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PubMed2005

Effect of the dopamine D2 receptor T allele on response latency after mild traumatic brain injury.

OBJECTIVE: The authors tested the hypothesis that the dopamine D2 receptor T allele (formerly described as the A1 allele) would be associated with poorer performance on memory and attention tasks following mild traumatic brain injury. METHOD: Thirty-nine patients with mild traumatic brain injury and 27 comparison subjects were genotyped. All subjects completed memory and attention tests, including the California Verbal Learning Test recognition task and the Continuous Performance Test. RESULTS: In both groups the T allele was associated with poorer performance on the California Verbal Learning Test recognition task. There was also a significant diagnosis-by-allele interaction on measures of response latency (Continuous Performance Test): the subjects with mild traumatic brain injury and the T allele had the worst performance. CONCLUSIONS: Genetic polymorphisms modulating central dopaminergic tone can affect cognitive outcome following mild traumatic brain injury.

Adult↗

PubMed2003

Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment.

OBJECTIVES: This study examined the relationships of measures of cognitive functioning and psychiatric symptoms with work outcomes and use of vocational services for clients with schizophrenia in a supported employment program. METHODS: Thirty clients who were newly enrolled in a supported employment program were evaluated with cognitive and symptom measures at program entry and two years later. The clients' amounts of competitive work, wages earned, on-job support, and contact with employment specialists during the two-year follow-up period were documented. RESULTS: Predictors of clients' work outcomes included previous work history, amount of government entitlement income received, severity of negative symptoms, involvement in sheltered work activity at baseline, and level of cognitive functioning, including scores on measures of executive functioning and verbal learning and memory. The amounts of on-job support and contact with employment specialists were predicted by the cognitive domains of executive functioning, verbal learning, attention, and psychomotor speed as well as by the severity of psychotic symptoms. CONCLUSIONS: Clients with schizophrenia who have higher levels of cognitive impairment may require greater amounts of vocational support than those with lower levels of impairment. A variety of rehabilitation strategies may be required to improve vocational outcomes and reduce the amount of supported employment services needed by clients with schizophrenia.

Adult↗

PubMedDate not supplied

Further concurrent validity data on the Westmead PTA Scale.

Further data supporting the concurrent validity of the Westmead PTA scale is presented. The initial concurrent validation data on the Westmead PTA Scale study was based on two separate groups of traumatic brain injury patients. In order to ensure that the results of that study were not due to sampling differences between the groups related to different degrees of recovery as a consequence of varying times since trauma, further investigation of the concurrent validity was undertaken using a group of patients as their own controls, tested once while in post-traumatic amnesia (PTA) and again shortly after emerging from PTA. Thirty patients with severe traumatic brain injuries, who were still experiencing PTA as defined by their Westmead PTA Scale performance, were assessed on an independent test of verbal learning ability. Once out of PTA, as defined by their performance on the Westmead PTA Scale they were retested on a parallel form of the test of verbal learning. Their performance on the two occasions differed significantly providing further concurrent validation of the Westmead PTA Scale.

Journal Article↗

PubMed2006

A cross-sectional study to investigate long-term cognitive function in people with treated pituitary Cushing's disease.

INTRODUCTION: It has been proposed that exposure to high levels of endogenous steroids in untreated pituitary Cushing's disease damages hippocampal structures leading to impairment in learning and memory processes. We hypothesised that patients with treated pituitary Cushing's disease would perform significantly worse on tests of cognitive ability than those with nonfunctioning pituitary adenomas. DESIGN: Sixteen adults with pituitary Cushing's disease (PCD) and 16 adults with non-functioning pituitary adenomas (NFA) undertook the following comprehensive neuropsychological assessments: National Adult Reading Test (NART: premorbid abilities), California Verbal Learning Test (CVLT 2 UK: learning and recall), Stroop (executive functioning), Trail-Making Test (TMT: executive functioning and attention), Adult Memory and Information Processing Battery (AMIPB: Information Processing Speed and Story Recall subtests). RESULTS: There was no significant difference in premorbid IQ scores (NFA mean=101 SD=13; PCD mean=102, SD=13), in verbal learning nor any significant difference in the percentage of verbal material retained in story recall (AMIPB). Performance on higher executive tasks Stroop and TMT and on measures of information processing was similar. However, there were significant decrements between some mean scores for both groups and published normative data with a clear association between higher HADS depression scores and impaired objective memory and attention which was not specific to PCD. CONCLUSIONS: We found no difference in cognitive function between patients with PCD and NFA. The results suggest a discrepancy between patients' subjective perception of functional cognitive impairments and objective findings on psychometric testing and point to the influence of affective symptoms on cognitive performance, particularly in Cushing's disease.

