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PubMed2006

Neuropsychological differentiation of dementia with Lewy bodies from normal aging and Alzheimer's disease.

We examined the diagnostic utility of selected neuropsychological measures in the differentiation of dementia with Lewy bodies (DLB) from normal aging and Alzheimer's disease (AD). Patients with DLB (n = 87), AD (n = 138), and a group of normal controls (n = 103) were recruited from the Mayo Alzheimer's disease patient registry and Alzheimer's Disease Research Center. Neuropsychological measures shown to have utility in previous studies were included in the analysis. The final multivariate logistic regression model distinguishing DLB from normal controls included Auditory Verbal Learning Test (AVLT) percent retention, Block Design, Trail Making Test-Part A, and Benton Visual Form Discrimination. This model has a sensitivity of 88.6% and specificity of 96.1%. The final multivariate logistic model distinguishing DLB from AD included Trail Making Part A, Boston Naming Test (BNT), AVLT percent retention, and copy of the Rey-Osterrieth Complex Figure. This model had a sensitivity of 83.3% and a specificity of 91.4%. AVLT and BNT had negative coefficients, indicating that lower scores decreased the likelihood of DLB relative to AD. These finding extend prior research suggesting a cognitive profile that can aid in the clinical diagnosis of DLB. Early attention and visual perceptual disturbance suggests DLB, while early impairment in memory and naming suggests AD.

Aged↗
PubMed1999

The relationship between auditory ERP and neuropsychological assessments in schizophrenia.

To clarify the cognitive significance of event-related potential (ERP) abnormalities in schizophrenia, we examined the relationships of amplitudes and latencies of ERP components with performance on neuropsychological tests in schizophrenic patients. Twenty patients underwent the Trail Making B Test (TM-B), which is sensitive to frontal lobe dysfunction, and the logical memory, verbal paired-association, and visual reproduction subtests of the Wechsler Memory Scale (WMS), which are sensitive to temporal lobe dysfunctions, and ERP recordings during performance of an oddball auditory discrimination task. Pearson product-moment correlations indicated that an increased P200 amplitude was correlated with poor performance on the TM-B, whereas a decreased P300 amplitude was correlated with poor performance on the verbal paired-association subtest of the WMS. These findings suggest that a P200 abnormality represents the frontal lobe dysfunction, and a P300 abnormality represents the left temporal lobe dysfunction in schizophrenia.

Adolescent↗
PubMed1991

A controlled trial of propoxyphene and naltrexone in patients with Tourette's syndrome.

To investigate the effect of drugs acting on the endogenous opioid system, we studied 10 adults with Tourette's syndrome who received propoxyphene hydrochloride (260 mg/day), naltrexone hydrochloride (50 mg/day), and placebo in a double-blinded, randomized clinical trial. Using a self-report scale (Tourette's Syndrome Symptom List), subjects noted a significant (p less than 0.04) lessening of tics after treatment with naltrexone when compared with placebo. An improvement in performance on the Trail Making B test, a measure of attention and visuomotor sequencing and planning, occurred after receiving naltrexone when compared with placebo (p less than 0.08) or propoxyphene (p less than 0.02). The Trail Making B test best discriminated the treatments (p less than 0.02, analysis of variance). No other treatment effects were observed for several other measures of tic severity, attentional ability, or obsessive-compulsive symptoms. Our findings indicate that pharmacological manipulation of the endogenous opioid system does influence symptoms of Tourette's syndrome.

Adult↗
PubMed1983

Neuropsychological impairment scale (NIS): initial validation study using trailmaking test (A & B) and WAIS digit symbol (scaled score) in a mixed grouping of psychiatric, neurological, and normal patients.

Described a 50-item, self-administered neuropsychological screening test with test results correlating with three reference measures for three participant groupings--Normals (N = 22), Psychiatric patients (N = 21) and Neurological patients (N = 14). Results suggest that neuropsychological self-description can correlate with performance measures that are known to be sensitive to cognitive impairment.

Adult↗
PubMed2003

Neuropsychological effects of long-term opioid use in chronic pain patients.

Opioids are thought to worsen the performance of psychomotor tasks due to their sedating and mental-clouding effects. As a result, some safety regulations currently restrict the use of opioids when driving or using heavy equipment. We investigated the psychomotor effects of long-term opioid use in 144 patients with low back pain. All subjects were administered two neuropsychological tests (Digit Symbol and Trail Making Test-B) before being prescribed opioids for pain; tests were re-administered at 90- and 180-day intervals. Test scores significantly improved while subjects were taking opioids for pain, which suggests that long-term use of oxycodone with acetaminophen or transdermal fentanyl does not significantly impair cognitive ability or psychomotor function.

