 12 healthy volunteers. Each volunteer received two modified hyperinsulinemic glucose clamps. One morning, plasma glucose was held constant at euglycemic levels (4.9 mM) for 95 min, and another morning, it was lowered over 35 min and then held constant at hypoglycemic levels (3.4 mM) for 60 min. A battery of psychomotor tests and a questionnaire assessing hypoglycemic symptoms were administered before and repeated during the last 30 min of each clamp. The questionnaire and three selected psychomotor tests were also administered repetitively during the 1st h of each clamp. During the hypoglycemic studies, a rise was seen in plasma epinephrine and pancreatic polypeptide at 45 min. An increase in symptom scores was first recorded at 50 min during the hypoglycemic studies [median 4 (range 0-13) vs. 2 (5-6), P less than .05]. Performance was impaired on two psychomotor tests included in the battery. One was the trail making test on fine motor performance (-19.3 +/- 4.2 targets/min, mean +/- SE vs. 1.2 +/- 4.8 targets/min, P less than .05), and the other was the digit-symbol substitution (DSS) test on information processing and memory (18 +/- 3 vs. 29 +/- 4 symbols/min, P less than .03). Of the tests administered during the 1st h, performance was impaired on the DSS. This impairment became significant at 45 min (14 +/- 4 vs. 22 +/- 4 symbols/min, P less than .005). In conclusion, mild hypoglycemia selectively impairs psychomotor performance in healthy volunteers but not before the onset of glucose counterregulation and warning symptoms.

Adult↗
PubMedDate not supplied

Olfactory function in chronic renal failure.

BACKGROUND: Patients with chronic renal failure (CRF) show a high prevalence of poor nutritional state so that dietary treatment becomes a significant part of the therapeutic regimen. Because smell plays an important role in nutrition, this study aimed to investigate olfactory function in CRF patients. METHODS: A total of 64 CRF patients were investigated. Forty-nine of them were treated with hemodialysis, 15 CRF patients were not dialysis dependent. For comparison we examined 15 healthy subjects. Olfactory function was assessed for odor discrimination, odor identification, and butanol odor thresholds. RESULTS: Olfactory loss was found in 56% of the patients, with 3 functional anosmics and 33 hyposmics. CRF had specific effects on individual tests of olfactory function. Elevated odor thresholds werefound in 11% of patients, 38% of patients had reduced odor discrimination, and 48% of patients exhibited deficits in odor identification. Results of psychological tests (Mini-Mental State Examination and Trail-Making Test) correlated with results from odor identification (p < 0.01) and discrimination (p < 0.01) but not with odor thresholds. CONCLUSIONS: The ability to discriminate and identify odors was found severely impaired whereas odor thresholds were similar to what is seen in the general population. Consequently, CRF patients should be counseled with regard to the possibility of reduced chemosensory functions.

Adult↗
PubMedDate not supplied

Neuropsychological findings in hyperthyroid patients.

AIM: to evaluate attention, concentration, memory changes and executive function inpatients with hyperthyroidism compared with normal thyroid function patients. METHODS: a cross sectional study was conducted in 21 patients (14F, 7M) with symptoms of sweating, sleep disturbance, fine tremor, headache, palpitation, nervousness, forgetfulness and diarrhea. Neurological examination found that 2 patients had proximal paresis and periodic paralysis. Their thyroid functions (FT4 and TSHS) were done, 13 patients were hyperthyroid, 2 patients were subclinical hyperthyroid and 6 patients were euthyroid. Neuropsychological tests such as: Mini Mental State Examination (MMSE), Trail Making Test (TMT) A and B, Continuous Performance Test (CPT), Vigilance Complex Task (VCT), Digit Forward and Backward Repetition (DFR, DBR) were performed in all of those patients. The mean age of sample was 47,3 +/- 8,45 years old and all of them had minimal 6 years education background, no history of cerebro vascular disease, brain injury or tumour or infection, epilepsy, cerebral degeneration, and taking neuroleptics or antidepressants. RESULTS: using the Kendall correlation coefficients showed that FT4 had negative correlation with VCT, CPT, DFR, DBR and positive correlation with TMT A (time) and TMT B (time and error). Study T-test showed that high level of thyroid function had significant difference in TMT A (time), TMT B (time), DBR, DFR, VCT, CPT. Fischer exact gave statistically significant in VCT and fine tremor in hyperthyroid patients (RR VCT 5.60, 95% CI 0.93-33.68, RR fine tremor 0.50, 95% CI 0.28-0.88). CONCLUSION: hyperthyroid patients had significant decrease on attention, concentration, verbal memory and executive function (working memory) compared with euthyroid patients.

Adult↗