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PubMed2005

Cognitive correlates of cortical cholinergic denervation in Parkinson's disease and parkinsonian dementia.

We recently reported findings that loss of cortical acetylcholinesterase (AChE) activity is greater in parkinsonian dementia than in Alzheimer's disease (AD). In this study we determined cognitive correlates of in vivo cortical AChE activity in patients with parkinsonian dementia (PDem, n = 11), Parkinson's disease without dementia (PD, n = 13), and in normal controls (NC, n = 14) using N-[(11)C]methyl-piperidin-4-yl propionate ([(11)C]PMP) AChE positron emission tomography (PET). Cortical AChE activity was significantly reduced in the PDem (-20.9%) and PD (-12.7 %) subjects (P < 0.001) when compared with the control subjects. Analysis of the cognitive data within the patient groups demonstrated that scores on the WAIS-III Digit Span, a test of working memory and attention, had most robust correlation with cortical AChE activity (R = 0.61, p < 0.005). There were also significant correlations between cortical AChE activity and other tests of attentional and executive functions, such as the Trail Making and Stroop Color Word tests. There was no significant correlation between cortical AChE activity and duration of motor disease (R = -0.01, ns) or severity of parkinsonian motor symptoms (R = 0.14, ns). We conclude that cortical cholinergic denervation in PD and parkinsonian dementia is associated with decreased performance on tests of attentional and executive functioning.

Acetylcholinesterase↗
PubMed1981

Combining psychometric data on brain damage and the influence of aging.

60 young and middle-aged patients (age 20 to 52 yr.) with generalized and chronic brain damage were individually matched for age, social class, education, and occupational history with normal control subjects with no history of brain damage. Both groups were given a battery of cognitive tests which included Clément's Digit Code test, Memory-for-Designs, Trail Making, the Spiral Aftereffect, Elithorn's mazes, Mill Hill vocabulary, Progressive Matrices, and the Synonym test. The discriminative efficiency of each measure was examined individually and in combination using discriminant function analysis. The most efficient individual discriminator was the Digit Code. When this was combined with the Trail Making Part B, correct over-all classification was 80%. No other addition improved discrimination significantly. Thus a battery of tests taking 10 min. to administer was as effective as the larger battery which took more than 2 hr. The gradient of test scores with age was examined cross-sectionally for each measure. For most tests, gradients were larger for the brain-damaged than for the control group.

Adult↗
PubMed1990

Chronic neurobehavioural effects of toluene.

Neurobehavioural tests were undertaken by 30 female workers exposed to toluene and matched controls with low occupational exposure to toluene. The environmental air levels (TWA) of toluene was 88 ppm for the exposed workers and 13 ppm for the controls. The toluene in blood concentrations for the exposed workers was 1.25 mg/l and for the controls 0.16 mg/l. Statistically significant differences between workers exposed to toluene and controls in neurobehavioural tests measuring manual dexterity (grooved peg board), visual scanning (trail making, visual reproduction, Benton visual retention, and digit symbol), and verbal memory (digit span) were observed. Further, the performance at each of these tests was related to time weighted average exposure concentrations of air toluene. The workers exposed to toluene had no clinical symptoms or signs. The question arises as to whether these impairments in neurobehavioural tests are reversible or whether they could be a forerunner of more severe damage.

Adult↗
PubMed1992

Chronic neurobehavioural effects of elemental mercury in dentists.

Neurobehavioural tests were performed by 98 dentists (mean age 32, range 24-49) exposed to elemental mercury vapour and 54 controls (mean age 34, range 23-50) with no history of occupational exposure to mercury. The dentists were exposed to an average personal air concentration time weighted average (TWA) of 0.014 (range 0.0007-0.042) mg/m3 for a mean period of 5.5 (range 0.7-24) years and had a mean blood mercury concentration of 9.8 (range 0.6-57) micrograms/l. In neurobehavioural tests measuring motor speed (finger tapping), visual scanning (trail making), visuomotor coordination and concentration (digit symbol), verbal memory (digit span, logical memory delayed recall), visual memory (visual reproduction, immediate and delayed recall), and visuomotor coordination speed (bender-gestalt time), the performance of the dentists was significantly worse than that of the controls. The dentists scored 3.9 to 38.9% (mean 13.9%) worse in these tests. In trail making, digit span, logical memory delayed recall, visual reproduction delayed recall, and bender-gestalt time test scores were more than 10% poorer. In each of the tests in which significant differences were found and in the block design time, the performance decreased as the exposed dose (product of the TWA of air mercury concentrations and the years of exposure) increased. These results raise the question as to whether the current threshold limit value of 0.050 mg/m3 (TWA) provides adequate protection against adverse effects of mercury.

