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At least 1,657 records · Page 92Linked to original sources
PubMed2000

Feeling unreal: a PET study of depersonalization disorder.

OBJECTIVE: The goal of this study was to assess brain glucose metabolism and its relationship to dissociation measures and clinical symptoms in DSM-IV depersonalization disorder. METHOD: Positron emission tomography scans coregistered with magnetic resonance images of eight subjects with depersonalization disorder were compared to those of 24 healthy comparison subjects. The two groups did not differ in age, sex, education, performance on a baseline neuropsychological battery, or performance on a verbal learning task administered during [(18)F]fluorodeoxyglucose uptake. A cortical analysis by individual Brodmann's areas was performed. RESULTS: Compared to the healthy subjects, subjects with depersonalization disorder showed significantly lower metabolic activity in right Brodmann's areas 22 and 21 of the superior and middle temporal gyri and had significantly higher metabolism in parietal Brodmann's areas 7B and 39 and left occipital Brodmann's area 19. Dissociation and depersonalization scores among the subjects with depersonalization disorder were significantly positively correlated with metabolic activity in area 7B. CONCLUSIONS: Depersonalization appears to be associated with functional abnormalities along sequential hierarchical areas, secondary and cross-modal, of the sensory cortex (visual, auditory, and somatosensory), as well as areas responsible for an integrated body schema. These findings are in good agreement with the phenomenological conceptualization of depersonalization as a dissociation of perceptions as well as with the subjective symptoms of depersonalization disorder.

Adult↗
PubMed2000

Absence of cognitive impairment at long-term follow-up in adolescents treated with ECT for severe mood disorder.

OBJECTIVE: Cognitive functions of adolescents treated with ECT for mood disorder were evaluated at long-term follow-up. METHOD: At an average of 3.5 years (SD=1.7) after the last ECT, 10 subjects treated during adolescence with bilateral ECT for severe mood disorder completed a clinical and cognitive evaluation, including the California Verbal Learning Test and Squire's Subjective Memory Questionnaire. The same assessments were given to 10 psychiatric comparison subjects matched for sex, age, and diagnosis. RESULTS: All cognitive test scores of the patients treated with ECT were similar to those of the comparison subjects and did not differ from norms from the community. Six of the 10 ECT-treated patients reported having had memory losses immediately after the ECT course, but only one complained of subjective memory impairment at follow-up. CONCLUSIONS: The results suggest that adolescents given ECT for severe mood disorder do not suffer measurable cognitive impairment at long-term follow-up.

Adolescent↗
PubMed2002

Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance.

OBJECTIVE: Studies suggest the presence of premorbid cognitive impairment in patients with schizophrenia, yet the onset and course of these deficits remain unclear. The purpose of this study was to investigate the longitudinal course of premorbid cognitive functioning in individuals with schizophrenia by using prospective data obtained from scholastic test results. METHOD: Scores from grades 4, 8, and 11 on the Iowa Tests of Basic Skills and the Iowa Tests of Educational Development were obtained for 70 subjects who later developed schizophrenia. The mean percentile rank of the subjects' scores in the areas of vocabulary, reading comprehension, language, mathematics, sources of information, and an overall composite category were compared with state norms. RESULTS: The subjects scored below the 50th percentile for each category in all three grades, but only language, reading, sources of information, and composite scores from grade 11 were significantly below state norms. With regard to longitudinal course, there was a significant linear decrease in language scores over time. Scores from grade 11 were positively correlated with WAIS-R IQ, verbal fluency, and Rey Auditory Verbal Learning scores at first illness episode. Scores from grade 11 were not significantly correlated with age at illness onset or ratings of disorganized, psychotic, or negative symptoms. CONCLUSIONS: Scholastic test scores at grades 4 and 8 were nonsignificantly below average in this group of children who later developed schizophrenia. However, test scores dropped significantly between grades 8 and 11. This corresponds to ages 13-16 years, or the onset of puberty. Poor or declining scholastic performance may be a precursor to the cognitive impairment seen during the first episode of illness.

Adolescent↗
PubMed2002

Frontal cortex atrophy predicts cognitive impairment in multiple sclerosis.

