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PubMed2002

An evaluation of the cumulative concussive effect of soccer heading in the youth population.

Soccer is the most popular team sport in the world, with 120 million individuals participating and 16 million of these individuals being based in the United States. In addition, soccer has become the fastest growing team sport in the United States over the past 10 years. Head impact injuries have been cited as comprising 15% of all injuries related to soccer. Previous studies have identified the technique of heading as being a significant factor in head impact injuries. In fact, 85% of various subgroups of participants, 19 years of age and older, have had a diminution in cognitive function abilities on a permanent basis. It was the purpose of this study to evaluate the effect of repetitive head impacts due to heading in 57 youth soccer players with a mean age of 11.5 years. The data were collected over three seasons during the first year, which correlated to approximately 60 games and/or practices. One team of 18 boys was followed for an additional year. The data collected included a cognitive function test, as well as documentation of concussive symptoms. These cognitive evaluations, conducted at both periods of time, revealed that statistically significant differences were not evident when compared to standardized norms with the exception of verbal learning. There was an inverse relationship between the number of ball impacts and verbal learning. Of note, however, is that 49% of the year-one study group did complain of headaches after heading the ball.

Adolescent↗
PubMed2003

Memory performance, but not information processing speed, may be reduced during early pregnancy.

Several studies have investigated aspects of cognitive functioning during late pregnancy or in the period around delivery. The present paper describes a controlled study of neurocognitive functioning in an early phase of pregnancy (14 weeks). Seventy-one pregnant women and 57 control subjects matched for age and education were tested with a cognitive test battery. Intentional learning was tested with the Verbal Learning Test, retrieval from semantic memory with the Fluency Test, and speed of information processing with the Concept Shifting Test, the Stroop test, and the Letter Digit Substitution Test. Results show that performance on tests measuring intentional learning and retrieval from semantic memory were lower in the pregnant group during early pregnancy as compared to a closely matched nonpregnant group. In contrast, speed of information processing was not different between the two groups. The differences observed in memory performance were not large and further research is needed to establish their clinical significance. In addition, the results should be interpreted with care, because our study has a cross-sectional design, which has limitations concerning the fact that preexisting performance differences might be possible. Therefore, longitudinal studies are essential to ascertain clear associations between pregnancy and cognitive performance.

Adult↗
PubMedDate not supplied

Neurocognitive function in panic disorder and social phobia patients.

A neuropsychological test battery designed to assess verbal learning and memory, visual memory, psychomotor speed, cognitive flexibility and concentration was administered to patients with panic disorder (N = 18) and social phobia (N = 18) and a group of healthy control subjects (N = 16). Overall, the neurocognitive performance of the panic disorder and social phobia patients was lower than that of control subjects. Analyses of the verbal test variables indicated reduced performance in panic disorder and social phobia patients, relative to control subjects, on measures of verbal learning and memory. In addition, panic disorder patients exhibited deficits on short-delay free recall. No group differences were observed on tests of visual memory, psychomotor speed, cognitive flexibility, and concentration. These results, while indicative of diminished neuropsychological test performance in patients with panic disorder and social phobia, do not suggest the presence of syndrome-specific or localized neurocognitive deficits.

Adult↗
PubMed1998

Neuropsychological performance across the menstrual cycle in women with and without Premenstrual Dysphoric Disorder.

This study examined neuropsychological performance across the menstrual cycle in women with varying levels of premenstrual symptomatology. Following a 2-month period of prospective symptom documentation, there were 19 women who met DSM-IV criteria for Premenstrual Dysphoric Disorder (PMDD group) and 18 women with mild to moderate symptoms. Neuropsychological functioning was evaluated at the late follicular (pre-ovulatory) and late luteal (premenstrual) phases across the domains of psychomotor speed, attention, and verbal learning and memory. Repeated measures analysis of variance yielded significant group x phase differences on the psychomotor index, with women in the PMDD group demonstrating significant psychomotor slowing in the late luteal phase. This psychomotor slowing was subtle, however, and scores remained within the normal range across testing sessions. No group or phase differences were found on indices of attention or verbal learning and memory. These results suggest that with the exception of subtle psychomotor slowing in the late follicular relative to the late luteal phase, there is no discernible difference in cognitive functioning between women with and without PMDD.

