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PubMed1998

Learning and memory difficulties after environmental exposure to waterways containing toxin-producing Pfiesteria or Pfiesteria-like dinoflagellates.

BACKGROUND: At the beginning of autumn, 1996, fish with "punched-out" skin lesions and erratic behaviour associated with exposure to toxins produced by Pfiesteria piscicida or Pfiesteria-like dinoflagellate species were seen in the Pocomoke River and adjacent waterways on the eastern shore of the Chesapeake Bay in Maryland, USA. In August, 1997, fish kills associated with Pfiesteria occurred in these same areas. People who had had contact with affected waterways reported symptoms, including memory difficulties, which raises questions about the human-health impact of environmental exposure to Pfiesteria toxins. METHODS: We assessed 24 people who had been exposed. We collected data on exposure history and symptoms, did a complete medical and laboratory assessment (13 people), and carried out a neuropsychological screening battery. Performance on neuropsychological measures was compared with a matched control group. RESULTS: People with high exposure were significantly more likely than occupationally matched controls to complain of neuropsychological symptoms (including new or increased forgetfulness); headache; and skin lesions or a burning sensation of skin on contact with water. No consistent physical or laboratory abnormalities were found. However, exposed people had significantly reduced scores on the Rey Auditory Verbal Learning and Stroop Color-Word tests (indicative of difficulties with learning and higher cognitive function), and the Grooved Pegboard task. There was a dose-response effect with the lowest scores among people with the highest exposure. By 3-6 months after cessation of exposure, all those assessed had test scores that had returned to within normal ranges. INTERPRETATION: People with environmental exposure to waterways in which Pfiesteria toxins are present are at risk of developing a reversible clinical syndrome characterised by difficulties with learning and higher cognitive functions. Risk of illness is directly related to degree of exposure, with the most prominent symptoms and signs occurring among people with chronic daily exposure to affected waterways.

Adult↗
PubMed2005

Assessment of story comprehension deficits after brain damage.

A story comprehension task was specifically developed for the clinical diagnosis of text comprehension deficits. The performance of 49 healthy control participants on qualitatively different Yes/No questions confirmed that both salience and explicitness of information had an impact on question difficulty. An unselected group of brain damaged patients (n = 96) made more errors, particularly on questions about implicit information. The subgroup of patients with left-hemispheric vascular aetiology (n = 18) had particular difficulties with stated details, patients with right-hemispheric vascular aetiology (n = 12) with implicit main ideas, and patients with traumatic brain injury (n = 34) were most impaired on implicit information. Correlations with neuropsychological test scores also confirmed that the questions successfully tapped different subprocesses of comprehension. Performance on implicit main ideas was correlated with tests of executive functions, whereas the performance on the other three question types was correlated with long-term memory and verbal learning. These results suggest that the story comprehension test is a useful diagnostic tool for neuropsychological assessment.

Adolescent↗
PubMed1998

First-language acquisition in adolescence: evidence for a critical period for verbal language development.

It has been hypothesized that there is a critical period for first-language acquisition that extends into late childhood and possibly until puberty. The hypothesis is difficult to test directly because cases of linguistic deprivation during childhood are fortunately rare. We present here the case of E.M., a young man who has been profoundly deaf since birth and grew up in a rural area where he received no formal education and had no contact with the deaf community. At the age of 15, E.M. was fitted with hearing aids that corrected his hearing loss to 35 dB, and he began to learn verbal Spanish. We describe his language development over the 4-year period since his acquisition of hearing aids and conclude that the demonstrates severe deficits in verbal comprehension and production that support the critical period hypothesis.

Adult↗
PubMed2005

Neurocognitive abilities in children with adenotonsillar hypertrophy.