The association between regional measures of cortical atrophy and neuropsychological (NP) dysfunction was studied in 35 multiple sclerosis (MS) patients. Patients underwent neurological examination, MRI, and NP testing. Blind quantitative MRI analysis yielded total T(2) lesion area (TLA) and third ventricle width (3VW). Cortical atrophy, rated by blind visual inspection, was more extensive in superior frontal and parietal cortices than in other regions. No MRI measures were correlated with depression scores. TLA and 3VW were significantly correlated with each NP test. Cortical atrophy measures for bilateral superior frontal cortex were retained in regression models predicting impairments in verbal learning, spatial learning, attention, and conceptual reasoning. The authors conclude that cerebral atrophy predicts NP impairment while accounting for the influence of TLA or 3VW. Regions of cortex most susceptible to atrophic and cognitive changes in MS are the right and left superior frontal lobes.

Adult↗
PubMed1996

Assessing the neuropsychological profile of stable schizophrenic outpatients.

In an administration of the Computerized Neuropsychological Test Battery (CNTB), stable schizophrenic outpatients (n = 26) showed significant impairment (P < 0.05) relative to normal control subjects (n = 28) in overall function and measures of verbal learning. Except on tests of motor speed, the performance profile of schizophrenic patients was similar to that of elderly normal control subjects (n = 33). This profile of deficits is consistent with findings of other investigators in similar patient populations. In addition to displaying sensitivity to the mild impairments found in outpatients, the CNTB showed high test-retest reliability (r = 0.76, P < 0.0001). It should be useful for evaluating cognitive impairment in clinical trials of prospective treatments.

Adult↗
PubMed2006

Effect of subjective reasoning and neurocognition on medication adherence for persons with schizophrenia.

OBJECTIVE: This study investigated the relationship between patients' reasoning about medication adherence and neurocognitive and clinical indices for a treatment-compliant sample of Japanese patients with schizophrenia. METHODS: Subjective reasoning about medication adherence was assessed by the Rating of Medication Influences (ROMI) scale. General intelligence, executive function, and verbal memory were assessed by the Wechsler Adult Intelligence Scale-Revised, Wisconsin Card Sorting Test, and Rey Auditory Verbal Learning Test, respectively. RESULTS: Higher prevention scores were associated with lower executive functioning and older age. Influence of others was associated with years of education, medication dosage, and IQ, and medication affinity was associated with education. CONCLUSIONS: These results suggest that executive functioning, education, and general IQ may all be important factors in individual motivation for medication adherence.

Adult↗
PubMed1995

Information-processing patterns in specific reading disability.

This research investigated specific processing strengths and weaknesses among three groups of readers who ranged in age from 6 through 10 years. The first-grade unsuccessful and the older unsuccessful readers had similar information-processing patterns, whereas collectively they differed significantly from the first-grade successful readers on short-term auditory/working memory and decoding/encoding. When separately compared to the controls, the age-matched high-risk group showed additional weakness in rapid automatized naming, and the reading-level-matched older disabled group showed additional weakness in phonological coding as well as visual sequential memory. Examination of second-level classifications using cluster analysis suggested the presence of three potential subtypes among the 50 poor readers. All were characterized by difficulty in what was interpreted as symbolic processing/memory (Subtype 1), which occurred in combination with visual processing deficiencies (Subtype 2) and with deficits in both visual processing and rapid automatized naming (Subtype 3).

Attention↗
PubMed1995

The persistence of rapid naming problems in children with reading disabilities: a nine-year follow-up.

In this study 9 children (6 boys, 3 girls) with reading disabilities and specific difficulties in rapid serial naming were followed from age 9 years to age 18 years. This group was taken from an earlier study sample of 82 third-grade children with learning disabilities. Tests of rapid serial naming, reading and spelling, general intelligence, articulation speed, and word fluency were administered to the subjects and to a matched control group (n = 10) in the initial study (at age 9) and in the present follow-up study (at age 18). The results showed that difficulties in both rapid naming and reading and spelling persisted into early adulthood in this subgroup. The development of naming speed is discussed in terms of a deficit model versus a developmental lag model of learning disability.

