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PubMed1996

Hypervigilance in patients with obsessive-compulsive disorder.

The hypothesis that patients with obsessive-compulsive disorder (OCD) suffer from hypervigilant attention was investigated via explicit memory (incidental recall and recognition) and priming (reading speed) measures. OCD patients did not differ from normal controls on explicit measures of memory; specifically, recognition of unusual words (experiment 1) and recall and recognition of words and feature-specific information (experiment 2). Although both normal controls and OCD patients showed priming, the pattern of priming differed for the two groups (experiment 2). Specifically, patients with OCD failed to show feature-specific priming, suggesting they may have attended more focally on the priming task than did normal controls. These findings support previous reports of normal performance in OCD on explicit memory tasks, but suggest more sensitive measures may reflect differences in processing information.

Adult↗
PubMed1988

The psychometric structure of the Wechsler Memory Scale in comparison to the WAIS-R in a low-IQ clinical population.

The psychometric structure of the Wechsler Memory Scale (WMS) and its relationship to the revised Wechsler Adult Intelligence Scale (WAIS-R) were studied in an outpatient population of 103 individuals with low Full Scale IQ scores (M = 71). We found that the age correction of the WMS scores gave memory quotients (WMQ) equivalent to WAIS-R FSIQ scores, but our findings also raised problems of interpretation. If the usual rule of thumb of a 12-point discrepancy between the MQ and the FSIQ were applied, the WMS might be relatively insensitive to memory impairment in this low-IQ clinical population, in which more numerous cases of impairment could be expected. Principal components analysis of the WMS raw scores and three WAIS-R scores included as reference variables yielded five orthogonal factors: Attention/Concentration; Visual Reproductions; New Verbal Learning; Well-learned Semantic Knowledge; and Intelligence. We argue that raw scores on the WMS should be reported to optimize possible diagnostic specificity and to align the WMS with experimental and clinical research in various types of memory functioning and impairment.

Adult↗
PubMed1990

Left temporal lobe brain damage pattern on the Wechsler Adult Intelligence Scale.

This study supports an association of left temporal brain damage with the unusual WAIS subtest pattern of more impaired Information and Vocabulary than Similarities scores. Temporal lesions may impair well-learned verbal memory more than reasoning skills. Thirty-six patients with localized left hemisphere brain damage in the frontal, parietal or occipital, and temporal lobe were compared using an index in which Information and Vocabulary were contrasted to Similiarities. Index scores were adjusted for age. Seventy-five percent of the temporal patients had negative index scores, and 75% of the frontal patients had positive index scores. Temporal patients tended to score more negatively on the index than did frontal patients, p less than .05.

Adult↗
PubMed1993

Malingering on neuropsychological memory tests: potential objective indicators.

We evaluated five potential indicators of malingering on the Rey Memory Test (RMT), Hebb's Recurring Digits (HRD), the Wechsler Memory Scale-Revised (WMS-R), the Complex Figure Test (CFT), and the Auditory Verbal Learning Test (AVLT). Fifty-seven subjects were assigned randomly to either a control group or a simulated malingering group. Two indicators-discriminant functions derived from the WMS-R and from the CFT/AVLT-achieved classification accuracy of 88% and 86%, respectively, without misidentifying controls as malingerers. Among the remaining indicators, there were problems with the recommended RMT cut-off, but it and the HRD show some promise. Subjects who simulated malingering did so by suppressing performance on tasks that involve recall as well as recognition memory and are relatively easy, but not obviously so.

Adult↗
PubMed1994

The differential pattern of memory deficit in normal aging and dementias of different etiology.

The study explored encoding, storage, and retrieval components of memory functioning in four groups of subjects: (1) normal elderly; (2) elderly subjects in the early prestages of DAT; (3) elderly subjects with a more advanced DAT; (4) younger subjects in the early prestages of AIDS dementia. Each group consisted of 26 subjects, who were administered the Rey Auditory-Verbal Learning Test. The results suggest impaired encoding and retrieval in the DAT groups. The AIDS group demonstrated deficient storage and retrieval. Their pattern of memory deficits was similar to that seen in normal aging. The results speak in favor of the hypothesis of subcortical nature of neurological changes in normal aging.