OBJECTIVE: Sleep apnea is one of the most deleterious disorders in children with adenotonsillar hypertrophy because it can induce hypoxemia of brain. Sleep apnea may lead to failure to thrive or to physical and mental delay in development, including cognitive disturbances. The aim of this study was to analyze the influence of adenotonsillar hypertrophy, causing obstructive sleep apnea on neurocognitive abnormalities. We were interested in sensorimotor coordination, perception, memory, learning ability, concentration, focused attention and language reception. MATERIALS AND METHODS: We examined 221 children. One-hundred and seventeen children had sleep apnea caused by adenotonsillar hypertrophy: 87 children aged 6-9 years and 34 children aged 10-13 years. The control group, without adenotonsillar hypertrophy, consisted of 104 healthy children. Both groups of children with and without apnea were examined psychologically to determine abilities and minor neurocognitive deficit. The token test (TT), diagnosis test of brain dysfunction (DCS-test), Luria auditory verbal learning test (LAVLT) and Rey complex figure test (RCFT) were applied to both groups. The tests: TT, DCS-test, RCFT were used to investigate the level of sensorimotor integration and perception processes. Memory and learning abilities were measured using LAVLT. The TT assessed language dysfunction in children. RESULTS: This study shows that adenotonsillar hypertrophy in children aged 6-9 years is associated with neurocognitive abnormalities such as: memory problems, concentration of attention deficits, learning disability, language dysfunction, lower sensorimotor integration and perception. The older children (aged 10-13 years) with adenotonsillar hypertrophy had memory problems and learning disabilities. They are likely to be caused by of concentration of attention deficits. The older children were found to have more severe language dysfunction. CONCLUSIONS: Our study shows that sleep apnea may lead to neurocognitive deficits. The results may be helpful in the process of making decision for or against surgery in doubtful cases. It is important to know the problems connected with apnea in order to recognize them and help the child develop by providing adequate treatment and cognitive stimulation.

Adenoids↗
PubMed1999

The effect of cocaine on traumatic brain injury outcome: a preliminary evaluation.

The effect of acute cocaine use on the functional and neuropsychological outcome of persons with traumatic brain injury, (TBI) was examined by comparing persons with TBI who tested positive for cocaine at the time of admission with persons with negative drug and alcohol screens. Subjects were matched for age, admission GCS score, level of education, and aetiology of injury (closed vs penetrating head injury). Dependent measures were: the Disability Rating Scale, the Functional Independence Measure, and selected neuropsychological tests. No group differences were found in DRS, FIM, FIM subsets, or FIM change. However, the cocaine group scored significantly lower than the no-drug group on the Rey Auditory Verbal Learning Test, but did not differ on any of the other neuropsychological tests.

Adolescent↗
PubMedDate not supplied

Intravenous l-DOPA plus carbidopa in depressed patients: average evoked response, learning, and behavioral changes.

The peripheral decarboxylase inhibitor carbidopa (L-alphamethyl-dopa-hydrazine) allowed safe intravenous administration of L-DOPA in amounts sufficient to alter cortical average evoked response (AER) and learning function in 13 depressed patients. The apparently rapid conversion of L-DOPA to dopamine, as reported from studies in animals, is consistent with the 20-30 min onset of effects seen in our study. Unipolar and bipolar depressed patients responded differently to the alterations in brain biogenic amines and also to the nonspecific stress of the experiment. Intravenous L-DOPA given acutely had effects on the AER that were similar to those documented with oral dopa given chronically--an augmentation of amplitude--intensity slopes in unipolar patients and a relative reduction of slopes in bipolar patients. In contrast, intravenous L-DOPA did not enhance verbal learning as did chronic oral treatment, but rather was associated with reduced learning compared with placebo infusions. Different neurochemical changes following L-DOPA given in single intravenous doses may be responsible for the different learning and behavioral changes form those found previously with oral dopa administered chronically.

Administration, Oral↗
PubMed1997

Safety of intrahippocampal depth electrodes for presurgical evaluation of patients with intractable epilepsy.

