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PubMed1981

[Assessment of the course of chronic hepatic encephalopathy. Comparison of various measurements with special reference to the trail-making test].

In eight patients with hepatic cirrhosis and chronic hepatic encephalopathy stage I and II the following measurements were performed in parallel on 58 occasions over eight months: number connection test, time-linked orientation, presence of liver flap, arithmetical test, handwriting sample, electroencephalogram, and venous blood ammonia level. The number connection test correlated significantly with all other parameters apart from the ammonia level. The number connection test had the highest correlation coefficient. The electroencephalogram showed a significant but only weak correlation with each of the other parameters. Results of the arithmetical test, time-linked orientation and handwriting correlated significantly with each other and with the other tests with the exception of the ammonia level. In contrast to the EEG multiple linear correlation of all parameters allowed accurate prediction of the early stage of chronic hepatic encephalopathy if the number of connection test is taken as the measure of the stage. The number of connection test is easy to perform and shows accurate reproducibility. It gives a value as to the severity of onsetting chronic hepatic encephalopathy which is independent of the tester.

Aged↗
PubMed1998

The differential contribution of mental tracking, cognitive flexibility, visual search, and motor speed to performance on parts A and B of the Trail Making Test.

Ninety-eight undergraduate students were subjected to the TMT as well as a series of derived measures from the TMT with a view to ascertaining the nature of the contribution of each to the performance. Performance on the TMT(A) was uniquely contributed to by visual search and motor speed measures, whereas the performance on TMT(B) was uniquely contributed to by the visual search and cognitive alternation measures. After controlling for the effects of TMT(A) on TMT(B), further variance in the score on TMT(B) was contributed to, in order of effect, by lowered reading level, poor skill in visual search, poor ability to mentally maintain two simultaneous sequences, as well as decrease in attention and working memory functions. The analysis indicates that, in a nonclinical sample, the TMT measures a number of different functions and the observation of impaired performance must be further investigated to ascertain the specific nature of these deficits in order to guide rehabilitation and management planning.

Adolescent↗
PubMed1976

A trial use of some of Reitan's neuropsychological tests to assess mild organic complications in psychiatric patients.

Several testing procedures borrowed from Reitan's extensive investigations of impairment in brain function were employed in the present study (Tactual Performance Test, Trail Making Test, Seashore Rhythm Test, Speech Sounds Perception Test, Finger Oscillation Test). These tests were administer to three groups of Ss matched for age, education, and sex distribution. All Ss were 40 years of age or older. The groups were: hospitalized psychiatric patients suspected by their psychiatrists of some degree of organic impairment; hospitalized psychiatric patients not suspected of any organic impairment; and nonhospitalized, apparently normally functioning control Ss. Four months after the beginning of the study, the psychiatrists reevaluated and reclassified the patient Ss and formed new groups of those suspected and not suspected of organic impairment. A comparison of group means that used the original S groups showed that three of nine test scores were nondiscriminating, while the remaining six discriminated the control Ss from the patients, but not the two patient groups from each other. A similar comparison that used the revised patient groups formed from the psychiatrists' re-evaluations after an additional 4 months of observation yielded four test scores that discriminated successfully between the two patient groups: Tactual Performance Test, total time; Trail Making Test, Part A and Part B; and Finger Oscillation Test, right hand. These four test scores predicted the later classification of the patients more accurately than did the psychiatrists' own original evaluations, which would be in keeping with the general function of diagnostic testing, i.e., to provide initial information about patients beyond that which can be obtained from initial psychiatric examination.

Brain Damage, Chronic↗
PubMed2004

Neurocognitive functioning and quality of life among dually diagnosed and non-substance abusing schizophrenia inpatients.

The aim of this study was to compare the domains of intellectual, memory and executive functions of persons with schizophrenia who concurrently have substance abuse disorders (the dually diagnosed) with a group of non-substance-abusing patients with schizophrenia and to ascertain if there were differences between the two groups in their perceptions of quality of life. Neuropsychological and quality of life data of 46 dually diagnosed and 43 non-substance-abusing patients with schizophrenia was analysed retrospectively. All subjects were inpatients of a state psychiatric hospital. Selected subtests of the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale-III constituted the intellectual and memory measures whilst the measures of executive functioning were the Stroop Color Word Test, the FAS version of the Controlled Oral Word Association Test, and the Trail Making Test (Trails A & B). Perceptions of quality of life were evaluated using the World Health Organization Quality of Life measure. The two groups did not differentiate on intellectual and memory domains, however, the dually diagnosed showed a significantly better facility with tasks of executive functions. In addition, the dually diagnosed expressed higher levels of satisfaction with their quality of life compared to the non-substance-abusing patients with schizophrenia. These results have implications for interventions.