Adult↗
PubMed2003

Effect of sleep deprivation on medical resident and student cognitive function: A prospective study.

OBJECTIVE: The purpose of this study was to determine whether cognitive function test results decrease after a typical night of on-call duty, on the basis of the amount of sleep that is obtained. STUDY DESIGN: Two standard cognitive functions tests (the Grooved Pegboard and California Verbal Learning Test II) were administered to the 30 participants who were members of the obstetrics and gynecology house staff and to medical students at Emory University School of Medicine. Each test was administered twice, before and after on-call duty. The data were analyzed with a paired two-tailed Student t test. RESULTS: For the California Verbal Learning Test II, trial 5 showed a decrease in score of 0.8 (P =.05) after on-call duty. Trials 1 through 5 showed a decrease in score of 3.5 (P =.01). CONCLUSION: This finding suggests that cognitive function test scores do decrease after on-call duty. Scrutiny of this issue by the Accreditation Council of Graduate Medical Education is justified, and the issue should continue to be evaluated. Our finding suggests that a change in our current educational structure is warranted.

Adult↗
PubMed1997

Affect recognition in schizophrenia: a function of global impairment or a specific cognitive deficit.

To investigate cognitive variables related to affect recognition in schizophrenia, 63 subjects with DSM-III-R diagnoses of schizophrenia or schizoaffective disorder were administered a test battery which included the Bell-Lysaker Emotion Recognition Task (BLERT), Wisconsin Card Sorting Test (WCST), Wechsler Memory (WMS-R) and Adult Intelligence Scales (WAIS-R), Hopkins Verbal Learning Test, Gorham's Proverbs, and Continuous Performance Task (CPT). Coefficients revealed a moderate relationship between emotion recognition and WCST and CPT but no significant relationship with other test variables. Multiple regression analysis demonstrated that approximately one-third of the variance in BLERT scores could be explained by cognitive variables including the Digit Symbol Subtest, CPT, and Hopkins Verbal Learning Test. Other analyses demonstrated that subjects with moderate to severe affect recognition impairment had more perseverative errors, had fewer complete categories on the WCST and had more errors on the CPT. However, there were no significant differences on global measures of impairment such as WAIS-R IQs and Digit Symbol Substitution Test. The discussion focuses on deficits in affect recognition as a distinct feature which contributes to the heterogeneity of the disorder.

Adult↗
PubMed1994

Effects of depression on memory performance and metamemory in children.

OBJECTIVE: To investigate the effects of depression on memory performance and metamemory in children. METHOD: Performance on automatic memory tasks (frequency of occurrence), effortful memory tasks (Children's Auditory Verbal Learning Test), and a Metamemory Battery were examined in 21 unmedicated, depressed children and 21 nondepressed controls (matched for age, gender, and full-scale IQ). Subjects were divided into three groups based on depression severity (high depressed, low depressed, nondepressed). RESULTS: High depressed patients demonstrated performance deficits relative to nondepressed and low depressed children on the Children's Auditory Verbal Learning Test, Immediate Recall trial. Both groups of depressed children performed more poorly on the Metamemory Battery when compared to nondepressed children. Severity of depression differentiated overall performance. Metamemory performance of depressed subjects indicates possible difficulty with overestimation of memory abilities. No differences were found on automatic memory task performance. CONCLUSIONS: Memory impairment in depression varies as a function of severity and may be evident only when a certain level of depression is reached. Overestimation of memory ability by depressed children may be an attempt to compensate for feelings of inadequacy or inferiority. It may also lead depressives to use poor judgment in selecting appropriate solutions for problems. Targeting these cognitive distortions could be a focal point of clinical and educational interventions.