Adolescent↗
PubMedDate not supplied

Cognitive deficits in nonretarded adults with fetal alcohol syndrome.

Persons with fetal alcohol syndrome (FAS) who are not mentally retarded often have difficulty qualifying for special educational and vocational services. In this pilot study, 16 nonretarded young adults with FAS were divided into two groups--one with average to above-average IQ and one with borderline to low-average IQ. Participants in both groups manifested clear deficits on neuropsychological measures sensitive to complex attention, verbal learning, and executive function. The frequency and severity of cognitive impairment demonstrated in both FAS groups were greater than what would have been predicted on the basis of IQ alone. The implications of these findings for identification and management of cognitive impairment in individuals with FAS are discussed.

Achievement↗
PubMedDate not supplied

Comparison of EEG background frequency analysis, psychologic test scores, short test of mental status, and quantitative SPECT in dementia.

Fourteen patients who had cognitive dysfunction were studied with quantitative electroencephalography (EEG), single-photon emission computed tomography (SPECT), and several tests of intellectual and memory function, including the Wechsler Adult Intelligence Scale (WAIS), the Auditory Verbal Learning Test, and the Short Test of Mental Status, to determine whether EEG background frequency content correlates with degree of dementia and with regional uptake of radioisotope on SPECT. The factors from spectral analysis that correlated best with psychometric data were mean frequency in the 1.5- to 20-Hz range and percentage power in the 13- to 20-Hz band (positive correlation) or the 1.5- to 8-Hz band (negative correlation). The WAIS subtest scores that correlated most with the EEG data were performance IQ and perceptual organization. Correlations between percentage power and amplitude ratio in the EEG frequency bands and regional SPECT counts were found, but most were not statistically significant.

Aged↗
PubMed2004

Predictors of neuropsychological test performance after pediatric traumatic brain injury.

The influence of neurological and demographic variables on neuropsychological test performance was examined in 100 9-to 16-year-old children with traumatic brain injury (TBI). Regression analyses were conducted to determine the relative contributions of coma, neuroimaging findings, ethnicity, socioeconomic status, and gender to variance in performance on the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), California Verbal Learning Test--Children's Version (CVLT-C), and the Children's Category Test. Both neurological and demographic variables contributed to performance on various WISC-III factor index scores as well as the CVLT-C. No evidence for a moderating effect of demographic variables was found, but speed of information processing mediated the effect of neurological and demographic variables on CLVT-C performance. It is concluded that demographic variables have an incremental effect on the neuropsychological test performance of children with TBI above and beyond the influence of injury severity.

Adolescent↗
PubMed2005

The impact of cognitive and psychiatric impairment of psychotic disorders on the test of memory malingering (TOMM).

The author analyzes the scores of inpatient psychiatric patients with varying degrees of cognitive impairment who met criteria for a psychotic disorder on the following tests: the Test of Memory Malingering (TOMM), the California Verbal Learning Test-Second Edition, Conner's Continuous Performance Test-Second Edition, and the Brief Psychiatric Rating Scale-Expanded Version. Group 1 consisted of psychotic-disordered patients with significant concentration problems (concentration impersistence = 29). Group 2 consisted of psychotic disordered patients without significant concentration problems (no concentration impairment = 21). Although psychotic patients with concentration problems showed greater variability across TOMM trials, both groups obtained mean scores above 45 on Trial 2 and the retention trial on the TOMM. These findings indicate that cognitive impairment associated with psychosis generally does not negatively impair TOMM performance to such a level that would produce a false positive on the TOMM. Implications for forensic assessment, study limitations, and future directions are discussed.