Adult↗
PubMedDate not supplied

Neurobehavioral impairment and seizures from formaldehyde.

Three patients were evaluated for effects of formaldehyde on central nervous system function. Three patients had used formalin, formaldehyde with or without phenol, to fix whole animals for 14-30 y, and a fourth patient was covered several times by formaldehyde and phenol rainout from manufacturing spills. All were disabled, and two had developed seizures. They had elevated mood state scores (82 to 162) and elevated symptom frequency scores (111 to 138), compared with referent subjects. There was excessive fatigue, somnolence, headache, difficulty remembering, irritability, and instability of mood. Compared with referents, choice reaction time was prolonged in four of four (4/4) subjects, blink latency was delayed in 2/2, balance was abnormal in 3/4, and visual fields were constricted in 2/3. Cognitive functions, measured by Culture Fair, block design, and digit symbol tests, were impaired in all. Delayed verbal recall and visual reproduction were impaired in 3/4. Perceptual motor speed on slotted pegboard and trail making A and B tests was reduced in 4/4. Errors on fingertip number writing were abnormal in all. Long-term memory was decreased in only one. Extensive use of formaldehyde at work or repeated airborne exposure to formaldehyde and phenol appears to have impaired central nervous system function.

Central Nervous System↗
PubMed1995

Cognitive function during insulin-induced hypoglycemia in humans: short-term cerebral adaptation does not occur.

It has been suggested that cerebral adaptation may occur in response to short-term hypoglycemia. This was examined in the present study by measuring serial changes in cognitive function and symptoms after 60 min of continuous hypoglycemia. Hypoglycemia was induced with a hyperinsulinemic glucose clamp on two separate occasions in 24 non-diabetic human subjects. Cognitive function was assessed using the following cognitive test battery: Paced Auditory Serial Addition Test (PASAT), Rapid Visual Information Processing (RVIP), Trail-Making B (TMB), Digit Symbol Substitution Test (DSST) and Four Choice Reaction Time (CRT). In condition A the blood glucose was maintained at 4.5 mmol/l throughout. On two separate occasions (condition B and condition C) the blood glucose was stabilised at 4.5 mmol/l for 30 min, lowered to 2.5 mmol/l for 60 min and restored to 4.5 mmol/l for 30 min. In each condition the cognitive test battery was performed immediately after stabilisation of blood glucose at 4.5 mmol/l and the subsequent battery was repeated at different time intervals: condition A--after a further 40 min of euglycemia; condition B--after 5 min of hypoglycemia; condition C--after 40 min of hypoglycemia. Acute hypoglycemia induced a significant deterioration in cognitive function which was manifest in all tests except TMB (P < 0.05), but performance ability did not differ between conditions B and C. Symptom scores, assessed by a scaled questionnaire, increased significantly during hypoglycemia (P < 0.001) but no differences were detected between the scores at 30 min and 60 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

The effects of sleep deprivation on divergent thinking and attention processes.

Twelve male undergraduate students were deprived of sleep for one night and were tested with a series of cognitive tasks. Their performance was compared to the performance of thirteen control subjects. Two hourly tasks and three occasional tasks were administered in order to examine cognitive performance following sleep loss. In an attempt to replicate the findings of Horne (1988a), the figural form of the Torrance Tests of Creative Thinking was administered. To explore the effects of short-term sleep deprivation on attention, the following tasks were also administered: a working memory task, a trail-making task, a vowel/consonant discrimination task, and a letter recognition task. Results of the Torrance test, trail-making task and letter recognition task revealed decreases in cognitive abilities following sleep loss, although all tasks required less than 10 minutes to administer. The results of this study suggest that cognitive measures following sleep deprivation have not been adequately explored. Results support the hypothesis that sleep serves a function of cognitive restitution, particularly in the maintenance of attentional mechanisms.

Journal Article↗
PubMed1989

Smooth pursuit eye tracking and neuro-psychological performance in healthy volunteers. Exploring a possible genetic marker for vulnerability to schizophrenia.

