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PubMed1989

Retrieval plus scanning: does it occur?

In the two experiments reported here, we tested the retrieval-plus-scan model of delayed probe recognition by adding a second probe 2 sec after subjects had responded to the first probe. According to this model, the list items should still be in consciousness from the first probe at the time of the second probe. Consequently, on tests in which the first probe had been tested immediately, we expected to find the same pattern of performance on both first and second probes. On tests in which the first probe came after a filled delay, we expected the first-probe data to show the effects of retrieval and proactive interference. These effects should not be present on the second probe. The results of the first-probe data in both experiments were consistent with the retrieval-plus-scan model. The second-probe data did not fit the model, however. In the first experiment, the second probe on what had been delayed first-probe trials still produced intercept differences, indicating the presence of retrieval. In the second experiment, the effects of proactive interference were still present on the second probe. It is suggested that these results not only invalidate the retrieval-plus-scan model for delayed probe recognition but that they, along with other results, cast doubt on a scanning operation in immediate probe recognition.

Adult↗
PubMed1996

Preparing students for health care delivery of the future: a service education partnership.

In conclusion, redesigning the senior leadership management theory course in our undergraduate baccalaureate nursing program to incorporate new concepts of managed care, case management, critical paths, and multidisciplinary collaborations was successful. Providing students with a "real world" project developing critical paths provided an opportunity for them to make a contribution to an organization while learning verbal and written collaborative skills that may prove crucial to their future in nursing. Critical path development projects will be pursued until those specific needs of the organization have been met. Other opportunities will become obvious for class projects as new challenges are presented for organizations to address in this ever-changing health care delivery system.

Case Management↗
PubMed2006

Objective neuropsychological test performance of professional divers reporting a subjective complaint of "forgetfulness or loss of concentration".

OBJECTIVE: This study attempted to determine whether the higher prevalence of reported "forgetfulness or loss of concentration" among professional divers can be confirmed using objective neuropsychological tests. Secondary aims were to qualify the functional nature of the complaints and to ascertain whether reduced performance was linked to diving history. METHODS: In a case-control study, the neuropsychological test performance of divers complaining of moderate or severe "forgetfulness or loss of concentration" was compared with two age-matched control groups reporting no or slight "forgetfulness or loss of concentration" ("nonforgetful" divers and "nonforgetful" nondivers). The group differences were analyzed using a multivariate analysis of co-variance, followed by canonical discriminant function analysis. Altogether 102 divers with a complaint, 100 nonforgetful divers, and 100 nonforgetful nondivers completed the study. RESULTS: The overall neuropsychological performance differed significantly between the groups [Pillai's trace: F(24,484)=2.04, P=0.003]. Verbal memory (Logical Memory and the California Verbal Learning Test), current intelligence (Wechsler Abbreviated Scale of Intelligence), and sustained attention (rapid visual processing) were poorer among the divers with a complaint than among the nonforgetful divers or the nonforgetful nondivers. The tests of memory, but not those of executive function, differentiated the divers with complaints from the two control groups. Mixed gas bounce diving and surface oxygen decompression diving, but not other techniques, were negatively associated with memory performance. CONCLUSIONS: A cognitive complaint of divers was confirmed using objective tests of neuropsychological performance. Memory, rather than executive function, was affected at the group level, but only to a mild degree. The relationships between diving experience and neuropsychological test performance were small and only seen with diving techniques used in the offshore oil and gas industry.

Adult↗
PubMed1985

Electroconvulsive therapy in 1985--a review.

Electroconvulsive therapy (ECT) has recently been re-examined in randomized, double-blind controlled trials. Although a variable placebo influence has been demonstrated, the effectiveness of ECT in severe depression is now well established. ECT may also have a role in the treatment of resistant schizophrenia. A bilateral convulsion is essential for therapeutic efficiency. Unilateral electrode placement is as effective as bilateral placement and reduces subsequent memory impairment considerably. A reduction in the total electrical energy used to produce the convulsion (with unidirectional squared wave forms and brief pulses) lessens cognitive difficulties after ECT. Long-term memory is not impaired but selective impairment of verbal and non-verbal learning can occur in the short term. Psychopharmacological studies suggest that postsynaptic dopamine transmission may be enhanced by ECT.

Animals↗
PubMed1999

[Construct validity of a new computer-assisted cognitive assessment battery in normal adults].