Attention↗
PubMed1996

Interference effects in chronic alcoholism.

This study investigated underlying mechanisms of the verbal memory disorder associated with chronic alcoholism. Previous investigations have suggested that alcoholics are more vulnerable to interference effects on verbal learning and memory tasks, both with respect to retroactive interference (RI) and proactive interference (PI); this was the hypothesis of the current study. Measures of RI and build-up and release from PI were administered to 31 abstinent male chronic alcoholics and 24 healthy male nonalcoholic control subjects. Alcoholics demonstrated more sensitivity to RI than controls. Additionally, alcoholics displayed a more rapid build-up of PI, although they showed normal release. An increased interference effect was found to be a component of chronic alcoholics' verbal memory impairment and may differentiate chronic alcoholism from other disorders affecting verbal learning and memory.

Adult↗
PubMed1995

Cognitive and neuropsychological characteristics of physically aggressive boys.

Cognitive-neuropsychological tests were given to adolescent boys (N = 177) to investigate processes associated with physical aggression. Factor analysis yielded 4 factors representing verbal learning, incidental spatial learning, tactile-lateral ability, and executive functions. Physical aggression was assessed at ages 6, 10, 11, and 12, and 3 groups were created: stable aggressive, unstable aggressive, and nonaggressive. The authors found main effects for only the executive functions factor even when other factors were used as additional covariates in a step-down analysis; nonaggressive boys performed better than stable and unstable aggressive boys. The covariates family adversity and anxiety were both related only to the verbal learning factor. This study highlights the importance of deficits in executive function in the expression of physical aggression relative to other cognitive-neuropsychological functions.

Aggression↗
PubMed1999

Declarative and procedural memory functioning in abstinent cocaine abusers.

BACKGROUND: We determined the nature and recovery of procedural and declarative memory functioning in a cocaine-abusing cohort in the 45-day period following use. METHODS: Thirty-seven cocaine abusers and 27 control subjects were administered the following memory and mood measures: California Verbal Learning Test, recall of the Rey-Osterrieth Complex Figure Test, Pursuit Rotor Task, and Profile of Mood States at 4 visits (within 72 hours of admission and at 10, 21, and 45 days following abstinence). RESULTS: Analysis of performance on the Rey-Osterrieth Complex Figure Test revealed that both groups improved in their recall over repeated administrations, though the control group recalled significantly more of the information than cocaine subjects during the 45-day interval. Results for the California Verbal Learning Test indicated improved learning for both subject groups over time, but no group x time interaction. On the Pursuit Rotor Task, cocaine abusers improved their performance at a faster rate than controls at visit 1. At day 45 (visit 4), cocaine abusers again showed improvement on the Pursuit Rotor Task, whereas controls demonstrated a relative plateau in rate of learning. CONCLUSIONS: This study documented a lasting detrimental effect on a sensitive nonverbal declarative memory task in cocaine-dependent subjects following abstinence of 45 days. In contrast, abstinence from cocaine during this 45-day period was associated with sustained improvement on a motor learning test in the cocaine abusers relative to controls.

Adult↗
PubMedDate not supplied

Challenging the serotonergic system in Parkinson disease patients: effects on cognition, mood, and motor performance.

