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Sample records for amenorrhea neurocognitive screening

  1. Chemotherapy-induced amenorrhea: a prospective study of brain activation changes and neurocognitive correlates.

    Science.gov (United States)

    Conroy, Susan K; McDonald, Brenna C; Ahles, Tim A; West, John D; Saykin, Andrew J

    2013-12-01

    Chemotherapy-induced amenorrhea (CIA) often occurs in pre- and peri-menopausal BC patients, and while cancer/chemotherapy and abrupt estrogen loss have separately been shown to affect cognition and brain function, studies of the cognitive effects of CIA are equivocal, and its effects on brain function are unknown. Functional MRI (fMRI) during a working memory task was used to prospectively assess the pattern of brain activation and deactivation prior to and 1 month after chemotherapy in BC patients who experienced CIA (n = 9), post-menopausal BC patients undergoing chemotherapy (n = 9), and pre- and post-menopausal healthy controls (n = 6 each). Neurocognitive testing was also performed at both time points. Repeated measures general linear models were used to assess statistical significance, and age was a covariate in all analyses. We observed a group-by-time interaction in the combined magnitudes of brain activation and deactivation (p = 0.006): the CIA group increased in magnitude from baseline to post-treatment while other groups maintained similar levels over time. Further, the change in brain activity magnitude in CIA was strongly correlated with change in processing speed neurocognitive testing score (r = 0.837 p = 0.005), suggesting this increase in brain activity reflects effective cognitive compensation. Our results demonstrate prospectively that the pattern of change in brain activity from pre- to post-chemotherapy varies according to pre-treatment menopausal status. Cognitive correlates add to the potential clinical significance of these findings. These findings have implications for risk appraisal and development of prevention or treatment strategies for cognitive changes in CIA.

  2. Adherence and neurocognitive screening in Romanian HIV patients

    Directory of Open Access Journals (Sweden)

    M Arbune

    2012-11-01

    Full Text Available Background: Adherence is critical for the effectiveness of antiretroviral HIV therapy (ART, accordingly decreasing the opportunistic diseases and increasing the quality of life. Neurocognitive disorders (NCD are still frequent in ART era and could impair the adherence, but how ethical is to refer ART in patients with NCD? Objective: To assess the relation between NCD and adherence in HIV Romanian patients. Material and methods: Cross-sectional screening study on 151 patients under ART, no drug users, from HIV Clinic - Galati, assessed by HIV-Associated Dementia Scale (HDS, Hospital Anxiety and Depression Scale (HADS [1], ART CNS-effectiveness Letendre scores [2] and adherence assessment questionnaire CNLAS- Romania. Normal values: HDS >10; anxiety/ depression <8. Statistical analysis performed: Chi-square test and Mann-Whitney test, with 5% significance level. Results: Characteristics of the patients: median age 22 [20; 56] years old; sex ratio F/M 1.17; median educational level 8 [0; >12] years; HBV co-infection 27.8%; AIDS stage 85.3%; current median CD4 526/mm3 [8; 1605] and 65% undetectable HIV-RNA levels. 49.6% (75/151 patients attain HDS scores <10 and imply probable NCD. Scores below 8 for anxiety are more frequent than for depression: 24% vs 13%. The median ART CNS penetration score is 8 [5; 12]. Adherence is considered for 66% patients and is correlating with CD4 number (p=0.001, educational level >4 years (p=0.001; OR=4.2, HDS >10 (p=0.01; OR=2.4 and ART-CNS penetration score >7 (p=0.023; OR=2.4. Low HDS are influenced by old age (p=0.003, depression (p=0.02 and ART-CNS penetration scores <7 (p=0.01. Anxiety is related neither with adherence nor with NCD by HDS, but females are obvious anxious than males (p<0.001. Conclusions: Basic educational level is sufficient for developing ART adherence. High scores of HDS screening should be predictors for ART adherence. Referring ART as well to patients with low HDS scores is rational and

  3. The construct validity of a brief neurocognitive screening battery in a paediatric oncology population

    OpenAIRE

    Prince, Elizabeth

    2014-01-01

    Introduction: Central nervous system (CNS) tumours and leukaemia in children are associated with detrimental neurocognitive outcomes across a wide range of cognitive domains. It is recommended these children receive regular neuropsychological assessment to screen for deficits that may affect their long term outcomes. Barriers to this include time constraints and practice effects associated with traditional neuropsychological assessment. CogState is a brief computerised neuropsychological batt...

  4. Secondary amenorrhea (image)

    Science.gov (United States)

    Secondary amenorrhea is the cessation of menstrual flow for a period of 6 months or more in the absence ... as anxiety can be the root cause of amenorrhea. Treatment can range from behavior modification for excessive ...

  5. Risk factors for neurocognitive impairment in HIV-infected patients and comparison of different screening tools

    Directory of Open Access Journals (Sweden)

    Elisa Moreira de Souza

    Full Text Available HIV-associated neurocognitive disorder (HAND is relatively frequent among HIV-infected patients and is often underdiagnosed. Assessment of HAND in daily clinical practice is challenging and different tools have been proposed. Objective : To evaluate risk factors and compare different screening tools for neurocognitive impairment in HIV-infected patients. Methods : HIV-infected patients were evaluated using the International HIV-Dementia Scale (IHDS, Mini-Mental State Examination (MMSE and a neurocognitive self-perception questionnaire recommended by the European AIDS Clinical Society. Sociodemographic, clinical and laboratory data were obtained through chart review and patient interview. Results : Among the 63 patients included, low performance on the IHDS was observed in 54.0% and IHDS score was inversely associated with age (OR 0.13; 95%CI [0.02-0.67]. Regarding cognitive self-perception, 63.5% of patients reported no impairment on the three domains covered by the questionnaire. Among those patients self-reporting no problems, 42.1% had low performance on the IHDS. None of the patients scored below the education-adjusted cut-off on the MMSE. Conclusion : IHDS scores suggestive of HAND were observed in more than half of the patients and lower scores were found among older patients. There was low agreement between the different tools, suggesting that the MMSE may be inadequate for assessing HAND. The self-assessment questionnaire had low sensitivity and might not be useful as a screening tool.

  6. Amenorrhea: an approach to diagnosis and management.

    Science.gov (United States)

    Klein, David A; Poth, Merrily A

    2013-06-01

    Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition is failure to reach menarche, is often the result of chromosomal irregularities leading to primary ovarian insufficiency (e.g., Turner syndrome) or anatomic abnormalities (e.g., Müllerian agenesis). Secondary amenorrhea is defined as the cessation of regular menses for three months or the cessation of irregular menses for six months. Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency. Pregnancy should be excluded in all cases. Initial workup of primary and secondary amenorrhea includes a pregnancy test and serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone. Patients with primary ovarian insufficiency can maintain unpredictable ovarian function and should not be presumed infertile. Patients with hypothalamic amenorrhea should be evaluated for eating disorders and are at risk for decreased bone density. Patients with polycystic ovary syndrome are at risk for glucose intolerance, dyslipidemia, and other aspects of metabolic syndrome. Patients with Turner syndrome (or variant) should be treated by a physician familiar with the appropriate screening and treatment measures. Treatment goals for patients with amenorrhea may vary considerably, and depend on the patient and the specific diagnosis.

  7. Are MMSE and HDS-R neuropsychological tests adequate for screening HIV-associated neurocognitive disorders?

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    Nakazato, Ai; Tominaga, Daisuke; Tasato, Daisuke; Miyagi, Kyoko; Nakamura, Hideta; Haranaga, Shusaku; Higa, Futoshi; Tateyama, Masao; Fujita, Jiro

    2014-03-01

    HIV-associated neurocognitive disorders (HAND) are one of major comorbidities in patients with HIV-1 infection. There are currently no standardized tests for screening HAND in such patients. The sensitivity of the cognitive function tests routinely used in clinical practice, such as the Mini-Mental State Examination and the Revised Hasegawa's Dementia Scale, is inadequate to rule out HAND, even in patients with clear abnormal behavior. We report a 41-year-old man with HIV-associated dementia, the most severe form of HAND, in whom the simplified methods did not show abnormal results, and a comprehensive battery of neuropsychological tests which covering several cognitive domains was needed to detect cognitive impairment.

  8. Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada

    OpenAIRE

    2014-01-01

    CRANIum, a cross-sectional epidemiology study in Western Europe and Canada, was conducted to describe and compare the prevalence of a positive screen for neurocognitive impairment (NCI), depressive symptoms, and anxiety in an HIV-positive population either receiving combination antiretroviral therapy (cART) or who were naive to antiretroviral therapy (ART). HIV-positive patients ≥18 years of age attending a routine medical follow-up visit and able to complete the designated screening tools we...

  9. Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada.

    Science.gov (United States)

    Robertson, Kevin; Bayon, Carmen; Molina, Jean-Michel; McNamara, Patricia; Resch, Christiane; Muñoz-Moreno, Jose A; Kulasegaram, Ranjababu; Schewe, Knud; Burgos-Ramirez, Angel; De Alvaro, Cristina; Cabrero, Esther; Guion, Matthew; Norton, Michael; van Wyk, Jean

    2014-01-01

    CRANIum, a cross-sectional epidemiology study in Western Europe and Canada, was conducted to describe and compare the prevalence of a positive screen for neurocognitive impairment (NCI), depressive symptoms, and anxiety in an HIV-positive population either receiving combination antiretroviral therapy (cART) or who were naive to antiretroviral therapy (ART). HIV-positive patients ≥18 years of age attending a routine medical follow-up visit and able to complete the designated screening tools were eligible for study inclusion. The Brief Neurocognitive Screen was used to assess NCI; depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale. The evaluable patient population (N = 2863) included 1766 men (61.7%) and 1096 (38.3%) women. A total of 1969 patients were cART-experienced (68.8%), and 894 were ART-naive (31.2%). A positive screen for NCI was found in 41.5% of patients (cART-experienced, 42.5%; ART-naive, 39.4%; p = 0.12). A positive screen for depressive symptoms was found in 15.7% of patients (cART-experienced, 16.8%; ART-naive, 13.3%; p = 0.01), whereas 33.3% of patients screened positive for anxiety (cART-experienced, 33.5%; ART-naive, 32.8%; p = 0.71). A greater percentage of women compared with men screened positive for NCI (51.78% vs. 35.1%; p < 0.0001) and depressive symptoms (17.9% vs. 14.3%; p = 0.01). These data suggest that neurocognitive and mood disorders remain highly prevalent in HIV-infected patients. Regular mental health screening in this population is warranted.

  10. [Functional hypothalamic amenorrhea].

    Science.gov (United States)

    Stárka, Luboslav; Dušková, Michaela

    2015-10-01

    Functional hypothalamic amenorrhea (FHA) besides pregnancy and syndrome of polycystic ovary is one of the most common causes of secondary amenorrhea. FHA results from the aberrations in pulsatile gonadotropin-releasing hormone (GnRH) secretion, which in turn causes impairment of the gonadotropins (follicle-stimulating hormone and luteinizing hormone). FHA is a form of the defence of organism in situations where life functions are more important than reproductive function. FHA is reversible; it can be normalized after ceasing the stress situation. There are three types of FHA: weight loss related, stress-related, and exercise-related amenorrhea. The final consequences are complex hormonal changes manifested by profound hypoestrogenism. Additionally, these patients present mild hypercortisolemia, low serum insulin levels, low insulin-like growth factor 1 (IGF-1) and low total triiodothyronine. Women health in this disorder is disturbed in several aspects including the skeletal system, cardiovascular system, and mental problems. Patients manifest a decrease in bone mass density, which is related to an increase in fracture risk. Therefore, osteopenia and osteoporosis are the main long-term complications of FHA. Cardiovascular complications include endothelial dysfunction and abnormal changes in the lipid profile. FHA patients present significantly higher depression and anxiety and also sexual problems compared to healthy subjects.

  11. [Diagnosis and management of amenorrhea in adolescent girls].

    Science.gov (United States)

    Laroche, E; Bricaire, L; Christin-Maitre, S

    2013-07-01

    Amenorrhea in adolescents can be primary, with or without breast development, or secondary. Whether amenorrhea is primary or secondary, height, body mass index, food intake, the level of physical activity per week, the presence of hirsutism or galactorrhea, pelvic pain and past history of intercourse need to be investigated. Initially, blood tests should include hCG, FSH, estradiol, testosterone and prolactin serum levels. This screening will discriminate between hypogonadotropic hypogonadism and amenorrhea from primary ovarian insufficiency (POI). In case of primary amenorrhea, hypogonadism may be due to congenital hypogonadotropic hypogonadism (HH) or more rarely acquired HH. If FSH is elevated, amenorrhea is due to primary ovarian failure, mainly related to Turner syndrome. If pubertal development is normal, a pelvic ultrasound should be performed. It may visualize a hindering of menses output or less frequently an absence of uterus, as in Rokitansky syndrome or androgen insentivity syndrome. The most frequent etiologies of secondary amenorrhea are polycystic ovarian syndrome (PCOS), functional hypothalamic amenorrhea and less frequently POI and hyperprolactinemia. The differential diagnoses of PCOS are late-onset 21-hydroxylase deficiency and very rare ovarian or adrenal tumors. When contraception is not necessary, hormonal replacement therapy, including estrogen and progestins should be administered in order to avoid hypoestrogenism. In case of PCOS, sequential progestins can be prescribed. A contraceptive pill can be considered when contraception is needed and/or when hyperandrogenism needs to be treated.

  12. An initial screening for HIV-associated neurocognitive disorders of HIV-1 infected patients in China

    OpenAIRE

    Zhang, Yulin; Qiao, Luxin; Ding, Wei; Wei, Feili; Zhao, Qingxia; WANG, XICHENG; Shi, Ying; Li, Ning; Smith, Davey; Chen, Dexi

    2012-01-01

    HIV-associated neurocognitive disorders (HAND), characterized by cognitive, motor, and behavioral abnormalities, are common among people living with HIV and AIDS. In combined antiretroviral therapy era in Western countries, nearly 40% of HIV-infected patients continue to suffer from HAND, mainly with mild or asymptomatic cognitive impairment. However, the prevalence and the clinical features of HAND in China are still not well known. In this study, a multi-center cross-sectional study was per...

  13. A Comparison of Five Brief Screening Tools for HIV-Associated Neurocognitive Disorders in the USA and South Africa.

    Science.gov (United States)

    Joska, J A; Witten, J; Thomas, K G; Robertson, C; Casson-Crook, M; Roosa, H; Creighton, J; Lyons, J; McArthur, J; Sacktor, N C

    2016-08-01

    Screening for HIV-associated neurocognitive disorders (HAND) is important to improve clinical outcomes. We compared the diagnostic sensitivity and specificity of the mini-mental state examination, International HIV dementia scale (IHDS), Montreal cognitive assessment, Simioni symptom questionnaire and cognitive assessment tool-rapid version (CAT-rapid) to a gold standard neuropsychological battery. Antiretroviral-experienced participants from Cape Town, South Africa, and Baltimore, USA, were recruited. The sensitivity and specificity of the five tools, as well as those of the combined IHDS and CAT-rapid, were established using 2 × 2 contingency tables and ROC analysis. More than a third (65165) had symptomatic HAND. In detecting HIV-D, the CAT-Rapid had good sensitivity (94 %) and weak specificity (52 %) (cut-point ≤10), while the IHDS showed fair sensitivity (68 %) and good specificity (86 %) (cut-point ≤10). The combined IHDS and CAT-rapid showed excellent sensitivity and specificity for HIV-D at a cut-off score of ≤16 (out of 20; 89 and 82 %). No tool was adequate in screening for any HAND. The combination IHDS and CAT-rapid tool appears to be a good screener for HIV-D but is only fairly sensitive and poorly specific in screening for any HAND. Screening for milder forms of HAND continues to be a clinical challenge.

  14. Primary amenorrhea: diagnosis and management.

    Science.gov (United States)

    Marsh, Courtney A; Grimstad, Frances W

    2014-10-01

    Puberty is a defining time of many adolescents' lives. It is a series of events that includes thelarche, pubarche, and menarche. Primary amenorrhea is the absence of menarche. There are numerous etiologies including outflow tract obstructions, gonadal dysgenesis, and anomalies of the hypothalamic axis. This review's aims are to define primary amenorrhea and describe the various causes, their workups, associated comorbidities, and treatment options. At the end, a generalist should be able to perform an assessment of an adolescent who presents with primary amenorrhea and, if warranted, begin initial treatment.

  15. Screening for Neurocognitive Impairment in HIV-Infected Individuals at First Contact after HIV Diagnosis: The Experience of a Large Clinical Center in Northern Italy.

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    Focà, Emanuele; Magro, Paola; Motta, Davide; Compostella, Silvia; Casari, Salvatore; Bonito, Andrea; Brianese, Nigritella; Ferraresi, Alice; Rodari, Paola; Pezzoli, Maria Chiara; Quiros-Roldan, Eugenia; Castelli, Francesco

    2016-03-24

    Neurocognitive disorders are emerging, probably underestimated, complications in HIV-infected people. The aim of the study was to assess neurocognitive profiles of newly detected HIV-infected patients. We performed an observational retrospective single-cohort study. Illiterates and patients with neurologic symptoms or previous psychiatric diagnosis were excluded. Neuropsychological profiles were assessed using a validated battery of neuropsychological tests. We included 206 patients; with males representing the majority of them (85%). Risk factors for HIV acquisition were unprotected sexual intercourse (homo/bisexual in 39.8% and heterosexual in 60.2%). Thirty-nine patients (18.9%) were previous injection drug users, while 41 (19.9%) were alcohol abusers. Mean education was 11.1 years (SD--standard deviation--3.7). A high prevalence of HIV-associated neurocognitive disorders (HAND, 47.1%) was present in HIV-infected patients: particularly, asymptomatic neurocognitive impairment (ANI) was found in 30.6%, mild neurocognitive disorder (MND) in 15% and HIV-associated dementia (HAD) in 1.5%. Male gender, low degree of education, AIDS diagnosis and gepatitis B virus (HBV) co-infection were factors independently associated with HAND in a multivariable logistic regression model. Our data suggest that patient-specific factors and AIDS diagnosis have a certain kind of impact in HAND occurrence. A complete neuropsychological screening must be recommended in all patients at HIV-infection diagnosis.

  16. Neurocognitive screening of mercury-exposed children of Andean gold miners.

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    Counter, S Allen; Buchanan, Leo H; Ortega, Fernando

    2006-01-01

    Performance on Raven's Coloured Progressive Matrices (RCPM) test of visual-spatial reasoning was used to evaluate the effects of mercury (Hg) exposure on 73 Andean children aged 5 to 11 years (mean: 8.4) living in the Nambija and Portovelo gold mining areas of Ecuador, where Hg is widely used in amalgamation. Mean levels of Hg found in blood (Hg(B)), urine (Hg(U)), and hair (Hg(H)) samples were 5.1 microg/L (SD: 2.4; range: 1-10 microg/L), 13.3 microg/L (SD: 25.9; range: 1-166 microg/L), and 8.5 microg/g (SD: 22.8; range: 1-135 microg/g), respectively. Of the children in the Nambija area 67-84.9% had abnormal RCPM standard scores (i.e., < or = 25%tile), depending on the test norm used in the data analysis. Higher standard scores for Peruvian (t = 4.77; p = < 0.0001) and Puerto Rican (t = 4.51; p = < 0.0001) norms than for U.S. norms suggested a linguistic influence. No difference was found between Peruvian and Puerto Rican norms (t = 0.832; p = < 0.408), which showed a significant positive correlation (r = 0.915, p = < 0.0001). Children with abnormal Hg(B) and Hg(H) levels had significantly lower scores on the RCPM subtest B than did children with nontoxic Hg levels (t = -2.16; p = < 0.034). These results suggest that a substantial number of Hg-exposed children in the Nambija study area have neurocognitive deficits in visual-spatial reasoning.

  17. Treating Athletic Amenorrhea: A Matter of Instinct?

    Science.gov (United States)

    Monahan, Terry

    1987-01-01

    Information is presented on the current status of research and treatment of athletic amenorrhea, including discussion of etiology, difficulties in research, study design, definition of amenorrhea, and future trends in research and treatment. (CB)

  18. Mullerian anomalies: a cause of primary amenorrhea

    OpenAIRE

    2013-01-01

    Background: The objectives of this study were to determine the etiologic causes of amenorrhea, the prevalence of mullerian anomalies as a cause of primary amenorrhea and the different varieties of mullerian anomalies causing primary amenorrhea. Methods: This study included all the women presenting with primary amenorrhea who presented to the department of obstetrics and gynecology, Sir T Hospital and Government Medical College, Bhavnagar from 1st January 2010 to 30th June 2012. Results: The c...

  19. Cytogenetic analysis of patients with amenorrhea

    Institute of Scientific and Technical Information of China (English)

    Zhang Ying; Zhang Xiu-ling; Li Yan

    2006-01-01

    Objective: To analyse the cytogenetic examination results and investigate the effect of chromosome abnormalities on amenorrhea.Methods: The routine cytogenetic analysis was performed, including the chromosome G band analysis and karyotype analysis of the cultured peripheral blood lymphocytes from the patients with primary amenorrhea or secondary amenorrhea.Results: One hundred and thirty-seven cases were found with chromosome abnormalities in 234 patients with primary amenorrhea. The incidence of chromosome abnormality was 58.6%. In 309 with secondary amenorrhea, the incidence of chromosome abnormality was 13.6%.The reported abnormalities included the numerical and structural abnormalities of X chromosome, 46,XY, 45,X0/46,XY,and the structural abnormality of autosome.Conclusions: Chromosome abnormality is one of the main causes of amenorrhea. Karyotype analysis of chromosome is absolutely necessary for the diagnosis and treatment of patient with amenorrhea.

  20. Diagnostic utility of the HIV dementia scale and the international HIV dementia scale in screening for HIV-associated neurocognitive disorders among Spanish-speaking adults.

    Science.gov (United States)

    López, Enrique; Steiner, Alexander J; Smith, Kimberly; Thaler, Nicholas S; Hardy, David J; Levine, Andrew J; Al-Kharafi, Hussah T; Yamakawa, Cristina; Goodkin, Karl

    2016-08-15

    Given that neurocognitive impairment is a frequent complication of HIV-1 infection in Spanish-speaking adults, the limited number of studies assessing HIV-associated neurocognitive disorders (HAND) in this population raises serious clinical concern. In addition to being appropriately translated, instruments need to be modified, normed, and validated accordingly. The purpose of the current study was to examine the diagnostic utility of the HIV Dementia Scale (HDS) and International HIV Dementia Scale (IHDS) to screen for HAND in Spanish-speaking adults living with HIV infection. Participants were classified as either HAND (N = 47) or No-HAND (N = 53) after completing a comprehensive neuropsychological evaluation. Receiver operating characteristic analyses found the HDS (AUC = .706) was more sensitive to detecting HAND than the IHDS (AUC = .600). Optimal cutoff scores were 9.5 for the HDS (PPV = 65.2%, NPV = 71.4%) and 9.0 for the IHDS (PPV = 59.4%, NPV = 59.1%). Canonical Correlation Analysis found the HDS converged with attention and executive functioning. Findings suggest that while the IHDS may not be an appropriate screening instrument with this population, the HDS retains sufficient statistical validity and clinical utility to screen for HAND in Spanish-speaking adults as a time-efficient and cost-effective measure in clinical settings with limited resources.

  1. Amenorrhea

    Science.gov (United States)

    ... pituitary • Increased prolactin by a small benign tumor • Pituitary damage • Radiation to the head Abnormal balance of other hormones • Polycystic ovary syndrome • Adrenal or thyroid gland disorders Scarring of the uterus • Some uterine procedures such ...

  2. Secondary Amenorrhea among Female Athletes. Current Understandings.

    Science.gov (United States)

    Sasiene, Gwen Hagenbuch

    1983-01-01

    Research pertaining to female athletes' problems with secondary amenorrhea is reviewed. Studies point to stress, weight loss, anorexia nervosa, obesity, arduous athletic training, and age of onset of training as factors which may contribute to this disorder. (PP)

  3. Low leptin levels predict amenorrhea in underweight and eating disordered females.

    Science.gov (United States)

    Köpp, W; Blum, W F; von Prittwitz, S; Ziegler, A; Lübbert, H; Emons, G; Herzog, W; Herpertz, S; Deter, H C; Remschmidt, H; Hebebrand, J

    1997-07-01

    Evidence that leptin plays an important role in reproductive function is accumulating rapidly. We hypothesized that low leptin synthesis is associated with amenorrhea. We therefore determined serum leptin levels in 43 underweight female students, who were screened for lifetime occurrence of amenorrhea. We assessed the predictive value of leptin, body mass index (BMI), fat mass and percent body fat, respectively, for lifetime occurrence of amenorrea. Factors predicting amenorrhea were tested for their capability to predict current amenorrhea in a second cohort of 63 inpatients with anorexia nervosa (AN) or bulimia nervosa (BN). Furthermore, the relationships between serum leptin levels and of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol and progesterone, respectively, were evaluated. Only leptin predicted lifetime occurrence of amenorrhea in the student cohort. The critical leptin level was in the range of 1.85 micrograms L-1. This level served to largely separate anorectic from bulimic patients. In patients with AN mean serum log10 leptin levels over the first 4 weeks of inpatient treatment were correlated with mean FSH, LH and estradiol levels, respectively. Evidently, a critical leptin level is needed to maintain menstruation. In affluent populations eating disorders are likely to be a major cause of a low leptin synthesis.

  4. Galactorrhea and amenorrhea in burn patients.

    Science.gov (United States)

    Goyal, Navin; Gore, Madhuri A; Shankar, Ravi

    2008-09-01

    Galactorrhea and/or amenorrhea, although uncommonly reported in post-burn patients, is a complex problem to treat. Patient is reluctant to volunteer history of these symptoms, unless asked specifically. To study profile of adult female patients with galactorrhea and/or amenorrhea in post burn period. A prospective study of all adult female patients presenting with or detected to have galactorrhea and/or amenorrhea in post burn period was conducted over 6 month's period. Detailed clinical examination, estimation of LH, FSH, Prolactin levels and X-ray of skull was done in all patients. The data collected was analyzed. Patients with hyperprolactinemia and galactorrhea were treated with Bromocriptine for 3 weeks to 3 months. In all patients with amenorrhea, pregnancy was ruled out by gynecological examination and urine pregnancy test. During this period, 30 patients (15.15%) were detected to have galactorrhea and/or amenorrhoea. The extent of burn in these patients was 20-65%of body surface area. Out of 30 patients, 5 had galactorrhea and amenorrhea, 1 galactorrhea alone and 24 had amenorrhea alone. Analysis of voluntary disclosures and detection on interrogation was done. Till the end of study, 4 patients with galactorrhea had complete relief, 2 patients reported reduction in discharge. Galactorrhea was distressing for all and was always associated with high prolactine levels .The reverse was not true. All the patients had chest burns besides other body areas. Association was noted between menstrual aberration and ovulatory phase at the time of burn. Galactorrhea and menstrual disturbances do exist in female patients in reproductive age group in post burn period and patients should be especially interrogated for these symptoms by the burn care providers.

  5. Primary amenorrhea with bilateral endometriotic cysts.

    Science.gov (United States)

    Jabeen, Sadaqat; Raees, Mehnaz

    2015-05-01

    Primary amenorrhea is a common problem. Diagnosis is usually by going through systematic approach of history, examination and investigations. This case had bilateral large endometriotic cysts in the adnexal region. Uterus was normal sized with well-formed endometrium. She underwent laparotomy followed by drainage of endometriotic cysts, stripping and reconstruction of ovaries was performed. Patient was given a trial of combined oral contraceptive pills for two consecutive cycles to observe withdrawal bleeding, but it failed. Till now we are unable to find out such case in literature. Exact case of primary amenorrhea could not be found.

  6. Cytogenetic investigation of patients with primary amenorrhea

    Directory of Open Access Journals (Sweden)

    K Vijaya Laxmi

    2012-01-01

    Full Text Available Primary amenorrhea refers to absence of spontaneous menarche even after the age of 16. Cytogenetic analysis in two cases with primary amenorrhea, short stature, poorly developed secondary sexual characteristics, and growth retardation were studied. Routine GTG-band analysis of metaphases from peripheral blood leucocytes revealed female karyotype with a 15(ps+ and an isochromosome of X, i(Xq, in one patient and 46,X, i(Xq, in another patient. Ascertainment of the karyotype aided in confirmation of the provisional diagnosis, a better phenotype-genotype correlation to understand clinical heterogeneity in genetic counseling.

  7. Cortisol secretion in patients with normoprolactinemic amenorrhea

    DEFF Research Database (Denmark)

    Boesgaard, S; Hagen, C; Andersen, A N;

    1988-01-01

    Patients with functional amenorrhea have raised central dopaminergic activity and opioid-mediated GnRH inhibition leading to inhibition of hypothalamic-pituitary-ovarian function. In the present study, basal serum cortisol and ACTH levels were measured in normoprolactinemic amenorrheic patients...