Adult↗
PubMed1998

Long-term tacrine treatment in three mild Alzheimer patients: effects on nicotinic receptors, cerebral blood flow, glucose metabolism, EEG, and cognitive abilities.

The effect of long-term treatment with tacrine (tetrahydroaminoacridine) was studied in three Alzheimer patients (aged 57, 64, and 68 years) with mild dementia. All three patients had a Mini-Mental State Examination score of 24/30 and carried at least one apolipoprotein E (ApoE) epsilon4 allele. Tacrine was given in doses between 80 and to 160 mg daily for 13-31 months. A lower tacrine concentration was observed generally in cerebrospinal fluid (CSF) compared with plasma. The acetylcholinesterase activity in CSF tended to be increased following longer periods of tacrine treatment, whereas the butyrylcholinesterase activity was decreased. The three patients repeatedly underwent positron emission tomography investigation of cerebral blood flow, nicotinic receptors, cerebral glucose metabolism, and electroencephalogram (EEG) and cognitive tests. Positive influences on these parameters were observed following both short-term and long-term treatment with tacrine. Improvement of nicotinic receptors (measured as 11C-nicotine binding), cerebral blood flow, EEG, and some cognitive tests (trail making test, block design test) occurred earlier after initiation of tacrine treatment compared with the glucose metabolism, which was increased after several months of tacrine treatment. An improvement in attention (trail making test) was observed following tacrine as sign for frontal lobe activation (EEG). The functional effects of tacrine in Alzheimer patients appeared to be related to both dose and length of cholinesterase inhibitor treatment.

Aged↗
PubMed1996

Cyclosporine may affect improvement of cognitive brain function after successful cardiac transplantation.

BACKGROUND: The effects of cardiac transplantation on cognitive brain function are uncertain. METHODS AND RESULTS: We measured cognitive brain function and quality of life in out-of-hospital cardiac transplant candidates (n = 55; ejection fraction, 19.9%; age, 54.8 years [means]). After transplantation, the patients were serially reevaluated at 4 months (n = 25) and at 12 months (n = 19). Brain function was measured objectively by cognitive P300 evoked potentials. Additionally, standard psychometric tests (Trail Making Test A, Mini-Mental State Examination, and Profile of Mood State test) were performed. Cognitive P300 evoked potentials were impaired in cardiac transplant candidates (359 ms, recorded at vertex) compared with 55 age- and sex-matched healthy subjects (345 ms, P < .01). Trail Making Test A was also abnormal (45 versus 31 seconds in 55 healthy subjects, P < .01). After transplantation, P300 measures were normalized at 4 months (345 ms, P < .05 versus before transplantation) but declined again at 12 months (352 ms, P = NS versus before transplantation). Stepwise multiple regression analysis revealed that cumulative cyclosporine dosage was the only predictor of individual cognitive brain function 4 months (753 mg/kg body wt, P < .05) and 12 months (2006 mg/kg body wt, P < .01) after transplantation, respectively. CONCLUSIONS: Objective cognitive P300 auditory evoked potential measurements indicate that cognitive brain function is significantly impaired in patients suffering from stable end-stage heart failure. Successful cardiac transplantation is effective to fully normalize impaired brain function. Subsequent relative long-term decline of cognitive brain function after successful cardiac transplantation is strongly suggested to be related to cumulative cyclosporine neurotoxicity.

Affect↗
PubMed1988

Neuropsychological impairment in Wilson's disease.

To examine the neuropsychological deficits of patients with Wilson's disease (WD), 19 neurologically impaired patients with WD were administered the Wechsler Adult Intelligence Scale (revised), Wechsler Memory Scale, Dementia Rating Scale, Wisconsin Card Sorting Test, Boston Naming Test, Trail Making Test, and Animal Naming Test. Their test scores were compared with those of 12 neurologically asymptomatic patients with WD and 15 normal controls. The neurologically impaired patients scored lower than did the control group on the Performance IQ, Full-Scale IQ, Dementia Rating Scale, and Trail Making Test, and they scored lower on the Wechsler Memory Scale than did both the asymptomatic and control groups. The major areas of deficit for the neurologically impaired WD group were in motor and memory functioning. Computed tomographic and neurologic examinations of the neurologically impaired patients with WD generally reflected abnormalities of the basal ganglia.

Adolescent↗