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PubMed2005

Cerebrovascular disease and dementia.

Cerebrovascular disease and dementia are extremely prevalent and disabling disorders affecting older people. Results of previous pathological investigations and later epidemiological studies have raised the possibility that the two disorders may be causally related. The study of such causal associations may provide insights that could lead to the development of strategies intended to prevent or treat dementia more effectively. Cerebrovascular disease has many manifestations, some of which are strong causal factors in the development of a future dementia. However, uncertainty and controversy exist regarding the presence and nature of the causal contribution of others. Potential therapeutic strategies for dementia are hindered by the lack of understanding of such relationships and the consequent difficulty in identifying a clear phenotype of dementia occurring predominantly due to cerebrovascular disease. The field is ripe for further examination of the associations between vascular factors and dementia, and the mechanisms underlying such associations. The interface between basic and clinical science has much to offer in clarifying the relationships between aging, vascular factors and cognitive decline in older people. In this review, we will attempt to synthesize data available from epidemiological, clinical and basic science research in the field of dementia related to cerebrovascular disease, highlighting potential avenues for further research.

Aging↗
PubMed2006

Cerebrovascular disease and dementia.

Cerebrovascular disease and dementia are extremely prevalent and disabling disorders affecting older people. Results of previous pathological investigations and later epidemiological studies have raised the possibility that the two disorders may be causally related. The study of such causal associations may provide insights that could lead to the development of strategies intended to prevent or treat dementia more effectively. Cerebrovascular disease has many manifestations, some of which are strong causal factors in the development of a future dementia. However, uncertainty and controversy exist regarding the presence and nature of the causal contribution of others. Potential therapeutic strategies for dementia are hindered by the lack of understanding of such relationships and the consequent difficulty in identifying a clear phenotype of dementia occurring predominantly due to cerebrovascular disease. The field is ripe for further examination of the associations between vascular factors and dementia, and the mechanisms underlying such associations. The interface between basic and clinical science has much to offer in clarifying the relationships between aging, vascular factors and cognitive decline in older people. In this review, we will attempt to synthesize data available from epidemiological, clinical and basic science research in the field of dementia related to cerebrovascular disease, highlighting potential avenues for further research.

Journal Article↗
PubMed2002

Effects of transcutaneous electrical nerve stimulation (TENS) on non-pain related cognitive and behavioural functioning.

An extensive search through nine electronic bibliographic databases (PubMed, Cochrane Library, Web of Science, ERIC, PsychINFO, Psyndex, Cinahl, Biological Abstracts, Rehabdata) was performed in order to review the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on non-pain related cognitive and behavioural functioning. Eight studies were identified on neglect due to stroke, six studies on Alzheimer's disease (AD), one study on aging, and two studies on coma due to traumatic brain injury. The results of the various studies revealed that TENS has a variety of effects. These consist of enhancement of somatosensory functioning, visuo-spatial abilities and postural control in neglect, improved memory, affective behaviour and rest-activity rhythm in AD and acceleration of awakening in coma. Effectiveness of TENS is discussed in relation to various stimulation parameters: duration, frequency, pulse width and intensity. It is argued that arousal may underlie the beneficial influence of TENS in various conditions. Finally, suggestions are offered for future research.

Adolescent↗
PubMed2005

No old man ever forgot where he buried his treasure: concepts of cognitive impairment in old age circa 1700.

Cognitive impairment in old age is one of the most important topics in modern geriatrics. This article discusses the historical dimensions of this phenomenon. To this end, a number of primary sources ranging from antiquity to the modern era are evaluated. Although a physiology and pathology of old age were conceptualized in Greco-Roman times, cognitive impairment in old age remained a marginal issue until the 17th century. Alternatively, after 1500, medicine boasted detailed theories on the physiology and pathology of old age. There are several possible explanations for this unusual situation. Underlying conflict between idealistic and materialistic views of man played a decisive role, for these concepts differed considerably regarding the intellectual and mental functioning of the soul as well as the effects of the passage of time. After Cartesianism and Iatromechanism had pushed these traditional boundaries back, the problem of cognitive impairment in old age was increasingly regarded as a physical illness and began to receive more attention. Just as its philosophical and theological context shaped early modern medicine, contemporary nonmedical disciplines such as genetics, (neuro-)biology, and the information sciences influence modern research.

Aged↗
PubMed2005

[Cognitive rehabilitation for Alzheimer disease--the learning therapy].

We propose a new intervention program, the concept of which is derived from the knowledge of both brain science and clinical studies. We set up a hypothesis that activation of the association cortices by cognitive tasks may well improve the function of these cortices. To choose effective cognitive tasks for activation of the association cortices, we reviewed previous neuroimaging studies. Then, we prepared two tasks in arithmetic and Japanese language, which were systematized basic problems in reading and arithmetic, for the training program. Sixteen experimental and 16 control subjects participated. The subjects of the experimental group were asked to perform a training program using learning tasks in reading and arithmetic. The function of the frontal cortex of the subjects was assessed by FAB (frontal assessment battery at bedside). After six months of training, the FAB score of the experimental group showed a statistically significant improvement. We also observed the restoration of communication and independence, and improvement in relationships with the clinical staff in the experimental group. Our results indicate that learning tasks of reading aloud and arithmetic calculation can be used for cognitive rehabilitation, which improves frontal functions, of dementia patients.

