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Psychorehabilitation aspects in older age groups.

Throughout medical history, suggestion is the oldest and most common method of relieving human distress and treating physical disease. One of the oldest Egyptian documents, the Ebers Papyrus (1552 BC) states, "Lay your hands upon him to quiet the pain in the arms and say that the pain will disappear." The psychogenic and therapeutic potency of Native American trance dances are also well documented. In a North American tribe practicing ancient traditions, such dances were found to produce an altered feeling for time, loss of conscious control, drastic emotional outbreaks, illusions, hypersuggestibility, and a deep feeling of restored youthfulness (Jilek, 1982). These and other historical documents show the deep historical connection between somatic and mental processes. From the viewpoint of a neurologist or a psychiatrist, a combination of somatic illness, depressive syndromes, organic psychosyndromes, and multimorbidity is frequent in elderly patients (Kortus, 1992). Thus, integrated psychotherapy in geriatric rehabilitation is necessary and useful. Practical psychotherapeutic methods are discussed in this manuscript.

Autogenic Training↗

Alzheimer's disease: rhythm, timing and music as therapy.

Active music-making provides a form of therapy for the Alzheimer's patient which may stimulate cognitive activities such that areas subject to progressive failure are maintained. Anecdotal evidence suggests that quality of life of Alzheimer's patients is significantly improved with music therapy, accompanied by the overall social benefits of acceptance and sense of belonging gained by communicating with others. Music therapy, when based on clear treatment objectives can reduce the individual prescription of tranquilizing medication, reduce the use of hypnotics and help overall goals of rehabilitation. Mood improvement and self-expression, the stimulation of speech and organisation of mental processes; and sensory stimulation and motor integration are promoted. Given that the rate of deterioration in Alzheimer's disease is not predictable, a series of single case experimental designs would generate valuable empirical data concerning treatment outcome and promote basic research into the timing functions required for the co-ordination of cognition, physiology, motor ability and the integrity of behaviour.

Alzheimer Disease↗

Cognitive side-effects of phenytoin compared with carbamazepine in patients with localization-related epilepsy.

In continuation of an earlier study of our group (Neurology, 43 (1) (1993) 41-51), we present the results of an investigation of the adverse effects of carbamazepine versus phenytoin on cognitive function. Two groups of twenty-five patients are compared in an open, parallel group and non-randomized clinical investigation: a group of patients on carbamazepine (CBZ) monotherapy versus a group of similar size on phenytoin (PHT) monotherapy. The two groups do not show significant differences on variables that could confound the comparison of drug-specific adverse effects: age, gender, intelligence, type of epilepsy, seizure type, seizure frequency, EEG focus and age at onset of the epilepsy. All patients were investigated with a comprehensive neuropsychological test battery ('FePsy'), assessing the cognitive domains of 'speed factors', memory and attention. The results show lower performance in the PHT group compared to the CBZ group on all tests measuring motor speed. Additionally, there is evidence that PHT also affects the speed of central 'higher cortical' processing systems. Our investigation also shows slower performance in tasks that measure speed of information processing ('mental speed'). The other investigated areas, i.e. short-term memory, long-term (verbal and non-verbal) memory and selective attention, do not reveal statistically significant differences between the two groups. These results reconfirm that patients on PHT may suffer from cognitive side-effects even when the medication is sufficiently controlled and the drugs are given within the assumed therapeutical interval.

Adolescent↗

Altered states of consciousness: processed EEG in mental disease.

Due to increasing life expectancy and a rising elderly population in Europe, the incidence of mild cognitive impairment which may predict diseases like Alzheimer's Disease or Vascular Dementia, is rising. Neurophysiological techniques are simple and inexpensive tools for early diagnosis and provide useful and objective correlates of cognitive activity both in normal subjects and patients suffering from the above conditions. Cognitive impairment due to different mental disease is characterized by decreased power and coherence in the alpha/beta band, which suggests functional disconnection among cortical areas, whereas both power and coherence in the delta and theta bands increase as a sign of cortical deafferentation from subcortical structures. Quantification of power and phase relationship by bispectral analysis suggests the Bispectral Index could be a useful but simple tool for early diagnosis of mental disease.

Aged↗

EEG theta rhythm in infants and preschool children.

