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Neuropsychological deficits in Parkinson's disease patients with visual hallucinations.

Recent neuropathological and neuroimaging studies suggest the involvement of several temporal regions in Parkinson's disease (PD) patients with visual hallucinations (VH). We examined 24 nondemented PD patients with VH, 21 PD patients without VH, and 21 healthy controls using a battery of tests assessing different aspects of temporal lobe function. PD patients with VH showed poorer performance in language, verbal learning, semantic fluency, and visuoperceptive functions compared to controls and PD patients without VH. Differences in verbal learning and visuoperceptive functions were independent of general cognitive status, disease severity, and depression. We suggest that a wide range of neuropsychological deficits can contribute to the emergence of VH in PD.

Aged↗

[Cognitive dysfunction following anterior communicating artery aneurysm rupture. Comparison with alcoholic Korsakoff syndrome on neuropsychological performance].

The present study aims to compare neuropsychological performance of patients following anterior communicating artery aneurysm rupture (ACoA) with that of patients with alcoholic Korsakoff syndrome (AKS). Fifteen ACoA patients and ten age-and education-matched AKS patients were included in the study. All the patients were tested at least one year post onset of their illness at a stable condition. The WAIS and forward digit span scores of AKS were also matched to ACoA, and simple attention and general intelligence were well preserved both in ACoA and AKS. Frontal function as measured by the Wisconsin card sorting test (Keio version) (KWCST) was equivalently impaired in the two groups. Anterograde memory as measured by Wechsler memory scale subtests, serial seven word learning test, Rey auditory verbal learning test, and logical memorizing test (Luria's paired word-picture association), was more severely impaired in AKS than ACoA in contrast to the comparable attention, intelligence, and frontal function: (1) memory tasks with low correlations to KWCST (serial word learning tasks and paired verbal associates), reflecting primary simple serial memorizing, and (2) memory tasks with high correlations to KWCST (logical memory and logical memorizing), reflecting higher and complicated strategic mnemonic activities. However, the correlations between these anterograde memory subtests and KWCST were substantially equivalent in ACoA and AKS. This suggests that the differences in anterograde amnesia demonstrated in ACoA and AKS may be of quantitative, not of qualitative property. The extent of deficits in semantic encoding as measured by Wickens' release from proactive interference paradigm (PI release) was also milder in ACoA than AKS. Both AKS and ACoA failed to show PI release in contrast to normal PI release demonstrated in age-matched ten healthy subjects. PI release in ACoA, however, was in between AKS and healthy subjects. The results were interpreted in the light of a recently postulated hypothesis that a combination of frontal lobe damage and memory impairment is crucial for causing a deficit in semantic encoding. The extent of damage in the memory circuit in ACoA may be variable, which may result in milder degree of anterograde amnesia and semantic encoding than AKS in the present study.

Alcohol Amnestic Disorder↗

The nature of learning and memory impairments in schizophrenia.

The California Verbal Learning Test was used to characterize the learning and memory impairment in schizophrenia (SC) and to evaluate potential clinical and demographic factors associated with this impairment. SC patients (n = 175) performed worse than normal comparison (NC) subjects (n = 229) on all learning, recall, and recognition memory measures. The most important clinical correlates of these impairments were earlier age of onset, more negative symptoms, and greater anticholinergic medication dosage. SC patients showed a prominent retrieval deficit as indicated by disproportionate improvement when tested in a recognition, rather than a free recall, format. A residual impairment seen with recognition testing suggests a mild encoding deficit as well. In contrast, the relative absence of a storage deficit is suggested by the lack of rapid forgetting. Using a discriminant function analysis that differentiates cortical dementia [i.e., Alzheimer's disease (AD)], subcortical dementia [i.e., Huntington's disease (HD)], and normals, it was found that 50% of the SC patients were classified as having a subcortical memory profile and 35% were classified as having a normal profile, whereas only 15% were classified as having a cortical memory profile. Although these findings reflect the clinical heterogeneity often found in SC, results suggest that most SC patients demonstrate a pattern of learning and memory impairments that resembles the pattern seen in patients with primary subcortical (specifically striatal) pathology.

Adult↗

Effects of chronic cocaine abuse on memory and learning.

Sixteen chronic (M = 5 years) weekly cocaine users who were at least 10 days (M = 20 days) abstinent were compared to age, education, race, and gender matched controls on the California Verbal Learning Test, Wechsler Adult Intelligence Scale-Revised (WAIS-R) Vocabulary, and Block Design. Subjects with developmental disorder, neurological, psychiatric, or other substance abuse history were excluded. Cocaine subjects learned and recalled fewer words than controls, but did not differ on IQ. Results suggested significant residual impairment in verbal learning efficiency subsequent to chronic cocaine use that results from memory storage difficulties rather than attentional impairment or general intellectual reduction. A dose-response relationship is suggested.