A computer-assisted battery for neuropsychological tests (CNT) has been designed to screen adults for cognitive impairment. The aim of this study was to gather evidence for the construct validity of CNT and also investigate the relationship between CNT and conventional neuropsychological tests. Subjects were 45 healthy adults (21 men and 24 women), who ranged in age from 20 to 70 years (mean = 33.5, SD = 1.9) with no history of substance abuse, or of psychotic or neurological disorders. The CNT in our study consists of six subtests designed to assess various components of driving, such as digit span, visual scanning, visual and verbal memory, complex reaction time, and vigilance. Mini-mental state test, Kana-hiroi test, word fluency, the auditory-verbal learning test and Raven's colored progressive matrices were also performed as conventional neuropsychological tests. Results showed there were high correlations between each CNT subtests and conventional neuropsychological tests. A factor analysis (with varimax rotation) identified 4 factors with eigen values greater than 1, which accounted for over 70% of the variance. CNT was able to estimate each factor related to cognitive function such as learning and memory, attention, judgment, and visual scanning selectively. CNT may thus be a useful tool for detection of cognitive impairment, although this test has important limitations. Broader applications of these tests will require extensive population-based validation.

Adult↗
PubMed1998

Neurodevelopmental Pathways in Schizophrenia.

We examined early-onset schizophrenia as a neurodevelopmental disorder. These data are from a 2-year longitudinal prospective study of youth with psychotic disorders. Standardized diagnostic and neuropsychological assessments include: Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV; Diagnostic Interview for Children and Adolescents, Revised; Premorbid Adjustment Scale; Wechsler Intelligence Scale for Children-III; the Wisconsin Card Sorting Test (WCST), and the California Verbal Learning Test. Pertinent family and developmental history are obtained via parent interviews and chart review. Forty-eight subjects have been recruited to date; 17 with schizophrenia, 13 with bipolar disorder, 10 with psychosis nos, seven with schizoaffective disorder, and one with an organic psychosis. Subjects with schizophrenia had higher ratings of premorbid social withdrawal and dysfunctional peer relationships. All groups had high rates of cognitive impairment, prenatal/perinatal complications, and comorbid psychiatric disorders. Homotypic family psychiatric history was associated with diagnosis in youth. Our data are consistent with a neurodevelopmental model, whereby specific genetic/neurological risk factors and nonspecific biologic/environmental modulating factors interact in the development of schizophrenia and other psychotic disorders.

Journal Article↗
PubMed1999

Remediation of attention deficits in head injury.

Head injury is associated with psychological sequelae which impair the patient's psychosocial functioning. Information processing, attention and memory deficits are seen in head injuries of all severity. We attempted to improve deficits of focused, sustained and divided attention. The principle of overlapping sources of attention resource pools was utilised in devising the remediation programme. Tasks used simple inexpensive materials. Four head injured young adult males with post concussion syndrome underwent the retraining program for one month. The patients had deficits of focused, sustained and divided attention parallel processing, serial processing, visual scanning, verbal learning and memory and working memory. After the retraining programme the deficits of attention improved in the four patients. Serial processing improved in two patients. Parallel processing and neuropsychological deficits did not improve in any patient. The symptom intensity reduced markedly and behavioural functioning improved in three of the four patients. The results supported an association between improving attention and reduction of symptom intensity. Attention remediation shows promise as a cost effective, time efficient and simple technique to improve the psychological and psychosocial functioning of the head injured patient.

Adult↗
PubMedDate not supplied

Memory dysfunction in multiple sclerosis corresponds to juxtacortical lesion load on fast fluid-attenuated inversion-recovery MR images.

BACKGROUND AND PURPOSE: MR imaging is a sensitive diagnostic tool and paraclinical marker of disease activity and prognosis in multiple sclerosis (MS), yet the role of MR imaging of MS is controversial. The aim of this study was to describe the relationship between cognitive function and MS lesion size and position, as shown on comparative images from conventional spin-echo (CSE) and fast fluid-attenuated inversion-recovery (fast FLAIR) MR studies. METHODS: CSE and fast FLAIR sequences consisted of 40 noncontiguous, 3-mm-thick axial sections matched for geometric position in 18 patients with relapsing-remitting MS. Lesions were scored for size, anatomic position, and their comparative appearance on CSE and fast FLAIR images. The neuropsychological assessment tested general psychological performance, memory, and frontal lobe executive function. RESULTS: Fast FLAIR images showed significantly more small (146 versus six) and medium-sized (18 versus four) juxtacortical lesions than did CSE sequences. Small juxtacortical lesions displayed only on fast FLAIR images had a distinctive appearance, suggestive of small areas of perivascular inflammation. The number of these lesions corresponded to reduced performance on the fifth and delayed trials of the Rey Auditory Verbal Learning memory function test. CONCLUSION: Fast FLAIR images show small lesions at the juxtacortical boundary that are not seen on CSE studies. The presence of such lesions correlates with impaired retention of information in memory tasks, which is characteristic of cognitive problems in patients with MS.