AIDS Dementia Complex↗
PubMed1999

A prospective analysis of cognitive function and anticardiolipin antibodies in systemic lupus erythematosus.

OBJECTIVE: To prospectively analyze the association between changes in cognitive function and circulating anticardiolipin antibodies (aCL) over a period of 5 years in patients with systemic lupus erythematosus (SLE). METHODS: Cognitive function was assessed in 51 unselected female SLE patients at baseline and after a mean followup of 64.5 months (range 52-71 months), using standardized tests of cognitive function, i.e., the Wechsler Adult Intelligence Scale-Revised, the Wechsler Memory Scale-Revised, and the California Verbal Learning Test. Circulating IgG, IgA, and IgM aCL and anti-double-stranded DNA (anti-dsDNA) antibody levels were determined by enzyme-linked immunosorbent assay on 4-7 occasions over the same time period. Persistent antibody reactivity was defined as levels more than 2 standard deviations (moderately positive) and more than 5 standard deviations (highly positive) above the mean for normal controls over the duration of the study. Changes in overall cognitive performance and in raw scores on individual cognitive tests were compared in patients who were persistently positive or negative for aCL. RESULTS: At baseline 11 patients (22%) were cognitively impaired, compared with 7 (14%) at followup. Between 16% and 37% of patients had persistently elevated aCL levels of different isotypes. There was no significant difference in the prevalence of overall cognitive impairment in patients who were persistently positive for aCL compared with those who were not. In contrast, over the period of study, patients who had persistent IgG aCL positivity had a reduction in psychomotor speed, and patients who had persistent IgA aCL positivity had a reduction in conceptual reasoning and executive ability. Similar associations with anti-dsDNA antibodies were not found. CONCLUSION: These results suggest that IgG and IgA aCL may be responsible for long-term subtle deterioration in cognitive function in patients with SLE.

Adult↗
PubMed1999

Bilateral subthalamic or pallidal stimulation for Parkinson's disease affects neither memory nor executive functions: a consecutive series of 62 patients.

There is a renewal of interest in surgical approaches including lesions and deep brain stimulation directed at motor subcorticofrontal loops. Bilateral lesioning presents a far greater risk of adverse effects, especially cognitive impairment. Furthermore, the main advantages of the stimulation procedure over lesioning are adaptability and reversibility of effects. The aim of this study was to assess the influence of bilateral stimulation of the subthalamic nucleus or internal globus pallidus on memory and executive functions in Parkinson's disease. Sixty-two patients were assessed before and after 3 to 6 months of chronic bilateral stimulation of the subthalamic nucleus (n = 49) or internal globus pallidus (n = 13). The neuropsychological tests used were the Mattis Dementia Rating Scale, the Grober and Buschke Verbal Learning Test, the Wisconsin Card Sorting Test, category and literal fluency, graphic and motor series, the Stroop Test, and the Trail Making Test. Mood was evaluated by the Beck Depression Inventory. Only 4 of 25 cognitive variables were affected by deep brain stimulation. Under stimulation, performance improved for Parts A and B of the Trail Making Test, but there was a deterioration in literal and total lexical fluency. There was also a mild but significant improvement in mood. It may therefore be concluded that stimulation of the subthalamic nucleus or internal globus pallidus does not change the overall cognitive performance in Parkinson's disease and does not greatly affect the functioning of subcorticofrontal loops involved in cognition in humans. This relative absence of cognitive impairment in bilateral deep brain stimulation is likely because of the accurate positioning of the electrodes, allowing the effects of stimulation to be confined to sensorimotor circuits.

Electric Stimulation↗
PubMed1984

Exposure-effect and exposure-response relationships between occupational exposure to styrene and neuropsychological functions.

A neuropsychological test battery was administered to 50 workers exposed to styrene and to 50 sex-, intelligence-, and age-matched controls. The main styrene metabolites, ie, mandelic acid (MA) and phenylglyoxylic acid (PGA), were measured as exposure indices in the urine collected on Saturday mornings, just before neuropsychological testing. Exposure-response and exposure-effect relationships were found between the intensity of the exposure (as reflected by the sum of MA and PGA) and the scores of the neuropsychological tests. Verbal learning skills were significantly impaired in workers with a sum of MA and PGA higher than 150 mmole/mole creatinine, corresponding to styrene airborne concentrations higher than 25 ppm (mean daily exposure). Logical memory and visuo-constructive abilities were shown to be significantly affected in workers with MA and PGA higher than 300 mmole/mole creatinine, corresponding to exposure levels of more than 50 ppm of styrene in air.