Journal Article↗

Physostigmine and cognition in schizotypal personality disorder.

There is evidence that reduced cholinergic activity may play a role in the pathophysiology of cognitive impairment in the schizophrenia spectrum. We tested the effects of physostigmine, an anticholinesterase inhibitor, on visuospatial working memory as evaluated by the Dot test, and on verbal learning and recall as measured by a serial learning task in patients with schizotypal personality disorder. Physostigmine tended to improve the Dot test, but not serial verbal learning performance in these patients.

Adult↗

Relations between visual and auditory continuous performance tests in a clinical population: a descriptive study.

Increased interest in auditory continuous performance tests (CPTs) exists despite the absence of a clear understanding about this procedure. The relation between auditory and visual CPTs and associations with IQ, achievement, and memory are evaluated in a referred sample of 634 children, ages 5.5 to 17.9. Age effects are found with CPT performance, regardless of modality. Total number correct or number of commissions correlations across tasks were greater than within-task number correct-number of commissions relations. The mean visual minus auditory correct difference score was 7.01; the mean commission difference score was -.85. Difference scores decreased with age and were not consistently related to other measures. Those with the lowest number correct on both CPTs (<25th percentile) were younger and had weaker short-term auditory memory and verbal learning skills; those falling in the problem quartile on commissions (>75th percentile) were younger and had poorer reading, verbal memory, and verbal learning. Total error scores (omissions + commissions) were inversely related to age. The auditory CPT has clinical utility, but other factors must be considered.

Achievement↗

Semantic and phonological coding in poor and normal readers.

Three studies were conducted evaluating semantic and phonological coding deficits as alternative explanations of reading disability. In the first study, poor and normal readers in second and sixth grade were compared on various tests evaluating semantic development as well as on tests evaluating rapid naming and pseudoword decoding as independent measures of phonological coding ability. In a second study, the same subjects were given verbal memory and visual-verbal learning tasks using high and low meaning words as verbal stimuli and Chinese ideographs as visual stimuli. On the semantic tasks, poor readers performed below the level of the normal readers only at the sixth grade level, but, on the rapid naming and pseudoword learning tasks, they performed below the normal readers at the second as well as at the sixth grade level. On both the verbal memory and visual-verbal learning tasks, performance in poor readers approximated that of normal readers when the word stimuli were high in meaning but not when they were low in meaning. These patterns were essentially replicated in a third study that used some of the same semantic and phonological measures used in the first experiment, and verbal memory and visual-verbal learning tasks that employed word lists and visual stimuli (novel alphabetic characters) that more closely approximated those used in learning to read. It was concluded that semantic coding deficits are an unlikely cause of reading difficulties in most poor readers at the beginning stages of reading skills acquisition, but accrue as a consequence of prolonged reading difficulties in older readers. It was also concluded that phonological coding deficits are a probable cause of reading difficulties in most poor readers.

Child↗

Active and passive P3 latency and psychometric performance: influence of age and individual differences.

The relationship of P3 latency of the event-related potential (ERP) to psychometric performance was investigated in 41 subjects who ranged in age from 20 to 88 years. P3 responses were recorded from subjects using an auditory oddball paradigm with and without task-demands. Subjects also received psychometric tests of verbal performance, visuospatial performance, concentration, and immediate, recent and remote memory. Factor analysis was used to reduce the set of psychometric measures to four factors (Verbal learning, general intelligence, narrative recall/fluency, and concentration). Both passive and active P3 latency showed a linear increase with age. Age was inversely correlated with verbal learning performance. After accounting for the influence of age, passive P3 latency correlated with the psychometric factor associated with narrative recall and verbal fluency. Active P3 latency was correlated with factors reflecting general intelligence and concentration. These findings suggest that cognitive processing speed contributes to psychometric performance in adults. The psychological or biological basis for this relationship remains to be identified.

Adult↗

Neuropsychological functioning in early onset psychotic disorders.