  8. [CYTOGENETIC ANALYSIS OF PATIENTS WITH PRIMARY AMENORRHEA].

    Science.gov (United States)

    Stoyanova, V; Linev, A; Ivanov, H; Vachev, T

    2015-01-01

    Primary amenorrhea is one of the common reproductive disorder affecting females. It leads to the absence of menarche in the reproductive age group in females and/or complete absence of reproductive organs. The physiology of menstruation and reproduction has a strong correlation with the expression of the X chromosome. Thus, the role of the clinical geneticists in terms of diagnosis, risk assessment, genetic counseling and management of patients with primary amenorrhea and their families is essential. The genetic contribution to amenorrhea is studied both at the cellular and molecular level aiming at chromosomal abnormalities and gene mutations. In the present study we aim to perform chromosomal analysis in 140 patients present with primary amenorrhea employing GTG banding technique. The resulting karyotype revealed 67.4% (n = 95) with normal chromosome composition and 32.6% (n = 46) showed chromosomal abnormalities. In patients with abnormal chromosome constituents, 20% (n = 9) exhibit numerical aberration, 22% (n = 10) showed structural abnormalities, 43% (n = 20) mosaic genotype and 15% (n = 7) of cases--male karyotype. Furthermore, the involvement of Y chromosome and the origin of marker chromosome was confirmed by applying fluorescent in situ hybridization (FISH) in four patients.

  9. The Six TCM Differential Treatments for Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Amenorrhea is a commonly encountered gynecolo- gical disorder in clinic. The causative factors are variant, and therefore the treatments should be different. In recent years, the author has adopted six TCM methods for the treatment based on syndrome differentiation. The results are satisfactory with illustrative cases introduced in the following.

  10. Treatment of Secondary Amenorrhea with Abdomen Acupuncture

    Institute of Scientific and Technical Information of China (English)

    韩燕

    2004-01-01

    @@ Abdomen acupuncture is a newly-emerged branch of body acupuncture, that has been used in clinic and gradually accepted by the patients. In recent years, the author has treated 33 cases of secondary amenorrhea with this art. The therapeutic results were satisfactory and reported as follows.

  11. Neurocognitive functions in pathological gambling: a comparison with alcohol dependence, Tourette syndrome and normal controls

    NARCIS (Netherlands)

    A.E. Goudriaan; J. Oosterlaan; E. de Beurs; W. van den Brink

    2006-01-01

    Aims Neurocognitive functions in pathological gambling have relevance for the aetiology and treatment of this disorder, yet are poorly understood. This study therefore investigated neurocognitive impairments of executive functions in a group of carefully screened Diagnostic and Statistical Manual ve

  12. Neurocognitive functions in pathological gambling: A comparison with alcohol dependence, Tourette syndrome and normal controls.

    NARCIS (Netherlands)

    Goudriaan, A.E.; Oosterlaan, J.; Beurs, de P.; Brink, van den W.

    2006-01-01

    Aims Neurocognitive functions in pathological gambling have relevance for the aetiology and treatment of this disorder, yet are poorly understood. This study therefore investigated neurocognitive impairments of executive functions in a group of carefully screened Diagnostic and Statistical Manual ve

  13. Cortisol secretion in patients with normoprolactinemic amenorrhea

    DEFF Research Database (Denmark)

    Boesgaard, S; Hagen, C; Andersen, A N

    1988-01-01

    Patients with functional amenorrhea have raised central dopaminergic activity and opioid-mediated GnRH inhibition leading to inhibition of hypothalamic-pituitary-ovarian function. In the present study, basal serum cortisol and ACTH levels were measured in normoprolactinemic amenorrheic patients...... with (N = 14) and without (N = 7) insulin-dependent diabetes mellitus. Basal serum cortisol levels was significantly (P less than 0.01) elevated in patients with normoprolactinemic amenorrhea compared with normal women. Basal serum cortisol was significantly (P less than 0.02) elevated in amenorrheic...... diabetic patients compared with menstruating diabetic women. In the amenorrheic groups both cortisol and ACTH levels increased significantly (P less than 0.01) after dopamine D-2 receptor blockade, whereas no hormonal changes occurred in the control groups. It is concluded that patients...

  14. Comparing neurocognitive impairment in schizophrenia and bipolar I disorder using the Screen for Cognitive Impairment in Psychiatry Scale

    Directory of Open Access Journals (Sweden)

    Juana Gómez-Benito

    2014-01-01

    Full Text Available El objetivo del estudio fue comparar las propiedades psicométricas del test Screen for Cognitive Impairment in Psychiatry (SCIP en pacientes diagnosticados de esquizofrenia (n = 126 o trastorno bipolar I (n = 76. Además, el deterioro cognitivo se comparó con un grupo control (n = 83 empleando el SCIP y una batería neuropsicológica completa. El test SCIP es una escala que evalúa rápida y fácilmente el deterioro cognitivo en trastornos psiquiátricos graves. En términos de consistencia interna, estabilidad temporal, estructura dimensional y validez de criterio, el SCIP proporciona resultados al mismo nivel de fiabilidad y validez en pacientes con esquizofrenia o trastorno bipolar I. Además, demostró que el deterioro cognitivo diferencial entre los dos grupos de pacientes se produce solo en la memoria verbal, aunque el tamaño del efecto de esta diferencia es pequeño. Por último, y frente al grupo control, se confirma el deterioro cognitivo a todos los niveles en ambos grupos de pacientes utilizando tanto el SCIP como la batería neuropsicológica, lo que indica que el SCIP es una buena herramienta de detección para los déficits cognitivos en esquizofrenia y trastorno bipolar, y útil en la práctica clínica habitual para profesionales de la salud. © 2013 Asociación Española de Psicología Conductual. Publicado por Elsevier España, S.L. Todos los derechos reservados.

  15. [Pituitary tumors manifesting with amenorrhea-galactorrhea].

    Science.gov (United States)

    Bartal, A; Razon, N

    1976-05-16

    The amenorrhea-galactorrhea syndrome which occurs at a time other than the post-partum period is most often seen in association with a tumor of the pituitary gland; the symptoms are caused by a hypersecretion of prolactin. Among a series of 19 patients in Tel Aviv who underwent surgery for treatment of pituitary tumors, 2 presented with the amenorrhea-galactorrhea syndrome. The first patient, a 16 year old, presented with headaches, nausea, and diplopia; she underwent a series of 3 surgical procedures and died of a respiratory arrest in the third post-operative period. The second patient was a 39 year old woman who had borne 5 children; she presented with loss of vision, underwent surgery, and did well post-operatively. The authors point out that whereas either amenorrhea or galactorrhea alone may be associated with a number of disorders, the combination of the two symptoms is characteristic of pituitary tumors. Both patients who were presented in this article had chromophobe adenomas of the pituitary. The authors also discuss the various biologic actions of prolactin and its interrelationships with other hormones.

  16. Cytogenetic investigation of 468 patients with primary amenorrhea

    Institute of Scientific and Technical Information of China (English)

    Yu Hong; Bian Xu-min; Liu Jun-tao; Hao Na; Zhou Jing; Liu Shan-ying

    2010-01-01

    Objective: To analyze the relationship between karyotypes and clinic features of patients with primary amenorrhea. Method: G-banding was employed in karyotype analysis of patients with primary amenorrhea. Results: Karyotype analysis of 468 patients with primary amenorrhea revealed that 255 patients (54.49%) had normal female karyotypes and 213 patients (45.41%) had abnormal karyotypes, including 143 patients with abnormal X chromosome, 4 patients with mosaic X-Y chromosome, 57 patients with 46,XY karyotype, 8 patients with abnormal autosome and one patient with X-autosome translocation. All primary amenorrhea patients with deletion or break-up in Xp11.1-11.4 were short in stature. Conclusion: One of the main reasons of primary amenorrhea was chromosome abnormalities, especially sex chromosome abnormalities. Karyotype analysis should be routinely applied to detect primary amenorrhea patients. Xp11-12 may be critical to development of stature.

  17. Cytogenetic and Clinical Analysis of 340 Chinese Patients with Primary Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    Hong Yu; Xun-min Bian; Jun-tao Liu; Na Hao; Jing Zhou; Shan-ying Liu

    2011-01-01

    Objective To analyze the relationship between karyotypes and clinic features of patients with primary amenorrhea.Methods G banding was done for 340 patients with primary amenorrhea to facilitate individual chromosome identification, and if specific staining for certain portions of the chromosome was necessary, C banding was used. The clinical data were recorded by physical examination and ultrasound scanmng.Results Karyotype analysis of the 340 patients revealed that 180 (52.94%) patients had normal female karyotypes and 160 (47.06%) patients had abnormal karyotypes. The abnormal karyotyp es included abnormal X chromosome (150 patients), mosaic X-Y chromosome (4 patients), abnormal autosome (5 patients), and X-autosome translocation (1 patient). The main clinical manifestations in patients with primary amenorrhea were primordial or absent uterus (95.9%), invisible secondary sex features (68.8%), little or absent ovary (62.6%), and short stature (30.0%). The incidence of short stature in patients with X chromosome aberration (46%, 69/150) was significangly higher that in patients with 46, XX (9.44%, 17/180) as well as 46, XY (6.67%, 3/45;X2=146.25, P=0.000). All primary amenorrhea patients with deletion or break-point at Xp 11.1-11.4 were short statures.Conclusions One of the main reasons of primary amenorrhea is choromosome abnormality, especially heterosome abnormality. It implies the need to routinely screen chromosomal anomalies for such patients. There might be relationship between Xp 11.1-11.4 integrity and height improvement.

  18. Causes of amenorrhea in Korea: Experience of a single large center

    OpenAIRE

    2014-01-01

    Objective To investigate the causes of amenorrhea in Korean women. Methods Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea wer...

  19. A rare case of primary amenorrhea

    Directory of Open Access Journals (Sweden)

    Himadri Bal

    2016-01-01

    Full Text Available Crytomenorrhea arises usually due to the imperforate hymen, sometimes due to vaginal septum, rarely due to cervical agenesis. Here, we present a case of primary amenorrhea resulting from cervical agenesis in a 38-year-old woman. She presented with primary amenorrhea and cyclic lower abdominal pain. She had undergone some surgery 5 years back, details of which were not available. On examination secondary sexual characters were normal, per abdomen there was an 18 weeks size firm abdominopelvic mass. Local vaginal examination showed a blind vaginal pouch. A clinical diagnosis of hematometra due to transverse vaginal septum was made. However, magnetic resonance imaging pelvis suggested hematometra with cervical stenosis. The patient was taken up for examination under anaesthesia (EUA and exploratory laparotomy. On opening the abdomen uterus found to be enlarged with dense adhesions all around and signs of endometriosis. Extensive adhesiolysis revealed bilateral chocolate cysts of ovaries with hematosalpinges and peritubal adhesions. Hysterotomy and drainage of tarry contents were followed by an exploration of the uterine cavity. The lower pole ended blindly with no evidence of any cervix. Peroperative diagnosis of cervical agenesis leading to hematometra and endometriosis was made. A subtotal hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination confirmed ovarian endometriosis and adenomyosis of uterus. Though reconstructive surgery for cervical dysgenesis has been successful in some cases, hysterectomy is generally recommended for cervical agenesis.

  20. Escitalopram-Induced Amenorrhea and False Positive Urine Pregnancy Test

    Science.gov (United States)

    Hour, Siv; Gunasekar, Palanikumar; Gray, Caron; Smith, James F.

    2017-01-01

    Escitalopram is a selective serotonin reuptake inhibitor antidepressant approved by the Food and Drug Administration for the treatment of major depressive disorder and generalized anxiety disorder. A 34-year-old female patient with major depressive disorder developed amenorrhea and had a false-positive urine pregnancy test after initiation of escitalopram treatment. To our knowledge, no published case report of amenorrhea and false-positive urine pregnancy tests in women taking escitalopram exists. This case report suggests that women of child-bearing age should be carefully monitored for amenorrhea while they are on an antidepressant treatment regimen. PMID:28197332

  1. Fingolimod-associated amenorrhea: a report of three cases.

    Science.gov (United States)

    Alroughani, R

    2014-10-01

    Amenorrhea has not been reported as an adverse event in fingolimod phase III clinical trials in patients with multiple sclerosis (MS) with either 0.5 mg or 1.25 mg dosages. Here we report three cases of young women with MS who developed amenorrhea within 6 months of initiation of fingolimod. They experienced irregularities in their menstrual cycles in the first 3 months, which progressed to amenorrhea by 5(th) or 6(th) month. Gynecology evaluations showed no other etiologies. Menses returned to baseline after discontinuation of fingolimod for 2-3 months. Amenorrhea could be associated with fingolimod in the first year. Future surveillance is advised to determine the incidence rate of this adverse event.

  2. [[The duration of postpartum amenorrhea in a Sundanese village

    Science.gov (United States)

    Takasaka, K

    1988-06-01

    "The duration of postpartum amenorrhea of women in a Sundanese agricultural village [in Indonesia] whose last pregnancy resulted in live birth in the past six years was studied. Data were collected from 197 women from September through November 1983....[The] results suggest that the duration of postpartum amenorrhea of women in a Sundanese agricultural village although relatively long, has recently become shorter." (SUMMARY IN ENG)

  3. Menstrual nirvana: amenorrhea through the use of continuous oral contraceptives.

    Science.gov (United States)

    Edelman, Alison

    2002-12-01

    Medically induced amenorrhea has been used successfully in women who have medical conditions that worsen during menstruation. Menstrual suppression through the use of continuous oral contraceptives has been proven to be safe, effective, and extremely acceptable to women. Women without medical indications for menstrual suppression may find medically induced amenorrhea to be a significant improvement in their quality of life. Greater satisfaction with use of oral contraception may encourage compliance and increase the prevalence of pill-related health benefits.

  4. Amenorrhea as a Diagnostic Criterion for Anorexia Nervosa

    OpenAIRE

    2012-01-01

    Amenorrhea is a current criterion for the diagnosis of anorexia nervosa (AN) according to the DSM-IV-TR. Nevertheless, when comparing groups of patients who fulfill all the criteria of this manual for AN and groups of women who show them all but amenorrhea, some studies did not find significant differences in the psychopathology typically associated with AN. The purpose of our study was to compare both groups in demographic, anthropometric, psychological and psychopathological variables. Ther...

  5. Ever intriguing and lsquo;Primary Amenorrhea'- an audit

    Directory of Open Access Journals (Sweden)

    Sapna Vinit Amin

    2014-08-01

    Full Text Available Background: Primary amenorrhea though its incidence is less than 0.1% often is a diagnostic challenge in establishing etiology and causes management dilemma to the gynecologist in the developing countries. Methods: A retrospective audit of all the cases of primary amenorrhea coming to our tertiary care teaching hospital in South India over 6 years, from January 2006 to December 2012. Results: Ninety-eight cases of primary amenorrhea were analyzed and it was found that the causes of primary amenorrhea were structural anomalies in 47.9%, endocrinological abnormality in 31.6%, and genetic factors in 20.5% of the patients. Mullerian anomalies were the most common cause for primary amenorrhea compared to gonadal dysgenesis in our study group; hence surgical correction formed an important mode of treatment following diagnosis. Conclusions: Primary amenorrhea work-up may seem to be complex, nevertheless a well elicited history, carefully conducted physical examination followed by use of imaging modalities and bio assays for endocrine abnormalities, permitted the clinician to narrow the diagnostic possibilities and reach an accurate diagnosis quickly that helped in choosing the appropriate management option. While managing, counselling of the patient and her near relatives was very essential for fruitful outcome. Among the surgical approaches for management, sigmoid vaginoplasty was found to be a promising alternative to MacIndoe's vaginoplasty in our series. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1090-1096

  6. A Rare Case of Primary Amenorrhea with Two Etiologies, Hypothalamic Amenorrhea, Transverse Vaginal Septum, and No Hematocolpos

    Directory of Open Access Journals (Sweden)

    Firouzeh Ghaffari

    2015-01-01

    Full Text Available We reported a rare case of hypothalamic amenorrhea and transverse vaginal septum. A 28-year-old woman presented with primary amenorrhea and no complaint of abdominal pain. Laparoscopy revealed a small rudimentary uterus with streak ovaries and a vaginal pouch. The patient with diagnosis of Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome was subjected to a vaginoplasty in another fertility center. In our institute, after two courses of estrogen and progesterone, sonography revealed hematocolpos, while, under anesthesia, transverse vaginal septum was resected. Hysteroscopy revealed normal uterine cavity. She became pregnant 5 months postoperatively with controlled ovarian stimulation (COS in conjunction with intrauterine insemination, and she has two healthy babies now. This case highlights the importance of careful evaluation of all primary amenorrheas. Clinicians should be aware of presence of more than one etiology which causes atypical presentations and accomplishes a systematic strategy for the evaluation of amenorrhea potential to avoid long-term side effects of a misdiagnosis.

  7. A Rare Case of Primary Amenorrhea with Two Etiologies, Hypothalamic Amenorrhea, Transverse Vaginal Septum, and No Hematocolpos

    OpenAIRE

    2015-01-01

    We reported a rare case of hypothalamic amenorrhea and transverse vaginal septum. A 28-year-old woman presented with primary amenorrhea and no complaint of abdominal pain. Laparoscopy revealed a small rudimentary uterus with streak ovaries and a vaginal pouch. The patient with diagnosis of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome was subjected to a vaginoplasty in another fertility center. In our institute, after two courses of estrogen and progesterone, sonography revealed hematocolpos...

  8. Using an algorithmic approach to secondary amenorrhea: Avoiding diagnostic error.

    Science.gov (United States)

    Roberts-Wilson, Tiffany K; Spencer, Jessica B; Fantz, Corinne R

    2013-08-23

    Secondary amenorrhea in women of reproductive age may be an indication of an undiagnosed, chronic condition and appropriate treatment is dependent upon accurate diagnosis of the underlying etiology. A thorough clinical assessment and a few common laboratory tests can easily identify the most frequent causes of secondary amenorrhea. However, once these have been ruled out, the more uncommon pathophysiologies can be difficult to diagnose due to similarities in presentation and appropriate laboratory testing and interpretation become critical. In these cases, misdiagnosis is unfortunately common and often the result of poor laboratory utilization in the form of a failure to employ indicated tests, the use of obsolete tests, or erroneous interpretation in the face of interfering factors or co-morbidities. Consequently, the algorithmic approach to laboratory evaluation in the context of secondary amenorrhea described in this review can minimize the risk of diagnostic error as well was decrease test volume, cost, and time to diagnosis.

  9. Postpartum Sexuality and the Lactational Amenorrhea Method for Contraception.

    Science.gov (United States)

    Labbok, Miriam H

    2015-12-01

    This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational Amenorrhea Method and progesterone-only oral contraceptives. Of interest is the finding that breastfeeding women may resume coital behavior earlier postpartum, but report increased discomfort over time. The high efficacy of the Lactational Amenorrhea Method is confirmed and data illustrating possible relaxation of some criteria are presented. The conflicting guidance of CDC and WHO concerning immediate postpartum use of progestin-only methods is presented. The dearth of recent studies calls for new research on these topics.

  10. Diagnostic pitfalls in the evaluation and management of amenorrhea in adolescents.

    Science.gov (United States)

    Azurah, Abdul Ghani Nur; Zainuddin, Ani Amelia; Jayasinghe, Yasmin

    2013-01-01

    Amenorrhea is a common menstrual problem seen in adolescents. Amenorrhea has been shown to have a negative impact on adolescents' quality of life. In this paper we discuss the various causes and investigations of amenorrhea in adolescents and address management dilemmas for specific conditions. Specific approaches in dealing with adolescents using the HEADSS (Home, Education, Activity, Drugs, Sexual activity, Suicidal) approach are discussed.

  11. Understanding the Female Athlete Triad: Eating Disorders, Amenorrhea, and Osteoporosis.

    Science.gov (United States)

    Beals, Katherine A.; Brey, Rebecca A.; Gonyou, Julianna B.

    1999-01-01

    Examines three disorders that can affect female athletes who focus on succeeding athletically and achieving a prescribed body weight: disordered eating, amenorrhea, and osteoporosis. The paper presents prevention and treatment suggestions for athletes with eating disorders, focusing on primary, secondary, and tertiary prevention. Recommends that…

  12. [Psychodiagnostic findings in anorexia nervosa and post-pill amenorrhea].

    Science.gov (United States)

    Ehle, G; Wahlstab, A; Ott, J

    1982-11-01

    Anorexia nervosa is originated from disturbances at various points of the cortico-hypothalamo-hypophyseal axis. 65 patients suffering from anorexia nervosa or post-pill-amenorrhea were classified by cluster-analysis with 174 marks of the social, psychodynamic and biological levels. The different psychodiagnostic characteristics (470-F-Test, Hamilton-Depression-Scale, Beck-Depression-Scale, Giessen-test) are discussed according to the 3 clusters.

  13. [Cytogenetic features of teenage girls with secondary amenorrhea].

    Science.gov (United States)

    Nachetova, T A; Nefidova, V E

    2014-11-01

    Some features of the chromosome apparatus status were studied in 25 adolescent girls, aged 14-18, with secondary amenorrhea and in 29 girls of the same age with a regular menstrual cycle. Materials for cytogenetic analysis were preparations of chromosomes at the stage of metaphase obtained from the culture of the peripheral blood lymphocytes. The technique of the culture preparation was carried out according to the standard method. 2225 metaphase plates were analyzed in girls with secondary amenorrhea, and 2603 plates were tested in their healthy age-mates. An increased total level of chromosomal aberrations and a rise in the frequency of disorders in the chromatid, chromosome and genome types of peripheral blood lymphocytes have been registered in the examined persons as compared with their healthy age-mates. We have shown, that polyploid cell registered in 15 times oftener in adolescent girls with SA as compared with healthy girls. It can be assumed that some marked changes in the frequency of chromosomal aberrations in patients with secondary amenorrhea and in their healthy age-mates may arise both as a result of exposure to the multiple environmental factors and disorders of rather complicated processes of DNA damages reparation.

  14. The -female athlete triad-: Eating disorders - amenorrhea- osteoporosis

    Directory of Open Access Journals (Sweden)

    Maria Polikandrioti

    2007-01-01

    Full Text Available The female athlete triad is a syndrome which consists of eating disorders, amenorrhea and osteoporosis. The syndrome is increasing in prevalence over the last thirty years, as more women are participating in sports at a competitive level. The aim of the present study was to review the research data regarding the female athlete triad in order to underline the significance of the problem. The method οf this study included search of international medical and nursing literature data-bases, for the reason that the female athlete triad has been extensively studied after 1990. The results from the review of relevant studies showed that female athletes who follow hard preparative athletic programmes in which body weight is critical for success, often manifest eating disorder patterns. These lead to dysregulation of the hypothalamic-pituitarian-ovarian axis (HPO and as a result to amenorrhea. Hypothalamic amenorrhea can lead to osteoporosis and increased fracture risk. Adolescents may particularly be at risk because it is during this crucial time that females attain their peak bone mass. Conclusively, a course of action that aims at preventing the occurrence of the syndrome is necessary. Prevention of the female athlete triad through education and identification of the athletes at risk may decrease the incidence of long-term catastrophic effects to health. Monitoring from a group of specialists should serve as a cornerstone when planning a program of training and preparation for high athletic performance

  15. Comparison of Montreal cognitive assessment scale and minimental state examination scale in screening HIV-associated neurocognitive disorders in Shenzhen, China%MoCA和MMSE在HIV相关性神经认知损害筛查中的比较

    Institute of Scientific and Technical Information of China (English)

    赵方; 邓永; 孙丽琴; 徐六妹; 李莎西; 王辉; 刘映霞

    2015-01-01

    目的 比较蒙特利尔认知评估量表(MoCA)和简易精神状态量表(MMSE)在筛查HIV相关性神经认知障碍(HAND)中的能力.方法 用MoCA量表和MMSE量表对门诊127例HIV/AIDS患者及60例健康对照进行测试,并对测试结果进行比较和统计分析.结果 MoCA量表得分在HIV +/AIDS组(26.28 ±2.43分)和HIV-对照组(27.33±1.30分)之间差异有统计学意义(P<0.01).MMSE量表得分在HIV +/AIDS组(27.45 ±1.31分)和对照组(27.70±0.89分)之间没有统计学差别(P=0.139).使用MoCA量表,HIV +/AIDS组的HAND患病率明显大于对照组(x2=16.01,P<0.001).使用MMSE量表在筛查HAND患病率,两组之间无差别(x2=2.37,P=0.124).结论 MoCA量表在筛查HIV相关性认知功能损害的敏感性优于MMSE量表,比较适合目前临床上HAND的早期筛查.%Objective To compare the performance of Montreal cognitive assessment scale (MoCA) and minimental state examination scale (MMSE) in screening HIV-associated neurocognitive disorders (HAND).Methods A case-control study of 127 HIV + and 60 HIV-individuals.All the subjects' cognitive functions were assessed using MoCA and MMSE separately.Results Mean MoCA score in cases was 26.28 ± 2.43 compared to 27.33 ± 1.30 in controls (P < 0.01).Mean MMSE score in cases was 27.45 ± 1.31 compared to 27.70 ±0.89 in controls (P =0.139).Using the MoCA screening revealed 43 (33.9%) cases had HAND compared with 6 (6.7 %) controls (x2 =16.01,P < 0.001).Using MMSE,6 (4.7%) cases and 1(1.7%) control had HAND (P=0.124).Conclusion The MoCA scale is more sensitive in deteting HAND than MMSE and is suited for the early cognitive screening of HIV patients in clinic.

  16. Amenorrhea, ptosis and high insulin requirement in a young girl.

    Science.gov (United States)

    Hari Kumar, K V S; Kumar, Sandeep

    2016-01-01

    Lipodystrophy is an uncommon condition leading to excessive insulin requirement and menstrual abnormalities in young girls with diabetes. Neurological symptoms are uncommon in patients of generalized or partial lipodystrophy. We recently encountered a young girl, who presented with high insulin requirement, amenorrhea and neurological symptoms. Detailed evaluation led to the diagnosis of congenital lipodystrophy and we describe the same in this report. We also highlight the atypical features of the congenital lipodystrophy and the reasons for the excessive insulin requirement in patients with diabetes mellitus.

  17. Chromosomal abnormalities and hormonal disorders of primary amenorrhea patients in Egypt

    Directory of Open Access Journals (Sweden)

    Faeza El-Dahtory

    2012-01-01

    Conclusion: The present study showed that karyotype and FISH are necessary to detect the causes of primary amenorrhea. This study also revealed the incidence of chromosomal abnormalities in women with primary amenorrhea in Egypt is similar to that reported in previous literatures.

  18. Hormone profile in juvenile systemic lupus erythematosus with previous or current amenorrhea

    NARCIS (Netherlands)

    Silva, Clovis A.; Deen, Maria E. J.; Febronio, Marilia V.; Oliveira, Sheila K.; Terreri, Maria T.; Sacchetti, Silvana B.; Sztajnbok, Flavio R.; Marini, Roberto; Quintero, Maria V.; Bica, Blanca E.; Pereira, Rosa M.; Bonfa, Eloisa; Ferriani, Virginia P.; Robazzi, Teresa C.; Magalhaes, Claudia S.; Hilario, Maria O.

    2011-01-01

    To identify the underlying mechanism of amenorrhea in juvenile systemic lupus erythematosus (JSLE) patients, thirty-five (11.7%) JSLE patients with current or previous amenorrhea were consecutively selected among the 298 post-menarche patients followed in 12 Brazilian pediatric rheumatology centers.

  19. Switching to quetiapine for risperidone-induced amenorrhea: Report of two cases

    Directory of Open Access Journals (Sweden)

    P K Pardal

    2010-01-01

    Full Text Available Almost all the antipsychotics can cause hyperprolactinemia-related side-effects like amenorrhea. Quetiapine has been reported to have minimal propensity to cause hyperprolactinemia. We report here two cases of risperidone-induced amenorrhea, who resumed their normal cycle on switching over the medication to quetiapine.

  20. Primary amenorrhea in anorexia nervosa: impact on characteristic masculine and feminine traits.

    Science.gov (United States)

    Baker, Jessica H; Sisk, Cheryl L; Thornton, Laura M; Brandt, Harry; Crawford, Steven; Fichter, Manfred M; Halmi, Katherine A; Johnson, Craig; Jones, Ian; Kaplan, Allan S; Mitchell, James E; Strober, Michael; Treasure, Janet; Woodside, D Blake; Berrettini, Wade H; Kaye, Walter H; Bulik, Cynthia M; Klump, Kelly L

    2014-01-01

    Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits.