PURPOSE: Intracerebral depth electrodes are used in preoperative evaluation of selected patients with intractable epilepsies. In spite of their usefulness, safety of depth electrodes is disputed, and the number of insertions is decreasing. This study examined retrospectively possible deleterious effects such as perioperative complications, induction of epileptogenesis, and neuropsychologic deficits. METHODS: Clinical course and neuroradiologic findings of 115 patients with bilaterally inserted longitudinal intrahippocampal depth electrodes (IDEs) were analyzed. Hippocampal resection specimens were examined histopathologically. To detect newly developed epileptogenic areas, EEG recordings, seizure control, and semiology after standardized resection procedures were compared between patients who received IDEs and those who did not. To demonstrate functional deficits caused by IDE insertion into an unaffected hippocampus of the speech-dominant hemisphere, changes of verbal learning and memory performances before and after right amygdalohippocampectomy were compared between patients evaluated with and without IDEs. RESULTS: Five significant complications without any permanent neurologic deficit were noted, and only one was specifically linked to IDE insertion. The tissue damage associated with the insertion was minimal and sharply circumscribed. No differences of seizure outcome after standardized resections were identified between patients with and without IDEs. In postoperative EEG recordings, there was no evidence of new epileptogenic areas. No verbal memory deficit caused by IDE implantation into the hippocampus of the speech-dominant hemisphere was detectable. CONCLUSIONS: Results indicate that it is safe to implant these IDEs in selected patients.

Adult↗
PubMedDate not supplied

The dose-response relationship for memory impairment by anticholinergic drugs.

Twelve stabilized chronic schizophrenic outpatients receiving maintenance treatment with fluphenazine decanoate plus anticholinergic antiparkinsonian drugs underwent two challenge sessions receiving, in random sequence and double-blind, injections of either benztropine or glycopyrrolate (a peripherally active anticholinergic agent that penetrates the CNS poorly, used as an active placebo). Performance on free recall testing was significantly worse after benztropine than after glycopyrrolate. It has previously been shown that routine clinical doses of anticholinergic antiparkinsonian drugs impair verbal learning relative to a drug-free baseline. Our results suggest that memory impairment continues to further increase as anticholinergic drugs are pushed to the upper limit of the acceptable clinical range.

Adult↗
PubMedDate not supplied

A comparison of spaced retrieval to other schedules of practice for people with dementia.

Spaced retrieval training uses a schedule of practice trials distributed according to a learner's performance. The authors compared spaced retrieval to four alternative schedules of practice to determine whether it is more effective than other schedules for people with dementia. Participants practiced (a) pill names or (b) nonverbal sequences. Spaced retrieval did not produce long-term retention more often than other schedules of practice on either task. Participants with higher scores on one portion of the Hopkins Verbal Learning Test-Revised were more likely to show long-term retention of pill names regardless of schedule of practice (Experiment 1).

Aged↗
PubMed2000

Mild hearing impairment can reduce verbal memory performance in a healthy adult population.

We studied to what extent immediate and delayed recall in an auditory verbal learning paradigm was affected by basic information processing speed (digit copying) and hearing acuity (average hearing acuity at 1, 2 and 4 KHz at the better ear). A group of 453 individuals in the age between 23 and 82 years with no overt hearing pathology was recruited from a larger study of cognitive aging (Maastricht Aging Study, MAAS). After controlling for age, sex, educational level, and processing speed it was found that a mild to moderate hearing loss predicted lower verbal memory performance. Auditory administered verbal memory tests can underestimate true memory performance, particularly in older individuals with unknown hearing status.

Adult↗
PubMed1996

Cognitive consequences of two-thirds anterior temporal lobectomy on verbal memory in 144 patients: a three-month follow-up study.

Previous studies have shown that left temporal lobectomy for intractable epilepsy can lead to verbal memory deficits. However, patients with left temporal lobe epilepsy (LTLE) frequently have impaired verbal memory preoperatively. The present analysis of 144 patients who underwent temporal lobe resections for either left (n = 68) or right (n = 76) temporal lobe epilepsy (LTLE, RTLE) addressed the questions of (a) whether a left two-thirds anterior temporal lobectomy (ATL) increases deficits in these qualitative aspects of verbal memory already impaired preoperatively, and (b) whether other aspects of verbal memory are additionally affected. We also evaluated possible determinants of preoperative abilities and postoperative changes, using multiple regression analysis. Preoperatively, patients with LTLE differed from patients with RTLE only in poorer performance on measures of long-term consolidation/retrieval (delayed recall). This is related to hippocampal pathology and seizure severity. Only left temporal lobe resections resulted in significant deterioration in verbal learning and memory. Acquisition over learning trials and recognition deteriorated most markedly, whereas performance in long-term consolidation/retrieval showed only minor changes. Preoperative performance levels, chronological age, the extent of the en bloc resection, preoperative performance on figural memory, and preoperative seizure severity were valuable determinants of postoperative changes in acquisition and recognition. In contrast, changes in consolidation/retrieval related only to preoperative ability. Left two-thirds ATL leads to new impairment in addition to preexisting memory deficits. The finding that left temporal lobectomy affects verbal acquisition and recognition more than long-term consolidation/retrieval, including the different determinants of these changes, most likely reflects the differential effects of surgery on mesial temporal and neocortical temporal functions.