This paper examines whether neuropsychological profiles of youth with early onset psychotic disorders predicted diagnostic or clinical status. Youth with schizophrenia (n=27), bipolar disorder (n=22), and psychosis NOS (n=20) were included. Subjects received an extensive neuropsychological evaluation, including measures of general cognition, attention, memory, and executive functioning. Medication status was not controlled. No statistically significant neurocognitive differences across diagnostic groups were found. Compared to standardized norms, youth with schizophrenia demonstrated deficits in general cognition, verbal learning, recall, sustained effort, and social knowledge. Subjects with bipolar disorder and psychosis NOS exhibited deficits on measures of verbal learning, recall, and sustained effort similar to those of youth with schizophrenia. Neurocognitive deficits in memory and attention appeared to be common among youth with psychotic illnesses, regardless of diagnosis. Those with schizophrenia may have greater global cognitive deficits and problems with social knowledge. Across diagnoses, subjects demonstrated relative strengths on tests that provided them with immediate feedback, and performed most poorly on tests requiring delayed recall.

Adolescent↗

Learning and memory in Holocaust survivors with posttraumatic stress disorder.

BACKGROUND: Impairments in explicit memory have been observed in Holocaust survivors with posttraumatic stress disorder. METHODS: To evaluate which memory components are preferentially affected, the California Verbal Learning Test was administered to Holocaust survivors with (n = 36) and without (n = 26) posttraumatic stress disorder, and subjects not exposed to the Holocaust (n = 40). RESULTS: Posttraumatic stress disorder subjects showed impairments in learning and short-term and delayed retention compared to nonexposed subjects; survivors without posttraumatic stress disorder did not. Impairments in learning, but not retention, were retained after controlling for intelligence quotient. Older age was associated with poorer learning and memory performance in the posttraumatic stress disorder group only. CONCLUSIONS: The most robust impairment observed in posttraumatic stress disorder was in verbal learning, which may be a risk factor for or consequence of chronic posttraumatic stress disorder. The negative association between performance and age may reflect accelerated cognitive decline in posttraumatic stress disorder.

Aged↗

Changes over time in memory, processing speed and clock drawing tests help to discriminate between vascular cognitive impairment, mild cognitive impairment and Alzheimer's disease.

Measures of cognitive change over time may help to better discriminate between mild cognitive impairment, Alzheimer's disease and vascular cognitive impairment than single assessments. Our hypothesis was that performance in processing speed and executive function would decline with mild cognitive impairment and Alzheimer's disease. Subjects included 36 controls, 18 cases with mild cognitive impairment, eight with vascular cognitive impairment and 24 with Alzheimer's disease who were tested on a cognitive battery at two episodes with a 12-month interval. Changes in performance were determined for each group with paired means tests. Controls improved in pattern comparison speed and the CLOX, a clock-drawing task to detect dysexecutive function. Those with vascular cognitive impairment declined in letter comparison speed, but improved in paragraph recall. Alzheimer's disease patients declined in CLOX and the Hopkins Verbal Learning Test. The mild cognitive impairment group showed no significant changes. Alzheimer's disease patients on treatment declined in Hopkins Verbal Learning Test, while those without treatment declined in The Placing Test and CLOX. Processing speed decline may be a marker of cerebrovascular disease, while decline in memory and executive function was more evident with Alzheimer's disease.

Aged↗

[Mnemonic performance in mild traumatic brain injury].

INTRODUCTION: Over the past few years there has been a lot of discussion over whether the mnemonic disorders that can appear after a mild traumatic brain injury (TBI) present as transitory deficits or can remain as permanent sequelae. AIMS: To study whether there are mnemonic disorders in mild TBI or not, and to examine their evolution over the first year. PATIENTS AND METHODS: 60 adult subjects of both sexes with mild TBI, all of whom satisfied the criteria of the Mild Traumatic Brain Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine, were studied at four different moments of their evolution (during the first seven days, at one month, at six months and at one year after the traumatism). The sample was completed with 60 normal adult subjects who shared similar demographic characteristics. MATERIAL: clinical scales for measuring TBI, cognitive screening tests and neuropsychological mnemonic tests that measure verbal learning, immediate and delayed logical verbal memory, visuospatial and visuo constructive memory. STATISTICAL ANALYSIS: data were analysed using ANOVA of repeated measures and a posteriori testing using Scheffe F test. CONCLUSIONS: Memory was affected in these patients for at least the first week after the traumatic injury took place. At one month, immediate and delayed logical verbal memory and visuo constructive memory showed cognitive performances that were similar to the control group. Learning and the verbal auditory capacity to retain a list of words were still altered one year after the traumatic injury occurred.

Adolescent↗

Atypical neuropsychological profile in a boy with 22q11.2 Deletion Syndrome.