Adult↗
PubMedDate not supplied

Quantification of lumbar function. Part 6: The use of psychological measures in guiding physical functional restoration.

The present article reviews the use of psychologic measures in guiding a functional restoration treatment program with chronic low-back pain patients. The results of the first 134 consecutive patients completing this program are reviewed. These results demonstrate that various psychologic measures paralleled improvement in physical function. Of particular interest is the finding that various Minnesota Multiphasic Personality Inventory (MMPI) scales that were initially clinically elevated showed a significant decrease to nonelevated levels after treatment. The clinical implications of these findings are discussed, along with the important observation that one should avoid assuming that a single psychologic test can reliably be used as the sole predictor variable in clinical cases.

Achievement↗
PubMed2003

Effects of acute tryptophan depletion on executive function in healthy male volunteers.

BACKGROUND: Neurocognitive impairment is frequently described in a number of psychiatric disorders and may be a direct consequence of serotonergic dysfunction. As impairments in executive functions are some of the most frequently described, the purpose of this study was to examine the performance of normal volunteers on a range of executive tasks following a transient reduction of central serotonin (5-HT) levels using the method of acute tryptophan depletion (ATD). METHODS: Fifteen healthy male subjects participated in a within-subject, double-blind, counterbalanced crossover study. ATD was induced by ingestion of a 100 g amino-acid drink. Executive function was evaluated using the Wisconsin Card Sorting Test, Stroop, Verbal Fluency and Trail Making. Visual analogue scales were administered to assess mood. RESULTS: Plasma free and total tryptophan concentrations were significantly reduced by the depleting drink (P < 0.001). ATD selectively improved motor speed/ attention on the Trails A test (P = 0.027), with no effect on subjective ratings of mood. Interaction effects between drink and the order of drink administration were observed on most neurocognitive tests. CONCLUSIONS: The improvement in simple motor speed/ attention following ATD is in keeping with the ascribed role of 5-HT in the cortex, however performance on tests of executive function is not robustly altered. The presence of interaction effects on most tasks suggests that subtle changes may occur but are masked, possibly by simple learning effects, in the context of a crossover design. This has implications for the design of future studies, particularly those examining executive functions.

Adolescent↗
PubMed1993

HIV-related ocular microangiopathic syndrome and cognitive functioning.

Ocular microangiopathic syndrome is found frequently in patients with AIDS or severe HIV infection. Symptoms of this microvascular syndrome can include cotton-wool spots, hemorrhages, and Roth's spots. The clinical and functional significance of HIV-related ocular microangiopathic syndrome has not been clarified as yet. The objective of this study was to evaluate a possible association between HIV-related ocular microangiopathic syndrome and cognitive functioning. Thirty-seven patients infected with HIV (24 with AIDS) underwent ophthalmological and neuropsychological examination. HIV-related ocular microangiopathic syndrome was measured by counting the number of cotton-wool spots in both eyes. Neuropsychological examination included five standardized tests, with the first three primarily measuring function of short-term memory; these tests were as follows: the Auditory-Verbal Learning Test, the Benton Test, the Stroop Colour Word Test, the Trail-Making Part B test, and the Vocabulary for Measuring Premorbid Intelligence test. HIV-related ocular microangiopathic syndrome was found in 15 patients with AIDS (62.5%), and in one patient, staged Walter Reed 5. In 10 patients, one eye was affected (mean count of cotton-wool spots 1.5). In six patients, both eyes were affected (mean count of cotton-wool spots 7.0). Univariate correlations between the number of cotton-wool spots in both eyes and test scores were as follows: Auditory-Verbal Learning Test: 0.56 (p < 0.001); Benton Test: 0.51 (p < 0.001); Stroop Colour and Word: 0.50 (p < 0.001); Trail-Making Part B: 0.15 (not significant); Vocabulary for Measuring Premorbid Intelligence: -0.05 (not significant). Multiple correlation between the test scores and the number of cotton-wool spots was 0.70 (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

Relationship of age and hypertension to neuropsychological test performance.

Young adult (X- = 29) and middle aged (X- =50) hypertensive and normotensive subjects were compared with respect to seven neuropsychological test scores derived from tests on the Halstead-Reitan battery. Age main effects, with inferior performance for the middle aged subjects, were observed for the localization and time portions of the Tactile Performance Test (TPT) and for the Trail Making A test. The multivariate age effect was significant for the composite of seven scores. A multivariate blood pressure main effect was obtained and main effect blood pressure was significant for the category test; hypertensives made more errors than normotensives. A blood pressure by age interaction was observed for finger tapping scores and the TPT-Memory scores with larger differences between hypertensives and normotensives for the younger than for the middle aged group. Results were discussed in terms of previous studies of age and hypertension with the WAIS, the Primary Mental Abilities Test and serial reaction time measures. The poor prediction of hypertensive status from individual neuropsychological test scores was emphasized and readers were cautioned not to conclude that essential hypertensives, as a group, can be characterized as brain damaged.