Adult↗

PubMed2001

Evaluation of cognitive performance in the heat by functional brain imaging and psychometric testing.

Military operations in tropical environments have imposed a significant challenge to the Australian Defence Forces (ADF). The hot and humid conditions are known to cause debilitating effects on soldiers deployed to northern regions of Australia, with the consequence that the effectiveness and efficiency of operations are severely compromised. While the adverse effects of thermal stress on soldiers' physiological capability are well established, this has not been confirmed for cognitive performance. A select range of psychometric tests were administered and functional brain electrical activity imaging was performed to investigate the impact of thermal stress on cognitive performance. The brain electrical activity of subjects was measured while undertaking a range of cognitive tasks. Steady State Probe Topography (SSPT), a novel brain imaging technology, was employed to monitor the changes in regional brain activity and neural processing speed of subjects under thermal stress. The psychometric test batteries included the following tasks; Rey Auditory Verbal Learning Test; Inspection Time; Digit Span test; a spatial working memory task; and the AX-continuous performance task. These tasks measure a range of cognitive processes including attention, memory, verbal learning, information processing and concentration. The functional brain imaging provided topographical information, which showed changes in electrical activity in response to thermal stress during cognitive performance. These changes in brain electrical activity and neural speed induced by thermal stress may help to identify the type of cognitive functions that are likely to be impaired under operational conditions. Results indicated that subjects experienced increasing cardiovascular strain through thermally neutral to thermally straining conditions. The results from the psychometric test battery showed some promising effects given the small sample size including deficits in working memory, in information retention and in information processing. There was also marked differences in the electrical responses of the brain when subjects were thermally strained. The Steady-State Visual Evoked Potential recordings showed an increase in amplitude and a decrease in latency, suggesting an increase in the utilisation of neural resources or effort by subjects to maintain the same level of performance as under thermally neutral conditions. The data are suggestive of the high sensitivity of brain imaging techniques with high temporal resolution to identify important decrements in cognitive performance in hostile environments.

Adult↗

PubMed1984

The nature of lorazepam-induced amnesia.

The effect of lorazepam (2.5 mg) was assessed in two tests of short-term retention (digit-span and Benton Visual Retention), and in verbal learning and picture recognition tests. Lorazepam was without effect in a test of digit-span, but it impaired performance in the Benton Visual Retention and picture recognition tests. In the verbal learning test lorazepam caused a severe anterograde amnesia. Increasing arousal during the presentation of material partially overcame this effect, but also improved the performance of controls. Lorazepam-treated subjects were able to learn a backwards-reading task at a rate no different from controls. The deficits caused by lorazepam are similar to those that have been observed in patients with the amnesic syndrome.

Adult↗

PubMed2002

Working memory performance predicts subjective cognitive complaints in HIV infection.

The authors examined the contribution of working memory performance to subjective cognitive complaints in HIV infection beyond the influence of depressive symptoms. Thirty-six adults with HIV infection were administered neuropsychological (NP) tests of working memory, complex psychomotor efficiency, verbal learning, delayed recall, and questionnaires measuring depressive symptoms and cognitive complaints. Working memory performance, depression scores, and complex psychomotor efficiency were most strongly associated with self-reported cognitive complaints, whereas verbal learning scores and simple psychomotor efficiency showed more modest associations. Regression analyses revealed working memory performance to be the strongest NP predictor of self-reported cognitive complaints, comparable with depression scores in the amount of variance explained. These results suggest that working memory performance may be well suited to reflect how patients function in their everyday environment.