Adult↗
PubMed2000

Demographic, clinical, and neurocognitive correlates of everyday functional impairment in severe mental illness.

Although cognitive deficits often accompany severe mental illness, their implications for everyday functioning remain poorly understood. In this study, an occupational therapist (OT) rated the everyday functioning of 105 adult psychiatric patients. Using demographic, clinical, and cognitive variables, the authors tested alternative models to account for the observed variability in OT ratings. Although age, education, and the presence of schizophrenia each contributed to a model that accounted for 27% of the variation in functional independence, adding terms for auditory divided attention and verbal learning increased the proportion of explained variance to 45% and decreased the beta weights for age and education--but not schizophrenia--to nonsignificant levels. These findings demonstrate the relevance of cognitive performance to everyday functioning in severe mental illness. They are discussed with respect to hypothesized determinants of psychiatric disability.

Activities of Daily Living↗
PubMed2000

A neuropsychological study of the postpolio syndrome: support for depression without neuropsychological impairment.

OBJECTIVE: This study aimed to examine cognitive functioning in postpolio syndrome (PPS) after controlling for the effects of depression and illness behavior. BACKGROUND: Few studies have investigated the possible cognitive sequelae of PPS, despite widespread documented subjective complaints of "mental fatigue." METHOD: A total of 23 PPS sufferers, 20 polio survivors without PPS, and 22 matched controls were compared using the Beck Depression Inventory-II; the Illness Behaviour Questionnaire; a chronic fatigue syndrome symptom checklist; and several measures of memory, attention, and concentration, including the Brown-Petersen Task, Stroop Test, Austin Maze, California Verbal Learning Test, Trail Making Test, Controlled Oral Word Association Test, and Symbol-Digit Modalities Test. RESULTS: In those participants with a medically confirmed diagnosis of PPS, there was a significantly higher level of depressive and hypochondriacal symptomatology as compared with the other two groups. Nevertheless, no significant differences existed between the three groups on neuropsychological measures. CONCLUSIONS: These results indicate that the attention and memory difficulties reported by PPS sufferers may be linked to the physical or psychological manifestations of the illness rather than to objective decrements in cognitive performance.

Adult↗
PubMed2000

Serial processing in reading aloud: no challenge for a parallel model.

K. Rastle and M. Coltheart (1999) challenged parallel models of reading by showing that the cost of irregularity in low-frequency exception words was modulated by the position of the irregularity in the word. This position-of-irregularity effect was taken as strong evidence of serial processing in reading. This article refutes Rastle and Coltheart's theoretical conclusions in 3 ways: First, a parallel model, the connectionist dual process model (M. Zorzi, G. Houghton, & B. Butterworth, 1998b), produces a position-of-irregularity effect. Second, the supposed serial effect can be reduced to a position-specific grapheme-phoneme consistency effect. Third, the position-of-irregularity effect vanishes when the experimental data are reanalyzed using grapheme-phoneme consistency as the covariate. This demonstration has broader implications for studies aiming at adjudicating between models: Strong inferences should be avoided until the computational models are actually tested.

Attention↗
PubMed2000

Asperger's syndrome.

This study presents a 14-year-old Saudi child with poor school achievement, diagnosed by psychiatrists as mentally retardated with a significant social deficit. No neurological disorder was evident. She has high to very high intellectual abilities on testing her intelligence quotient. Her verbal learning ability was also very high. Her social skills and capacity were impaired. No evidence of poor language was detected. The patient is diagnosed as suffering from Asperger's syndrome, and not mentally retarded. She has the criteria for Asperger's syndrome according to Diagnostic and Statistical Manual, 4th edition, including the significant social deficit with normal intellectual functioning. The utility of such a diagnosis is briefly discussed.

Adolescent↗
PubMedDate not supplied

Neuropsychological symptoms associated with low-level exposure to solvents and (meth)acrylates among nail technicians.