  1. Neurocognitive impairment in dramatic personalities: histrionic, narcissistic, borderline, and antisocial disorders.

    Science.gov (United States)

    Burgess, J W

    1992-06-01

    Thirty-seven patients with personalities in the dramatic cluster (DSM-III-R histrionic, narcissistic, borderline, and antisocial) and 40 controls matched for age and gender were evaluated on 16 neurocognitive variables. The evaluation screened for deficits in functions of attention, memory, language, abstraction, and behavior planning/sequencing. Analysis of variance revealed significant deficits in neurocognitive performance among patients with dramatic personalities, particularly in subtests requiring multi-step, multi-element associative operations.

  2. An overview of amenorrhea and respective remedies in Traditional Persian Medicine

    Directory of Open Access Journals (Sweden)

    Abdolmajid Elahi

    2016-03-01

    Full Text Available Amenorrhea is described as complete absence or cessation of menstruation. Besides conventional treatment approaches, traditional and complementary medical systems have suggested numerous natural medications for management of amenorrhea. Current study aimed to compile the pharmacological reports on amenorrhea from the standpoints of early Persian scholars. Medical and pharmaceutical manuscripts of Persian medicine from 9th to 18th centuries A.D. have been reviewed to extract the critical points and natural remedies. Based on Traditional Persian Medicine (TPM, impairment in uterus, brain and circulation are main causes of amenorrhea. Any obstruction, either anatomical or functional, in uterus and allied organs or tissues may lead the body to this disorder. Concerning herbal therapy of amenorrhea in TPM, 71 medicinal plants related to 35 families were found. The most prevalent families were Apiaceae, Asteraceae, Lamiaceae and Fabaceae, respectively. Usual routes of administration were oral, vaginal and topical. However, there was one report on a medicament, spoken to be effective nasally. Traditionally, emmenagogue medicines should possess diuretic activity to be effective for amenorrhea. All reported remedies were known as diuretic agents. However, this description is not corresponded with what is now accepted as diuretic. On the other hand, only Foeniculum vulgare showed therapeutic effects on amenorrhea in a randomized placebo-controlled trial. Despite lack of novel information on emmenagogue activity of these remedies, design and conducting evidence-based animal or human studies may be beneficial for new drug discovery from traditional knowledge.

  3. Mosaic triple X syndrome in a female with primary amenorrhea

    Directory of Open Access Journals (Sweden)

    A Venkateshwari

    2012-01-01

    Full Text Available Background: Turner′s syndrome is the most common chromosomal abnormality in females, affecting 1 in 2,500 live female births. It is a result of absence of an X chromosome or the presence of a structurally abnormal X chromosome. Its most consistent clinical features are short stature and ovarian failure. Aim: The aim of the study was to report a rare case of mosaic triple X syndrome in a female with primary amenorrhea. Materials and Methods: The chromosomal analysis using GTG banding was carried out, which revealed a mosaicism with 45,XO/47,XXX chromosomal constitution. Fluorescent in situ hybridization was also carried out to further confirm the observation made in the study. Conclusion: The physical features presented by the female could be due to the 45,XO/47,XXX mosaicism and the karyotype analysis was consistent with the diagnosis and clinical symptoms. Triple X mosaicism was confirmed with conventional and molecular cytogenetic analysis.

  4. Computed tomographic scan of amenorrhea-galactorrhea syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Nemoto, Yutaka; Inoue, Yuichi; Takemoto, Kazumasa; Oda, Atsuo; Yahata, Satoshi (Osaka City Univ. (Japan). Faculty of Medicine)

    1984-05-01

    Thin (2 mm) section CT scans of a pituitary gland of 30 amenorrhea-galactorrhea patients were reviewed. Eleven out of 30 patients were diagnosed as having a pituitary adenoma (tumor group); nine prolactionomas were verified by surgery. Tumor density compared with normal pituitary gland was low in five, low-mixed in three and isodense in four. The upper margin of a prolactinoma was convexed upward in seven, flat in two and concaved downward in two. Pituitary stalk was deviated in two and not visualized in four. Serum prolactine level (PRL) was more than 130 ng/ml in tumor group. There was a positive correlation between the size of a prolactinoma and PRL. Four prolactinomas invaded the cavernous sinus; three of them showed higher PRL than 1,000 ng/ml.

  5. Association of baseline bleeding pattern on amenorrhea with levonorgestrel intrauterine system use.

    Science.gov (United States)

    Mejia, Manuela; McNicholas, Colleen; Madden, Tessa; Peipert, Jeffrey F

    2016-11-01

    This study aims to evaluate the effect of baseline bleeding patterns on rates of amenorrhea reported at 12 months in levonorgestrel (LNG) 52 mg intrauterine system (IUS) users. We also assessed the effect of baseline bleeding patterns at 3 and 6 months postinsertion. In this secondary analysis of the Contraceptive CHOICE Project, we included participants who had an LNG-IUS inserted within 1 month of enrollment and continued use for 12 months. Using 12-month telephone survey data, we defined amenorrhea at 12 months of use as no bleeding or spotting during the previous 6 months. We used chi-square and multivariable logistic regression to assess the association of baseline bleeding pattern with amenorrhea while controlling for confounding variables. Of 1802 continuous 12-month LNG-IUS users, amenorrhea was reported by 4.9%, 14.8% and 15.4% of participants at 3, 6 and 12 months, receptively. Participants with light baseline bleeding or short duration of flow reported higher rates of amenorrhea at 3 and 6 months postinsertion (p<.03), while LNG-IUS users with heavy or prolonged flow were less likely to report amenorrhea at 3 and 6 months (p<.03). In a multivariable analysis, participants with self-reported heavy bleeding at baseline were less likely to report amenorrhea at 12 months than those who reported moderate bleeding (ORadj, 0.36; 95% CI, 0.16-0.69). Women with heavier menstrual bleeding are less likely than women with moderate flow to report amenorrhea following 12 months of LNG-IUS use. Baseline heavy menstrual flow reduces the likelihood of amenorrhea with LNG-IUS use, information that could impact contraceptive counseling. Anticipatory counseling can improve method satisfaction and continuation, an important strategy to continue to reduce unintended pregnancy and abortion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 经闭治验两则%Two Pieces of Amenorrhea Prescription

    Institute of Scientific and Technical Information of China (English)

    何运林

    2013-01-01

      根据祖国医学对闭经的治疗,结合笔者的临床经验,对两例闭经患者进行中医药治疗,疗效确切,以期丰富闭经的治疗经验。%According to the treatment of traditional Chinese medicine for amenorrhea, combined with the author's clinical experi-ence, two cases of patients with amenorrhea treating with traditional Chinese medicine was definite effective, which enriched clini-cal experience of amenorrhea.

  7. [Prevalence and etiology of secondary amenorrhea in a selected Mexican population].

    Science.gov (United States)

    Hernández, I; Cervera-Aguilar, R; Vergara, M D; Ayala, A R

    1999-08-01

    Studies performed upon american and european population indicate that secondary amenorrhea is associated to 3 months without menses, despite biases observed in age variation and intervals of apparition; nonetheless a 3 month lapse is the standard of reference to quality patients within mexican females. Hence, we investigated the prevalence of secondary amenorrhea among all females (n = 1099) that consulted in our clinic, grouped by age (15-50 yrs), time (months) of amenorrea and identifying the etiology when possible. The prevalence observed was 4.9% with major incidence of 4-12 months of amenorrhea duration (x 5.7 months) between 26-35 years of age. The three most common causes in order of frequency were: Hypothyroidism (14.8%); hiperandrogenism (12.9%) and pituitary adenoma (11.1%). It is concluded that the prevalence of secondary amenorrhea in our study resembled that found in the literature, although in this instance primary hyperthyroidism was the leading cause.

  8. [Primary amenorrhea by transverse vaginal septum: a case report and review of the literature].

    Science.gov (United States)

    González-Zárate, Alba Citlalli; Velásquez-Mamani, Jaime

    2014-09-01

    The transverse vaginal septum is one of the rarest anomalies of the reproductive tract classified depending on location. It is manifested by primary amenorrhea, cyclic pain and progressive mass growth at abdominopelvic level, ultrasound and magnetic resonance imaging provides the diagnosis, location and thickness of a transverse vaginal septum, treatment is surgical. We present a case of a teenage patient with primary amenorrhea due to lower transverse vaginal septum with surgical resection and satisfactory follow-up with successful vaginal patency.

  9. Contemporary issues in primary amenorrhea: An experience from a Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    Ashok Krishna Bhuyan

    2012-01-01

    Full Text Available Introduction: Amenorrhea is classified as primary if menstrual bleeding has never occurred in the absence of hormonal treatment. The clinical significance of a lack of regular menstrual cycles extends beyond reproductive concerns. Episodes of amenorrhea as short as 90 day may have implications for bone and cardiovascular health. Aims and Objective: To evaluate all patients presenting with primary amenorrhea in the Endocrinology OPD of Gauhati Medical College and Hospital. Materials and Methods: A total of 14 patients presenting to the Endocrinology OPD from March 2010 to May 2012 with a history of primary amenorrhea were included in the study. All patients were subjected to a detailed history, a thorough clinical examination, and relevant biochemical, hormonal, and radiological investigations. Result: In our study, the average age of presentation was 17.23 ± 4.2 years. Out of the 14 patients presenting with primary amenorrhea, 5 patients (35.71% were found to have Turner′s syndrome, 2 (14.28% had XX (pure gonadal dysgenesis, 2 (14.28% patients had XY gonadal dysgenesis (Swyer syndrome, 2 (14.28% patients had Müllerian agenesis, 2 (14.28% patients had hypothalamic amenorrhea, and 1 (7.14% patient was found to have multiple pituitary hormone deficiency. Conclusion: In concordance with other studies, Turner′s syndrome, Müllerian agenesis, and gonadal dysgenesis are the commonest causes of primary amenorrhea in our study. However, in contrast to certain Western reports, primary amenorrhea rather than short stature remains the commonest cause for seeking medical evaluation in patients with Turner′s syndrome.

  10. Neurocognition and Duration of Psychosis

    DEFF Research Database (Denmark)

    Rund, Bjørn Rishovd; Barder, Helene Eidsmo; Evensen, Julie

    2016-01-01

    A substantial proportion of schizophrenia-spectrum patients exhibit a cognitive impairment at illness onset. However, the long-term course of neurocognition and a possible neurotoxic effect of time spent in active psychosis, is a topic of controversy. Furthermore, it is of importance to find out...... what predicts the long-term course of neurocognition. Duration of untreated psychosis (DUP), accumulated time in psychosis the first year after start of treatment, relapse rates and symptoms are potential predictors of the long-term course. In this study, 261 first-episode psychosis patients were...... relationship between psychosis before (DUP) or after start of treatment and the composite score was found, providing no support for the neurotoxicity hypothesis, and indicating that psychosis before start of treatment has no significant impact on the course and outcome in psychosis. We found no association...

  11. Study on Correlation between Neuropeptide and Functional Hypothalamic Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    陈晓燕; 吕淑兰; 曹缵孙; 毛文军; 宋青

    2001-01-01

    Objective To explore the correlation between neuropeptide and functional hypothalam ic amenorrhea (FHA)Materials & Methods The basic and GnRH-stimulated levels of serum FSH, LH and plasma β-endorphin (β-EP), somatostatin (SS) in 33 patients with FHA and 17 women with normal menstrual cycles were tested by RIA.Results β-EP level in FHA group was significantly higher than that in control group and had a negative correlation with FSH and LH. The basic SS level in FHA group had no significant difference compared with the control group, but it had negative correlation with LH and no correlation with FSH. β-EP level in FHA group decreased after being stimulated with GnRH, and reached its minimum value after 15 min, then gradually rose back to the basic level. β-EP level in control group had no regular changes. SS level in both group did not change obviously.Conclusion The increased level of β-EP may play an important role in FHA. GnRH can inhibit β-EP level to some extent, while the effect of SS on FHA deserve further research.

  12. The relation between athletic sports and prevalence of amenorrhea and oligomenorrhea in Iranian female athletes

    Directory of Open Access Journals (Sweden)

    Dadgostar Haleh

    2009-07-01

    Full Text Available Abstract Background In 1992, the concept of female athlete triad was introduced to describe the interrelated problems of amenorrhea, eating disorders and osteoporosis seen in female athletes. To gain a clearer picture of amenorrhea/oligomenorrhea in Iran, one of the main components of the female athlete triad, we therefore established this study on the prevalence of amenorrhea/oligomenorrhea in elite Iranian female athletes, also evaluating the risk factors of these disorders in the same population. Methods This study performed as a cross-sectional study. All elite Iranian female athletes of 34 sports federation, including female athletes in national teams and medalists of Tehran were invited to participate. A total of 788 (95% response rate returned the questionnaires and were examined. Younger athletes under the age of menarche were excluded. Each athlete completed a self-administered questionnaire, which covered the following questions about participant's demographic information, athletic history, history of injuries and menstrual pattern. In order to diagnose the causes of amenorrhea/Oligomenorrhea including polycystic ovary syndrome(PCOS, participants with amenorrhea/Oligomenorrhea underwent further investigation. They were evaluated by following Para clinic investigation, and an ultrasonographic study of ovary. Results The age ranged from 13–37 (mean = 21.1, SD = 4.5. Seventy one (9.0% individuals had amenorrhea/oligomenorrhea, among those, 11 (15.5% had PCOS. There was also a positive association between amenorrhea/oligomenorrhea and the following: age under 20 OR; 2.67, 95%CI(1.47 – 4.85, weight class sports OR; 2.09, 95%CI(1.15 – 3.82, endurance sports OR; 2.89, 95%CI(1.22 – 6.84, late onset of menarche OR; 3.32 95%CI(1.04–10.51, and use of oral contraceptive pills OR; 6.17, 95%CI(3.00 – 12.69. Intensity of training sport or BMI were not risk factors. Conclusion These findings support the previous findings in the literature

  13. Nomenclature of primary amenorrhea: A proposal document of the Japan Society of Obstetrics and Gynecology committee for the redefinition of primary amenorrhea.

    Science.gov (United States)

    Shozu, Makio; Ishikawa, Hiroshi; Horikawa, Reiko; Sakakibara, Hideya; Izumi, Shun-Ichiro; Ohba, Takashi; Hirota, Yasushi; Ogata, Tsutomu; Osuga, Yutaka; Kugu, Koji

    2017-08-17

    The aim of this study was to provide medical terms to describe the condition of a girl who should be evaluated for primary amenorrhea in order to facilitate intervention at an appropriate time. We performed a literature and clinical guidelines search for recent practices with regard to menarche and discussed relevant cases that had been experienced by committee members. Additionally, we theoretically reviewed medical terms defined in the Glossary Book of Obstetrics and Gynecology in Japan (Japan Society of Obstetrics and Gynecology, 3rd edition). The committee for the redefinition of primary amenorrhea proposed the introduction of two terms and the deletion of one term that had been defined by the Japan Society of Obstetrics and Gynecology, instead of changing the age definition of primary amenorrhea. 'Delayed menarche' was introduced to describe a condition in which a girl has never experienced cyclic menstruation (menarche) by 15-17 years of age. 'Late menarche' was also introduced to describe a condition in which a girl has experienced menarche at 15 years of age or older. 'Delayed menstruation,' which was defined as a condition in which a girl experiences menarche at 15-18 years of age, was deleted. The new terms 'delayed menarche' and 'late menarche' were introduced, and the term 'delayed menstruation' was deleted. The new system might help in the early detection and appropriate treatment of primary amenorrhea. © 2017 Japan Society of Obstetrics and Gynecology.

  14. Neurocognitive Aspects of Pediatric Sickle Cell Disease.

    Science.gov (United States)

    Brown, Ronald T.; And Others

    1993-01-01

    This literature review on neurocognitive functioning and learning of children with sickle cell disease found diffuse neurocognitive deficits, with much variability across subjects. Studies of psychosocial development of these children indicate that behavioral problems, low self-esteem, and body image disturbances are frequently characteristic.…

  15. Neurocognitive Phenotypes in Severe Childhood Psychiatric Disorders.

    Science.gov (United States)

    Kavanaugh, Brian C; Dupont-Frechette, Jennifer A; Tellock, Perrin P; Maher, Isolde D; Haisley, Lauren D; Holler, Karen A

    2016-10-01

    This study investigated the presence of potential neurocognitive phenotypes within a severe childhood psychiatric sample. A medical chart review was conducted for 106 children who received a neuropsychological evaluation during children's psychiatric inpatient program hospitalization. A hierarchical cluster analysis was conducted to identify distinct clinical clusters based on neurocognitive measures. Cluster analysis identified four distinct clusters, subsequently labeled neurocognitive phenotypes: "intact cognition" (27%), "global dysfunction" (20%), "organization/planning" (21%), and "inhibition-memory" (32%). Significant differences were identified in history of legal involvement and antipsychotic medications at hospital admission. Differences between none-minimal and moderate-high neurocognitive dysfunction were identified in age, amount of diagnoses and antipsychotic medications at admission, and hospital length of stay. Current findings provide preliminary evidence of underlying neurocognitive phenotypes within severe childhood psychiatric disorders. Findings highlight the importance of neuropsychological evaluation in the treatment of childhood psychiatric disorders.

  16. Neurocognitive insight and objective cognitive functioning in schizophrenia.

    Science.gov (United States)

    Burton, Cynthia Z; Harvey, Philip D; Patterson, Thomas L; Twamley, Elizabeth W

    2016-03-01

    Neurocognitive impairment is a core component of schizophrenia affecting everyday functioning; the extent to which individuals with schizophrenia show awareness of neurocognitive impairment (neurocognitive insight) is unclear. This study investigated neurocognitive insight and examined the cross-sectional relationships between neurocognitive insight and objective neurocognition and functional capacity performance in a large outpatient sample. 214 participants with schizophrenia-spectrum disorders completed measures of neurocognition, functional capacity, and self-reported neurocognitive problems. Latent profile analysis classified participants with regard to neuropsychological performance and self-report of neurocognitive problems. The resulting classes were then compared on executive functioning performance, functional capacity performance, and psychiatric symptom severity. More than three quarters of the sample demonstrated objective neurocognitive impairment (global deficit score≥0.50). Among the participants with neurocognitive impairment, 54% were classified as having "impaired" neurocognitive insight (i.e., reporting few neurocognitive problems despite having objective neurocognitive impairment). Participants with impaired vs. intact neurocognitive insight did not differ on executive functioning measures or measures of functional capacity or negative symptom severity, but those with intact neurocognitive insight reported higher levels of positive and depressive symptoms. A substantial portion of individuals with schizophrenia and objectively measured neurocognitive dysfunction appear unaware of their deficits. Patient self-report of neurocognitive problems, therefore, is not likely to reliably assess neurocognition. Difficulty self-identifying neurocognitive impairment appears to be unrelated to executive functioning, negative symptoms, and functional capacity. For those with intact neurocognitive insight, improving depressive and psychotic symptoms may be

  17. The psychobiology and diagnostic significance of amenorrhea in patients with anorexia nervosa.

    Science.gov (United States)

    Gendall, Kelly A; Joyce, Peter R; Carter, Frances A; McIntosh, Virginia V; Jordan, Jennifer; Bulik, Cynthia M

    2006-05-01

    Amenorrhea is a diagnostic criterion for anorexia nervosa (AN), although menstrual cycles have been found to persist in some women with all the other features of AN. This study sought to determine factors that are associated with amenorrhea in 39 women with current primary spectrum AN. The use of exercise to control weight (odds ratio (OR) = 3.5; 95% confidence interval (CI) = 1.3-9.9; P = .02), low novelty seeking scores (OR = 0.7; 95% CI = 0.58-0.94; P = .02), and low systolic blood pressure (OR = 0.9; 95% CI = 0.84-0.99; P = .046) were predictors of amenorrhea independent of body mass index.

  18. Amenorrhea in the Female Athlete: What to Do and When to Worry.

    Science.gov (United States)

    Berz, Kate; McCambridge, Teri

    2016-03-01

    Functional hypothalamic amenorrhea is a diagnosis of exclusion that is common in female athletes, particularly those participating in aesthetic sports (ballet, other dance genres, figure skating, and gymnastics) and endurance sports (cross-country running). Although common, it should be considered abnormal even in the high-level elite athlete. Amenorrhea in combination with low energy availability and low bone density is labeled "the Female Athlete Triad." Studies have demonstrated numerous long-term consequences of athletes suffering from all or a portion of this triad, including increased rate of musculoskeletal injuries, stress fractures, abnormal lipid profiles, endothelial dysfunction, potential irreversible bone loss, depression, anxiety, low self- esteem, and increased mortality. This article provides the clinician with the tools to evaluate an athlete with secondary amenorrhea, reviews the recommended treatment options for affected athletes, and discusses when to return to the activity in an effort to facilitate "healthy" participation.

  19. Hormone profile in juvenile systemic lupus erythematosus with previous or current amenorrhea.

    Science.gov (United States)

    Silva, Clovis A; Deen, Maria E J; Febrônio, Marilia V; Oliveira, Sheila K; Terreri, Maria T; Sacchetti, Silvana B; Sztajnbok, Flavio R; Marini, Roberto; Quintero, Maria V; Bica, Blanca E; Pereira, Rosa M; Bonfá, Eloisa; Ferriani, Virginia P; Robazzi, Teresa C; Magalhães, Claudia S; Hilário, Maria O

    2011-08-01

    To identify the underlying mechanism of amenorrhea in juvenile systemic lupus erythematosus (JSLE) patients, thirty-five (11.7%) JSLE patients with current or previous amenorrhea were consecutively selected among the 298 post-menarche patients followed in 12 Brazilian pediatric rheumatology centers. Pituitary gonadotrophins [follicle-stimulating hormone (FSH) and luteinizing hormone (LH)] and estradiol were evaluated in 32/35 patients, and prolactin and total testosterone in 29/35 patients. Patient's medical records were carefully reviewed according to demographic, clinical and therapeutic findings. The mean duration of amenorrhea was 7.2 ± 3.6 months. Low FSH or LH was observed in 7/32 (22%) JSLE patients and normal FSH or LH in 25 (78%). Remarkably, low levels of FSH or LH were associated with higher frequency of current amenorrhea (57% vs. 0%, P = 0.001), higher median disease activity (SLEDAI) and damage (SLICC/ACR-DI) (18 vs. 4, P = 0.011; 2 vs. 0, P = 0.037, respectively) and higher median current dose of prednisone (60 vs. 10 mg/day, P = 0.0001) compared to normal FSH or LH JSLE patients. None of them had decreased ovarian reserve and premature ovarian failure. Six of 29 (21%) patients had high levels of prolactin, and none had current amenorrhea. No correlations were observed between levels of prolactin and SLEDAI, and levels of prolactin and SLICC/ACR-DI scores (Spearman's coefficient). We have identified that amenorrhea in JSLE is associated with high dose of corticosteroids indicated for active disease due to hypothalamic-pituitary-ovary axis suppression.

  20. Progress in Diagnosis of Amenorrhea%闭经的诊断进展

    Institute of Scientific and Technical Information of China (English)

    胡琳莉(综述); 孙莹璞(审校)

    2013-01-01

    The normal menstruation depends on the intercoordination between the hypothalamus-pituitary- ovary system and the endometrium induced by ovarian hormone. Dysfunction of any aspect will result in amenorrhea,and then affect fertility. There are many causes of amenorrhea. The key of successful treatment is the clarified diagnosis. The overall diagnosis of amenorrhea should combine history,physical examination,endocrine and auxiliary examination. The most common causes of amenorrhea are hypothalamic amenorrhea,polycystic ovary syndrome,hyperprolactinemia and premature ovarian failure. This review discussed the etiological diagnosis of amenorrhea.%女性正常月经依赖于下丘脑、垂体和卵巢及其激素诱导的子宫内膜之间的相互协调作用,其中任何一个方面出现功能障碍都可能导致闭经,影响生育。引起闭经的病因众多,明确诊断闭经的病因是治疗的关键。病史、体格检查、内分泌功能检查和辅助检查相结合可对闭经进行全面诊断。临床上最常见的闭经病因为下丘脑病变、多囊卵巢综合征、高催乳素血症和卵巢衰竭,综述临床常见闭经病因的诊断进展。

  1. Secondary amenorrhea in severe Asherman's syndrome: step by step fertility retrieval by Bettocchi's hysteroscope: some considerations.

    Science.gov (United States)

    Gizzo, Salvatore; Saccardi, Carlo; Di Gangi, Stefania; Bertocco, Anna; Vendemiati, Lucia; Righetto, Lara; Patrelli, Tito Silvio; D'antona, Donato; Nardelli, Giovanni Battista

    2014-03-01

    The aim of this report was to define the best diagnostic and therapeutic approach when secondary amenorrhea is related to undiagnosed Asherman syndrome. We present a single case of secondary amenorrhea with a previous diagnosis of alterated hypothalamic-hypophysary regulation, with a component of ovarian function in probable reduction, which was evaluated in our department and resulted affected by Asherman's syndrome IV stage. We describe step by step the diagnosis and treatment of a previously misdiagnosed case of severe Asherman's syndrome. An appropriate diagnosis and adequate treatment are mandatory to allow menses and fertility to be restored when severe Asherman's syndrome occurs.

  2. Case of a woman with acromegaly whose presenting complaint was prolonged post-partum amenorrhea.

    Science.gov (United States)

    Hara, Tomomi; Kanasaki, Haruhiko; Oride, Aki; Moriyama, Masayuki; Kyo, Satoru

    2016-10-01

    We report a case of a woman who was incidentally diagnosed with acromegaly after referral for prolonged post-partum amenorrhea. A 25-year-old woman, gravida 2 para 1, had a normal transvaginal delivery and breastfeeding had been discontinued more than a year after delivery. Thereafter, spontaneous menstruation did not restart and she underwent hormonal therapy. Subsequently, she was referred to our university hospital for prolonged amenorrhea. Hormonal examination revealed severe hypogonadotropic hypogonadism (luteinizing hormone 0.5 mIU/mL, follicle-stimulating hormone acromegaly. © 2016 Japan Society of Obstetrics and Gynecology.

  3. Neurocognitive Processing Steps during Remembrance

    Directory of Open Access Journals (Sweden)

    Mukundan CR

    2016-12-01

    Full Text Available A method of recording several of the electrophysiological changes seen during remembrance of experiential components of autobiographic episodes has been developed for use in forensic investigations of suspects and accused persons. The technique has been called Brain Electrical Oscillations Signature [BEOS] profiling and has been used successfully used in several hundreds of cases as aid for investigation. The two important facilitating aspects of the test are that [1] remembrance can be automatically cued by presenting short verbal statements referring to various components of an experience, and the remembrance is automatic and mandatory when a cue is presented, in normal individuals. [2] There is also no need for any response from the subject while receiving the cueing information. Knowing the occurrence of an activity in the past does not trigger any remembrance of own participation. Remembrance of participation in an activity occurs only if the person has participated in the activity referred by the probe. Remembrance has several neurocognitive components, which are reflected in the scalp EEG of a person. Sets of verbal probes representing different formulations of the episode and the different roles of individuals, as they are essentially possibilities arrived at by an investigating team, when more than one person is suspected to be involved in the activity are presented to the suspected persons. Each multichannel epoch of EEG time locked to each probe, acquired with its pre-probe baseline, is acquired and analyzed to determine the statistical significance of the differences in the different components across the EEG channels of each epoch, related to each probe, is analyzed and statistically compared. Presence of Experiential Knowledge is arrived at if all the changes indicating multiple neurocognitive processing components are significantly present.

  4. Chemotherapy-induced amenorrhea in patients with breast cancer with a BRCA1 or BRCA2 mutation.

    Science.gov (United States)

    Valentini, Adriana; Finch, Amy; Lubinski, Jan; Byrski, Tomasz; Ghadirian, Parviz; Kim-Sing, Charmaine; Lynch, Henry T; Ainsworth, Peter J; Neuhausen, Susan L; Greenblatt, Ellen; Singer, Christian; Sun, Ping; Narod, Steven A

    2013-11-01

    To determine the likelihood of long-term amenorrhea after treatment with chemotherapy in women with breast cancer who carry a BRCA1 or BRCA2 mutation. We conducted a multicenter survey of 1,954 young women with a BRCA1 or BRCA2 mutation who were treated for breast cancer. We included premenopausal women who were diagnosed with invasive breast cancer between 26 and 47 years of age. We determined the age of onset of amenorrhea after breast cancer for women who were and were not treated with chemotherapy, alone or with tamoxifen. We considered chemotherapy-induced amenorrhea to have occurred when the patient experienced ≥ 2 years of amenorrhea, commencing within 2 years of initiating chemotherapy, with no resumption of menses. Of the 1,426 women who received chemotherapy, 35% experienced long-term amenorrhea. Of the 528 women who did not receive chemotherapy, 5.3% developed long-term amenorrhea. The probabilities of chemotherapy-induced amenorrhea were 7.2% for women diagnosed before age 30 years, 33% for women age 31 to 44 years, and 79% for women diagnosed after age 45 years (P trend < .001). The probability of induced amenorrhea was higher for women who received tamoxifen than for those who did not (52% v 29%; P < .001). Age at treatment and use of tamoxifen are important predictors of chemotherapy-induced amenorrhea in women who carry a BRCA1 or BRCA2 mutation. The risk of induced long-term amenorrhea does not seem to be greater among mutation carriers than among women who do not carry a mutation.