Adult↗

PubMed2004

Chronic MDMA (ecstasy) use, cognition and mood.

RATIONALE: It has been suggested that 3,4-methylenedioxymethamphetamine (MDMA or ecstasy) causes damage to the serotonergic system, and that this damage results in cognitive and mood impairments. OBJECTIVES: To examine the effect of chronic MDMA usage on a wide battery of cognitive tests and psychological abilities and processes. METHODS: In the present study, the performance of 17 participants with a history of MDMA use was compared to the performance of 15 control subjects on a battery of neuropsychological tests. This battery included tests for depression, immediate word recall, delayed recall, attention and working memory. RESULTS: Results indicated that the MDMA group had significantly higher scores for depression than the control group, and displayed poorer delayed recall and verbal learning than controls after accounting statistically for the effects of cannabis and depression. CONCLUSIONS: These results suggest that MDMA users exhibit difficulties in coding information into long-term memory, display impaired verbal learning, are more easily distracted, and are less efficient at focusing attention on complex tasks.

Adult↗

PubMed1983

Digoxin-related impairment of learning and memory in cardiac patients.

The relationship between the plasma level of the cardiac glycoside digoxin and performance on a range of cognitive tasks was investigated in a group of cardiac outpatients on maintenance therapy. The cognitive functions assessed were speed of decision-making and recognition memory of nonverbal and verbal material, competitive audio-visual attention performance, visuo-motor-choice reaction time and auditory verbal learning (AVL). Multiple regression analysis of the data revealed a strong relationship between plasma digoxin level at the time of testing and the number of trials to criterion in the AVL task (plasma digoxin level 0.7-1.8 nmol/l). Further data analysis indicated that this association was unlikely to be due to age, education or severity of cardiac disorder. The results strongly suggest that an increasing plasma level of digoxin may produce a progressive deterioration in auditory verbal learning and short-term memory.

Adult↗

PubMed2004

Cognitive and clinical predictors of success in vocational rehabilitation in schizophrenia.

Cognitive impairments in schizophrenia appear to be associated with social problem solving, social and vocational functioning, and psychosocial skill acquisition. The present study examined the relationship of cognitive functioning, as well as clinical symptoms, to vocational outcomes among individuals with schizophrenia. One hundred and twelve participants with DSM-IV schizophrenia spectrum diagnoses underwent a comprehensive neuropsychiatric evaluation after enrolling in one of several employment programs. The neuropsychological evaluation examined verbal learning and memory, attention, speed of information processing, and executive functioning. Clinical symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS). Vocational outcomes were assessed 4 months after baseline assessment and included both measures of employment outcome (e.g., earnings) and of work performance as assessed by the Work Behavior Inventory (WBI). Negative symptoms, learning and memory performance, processing speed, and executive functioning were related to hours, weeks, and wages earned on the job. Stepwise multiple regression analyses found that among baseline clinical and cognitive predictors, only verbal learning and memory and cognitive disorganization symptoms were significant predictors of work behaviors 4 months later. Learning and memory were the only significant predictors of integrated employment at 4 months. These results suggest specific aspects of cognition may be modestly predictive of vocational outcomes.

Achievement↗

PubMed2005

The implications of memory profiles in schizophrenia on vocational and neuropsychological functioning.