OBJECTIVE: To study behavioral correlates of theta oscillations in infants and preschool children. METHODS: EEG was recorded during baseline (visual attention) and two test conditions--exploration of toys and attention to 'social' stimulation. Age specific frequency boundaries of theta and mu rhythms were assessed using narrow bin analysis of EEG spectra. RESULTS: Theta spectral power increased whereas mu power decreased under test conditions in both age groups. In preschoolers theta rhythm increased predominantly over anterior regions during exploratory behavior and over posterior regions during attention to social stimulation. Theta frequency range changed with age from 3.6 to 5.6 Hz in infants to 4-8 Hz in children, and mu range from 6.4-8.4 Hz to 8.4-10.4 Hz. CONCLUSIONS: In early life, theta oscillations are strongly related to behavioral states with substantial attentional and emotional load. The scalp distribution of theta spectral power depends on age and behavioral condition and may reflect engagement of different brain networks in control of behavior. SIGNIFICANCE: The findings contribute to the scanty knowledge about the developmental course of theta rhythm. Data on behavioral correlates of theta rhythm in early life may improve our understanding of cognitive and mental processes in healthy and neuropsychiatrically diseased children.

Age Factors↗

The wording of conclusions in relational reasoning.

Literature on relational reasoning mainly focuses on the performance question. It is typically argued that problem difficulty relies on the number of "mental models" compatible with the problem. However, no study has ever investigated the wording of conclusions that participants formulate. In the present work, we analyze the relational terms that people use in drawing conclusions from spatial relation problems (A is to the left of B, B is to the left C, D is in front of A, E is in front C, What is the relation between D and E?). We observed a general preference for expressing conclusions with 'left' rather than conclusions with 'right'. We also found that three factors had an influence on the wording of the conclusions: the linguistic form of premises, the question type and the presentation format. On the other hand, the number of models and premise order did not affect the wording of conclusions. Our study shows that the type of conclusion produced provides a new key to identifying the mental processes involved in spatial reasoning. Implications for the two main approaches to reasoning processes (i.e. the analogical and the propositional approaches) are discussed.

Child↗

On the capacity of attention: its estimation and its role in working memory and cognitive aptitudes.

Working memory (WM) is the set of mental processes holding limited information in a temporarily accessible state in service of cognition. We provide a theoretical framework to understand the relation between WM and aptitude measures. The WM measures that have yielded high correlations with aptitudes include separate storage-and-processing task components, on the assumption that WM involves both storage and processing. We argue that the critical aspect of successful WM measures is that rehearsal and grouping processes are prevented, allowing a clearer estimate of how many separate chunks of information the focus of attention circumscribes at once. Storage-and-processing tasks correlate with aptitudes, according to this view, largely because the processing task prevents rehearsal and grouping of items to be recalled. In a developmental study, we document that several scope-of-attention measures that do not include a separate processing component, but nevertheless prevent efficient rehearsal or grouping, also correlate well with aptitudes and with storage-and-processing measures. So does digit span in children too young to rehearse.

Adolescent↗

Suggestion overrides the Stroop effect in highly hypnotizable individuals.

Cognitive scientists distinguish between automatic and controlled mental processes. Automatic processes are either innately involuntary or become automatized through extensive practice. For example, reading words is a purportedly automatic process for proficient readers and the Stroop effect is consequently considered the "gold standard" of automated performance. Although the question of whether it is possible to regain control over an automatic process is mostly unasked, we provide compelling data showing that posthypnotic suggestion reduced and even removed Stroop interference in highly hypnotizable individuals. Drawing on a large sample of highly hypnotizable participants, we examined the effects of suggestion on Stroop performance both with and without a posthypnotic suggestion to perceive the input stream as meaningless symbols. We show that suggestion administered to highly hypnotizable persons significantly reduced Stroop interference and derailed a seemingly automatic process.

Adult↗

How something can be said about telling more than we can know: on choice blindness and introspection.

The legacy of Nisbett and Wilson's classic article, Telling More Than We Can Know: Verbal Reports on Mental Processes (1977), is mixed. It is perhaps the most cited article in the recent history of consciousness studies, yet no empirical research program currently exists that continues the work presented in the article. To remedy this, we have introduced an experimental paradigm we call choice blindness [Johansson, P., Hall, L., Sikström, S., & Olsson, A. (2005). Failure to detect mismatches between intention and outcome in a simple decision task. Science, 310(5745), 116-119.]. In the choice blindness paradigm participants fail to notice mismatches between their intended choice and the outcome they are presented with, while nevertheless offering introspectively derived reasons for why they chose the way they did. In this article, we use word-frequency and latent semantic analysis (LSA) to investigate a corpus of introspective reports collected within the choice blindness paradigm. We contrast the introspective reasons given in non-manipulated vs. manipulated trials, but find very few differences between these two groups of reports.

Affect↗

Residual neuropsychological effects of illicit 3,4-methylenedioxymethamphetamine (MDMA) in individuals with minimal exposure to other drugs.