  5. Neurocognitive dysfunction in first-episode psychosis

    DEFF Research Database (Denmark)

    Rund, Bjørn Rishovd; Melle, Ingrid; Friis, Svein

    2004-01-01

    The authors examined the relationship of neurocognitive function with duration of untreated psychosis, premorbid illness factors, and clinical symptoms to determine whether long duration of untreated psychosis independently compromises cognitive function....

  6. A case of primary amenorrhea with 46+XY genotype from Kashmir Valley

    Directory of Open Access Journals (Sweden)

    Shahid Mudassir Baba

    2013-01-01

    Full Text Available Primary amenorrhea is one of the common reproductive disorder affecting females. It leads to the absence of menarche in the reproductive age group in females and/or complete absence of reproductive organs. There are many causes which lead to PA, including genetic aberrations which are the leading factors.

  7. Clinical research of impulse GnRH infusion treatment to a patient with central secondary amenorrhea

    Institute of Scientific and Technical Information of China (English)

    孙首悦

    2014-01-01

    Objective To apply continuous subcutaneous pulse infusion of gonadotropin-releasing hormone(GnRH)to treat patients with central secondary amenorrhea,and to observe the induction of spontaneous ovulation and natural fertilization.Methods Using micro-pulse infusion pumps with each 90-minute infusion of LHRH 10μg daily,the serum LH,FSH,estrogen,and progesterone lev-

  8. Exercise-Associated Amenorrhea: Are Altered Leptin Levels an Early Warning Sign?

    Science.gov (United States)

    Warren, Michelle P.; Ramos, Russalind H.; Bronson, Emily M.

    2002-01-01

    Although the exact cause of the female athlete triad (amenorrhea, disordered eating, and osteoporosis) is unknown, recent research implicates leptin, a hormone secreted by adipocytes. Leptin may be an important indicator of nutritional status and may play a role in reproductive function. Physicians who develop a plan for early recognition and…

  9. Synchronized brain activity and neurocognitive function in patients with low-grade glioma : a magnetoencephalography study

    NARCIS (Netherlands)

    Bosma, Ingeborg; Douw, Linda; Bartolomei, Fabrice; Heimans, Jan J.; van Dijk, Bob W.; Postma, Tjeerd J.; Stam, Cornelis J.; Reijneveld, Jaap C.; Klein, Martin

    2008-01-01

    We investigated the mechanisms underlying neurocognitive dysfunction in patients with low-grade glioma (LGG) by relating functional connectivity revealed by magnetoencephalography to neurocognitive function. We administered a battery of standardized neurocognitive tests measuring six neurocognitive

  10. Theory of mind and neurocognitive functioning in schizophrenia

    OpenAIRE

    Rumyantseva E. E.

    2016-01-01

    The aim of this work was to study the problem of interrelation between theory of mind and neurocognitive functioning in schizophrenia. Tasks: analysis of the literature on the problem of interrelation of theory of mind and neurocognitive functioning in schizophrenia. Subject of research: interrelation of theory of mind and neurocognitive functioning. Research hypothesis: the state of the mental model correlated with neurocognitive functioning. Registered a decline in the functioning of theory...

  11. Empathizing: neurocognitive developmental mechanisms and individual differences.

    Science.gov (United States)

    Chakrabarti, Bhismadev; Baron-Cohen, Simon

    2006-01-01

    This chapter reviews the Mindreading System model encompassing four neurocognitive mechanisms (ID, EDD, SAM, and ToMM) before reviewing the revised empathizing model encompassing two new neurocognitive mechanisms (TED and TESS). It is argued that the empathizing model is more comprehensive because it entails perception, interpretation, and affective responses to other agents. Sex differences in empathy (female advantage) are then reviewed, as a clear example of individual differences in empathy. This leads into an illustration of individual differences using the Empathy Quotient (EQ). Finally, the neuroimaging literature in relation to each of the neurocognitive mechanisms is briefly summarized and a new study is described that tests if different brain regions respond to the perception of different facial expressions of emotion, as a function of the observer's EQ.

  12. Neuroimaging of HIV-associated neurocognitive disorders

    Directory of Open Access Journals (Sweden)

    Michel Elyas Jung Haziot

    Full Text Available ABSTRACT A significant increase in the incidence of cognitive impairment in HIV/AIDS patients has been continuously observed. Consequently, three classification categories of cognitive impairment have been proposed: asymptomatic neurocognitive impairment (ANI and mild neurocognitive disorder (MND, that correspond to the mild and intermediate forms, and HIV-associated dementia (HAD for the most severe cases. HIV-associated neurocognitive disorders (HAND is a broad term that encompasses these three categories. Moreover, the application of neuroimaging methods has led to a major breakthrough in understanding of the neurological changes in HIV, providing greater reliability in the exclusion of associated diseases and allowing earlier diagnosis. Therefore, abnormalities and/or specific neuroimaging elements may soon be incorporated into the HAND classification criteria, which will be of great value in the management of these diseases, including in the optimization of high CNS penetration antiretroviral regimens.

  13. Incidence of Chemotherapy-Induced Amenorrhea After Adjuvant Chemotherapy With Taxane and Anthracyclines in Young Patients With Breast Cancer

    OpenAIRE

    2013-01-01

    Background Chemotherapy-induced amenorrhea is one of long term side effects of adjuvant chemotherapy in patients with breast cancer which may interfere with their future reproductive function. Although amenorrhea is well recognized, the actual incidence following taxanes remains uncertain. Methods In a cross sectional study, we identified breast cancer patients aged 45 years or younger who were treated with adjuvant anthracycline and taxane-based regimens at three different oncology departmen...

  14. Amenorrhea as a rare drug-related adverse event associated with everolimus for pancreatic neuroendocrine tumors.

    Science.gov (United States)

    Kawaguchi, Yoshiaki; Maruno, Atsuko; Kawashima, Yohei; Ito, Hiroyuki; Ogawa, Masami; Mine, Tetsuya

    2014-11-14

    The patient was an asymptomatic 43-year-old woman. Abdominal ultrasonography and enhanced computed tomography showed a tumor lesion accompanied by multiple cystic changes in the liver and the pancreatic tail. Endoscopic ultrasound-fine needle aspiration was performed on the pancreatic tumor lesion and revealed pancreatic neuroendocrine tumor (PNET). As it was unresectable due to multiple liver metastases, the decision was made to initiate treatment with everolimus and transcatheter arterial chemoembolization. The patient ceased menstruating after the start of everolimus administration. When the administration was discontinued due to interstitial lung disease, menstruation resumed, but then again stopped with everolimus resumption. An association between everolimus and amenorrhea was highly suspected. Amenorrhea occurred as a rare adverse event of everolimus. As the younger women might be included in PNETs patients, we should put this adverse event into consideration.

  15. Syndrome of Galactorrhea, Amenorrhea, and Obesity as Possible Indicators of Prolactinoma: A Case Study Approach

    Science.gov (United States)

    Shaw, Betsy; Creary, Ludlow; Rao, Vitaya

    1986-01-01

    Four female patients were found to have microadenomas and high prolactin levels, but the symptoms of the syndrome varied among the patients. Three of four patients had overt galactorrhea, obesity, and amenorrhea. One patient was postmenopausal, and another showed menstrual irregularities. Two patients sought medical attention for headaches, and one for visual disturbances. Two patients previously had used psychotropic drugs, and two patients used birth control pills. When tested, all patients had high serum prolactin levels, abnormal sellar tomograms, and the presence of microadenoma of the pituitary was confirmed by computerized tomography. Because of the high incidence of pituitary tumor among these four patients, this study suggests that a complete workup should be done for patients having galactorrhea, amenorrhea, and obesity as a syndrome or as separate entities. PMID:3806693

  16. A case report of young hypertensive with primary amenorrhea: uncommon variant of congenital adrenal hyperplasia

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    Divendu Bhushan

    2015-10-01

    Full Text Available Hypertension in young should be evaluated in detail because secondary causes are more common in this subset of patients. As on one hand it help us in treating blood pressure and its complications including stroke , coronary artery disease and renal failure, other hand we should also treat the other complications like growth, puberty and electrolyte imbalance. Here we present a case who admitted in cardiology unit with accelerated HTN and hypokalaemia, and on detailed evaluation found to have primary amenorrhea. Identification of the cause not only leads to correct hypertension with minimal drugs but she got the reason of her amenorrhea. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1642-1644

  17. Chemotherapy-related amenorrhea after adjuvant paclitaxel-trastuzumab (APT trial).

    Science.gov (United States)

    Ruddy, Kathryn J; Guo, Hao; Barry, William; Dang, Chau T; Yardley, Denise A; Moy, Beverly; Marcom, P Kelly; Albain, Kathy S; Rugo, Hope S; Ellis, Matthew J; Shapira, Iuliana; Wolff, Antonio C; Carey, Lisa A; Overmoyer, Beth A; Hudis, Clifford; Krop, Ian E; Burstein, Harold J; Winer, Eric P; Partridge, Ann H; Tolaney, Sara M

    2015-06-01

    Chemotherapy-related amenorrhea (CRA) is associated with infertility and menopausal symptoms. Learning how frequently paclitaxel and trastuzumab cause amenorrhea is important. Most other adjuvant breast cancer therapies induce CRA in approximately 50 % of all premenopausal recipients [1]. 410 patients enrolled on the APT Trial, a single-arm phase 2 adjuvant study of 12 weeks of paclitaxel and trastuzumab followed by nine months of trastuzumab monotherapy. Eligible patients had ≤3 cm node-negative HER2 + breast cancers. Premenopausal enrollees were asked to complete menstrual surveys every 3-12 months for 72 months. Women who responded to at least one survey at least 15 months after chemotherapy initiation (and who did not undergo hysterectomy and/or bilateral oophorectomy or receive ovarian suppressing medications prior to 15 months) were included in this analysis. A participant was defined as having amenorrhea in follow-up if her self-reported last menstrual period at last follow-up was greater than 12 months prior to the survey. Among the 64 women in the evaluable population (median age at study entry 44 years, range 27-52 years), the median time between chemotherapy initiation and last menstrual survey was 51 months (range 16-79). 18 of 64 women (28 %, 95 % CI 18-41 %) were amenorrheic at that time point. Amenorrhea rates among premenopausal women treated with adjuvant paclitaxel and trastuzumab for early stage breast cancer appear lower than those seen historically with standard alkylator-based breast cancer regimens. Future studies are needed to understand the impact of this regimen on related issues of fertility and menopausal symptoms.

  18. Female patient with amenorrhea as complication of radiotherapy for Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kock, H.C.L.V. (St. Elisabeth en Mariaziekenhuis, Tilburg (Netherlands). Afdeling Gynaecologie en Obstetrie)

    1983-07-02

    A 25 year old woman was treated for Hodgkins disease with some surgery and radiotherapy directed to para-aortal, para-illiacal and inguinal lymph nodes. Half a year after remission she presented with secondary amenorrhea which was diagnosed as complication of the radiotherapy. She also became sterile. Genetic radiation effects are discussed and an improvement in the method of treatment to avoid sterility is proposed.

  19. Serum Levels of Tryptophan, 5-Hydroxytryptophan and Serotonin in Patients Affected with Different Forms of Amenorrhea

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    S. Comai

    2010-06-01

    Full Text Available Tryptophan (Trp is present in the serum, partly bound to albumine and in the free form. The unbound portion of circulating tryptophan has the property of crossing the hematoencephalic barrier and being converted within the brain into serotonin (5-HT through the enzymatic processes of hydroxylation and decarboxylation. The serotoninergic system plays an important role in neuroendocrine control of reproductive hormone secretion, and in particular, it may influence GnRH pulsatility, a function essential for reproductive processes. In this study, we analysed serum levels of tryptophan, serotonin and 5-hydroxytryptophan (5-HTP in women with three different forms of amenorrhea: 16 patients were diagnosed with anorexia nervosa, 60 patients with functional hypothalamic amenorrhea, and 14 patients with hyperprolactinemia. Data were compared with those of a group of 25 healthy women. Serum Trp levels were significantly (P ≤ 0.05 lower in the anorexic (11.64 ± 0.53 µg/ml, mean ± S.E. than in the control (12.98 ± 0.37 µg/ml groups. In addition, in the anorexic group a statistical dispersion of Trp values was shown indicating a bimodal data distribution suggesting the existence of two different subgroups of patients. Regarding 5-HTP, an increase of its serum level was observed in all the groups with amenorrhea with the highest value in hyperprolactinemic patients. On the contrary, no statistical differences in serum 5-HT levels among the four analyzed groups were observed. This study shows that women affected by various forms of amenorrhea present an altered metabolism of tryptophan via serotonin and, in particular, markedly high differences are observed between the two subgroups of anorexic patients.

  20. Mentha longifolia syrup in secondary amenorrhea: a double-blind, placebo-controlled, randomized trials

    Directory of Open Access Journals (Sweden)

    Mokaberinejad Roshanak

    2012-12-01

    Full Text Available Abstract Background Amenorrhea is defined as the cessation of menses. Hormone therapy is the most common treatment. Due to the contraindications and side effects of it and the increasing demand for alternative medicine substitutes, Mentha longifolia L. was used in this study. Mentha longifolia L. is a known medication in Iranian traditional medicine to induce menstrual bleeding in women with secondary amenorrhea and oligomenorrhea. Methods A double-blind, randomized, placebo-controlled, multicenter study was conducted in 120 women with secondary amenorrhea and oligomenorrhea. Treatment consisted of sequential oral syrup, 45 ml (15 ml three times a day for 2 weeks. If the patients did not have menstruation after 2 weeks of taking the medication, we would wait for two more weeks. If the patients had menstruation at each stage of using the drug, we started it one week after the end of menstruation. But if the patients had not menstruate after four weeks (two-week using of drug and waiting for two more weeks, the previous steps were repeated. The drug and placebo were repeated in three cycles of menstruation. Bleeding was documented by the patient on diary cards. The primary outcome variable was the occurrence (yes/no of bleeding during the first treatment cycle. The secondary efficacy outcome was the regularity of bleeding pattern during the three cycles of the study. Results The number of women with bleeding during the first cycle were higher in the drug group as in the placebo group (68.3% vs. 13.6%; p Mentha longifolia L. syrup. Conclusion In conclusion, Mentha longifolia L. syrup is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with secondary amenorrhea and oligomenorrhea.

  1. FEMALE GENITAL TUBERCULOSIS AS A CAUSE OF PRIMARY AMENORRHEA IN A YOUNG UNMARRIED WOMAN.

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    Zende Prashant

    2013-05-01

    Full Text Available ABSTRACT: Primary Amenorrhea is defined as 1No periods by ag e 14 in the absence of growth or development of secondary sexual character.2No peri ods by age 16 regardless of the presence of normal growth & development with the appearance of secondary sexual characters. Incidence of Extrapulmonary TB(EPTBis increasing i n young women throughout the world. We report a case of young woman apparently having n o sings & symptoms of Tuberculosis. CASE REPORT :-18 years young female patient was referred to us as a case of Primary Amenorrhea.She had Normal secondary sexual characte rs & normal Breast Development(Tanner staging of Breast-IV.She had negative Progesterone Challenge Test (PCT.Estrogen & Progesterone Challenge Test was negative. Diagnosis of End Organ Problem was done. Diagnosis of Genital Tuberculosis was confirmed by Hysterolaparoscopy. S he was given AKT for six months. Now she has positive Progestogen Challenge Test. DISCUSSION : Hysterolaparoscopy is important investigation in a case of Primary Amenorrhea with negative Estrogen & Progesterone Challenge Test. Counseling is necessary in unmarried young wo man for Minimally Invasive procedure like Hysterolaparoscopy. Short Chemotherapy has found to useful for FGTB.

  2. Joint action: Neurocognitive mechanisms supporting human interaction

    NARCIS (Netherlands)

    Bekkering, H.; Bruijn, E.R.A. de; Cuijpers, R.H.; Newman-Norlund, R.D.; Schie, H.T. van; Meulenbroek, R.G.J.

    2009-01-01

    Humans are experts in cooperating with each other when trying to accomplish tasks they cannot achieve alone. Recent studies of joint action have shown that when performing tasks together people strongly rely on the neurocognitive mechanisms that they also use when performing actions individually, th

  3. Explaining neurocognitive aging: Is one factor enough?

    NARCIS (Netherlands)

    K.R. Ridderinkhof

    2002-01-01

    Discusses a number of recent developments in the literature on aging. The classic distinction between generalized and process-specific cognitive changes with old age has reappeared in the distinctions between the frontal lobe hypothesis and more differentiated views of neurocognitive aging. The auth

  4. Neurocognitive Treatments for Eating Disorders and Obesity.

    Science.gov (United States)

    Eichen, Dawn M; Matheson, Brittany E; Appleton-Knapp, Sara L; Boutelle, Kerri N

    2017-09-01

    Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.

  5. Dual-Retrieval Models and Neurocognitive Impairment

    Science.gov (United States)

    Brainerd, C. J.; Reyna, V. F.; Gomes, C. F. A.; Kenney, A. E.; Gross, C. J.; Taub, E. S.; Spreng, R. N.

    2014-01-01

    Advances in dual-retrieval models of recall make it possible to use clinical data to test theoretical hypotheses about mild cognitive impairment (MCI) and Alzheimer's dementia (AD), the most common forms of neurocognitive impairment. Hypotheses about the nature of the episodic memory declines in these diseases, about decline versus sparing of…

  6. Dual-Retrieval Models and Neurocognitive Impairment

    Science.gov (United States)

    Brainerd, C. J.; Reyna, V. F.; Gomes, C. F. A.; Kenney, A. E.; Gross, C. J.; Taub, E. S.; Spreng, R. N.

    2014-01-01

    Advances in dual-retrieval models of recall make it possible to use clinical data to test theoretical hypotheses about mild cognitive impairment (MCI) and Alzheimer's dementia (AD), the most common forms of neurocognitive impairment. Hypotheses about the nature of the episodic memory declines in these diseases, about decline versus sparing of…

  7. Disordered eating, amenorrhea, and substance use and misuse among professional ballet dancers: Preliminary analysis

    Directory of Open Access Journals (Sweden)

    Mia Peric

    2016-04-01

    Full Text Available Background: Substance use and misuse (SUM, eating disorders (ED and consequent amenorrhea (AM occur frequently in professional ballet dancing. The objective of this study has been to explore the prevalence and association between ED, AM and SUM in ballet. Material and Methods: The sample comprised 21 ballet dancers, 23.1±4.5 years old, members of the professional National Ballet Ensemble from Croatia. Variables were collected by questionnaires examining SUM, occurrence of amenorrhea, and corresponding ballet-specific and socio-demographic factors (Questionnaire on Substance Use – QSU and the level of ED (Brief Eating Disorder in Athletes Questionnaire – BEDA-Q. Results: Smoking is prevalent in 40% of dancers (25% smoke on a daily basis, 36% often use analgesics, and 25% engage in binge drinking at least once a month. Smoking and binge drinking are less frequent in ballerinas with a higher academic level (r = 0.60 and r = 0.54 for binge drinking and smoking, respectively; p < 0.05. Alcohol drinking is higher among dancers who consume analgesics more often and those with a higher BEDA-Q score (r = 0.53 and r = 0.54 for analgesics and BEDA-Q, respectively; p < 0.05. Amenorrhea is more prevalent among those dancers with a higher BEDA-Q score. Women who consume nutritional supplements are less likely to use analgesics (Mann Whitney U test = 2.11; p < 0.05. Conclusions: Efforts seeking to prevent ED in ballet should target dancers who consume alcohol to a greater extent. Future studies should specifically explore the less frequent consumption of analgesics among dancers who consume nutritional supplements. Med Pr 2016;67(1:21–27

  8. Clinical and neurocognitive outcome in symptomatic isovaleric acidemia

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    Grünert Sarah C

    2012-01-01

    Full Text Available Abstract Background Despite its first description over 40 years ago, knowledge of the clinical course of isovaleric acidemia (IVA, a disorder predisposing to severe acidotic episodes during catabolic stress, is still anecdotal. We aimed to investigate the phenotypic presentation and factors determining the neurological and neurocognitive outcomes of patients diagnosed with IVA following clinical manifestation. Methods Retrospective data on 21 children and adults with symptomatic IVA diagnosed from 1976 to 1999 were analyzed for outcome determinants including age at diagnosis and number of catabolic episodes. Sixteen of 21 patients were evaluated cross-sectionally focusing on the neurological and neurocognitive status. Additionally, 155 cases of patients with IVA published in the international literature were reviewed and analyzed for outcome parameters including mortality. Results 57% of study patients (12/21 were diagnosed within the first weeks of life and 43% (9/21 in childhood. An acute metabolic attack was the main cause of diagnostic work-up. 44% of investigated study patients (7/16 showed mild motor dysfunction and only 19% (3/16 had cognitive deficits. No other organ complications were found. The patients' intelligence quotient was not related to the number of catabolic episodes but was inversely related to age at diagnosis. In published cases, mortality was high (33% if associated with neonatal diagnosis, following manifestation at an average age of 7 days. Conclusions Within the group of "classical" organic acidurias, IVA appears to be exceptional considering its milder neuropathologic implications. The potential to avoid neonatal mortality and to improve neurologic and cognitive outcome under early treatment reinforces IVA to be qualified for newborn screening.

  9. Neurocognition and cognitive biases in schizophrenia.

    Science.gov (United States)

    Garcia, Cristina P; Sacks, Stephanie A; Weisman de Mamani, Amy G

    2012-08-01

    Individuals with schizophrenia have been found to exhibit a number of information processing biases that may play a role in the development and exacerbation of symptoms and may impair overall functioning. However, little is known about the factors that are associated with these cognitive biases. Recently, researchers have begun to consider whether neurocognitive deficits, common in schizophrenia, may be risk factors for the development of cognitive biases. In the present study, we assessed neurocognition (verbal learning, delayed verbal recall memory, and verbal recognition memory) and cognitive biases (knowledge corruption and impaired cognitive insight) in 72 individuals with schizophrenia or schizoaffective disorder. As hypothesized, poorer delayed verbal recall memory was associated with increased knowledge corruption. Contrary to expectations, verbal learning and verbal memory were not associated with cognitive insight. These findings suggest that an inadequate recall memory system may put patients with schizophrenia at greater risk for cognitive distortions.

  10. A case of dyskeratosis congenita with primary amenorrhea and adenocarcinoma of stomach

    Directory of Open Access Journals (Sweden)

    Nandini Chakrabarti

    2011-01-01

    Full Text Available Dyskeratosis congenita (DC is a rare disease characterized by hyperpigmentation, nail dystrophy and mucous membrane abnormality. Commonly occurring in males, the patients die young usually due to bone marrow suppression. Malignancies of various descriptions have been reported in this disease, the commonest being solid tumors of head/neck (squamous cell carcinoma. We report the case of a female patient with DC, who presented to us with severe wasting and primary amenorrhea and died of carcinoma stomach in our hospital 3 weeks later.

  11. Mentha Longifolia Syrup in Secondary Amenorrhea: a Double-blind, Placebo-Controlled, Randomized Trials

    Directory of Open Access Journals (Sweden)

    Roshanak Mokaberinejad

    2012-12-01

    Full Text Available Amenorrhea is defined as the cessation of menses. Hormone therapy is the most common treatment. Due to the contraindications and side effects of it and the increasing demand for alternative medicine substitutes, Mentha longifolia L. was used in this study. Mentha longifolia L. is a known medication in Iranian traditional medicine to induce menstrual bleeding in women with secondary amenorrhea and oligomenorrhea.Methods A double-blind, randomized, placebo-controlled, multicenter study was conducted in 120 women with secondary amenorrhea and oligomenorrhea. Treatment consisted of sequential oral syrup, 45 ml (15 ml three times a day for 2 weeks. If the patients did not have menstruation after 2 weeks of taking the medication, we would wait for two more weeks. If the patients had menstruation at each stage of using the drug, we started it one week after the end of menstruation. But if the patients had not menstruate after four weeks (two-week using of drug and waiting for two more weeks, the previous steps were repeated. The drug and placebo were repeated in three cycles of menstruation. Bleeding was documented by the patient on diary cards. The primary outcome variable was the occurrence (yes/no of bleeding during the first treatment cycle. The secondary efficacy outcome was the regularity of bleeding pattern during the three cycles of the study.Results The number of women with bleeding during the first cycle were higher in the drug group as in the placebo group (68.3% vs. 13.6%; p < 0.001. The regularity of bleeding throughout the study was markedly better in the drug group compared with those given placebo (33.3% vs. 3.3%; p < 0.001. No notable complication or side effect was reported in relation to Mentha longifolia L. syrup.ConclusionIn conclusion, Mentha longifolia L. syrup is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with secondary amenorrhea and oligomenorrhea.

  12. Mentha longifolia syrup in secondary amenorrhea: a double-blind, placebo-controlled, randomized trials

    Science.gov (United States)

    2012-01-01

    Background Amenorrhea is defined as the cessation of menses. Hormone therapy is the most common treatment. Due to the contraindications and side effects of it and the increasing demand for alternative medicine substitutes, Mentha longifolia L. was used in this study. Mentha longifolia L. is a known medication in Iranian traditional medicine to induce menstrual bleeding in women with secondary amenorrhea and oligomenorrhea. Methods A double-blind, randomized, placebo-controlled, multicenter study was conducted in 120 women with secondary amenorrhea and oligomenorrhea. Treatment consisted of sequential oral syrup, 45 ml (15 ml three times a day) for 2 weeks. If the patients did not have menstruation after 2 weeks of taking the medication, we would wait for two more weeks. If the patients had menstruation at each stage of using the drug, we started it one week after the end of menstruation. But if the patients had not menstruate after four weeks (two-week using of drug and waiting for two more weeks), the previous steps were repeated. The drug and placebo were repeated in three cycles of menstruation. Bleeding was documented by the patient on diary cards. The primary outcome variable was the occurrence (yes/no) of bleeding during the first treatment cycle. The secondary efficacy outcome was the regularity of bleeding pattern during the three cycles of the study. Results The number of women with bleeding during the first cycle were higher in the drug group as in the placebo group (68.3% vs. 13.6%; p < 0.001). The regularity of bleeding throughout the study was markedly better in the drug group compared with those given placebo (33.3% vs. 3.3%; p < 0.001). No notable complication or side effect was reported in relation to Mentha longifolia L. syrup. Conclusion In conclusion, Mentha longifolia L. syrup is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with secondary amenorrhea and oligomenorrhea. PMID

  13. Neurocognitive impairment in obstructive sleep apnea.

    Science.gov (United States)

    Lal, Chitra; Strange, Charlie; Bachman, David

    2012-06-01

    Obstructive sleep apnea syndrome (OSAS) is a common disorder with far-reaching health implications. One of the major consequences of OSAS is an impact on neurocognitive functioning. Several studies have shown that OSAS has an adverse effect on inductive and deductive reasoning, attention, vigilance, learning, and memory. Neurocognitive impairment can be measured objectively with tests such as the Wechsler Adult Intelligence Scale-Revised, the Psychomotor Vigilance Task, the Steer Clear Performance Test, and tests of repetitive finger tapping. In children, OSAS may cause attention-deficit hyperactivity disorder in addition to behavioral problems and learning disabilities. Risk factors for cognitive impairment include increasing age, male sex, apolipoprotein E ε4 allele positivity, current cigarette smoking, obesity, hypertension, diabetes mellitus, metabolic syndrome, Down syndrome, hypothyroidism, significant alcohol consumption, stroke, and the use of psychoactive medications. At a cellular level, OSAS likely causes cognitive impairment through intermittent hypoxia, hormonal imbalance, and/or systemic inflammation, either independently or via the resultant endothelial dysfunction that occurs. Excessive daytime sleepiness should be measured and minimized in all studies of neurocognitive impairment. Recent studies have used functional and structural neuroimaging to delineate the brain areas affected in patients with OSAS with neurocognitive dysfunction. A common finding in several of these studies is decreased hippocampal volume. Other affected brain areas include the frontal and parietal lobes of the brain, which show focal reductions in gray matter. These changes can be reversed at least partially with the use of CPAP, which highlights the importance of early recognition and treatment of OSAS. The currently available data in this field are quite limited, and more research is needed.

  14. Neurocognition: The Food–Brain Connection1234

    OpenAIRE

    Hill, James O.; Berridge, Kent; Avena, Nicole M.; Ziauddeen, Hisham; Alonso-Alonso, Miguel; Allison, David B.; Khan, Naiman A.; Kelley, Michael

    2014-01-01

    This article summarizes presentations from “Neurocognition: The Food–Brain Connection” symposium held at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014 in San Diego, CA on 28 April 2014. Presenters reviewed research from several disciplines, including neurobiology, neuropsychology, cognitive neuroscience, and nutrition, concerning the role of the brain in food-intake regulation, reward, and addiction. A transdisciplinary approach was taken to evaluate the state of...