Eye movement dysfunction (EMD) has been repeatedly found in schizophrenics and their first-degree relatives. In the present study, smooth pursuit eye tracking was measured in healthy subjects and related to performance on computerized neuropsychological tasks assumed to involve frontal or frontoparietal functions: monitoring perspective fluctuations (Necker cube), finger tapping, trail making, reaction time (RT) and a perceptual maze test. Poor trackers performed worse on tasks requiring parallel processing (trail making with letters and digits and RT with random auditory signals for response inhibition) and made more errors and cancellations on the mazes. Results are in line with our earlier EMD results on schizophrenics, showing poor performance on frontal tasks. However, their deficiency was more pervasive, whereas the present healthy EMD subjects only had difficulties with more complex tasks. The results are of interest in view of the recent evidence that EMD may be a genetic marker for vulnerability to schizophrenia.

Adult↗
PubMed2006

[Outcome and cognitive changes of mild cognitive impairment in the elderly: a follow-up study of 47 cases].

OBJECTIVE: To examine the cognitive changes and outcome of mild cognitive impairment (MCI) in the elderly and to explore the predictive factors of development from MCI into dementia. METHOD: A cross-sectional and longitudinal parallel cohort study design was conducted among 47 patients with MCI (MCI group), aged 72.4 +/- 7.1, and 50 sex, marital status, and professional structure-matched normal controls (NC group), aged 67.9 +/- 5.3, using the Neuropsychological Battery of Cognitive Assessment Instruments developed by World Health Organization (WHO-BCAI) and the Wechsler Memory Scale (WMS) to assess the cognitive function. Follow-up was conducted for 34.0 +/- 1.8 months. The diagnosis of dementia was based on the criteria in the Diagnostic and Statistical Manual-IV. RESULTS: Dementia was diagnosed in 13 of the 47 MCI patients with a prevalence rate of 27.7%, significantly higher than that in the NC group (2.0%, 1/50, P < 0.01). The mean total score of mini-mental status examination (MMSE) of the MCI group decreased by 2.2 +/- 3.7, significantly more than that of the NC group (1.0 +/- 1.9, P < 0.01). The mean total mental quotient (MQ) of the MCI group decreased by 12.6 +/- 17.3, significantly more than that of the NC group (3.9 +/- 8.4, P < 0.01). The values of MMSE and MQ of the 13 cases in the MCI group who developed into dementia patients decreased by 5.5 +/- 2.8 and 30.0 +/- 18.0 respectively. The WHO-BCAI assessment demonstrated that the scores of performance of verbal learning, verbal fluency, visual reasoning, trail making, sorting and spatial construct tests of the cases in the MCI group who developed into dementia patients were significantly poorer than those of the NC group (P < 0.01). Logistic analysis based on the baseline assessment suggested that the total score of MMSE and its subtest of orientation, score of orientation memory of WMS, and the scores of performance of trail making, attention, and delayed recall tested by WHO-BCAI were all statistically significant predictive factors for MCI converting into dementia (P < 0.01 or 0.05). The predictive accuracy rates of MMSE, WMS, and WHO-BCAI were 70.3%, 78.4% and 90.7% respectively. CONCLUSION: MCI diagnosed based on the criteria of pure MCI modified by the authors is indeed a transitional state from normal aging to dementia, especially Alzheimer's type of dementia. The cognitive change for MCI converting into dementia is characterized in the areas of orientation, attention, speech and executive function. These predictive factors for MCI to develop dementia are valuable in early detection and prevention of dementia in the elderly.

Adult↗
PubMed2000

Executive/attentional performance and measures of schizotypy in patients with schizophrenia and in their nonpsychotic first-degree relatives.