BACKGROUND: A substantial literature suggests that users of illicit 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy") display residual cognitive deficits. Most MDMA users, however, use other illicit drugs as well, so it is difficult to be certain that these deficits are due to MDMA, as opposed to other drug use or additional confounding factors. METHODS: We administered a battery of neuropsychological tests to 23 young MDMA users who reported minimal exposure to any other drugs, including alcohol, and to 16 comparison individuals equally involved with the rave subculture, but reporting no MDMA use. We compared the groups by regression analyses adjusting for numerous potentially confounding variables. To test for a possible dose-response effect, we also performed a median split of 12 moderate MDMA users (22-50 lifetime uses) and 11 heavy users (60-450 uses), and compared these subgroups with non-users. RESULTS: MDMA users as a whole performed worse than non-users on most test measures, but these comparisons rarely reached statistical significance. This picture changed markedly in the subgroup analysis: although moderate users displayed virtually no differences from non-users on any measures, the heavy users displayed significant deficits on many measures, particularly those associated with mental processing speed and impulsivity. These differences did not appear explainable by differences in family-of-origin variables, verbal IQ, levels of depression, or time since last MDMA use. CONCLUSIONS: The presence of residual cognitive deficits, even among unusually "pure" frequent users of illicit MDMA, analyzed with adjustment for confounding variables, augments the evidence that MDMA itself, rather than some associated factor, is responsible for the deficits observed.

Adolescent↗

Worry and eating disorders: a psychopathological association.

UNLABELLED: Worry is a mental process associated with anxiety disorders. The key feature of worry is the predominance of a negative-type and preoccupied thought about possible threatening future events. OBJECTIVE: Some studies have shown that worry may be a feature of eating disorders. This study aims to measure whether worry is significantly higher in eating disordered individuals than in a normal control group and whether worry is associated with the Eating Disorders Inventory. METHODS: Sixty-three individuals affected by an eating disorder (34 anorexics and 29 bulimics) completed the Penn State Worry Questionnaire, the Structured Clinical Interview for DSM, and the Eating Disorder Inventory. Thirty normal controls completed the Penn State Worry Questionnaire. RESULTS: Penn State Worry Questionnaire scores were significantly higher in eating disordered individuals than in controls. It was associated with all the symptoms of eating disorders and was correlated with all the EDI subscales, except for the subscale 'bulimia'. These findings suggest that worry is important for understanding the psychopathology of eating disorders.

Adult↗

But I thought it was Mickey Mouse: the effects of new postevent information on 18-month-olds' memory.

Two experiments examined the effects of postevent information on 18-month-olds' event memory. Experiment 1 (N=60) explored whether children's memory was reinstated when action information was eliminated from the reinstatement and only object information was introduced. Experiment 2 (N=48) examined children's recall when either (a). information about the objects' target actions was replaced with new action information or (b). the original training objects were replaced with new objects. In an elicited-imitation paradigm, children were trained to perform six target actions, watched a video reinstatement 10 weeks later, and were tested for recall 24 h after reinstatement. Two results were found. First, a video reminder eliminating action information reinstated children's memory as effectively as a video containing object and action information. Second, children were reminded of their past training when during reinstatement action information was preserved and new objects were presented but were not reminded when object information was preserved and new actions were presented.

Child Development↗

A delivery device for presentation of tactile stimuli during functional magnetic resonance imaging.

We describe a novel stimulus delivery system designed to present tactile stimuli to a subject in the tunnel of a magnetic resonance imaging (MRI) system. Using energy from an air-driven piston to turn a wheel, the device advances a conveyor belt with a pre-determined sequence of stimuli that differ in their spatial features into the tunnel of the MRI. The positioning of one or several stimulus objects in a window near the subject's hand is controlled by a photoelectric device that detects periodic openings in the conveyor belt. Using this electric signal to position each presentation avoids cumulative positioning errors and provides a signal related to the progression of the experiment. We used a series of shapes that differed in their spatial features but the device could carry stimuli with a diversity of shapes and textures. This flexibility allows the experimenter to design a wide variety of psychophysical experiments in the haptic world and possibly to compare and contrast these stimuli with the cognitive treatment of similar stimuli delivered to the other senses. Appropriate experimental design allows separation of motor, sensory and memory storage phases of mental processes.

Electronics↗

The neuropsychology of vascular cognitive impairment: is there a specific cognitive deficit?