BACKGROUND: Parkinson disease (PD) is a neuropsychiatric disease that is characterized by motor and neuropsychiatric symptoms. Multiple neurotransmitter systems, including the serotonergic system, are involved in the pathophysiology of this disease. The exact role of the serotonergic system in PD is still unclear. OBJECTIVE: To investigate the role of serotonin on specific aspects of cognition, mood, and motor performance in PD. METHODS: In a double-blind, randomized, placebo-controlled, crossover design, the effects of a nonspecific serotonergic challenge with citalopram, a selective serotonin reuptake inhibitor, and a 5-HT1a receptor-specific challenge with buspirone on the Visual Verbal Learning Task, Concept Shifting Task, Profile of Mood State Questionnaire, motor section of the Unified Parkinson Disease Rating Scale (section 3), Simple Reaction Time Task, and Finger Precuing Task were studied in 21 PD patients in early stages of their disease and 21 age-, sex-, and education-matched healthy volunteers. RESULTS: The serotonergic challenges resulted in similar effects for both groups. No changes of scores on the cognitive tasks (Visual Verbal Learning Task and Concept Shifting Task) were observed. Results of the Profile of Moods State Questionnaire indicated that, at baseline, PD patients scored less than controls on all 5 subscales. Motor performance (measured by reaction time) was negatively affected by the interventions. CONCLUSIONS: The effects of nonspecific and 5-HT1a receptor-specific challenging of the serotonergic neurotransmitter system had similar effects in both PD patients and healthy control subjects. These findings indicate that serotonergic function is not impaired in early PD and that serotonin, although involved in the pathophysiology of PD, does not seem to play a direct role in cognition, mood, and motor performance in PD patients, but may be involved in hypokinesia.

Affect↗
PubMed2006

Cognitive functions in juvenile and adult patients with gelastic epilepsy due to hypothalamic hamartoma.

PURPOSE: To describe extend and severity of cognitive deficits in juvenile and adult patients with gelastic seizures and hypothalamic hamartoma (HH) and to analyze the impact of epilepsy-related variables on cognitive performance. METHODS: Thirteen juvenile and adult patients (mean age, 25 years; seven men) underwent comprehensive neuropsychological testing assessing intellectual performance, attention and executive functions, verbal and visual memory, and visuospatial abilities. RESULTS: Intellectual abilities ranged from moderate mental retardation to good average performance; 54% of the patients displayed below-average global intellectual abilities. Attentional and executive functions were impaired in 23% to 46% of the patients. Below-average visuospatial capabilities were observed in 39% of the cases. Memory functions were impaired regarding both visual (77%) and verbal learning (62%). Nonparametric correlation analysis revealed a significant relation between monthly partial seizure frequency and reduced cognitive flexibility and reduced performance in mental rotation. In addition, HH volume was significantly negatively correlated with cognitive flexibility, whereas age at onset and duration of epilepsy did not show significant correlation to cognitive performance. CONCLUSIONS: More than half of the adult patients with gelastic seizures and HH displayed deficits in a broad range of cognitive functions, expressed mostly in visual and verbal learning and memory. Some of the deficits could be shown to correlate with disease-related characteristics representing the severity of the epilepsy or the size of the underlying lesion. These findings prompt for a longitudinal investigation of the development of these cognitive deficits to analyze further the relevant factors contributing to this wide spectrum of cognitive impairments.

Adolescent↗
PubMed1992

A model-based study of learning and memory following transient global amnesia attacks.

Verbal learning and forgetting were studied in patients one month after an episode of Transient Global Amnesia and in normal control subjects by means of a two-stage stochastic model, which allows independent measurements of encoding, storage and forgetting. We preliminarily ascertained both the necessity and the sufficiency of the model to account for several performance scores of the two experimental groups, and then compared the learning and forgetting functions between groups. In spite of the analytical power of the statistical method adopted. Transient Global Amnesia was not found to entail persistent impairment of encoding and storage, as well as of retaining memory traces and retrieval algorhythm.

Cerebral Cortex↗
PubMed2005

Apolipoprotein E epsilon4 allele and lorazepam effects on memory in high-functioning older adults.