Aged↗
PubMed1985

X chromosome abnormalities and cognitive development: implications for understanding normal human development.

Recent advances in the biological sciences have offered new opportunities to identify biological contributions as they interact with social experience to help determine psychological development. The role of biological factors is more easily demonstrated in subhuman species in which extensive experimental manipulations of variables are possible. One strategy for the study of human behaviour genetics has been the systematic analysis of behaviour in individuals with naturally occurring X chromosome variations. The aim has been to demonstrate whether or not the range of expected variability in particular areas of behavioural development was narrowed by the specific genotypic abnormality. The knowledge obtained from these studies can be applied meaningfully to enhance our understanding about human behavioural development in chromosomally unaffected individuals.

Auditory Perception↗
PubMed2005

Students' reactions to three typical examinations in health sciences.

OBJECTIVE: A search for universal and particular changes in emotional, behavioral and cognitive assessments in relation to three types of examinations: an oral presentation, an objective structured clinical examination (OSCE) and a pencil and paper examination. METHODS: One hundred and two students of health professions completed the Profile of Mood States (POMS) questionnaire before (t1) and after (t2) each type of examination. Data regarding stress-related symptoms, attitudes, and preparation behavior were collected at (t2). RESULTS: POMS six subscales scores at (t1) did not differ by examination type and five of them were statistically significant higher at (t1) than (t2) regardless of examination type. "Preparing behavior" also emerged as a universal feature. As for the particular aspects of each examination, OSCE students felt more depression-dejection and fatigue at (t2) than at (t1). Oral presentation was perceived as the most difficult by students, who also reported more symptoms. For this type of examination, the students regained their confidence towards the end of the presentation and perceived classmates as most supportive and least disturbing. The pencil and paper examination was evaluated as the easiest by students, produced fewest symptoms and no excitement during the examination. CONCLUSIONS: Three types of examinations, frequently used in health sciences, appeared to initiate different physical, emotional, and social reactions.

Adult↗
PubMed1991

Morality and pretextuality, psychiatry and law: of "ordinary common sense," heuristic reasoning, and cognitive dissonance.

The thesis of this paper is that we will not make significant progress in understanding the tensions between the legal and mental health systems until we look carefully at a series of dissonances that affect both systems. We must consider the way that the law frequently condones pretextuality as a way of dealing with troubling or cognitively dissonant information, and the way that mental health professionals encourage a self-referential concept of morality as a way of subverting legal doctrines with which they disagree. These dissonances must be considered contextually in connection with the ways that courts generally read social science data and the ways that jurors and legislators employ such cognitive devices as "ordinary common sense" and heuristic reasoning in their judgments of cases involving mental disability questions. To ameliorate the current dilemma, we must redefine institutional and professional roles, reconsider the way we privilege expertise, recalibrate our allocation of "moral jurisdiction" over these matters, and consciously confront the way our simplifying thinking mechanisms distort the underlying social and political issues.

Forensic Psychiatry↗
PubMed1980

Certainty: a failed quest?

Can the quest for certainty ever succeed? The focus in this paper is on psychoanalytic considerations about certainty and on the issue of certainty within psychoanalytic theory and practice. The relation of certainty to truth, knowledge, and belief is discussed. The universal quest for certainty and the efforts to achieve it are examined; the uncertainties of science, including psychoanalysis, are emphasized.

Affect↗
PubMed2002

A space for measuring mind and brain: interdisciplinarity and digital tools in the development of brain mapping and functional imaging, 1980-1990.

Brain mapping is said to have opened up the possibility of a new collaboration between the sciences of mind and the sciences of the brain, potentially leading to a new kind of scientist, sometimes called "cognitive neuroscientist." This article traces the recent history of brain mapping and analyzes the processes that have led to a new "close working relationship" between the sciences of mind and brain. A key part of the working relationship is shown to be constituted through the development of the Talairach system, a digital space in which to measure structure and function. The development of meaningful brain mapping data involves the creation of measurement spaces that allow interdisciplinary collaboration and is not the result solely of theoretical developments or of the application of a technology.

Brain↗
PubMed2000

Cognitive therapy: looking backward, looking forward.

This article reviews some of the historical factors associated with the unprecedented strength and popularity of cognitive therapy, and offers predictions for the next half-century of this approach to treatment. It is predicted that the future will bring with it increased demands on cognitive therapy for evaluation of processes of change (including identification of therapeutic specifics and nonspecifics, technical specification of the process of therapy, and examination of therapist and patient predictors of change), and accountability and efficiency in the public and private sectors. With the increase in personal autonomy, globalization, and technology, the demands from the general public also will increase. One possible risk of the trend towards increased technology is that cognitive therapy may become overly technical. Although specific therapy techniques are crucial to delivering effective treatment, it is also the "nonspecifics" of therapy that add to the "art" of psychotherapy. The final challenge of cognitive therapy also may be the most difficult--to continue to be an empirically based science while maintaining its role in the art of healing.