The concept of Vascular Cognitive Impairment (VCI) encompasses patients across the entire continuum of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from high-risk patients with no frank cognitive deficit (the "brain-at-risk" stage) through vascular dementia (VaD). There are accepted differences in the neuropsychological profile of patients with Alzheimer's disease (AD) and VaD. In patients with VaD, executive functions that tend to be disproportionately impaired include planning and sequencing, speed of mental processing, performance on unstructured tasks, and attention. Language production may be impaired in patients with VaD but primary language functions otherwise tend to be preserved. Patients with VaD also exhibit significantly more perseverations than patients with AD. Memory impairment is typically evident in patients with AD+CVD but memory impairment may also occur as a primary consequence of stroke in the posterior cerebral artery territory with involvement of the medial temporal lobe, or as a secondary consequence of a cognitive syndrome involving inattention due to primary executive dysfunction. Compared to VaD, patients with AD may exhibit greater deficits in functions (including memory) mediated by posterior cortical structures, such as the temporal and parietal lobes. AD patients exhibit a faster rate of information decay, reduced ability to benefit from cues to facilitate retrieval, and higher frequency of intrusion errors; in addition, certain aspects of language function, such as naming, may exacerbate deficits on verbal memory tasks. AD tends to affect lexicon while VaD tends to affect syntax. When patients with AD exhibit perseverations, they tend to be elicited by tests of semantic knowledge.

Brain↗

The role of the human ventromedial prefrontal cortex in memory for contextual information.

There is a growing body of evidence that the ventromedial prefrontal cortex (VMPFC) is implicated in the new learning of visual items. Little is known, however, as to the involvement of that portion of the prefrontal cortex in the learning of temporal and spatial relationship of those items. The aim of the present study, therefore, was to investigate the role of the VMPFC in memory for temporal and spatial order. Patients who had undergone surgery of the anterior communicating artery aneurysm, and normal control subjects (C), participated in the study. The patients were subdivided into three groups: with resection of the left (LGR+) or right (RGR+) gyrus rectus, and without such a resection (GR-). Subjects were presented with two memory tests: a temporal order (TO) test and a spatial order (SO) test. In the TO test, the LGR+ and RGR+ groups performed worse than the C group, while the GR- group did not differ significantly from the C group. In the SO test, the LGR+ and RGR+ groups did not differ significantly from the C and GR- groups. However, the trend appears to be the same for both tests, although only the TO test provides statistically significant group differences. Our results thus suggest that the VMPFC is involved in memory for contextual information. Together with previous findings, the data suggest that the learning of the relationship between items as well as the learning of those items are mediated by overlapping areas of the VMPFC.

Aneurysm, Ruptured↗

Spatiotemporal properties of the BOLD response in the songbirds' auditory circuit during a variety of listening tasks.

Auditory fMRI in humans has recently received increasing attention from cognitive neuroscientists as a tool to understand mental processing of learned acoustic sequences and analyzing speech recognition and development of musical skills. The present study introduces this tool in a well-documented animal model for vocal learning, the songbird, and provides fundamental insight in the main technical issues associated with auditory fMRI in these songbirds. Stimulation protocols with various listening tasks lead to appropriate activation of successive relays in the songbirds' auditory pathway. The elicited BOLD response is also region and stimulus specific, and its temporal aspects provide accurate measures of the changes in brain physiology induced by the acoustic stimuli. Extensive repetition of an identical stimulus does not lead to habituation of the response in the primary or secondary telencephalic auditory regions of anesthetized subjects. The BOLD signal intensity changes during a stimulation and subsequent rest period have a very specific time course which shows a remarkable resemblance to auditory evoked BOLD responses commonly observed in human subjects. This observation indicates that auditory fMRI in the songbird may establish a link between auditory related neuro-imaging studies done in humans and the large body of neuro-ethological research on song learning and neuro-plasticity performed in songbirds.

Acoustic Stimulation↗

Prose recall and amnesia: more implications for the episodic buffer.

Baddeley and Wilson [Baddeley, A. D., & Wilson, F. B. (2002). Prose recall and amnesia: implications for the structure of working memory. Neuropsychologia 40, 1737-1743.] have argued that their finding of a positive association between amnesics' immediate prose recall scores and their scores on measures of executive function and fluid intelligence supports the view that an episodic buffer exists. However, the pattern of data from amnesics tested in our laboratory presented some problems for this conceptualisation of the episodic buffer.

Adult↗

Transient hypofrontality as a mechanism for the psychological effects of exercise.

Although exercise is known to promote mental health, a satisfactory understanding of the mechanism underlying this phenomenon has not yet been achieved. A new mechanism is proposed that is based on established concepts in cognitive psychology and the neurosciences as well as recent empirical work on the functional neuroanatomy of higher mental processes. Building on the fundamental principle that processing in the brain is competitive and the fact that the brain has finite metabolic resources, the transient hypofrontality hypothesis suggests that during exercise the extensive neural activation required to run motor patterns, assimilate sensory inputs, and coordinate autonomic regulation results in a concomitant transient decrease of neural activity in brain structures, such as the prefrontal cortex, that are not pertinent to performing the exercise. An exercise-induced state of frontal hypofunction can provide a coherent account of the influences of exercise on emotion and cognition. The new hypothesis is proposed primarily on the strength of its heuristic value, as it suggests several new avenues of research.

Adaptation, Psychological↗