Studies in schizophrenia suggest that verbal learning and memory may distinguish three subgroups of patients: an unimpaired memory profile group and two groups that have memory profiles similar to those seen in cortical and subcortical dementias. Using the Hopkins Verbal Learning Test, Revised edition (HVLT-R), this study attempted to differentiate patients into three memory profile groups and to examine the validity of these groups with respect to vocational outcomes and neuropsychological functioning. Results from this study replicated previous findings and extended them by demonstrating a link to vocational outcome. In addition, the proportion of patients in each group closely resembled that obtained in previous studies. Specifically, the relatively unimpaired memory group (42%) showed overall better memory and neuropsychological performance than the two impaired groups, the subcortical group (38%) showed impaired recall but intact recognition and deficits in visuospatial functioning, and the cortical group (20%) showed deficits in recall, recognition, and sustained attention/executive functioning. There were no clinical differences between the three groups, but both the unimpaired and subcortical groups increased the number of hours worked following a vocational rehabilitation program. Given these differences, more research is warranted to explore the effect of memory impairment subtypes on vocational outcome measures.

Adult↗

PubMed2000

A revised spatial serial learning and memory procedure using Corsi's Block-tapping apparatus.

The purpose of this study was to use Corsi's Block Tapping Test as a spatial analog of Benton's Serial Digit Learning Test, using the cognitive neuroscience approach utilized in the California Verbal Learning Test. 60 normal participants, ages 19-52 years, were included and administered an 8-block sequence for 9 trials or until they recalled the entire sequence for 3 consecutive errorless trials. The score was the number of blocks tapped in the correct serial order. An interference trial was administered. Following a 10-min. delay, free recall of the original sequence, cued recall, and recognition measures were obtained. Retroactive interference was significant, but no proactive interference emerged. Scores showed a strong primacy effect. Most participants who learned the sequence to the criterion of three successive errorless trials recalled the sequence after the 10-min. delay. Scores on the cued recall and recognition trials tended to support their validity as less demanding retrieval tasks. The use of this spatial learning and memory procedure allows finer discriminations among nonverbal memory deficits and may facilitate direct comparisons with scores on verbal memory tasks such as Serial Digit Learning and the California Verbal Learning Test.

Adult↗

PubMed1996

Cognitive function in patients with sleep apnea after acute nocturnal nasal continuous positive airway pressure (CPAP) treatment: sleepiness and hypoxemia effects.

Patients with sleep apnea are typically hypersomnolent during the daytime and may demonstrate higher order cognitive dysfunction. A persistent problem in interpreting impaired neuropsychological test performance in such patients is whether the observed deficits can be explained wholly by impaired vigilance. We examined 37 sleep apnea patients prior to and immediately subsequent to successful sleep apnea treatment with nasal continuous positive airway pressure (CPAP). Patients were evaluated immediately after morning awakening in the sleep lab. A brief neuropsychological evaluation, was administered at that time. Following this, alertness was measured with a 30-min polysomnographically determined sleep latency test. Both test (approximately 50 min in duration) were performed once following a baseline (diagnostic) night in the sleep lab and once in the morning following a CPAP (therapeutic) night in the lab. Subgroup analyses indicted that while vigilance impairment can account for some of the decreased test performance seen in sleep apnea (auditory verbal learning) the effects of severe nocturnal hypoxemia appear to affect other function (sustained attention in repetitive arithmetic calculations) that were not easily modified by treatment. Thus, performance on the recall trial of the Rey Auditory Verbal Learning Test increased from pre-CPAP to post-CPAP for the increased alertness group but decreased significantly for the decreased alertness group. On the Wilkinson Addition Test, non-hypoxemic patients showed statistically significant improvement in problems correctly solved from pre-CPAP to post-CPAP, but the hypoxemic patients showed only a marginal increase. These results are compatible with other studies suggesting that patients having sleep apnea may incur deficits as a result of both decreased vigilance and hypoxemia, and that at least some of these deficits are immediately reversible.

Adult↗

PubMed2006

The neurocognitive effects of aripiprazole: an open-label comparison with olanzapine.