CONTEXT: The apolipoprotein E (APOE) epsilon4 allele has been implicated as a significant risk factor in the development of late-onset Alzheimer disease, but the evidence of cognitive sequelae in healthy individuals has been mixed. OBJECTIVE: To determine if the APOE epsilon4 allele increases susceptibility to lorazepam-induced verbal learning impairment in nondemented older adults. DESIGN: A placebo-controlled crossover design. SETTING: A community-based sample of subjects. PARTICIPANTS: Sixty-four cognitively intact and highly educated (>12 years) adults. Twenty-four subjects (mean age, 66.3 years) were carriers of an APOE epsilon4 allele (epsilon4 positive) and 40 (mean age, 66.0 years) were not (epsilon4 negative). INTERVENTIONS: All subjects received a single oral dose of placebo and lorazepam (0.5 and 1.0 mg) 1 week apart. MAIN OUTCOME MEASURE: We used the Buschke Selective Reminding Test to assess verbal learning during a 5-hour period after placebo or lorazepam administration. RESULTS: We found a time-related, dose-dependent effect of lorazepam, with long-term recall generally decreasing with higher doses of lorazepam at up to 2.5 hours. At 5 hours, the epsilon4-negative group showed significant improvement in long-term memory, but the epsilon4-positive group demonstrated a persistent deficit. Subsequent analysis revealed that the poor performance at 5 hours was found in an epsilon4-positive subgroup with lower baseline performance. CONCLUSIONS: In cognitively intact, older adults, the effect of the APOE epsilon4 allele is not necessarily seen in the immediate response to benzodiazepine challenge. Rather, the APOE epsilon4 allele appears to affect the carrier's ability to recover from a cognitive challenge in a normal fashion, at least in a subgroup of subjects with relatively low baseline performance. This suggests that although carrying an APOE epsilon4 allele increases the risk for cognitive toxic effects, allele status alone is not a sufficient predictor of such effects. Studying the response to and the recovery from cognitive challenges may provide insights into the role of the APOE epsilon4 allele and its interaction with other factors in the development of Alzheimer disease and other age-related cognitive problems.

Aged↗
PubMed1997

Differential involvement of left temporolateral and temporomesial structures in verbal declarative learning and memory: evidence from temporal lobe epilepsy.

A wealth of animal and human research has pointed to a significant involvement of the temporal lobes in memory processing, and yet the different functional roles of temporal cortical vs. mesial structures remain unclear. We studied verbal declarative memory, by using a word list paradigm that differentiates among learning (immediate recall), memory (delayed recall), and recognition, in epilepsy patients being considered for surgical resection of the left temporal lobe. Verbal memory was evaluated preoperatively and during the recording of intracranial event related potentials and postoperatively after selective hippocampectomy, temporal cortical lesionectomy, or anterior two-thirds en bloc temporal lobe resection procedures. Preoperative differences in verbal memory performance as a function of differences in underlying neuropathology, concurrent event-related potentials, and specific patterns of postoperative memory impairments lead to converging evidence that verbal declarative memory relies on a synergistic interaction of at least two functionally distinct brain systems. Material-specific data acquisition, or working memory, is mediated by neocortical temporal structures, whereas long-term consolidation/retrieval is particularly mediated by temporomesial structures. In contrast to the left temporal neocortex, the function of the temporomesial system appears to be material nonspecific. Apparently, its preferential involvement in verbal memory is due to its close interaction with overlying neocortical structures that are specialized for language processing.

Adult↗
PubMed2000

Factor analysis of the Neuropsychological Screening Battery for Hispanics (NeSBHIS).

The Neuropsychological Screening Battery for Hispanics (NeSBHIS; Pontón et al., 1996) was developed to provide clinicians and researchers with appropriate tests and norms to assess the Latino population. However, the construct validity of the NeSBHIS is unclear, and its clinical utility is untested. This study provides data on the construct validity of this battery via factor analytic methodology. Five factors were identified: (a) a language factor, which included the Controlled Oral Word Association Test, the Pontón-Satz Boston Naming Test, and the Escala de Inteligencia Wechsler para Adultos (EIWA; Wechsler, Green, & Martinez, 1968) Digit Span; (b) a verbal learning factor, which included all the World Health Organization--University of California, Los Angeles Auditory Verbal Learning Test scores (Trials V, VII, and VIII); (c) an attentional-mental control factor, which included the EIWA Digit Symbol, Color Trails 1 and 2, and the EIWA Block Design; (d) a visuospatial factor, made up of the Rey-Osterrieth Complex Figure Test Copy and Memory and the Raven's Standard Progressive Matrices total score; and (e) a psychomotor factor, the Pin Test. This was a stable factor structure, suggesting that the NeSBHIS has a robust construct validity.