Adult↗
PubMed2004

Depressed mood and memory impairment in temporal lobe epilepsy as a function of focus lateralization and localization.

OBJECTIVE: Memory disorders and depressed mood are prominent psychological symptoms of temporal lobe epilepsies (TLEs). We examined the interaction of depressive mood and memory as a function of focus localization. METHODS: One hundred fifty-two TLE patients with right mesial (n=37, RTLE-AHS), right lateral (n=31, RTLE-LAT), left mesial (n=42, LTLE-AHS), and left lateral (n=42, LTLE-LAT) lesions and epilepsies underwent comprehensive presurgical evaluation and neuropsychological assessment of mood and memory. Univariate and multivariate analyses of covariance (ANCOVAs) and partial correlation analyses were performed to reveal interactions of depression and memory as a function of focus localization. RESULTS: No differences between the study groups were revealed for depression, indicating a general risk of 30% for depressed mood (BDI>12) in patients with TLE. ANCOVAs revealed significant main effects of focus side (left: verbal learning deficits; right: figural learning deficits) and site (mesial at disadvantage) on learning and memory scores. Correlation analyses revealed interactions between memory and mood only in LTLE-LAT patients. CONCLUSIONS: Although the data provide evidence that side and site of the epileptogenic region differentially affect material specific memory performance, there was no evidence of a specific temporal target region for depressive mood. In the majority of the patients, depressed mood and memory impairment appeared as independent rather than as related symptoms of TLE. In LTLE-LAT, however, mood was significantly related to verbal and figural memory performance. Epilepsy-driven pathological left temporofrontal circuits are discussed as a prerequisite for the coupling of mood disorders and memory impairment in this specific patient subgroup which is also known from the psychiatric major depression syndrome.

Adult↗
PubMed2001

Enhanced verbal memory in nondemented elderly women receiving hormone-replacement therapy.

OBJECTIVE: This study examined the effects of hormone-replacement therapy on memory and other cognitive abilities in cognitively intact older women. METHOD: This prospective observational study in nondemented postmenopausal women aged 50-89 from the Baltimore Longitudinal Study of Aging involved study groups consisting of 103 women who were receiving oral or transdermal estrogen-replacement therapy (44 of whom were receiving adjuvant progesterone) and 81 women who had never received such therapy. Groups were naturally matched on education, health status, depressive symptoms, annual income, and general verbal ability. To restrict the study group to cognitively healthy women, prospective clinical data were used to exclude women who developed dementia up to 5 years after assessment. Data were cross-sectional. Multivariate analysis of variance and follow-up univariate analyses of variance were performed to compare those women who were receiving and those who had never received hormone-replacement therapy on measures of verbal memory, figural memory, mental rotations, attention, and working memory. RESULTS: The women receiving hormone-replacement therapy performed significantly better on measures of verbal learning and memory than did those who had never received hormones, but there were no significant differences in scores on other cognitive tests. Specific aspects of memory performance, including encoding and retrieval, were superior among the women receiving hormone therapy. CONCLUSIONS: These findings, based on groups of women who were receiving and had never received hormone-replacement therapy and who were naturally matched on health and cognitive status, suggest that hormone-replacement therapy may have a selective beneficial effect on verbal memory in older nondemented women.

Aged↗
PubMedDate not supplied

Acute effect of drugs upon memory of patients with senile dementia.

Memory has been tested in senile demented patients with the Rey Auditory Verbal Learning Test. The processus of memorization can be significantly facilitated in acute conditions by lysin-vasopressin, to a lesser degree by piracetam and highly worsened by scopolamine. No effect of physostigmine has been observed.