  15. Perinatal iron deficiency and neurocognitive development

    Directory of Open Access Journals (Sweden)

    Emily Clare Radlowski

    2013-09-01

    Full Text Available Iron deficiency is the most common form of nutrient deficiency worldwide. It is highly prevalent due to the limited availability of high quality food in developing countries, and poor dietary habits in industrialized countries. According to the World Health Organization, it affects nearly 2 billion people and up to 50% of women who are pregnant. Maternal anemia during pregnancy is especially burdensome to healthy neurodevelopment in the fetus because iron is needed for proper neurogenesis, development, and myelination. Maternal anemia also increases the risk of low birth weight, either due to premature birth or fetal growth restriction, which is associated with delayed neurocognitive development and even psychiatric illness. As rapid neurodevelopment continues after birth infants that received sufficient iron in utero, but that receive a low iron diet after 6 months of age, also show deficits in neurocognitive development, including impairments in learning and memory. Unfortunately, the neurocognitive complications of iron deficiency during critical pre- and postnatal periods of brain development are difficult to remedy, persisting into adulthood. Thus, preventing iron deficiency in the pre- and postnatal periods is critical as is devising new means to recapture cognitive function in individuals who experienced early iron deficiency. This review will discuss the prevalence of pre- and postnatal iron deficiency, the mechanism, and effects of iron deficiency on brain and cognitive development.

  16. Krukenberg tumor presenting with amenorrhea as the sole initial symptom: Case report and review of the literature.

    Science.gov (United States)

    Sahin, Suleyman; Karatas, Fatih; Hacioglu, B; Aytekin, A; Imamoglu, I; Koseoglu, N; Sari, E; Altinbas, M

    2015-01-01

    Krukenberg tumor (KT), mostly originates from gastric cancer, is the metastatic tumor of ovaries accounting for 1-2% of all ovarian cancer. Common presenting symptoms include abdominal pain, distension, and ascites. Rests of the patients have non-specific gastrointestinal symptoms including dyspepsia, weight loss, nausea and vomiting. Gynecologic symptoms such as virilization, menstrual bleeding or irregularity and amenorrhea are much less frequent in the literature cases. Here, we present an unusual case of KT presented with amenorrhea as the sole initial symptom.

  17. Metformin, oral contraceptives or both to manage oligo-amenorrhea in adolescents with polycystic ovary syndrome? A clinical review.

    Science.gov (United States)

    Palomba, Stefano; Materazzo, Caterina; Falbo, Angela; Orio, Francesco; La Sala, Giovanni Battista; Sultan, Charles

    2014-05-01

    The management of oligo-amenorrhea in adolescent patients with polycystic ovary syndrome (PCOS) represents an important and difficult challenge. Metformin and/or oral contraceptives (OCs) are different strategies widely proposed in these patients. The objective of the current review was to provide an overview on the use of metformin and/or OCs for the management of oligo-amenorrhea in adolescents with PCOS underlining their potential risks and benefits in order to help the clinician to choose the best patients' tailored treatment.

  18. 浅谈闭经的中医辨证治疗%TCM Treatment of Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    李晓姝

    2015-01-01

    目的:对中医治疗闭经的疗法进行分析。方法随机选取我院2012年4月~2014年4月间收治的患有闭经的36例患者进行回顾分析。结果经过中医辨证分析及对症治疗,36例患者中有17例疗效显著,已痊愈,有16例患者有明显好转,其余3例治疗无效,总有效率为91.66%.结论采用中医疗法治疗闭经可取得良好的效果。%Objective To analyze TCM treatment for menopause therapy. Methods Our hospital between April 2012 to April 2014 in 36 patients suffering from amenorrhea were retrospectively analyzed. Results Analysis of TCM and symptomatic treatment,36 patients had a significant effect,17 cases have been recovered,16 patients had significantly improved,and three cases were ineffective,the total effective rate was 91.66%. Conclusion The use of traditional chinese medicine therapy amenorrhea can achieve good results.

  19. Deoxyribonucleic acid damage study in primary amenorrhea by comet assay and karyotyping

    Directory of Open Access Journals (Sweden)

    Sarah Ramamurthy

    2013-01-01

    Full Text Available Aim: This study aims at evaluating the chromosomal abnormalities and deoxyribonucleic acid (DNA damage in cases with primary amenorrhea by karyotyping and comet assay. Study Design: A total of 30 cases of primary amenorrhea were recruited. Secondary sexual characters were assessed by Tanner staging. Chromosomal analysis was performed by conventional phytohemagglutinin stimulated lymphocyte cell culture technique. Alkaline version of comet assay was used to evaluate DNA damage. Results: The chromosomal pattern of 20 subjects (66.7% was found to be normal (46,XX. Two subjects had 46,XY pattern and eight subjects had Turner syndrome (45,X or 45,X/46,XX. The comet parameters were found to be increased among subjects with 45,X monosomy, when compared to the rest of the study group and also in subjects with Tanner stage 1 when compared to stage 2. Conclusion: Comet assay revealed increased DNA damage in cases with 45,X monosomy, compared with subjects with 46,XX and 46,XY karyotype, which correlated with clinical features.

  20. [Psychogenic amenorrhea].

    Science.gov (United States)

    Lachowsky, M; Winaver, D

    2007-01-01

    Any amenorrhoea noticed outside pregnancy, lactation and menopause periods might be of organic or functional origin. Today, non organic amenorrhoea are either called hypothalamic amenorrhoea, more exactly supra hypothalamic amenorrhoea; functional amenorrhoea--this definition being characterized by its lack of any anatomic substratum; or, psychogenic amenorrhoea--an etiologic definition. Like any amenorrhoea, functional or psychogenic amenorrhoea is the consequence of either anovulation or endometrial hypotrophy. Neuroendocrine sciences do open new exciting research perspectives but other ways all the more promising since hormonal mechanics would not be the explanation. Work on the unconscious is indeed the other road leading to these psychogenic amenorrhoea. The term "psychogenic"--of psychological origin--does not mean of unknown origin, provided we recognize the strong link between psyche and soma. Treatment for this kind of amenorrhoea is twofold: medical and psychotherapeutic. Even though psychological etiology is obvious, clinical examination must be rigorous and completed by complementary exams which will guide the therapeutics. This is reassuring to the patient for the gynaecologist she chose to consult is implied, and not the psychotherapist. This reassures us too, because what we care for, as doctors, is first of all the body. Psychotherapeutic support can be provided by the general practitioner or the gynaecologist, both with psychosomatics training, but a multidisciplinary approach must often be worked out.

  1. Secondary amenorrhea

    Science.gov (United States)

    ... tumors Drugs for cancer treatment Drugs to treat schizophrenia or psychosis Overactive thyroid gland Polycystic ovarian syndrome ... Professional See your primary health care provider or women's health care provider if you have missed more ...

  2. Amenorréia e osteoporose em adolescentes atletas Amenorrhea and osteosporosis in adolescents athletes

    Directory of Open Access Journals (Sweden)

    Graziela MANTOANELLI

    2002-09-01

    Full Text Available A participação feminina no esporte foi crescendo ao longo dos anos. Trabalhos científicos têm mostrado os benefícios trazidos por esta prática para a saúde da mulher, mas quando se trata de esporte competitivo podem surgir problemas. A complicação mais comum descrita pela literatura é a "tríade da atleta", a qual envolve três processos: o distúrbio alimentar, a amenorréia e a osteoporose. A amenorréia atinge, nos Estados Unidos, até 66% das atletas de competição, e algumas de suas possíveis causas são: perda de peso, excesso de treino, quantidade insuficiente de gordura corporal, perda de estoques específicos de gordura corporal e dieta inadequada. Como conseqüência da amenorréia, a esportista pode desenvolver osteoporose precoce. Não se sabe ao certo a porcentagem de atletas com osteopenia, mas há indícios de que a falta de estrógeno, a dieta inadequada e o consumo insuficiente de cálcio serem fatores que as predispõem a desenvolver a doença.The female participation in sports has been increasing over the years. Scientific studies have shown the benefits this practice brings to women's health, but, when it comes to competitive sports, problems may arise. The most common complication described by the literature is the "Female Athlete Triad", which involves three processes: the eating disorder, the amenorrhea, and the osteoporosis. In the United States, the amenorrhea afflicts up to 66% of the competition athletes, and some of its possible causes of are: weight loss, excessive training, insufficient quantity of body fat, loss of specific stores of body fat, and inadequate diet. As a consequence of the amenorrhea, the sportswoman may develop precocious osteoporosis. It is not known for sure the percentage of athletes with osteopenia, but there are indications that the lack of estrogen, the inadequate diet, and the insufficient consumption of calcium are factors predisposing them to develop the disease.

  3. Prevalence of neurocognitive disorders and depression in a Brazilian HIV population

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    Flávio Trentin Troncoso

    2015-08-01

    Full Text Available AbstractINTRODUCTION:Combined antiretroviral therapy has enabled human immunodeficiency virus (HIV carriers to live longer. This increased life expectancy is associated with the occurrence of degenerative diseases, including HIV-associated neurocognitive disorders (HAND, which are diagnosed via a complex neuropsychological assessment. The International HIV Dementia Scale (IHDS is a screening instrument validated in Brazil for use in the absence of neuropsychological evaluation. HIV patients are frequently diagnosed with depression. We aimed to determine the prevalence of neurocognitive impairment using the IHDS and depressive disorders using the Hamilton Rating Scale for Depression (HAM-D17, compare the IHDS performance with the performances on the Timed Gait Test (TGT, the Digit Symbol Coding Test (DS and the Brazilian version of the Scale of Instrumental Activities of Daily Living (IADL, and evaluate the association between the IHDS performance and clinical-demographic variables.METHODS:One hundred fourteen patients were evaluated in a cross-sectional study conducted in a public outpatient clinic for infectious diseases in Marília City, State of São Paulo, Brazil. Data were collected following consultation. Statistical analysis was performed in accordance with the nature and distribution of the data and hypotheses.RESULTS:According to the IHDS, 53.2% of the sampled patients were neuropsychologically impaired. According to the HAM-D17, 26.3% had depressive disorders. There were significant associations between the IHDS and the TGT and DS. Multiple regression analysis indicated that female gender, educational level, and cluster of differentiation 4 (CD4 levels were significantly and independently associated with neurocognitive impairment.CONCLUSIONS:The prevalence of neurocognitive impairment according to the IHDS is high and associated with female gender, education level, and low CD4 levels.

  4. Steroidogenic factor-1 (SF-1 gene mutation as a frequent cause of primary amenorrhea in 46,XY female adolescents with low testosterone concentration

    Directory of Open Access Journals (Sweden)

    Servant Nadège

    2010-03-01

    Full Text Available Abstract Background Primary amenorrhea due to 46,XY disorders of sex differentiation (DSD is a frequent reason for consultation in endocrine and gynecology clinics. Among the genetic causes of low-testosterone primary amenorrhea due to 46,XY DSD, SRY gene is reported to be frequently involved, but other genes, such as SF1 and WT1, have never been studied for their prevalence. Methods We directly sequenced SRY, SF1 and WT1 genes in 15 adolescent girls with primary amenorrhea, low testosterone concentration, and XY karyotype, to determine the prevalence of mutations. We also analyzed the LH receptor gene in patients with high LH and normal FSH concentrations. Results Among the 15 adolescents with primary amenorrhea and low testosterone concentration, we identified two new SRY mutations, five new SF1 mutations and one new LH receptor gene mutation. Our study confirms the 10-15% prevalence of SRY mutations and shows the high prevalence (33% of SF1 abnormalities in primary amenorrhea due to 46,XY DSD with low plasma testosterone concentration. Conclusions The genetic analysis of low-testosterone primary amenorrhea is complex as several factors may be involved. This work underlines the need to systematically analyze the SF1 sequence in girls with primary amenorrhea due to 46,XY DSD and low testosterone, as well as in newborns with 46,XY DSD.

  5. [ROLE OF LEPTIN IN THE FORMATION OF SECONDARY AMENORRHEA IN ADOLESCENT GIRLS].

    Science.gov (United States)

    Levenets, S A; Nachotova, T A; Kashkalda, D A

    2015-01-01

    In order to understand the role of leptin in the formation of secondary amenorrhea (SA) during puberty, 78 girls aged from 13 to 17 years with SA and 74 girls of the same age with regular menstrual cycle have been examined with the estimation of body mass index (BMI) and hormonal/metabolic state. The obtained data show a strong connection between leptin level, BMI and parameters of energetic metabolic state (insulin; HOMA index); regression analysis results indicated the participation of leptin in steroidogenesis. Odds ratio (OR) values indicated an important role of leptin in the formation of SA during body weight deficit and normal BMI. It has been found that various clinical types of SA have different patterns of leptin influence.

  6. Hormone Use for Therapeutic Amenorrhea and Contraception During Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Chang, Katherine; Merideth, Melissa A; Stratton, Pamela

    2015-10-01

    There is a growing population of women who have or will undergo hematopoietic stem cell transplant for a variety of malignant and benign conditions. Gynecologists play an important role in addressing the gynecologic and reproductive health concerns for these women throughout the transplant process. As women undergo cell transplantation, they should avoid becoming pregnant and are at risk of uterine bleeding. Thus, counseling about and implementing hormonal treatments such as gonadotropin-releasing hormone agonists, combined hormonal contraceptives, and progestin-only methods help to achieve therapeutic amenorrhea and can serve as contraception during the peritransplant period. In this commentary, we summarize the timing, risks, and benefits of the hormonal options just before, during, and for the year after hematopoietic stem cell transplantation.

  7. Heart rate variability in adolescents with functional hypothalamic amenorrhea and anorexia nervosa.

    Science.gov (United States)

    Bomba, Monica; Corbetta, Fabiola; Gambera, Alessandro; Nicosia, Franco; Bonini, Luisa; Neri, Francesca; Tremolizzo, Lucio; Nacinovich, Renata

    2014-02-28

    Aim of this study consisted in assessing the 24-h heart rate variability (HRV), a measure of autonomic nervous system (ANS) imbalance, in 21 adolescents with functional hypothalamic amenorrhea (FHA, 11 normogonadotropic, N-FHA, and 10 hypogonadotropic, Hy-FHA) compared to 21 patients with anorexia nervosa (AN) and 21 controls. As expected, subjects with AN showed a significant dysregulation in multiple HRV parameters, while Hy-FHA patients presented with a dysregulation in a few domains (SDNN, HFr), which was not present in girls with N-FHA, who showed values largely similar to controls. FHA might represent part of the AN biological spectrum, and a link between these two conditions might exist, possibly related to the degree of psychological and/or hormonal dysfunction.

  8. Neurocognitive impairment in childhood chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Kei eMizuno

    2013-04-01

    Full Text Available Neurocognitive impairment is a feature of childhood chronic fatigue syndrome (CCFS. Several studies have demonstrated reduced attention control in CCFS patients in switching and divided attention tasks. In students, the extent of deterioration in task performance depends on the level of fatigue. Poor performance in switching and divided attention is common in both fatigued students and CCFS patients. Additionally, attentional functions show dramatic development from childhood to adolescence, suggesting that abnormal development of switching and divided attention may be induced by chronic fatigue. The brain structures associated with attentional control are situated in the frontal and parietal cortices, which are the last to mature, suggesting that severe fatigue in CCFS patients and students may inhibit normal structural and functional development in these regions. A combination of treatment with cognitive behavioral therapy and antidepressant medication is effective to improve attentional control processing in CCFS patients. Studies identifying the features of neurocognitive impairment in CCFS have improved our current understanding of the neurophysiological mechanisms of CCFS.

  9. Theory of mind in the early course of schizophrenia: stability, symptom and neurocognitive correlates, and relationship with functioning.

    Science.gov (United States)

    Ventura, J; Ered, A; Gretchen-Doorly, D; Subotnik, K L; Horan, W P; Hellemann, G S; Nuechterlein, K H

    2015-07-01

    Numerous studies have reported links between theory of mind (ToM) deficits, neurocognition and negative symptoms with functional outcome in chronic schizophrenia patients. Although the ToM deficit has been observed in first-episode patients, fewer studies have addressed ToM as a possible trait marker, neurocognitive and symptom correlations longitudinally, and associations with later functioning. Recent-onset schizophrenia patients (n = 77) were assessed at baseline after reaching medication stabilization, and again at 6 months (n = 48). Healthy controls (n = 21) were screened, and demographically comparable with the patients. ToM was assessed with a Social Animations Task (SAT), in which the participants' descriptions of scenes depicting abstract visual stimuli 'interacting' in three conditions (ToM, goal directed and random) were rated for degree of intentionality attributed to the figures and for appropriateness. Neurocognition, symptoms and role functioning were also assessed. On the SAT, patients had lower scores than controls for both intentionality (p schizophrenia patients and appears to be moderately trait-like. ToM is also moderately correlated with neurocognition, negative and positive symptoms, and role functioning. ToM appears to influence negative symptoms which in turn makes an impact on role functioning.

  10. Amenorréia e anormalidades do cromossomo X Amenorrhea and X chromosome abnormalities

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano Machado Rosa

    2008-10-01

    Full Text Available OBJETIVO: correlacionar as manifestações clínicas de pacientes com amenorréia e anormalidades do cromossomo X. MÉTODOS: realizou-se uma análise retrospectiva dos achados clínicos e laboratoriais das pacientes com amenorréia e anormalidades do cromossomo X, atendidas entre janeiro de 1975 e novembro de 2007. Suas medidas antropométricas foram avaliadas através de tabelas de crescimento padrão, sendo que, quando presentes, dismorfias menores e maiores foram anotadas. O estudo dos cromossomos foi realizado através do cariótipo com bandamento GTG. RESULTADOS: do total de 141 pacientes com amenorréia, 16% apresentavam anormalidades numéricas e 13% estruturais do cromossomo X. Destas pacientes com anormalidade do X (n=41, 35 possuíam descrição clínica completa. Todas elas apresentavam hipogonadismo hipergonadotrófico. Amenorréia primária foi observada em 24 pacientes, das quais 91,7% com fenótipo de síndrome de Turner. Com exceção de um caso com deleção Xq22-q28, todas as demais pacientes com este fenótipo apresentavam alterações envolvendo Xp (uma com uma linhagem 46,XY associada. Os dois casos restantes com apenas amenorréia primária possuíam deleções proximais de Xq. Entre as 11 pacientes com amenorréia secundária, 54,5% apresentavam fenótipo de Turner (todas com monossomia do X isolada ou em mosaico. Entre aquelas com fenótipo de falência ovariana isolada observaram-se somente deleções Xq e trissomia do X. CONCLUSÕES: a análise cromossômica deve sempre ser realizada em mulheres com falência ovariana de causa não conhecida, mesmo na ausência de achados dismórficos. Esta também é de extrema importância em pacientes sindrômicas, pois, além de confirmar o diagnóstico, é capaz de identificar pacientes em risco, como nos casos com uma linhagem 46,XY.PURPOSE: to correlate the clinical manifestations of patients with amenorrhea and X chromosome abnormalities. METHODS: a retrospective analysis of the

  11. Adenotonsillectomy and neurocognitive deficits in children with Sleep Disordered Breathing.

    Directory of Open Access Journals (Sweden)

    Mark J Kohler

    Full Text Available BACKGROUND: Sleep Disordered Breathing (SDB is a common childhood disorder that encompasses a range of sleep-related upper airway obstruction. Children with SDB demonstrate significant neurocognitive deficits. Adenotonsillectomy is the first line of treatment for SDB and whilst this improves respiratory disturbance, it remains to be established whether neurocognitive gains also result. METHODS: A total of 44 healthy snoring children aged 3-12 years awaiting adenotonsillectomy (SDB group, and 48 age and gender matched non-snoring controls from the general community, completed the study. All children underwent polysomnography and neurocognitive assessment at baseline and after a 6-month follow-up (after surgery in the snoring group. Our primary aim was to determine whether neurocognitive deficits in snoring children were significantly improved following adenotonsillectomy. RESULTS: Wide ranging neurocognitive deficits were found at baseline in SDB children compared to controls, most notably a 10 point IQ difference (P<.001 and similar deficits in language and executive function. Whilst adenotonsillectomy improved respiratory parameters and snoring frequency at 6 months post surgery, neurocognitive performance did not improve relative to controls. CONCLUSION: Adenotonsillectomy successfully treated the respiratory effects of SDB in children. However, neurocognitive deficits did not improve 6-months post-operatively.

  12. [Do Intellectual Activities Influence Onset of Neurocognitive Disorder?].

    Science.gov (United States)

    Matsuda, Osamu

    2016-07-01

    In this paper, the author has discussed whether and how intellectual activities influence the onset of neurocognitive disorder based on findings from previous studies. The activities discussed include those involving education and learning during childhood, hobbies and leisure activities with cognitive stimulation, and those through cognitive intervention. There are various opinions on the effect of intellectual activities on the onset of neurocognitive disorder. However, because the relationship between intellectual activities and the onset of neurocognitive disorder has never been fully examined, it seems necessary to discuss this aspect carefully.

  13. Chronic hepatitis C virus infection and neurocognitive function in adult survivors of childhood cancer.

    Science.gov (United States)

    Studaway, Adrienne; Ojha, Rohit P; Brinkman, Tara M; Zhang, Nan; Baassiri, Malek; Banerjee, Pia; Ehrhardt, Matthew J; Srivastava, Deokumar; Robison, Leslie L; Hudson, Melissa M; Krull, Kevin R

    2017-07-25

    Cancer survivors transfused with blood products before reliable screening for hepatitis C virus (HCV) are at risk for infection. This study examined the impact of HCV on neurocognitive function and health-related quality of life (HRQOL) among adult survivors of childhood cancer. Neurocognitive testing was conducted for 836 adult survivors of childhood cancer (mean age, 35 years [standard deviation, 7.4 years]; time since diagnosis, 29 years [standard deviation, 6.2 years]) who received blood products before universal HCV screening. No differences were observed between confirmed HCV-seropositive survivors (n = 79) and HCV-seronegative survivors (n = 757) in the primary diagnosis or neurotoxic therapies. Multivariate regression models were used to compare functional outcomes between seropositive and seronegative survivors. Compared with seronegative survivors, seropositive survivors demonstrated lower performance on measures of attention (P function (P = .001). After adjustments for sex, age at diagnosis, and treatment exposures, seropositive survivors had a higher prevalence of impairment in processing speed (prevalence ratio [PR], 1.3; 95% confidence interval [CI], 1.1-1.6) and executive functioning (PR, 1.3; 95% CI, 1.1-1.6). Differences were not associated with the treatment of HCV or the presence of liver cirrhosis. Seropositive survivors reported worse general HRQOL (PR, 1.6; 95% CI, 1.2-2.1), which was associated with the presence of liver cirrhosis (P = .001). Survivors of childhood cancer with a history of HCV infection are at risk for neurocognitive impairment and reduced HRQOL beyond the known risks associated with neurotoxic cancer therapies. Cancer 2017. © 2017 American Cancer Society. © 2017 American Cancer Society.

  14. Neurocognitive mechanisms of prosociality in childhood.

    Science.gov (United States)

    Steinbeis, Nikolaus

    2017-08-12

    This paper reviews the neurocognitive mechanisms underlying prosocial development in childhood. I begin by arguing that most prosociality is costly. This cost needs to be regulated for prosocial behavior to occur. The precise regulatory mechanisms depend on the type of prosocial behavior and include behavioral control in the case of sharing and emotion regulation in the case of helping. I review evidence that these regulatory mechanisms are subserved by prefrontal cortical circuitry, which depending on the mechanism interacts with different brain regions coding for self-related and other-related affect to produce prosocial behavior. I conclude that the maturation of prefrontal cortical circuitry drives the development of both sharing and helping in childhood through supporting the emergence of relevant regulatory mechanisms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. 225例闭经患者染色体核型分析及临床意义%Chromosome karyotypte and clinical analyse in 225 amenorrheas

    Institute of Scientific and Technical Information of China (English)

    郑燕銮; 徐岚; 张新能

    2015-01-01

    目的:分析原发闭经和继发闭经患者的染色体异常情况并探讨其临床意义。方法抽取患者外周血培养,制备染色体,采用G显带分析。结果225例原发闭经和继发闭经患者,共检出异常核型63例,占28%。其中,原发闭经患者148例,异常核型55例,占37.16%。继发闭经患者77例,核型异常8例,占10.39%。结论染色体异常是导致原发闭经和继发闭经的主要原因,对闭经患者进行染色体检查,明确闭经原因,及早对症治疗有重要意义。%Objective To analyse the suffer′excrescent circumstance in chromosome who are primary amenorrhea or secondary amenorrhea and inquiry its clinical meaning .Methods Take out patients′peypheyal vein blood to cultuve ,the chromosome was pre‐pared ,G band was analysed .Results primary amenorrhea or secondary amenorrhea suffer totally 225 ,there were 63 with chromo‐som abnormal karyotyptes which occupies 28% ;Among 148 the patiens of primary amenorrhea ,chromosom abnormal karyotyptes were 55 examples which occupies 37 .16% ,secondary amenorrhea is 77 examples ,chromosom abnormal karyotyptes were 8 exam‐ples which occupies 10 .39% .Conclusion Chromosome abnormals are the main cause of primary amenorrhea and secondary amen‐orrhea .in patients with chromosom analyse ,to kncw the cause of amenorrhea ,early symptomatic treatment is important .

  16. Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: a distinct phenotype

    Directory of Open Access Journals (Sweden)

    Javed A

    2015-01-01

    Full Text Available Asma Javed,1 Rahul Kashyap,2 Aida N Lteif1 1Pediatric and Adolescent Medicine, Division of Pediatric Endocrinology Mayo Clinic, Rochester, MN, USA; 2Department of Anesthesia and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA Objective: To compare the reproductive, metabolic, and skeletal profiles of young athletic women with functional hypothalamic amenorrhea (FHA as well as clinical or biochemical hyperandrogenism (FHA-EX+HA with body mass index matched women with FHA due to exercise (FHA-EX or anorexia nervosa (FHA-AN alone.Design: Retrospective cohort study.Setting: Tertiary care teaching hospital.Population: Adolescents and young women, 15–30 years of age, diagnosed with FHA along with concurrent signs of hyperandrogenism (n=22 and body mass index matched control groups consisting of 22 women in each group of FHA-EX and FHA-AN. Main outcomes: 1 Reproductive hormone profile: luteinizing hormone (LH, follicle stimulating hormone (FSH, total testosterone, pelvic ultrasound features. 2 Metabolic function and skeletal health markers: fasting glucose, cholesterol, number of stress fractures and bone mineral density as assessed by spine dual-energy X-ray absorptiometry z scores. Results: FHA-EX+HA group was older at diagnosis compared to the other groups with a median (interquartile range [IQR] age of 22 (18.75–25.25 years versus (vs 17.5 (15.75–19 for FHA-EX; (P<0.01 and 18 (16–22.25 years for FHA-AN (P=0.01. There were no differences among the groups based on number of hours of exercise per week, type of physical activity or duration of amenorrhea. Median (IQR LH/FSH ratio was higher in FHA-EX+HA than both other groups, 1.44 (1.03–1.77 vs 0.50 (0.20–0.94 for FHA-EX and 0.67 (0.51–0.87 for FHA-AN (P<0.01 for both. Total testosterone concentrations were not different among the groups. Median (IQR fasting serum glucose concentration was higher in FHA-EX+HA vs FHA-EX, 88.5 mg/dL (82.8–90 mg/dL vs 83.5 mg/dL (78.8–86.3 mg

  17. Core of schizophrenia: estrangement, dementia or neurocognitive disorder?

    DEFF Research Database (Denmark)

    Mortensen, Erik L; Urfer-Parnas, Annick; Mortensen, Erik Lykke

    2010-01-01

    BACKGROUND: The recent literature frequently represents schizophrenia as a deteriorating neurocognitive process similar to organic degenerative dementia. METHODS: This study addresses the following questions: (1) Did the classic authors equate degenerative dementia with schizophrenia? (2) Is ther...

  18. Debating the utility of computerised neurocognitive testing in the ...

    African Journals Online (AJOL)

    computerised neurocognitive baseline testing in the sports concus- sion context,. 1 ... article does not present a balanced and representative review of the literature … and does nothing to move our understanding of concussion forward …

  19. Prevalence of HIV associated neurocognitive deficit among HIV ...

    African Journals Online (AJOL)

    ... of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: ... the factors associated with cognitive impairment among HIV positive people in ... activity of daily living scale and Hospital Anxiety and Depression scale were ...