Adolescent↗
PubMed2004

Cognitive effects of olanzapine treatment in schizophrenia.

Improvement in some but not all domains of cognition during treatment with the atypical antipsychotic drugs clozapine, quetiapine, olanzapine, and risperidone has been reported in some but not all studies. It has been recently suggested that these reports are an artifact, related to lessening of the impairment due to typical neuroleptic drugs and anticholinergic agents. The purpose of this study was to further test the hypothesis that olanzapine, an atypical antipsychotic drug reported to have anticholinergic properties, improves cognition in patients with schizophrenia, including domains of cognition related closely to work and social function (ie, verbal learning and memory) and that this improvement is independent of improvement in psychopathology. Thirty-four patients with schizophrenia who were partial responders to typical antipsychotic drug treatment were evaluated with a comprehensive neurocognitive battery, including measures of executive functioning; verbal and visual learning and memory; working memory; immediate, selective, and sustained attention; perceptual/motor processing; and motor skills prior to and following treatment with olanzapine for 6 weeks. The Brief Psychiatric Rating Scale (BPRS) was used to assess psychopathology in patients treated with typical antipsychotic drugs. Subjects were switched to olanzapine (average dose 13.4 mg, range 5-20 mg) and reassessed following 6 weeks and 6 months of treatment. Significant improvement was noted in 9 of 19 cognitive tests, including measures of selective attention, verbal learning and memory, and verbal fluency. No cognitive test was worsened by olanzapine treatment. Improvements in the BPRS Total and Positive Symptom Subscale scores were noted. Improvements in verbal learning and memory, sustained attention, and psychomotor tracking were independent of improvement in psychopathology. These data suggest that olanzapine improved some but not all cognitive deficits in schizophrenia, including verbal memory, a cognitive domain impaired by anticholinergic drugs. The basis for the improvement in cognitive scores, which should lead to improvement in role functioning if real, is discussed.

Adult↗
PubMed2001

Reduced neuropsychologic measures as predictors of treatment outcome in patients with temporomandibular disorders.

AIMS: To determine via a prospective investigation whether the presence of neuropsychologic or cognitive deficiencies could be identified in patients with temporomandibular disorders (TMD) and used to predict treatment outcome. This was based on the theory that measurable reductions in neuropsychologic and cognitive function might have a negative impact on treatment outcome in patients with essentially nontraumatic TMD, as has been shown for patients with posttraumatic TMD. METHODS: Various neuropsychologic, psychosocial, and clinical parameters (including but not limited to the Peterson-Peterson Consonant Trigram Test and the California Verbal Learning Test) were used to pretest patients suffering from TMD prior to treatment. Patients were then entered into treatment, after which determination of treatment success was made both by the use of visual analog scales for pain and global transitional outcome measures (e.g., "better," responders versus "same/worse," nonresponders). After determination of treatment success was made, treatment response was correlated with the various clinical, cognitive, and neuropsychologic test scores. RESULTS: Overall, the nonresponders did worse in both the neuropsychologic and psychosocial assessments, with greater memory deficits, sleep disturbances, depression, and fatigue and lower energy levels as compared to responders. Among the best predictors of treatment outcome were the Peterson-Peterson Consonant Trigram Test scores, as well as the scores on the California Verbal Learning Test (i.e., poorer test outcomes predicted nonresponse). Neither responders nor nonresponders could be distinguished from one another based on clinical parameters of maximum interincisal opening or muscle tenderness. Three psychosocial variables were also found to be predictors of poor outcome: sleep disturbance, fatigue, and income. Pretreatment pain on chewing was also found to be a reliable predictor of poor treatment outcome. CONCLUSION: We conclude that various neuropsychologic, psychosocial, and some clinical parameters may provide pretreatment prediction of treatment outcome in an idiopathic TMD population.

Adolescent↗