Adult↗
PubMed1994

Comparison of Neuropsychological Test Performance in PTSD, Generalized Anxiety Disorder, and Control Vietnam Veterans

Although impairment in cognitive functioning is theoretically linked to the presence of post-traumatic stress disorder (PTSD), the actual impact of this disorder on neuropsychological performance remains largely unknown. While a modest amount of empirical attention has been directed toward examining the neuropsychological correlates of PTSD, several methodological problems, most notably small sample sizes and the resulting lack of power, have greatly restricted generalizability of findings. The present study examined the neuropsychological performance pattern of Vietnam veterans with PTSD (n = 241) as compared to those with generalized anxiety disorder (n = 241) and no history of psychiatric diagnosis (n = 241). A one-way MANOVA revealed no significant differences among the groups on any of the dependent measures of cognitive functioning, including the Wechsler Adult Intelligence Scale-Revised Block Design subtest, the California Verbal Learning Test, the Rey-Osterrieth Complex Figure Drawing Test, and the Paced Auditory Serial Addition Test. The results are reconciled as they relate to previous research examining the theoretical constructs of PTSD, clinical applications, and directions for future research.

Journal Article↗
PubMedDate not supplied

Effects of galantamine on working memory and global functioning in patients with mild cognitive impairment: a double-blind placebo-controlled study.

Mild cognitive impairment (MCI) causes memory impairment and executive function deficits in those with the condition. There is also some evidence that MCI patients are impaired in their daily functioning. Cholinesterase inhibitors have been widely used for patients with Alzheimer's disease (AD), with evidence of improving cognitive function. There is currently no established treatment for MCI, and cholinesterase inhibitors are beginning to be studied in these patients. Galantamine is a cholinesterase inhibitor that also has nicotinic receptor-modulating properties that has been successful in improving AD patients. This study examined the effects of galantamine in patients with MCI in areas of memory, executive functioning, and global functioning. There was a significant improvement in scores on the Functional Activities Questionnaire, which is a measure of global functioning. There were also improvements in the galantamine group on two of six measures in the Cambridge Automated Neuropsychiatric Test Assessment Battery and in immediate free recall on the California Verbal Learning Test.

Activities of Daily Living↗
PubMed1996

Screening and Neuropsychological Assessment of Spray Painters at Risk for Organic Solvent Neurotoxicity.

The aim of this study was twofold: 1) To examine the usefulness of the screening Questionnaire 16 (Q16) in relation to Type 2 organic solvent neurotoxicity (OSN). Type 2 OSN is defined by chronic exposure to neurotoxic solvents and symptoms of neurotoxocity, and is divided into Type 2A, characterized by sustained personality or mood change, and Type 2B, characterized by impairment in intellectual function. 2) To determine the sensitivities of a number of neuropsychological tests in the assessment of OSN. Subjects of the study were 20 spray painters with high Q16 scores and two control groups-20 spray painters with low Q16 scores, and ten nonexposed panel beaters (aged 23-53 years). The subjects were given psychological and neuropsychological assessments by a psychologist blind to their Q16 status. Seven of the 20 men with high Q16 scores had significant numbers of both neuropsychological and psychological symptoms, with an additional four having small numbers of cognitive symptoms only. Men who had low Q16 scores did not have enough symptoms to indicate clear OSN, although eight men in this group had small numbers of depressed neuropsychological test scores. A MANOVA on individual tests demonstrated that single tests failed to discriminate the groups at the 0.05 level. The results suggest that the Q16 effectively screens men with clear Type 2 OSN, most of whom have both psychological and neuropsychological symptoms. It is less reliable for screening men with few neuropsychological deficits. Those tests most sensitive to the neuropsychological symptoms of OSN are Digit Symbol, the Rey Osterreith Complex Figure, and the California Verbal Learning Test. The results of the study do not provide strong support for the division of Type 2 OSN into Type 2A and Type 2B OSN.

Journal Article↗
PubMed1992

The Edinburgh cohort of HIV-positive drug users: pattern of cognitive impairment in relation to progression of disease.