Adult↗
PubMed2004

Role of dopamine D3 receptor (DRD3) and dopamine transporter (DAT) polymorphism in cognitive dysfunctions and therapeutic response to atypical antipsychotics in patients with schizophrenia.

Molecular components of the dopaminergic system may play an important role in the pathophysiology of schizophrenia. In this study, we investigated the relationship of the Ser9Gly (S/G) polymorphism of the dopamine D3 receptor (DRD3) and the variable number of tandem repeats (VNTR) polymorphism of the dopamine transporter (DAT) with therapeutic response to atypical antipsychotics (clozapine, olanzapine, quetiapine, risperidone) and cognitive functions. No associations were found between the DRD3 and DAT polymorphisms and schizophrenia. The S/S genotype and the S allele were more frequent in the non-responder patients (n = 28) than in the group of responders (n = 47) (cut-off: >20-point improvement in Global Assessment of Functioning (GAF) scale). The patients with S/S genotype completed fewer categories and had more perseverative errors in the Wisconsin Card Sorting Test (WCST) compared with the S/G patients. The S/S and S/G patients did not differ in positive and negative symptoms, GAF scores, WCST failure to maintain set, and verbal learning. No differences in symptoms or WCST measures were observed in the patients with different DAT genotypes. These results suggest that the S/S genotype of the DRD3 is associated with worse therapeutic response and more severe executive dysfunctions in patients with schizophrenia.

Adult↗
PubMed1993

Dopamine agonist treatment of antegrade amnesia from a mediobasal forebrain injury.

We studied the persistent antegrade memory impairment in a woman whose brain had been surgically impaled, leaving a 1-cm-wide mediobasal tract of encephalomalacia that extended just anterior to the septal nuclei and medial to the nucleus accumbens. In a blinded, controlled, alternating repeated-measures protocol, bromocriptine significantly improved her verbal learning, functional memory, and daily recall, perhaps by acting on neurons that had been disconnected from the ventral tegmental tract's dopaminergic inputs.

Adult↗
PubMed2004

'Chemobrain' in breast carcinoma?: a prologue.

BACKGROUND: Chemotherapy-induced cognitive dysfunction in patients with breast carcinoma has been described previously. However, those studies only assessed patients' postchemotherapy cognitive functioning and were not able to determine the relation between cognitive function and other treatments, such as surgery and radiotherapy, that often precede systemic chemotherapy. METHODS: Eighty-four women with breast carcinoma underwent a comprehensive neuropsychologic evaluation before receiving adjuvant therapy for nonmetastatic primary breast carcinoma. RESULTS: Before the start of systemic therapy, 35% of women in the current cohort exhibited cognitive impairment. Verbal learning (18%) and memory function (25%) were impaired significantly more frequently relative to normative expectations. Although the impairments were not significant in the women who were examined, nonverbal memory (17%), psychomotor processing speed and attention (13%), confrontational naming (13%), visuoconstruction (13%), and upper-extremity fine motor dexterity (12%) were impaired more frequently than was expected. Affective distress was related significantly to cognitive impairment (Pearson chi-square = 9.90; P = 0.002). Given the conservative statistical approach employed, extent of surgery, hormone replacement therapy history, and current menopausal status failed to achieve statistical significance, but these variables did exhibit provocative trends with respect to cognitive impairment. CONCLUSIONS: Cognitive impairment frequently is observed before the administration of systemic chemotherapy. Thus, investigations purporting to measure chemotherapy-induced cognitive dysfunction must employ study designs that incorporate prechemotherapy baseline assessments to accurately detect changes in cognitive function that are attributable to chemotherapy.

Adult↗
PubMed2002

The acute nootropic effects of Ginkgo biloba in healthy older human subjects: a preliminary investigation.