  20. Neurocognitive performance following acute mephedrone administration, with and without alcohol

    NARCIS (Netherlands)

    de Sousa Fernandes Perna, E B; Papaseit, E; Pérez-Mañá, C; Mateus, J; Theunissen, E L; Kuypers, K.P.C.; de la Torre, R; Farré, M; Ramaekers, J G

    2016-01-01

    Recreational use of mephedrone, alone and in combination with alcohol, has increased over the past years. Pharmacological properties of mephedrone share similarities with methylenedioxymethamphetamine (MDMA), but its effect on neurocognitive function has not been well established in humans. The pres

  1. Discrete neurocognitive subgroups in fully or partially remitted bipolar disorder

    DEFF Research Database (Denmark)

    Jensen, Johan Høy; Knorr, Ulla; Vinberg, Maj

    2016-01-01

    BACKGROUND: Neurocognitive impairment in remitted patients with bipolar disorder contributes to functional disabilities. However, the pattern and impact of these deficits are unclear. METHODS: We pooled data from 193 fully or partially remitted patients with bipolar disorder and 110 healthy...... controls. Hierarchical cluster analysis was conducted to determine whether there are discrete neurocognitive subgroups in bipolar disorder. The pattern of the cognitive deficits and the characteristics of patients in these neurocognitive subgroups were examined with analyses of covariance and least...... significance difference pairwise comparison. RESULTS: Three discrete neurocognitive subgroups were detected: one that was cognitively intact (46.1%), one that was selectively impaired with deficits in processing speed (32.6%), and one that was globally impaired across verbal learning, working memory...

  2. Tripterygium glycosides-induced amenorrhea%雷公藤多苷致闭经

    Institute of Scientific and Technical Information of China (English)

    路敏; 周颖; 崔一民; 白文佩

    2014-01-01

    A 41-year-old female patient received tripterygium glycosides 20 mg thrice daily, prednisone 20 mg once daily,valsartan 80 mg once daily,amlodipine besylate 5 mg once daily,calcium carbonate 750 mg thrice daily and calcitriol 0. 25 μg once daily for glomerulonephritis and renal hypertension. Tripterygium glycosides and prednisone had to discontinue because the patients developed amenorrhea about one month after the therapy,and amenorrhea has lasted for five months. The sex hormone levels were measured as follows:luteinizing hormone 29 U/L,follicle-stimulating hormone 7 U/L,estradiol 1 168 pmol/L,prolactin 0. 02 nmol/L,testosterone 0. 12 nmol/L;progesterone 1. 5 nmol/L. Hormone replacement therapy with dydrogesterone 10 mg twice daily for 10 days was given. Her menstruation started on day 4 after dydrogesterone discontinuation and lasted for 5 days. The regular menstrual cycle has been restored.%1例41岁女性患者因肾小球肾炎、肾性高血压给予雷公藤多苷(20 mg,3次/d)、泼尼松(20 mg,1次/d)、缬沙坦(80 mg,1次/d)、苯磺酸氨氯地平(5 mg,1次/d)、碳酸钙(750 mg,3次/d)和骨化三醇(0.25μg,1次/d)口服。治疗1个多月后,患者因月经未来潮停用雷公藤多苷和泼尼松,但停药后月经仍未来潮,共闭经5个月。性激素检查:黄体生成激素29 U/L;卵泡刺激素7 U/L;雌二醇1168 pmol/L;催乳激素0.02 nmol/L;睾酮0.12 nmol/L;孕酮1.5 nmol/L。给予性激素地屈孕酮10 mg,2次/d口服治疗,连用10 d。停用地屈孕酮后第4天月经来潮,持续5 d。此后患者恢复正常月经周期。

  3. Function and innervation of the locus ceruleus in a macaque model of Functional Hypothalamic Amenorrhea.

    Science.gov (United States)

    Bethea, Cynthia L; Kim, Aaron; Cameron, Judy L

    2013-02-01

    A body of knowledge implicates an increase in output from the locus ceruleus (LC) during stress. We questioned the innervation and function of the LC in our macaque model of Functional Hypothalamic Amenorrhea, also known as Stress-Induced Amenorrhea. Cohorts of macaques were initially characterized as highly stress resilient (HSR) or stress-sensitive (SS) based upon the presence or absence of ovulation during a protocol involving 2 menstrual cycles with psychosocial and metabolic stress. Afterwards, the animals were rested until normal menstrual cycles resumed and then euthanized on day 5 of a new menstrual cycle [a] in the absence of further stress; or [b] after 5 days of resumed psychosocial and metabolic stress. In this study, parameters of the LC were examined in HSR and SS animals in the presence and absence of stress (2×2 block design) using ICC and image analysis. Tyrosine hydroxylase (TH) is the rate-limiting enzyme for the synthesis of catecholamines; and the TH level was used to assess by inference, NE output. The pixel area of TH-positive dendrites extending outside the medial border of the LC was significantly increased by stress to a similar degree in both HSR and SS animals (p<0.0001). There is a significant CRF innervation of the LC. The positive pixel area of CRF boutons, lateral to the LC, was higher in SS than HSR animals in the absence of stress. Five days of moderate stress significantly increased the CRF-positive bouton pixel area in the HSR group (p<0.02), but not in the SS group. There is also a significant serotonin innervation of the LC. A marked increase in medial serotonin dendrite swelling and beading was observed in the SS+stress group, which may be a consequence of excitotoxicity. The dendrite beading interfered with analysis of axonal boutons. However, at one anatomical level, the serotonin-positive bouton area was obtained between the LC and the superior cerebellar peduncle. Serotonin-positive bouton pixel area was significantly

  4. Age, anti-müllerian hormone, antral follicles count to predict amenorrhea or oligomenorrhea after chemotherapy with cyclophosphamide

    OpenAIRE

    2015-01-01

    Background A cohort study was performed to identify ovarian reserve markers (ORM) that predicts amenorrhea or oligomenorrhea 6 months after cyclophosphamide CTX in women with breast cancer. Methods 52 eumenorrheic patients with breast cancer were enrolled. FSH, anti-Müllerian hormone (AMH), antral follicles count (AFC) were measured before and 6 months after CTX. A logistic regression for independent samples and determination of the ROC curve were performed. Results The age of 32 years presen...

  5. Neurocognitive models of aggression, the antisocial personality disorders, and psychopathy

    OpenAIRE

    Blair, R.

    2001-01-01

    This paper considers neurocognitive models of aggression and relates them to explanations of the antisocial personality disorders. Two forms of aggression are distinguished: reactive aggression elicited in response to frustration/threat and goal directed, instrumental aggression. It is argued that different forms of neurocognitive model are necessary to explain the emergence of these different forms of aggression. Impairments in executive emotional systems (the somatic marke...

  6. A 15-year-old female with amenorrhea, abdominal distention, and elevated human chorionic gonadotropin: pregnancy, right? Not so fast….

    Science.gov (United States)

    Aggarwal, Arun; Ocon, Anthony J; Nibhanipudi, Kumara

    2012-10-01

    Nongestational choriocarcinoma, a rare ovarian tumor, may present in young women with amenorrhea, abdominal distention, and elevated urine human chorionic gonadotropin (hCG), all of which may be mistaken for pregnancy. A 15-year-old Hispanic female, who reported no sexual activity, presented with 6 months of amenorrhea, abdominal pain, and progressive abdominal distension. Initially, suspicion of pregnancy was considered. Physical examination was significant for abdominal distension, but no uterine fundus or fetal anatomy could be palpated, and auscultation did not reveal any fetal heart sounds or bruits. Laboratory values showed elevated urine hCG, cancer antigen 125, and cancer antigen 19.9 levels but normal serum hCG level and was inconsistent with pregnancy. Computed tomographic scans revealed a large abdominal heterogeneous mass and pleural effusions. Salpingo-oophorectomy with total omentectomy and inversion appendectomy removed a 21 × 20.5 × 16.5-cm tumor. Pathological testing determined it to be a nongestational choriocarcinoma. This rare tumor is more common in the pediatric adolescent population than in adults. Surgical resection and chemotherapy often result in a positive prognosis. In female adolescent patients presenting with elevated hCG level, amenorrhea, and abdominal distention, choriocarcinoma should be considered, especially in those with no history of sexual activity or before menarche.

  7. The influence of estrogen therapies on bone mineral density in premenopausal women with anorexia nervosa and amenorrhea.

    Science.gov (United States)

    Lebow, Jocelyn; Sim, Leslie

    2013-01-01

    Low bone mineral density is one of the primary risks of chronic amenorrhea, and the effects of potentially long-term menstrual disruption on bone mass are serious concerns for individuals with a past or current anorexia nervosa (AN) diagnosis. As such, estrogen therapies are frequently used to address amenorrhea associated with AN. A systematic review of the literature was conducted to examine the effectiveness of estrogen therapies on bone mineral density in women with amenorrhea. Data regarding the effectiveness of oral contraceptives were of low quality and mixed, with the majority of studies finding no benefit of these treatments on bone mineral density. Hormone replacement therapy findings were also mixed, though promising results were found in a study comparing transdermal administration of physiologic estrogen, delivered in developmentally sensitive incremental doses to placebo controls. Though this study suggests a possible role for estrogen therapies in addressing bone density loss in women with AN, in general, more studies are needed. Clinical drawbacks of using these therapies in the treatment of AN, including the loss of menses resumption as a clinical marker for weight and nutritional rehabilitation, must be considered in the decision to use estrogen therapies, particularly given the uncertain effectiveness of most of these treatments.

  8. Multiple endocrine adenomatosis with Cushing's disease and the amenorrhea-galactorrhea syndrome responsive to proton beam irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Veseley, D.L.; Fass, F.H.

    1981-09-01

    Multiple endocrine adenomatosis (MEA) or neoplasia is a hereditary disorder consisting of tumors of hyperplasia of several endocrine glands. In MEA-1 the pituitary, parathyroids, and pancreatic islets are most frequently involved, while in MEA-2 the thyroid (medullary carcinoma of the thyroid), parathyroids,and adrenals (pheochromocytomas) are the endocrine glands most likely to be involved. Cushings's syndrome may occur in MEA-1 and has also been found in patients with MEA-2, where the cause of Cushing's syndrome is usually ectopic ACTH production from medullary carcinoma of the thyroid. Recently, there have been reports of amenorrhea-galactorrhea syndrome in patients with MEA-1, and confirmation that hyperprolactinemia is associated with this syndrom has been found in patients with MEA-1. The present report details a patient who has been followed up for 20 years since she first presented with amenorrhea and galactorrhea. Ten years after first being seen she was noted to have Cushing's syndrom and hyperparathyroidism due to parathyroid hyperplasia. Both the amenorrhea-galactorrhea syndrome and Cushing's sydrome disappeared with proton beam irradiation to the pituitary.

  9. Neurocognitive functioning after carotid revascularization: a systematic review.

    Science.gov (United States)

    Plessers, Maarten; Van Herzeele, Isabelle; Vermassen, Frank; Vingerhoets, Guy

    2014-01-01

    The objective of this study was to review the recent literature regarding the neurocognitive consequences of carotid endarterectomy (CEA) and carotid stenting (CAS). A PubMed and Web of Science search was conducted using the key words 'carotid' in combination with 'cognitive', 'cognition', 'neurocognition', 'neurocognitive', 'neuropsychology', and 'neuropsychological'. Bibliographies of relevant articles were cross-referenced. We included 37 studies published since 2007 of which 18 examined CEA, 12 CAS, and 7 compared CEA to CAS. There is a wide variability in the reported neurocognitive outcome following CEA and CAS. Nonetheless, none of the included studies unveiled significant differences between CEA and CAS on postoperative neurocognitive functioning. Postoperative changes observed for CEA and CAS separately seem limited to a small percentage (around 10-15%) of patients and can either present as an improvement or impairment. The available data seem to suggest that no obvious cognitive differences between CAS and CEA can be observed after intervention. Both improvement and deterioration in cognitive functioning can be observed following CAS or CEA. Methodological differences such as patient heterogeneity, implementation and type of control groups, type of psychometric tests used, statistical analyses, or timing of the assessments play an important role in explaining the sometimes divergent results of the included studies. Large-scale and methodologically solid studies comparing CEA and CAS on neurocognitive outcome remain warranted. Future studies should implement adequate control groups to correct for practice effects in the target groups.

  10. Theory of mind and neurocognitive functioning in schizophrenia

    Directory of Open Access Journals (Sweden)

    Rumyantseva E.E.

    2016-02-01

    Full Text Available The aim of this work was to study the problem of interrelation between theory of mind and neurocognitive functioning in schizophrenia. Tasks: analysis of the literature on the problem of interrelation of theory of mind and neurocognitive functioning in schizophrenia. Subject of research: interrelation of theory of mind and neurocognitive functioning. Research hypothesis: the state of the mental model correlated with neurocognitive functioning. Registered a decline in the functioning of theory of mind in schizophrenia. It is known that hypofrontality in schizophrenia determines the reduction of social perception. A number of authors allocate structures in the brain, providing mental models: regions of the medial prefrontal cortex and posttemporal areas, including the temporo parietal region. Some studies found relationship between the theory of mind and memory, executive functions. However, there are studies, which has not been found the interrelation between theory of mind and neurocognitive functioning. Nonetheless, some studies concluded that currently there is no consensus about the influence of neurocognitive functioning on the theory of mind in schizophrenia.

  11. Neurocognitive robot-assisted therapy of hand function.

    Science.gov (United States)

    Metzger, Jean-Claude; Lambercy, Olivier; Califfi, Antonella; Conti, Fabio M; Gassert, Roger

    2014-01-01

    Neurocognitive therapy, according to the Perfetti method, proposes exercises that challenge motor, sensory as well as cognitive functions of neurologically impaired patients. At the level of the hand, neurocognitive exercises typically involve haptic exploration and interaction with objects of various shapes and mechanical properties. Haptic devices are thus an ideal support to provide neurocognitive exercises under well-controlled and reproducible conditions, and to objectively assess patient performance. Here we present three neurocognitive robot-assisted exercises which were implemented on the ReHapticKnob, a high-fidelity two-degrees-of-freedom hand rehabilitation robot. The exercises were evaluated for feasibility and acceptance in a pilot study on five patients suffering from different neurological disorders. Results showed that all patients were able to take part in the neurocognitive robot-assisted therapy, and that the proposed therapy was well accepted by patients, as assessed through subjective questionnaires. Force/torque and position measurements provided insights on the motor strategy employed by the patients during the exploration of virtual object properties, and served as objective assessment of task performance. The fusion of the neurocognitive therapy concept with robot-assisted rehabilitation enriches therapeutic approaches through the focus on haptics, and could provide novel insights on sensorimotor impairment and recovery.

  12. Spectrum of MRI Appearance of Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome in Primary Amenorrhea Patients.

    Science.gov (United States)

    Boruah, Deb Kumar; Sanyal, Shantiranjan; Gogoi, Bidyut Bikash; Mahanta, Kangkana; Prakash, Arjun; Augustine, Antony; Achar, Sashidhar; Baishya, Hiranya

    2017-07-01

    Mayer-Rokitansky-Kuster-Hauser (MRKH) synd-rome is a malformation in female genital tract due to interrupted embryonic development of para-mesonephric ducts leading to uterine and proximal vagina aplasia or hypoplasia. To analyse the MRI findings in females suspected of MRKH syndrome in a primary amenorrhea workup. A cross-sectional study comprising of 11 patients of MRKH syndrome presented in a tertiary care centre from March 2016 to February 2017 evaluated in 1.5 Tesla MRI scanner. Normal positioned small vestigial uterus demonstrated in two patients (18.2%) and complete uterine and proximal vaginal agenesis were noted in nine patients (81.8%). The mean volume of rudimentary right uterine bud was 2.26 mL ±3.3 (SD) and left uterine bud was 1.27 mL±1.1 (SD). The mean volume of right ovary was 4.74 mL±2.58 (SD) and left ovary was 4.65 mL±2.2 (SD). The mean developed vaginal length was 26.2 mm±6.34 (SD). The rudimentary uterine buds associated with MRKH syndrome always maintained caudal relationship with ovary. Ovaries or rudimentary uterine buds can be ectopic and should be recognized with MRI before undergoing fertility treatment. Following MRI diagnosis, surgery allows patients to have sexual function with possible attainment of reproduction after assisted reproduction technique or surrogacy.

  13. 17-Alpha Hydroxylase Deficiency: A Rare Case of Primary Amenorrhea and Hypertension

    Directory of Open Access Journals (Sweden)

    Yasin Şimşek

    2014-12-01

    Full Text Available 17-alpha hydroxylase deficiency (17OHD is an uncommon cause of congenital adrenal hyperplasia (CAH resulting from mutation in the CYP17 gene. It is an autosomal recessive disease leading to the deficiency of enzyme activity which results in impaired synthesis of cortisol, androgen and sex steroids. A 35-year-old woman was admitted to the hospital with hypokalemia, weakness, and fatigue. Medical history revealed two attempts of in vitro fertilization (IVF without achieving pregnancy. Laboratory evaluation showed hypokalemia, hypocortisolemia, hypergonadotropic hypogonadism and increased levels of 11-deoxycorticosterone. Her karyotype was 46XX. The patient had no history of menarche. She had Tanner stage 2 breast development. Genotyping showed homozygous mutation located in exon 7 which abolishes both 17-alpha hydroxylase and 17,20 lyase activities of the CYP17A1 protein. After starting dexamethasone 0.5 mg/day, her potassium level was normalized, and blood pressure improved. In conclusion, a comprehensive evaluation should be performed before using assisted reproductive techniques, such as in vitro fertilization in hypertensive women with sexual infantilism, primary amenorrhea, and hypokalemia.

  14. [Effect of Tongdatang Serial Recipe on antipsychotic drug-induced galactorrhea-amenorrhea syndrome].

    Science.gov (United States)

    Ding, Ying; Qian, Hui-Zhong; Wang, Yi-Qiang

    2008-03-01

    To observe the clinical effect of self-formulated Tongdatang serial recipe (TDT) in treating antipsychotic drug-induced galactorrhea-amenorrhea syndrome (GAS). One hundred female schizophrenic patients with antipsychotic drug-induced GAS were selected and equally assigned to the treatment group and the control group at random. Both received antipsychotic drug-therapy, but combined with TDT and placebo respectively. The efficacy was evaluated by determining prolactin level before, 4 and 8 weeks after treatment. The treatment course was completed in 96% of patients. Therapeutic efficacy on the 49 patients of the treatment group was cured in 31 (63.3%), markedly effective in 11 (22.4%), effective in 4 (8.2%) and ineffective in 3 (6.1%), with total effective rate of 93.9%, while in 47 patients of the control group, the corresponding cases (%) was 0, 3 (6.4%) , 7 (14.9%) and 37 (78.7%), respectively, with the total effective rate of 21.3%. Prolactin levels in the two groups were insignificantly different before treatment, it reduced in the treatment group after treatment (P < 0.01), and the decrement in the treatment group was more significant than that in the control group (P < 0.05). Satisfactory effect could achieved by using TDT for treatment of antipsychotic drug-induced GAS.

  15. [Secondary amenorrhea and LH hypersecretion. An unusual report of a granulosa cell ovarian tumor].

    Science.gov (United States)

    Arteaga, E; Campusano, C; Fernández, C

    1993-04-01

    Granulosa cell ovarian tumors are infrequent. Since they originate from the gonadal stroma, they retain a high secretory potential and some of their clinical manifestations may be secondary to the production of sexual steroids. A 36 year old woman with an ovarian tumor presenting as a secondary amenorrhea is reported. This patient had a positive progesterone test and her hormonal profile showed a maintained LH hypersecretion (> 75 mUl/ml) which, joined to the presence of a hypophyseal microadenoma lead to suspect the presence of a gonadotrophin secreting tumor. The absence of LH response to TRH and its adequate suppression using oral contraceptives discarded this diagnosis. The histopathology of the excised ovarian tumor demonstrated that it is was a granulosa cell tumor. The physiopathological explanation of the case is based on the maintained levels of estrogens produced by the tumor that, through a positive feed-back mechanism similar to that of the polycystic ovary syndrome, produced a tonic LH elevation and GnRH hyper response. After the tumor excision, ovulatory cycles resumed and the patient became pregnant, facts that confirm the postulated hypothesis.

  16. Randomized Trial of Central Nervous System–Targeted Antiretrovirals for HIV-Associated Neurocognitive Disorder

    Science.gov (United States)

    Ellis, Ronald J.; Letendre, Scott; Vaida, Florin; Haubrich, Richard; Heaton, Robert K.; Sacktor, Ned; Clifford, David B.; Best, Brookie M.; May, Susanne; Umlauf, Anya; Cherner, Mariana; Sanders, Chelsea; Ballard, Craig; Simpson, David M.; Jay, Cheryl; McCutchan, J. Allen

    2014-01-01

    Background. Antiretroviral (ARV) medications differentially penetrate across the blood-brain barrier into central nervous system (CNS) tissues, potentially influencing their effectiveness in treating brain infection. Methods. This randomized controlled clinical trial (RCT) called for 120 participants at 5 study sites to be randomized 1:1 to CNS-targeted (CNS-T) or non–CNS-T ART. Entry clinical factors such as ARV experience were balanced across arms using an adaptive randomization approach. The primary outcome, change in neurocognitive performance, was measured as the difference in global deficit score (GDS) from baseline to week 16. Results. The study was terminated early on the recommendation of its data safety monitoring board on the basis of slow accrual and a low likelihood of detecting a difference in the primary outcome. No safety concerns were identified. Of 326 participants screened, 59 met entry criteria and were randomized. The primary intent-to-treat analysis included 49 participants who completed week 16. These comprised 39 men and 10 women with a mean age of 44 years (SD, 10 years), and median nadir and current CD4+ T-cell counts of 175 cells/µL and 242 cells/µL, respectively. The proportional improvement in GDS from baseline was nonsignificantly larger (7%; 95% confidence interval [CI], −31% to 62%) in the CNS-T arm than in the non-CNS-T arm, representing a treatment effect size of 0.09 (95% CI, −.48 to .65). Prespecified secondary analysis showed a trend interaction (P = .087), indicating that participants who had baseline plasma virologic suppression may have benefited from CNS-T. Conclusions. This study found no evidence of neurocognitive benefit for a CNS-T strategy in HIV-associated neurocognitive disorders. A benefit for a subgroup or small overall benefits could not be excluded. Clinical Trials Registration NCT00624195. PMID:24352352

  17. Neurocognitive impairment in HIV-1 clade C- versus B-infected individuals in Southern Brazil.

    Science.gov (United States)

    de Almeida, Sergio Monteiro; Ribeiro, Clea Elisa; de Pereira, Ana Paula; Badiee, Jayraan; Cherner, Mariana; Smith, Davey; Maich, Ingrid; Raboni, Sonia Mara; Rotta, Indianara; Barbosa, Francisco Jaime; Heaton, Robert K; Umlauf, Anya; Ellis, Ronald J

    2013-12-01

    HIV-1 clade C isolates show reduced Tat protein chemoattractant activity compared with clade B. This might influence neuropathogenesis by altering trafficking of monocytes into the CNS. A previous study suggested low rates of HIV-associated dementia in clade C-infected individuals. The present study evaluated neurocognitive impairment rates in clade B- and C-infected individuals from the same local population. HIV+ and HIV- participants were recruited from the same geographic region in Southern Brazil. We evaluated neuropsychological (NP) impairment using a screening instrument (the International HIV Dementia Scale (IHDS)), as well as a Brazilian Portuguese adaptation of a comprehensive battery that has demonstrated sensitivity to HIV-associated neurocognitive disorders (HAND) internationally. NP performance in controls was used to generate T scores and impairment ratings by the global deficit score (GDS) method. Clade assignments were ascertained by sequencing pol and env. Blood and cerebrospinal fluid were collected from all HIV+ participants. HIV+ and HIV- participants were comparable on demographic characteristics. HIV+ participants overall were more likely to be impaired than HIV- by the IHDS and the GDS. Clade B- and C-infected individuals were demographically similar and did not differ significantly in rates of impairment. The prevalence of pleocytosis, a marker of intrathecal cellular chemotaxis, also did not differ between clade B and C infections. Clade B and C HIV-infected individuals from the same geographic region, when ascertained using comparable methods, did not differ in their rates of neurocognitive impairment, and there was no evidence of differences in CNS chemotaxis.

  18. Neurocognitive Impairment in HIV-1 Clade C versus B Infected Individuals in Southern Brazil

    Science.gov (United States)

    de Almeida, Sergio Monteiro; Ribeiro, Clea Elisa; de Pereira, Ana Paula; Badiee, Jayraan; Cherner, Mariana; Smith, Davey; Maich, Ingrid; Raboni, Sonia Mara; Rotta, Indianara; Barbosa, Francisco Jaime; Heaton, Robert K.; Umlauf, Anya; Ellis, Ronald J.

    2014-01-01

    HIV-1 clade C isolates show reduced Tat protein chemoattractant activity compared with clade B. This might influence neuropathogenesis by altering trafficking of monocytes into the CNS. A previous study suggested low rates of HIV-associated dementia in clade C infected individuals. The present study evaluated neurocognitive impairment rates in clade B- and C-infected individuals from the same local population. HIV+ and HIV- participants were recruited from the same geographic region in southern Brazil. We evaluated neuropsychological (NP) impairment using a screening instrument (the International HIV Dementia Scale; IHDS), as well as a Brazilian Portuguese adaptation of a comprehensive battery that has demonstrated sensitivity to HIV associated neurocognitive disorders (HAND) internationally. NP performance in controls was used to generate T-scores and impairment ratings by the global deficit score (GDS) method. Clade assignments were ascertained by sequencing pol and env. Blood and cerebrospinal fluid (CSF) were collected from all HIV+ participants. HIV+ and HIV- participants were comparable on demographic characteristics. HIV+ participants overall were more likely to be impaired than HIV- by the IHDS and the GDS. Clade B and C infected individuals were demographically similar and did not differ significantly in rates of impairment. The prevalence of pleocytosis, a marker of intrathecal cellular chemotaxis, also did not differ between clade B and C infections. Clade B and C HIV-infected individuals from the same geographic region, when ascertained using comparable methods, did not differ in their rates of neurocognitive impairment, and there was no evidence of differences in CNS chemotaxis. PMID:24277437

  19. Acute lorazepam effects on neurocognitive performance.

    Science.gov (United States)

    Loring, David W; Marino, Susan E; Parfitt, David; Finney, Glen R; Meador, Kimford J

    2012-11-01

    A double-blind, placebo-controlled, crossover design was employed to determine whether acute lorazepam (2 mg orally) cognitive side effects would emerge in a differential age-dependent fashion in 15 young (mean age=22 years) and 12 older (mean age=64 years) subjects. Acute use of lorazepam is frequently the initial treatment choice for convulsive status epilepticus or repetitive seizure clusters. Cognitive assessment was performed during drug and placebo conditions using a computerized battery of cognitive tests. With the exception of performance on the reasoning composite score, significant drug effects were present on all primary cognitive domain measures. However, the only significant drug-by-age interaction effect was seen for dual-task performance. The relationship between test performance and plasma lorazepam concentrations was generally modest and non-significant, suggesting that individual differences in pharmacokinetics are not a major factor contributing to the emergence of cognitive side effects. Despite robust lorazepam effects on multiple measures of neurocognitive function, differential age effects are largely restricted to dual-task performance. These results indicate that with the exception of dual-task performance, older individuals in the age range of this study do not appear to be at increased risk for the emergence of cognitive side effects following a single 2-mg dose of lorazepam.

  20. Neurocognitive functioning in compulsive buying disorder.

    Science.gov (United States)

    Derbyshire, Katherine L; Chamberlain, Samuel R; Odlaug, Brian L; Schreiber, Liana R N; Grant, Jon E

    2014-02-01

    Compulsive buying (CB) is a fairly common behavioral problem estimated to affect 5.8% of the population. Although previous research has examined the clinical characteristics of CB, little research has examined whether people with CB manifest cognitive deficits. Twenty-three non-treatment-seeking compulsive buyers (mean age, 22.3±3.5; 60.9% female) and 23 age- and sex-matched healthy controls (mean age, 21.1±3.4, 60.9% female) underwent neurocognitive assessment. We predicted that the following cognitive domains would be impaired in CB: spatial working memory (Spatial Working Memory test), response inhibition (Stop-Signal Task), cognitive flexibility (Intra-Extra Dimensional Set Shift task), and decision making (Cambridge Gambling Task). Compared with controls, individuals with CB exhibited significant impairments in response inhibition (P=.043), risk adjustment during decision making (P=.010), and spatial working memory (P=.041 total errors; P=.044 strategy scores). Deficits were of large effect size (Cohen's d, 0.6 to 1.05). These pilot data suggest that individuals with CB experience problems in several distinct cognitive domains, supporting a likely neurobiological overlap between CB and other putative behavioral and substance addictions. These findings may have implications for shared treatment approaches as well as how we currently classify and understand CB.