OBJECTIVE: To evaluate reports of neuropsychological symptoms among women occupationally exposed to products commonly used in nail studios. BACKGROUND: Typical preparations found in nail studios contain a variety of organic solvents (e.g., toluene, acetone, formaldehyde) and (meth)acrylates with known neurotoxic properties. Little research has focused on the neuropsychological sequelae of exposure to these substances occurring in the cosmetics industry. METHOD: Participants included nail salon technicians (n = 150) and controls (n = 148). Nail technicians were compared with demographically similar controls using the Neuropsychological Impairment Scale, a self-reported measure of neuropsychological and psychological symptoms. Aspects of the workplace environment (e.g., square footage of the salon, adequacy of ventilation, hours worked) also were assessed. RESULTS: A MANOVA revealed small but significant differences in the overall level of symptoms as well as in individual scales measuring neurologic complaints, cognitive efficiency, memory, verbal learning, and academic skills (p < 0.001). Moreover, nail technicians were significantly more likely to score above the clinical cutoffs than were controls on four of the seven clinical scales and two of the three summary indices. Multiple regression analysis indicated that the severity of symptoms was associated with level of occupational exposure (p < 0.01). The cumulative impact of workplace size and ventilation were most strongly associated with symptom severity. CONCLUSIONS: Exposure to low-level neurotoxins common to nail studios results in the self-reported experience of cognitive and neurologic symptoms similar to other types of solvent and (meth)acrylate exposure. The profile of reported symptoms is consistent with deficits typically observed in this type of neurotoxic exposure: neurologic complaints as well as perceived problems with cognitive efficiency, memory, and learning. Additionally, the nail technicians reported a higher overall level of complaints and greater severity of symptoms than did the controls.

Adolescent↗
PubMedDate not supplied

[Cognitive effects of therapy with topiramate in patients with refractory partial epilepsy].

INTRODUCTION: Multiple studies have demonstrated that antiepileptic drug therapy may have consequences on cognitive function. Topiramate (TPM) is a new antiepileptic drug characterized by several mechanisms of action, which has proved to be clinically effective in the reduction of the quantity of crisis in epileptic patients. Clinical studies frequently report subjective cognitive complains, inconsistently sustained. The main objective of this study was to assess neuropsychological effects attributable to the addition of TPM to the current antiepileptic therapy, in patients with refractory partial epilepsy. PATIENTS AND METHODS: 44 patients were assessed through a cognitive battery applied before beginning of therapy with TPM and 6 months after the dosage had been stabilized. Tests had been chosen to assess verbal and non verbal memory, executive functions, language, visuomotor processing and psychomotor functions. The cognitive study was conducted in parallel with clinical trials TOPMAT-EPAJ-111 and TOP-POR1. RESULTS: The statistical analysis of results didn t show changes in motor tests, in sustained attention and in logical and visual memory. Deterioration of semantic verbal fluency, verbal learning, work memory and visuomotor skills was observed. Considering the effects of the dosage of topiramate and the total quantity of antiepileptic drugs, major commitment was observed in patients taking more than 400 mg/day. CONCLUSIONS: Like other antiepileptic drugs, topiramate, used in polytherapy in patients with refractory epilepsy, may have consequences on cognitive functions. These changes may be related with the potentiating action of this drug at the level of neurotransmission system of gamma amino butyric acid (GABA), substance that has inhibitory properties in the fore regions of the brain.

Adolescent↗
PubMedDate not supplied

[Broad clinical and prognostic spectrum of the Rolandic epilepsies. Typical forms].

OBJECTIVE: We reviewed studies on Rolandic epilepsies (ER) and analyzed them according to definite criteria to establish the typical clinical and electroencephalographic phenotypes and therapeutic strategy to be used. DEVELOPMENT: The criteria for definition leave gaps which permit inclusion, as typical forms of ER, variant forms or syndromes related to ER. Clinical phenotypes: 1) Classical phenotypes with senso motor, phonatory or autonomic seizures; 2) Benign partial state which is rarely seen; 3) ER with cognitive involvement usually of attention, reading, auditory verbal learning, semantic fluency and visuomotor coordination; 4) Idiopathic ER with interictal facial myoclonus; and 5) Other phenotypes include ER coinciding with a pre existing cerebral disorder and transient EPOCS of iatrogenic origin. EEG phenotypes: 1) Classical EEG with unilateral or bilateral, synchronous or asynchronous Rolandic paroxysms; 2) Phenotypes with generalized PO; 3) Phenotype with centroparietal slow waves, rare and usually transient. The various authors do not agree as to whether treatment should be recommended although in the studies we consulted there was a high proportion of ER and it was recognized that the risk of inducing EPOCS on treatment was low. CONCLUSIONS: Analysis of the literature of typical forms of ER shows that apart from the classical form there is a continuous range of epileptic dysfunction, both clinical and of EEG, which includes the related variant forms and syndromes, although the long term prognosis of all is good, some with and some without treatment

Electroencephalography↗
PubMed2002

Cognitive impairment in heart failure: issues of measurement and etiology.