Ginkgo biloba has been shown to have chronic memory enhancing effects in healthy subjects and patients with dementia. There is limited research on the acute nootropic effects of Ginkgo biloba in humans. The current study aimed to examine the acute effects of Ginkgo biloba (120 mg) on memory functioning in healthy older volunteers using the cognitive drug research (CDR) battery of memory tests and the Rey auditory verbal learning task (AVLT). The study was a double-blind placebo-controlled design, with each participant tested under both placebo and Ginkgo biloba treatment conditions. Testing was conducted pre- and 90 min post-drug administration for each treatment condition. Treatment conditions were separated by a 7 day wash out period. No acute effects of Ginkgo biloba were found for any of the memory tests examined. The findings suggest that 120 mg of Ginkgo biloba has no acute nootropic effects in healthy older humans.

Aged↗
PubMed2004

Effects of a combined extract of Ginkgo biloba and Bacopa monniera on cognitive function in healthy humans.

Extracts of Ginkgo biloba and Bacopa monniera have been shown to produce positive effects on cognitive function in healthy subjects. While the exact mechanisms are not known, it has been suggested that antioxidant properties and cholinergic modulation may play a role. In the current study the sub-chronic (2 weeks) and chronic (4 weeks) effects of an extract containing Ginkgo biloba (120 mg) and Bacopa monniera (300 mg) (Blackmores Ginkgo Brahmi) on cognitive function were examined. The study was a randomized, double-blind, placebo-controlled, independent group design in which 85 healthy subjects were allocated to one of two treatment conditions (placebo or combined Ginkgo biloba and Bacopa monniera extract). Testing was conducted at baseline and 2 and 4 weeks post treatment. The results showed that the combined extract relative to placebo did not demonstrate any significant effects on tests investigating a range of cognitive processes including attention, short-term and working memory, verbal learning, memory consolidation, executive processes, planning and problem solving, information processing speed, motor responsiveness and decision making. These findings suggest that at least within the current treatment duration and doses, an extract containing Ginkgo biloba and Bacopa monniera had no cognitive enhancing effects in healthy subjects.

Adult↗
PubMed1995

Encoding specificity and intrusion in Alzheimer's disease and amnesia.

This study was designed to examine how the pattern of memory deficits and the interaction between episodic and semantic encoding/retrieval conditions influenced intrusions in a population of Alzheimer and amnesic patients. We used as a model for an encoding/retrieval experiment a 2 x 2 experimental design in which two encoding conditions are crossed with two retrieval conditions. It was found that encoding specificity affected intrusions only if patients, regardless of their clinical diagnosis, were grouped according to the type of memory impairment.

Aged↗
PubMed1997

Reorganization of verbal memory function in early onset left temporal lobe epilepsy.

The purpose of this investigation was to examine the issue of reorganization of verbal memory function following early insult to the left mesial temporal region. It was hypothesized that reorganization of memory function was most likely to occur in those patients with an early age of seizure onset who have a more limited degree of extra-hippocampal neuropathology. Fifty-four patients with epilepsy of unequivocal left temporal lobe origin were classified into four groups on the basis of the presence/absence of hippocampal sclerosis and degree of postoperative seizure relief. Measures of verbal learning and memory as well as nonmemory measures were administered both before and 6 to 8 months after anterior temporal lobectomy. Findings were consistent with the reorganization proposal. The clinical and theoretical significance of the findings are discussed.

Adult↗
PubMed1997

Parsing schizophrenia with neurocognitive tests: evidence of stability and validity.

The stability and validity of a neurocognitive typology for schizophrenia were studied in 55 chronic patients who met DSMIII-R criteria for the illness. Subtypes were based on an earlier cluster analytic study by Heinrichs and Awad (1993) that utilized the following variables: IQ (WAIS-R), categories (Wisconsin Card Sorting Test), free recall intrusions (California Verbal Learning Test), and bilateral motor performance (Purdue Pegboard). Stability was examined by analyzing subtype assignment at the original assessment and 3 years later at follow-up. Stability over this interval was variable with an overall kappa of .45 and individual kappas from .12 to .66. Adjunct cognitive and clinical data gathered at follow-up provide evidence for the validity of several subtypes, especially in terms of their cognitive and functional differences. There was no evidence of symptom differences in this relatively asymptomatic medicated sample of patients. The results are discussed in terms of the possibility that several patterns of neurocognitive dysfunction may underlie schizophrenia, with implications for understanding the heterogeneity of the illness and its variable functional outcomes.

Adult↗