  1. Neurocognitive effects in welders exposed to aluminium.

    Science.gov (United States)

    Giorgianni, Concetto Mario; D'Arrigo, Graziella; Brecciaroli, Renato; Abbate, Adriana; Spatari, Giovanna; Tringali, Maria Antonietta; Gangemi, Silvia; De Luca, Annamaria

    2014-05-01

    Various authors who studied the effects of aluminium (Al) exposure on the neurocognitive system in the last 30 years have reached different and often contradictory conclusions. The aim of this study is to help clarify the effects that the metal causes on cognitive ability in a group of naval welders exposed to Al. The study was performed on a sample of 86 male Al welders in a shipyard in Messina. The average value of environmental Al, recorded in the workplace, was 19.5 mg/m(3). The blood levels of Al, zinc, manganese, lead and chromium were monitored in all the subjects. The reagents used for the neuropsychic study were the Wechsler Memory Scale (WMS), the Colour Word Test or Stroop Test and the Test of Attention Matrixes. The results were compared with those obtained in a similar control group not exposed to Al and with an Al-b value of 6.93 g/l. For all the mental reagents used, the reply is obtained in the sample of exposed subjects showed decreased cognitive response with regard to attention and memory performance. The comparison between the individual tests showed greater sensitivity of performance studied using the WMS and the Stroop Test compared with the Test of Attention Matrixes. The alterations encountered in the cognitive functions studied increased proportionally to time of exposure and quantity of metal absorbed. The study confirmed that occupational exposure to Al causes alteration in cognitive responses that are more evident in complex functions.

  2. Ten year neurocognitive trajectories in first-episode psychosis.

    Science.gov (United States)

    Barder, Helene E; Sundet, Kjetil; Rund, Bjørn R; Evensen, Julie; Haahr, Ulrik; Ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan O; Langeveld, Johannes; Larsen, Tor K; Melle, Ingrid; Opjordsmoen, Stein; Røssberg, Jan I; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2013-01-01

    Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Forty-three FEP subjects (51% male, 28 ± 9 years) were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. The four neurocognitive indices showed overall stability over the 10 year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year [F (4, 38) = 5.8, p = 0.001, η(2) = 0.40]. Main findings are long-term stability in neurocognitive functioning in FEP patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed.

  3. Ten year neurocognitive trajectories in first-episode psychosis

    Directory of Open Access Journals (Sweden)

    Helene Eidsmo Barder

    2013-10-01

    Full Text Available Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory.Method: Forty-three FEP subjects (51% male, 28±9 years were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. Results: The four neurocognitive indices showed overall stability over the ten year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year (F (4,38=5.8, p=0.001, η2=0.40Conclusions: Main findings are long-term stability in neurocognitive functioning in first episode psychosis patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that most patients should expect no change in cognitive performance during the first 10 years after being diagnosed.

  4. Ten year neurocognitive trajectories in first-episode psychosis

    DEFF Research Database (Denmark)

    Barder, Helene E; Sundet, Kjetil; Rund, Bjørn R

    2013-01-01

    Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitud......Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year...... longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Method: Forty-three FEP subjects (51% male, 28 ± 9 years...... of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed....

  5. Sensory processing, neurocognition, and social cognition in schizophrenia: Towards a cohesive cognitive model

    NARCIS (Netherlands)

    Jong, J.S. de; Gelder, B.B. de; Hodiamont, P.P.G.

    2013-01-01

    Schizophrenia research has identified deficits in neurocognition, social cognition, and sensory processing. Because a cohesive model of "disturbed cognitive machinery" is currently lacking, we built a conceptual model to integrate neurocognition, social cognition, and sensory processing. In a cross-

  6. Neurocognitive Impairment is Associated with Lower Health Literacy Among Persons Living with HIV Infection

    Science.gov (United States)

    Morgan, Erin E.; Iudicello, Jennifer E.; Cattie, Jordan E.; Blackstone, Kaitlin; Grant, Igor

    2014-01-01

    This study sought to determine the effects of HIV-associated neurocognitive disorders (HAND) on health literacy, which encompasses the ability to access, understand, appraise, and apply health-related information. Participants included 56 HIV seropositive individuals, 24 of whom met Frascati criteria for HAND, and 24 seronegative subjects who were comparable on age, education, ethnicity, and oral word reading. Each participant was administered a brief battery of well-validated measures of health literacy, including the Expanded Numeracy Scale (ENS), Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy in Medicine (REALM), and Brief Health Literacy Screen (BHLS). Results revealed significant omnibus differences on the ENS and NVS, which were driven by poorer performance in the HAND group. There were no significant differences on the REALM or the BHLS by HAND status. Among individuals with HAND, lower scores on the NVS were associated with greater severity of neurocognitive dysfunction (e.g., working memory and verbal fluency) and self-reported dependence in activities of daily living. These preliminary findings suggest that HAND hinders both fundamental (i.e., basic knowledge, such as numeracy) and critical (i.e., comprehension and application of healthcare information) health literacy capacities, and therefore may be an important factor in the prevalence of health illiteracy. Health literacy-focused intervention may play an important role in the treatment and health trajectories among persons living with HIV infection. PMID:25008384

  7. Neurological and neurocognitive functions from intrauterine methylmercury exposure.

    Science.gov (United States)

    Yorifuji, Takashi; Kado, Yoko; Diez, Midory Higa; Kishikawa, Toshihiro; Sanada, Satoshi

    2016-05-03

    In the 1950s, large-scale food poisoning caused by methylmercury was identified in Minamata, Japan. Although severe intrauterine exposure cases (ie, congenital Minamata disease patients) are well known, possible impacts of methylmercury exposure in utero among residents, which is likely at lower levels than in congenital Minamata disease patients, are rarely explored. In 2014, the authors examined neurological and neurocognitive functions among 18 exposed participants in Minamata, focusing on fine motor, visuospatial construction, and executive functions. More than half of the participants had some fine motor and coordination difficulties. In addition, several participants had lower performance for neurocognitive function tests (the Rey-Osterrieth Complex Figure test and Keio version of the Wisconsin card sorting test). These deficits imply diffuse brain damage. This study suggests possible neurological and neurocognitive impacts of prenatal exposure to methylmercury among exposed residents of Minamata.

  8. Social cognition and neurocognitive deficits in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Bliksted, Vibeke Fuglsang; Fagerlund, Birgitte; Weed, Ethan;

    2014-01-01

    -episode schizophrenia. Researchers have speculated about social cognitive subgroups since patients with schizophrenia appear to be a very heterogeneous group. METHODS: Patients with a recent diagnosis of first-episode schizophrenia were tested regarding theory of mind, social perception, neurocognition, IQ...... symptoms. CONCLUSIONS: Complex aspects of social cognition explained 24% of the variance in the patient group. The other principal components consisted mainly of aspects of simple perception of theory of mind. Neurocognition and clinical symptoms only explained a minor proportion of the variance......, and clinical symptoms. RESULTS: Data from 36 first-episode schizophrenia patients and 36 one to one matched healthy controls were analysed. Principal component analysis in the patient group was used to examine the variance contributed by different aspects of social cognition, neurocognition, and clinical...

  9. Primary amenorrhea after bone marrow transplantation and adjuvant chemotherapy misdiagnosed as disorder of sex development: A case report.

    Science.gov (United States)

    Huang, He; Tian, Qinjie

    2016-11-01

    Disorders of sex development (DSD) is a congenital condition in which the development of chromosomal, gonadal or genital sex is atypical. Majority of patients present clinical characteristics of primary amenorrhea, absent secondary sex characters, and abnormal hormone level. A female appearance patient with primary amenorrhea and 46 XY karyotype seems to be solid evidences to diagnose Y-chromosome-related DSD diseases, while it is not necessarily the accurate diagnosis. We report the case of an 18-year-old girl with primary amenorrhea and 46 XY karyotype misdiagnosed as Y-chromosome-related DSD. The patient has normal female reproductive organs and a disrupted pubertal development after the treatment for acute myeloid leukemia (AML). We consider that her gonads were probably functional and later impaired after AML. The clinical manifestations were not consistent with DSD. With doubts, we found that she received bone marrow transplantation (BMT) from her brother and adjuvant chemotherapy 6 years ago. Her karyotype changed from normal female to a karyotype of donor (her brother) origin after BMT.Adjuvant chemotherapy for AML may impair her ovarian function and finally bring about disrupted puberty or primary ovarian insufficiency (POI). We provided close follow-up. During the second visit, the patient had her menarche lasting 4 days without any medication. The present case serves as a reminder that a correct diagnosis depends on the comprehensive collection of present and past medical history, complete physical examination, and careful evaluation of related adjuvant tests. Do not presumptively judge a test and mislead reasoning. In addition, ovarian function protection should be considered for young girls having chemotherapy.

  10. Neurocognitive Functioning after Carotid Revascularization: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Maarten Plessers

    2014-06-01

    Full Text Available Background: The objective of this study was to review the recent literature regarding the neurocognitive consequences of carotid endarterectomy (CEA and carotid stenting (CAS. Methods and Results: A PubMed and Web of Science search was conducted using the key words ‘carotid' in combination with ‘cognitive', ‘cognition', ‘neurocognition', ‘neurocognitive', ‘neuropsychology', and ‘neuropsychological'. Bibliographies of relevant articles were cross-referenced. We included 37 studies published since 2007 of which 18 examined CEA, 12 CAS, and 7 compared CEA to CAS. There is a wide variability in the reported neurocognitive outcome following CEA and CAS. Nonetheless, none of the included studies unveiled significant differences between CEA and CAS on postoperative neurocognitive functioning. Postoperative changes observed for CEA and CAS separately seem limited to a small percentage (around 10-15% of patients and can either present as an improvement or impairment. Key Messages: The available data seem to suggest that no obvious cognitive differences between CAS and CEA can be observed after intervention. Both improvement and deterioration in cognitive functioning can be observed following CAS or CEA. Methodological differences such as patient heterogeneity, implementation and type of control groups, type of psychometric tests used, statistical analyses, or timing of the assessments play an important role in explaining the sometimes divergent results of the included studies. Large-scale and methodologically solid studies comparing CEA and CAS on neurocognitive outcome remain warranted. Future studies should implement adequate control groups to correct for practice effects in the target groups.

  11. Neurocognitive performance as an endophenotype for mood disorder subgroups.

    Science.gov (United States)

    Merikangas, Alison K; Cui, Lihong; Calkins, Monica E; Moore, Tyler M; Gur, Ruben C; Gur, Raquel E; Merikangas, Kathleen R

    2017-06-01

    There is growing evidence that neurocognitive function may be an endophenotype for mood disorders. The goal of this study is to examine the specificity and familiality of neurocognitive functioning across the full range of mood disorder subgroups, including Bipolar I (BP-I), Bipolar II (BP-II), Major Depressive Disorders (MDD), and controls in a community-based family study. A total of 310 participants from 137 families with mood spectrum disorders (n=151) and controls (n=159) completed the University of Pennsylvania's Computerized Neurocognitive Battery (CNB) that assessed the accuracy and speed of task performance across five domains. Mixed effects regression models tested association and familiality. Compared to those without mood disorders, participants with BP-I had increased accuracy in complex cognition, while participants with MDD were more accurate in emotion recognition. There was also a significant familial association for accuracy of complex cognition. Mood disorder subgroups did not differ in performance speed in any of the domains. The small number of BP-I cases, and family size limited the statistical power of these analyses, and the cross-sectional assessment of neurocognitive function precluded our ability to determine whether performance precedes or post dates onset of disorder. This is one of the few community-based family studies of potential neurocognitive endophenotypes that includes the full range of mood disorder subgroups. There were few differences in neurocognitive function except enhanced accuracy in specific domains among those with BP-I and MDD. The differential findings across specific mood disorder subgroups substantiate their heterogeneity in other biologic and endophenotypic domains. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. 73 cases of primary amenorrhea etiology cytogenetic%73例原发性闭经患者细胞遗传学病因分析

    Institute of Scientific and Technical Information of China (English)

    史彩虹; 刘芳; 周友泉; 王厚照

    2011-01-01

    Objective: Xiamen patients with primary amenorrhea and the main features of cytogenetic abnormalities of the sex chromosomes influence gonad development. Methods: 73 patients with primary amenorrhea patients after routine gynecological examination, B - and endocrine function tests, the use of peripheral blood lymphocyte culture for cytogenetic analysis. Results; Of 73 cases detected in patients with primary amenorrhea, normal karyotype of chromosome 52 cases, accounting for 71. 2% , abnormal karyotypes in 21 cases, 28. 8% , including the number of sex chromosomes, structural abnormalities, and chimeras. Conclusion: Chromosomal abnormalities are the main causes of primary amenorrhea, and amenorrhea in patients with chromosome, a clear cause amenorrhea, early symptomatic treatment is important.%目的 探讨厦门地区原发性闭经患者细胞遗传学的主要特征及性染色体异常对性腺发育的影响.方法 73例原发性闭经患者经常规妇科检查、B超及内分泌功能检查后,采用外周血淋巴细胞培养进行细胞遗传学分析.结果 73例原发性闭经患者中检出染色体正常核型52例,占71.2%,异常核型21例,占28.8%,包括性染色体数目、结构异常及嵌合体.结论 染色体异常是导致原发性闭经的主要原因,对闭经患者进行染色体检查,明确闭经原因,及早对症治疗有重要意义.

  13. Depression and Apathy Among People Living with HIV: Implications for Treatment of HIV Associated Neurocognitive Disorders

    Science.gov (United States)

    Whitehead, Nicole E.; Burrell, Larry E.; Dotson, Vonetta M.; Cook, Robert L.; Malloy, Paul; Devlin, Kathryn; Cohen, Ronald A.

    2015-01-01

    Depression and apathy are common among people living with HIV (PLWH). However, in PLWH, it is unclear whether depression and apathy are distinct conditions, which contribute to different patterns of disruption to cognitive processing and brain systems. Understanding these conditions may enable the development of prognostic indicators for HIV associated neurocognitive disorders (HAND). The present study examined substance use behavior and cognitive deficits, associated with depression and apathy, in 120 PLWH, using hierarchical regression analyses. Higher levels of depression were associated with a history of alcohol dependence and greater deficits in processing speed, motor and global cognitive functioning. Higher levels of apathy were associated with a history of cocaine dependence. It is recommended that PLWH get screened appropriately for apathy and depression, in order to receive the appropriate treatment, considering the comorbidities associated with each condition. Future research should examine the neurological correlates of apathy and depression in PLWH. PMID:25533921

  14. What lies behind chemotherapy-induced amenorrhea for breast cancer patients: a meta-analysis.

    Science.gov (United States)

    Zhao, Jianli; Liu, Jieqiong; Chen, Kai; Li, Shunrong; Wang, Ying; Yang, Yaping; Deng, Heran; Jia, Weijuan; Rao, Nanyan; Liu, Qiang; Su, Fengxi

    2014-05-01

    To evaluate the incidence of chemotherapy-induced amenorrhea (CIA) and its therapeutic impact in premenopausal breast cancer patients. A systematic search was performed to identify clinical studies that compared the incidence of CIA with different chemotherapy regimens and oncological outcomes with and without CIA. The fixed-effects and random-effects models were used to assess the pooled estimates. Heterogeneity and sensitivity analyses were performed to explore heterogeneity among studies and to assess the effects of study quality. A total of 15,916 premenopausal breast cancer patients from 46 studies were included. The cyclophosphamide-based regimens, taxane-based regimens, and anthracycline/epirubicin-based regimens all increased the incidence of CIA with pooled odds ratios of 2.25 (95 % CI 1.26-4.03, P = 0.006), 1.26 (95 % CI 1.11-1.43, P = 0.0003) and 1.39 (95 % CI 1.15-1.70, P = 0.0008), respectively. The three-drug combination regimens of cyclophosphamide,anthracycline/epirubicin, and taxanes (CAT/CET) caused the highest rate of CIA compared with the other three drug combinations (OR 1.41, 95 % CI 1.16-1.73, P = 0.0008). Tamoxifen therapy was also correlated with a higher incidence of CIA, with an OR of 1.48. Patients with CIA were found to exhibit better disease-free survival (DFS) and overall survival (OS) compared with patients without CIA. With respect to molecular subtype, this DFS advantage remained significant in hormone-sensitive patients (HR 0.61, 95 % CI 0.52-0.72, P < 0.00001). The current meta-analysis has demonstrated that anthracycline/epirubicin, taxanes, cyclophosphamide, and tamoxifen all contributed to elevated rates of CIA, and CIA was not merely a side effect of chemotherapy but was a better prognostic marker, particularly for ER-positive premenopausal early-stage breast cancer patients. However, this topic merits further randomized control studies to detect the associations between CIA and patient prognosis after adjusting for age, ER

  15. MUSCULAR OXIDATIVE CAPACITY IN OVARIECTOMIZED RATS DISCUSSION ON THE ENDURANCE PERFORMANCE OF FEMALE ATHLETES WITH SPORTS-RELATED-AMENORRHEA

    Directory of Open Access Journals (Sweden)

    Natsuo Yasui

    2004-11-01

    Full Text Available The purpose of this study was to evaluate the effects of ovariectomy on intramuscular energy metabolism in adult rats. Based on the results, we discussed the skeletal muscle metabolism in female athlete with sports related amenorrhea. Twenty-five adult (20-week-old Sprague-Dawley female rats were used. Fifteen rats underwent ovariectomy (OVX group, and the other ten rats were sham-operated (Sham group. One and four weeks after surgery, muscular oxidative capacity was measured using 31P-MR spectra of the gastrocnemius-plantaris-soleus (GPS muscles group at rest and during electric stimulation. Wet weight and maximum tension of the whole GPS muscles group were also measured. From the MRS measurements, the muscle oxidative capacity in the OVX group was significantly lower than that in the Sham group (p < 0.05 at both one and four weeks after surgery. The muscle's wet weight one week after surgery in the OVX group was the same as the Sham group, while four weeks after surgery it was significantly greater than that in the Sham group (p < 0.05. There were no significant differences in maximum tension among the groups. In conclusion, in adult rats the oxidative capacity decreased due to ovariectomy despite the increase in muscle weight. It is suggested that the muscular endurance capacity in female adult athletes with sports related amenorrhea may deteriorate.

  16. A rare case of ovarian granulosa cell tumour in an adolescent girl with secondary amenorrhea and virilisation

    Directory of Open Access Journals (Sweden)

    Arun Nayak

    2015-10-01

    Full Text Available Sex cord stromal ovarian tumors account for about 5-8% of all ovarian malignancies. Granulosa cell tumor is an estrogen secreting low grade malignant tumor and is seen in women of all ages with 2% bilaterality. Based upon histology, these neoplasms can be classified as adult and juvenile Granulosa cell tumors. Pre-pubertal lesions present clinically with sexual pseudo precocity whereas post-pubertal lesions present with menstrual irregularities or secondary amenorrhea or postmenopausal bleeding. This case report presents a rare case of Granulosa cell tumor with clinical presentation mimicking virilizing ovarian neoplasm in a 19 year old girl with history of abdominal swelling, secondary amenorrhea and virilization since one year duration. Clinical examination revealed a 20-22 weeks size abdominal mass, cystic in consistency, arising from pelvis and CT scan suggested presence of mucinous cystadenoma with solid areas with suspected malignancy. Exploratory laparotomy with right salpingo-oophorectomy was performed with staging as tumor was found confined to ovary with no involvement of other ovary or any other pelvic organ or peritoneum. Therefore, disease was staged as stage 1A. Histopathological examination confirmed the presence of Granulosa cell tumor with fibrothecomatous areas. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1653-1656

  17. Neurocognitive impairments at various stages of clinical opiate addiction

    Directory of Open Access Journals (Sweden)

    Faniya Shigakova

    2012-05-01

    Full Text Available In opiate addicts with various duration of drug use neurocognitive impairments as well as a number of typical physical changes occurring in the brain were registered. The opiate addicts’ cerebral hemodynamics and higher brain functions were examined by drug use duration and patient’s age.

  18. Neurocognitive moderation of associations between cannabis use and psychoneuroticism

    NARCIS (Netherlands)

    Huijbregts, Stephan C. J.; Griffith-Lendering, Merel F. H.; Vollebergh, Wilma A. M.; Swaab, Hanna

    2014-01-01

    Background: Cannabis use has been associated with neurocognitive impairments and psychopathology. The strength of such associations does however appear to depend on many different factors, such as duration and intensity of use, but also differential susceptibility due to genetic make-up and environm

  19. Selective Neurocognitive Impairments in Adolescents with Major Depressive Disorder

    Science.gov (United States)

    Han, Georges; Klimes-Dougan, Bonnie; Jepsen, Susie; Ballard, Kristin; Nelson, Megan; Houri, Alaa; Kumra, Sanjiv; Cullen, Kathryn

    2012-01-01

    This study investigated whether major depression in adolescence is characterized by neurocognitive deficits in attention, affective decision making, and cognitive control of emotion processing. Neuropsychological tests including the Wechsler Abbreviated Scale of Intelligence, the Continuous Performance Test-Identical Pairs, the Attention Network…

  20. Neurocognitive psychotherapy for adult attention deficit hyperactive disorder

    Directory of Open Access Journals (Sweden)

    Susmita Halder

    2009-01-01

    Full Text Available Previously thought as a childhood disorder, attention-deficit hyperactivity disorder (ADHD is reported to be spreading at an increasing rate and affecting 4% to 5% of the adult population. It is characterized by persistent problems of inattention, hyperactivity and impulsivity. We present the case of an adult ADHD patient intervened with neurocognitive psychotherapy.

  1. Persistent neurocognitive problems after adjuvant chemotherapy for breast cancer

    NARCIS (Netherlands)

    Kreukels, B.P.C.; van Dam, F.S.A.M.; Ridderinkhof, K.R.; Boogerd, W.; Schagen, S.B.

    2008-01-01

    Background: Neurocognitive problems have been observed in a number of women previously treated with adjuvant chemotherapy for breast cancer. The present study aims to combine the results of neuropsychological and electrophysiological techniques collected in patients with breast cancer treated with c

  2. Smoking abstinence and neurocognition: implications for cessation and relapse.

    Science.gov (United States)

    McClernon, F Joseph; Addicott, Merideth A; Sweitzer, Maggie M

    2015-01-01

    In this chapter, we review the last decade of research on the effects of smoking abstinence on various forms of neurocognition, including executive function (working memory, sustained attention, response inhibition), reward processing, and cue-reactivity. In our review we identify smoking abstinence-induced deficits in executive function mediated by effects on frontal circuitry, which in turn is known to be affected by modulation of cholinergic, dopaminergic, and other neurotransmitter systems. We also review evidence that smoking abstinence blunts reactivity to non-drug reinforcers-a finding that is consistent with results in the animal literature. Finally, our review of cue-reactivity indicates that smoking abstinence does not appear to amplify cue-provoked craving, although it may increase attentional bias to smoking-related cues. Inconsistencies across findings and potential contributing factors are discussed. In addition, we review the literature on the effects of nicotine and non-nicotine factors in neurocognition. Finally, we provide a multi-factor model and an agenda for future research on the effects of smoking abstinence on neurocognition. The model includes four distinct yet interacting factors, including: Negative Reinforcement, Drug-Reward Bias, Goal and Skill Interference, and Non-Cognitive Factors. Additional research is needed to further evaluate the scope and time-course of abstinence-induced changes in neurocognition, the mechanisms that underlie these changes and the specific role of these processes in drug reinforcement, lapse, and relapse.

  3. The importance of measurement invariance in neurocognitive ability testing

    NARCIS (Netherlands)

    Wicherts, J.

    2016-01-01

    Objective: Neurocognitive test batteries such as recent editions of the Wechsler’s Adult Intelligence Scale (WAIS-III/WAIS-IV) typically use nation-level population-based norms. The question is whether these batteries function in the same manner across different subgroups based on gender, age, educa

  4. Effects of caffeine intake and smoking on neurocognition in schizophrenia.

    Science.gov (United States)

    Núñez, Christian; Stephan-Otto, Christian; Cuevas-Esteban, Jorge; Maria Haro, Josep; Huerta-Ramos, Elena; Ochoa, Susana; Usall, Judith; Brébion, Gildas

    2015-12-30

    Although most studies support the beneficial effects of caffeine on neurocognition, its effects have never been assessed in psychiatric patients. In addition, results from studies in smokers are contradictory. Moreover, there are no data available about the neurocognitive effects of caffeine and tobacco together. We explored the concomitant effects of regular caffeine and tobacco intake on neurocognition in 52 schizophrenic patients and 61 healthy controls. Verbal fluency, processing speed, and working, visual and verbal memory were assessed. For each measurement, two tasks with two levels of complexity were administered. Our results showed that caffeine intake had beneficial effects on male schizophrenic patients only in complex tasks requiring deeper cognitive processing (semantic fluency, cognitive speed, working memory, and visual memory). Female patients and controls were unaffected. In contrast, smoking had a negative effect on male, but not on female, schizophrenic patients in semantic fluency. The effects of smoking in controls were inconsistent. In conclusion, our data showed, for the first time, beneficial effects of caffeine intake on neurocognition in male schizophrenic patients. These data suggest that further research of therapeutics based on caffeine is needed, as this could be beneficial for schizophrenic patients. In contrast, smoking appears to be detrimental.

  5. NEUROCOGNITIVE ASSESSMENT OF ALCOHOL INPATIENTSDURING RECOVERY FROM ALCOHOLISM*

    Directory of Open Access Journals (Sweden)

    Lilijana Šprah

    2008-05-01

    Our study demonstrated that some alcohol-related cognitive, emotional and motivationaldeficits can also persist to certain extent after several weeks of sobriety. Especially alcoholabstainers with suicidal history revealed a specific neuropsychological profile in this regard. Employed neurocognitive assessment proved as useful approach for clinical evaluation of alcohol abstainers functioning, since cognitive deficits have been also hypothesizedto affect the efficacy of alcoholism treatment

  6. Neurocognitive Performance in Children with ADHD and OCD

    Science.gov (United States)

    Vloet, Timo D.; Marx, Ivo; Kahraman-Lanzerath, Berrak; Zepf, Florian D.; Herpertz-Dahlmann, Beate; Konrad, Kerstin

    2010-01-01

    Attention-deficit/hyperactivity Disorder (ADHD) and obsessive-compulsive disorder (OCD) have both been linked to dysfunction in the cortico-striato-thalamo-cortical circuitry (CSTCC). However, the exact nature of neurocognitive deficits remains to be investigated in both disorders. We applied two neuropsychological tasks that tap into different…

  7. "Cost in Transliteration": The Neurocognitive Processing of Romanized Writing

    Science.gov (United States)

    Rao, Chaitra; Mathur, Avantika; Singh, Nandini C.

    2013-01-01

    Romanized transliteration is widely used in internet communication and global commerce, yet we know little about its behavioural and neural processing. Here, we show that Romanized text imposes a significant neurocognitive load. Readers faced greater difficulty in identifying concrete words written in Romanized transliteration (Romanagari)…

  8. Neurocognitive psychotherapy for adult attention deficit hyperactive disorder

    OpenAIRE

    Susmita Halder; Akash Kumar Mahato

    2009-01-01

    Previously thought as a childhood disorder, attention-deficit hyperactivity disorder (ADHD) is reported to be spreading at an increasing rate and affecting 4% to 5% of the adult population. It is characterized by persistent problems of inattention, hyperactivity and impulsivity. We present the case of an adult ADHD patient intervened with neurocognitive psychotherapy.

  9. Phenomenological and neurocognitive perspectives on delusions: A critical overview

    Science.gov (United States)

    Sass, Louis; Byrom, Greg

    2015-01-01

    There is considerable overlap between phenomenological and neurocognitive perspectives on delusions. In this paper, we first review major phenomenological accounts of delusions, beginning with Jaspers’ ideas regarding incomprehensibility, delusional mood, and disturbed “cogito” (basic, minimal, or core self-experience) in what he termed “delusion proper” in schizophrenia. Then we discuss later studies of decontextualization and delusional mood by Matussek, changes in self and world in delusion formation according to Conrad's notions of “apophany” and “anastrophe”, and the implications of ontological transformations in the felt sense of reality in some delusions. Next we consider consistencies between: a) phenomenological models stressing minimal-self (ipseity) disturbance and hyperreflexivity in schizophrenia, and b) recent neurocognitive models of delusions emphasizing salience dysregulation and prediction error. We voice reservations about homogenizing tendencies in neurocognitive explanations of delusions (the “paranoia paradigm”), given experiential variations in states of delusion. In particular we consider shortcomings of assuming that delusions necessarily or always involve “mistaken beliefs” concerning objective facts about the world. Finally, we offer some suggestions regarding possible neurocognitive factors. Current models that stress hypersalience (banal stimuli experienced as strange) might benefit from considering the potential role of hyposalience in delusion formation. Hyposalience – associated with experiencing the strange as if it were banal, and perhaps with activation of the default mode network – may underlie a kind of delusional derealization and an “anything goes” attitude. Such an attitude would be conducive to delusion formation, yet differs significantly from the hypersalience emphasized in current neurocognitive theories. PMID:26043327

  10. What are the neurocognitive correlates of basic self-disturbance in schizophrenia? Integrating phenomenology and neurocognition: Part 2 (aberrant salience).