In this article the general and specific cognitive impairments of the boy R.H. with a de novo deletion 22q11.2 are described. His full-scale IQ was 73, and he obtained only slightly better verbal than non-verbal subtest scores. Neuropsychological assessment revealed specific impairments in perceptual categorization of objects presented suboptimal, matching of unfamiliar faces, and verbal learning and memory. In contrast, he performed in accordance with his intelligence level on other visual perceptual tasks, on non-verbal learning and memory tasks, and on attention tasks. Voxel-wise statistical comparison of a high-resolution T1-weighted magnetic resonance image of R.H's brain with similar images obtained from 14 normal control children revealed as major abnormalities a reduction of the right inferior parietal and superior occipital lobe, and a bilateral reduction of deep white matter behind the inferior frontal gyrus. These cognitive impairments and MRI abnormalities are not commonly described in 22q11.2 Deletion Syndrome and may indicate a larger heterogeneity in the neurocognitive phenotype than currently evidenced. At least in this boy the microdeletion seems to have interfered with the development and functioning of particular neural subsystems, while the structure and functioning of other subsystems was left intact.

Attention Deficit Disorder with Hyperactivity↗

Cognitive effects of chronic exposure to lead and solvents.

BACKGROUND: Occupational exposure to lead and solvents has declined steadily over the past 20 years, however, construction workers continue to be exposed to these neurotoxicants. The purpose of this study was to investigate the cognitive effects of chronic occupational exposure to lead and solvents. METHOD: Based on K-XRF of tibial bone lead and occupational history of solvent exposure, subjects were classified into four exposure groups: lead (N = 40), solvent (N = 39), lead/solvent (N = 45), and control (N = 33). All subjects completed tests to assess concentration, motor skills, memory, and mood. RESULTS: Relative to controls, the lead, solvent, and lead/solvent groups performed significantly more poorly on a test of verbal memory, while the lead and lead/solvent groups were slower than the solvent and control groups on a task of processing speed. Bone lead was a significant predictor of information processing speed and latency of response while solvent exposure was a significant predictor of verbal learning and memory. CONCLUSIONS: Bone lead was associated with slower speed of processing while exposure to lead and/or solvents reduced efficiency of verbal learning.

Affect↗

Verbal discrimination learning as a function of brain damage, aging, and institutionalization.

The relationship between young non-brain-damaged nonpatients, elderly non-brain-damaged patients and elderly brain-damaged patients and the acquisition and extinction of verbal discrimination conditioned responses were investigated in this study. Four groups of 10 Ss each were used: one group of elderly brain-damaged patients with no speech impairment; one group of elderly non-brain-damaged patients; and one group of young nonpatient Ss used as a comparison group. The three elderly, brain-damaged and non-brain-damaged groups were unable to make a simple verbal discrimination, while the younger nonpatient group had a nearly perfect record of discrimination responses. No significant differences were obtained between the three elderly patient groups.

Adult↗

Verbal memory in schizophrenia: sex differences over repeated assessments.

There is conflicting evidence regarding the presence and direction of gender differences in verbal memory capacity in schizophrenia. We examined gender differences in verbal memory performance in schizophrenia and their interactions with repeated assessments and psychiatric symptoms. California Verbal Learning Test (CVLT) data were collected from 28 outpatients diagnosed with schizophrenia. The CVLT was administered on five occasions, 3 months apart. CVLT data were examined using repeated measures analyses, using maximum likelihood estimates, with Brief Psychiatric Rating Scale (BPRS) scores at assessments 1-5 as a time-varying covariate. There were significant main effects of time and gender, with scores improving over time, and women performing better than men. There was also a significant time by gender interaction. The BPRS covariate effect was not significant. Results are discussed in terms of implications for gender-informed approaches to rehabilitation treatments.

Adolescent↗

Declarative memory following anterior temporal lobectomy in humans.

This study hypothesized that verbal memory decline following anterior temporal lobectomy (ATL) is associated with a lack of significant neuropathology in resected left, but not right, hippocampus and is limited to measures of episodic memory only. Tests of immediate (digit span), semantic (visual naming), and episodic memory as measured by the California Verbal Learning Test (CVLT) were administered before and 6 months after resection of the anterior left (n = 36) or right (n = 26) temporal lobe. There were no effects of hippocampal pathology on measures of immediate or semantic memory for either ATL group or for episodic memory for the right ATL group. Left ATL patients who demonstrated no/mild hippocampal sclerosis exhibited significantly greater postoperative decline in episodic memory compared with those with moderate/marked hippocampal sclerosis on multiple CVLT indices (recall measures, learning characteristics, and contrast measures).

Adult↗