Previous studies of executive/attentional functions have found impairments in nonpsychotic first-degree relatives of patients with schizophrenia. The aims of this study were: (1) to replicate these findings by three laboratory measures of attention/information processing - a continuous performance test (DS-CPT), a forced-choice span of apprehension task (SPAN), and a digit symbol substitution test (DSST), and by a series of neuropsychological tests sensitive to prefrontal cortical damage - Trail Making A and B, verbal fluency (VFT), Stroop Color and Word Test (Stroop), and Wisconsin Card Sorting Test (WCST); (2) to investigate whether such executive/attentional deficits are associated with schizotypal traits assessed using the social anhedonia, physical anhedonia, perceptual aberration and magical ideation scales (Chapman, L.J., Chapman, J.P., Raulin, M.L. 1976. Scales for physical and social anhedonia. J. Abnorm. Psychol. 85, 374-382; Chapman, L.J., Chapman, J.P., Raulin, M.L., 1978. Body-image aberration in schizophrenia. J. Abnorm. Psychol. 87, 399-407; Eckblad, M., Chapman, L.J., 1983. Magical ideation as an indicator of schizotypy. J. Consult. Clin. Psychol. 51, 215-225). In both patient and relative groups, performance was significantly poorer on the DSST, VFT and Trail B, and the reaction time on the SPAN was significantly longer. These neuropsychological impairments were present as much in siblings as in parents of schizophrenic patients; age did not appear to cancel differences between the relative and control groups. In the relative group, the four scores of schizotypy were at an intermediate level between those of patient and control groups, and the social anhedonia and perceptual aberration scores tended to be significantly different between the relative and the control groups. Only two significant correlations were found between the neuropsychological performance and the measures of schizotypy.

Adolescent↗
PubMed2003

Cognitive effects of unilateral posteroventral pallidotomy: a 4-year follow-up study.

We assessed the long-term neuropsychological effects of unilateral posteroventral pallidotomy in Parkinson's disease. Eleven Parkinson's disease patients, from an original cohort of 15 consecutive patients who underwent pallidotomy, were evaluated. A neuropsychological battery was administered to each patient before (3 days) and after (3 months and 4 years) surgery during the effects of levodopa. The following tests were administered: Rey's Auditory-Verbal Learning Test, Visual Associative Learning test from the Wechsler Memory Scale-Revised, Luria's motor alternation, Benton's Judgment of Line Orientation, Trail Making, phonetic verbal fluency, Stroop test, Petrides' working memory tasks, Beck's depression questionnaire and the Maudsley obsessional-compulsive inventory. In the 3-month postoperative assessment, there was a significant worsening in phonetic verbal fluency and an improvement in Benton's Judgment of Line Orientation test. In the 4-year follow-up assessment, phonetic verbal fluency and Benton's Judgment of Line Orientation test returned to baseline scores. Although there was no significant difference between pre- and postsurgical scores for long-term visual associative memory, there was a significant deterioration between 3-month and 4-year follow-up performances. Our results suggest that unilateral posteroventral pallidotomy may produce transient changes in prefrontal and visuospatial functions, but there is no evidence of permanent neuropsychological effects.

Aged↗
PubMed2004

[Correlation between evolution of the cognitive function and mortality after hospital discharge in elderly patients with advanced heart failure].

OBJECTIVE: To assess the relation between the evolution of cognitive performance and the prognosis of elderly patients after compensation of advanced heart failure. METHODS: Thirty-one patients older than 64 (68 +/- 7) years and admitted with New York Heart Association class IV heart failure and ejection fraction = 0.45 (0.38 +/- 0.06) were consecutively selected. They underwent cognitive tests (digit span, digit symbol, letter cancellation, trail making A and B) and the 6-minute walking test 4 days before (T1) and 6 weeks after (T2) hospital discharge, and their performances were compared using the t test. The prognostic value of the scores of the cognitive tests was analyzed with logistic regression, and the value of greatest accuracy of the tests was associated with the prognosis determined by the ROC curve. RESULTS: After 24.7 months, 17 (55%) patients had died. The performances in the 6-minute walking test and most cognitive tests improved between T1 and T2. The digit span score of the survivors ranged from 3.9 to 5.2 (P=0.003) and remained unaltered among those who died (4.1 to 3.9; P=0.496). An improvement < 0.75 points in the score was associated with mortality (relative risk of 8.1; P=0.011). CONCLUSION: In the elderly, after compensation of advanced heart failure, the lack of evolutionary improvement in cognitive performance was associated with a worse prognosis.

Aged↗
PubMed1976

Neuropsychologic effects of diazepam related to single dose kinetics and liver function.

The neurophysiologic and neuropsychologic effects and their relation to the kinetics of diazepam (DZ) were studied in 10 patients with impaired liver function of various degrees and in three normal subjects after 10 mg DZ i.v. The plasma concentration data were treated according to a two-compartment open model. Neurophysiologic effect measurements were obtained from galvanic skin response, continuous reaction times (CRT), heart rate, and averaged evoked potentials; neuropsychologic measurements were obtained from trail making A + B, hidden pattern, word fluency, and subtraction tests; in addition, clinical effects were rated by Beechers Mood Scale and Spielbergers Anxiety Scale. Except for trail making A and word fluency all tests discriminated well between the experimental conditions with or without diazepam. No difference from normal in the response to acute diazepam administration could be detected in patients with reduced liver function. A linear correlation between prolongation in CRT and DZ log plasma concentration was demonstrated in the entire, heterogenous patient material. In the clinical ratings only items of a predominantly sedative and autonomic significance responded to the diazepam injection, while predominantly anxiolytic items did not.