BACKGROUND: Clinicians need easy methods of screening for cognitive impairment in patients with heart failure. If correlates of cognitive impairment could be identified, more patients with early cognitive impairment could be treated before the problem interfered with adherence to treatment. OBJECTIVES: To describe cognitive impairment in patients with heart failure, to explore the usefulness of 4 measures of cognitive impairment, and to assess correlates of cognitive impairment. METHODS: A descriptive, correlational design was used. Four screening measures of cognition were assessed in 42 patients with heart failure: Commands subtest and Complex Ideational Material subtest of the Boston Diagnostic Aphasia Examination, Mini-Mental State Examination, and Draw-a-Clock Test. Cognitive impairment was defined as performance less than the standardized (T-score) cutoff point on at least 1 of the 4 measures. Possible correlates of cognitive impairment included age, education, hypotension, fluid overload (serum osmolality < 269 mOsm/kg), and dehydration (serum osmolality > or = 295 mOsm/kg). RESULTS: Cognitive impairment was detected in 12 (28.6%) of 42 participants. The 4 screening tests varied in effectiveness, but the Draw-a-Clock Test indicated impairment in 50% of the 12 impaired patients. A summed standardized score for the 4 measures was not significantly associated with age, education, hypotension, fluid overload, or dehydration in this sample. CONCLUSIONS: Cognitive impairment is relatively common in patients with heart failure. The Draw-a-Clock Test was most useful in detecting cognitive impairment, although it cannot be used to detect problems with verbal learning or delayed recall and should not be used as the sole screening method for patients with heart failure. Correlates of cognitive impairment require further study.

Adult↗
PubMed2003

Effect of manipulation and irrelevant noise on working memory capacity of patients with Alzheimer's dementia.

The effect of manipulation and distracting noise on immediate serial recall was measured in patients with dementia of the Alzheimer type (DAT), neurologically healthy elderly individuals, and young adults. In Experiment 1, the authors compared serial word recall with word recall in alphabetical order. Alphabetical recall requires the active manipulation of the contents of working memory. Findings indicated that DAT patients were severely impaired in the alphabetical recall task, whereas the performance of neurologically healthy elderly participants was comparable with the performance of young adult participants. In Experiment 2, the authors investigated the effect of different irrelevant auditory backgrounds on immediate digit recall. In this task, both elderly participants and DAT patients performed similarly to the group of young adult participants, indicating comparable efficacy to resist auditory distraction.

Adolescent↗
PubMedDate not supplied

[Position test: an instrument for measuring the cognitive plasticity in the elderly with mild cognitive impairment].

INTRODUCTION: The search for variables that mediate in the shift from mild cognitive impairment (MCI) to dementia is currently a very active field of research. In this area, the term cognitive plasticity or modifiability can be of great interest. Proof of the existence of plasticity in the elderly with MCI and its possible value as an indicator of the shift from this condition to dementia have aroused an interest in investigating evaluation tools that enable the evaluation of plasticity in old age. AIMS. In this study we assess the validity of the position test (PT) as a measure of cognitive plasticity in the elderly and we examine its existence in people with MCI. PATIENTS AND METHODS: A total of 117 elderly subjects were evaluated with the Spanish version of the MMSE (Minimental State Examination) as a screening test for cognitive impairment, the AVLT LP (Auditory Verbal Learning Test Learning Potential), a test that is frequently used to evaluate plasticity, and the PT. RESULTS: Findings show that the PT evaluates cognitive plasticity in the elderly suffering from MCI, that it is possible to shorten the test without losing its evaluative properties and that performance in the test is not affected by educational level. Furthermore, it also reveals the fact that some elderly people with MCI show plasticity. CONCLUSION: The data obtained allow us to state that the PT is ideal for evaluating plasticity in the elderly, and we also recommend further research into plasticity and its possible relation with the cognitive progress of people with MCI.

Aged↗