RATIONALE: Cognitive deficits are a core feature of schizophrenia. As a target of intervention, improvements in cognition may lead to improvements in functional outcome. OBJECTIVES: The present paper is the first report, to our knowledge, on the neurocognitive effects of aripiprazole. Unlike other second-generation antipsychotics, aripiprazole is a D(2) and D(3) receptor partial agonist. It is unknown what effects this unusual pharmacological profile may yield on neurocognition. MATERIALS AND METHODS: The present open-label study included data on 169 patients with schizophrenia or schizoaffective disorder who were randomly treated with aripiprazole or olanzapine. Subjects received a neurocognitive battery at baseline, week 8, and 26. RESULTS: The aripiprazole group had a significantly greater dropout rate than the olanzapine group. Neurocognitive data were reduced through a principal components analysis that yielded a three-factor solution. The factors were general cognitive functioning, executive functioning, and verbal learning. For general cognitive functioning, both groups improved from baseline and the effects were relatively stable over the 26-week protocol. There were no differential treatment effects. For executive functioning, neither group improved significantly from baseline. For verbal learning, the aripiprazole group improved significantly from baseline to the 8th and 26th week of assessment, and there was a between-group effect favoring aripiprazole over olanzapine that was largely attributable to the differences in performance within the 8th week. Separate analyses were conducted for a measure of sustained attention (Continuous Performance Test-Identical Pairs). There were no differential treatment effects on this measure. CONCLUSIONS: The findings from this open-label study suggest that the neurocognitive effects of aripiprazole are at least as good as those of olanzapine.

Adult↗

PubMed2006

Impairment of memory organization in patients with schizophrenia or schizotypal disorder.

Verbal learning and the organization of memory in patients with schizophrenia or schizotypal disorder were compared with normal subjects. Three indices of memory organization (semantic clustering, serial clustering, and subjective clustering) were calculated from participants' responses on the Japanese Verbal Learning Test. Schizophrenic and schizotypal patients showed similar decrements in semantic organization compared with normal subjects. Neither patient group showed any effect of learning on their use of semantic organization, although both groups recalled more items as the number of trials increased. These results suggest that impairment of memory organization is a common characteristic of schizophrenia spectrum disorders.

Adolescent↗

PubMed1982

Comparison of sign versus verbal symbol training in retarded adults.

Sign language as an alternative or as an augmentive system to verbal language training in the mentally retarded is in widespread use. This study began an exploration of the relationship between sign and verbal learning in 10 institutionalized severely mentally retarded adults. Three experimental groups were taught color labels. Three persons received sign training only, 4 more received verbal training only, and last 3 received combined verbal and sign training. Sign labels tended to be learned more efficiently than verbal labels by this small group. Combined sign and verbal training improved verbal learning whereas sign learning was not improved through the combined approach. Replication and extension of this preliminary work with a larger and more representative sample is needed.

Adult↗

PubMed1998

The differential effects of cueing on recall in Parkinson's disease and normal subjects.

Patients with Parkinson's disease (PD) are known to be impaired in supraspan verbal learning due to reduced availability of internal encoding capacity. PD patients may suffer from poor semantic, source and sequential processing capacity. Thirty-three patients with idiopathic PD and 42 matched normal control subjects (NC) were administered the California Verbal Learning Test under 3 conditions of graded cueing. While the PD patients benefited significantly and progressively from increasingly explicit cueing, the NC group did not since their performance was optimal even without cueing. Results are discussed in relation to frontal executive control of attentional resources and the establishment of encoding strategies.

Aged↗

PubMed1983

Cognitive functions in tardive dyskinesia.

Cognitive functions of psychiatric patients with and without tardive dyskinesia were evaluated using the Wechsler Adult Intelligence Scale, Wechsler Memory Scale and Rey Auditory Verbal Learning Test. Schizophrenic patients with and without tardive dyskinesia did not differ in their performance on the administered psychological tests. However, affective disorder patients with tardive dyskinesia showed significantly more impairment on the Wechsler Memory Scale and Rey Auditory Verbal Learning Test than affective disorder patients without tardive dyskinesia. These findings suggest that affective disorder patients who develop tardive dyskinesia may have some predisposing brain damage or that tardive dyskinesia in these patients represents both a motor and a dementing disorder.

Antipsychotic Agents↗