Aged↗
PubMed2003

Thalamic stimulation for tremor. Subtle changes in episodic memory are related to stimulation per se and not to a microthalamotomy effect.

The aim of this study was to investigate the impact of unilateral deep brain stimulation (DBS) of the ventrointermediate (Vim) thalamic nucleus on neuropsychological functioning comparing stimulation-on with stimulation-off conditions. Nine patients [five patients with Parkinson's Disease (PD), two patients with essential tremor (ET) and 2 patients with multiple sclerosis (MS)] underwent comprehensive neuropsychological testing for cognitive functions, including general mental impairment, aphasia, agnosia, executive and constructional abilities, learning, memory, cognitive processing speed and attention as well as depression. The neuropsychological assessments were performed at least 6 months postoperatively (mean 9 months). Testing in the stimulation-on and stimulation-off condition was obtained within a period of 3 to 4 weeks. Unilateral DBS resulted in improvement of tremor in all patients. There were no significant differences between the stimulation-on and the stimulation-off condition with the exception of a decrement of word-recall in the short delay free-recall subtest of the Rey Auditory-Verbal Learning Test (RAVLT). Subgroup analysis indicated that the impairment in word-recall was related to left-sided thalamic stimulation. Our study confirms that chronic unilateral DBS is a safe method with regard to cognitive function. The subtle changes in episodic memory are related to stimulation per se and not to a microthalamotomy effect.

Aged↗
PubMed1999

The effects of clozapine on cognitive functioning in schizophrenia.

Cognitive function may be markedly impaired in patients with schizophrenia; however, it has only recently been recognized as an important factor in determining patient outcome. Research has shown that improvements in cognitive functioning occur independently of improvements in positive or negative clinical symptoms, and whereas typical antipsychotics may improve clinical symptoms, they have little or no efficacy in improving cognitive dysfunction. However, there is evidence that the atypical antipsychotic clozapine may improve this core deficit of schizophrenia. This review summarizes 12 published studies that assessed the effect of clozapine on cognitive functioning. As a group, these studies suggest that psychomotor speed, verbal fluency, and verbal learning and memory may be improved by treatment with clozapine. Such cognitive improvements with clozapine treatment may offer an advantage to patients with schizophrenia by enhancing the possibility of better vocational functioning and quality of life.

Antipsychotic Agents↗
PubMed2005

Neuroanatomic correlates of CVLT-C performance following pediatric traumatic brain injury.

Traumatic brain injury (TBI) frequently results in memory problems, and the degree of memory impairment is related to injury severity and is commonly associated with lesions in frontal and temporal brain areas. This study examined the relationship among injury severity, brain lesions, and memory in children with moderate to severe TBI using Donders' (1999) 5-factor model of performance on the California Verbal Learning Test-Children's Version (CVLT-C). Seventy-six children underwent magnetic resonance imaging (MRI) scans 3 months post-TBI and testing 1 year post-TBI. Results showed injury severity (Glasgow Coma Scale) was not predictive of performance on 4 of the 5 factors. Volume of frontal and/or temporal brain lesions was significantly predictive of performance on 3 of the 5 factors. Unexpectedly, lesion volume outside these areas (extra-frontotemporal) was predictive of performance on all 5 factors. In contrast, Verbal IQ at 1 year was most strongly associated with preinjury factors (socioeconomic status and special education involvement), although extra-frontotemporal lesions also contributed to the variability in this measure. Results suggest that in children with moderate to severe TBI, extra-frontal/temporal lesions are predictive of memory outcome 1 year postinjury above and beyond initial severity or frontal/temporal contusions. This finding may relate to widespread diffuse axonal injury, which potentially disconnects brain circuits mediating memory following moderate to severe TBI.

Adolescent↗
PubMed1977

Rehabilitative treatment of hearing-impaired children.

The prevalence of hearing impairment and the educational effects of untreated hearing problems are described and the conditions required for verbal learning among severely and profoundly hearing-impaired children are outlined. Results of a longitudinal study undertaken at McGill University are briefly presented and the spoken language skills acquired by profoundly hearing-impaired children enrolled in this study are discussed.

Child↗