Diazepam↗
PubMed2006

Cerebrovascular risk factors do not contribute to genetic variance of cognitive function: the ERF study.

Impaired cognition in later life may result from Alzheimer's disease-related pathology, but also from vascular pathology. We studied to what extent vascular risk explained heritability of cognition in 780 individuals, related in one extended pedigree in a genetically isolated population, in the ERF study. Heritability was estimated using variance components modelling (SOLAR). Univariate analyses included models with and without vascular disease; bivariate analyses included both cognitive and vascular traits, such as blood pressure, serum glucose or lipids. Heritability for immediate and delayed recall, recognition, semantic fluency, Trail making B and Stroop tests was significant, with estimates from 0.16 to 0.36. Vascular factors did not affect cognitive functions, except immediate recall and the Stroop test. Heritability estimates did not change significantly when adjusted for vascular disease. We found no genetic correlation between cognition and vascular traits. Therefore, in this population vascular disease is mildly associated with cognitive dysfunction, and in those with vascular disease, the underlying genetic risk factors are not likely to account for the genetic variation in cognition at adult age.

Adult↗
PubMed2001

Neuropsychological functioning in substance-dependent patients.

The present study examined neurocognitive functioning in groups of individuals addicted to various psychoactive substances. One hundred ten patients admitted to treatment for substance misuse were assessed using a semistructured clinical interview, the Beck Depression Inventory, the Symptom CheckList-90, the Trail Making A and B tests, and the Shipley Institute of Living Scale. Results revealed that at intake, alcohol- and benzodiazepine-addicted clients exhibited higher levels of cognitive impairment and psychological distress than patients dependent on other drugs. Regression analysis showed that the Shipley vocabulary raw score was a significant predictor of length of stay in treatment.

Adult↗
PubMed1993

Disturbed frontal regulation of attention in Parkinson's disease.

Parkinson's disease is characterized not only by tremor, akinesia and rigidity, but also by frontal cognitive dysfunction, that can be understood as a disturbance in the 'Supervisory Attentional System' (SAS). This concept refers to a system, located in the frontal cortex, that regulates attentional processes under novel, non-routine conditions. The hypothesis that cognitive dysfunction in Parkinson's disease results from a disturbance in the SAS was investigated by recording 'processing negativity' in 33 parkinsonian patients and 17 controls. Processing negativity is an event-related potential that reflects neuronal activity during selective attention. The contribution of the frontal cortex to selective attention can be studied directly using processing negativity. Parkinsonian patients were also scored for clinical symptoms and subjected to a neuropsychological test battery. Processing negativity was clearly disturbed in the parkinsonian patients. Moreover, parkinsonian patients with the lowest scores on 'frontal' neuropsychological tests such as Stroop, Trail Making and Word Fluency, also had the lowest processing negativity. Our results support the hypothesis that cognitive dysfunction in Parkinson's disease might be understood as a disturbance in the frontal regulation of attentional processes. Degeneration of the dopaminergic mesocortical innervation of the frontal cortex in Parkinson's disease is a possible neurochemical substrate of these frontal attentional disturbances.

Aged↗
PubMed1983

Neuropsychological abnormalities in Gilles de la Tourette's syndrome.

Seven patients with Gilles de la Tourette's syndrome underwent an extensive psychological and neuropsychological examination. On psychological examination, it was found that consistent with previous reports these patients had a high incidence of Verbal IQ-Performance IQ discrepancies on the Revised Wechsler Intelligence Scale for Children, and had average mental arithmetic but poor written arithmetic. On neuropsychological examination, no single measure was performed poorly by all subjects, but there was a high incidence of poor performance on several measures from the Halstead-Reitan Battery. High frequency of abnormal performance for age was observed on the Category, Trail Making and Tactual Performance Tests. In addition, the patients had an interesting pattern of average auditory attention span but poor visual attention span. The pattern of visuomotor and visuospatial deficits was discussed with respect to possible underlying mechanisms.

Adolescent↗