To examine the neuropsychiatric effects of infection with HIV, 220 drug users (27 HIV negative, 193 HIV positive) completed tests evaluating premorbid intelligence, memory, non-verbal performance, information processing speed, and mood. When these measures were compared cross-sectionally by the severity of HIV illness, symptomatic patients (in CDC stage IV) were impaired on Trails B, two-choice decision time, delayed recall of the Wechsler Logical Memory Test and most components of the Auditory Verbal Learning Test. These findings imply reduced capacity for concentration, speed of thought and memory. When 101 patients were retested a mean of 16 months after their initial assessment, performance on Trails A and B, Block Design and delayed recall of the Wechsler Logical Memory Test deteriorated more for patients at, or progressing within, CDC stage IV, than performance of patients at stage III. The results broadly correspond to the cross-sectional findings. However, there was a decline in all tests of memory function for the sample independent of clinical staging. This may be evidence of brain involvement before the appearance of other symptoms. Self-rated measures of mood did not change cross-sectionally, progressively, or interactively with time and stage of HIV illness, and cannot account for the changes in cognitive function observed. Change in drug use, similarly, does not account for the cognitive findings. Four (5%) of the retested subjects developed AIDS dementia complex, but most of the performance and memory impairments seen were subclinical despite the destructive neuropathology presumed to underlie intellectual decline in patients with HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Dementia Complex↗
PubMed2006

The relationship between hippocampal volume and declarative memory in a population of combat veterans with and without PTSD.

Both reduced hippocampal volume and cognitive alterations have been found in posttraumatic stress disorder (PTSD). The purpose of this article was to examine the relationship between hippocampal volume, combat exposure, symptom severity, and memory performance in a sample of combat veterans with and without a history of PTSD. Subjects were 33 male veteran volunteers (16 PTSD+, 17 PTSD-) who underwent an MRI and neuropsychological testing with the California Verbal Learning Test (CVLT), a measure of declarative memory. Relationships between hippocampal volume (i.e., right + left hippocampal volume/whole brain volume) and performance on the CVLT were determined using partial correlational analysis controlled for age and Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) vocabulary scores. Percent hippocampal volume for the entire sample was positively associated with several aspects of memory performance as reflected by the CVLT. In the PTSD+ group, CVLT performance was negatively correlated with lifetime, but not current CAPS symptoms. CVLT performance appears to be strongly correlated with hippocampal volume in a group of trauma survivors with and without PTSD. Insofar as CVLT performance in the PTSD group was negatively associated with worst episode, but not to current PTSD symptoms, memory performance in combat veterans may reflect some aspect of risk related to the magnitude of the psychological response to trauma, rather than current symptoms that may be interfering with cognitive performance. It will be of interest to study cognitive abilities that may relate to the likelihood of specific PTSD symptoms and to track changes in CVLT performance and hippocampal volume over time in persons with and without a history of trauma exposure.

Aged↗
PubMed2004

Outcomes of a randomized trial of hyperfractionated cranial radiation therapy for treatment of high-risk acute lymphoblastic leukemia: therapeutic efficacy and neurotoxicity.

PURPOSE: We evaluated 8-year survival and late neuropsychologic toxicity in children with acute lymphoblastic leukemia treated in a randomized clinical trial to test whether hyperfractionated (twice daily) cranial radiation therapy (CRT) can reduce incidence and severity of late toxicities associated with 18 Gy of CRT. PATIENTS AND METHODS: Between 1987 and 1995, 369 children treated on two consecutive Dana-Farber Cancer Institute Consortium protocols for high-risk acute lymphoblastic leukemia were randomly assigned to conventionally fractionated CRT (CFX) or hyperfractionated CRT (HFX) to a total dose of 18 Gy. Neuropsychologic testing was completed for 125 of 287 children in continuous complete remission. Event-free and overall survival, as well as neuropsychologic function, were compared for the two arms of the protocol. RESULTS: Eight-year event-free survival (+/- SE) was 80% +/- 3% for children randomly assigned to CFX and 72% +/- 3% for HFX (P =.06). Overall survival was 85% +/- 3% for CFX and 78% +/- 3% for HFX (P =.06). CNS relapses occurred in 2.8% of patients receiving CFX and 2.7% receiving HFX (P =.99). Cognitive function for both groups was solidly in the average range, with no group differences in intelligence, academic achievement, visuospatial reasoning, or verbal learning. Children on the HFX arm exhibited a modest advantage for visual memory (P <.05). CONCLUSION: HFX provides no benefit in terms of cognitive late effects and may compromise antileukemic efficacy. HFX should not be substituted for conventionally dosed CRT in children who require radiation therapy for treatment of acute lymphoblastic leukemia.

Adolescent↗