Adult↗
PubMed1992

Cognitive function, insulin-dependent diabetes and hypoglycaemia.

A series of seven psychometric tests, to evaluate mental concentration and the ability to retain selective attention, lexical fluency, wordlist memorizing and psychomotor speed, was performed on 25 non-diabetic control subjects and 55 insulin-dependent diabetes (IDD) patients of similar social background and professional status. When tested, none of the diabetics was hypoglycaemic and these patients were divided into two groups: Group I: 30 IDD patients unaware of hypoglycaemia, and experiencing frequent and severe episodes of hypoglycaemia. Group II: 25 IDD patients aware of hypoglycaemia. Groups I and II had experienced the disease for the same period of time (17 +/- 13 vs. 14 +/- 11 years, respectively) and they had similar HbA1c levels (7.14 +/- 1.25% vs. 8.6 +/- 1.88%, respectively) and degenerative complications. Compared with the scores of the controls, the Group I scores were lower in four tests: trail-making part A (psychomotor speed; P less than 0.001) and part B (retaining selective attention; P less than 0.01), lexical fluency (P less than 0.01) and Rey auditory-verbal learning test (wordlist learning; P less than 0.05). Group II scores were lower in two tests: trail-making part A (P less than 0.01) and part B (P less than 0.05). In word memorizing, the performance of Group I was inferior to that of Group II (P less than 0.05). In general, these psychometric tests showed that IDD scores were lower than those of the controls, with an average of 67% for Group II and 80% for Group I. Chronic hyperglycaemia and severe hypoglycaemia may have a deleterious effect on cognitive performance. In particular, several severe episodes of hypoglycaemia could be responsible for permanent memory impairment.

Adolescent↗
PubMed2005

Citalopram versus sertraline in late-life nonmajor clinically significant depression: a 1-year follow-up clinical trial.

OBJECTIVE: The aim of this study was to compare over 1 year the effect of sertraline and citalopram on depressive symptoms and cognitive functions of nondemented elderly patients with minor depressive disorder and subsyndromal depressive symptomatology. METHOD: We recruited 138 consecutive non-demented outpatients of either sex, aged > or =65 years, who were classified as meeting research criteria for minor depressive disorder or sub-syndromal depressive symptomatology using the Structured Clinical Interview for DSM-IV. Subjects were assigned to receive citalopram 20 mg/day (66 patients) or sertraline 50 mg/day (72 patients) orally for 1 year. Patients were assessed at baseline and after 1, 2, 3, and 6 months and at 1 year by raters masked with regard to patients' treatment assignments. The Hamilton Rating Scale for Depression, the Geriatric Depression Scale, and the Global Assessment of Functioning were administered to assess the course of depressive symptoms and social functioning during the study. Cognitive measures included Trail Making Test-Parts A and B, Wechsler Memory Scale, Mini-Mental State Examination, and a verbal fluency test. Data were collected from March 2000 to March 2003. RESULTS: The overall completion rate was 72%. Both treatments induced a significant, sustained, and comparable improvement in depressive symptoms and in social functioning. Nearly half of the subjects in the 2 groups achieved remitter status at study endpoint. Significant within-group improvements also were observed in all cognitive measures. Both drugs were well tolerated during the whole study period. CONCLUSION: Our results suggest that sertraline and citalopram can improve depressive symptoms and cognitive functions of minor depressive disorder and subsyndromal depressive symptomatology in elderly nondemented patients.

Age Factors↗
PubMed1976

Retest reliability of the Halstead Impairment Index in a normal, a schizophrenic, and two samples of organic patients.

In a 1974 study Matarazzo, et al. reported the test-retest reliability of the Halstead-Reitan Neuropsychological Battery for a sample of normal young men and a comparison group of older Ss with cerebrovascular disease. The present study extended this earlier one by addition of comparable test-retest findings from two additional comparison groups: a sample of chronic schizophrenic Ss and a sample of organic patients who underwent endarterectomy. Despite the lack of comparability across the four samples on many dimensions, including age and test-retest interval, the results again reveal a high degree of clinical as well as purely psychometric reliability for most of the tests in the neuropsychological battery and the additional suggestion for further research that the test-retest instability found for some of the Ss in the schizophrenic sample may, itself, hold promise of differential clinical significance in the diagnosis of a "schizophrenic" vs. "organic" process.

Auditory Perception↗