Cognitive Behavioral Therapy↗
PubMed1999

Brain insulin receptors and spatial memory. Correlated changes in gene expression, tyrosine phosphorylation, and signaling molecules in the hippocampus of water maze trained rats.

Evidence accumulated from clinical and basic research has indirectly implicated the insulin receptor (IR) in brain cognitive functions, including learning and memory (Wickelgren, I. (1998) Science 280, 517-519). The present study investigates correlative changes in IR expression, phosphorylation, and associated signaling molecules in the rat hippocampus following water maze training. Although the distribution of IR protein matched that of IR mRNA in most forebrain regions, a dissociation of the IR mRNA and protein expression patterns was found in the cerebellar cortex. After training, IR mRNA in the CA1 and dentate gyrus of the hippocampus was up-regulated, and there was increased accumulation of IR protein in the hippocampal crude synaptic membrane fraction. In the CA1 pyramidal neurons, changes in the distribution pattern of IR in particular cellular compartments, such as the nucleus and dendritic regions, was observed only in trained animals. Although IR showed a low level of in vivo tyrosine phosphorylation, an insulin-stimulated increase of in vitro Tyr phosphorylation of IR was detected in trained animals, suggesting that learning may induce IR functional changes, such as enhanced receptor sensitivity. Furthermore, a training-induced co-immunoprecipitation of IR with Shc-66 was detected, along with changes in in vivo Tyr phosphorylation of Shc and mitogen-activated protein kinase, as well as accumulation of Shc-66, Shc-52, and Grb-2 in hippocampal synaptic membrane fractions following training. These findings suggest that IR may participate in memory processing through activation of its receptor Tyr kinase activity, and they suggest possible engagement of Shc/Grb-2/Ras/mitogen-activated protein kinase cascades.

3T3 Cells↗
PubMed1979

Einstein's creative thinking and the general theory of relativity: a documented report.

A document written by Albert Einstein has recently come to light in which the eminent scientist described the actual sequence of his thoughts leading to the development of the general theory of relativity. The key creative thought was an instance of a type of creative cognition the author has previously designated "Janusian thinking," Janusian thinking consists of actively conceiving two or more opposite or antithetical concepts, ideas, or images simultaneously. This form of high-level secondary process cognition has been found to operate widely in art, science, and other fields.

Creativity↗
PubMed2004

The science and meaning of the self.

Scientists and practitioners alike invest in theorizing the self in psychology, but prioritize differently theoretical and practical objectives. Theorizing the self differs also when mapped onto the 'science versus art' debate, viewed historically and with reference to the philosophy of science. Jung's model of the psyche is compared and contrasted with social cognitive models of self-concept. Finally, some implications of social constructionism are considered.

Ego↗
PubMed2004

Developing new treatments: on the interplay between theories, experimental science and clinical innovation.

It is often argued that behaviour therapy and cognitive-behaviour therapy have a sound theoretical and experimental basis. In the early days of behaviour therapy, the learning theory accounts that were the basis of treatment made clear suggestions about the procedures that were likely to be effective in treatment. In contrast, more recent cognitive-behavioural models tend to specify targets for therapy, but not the procedures that might be optimal for changing the targets. As a consequence, a considerable amount of work has to be done in order to create an effective cognitive-behavioural treatment from a promising cognitive-behavioural model. The process by which cognitive-behavioural treatments are developed is rarely discussed in the literature. For this reason, the way in which one group has used a mixture of phenomenological, experimental and treatment development studies to create effective cognitive therapy programmes for anxiety disorders is described.

Anxiety Disorders↗
PubMed2000

Can depression be de-medicalized in the 21st century: scientific revolutions, counter-revolutions and the magnetic field of normal science.

This article is about our scientific investigations of the change mechanisms in cognitive therapy (CT) for depression. In a previous clinical trial, we found that so-called 'cognitive' interventions were not necessary for the success of CT: the behavioral activation (BA) component, a treatment precluding attempts to change thinking, worked as well as the entire CT package, both in maximizing acute treatment response and in relapse prevention over a two year period. We tentatively suggested at the time of publication [Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E. T., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treament for depression. Journal of Consulting and Clinical Psychology, 64, 295-304; Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive-behavioral treatment for depression: relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377-384.] that the 'cognitive' components of CT may not only be unnecessary but potentially a liability, since they result in a less parsimonious treatment package that may be not be cost effective. In this article, we not only defend this contention, but counteract the skepticism expressed by some CT advocates that the quality of our CT was deficient. Finally, we describe a study designed to confirm our conclusions from the earlier trial and, in the process, reintroduce a contextual perspective on depression, one which counters the currently dominant defect models reflected in both Beck's cognitive model and in theories that emphasize biological causation.

Cognitive Behavioral Therapy↗