    Science.gov (United States)

    Nelson, B; Whitford, T J; Lavoie, S; Sass, L A

    2014-01-01

    Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. Little is known about the neurocognitive underpinnings of basic self-disturbance. In these two theoretical papers (of which this is Part 2), we review some recent phenomenological and neurocognitive research and point to a convergence of these approaches around the concept of self-disturbance. Specifically, we propose that subjective anomalies associated with basic self-disturbance may be associated with: 1. source monitoring deficits, which may contribute particularly to disturbances of "ownership" and "mineness" (the phenomenological notion of presence or self-affection) and 2. aberrant salience, and associated disturbances of memory, prediction and attention processes, which may contribute to hyper-reflexivity, disturbed "grip" or "hold" on perceptual and conceptual fields, and disturbances of intuitive social understanding ("common sense"). In this paper (Part 2) we focus on aberrant salience. Part 1 (this issue) addressed source monitoring deficits. Empirical studies are required in a variety of populations in order to test these proposed associations between phenomenological and neurocognitive aspects of self-disturbance in schizophrenia. An integration of findings across the phenomenological and neurocognitive "levels" would represent a significant advance in the understanding of schizophrenia and possibly enhance early identification and intervention strategies.

  11. Analysis of neurocognitive function and CNS endpoints in the PROTEA trial: darunavir/ritonavir with or without nucleoside analogues

    Directory of Open Access Journals (Sweden)

    Amanda Clarke

    2014-11-01

    Full Text Available Introduction: During treatment with protease inhibitor monotherapy, the number of antiretrovirals with therapeutic concentrations in the cerebrospinal fluid (CSF is lower, compared to standard triple therapy. However, the clinical consequences are unclear. Methods: A total of 273 patients with HIV RNA <50 copies/mL for over 24 weeks on current antiretrovirals randomized to darunavir/ritonavir (DRV/r 800/100 mg once-daily, either as monotherapy (n=137 or with 2NRTIs (n=136. Neurocognitive function was evaluated in all patients by the Hopkins Verbal Learning Tests, the Colour Trail Tests and the Grooved Pegboard Test at screening, baseline and at Week 48. A global neurocognitive score (NPZ-5 was derived by averaging the standardized results of the five domains. In a central nervous system (CNS sub-study (n=70, HIV RNA levels in the CNS were evaluated at baseline and Week 48. Clinical adverse events related to the CNS were collected at each visit. Results: Patients were 83% male and 88% White, with median age 43 years. There were more patients with nadir CD4 count below 200 cells/µL in the DRV/r monotherapy arm (41/137, 30% than the triple therapy arm (30/136, 22%. At Week 48, there was no difference between the treatment arms for the five combined domains of the neurocognitive score. At Week 48, the percentage of patients with an abnormal neurocognitive score among the five domains was 12.2% for DRV/r monotherapy and 14.9% for triple therapy. However, one patient on DRV/r monotherapy with a CD4 nadir of 17 cells/µL was hospitalized with HIV encephalomyelitis at Week 24, with HIV RNA 2500 copies/mL in the CSF and 125 copies/mL in the plasma. Symptoms resolved after intensification with high dose zidovudine. A second patient on DRV/r monotherapy with CD4 nadir of 166 cells/µL had a rise in HIV RNA in CSF from <40 copies/mL at baseline to 654 copies/mL at Week 48, with concurrent plasma HIV RNA of 77 copies/mL. Conclusions: In this study for

  12. Deletion of 7q34-q36.2 in two siblings with mental retardation, language delay, primary amenorrhea, and dysmorphic features

    DEFF Research Database (Denmark)

    Sehested, Line T; Møller, Rikke S; Bache, Iben

    2010-01-01

    and neuropsychiatric disorders including mental retardation, language delay and epilepsy. The sister had primary amenorrhea. Array CGH revealed a 12.2¿Mb deletion at 7q34-q36.2 including more than 60 genes where CNTNAP2 and NOBOX are of special interest. Comparison of the clinical and cytogenetic findings of our...

  13. Cytogenetics studies of 468 patients with primary amenorrhea%468例原发性闭经患者细胞遗传学分析

    Institute of Scientific and Technical Information of China (English)

    禹虹; 边旭明; 刘俊涛; 郝娜; 周京; 刘善英

    2011-01-01

    目的 分析原发性闭经患者染色体细胞核型与临床特征的关系.方法 原发闭经患者行外周血淋巴细胞培养,常规G显带染色体核型分析(必要时行C显带).结果 468例原发闭经患者中46,XX核型为255例(54.49%),41种异常核型213例(45.51%),包括X染色体异常143例、X-Y染色体异常4例、46,XY女性57例、常染色体异常8例、X-常染色体易位1例.75.52%身材矮小原发闭经患者X染色体异常,Xp11.1-11.4与Xp21-22缺失或断裂的患者均出现身材矮小.结论 人类细胞染色体异常是原发闭经的重要原因之一,应常规行细胞遗传学检查.临床表型与染色体特殊部位有一定关系,Xp11.1-11.4与Xp21-22可能与身高发育有关.%Objective To analyze the relationship between karyotypes and clinic features of patients with primary amenorrhea. Method Karyotype analysis of patients with primary amenorrhea was performed by using G-banding technique. Results Karyotype analysis of 468 patients with primary amenorrhea revealed that 255 patients (54. 49% ) had normal female karyotypes and 213 patients (45.51%) had abnormal karyotypes, including 143 patients with abnormal X chromosome, 4 patients with mosaic X -Y chromosome, 57 patients with 46, XY karyotype, 8 patients with abnormal autosome and one patient with Xautosome translocation. 75.52% primary amenorrhea patients with short stature had abnormal X chromosome, and all primary amenorrhea patients with deletion or break-up of Xp11. 1 - 11.4 and Xp21 - 22 were short statures. Conclusion One of the main reasons of primary amenorrhea was chromosome abnormity,especial heterosome abnormity. Karyotype analysis should be used to detect primary amenorrhea patients in regular. There might be relationship between height improvement and the abnormity of Xp11. 1 - 11.4 and Xp21 - 22.

  14. 浅谈针灸治疗运动性闭经%Discuss the Treatment of Athletic Secondary Amenorrhea by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    彭举华

    2013-01-01

      目的:对目前女性,尤其是年轻的女运动员出现的越来越多的运动性闭经现象进行调查与分析,根据其临床特点及诊治过程进行研究分析,为运动性闭经的治疗提供经验和方法。方法:我们可以使用中医针灸的治疗方法来治疗运动性闭经。结果:临床试验的经验表明,针灸疗法在治疗运动性闭经方面具有可观的效果。结论:我们了解到运动性闭经的症状主要会在女运动员中出现较多,她们参加较多的体育训练或者是各种比赛,在高强度大运动量的训练或比赛后,运动员容易出现精神过度紧张、内分泌失调等症状,这些都与运动性闭经的产生原因有关。因此,通过研究,我们可以运用针灸疗法来对运动性闭经进行有效的治疗。%Objective:To investigate and analyze the phenomenon of more and more athletic sec-ondary amenorrhea had happened in groups of young female athletes, and try to offer some experi-ence and methods of treatment of athletic secondary amenorrhea, according to the research on clini-cal features and diagnosis and treatment process. Methods: We can treat the athletic secondary amenorrhea using the acupuncture. Results:The clinical trial experience has shown that it would be effective by using the acupuncture therapy in treating the athletic secondary amenorrhea. Conclu-sion:We know that the symptoms of athletic secondary amenorrhea prefer to happen to groups of fe-male athletes, they ofter participate a variety of training or games, after the high-intensity training and games, athletes would more easily develop symptoms like excessive psychological stress and endocrine dyscrasia, which all related to the cause of athletic secondary amenorrhea. Therefore, through the research, we can use acupuncture therapy to treat athletic secondary amenorrhea.

  15. 人工流产术后闭经的病因学分析%Etiology of Artificial amenorrhea after abortion

    Institute of Scientific and Technical Information of China (English)

    杨家容; 刘敏; 龙文娟

    2015-01-01

    Objective To analyze the risk factors amenorrhea after abortion, and discuss abortion prevention countermeasure amenorrhea. Methods A hospital in April 2013 May 2014 patients undergoing artificial abortion after 94 cases of amenorrhea observation group, the election period selected lines into my clinical abortion complications did not occur in the control group of women to 120 cases retrospectively analyzed two groups of patients with general information for statistical analysis and comparison, laboratory tests comparing two groups of patients.Results The results showed that hysteroscopy half of the total test results of the cervix and cervical synechia,no abnormal cervical highest proportion. Observation group compared with the control group of patients, ovulation, E2 and FSH levels and LH levels were statistically significant. Conclusion Ovarian function, prolactin levels, levels of hypothalamic function can significantly affect the probability of amenorrhea after artificial abortion, and therefore need to adjust prolactin levels before and after surgery, to improve ovarian function, and hypothalamus state.%目的:对人工流产术后发生闭经的原因进行病因学分析,并探讨人工流产后预防闭经对策。方法选取我院2013年4月~2014年4月进行人工流产术后发生闭经的患者94例为观察组,选同期入我院行人工流产术未发生并发症女性120例为对照组,对其临床资料进行回顾性分析,对两组患者一般资料进行统计学分析,对比两组患者的实验室检查结果。结果宫腔镜检查结果表明宫颈内口和宫颈黏连的约占总检查结果的一半,宫颈内未见异常的所占比例最高。观察组与对照组相比,有无排卵,雌二醇(E2)和促卵泡生长激素(FSH)水平及黄体生成素(LH)的水平均有统计学差异。结论卵巢功能,催乳素水平,丘脑功能水平均能显著影响人工流产术后发生闭经的概率,因此

  16. New method for the induction of therapeutic amenorrhea: low dose endometrial afterloading irradiation. Clinical and hormonal studies

    Energy Technology Data Exchange (ETDEWEB)

    Gronroos, M.; Turunen, T.; Raekallio, J.; Ruotsalinen, P.; Salmi, T. (Turku Univ. (Finland). Dept. of Obstetrics and Gynecology)

    1982-08-01

    The authors present a new method for the induction of therapeutic amenorrhea: low dose endometrial afterloading irradiation. The problem with this method has been how to inactivate the endometrium while maintaining the physiological function of the ovaries. In 5/29 young patients regular or irregular bleedings occurred after an endometrial dose of 11+-1 Gy. These subjects were given a repeat low dose intrauterine irradiation. Thereafter no bleedings were found in four out of five patients. Two to 9 years after the repeat irradiation the plasma levels of E/sub 1/, E/sub 2/, FSH and LH corresponded closely to those of healthy women in reproductive age in three out of five patients; some high plasma P levels indicated ovulation. In two patients the E/sub 1/, E/sub 2/, and P values were more likely postmenopausal but, on the other hand, FSH and LH values reproductive ones. 19 refs.

  17. International Neurocognitive Normative Study: Neurocognitive Comparison Data in Diverse Resource Limited Settings: AIDS Clinical Trials Group A5271

    Science.gov (United States)

    Robertson, K; Jiang, H; Evans, SR; Marra, CM; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, TB; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S.; Kumarasamy, N; La Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L.; Amod, F; Walawander, A

    2016-01-01

    Summary ACTG A5271 collected neurocognitive normative comparison test data in 2400 at-risk HIV seronegative participants from Brazil, India, Malawi, Peru, South Africa, Thailand and Zimbabwe. The participants were enrolled in strata by site (10 levels), age (2 levels), education (2 levels), and gender (2 levels). These data provide necessary normative data infrastructure for future clinical research and care in these diverse resource limited settings. Infrastructure for conducting neurological research in resource limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment, and normative data needed for clinical interpretation impede research and clinical care. Here we report on ACTG 5271, which provided neurological training of clinical site personnel, and collected neurocognitive normative comparison data in diverse settings. At 10 sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n=240), India (n=480), Malawi (n=481), Peru (n=239), South Africa (480), Thailand (n=240) and Zimbabwe (n=240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline, and 770 at six-months. Participants were enrolled in 8 strata, gender (female and male), education (<10 years and ≥ 10 years), and age (<35 years and ≥35 years). Of 2400 enrolled, 770 completed the six-month follow up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p<.0001). There was variation between the age, gender and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the

  18. Distinct Neurocognitive Strategies for Comprehensions of Human and Artificial Intelligence

    Science.gov (United States)

    Ge, Jianqiao; Han, Shihui

    2008-01-01

    Although humans have inevitably interacted with both human and artificial intelligence in real life situations, it is unknown whether the human brain engages homologous neurocognitive strategies to cope with both forms of intelligence. To investigate this, we scanned subjects, using functional MRI, while they inferred the reasoning processes conducted by human agents or by computers. We found that the inference of reasoning processes conducted by human agents but not by computers induced increased activity in the precuneus but decreased activity in the ventral medial prefrontal cortex and enhanced functional connectivity between the two brain areas. The findings provide evidence for distinct neurocognitive strategies of taking others' perspective and inhibiting the process referenced to the self that are specific to the comprehension of human intelligence. PMID:18665211

  19. Aerobic Exercise in People with Schizophrenia: Neural and Neurocognitive Benefits.

    Science.gov (United States)

    Vakhrusheva, Julia; Marino, Brielle; Stroup, T Scott; Kimhy, David

    2016-06-01

    Schizophrenia is characterized by extensive neurocognitive deficits, which are linked to greater disability, poorer functional outcome, and have been suggested to impact daily functioning more than clinical symptoms. Aerobic exercise (AE) has emerged as a potential intervention. This review examines the impact of AE on brain structure and function along with neurocognitive performance in individuals with schizophrenia. Preliminary evidence indicates that AE can increase hippocampal volume and cortical thickness, in addition to exerting a neuroprotective effect against hippocampal volume decrease and cortical thinning. There is also evidence that AE is able to significantly increase serum brain-derived neurotrophic factor (BDNF) levels, which are implicated in neurogenesis, neuroplasticity, and cognitive improvement. Finally, evidence suggests that AE plays a significant role in improving overall cognition, including improvements in processing speed, working memory, and visual learning. The authors discuss the implications of the findings and provide recommendations for future research and areas of inquiry.

  20. Distinct neurocognitive strategies for comprehensions of human and artificial intelligence.

    Directory of Open Access Journals (Sweden)

    Jianqiao Ge

    Full Text Available Although humans have inevitably interacted with both human and artificial intelligence in real life situations, it is unknown whether the human brain engages homologous neurocognitive strategies to cope with both forms of intelligence. To investigate this, we scanned subjects, using functional MRI, while they inferred the reasoning processes conducted by human agents or by computers. We found that the inference of reasoning processes conducted by human agents but not by computers induced increased activity in the precuneus but decreased activity in the ventral medial prefrontal cortex and enhanced functional connectivity between the two brain areas. The findings provide evidence for distinct neurocognitive strategies of taking others' perspective and inhibiting the process referenced to the self that are specific to the comprehension of human intelligence.

  1. Tryptophan, Neurodegeneration and HIV-Associated Neurocognitive Disorder

    Directory of Open Access Journals (Sweden)

    Nicholas W.S. Davies

    2010-06-01

    Full Text Available This review presents an up-to-date assessment of the role of the tryptophan metabolic and catabolic pathways in neurodegenerative disease and HIV-associated neurocognitive disorder. The kynurenine pathway and the effects of each of its enzymes and products are reviewed. The differential expression of the kynurenine pathway in cells within the brain, including inflammatory cells, is explored given the increasing recognition of the importance of inflammation in neurodegenerative disease. An overview of common mechanisms of neurodegeneration is presented before a review and discussion of the evidence for a pathogenetic role of the kynurenine pathway in Alzheimer’s disease, HIV-associated neurocognitive disorder, Huntington’s disease, motor neurone disease, and Parkinson’s disease.

  2. Telepsychiatry for Neurocognitive Testing in Older Rural Latino Adults.

    Science.gov (United States)

    Vahia, Ipsit V; Ng, Bernardo; Camacho, Alvaro; Cardenas, Veronica; Cherner, Mariana; Depp, Colin A; Palmer, Barton W; Jeste, Dilip V; Agha, Zia

    2015-07-01

    As the population of older Latinos in the U.S. increases, availability of culturally adapted geriatric psychiatry services is becoming a growing concern. This issue is exacerbated for rural Latino populations. In this study, we assessed whether neurocognitive assessment via telepsychiatry (TP) using a Spanish-language battery would be comparable to in-person (IP) testing using the same battery in a sample of Spanish-speaking older adults in a rural setting. Patients (N = 22) received IP and TP testing 2 weeks apart. The order of IP and TP test administrations in individual subjects was determined randomly. Comparison of scores indicated that there were no significant differences between IP and TP test performance though both groups scored non-significantly higher at the second visit. This study demonstrates feasibility and utility of neurocognitive testing in Spanish using TP among older rural Latinos.

  3. Effect of a Hypocretin/Orexin Antagonist on Neurocognitive Performance

    Science.gov (United States)

    2014-09-01

    Spectral analysis will organize sleep epochs by stage and time. Artifacts will be tagged for removal for spectral analysis. 7.2 Safety Assessment...hope to begin analyses in November 2014. 15. SUBJECT TERMS Neurocognitive Performance, Sleep , Hypocretin, Orexin 16. SECURITY... CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC a. REPORT U b. ABSTRACT U c. THIS PAGE U

  4. Neurocognitive Impairment in Children and Adolescents with SLE

    OpenAIRE

    2009-01-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease in which neuropsychiatric manifestations are a common cause of significant morbidity. The American College of Rheumatology (ACR) has identified 19 distinct neuropsychiatric syndromes of SLE although the 1982 ACR classification criteria for SLE recognize only two: seizures and psychosis.1 Neurocognitive impairment (NCI) is one of the most common and clinically challenging of all SLE manifestations, however, its pathophysiol...

  5. Audiovisual emotional processing and neurocognitive functioning in patients with depression

    Directory of Open Access Journals (Sweden)

    Sophie eDoose-Grünefeld

    2015-01-01

    Full Text Available Alterations in the processing of emotional stimuli (e.g. facial expressions, prosody, music have repeatedly been reported in patients with major depression. Such impairments may result from the likewise prevalent executive deficits in these patients. However, studies investigating this relationship are rare. Moreover, most studies to date have only assessed impairments in unimodal emotional processing, whereas in real life, emotions are primarily conveyed through more than just one sensory channel. The current study therefore aimed at investigating multi-modal emotional processing in patients with depression and to assess the relationship between emotional and neurocognitive impairments. 41 patients suffering from major depression and 41 never-depressed healthy controls participated in an audiovisual (faces-sounds emotional integration paradigm as well as a neurocognitive test battery. Our results showed that depressed patients were specifically impaired in the processing of positive auditory stimuli as they rated faces significantly more fearful when presented with happy than with neutral sounds. Such an effect was absent in controls. Findings in emotional processing in patients did not correlate with BDI-scores. Furthermore, neurocognitive findings revealed significant group differences for two of the tests. The effects found in audiovisual emotional processing, however, did not correlate with performance in the neurocognitive tests.In summary, our results underline the diversity of impairments going along with depression and indicate that deficits found for unimodal emotional processing cannot trivially be generalized to deficits in a multi-modal setting. The mechanisms of impairments therefore might be far more complex than previously thought. Our findings furthermore contradict the assumption that emotional processing deficits in major depression are associated with impaired attention or inhibitory functioning.

  6. Neurocognitive profiles in MSUD school-age patients.

    Science.gov (United States)

    Bouchereau, Juliette; Leduc-Leballeur, Julie; Pichard, Samia; Imbard, Apolline; Benoist, Jean-François; Abi Warde, Marie-Thérèse; Arnoux, Jean-Baptiste; Barbier, Valérie; Brassier, Anaïs; Broué, Pierre; Cano, Aline; Chabrol, Brigitte; Damon, Gilles; Gay, Claire; Guillain, Isabelle; Habarou, Florence; Lamireau, Delphine; Ottolenghi, Chris; Paermentier, Laetitia; Sabourdy, Frédérique; Touati, Guy; Ogier de Baulny, Hélène; de Lonlay, Pascale; Schiff, Manuel

    2017-05-01

    Maple syrup urine disease (MSUD), an inborn error of amino acids catabolism is characterized by accumulation of branched chain amino acids (BCAAs) leucine, isoleucine, valine and their corresponding alpha-ketoacids. Impact on the cognitive development has been reported historically, with developmental delays of varying degree. Currently, earlier diagnosis and improved management allow a better neurodevelopment, without requirement of special education. However, specific impairments can be observed, and so far, results of detailed neurocognitive assessments are not available. The aim of this study was to analyse neurocognitive profiles of French MSUD patients. This was a multicentre retrospective study on MSUD patients who underwent neurocognitive evaluation at primary school age. Twenty-one patients with classical neonatal onset MSUD were included. The patients' mean age at the time of evaluation was 8.7 years. The mean intellectual quotient (IQ) score was in the normal range (95.1 ± 12.6). In a subset of eight patients, a consistent developmental pattern of higher verbal than performance IQ was observed (mean of the difference 25.7 ± 8.7, p < 0.0001). No correlation could be established between this pattern and long-term metabolic balance (BCAA blood levels), or severity of acute metabolic imbalances, or leucine blood levels at diagnosis and time to toxin removal procedure. These data show that some MSUD patients may exhibit an abnormal neurocognitive profile with higher verbal than performance abilities. This might suggest an executive dysfunction disorder that would need to be further investigated by specialized testing. This pattern is important to detect in MSUD, as appropriate neuropsychological treatment strategies should be proposed.

  7. Neurocognitive performance following acute mephedrone administration, with and without alcohol.

    Science.gov (United States)

    de Sousa Fernandes Perna, E B; Papaseit, E; Pérez-Mañá, C; Mateus, J; Theunissen, E L; Kuypers, Kpc; de la Torre, R; Farré, M; Ramaekers, J G

    2016-12-01

    Recreational use of mephedrone, alone and in combination with alcohol, has increased over the past years. Pharmacological properties of mephedrone share similarities with methylenedioxymethamphetamine (MDMA), but its effect on neurocognitive function has not been well established in humans. The present study assessed the effect of mephedrone alone and after co-administration with alcohol on neurocognitive function. It was hypothesised that mephedrone would improve psychomotor performance but impair memory performance, when administered alone. Neurocognitive performance was expected to be impaired following mephedrone when combined with alcohol. Eleven participants received single doses of 200 mg mephedrone or placebo combined with 0.8 g/kg alcohol or placebo. Neurocognitive performance was assessed at baseline (T0), at one hour (T1) and four hours after (T2) mephedrone administration, by means of the Divided Attention Task (DAT), Critical Tracking Task (CTT), and the Spatial Memory Test (SMT). Mephedrone intoxication impaired short-term spatial memory at T1 and improved critical tracking performance at T2 Mephedrone alone did not affect divided attention, but did show an interaction with alcohol on reaction time at T2 Reaction time decreased when mephedrone was combined with alcohol as compared to alcohol alone. Alcohol intoxication impaired both short- and long-term spatial memory at T1 and divided attention at T1 and T2 Critical tracking performance was not affected by alcohol intoxication. The current findings support the hypothesis that mephedrone improves psychomotor performance, impairs spatial memory and does not affect divided attention performance. Stimulatory effects of mephedrone were not sufficient to compensate for the impairing effects of alcohol on most performance parameters.

  8. Effects of Cannabis on Neurocognitive Functioning: Recent Advances, Neurodevelopmental Influences, and Sex Differences

    Science.gov (United States)

    Crane, Natania A.; Schuster, Randi Melissa; Fusar-Poli, Paolo; Gonzalez, Raul

    2012-01-01

    Decades of research have examined the effects of cannabis on neurocognition. Recent advances in this field provide us with a better understanding of how cannabis use influences neurocognition both acutely (during intoxication) and non-acutely (after acute effects subside). Evidence of problems with episodic memory is one of the most consistent findings reported; however, several other neurocognitive domains appear to be adversely affected by cannabis use under various conditions. There is significant variability in findings across studies, thus a discussion of potential moderators is increasingly relevant. The purpose of this review was to 1) provide an update on research of cannabis’ acute and non-acute effects on neurocognition, with a focus on findings since 2007 and 2) suggest and discuss how neurodevelopmental issues and sex differences may influence cannabis effects on neurocognition. Finally we discuss how future investigations may lead to better understanding of the complex interplay among cannabis, stages of neurodevelopment, and sex on neurocognitive functioning. PMID:23129391

  9. Negative symptoms mediate the relationship between neurocognition and function in individuals at ultrahigh risk for psychosis

    DEFF Research Database (Denmark)

    Glenthøj, L B; Jepsen, J R M; Hjorthøj, C

    2017-01-01

    and social skills act as mediators between neurocognition and functional outcome in UHR individuals. METHODS: Ultrahigh risk participants (N = 84) underwent neurocognitive testing using the Brief Assessment of Cognition in Schizophrenia. Social skills and negative symptoms were assessed using the High...... to the measures of functioning. Negative symptoms mediated the relationship between neurocognition and four of the five measures of functioning. We did not find social skills to mediate between neurocognition and functioning. CONCLUSION: Negative symptoms appear to mediate the relationship between neurocognition...... and functional outcome in UHR individuals, but the finding needs to be confirmed and extended to longitudinal studies. This underscores the importance of focusing on both neurocognition and negative symptoms when aiming at improving the functional outcome of UHR individuals....

  10. 穴位埋线疗法配合闭经汤治疗继发性闭经的临床疗效%The Clinical Curative Effect of Acupoint Catgut Embedding Therapy Combined With Amenorrhea Decoction in the Treatment of Secondary Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    陈丽; 武永飞

    2016-01-01

    Objective To delve into acupuncture points embedded wire with amenorrhea soup treatment the clinical effect of secondary amenorrhea. Methods 80 cases of secondary amenorrhea patients in our hospital from September 2014 to October 2015 were chosen as the research object, 80 patients were randomly divided into observation group and control group, 40 cases in each group, the control group using amenorrhea decoction treatment, the observation group combined with acupoint catgut embedding therapy.Results Compared with the control group the observation groupwas better than the control group (P<0.05), the difference was statistically significant.Conclusion In the treatment of patients with secondary amenorrhea, the use of acupuncture point bury line and amenorrhea soup combined treatment the overall effect is better.%目的:深入探讨穴位埋线配合闭经汤治疗继发性闭经的临床效果。方法选取我院2014年9月~2015年10月收治的80例继发性闭经患者为研究对象,随机将80例患者分为观察组和对照组,每组各40例;对照组采用闭经汤治疗,观察组联合穴位埋线治疗。结果治疗有效率比较,观察组优于对照组(P<0.05),差异有统计学意义。结论在继发性闭经患者的治疗中,采用穴位埋线和闭经汤联合治疗整体效果较好。

  11. Altered structural brain changes and neurocognitive performance in pediatric HIV

    Directory of Open Access Journals (Sweden)

    Santosh K. Yadav

    2017-01-01

    Full Text Available Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI on a 3 T clinical scanner. Altered cortical thickness, subcortical volumes, and abnormal neuropsychological test scores were observed in pediatric HIV patients. The structural network connectivity analysis depicted lower connection strengths, lower clustering coefficients, and higher path length in pediatric HIV patients than healthy controls. The network betweenness and network hubs in cortico-limbic regions were distorted in pediatric HIV patients. The findings suggest that altered cortical and subcortical structures and regional brain connectivity in pediatric HIV patients may contribute to deficits in their neurocognitive functions. Further, longitudinal studies are required for better understanding of the effect of HIV pathogenesis on brain structural changes throughout the brain development process under standard ART treatment.

  12. Neurocognitive profiles of learning disabled children with neurofibromatosis type 1

    Directory of Open Access Journals (Sweden)

    Miladys eOrraca-Castillo

    2014-06-01

    Full Text Available Neurofibromatosis 1 (NF1 is a genetic condition generally associated with intellectual deficiency and learning disabilities. Although there have been groundbreaking advances in the understanding of the molecular, cellular, and neural systems underlying learning deficits associated to NF1 in animal models, much remains to be learned about the spectrum of neurocognitive phenotype associated with the NF1 clinical syndrome. In the present study, 32 children with NF1 ranging from 7 to 14 years were evaluated with neurocognitive tests dedicated to assess basic capacities which are involved in reading and mathematical achievement. Deficits in lexical and phonological strategies and poor number facts retrieval were found underlying reading and arithmetic disorders, respectively. Additionally, efficiencies in lexical/phonological strategies and mental arithmetic were significant predictors of individual differences in reading attainment and math. However, deficits in core numeric capacities were not found in the sample, suggesting that it is not responsible for calculation dysfluency. The estimated prevalence of Developmental Dyscalculia was 18.8%, and the male:female ratio was 5:1. On the other hand, the prevalence of Developmental Dyslexia was almost 3 times as high (50%, and no gender differences were found (male:female ratio=1:1. This study offers new evidence to the neurocognitive phenotype of NF1 contributing to an in depth understanding of this condition, but also to possible treatments for the cognitive deficits associated with NF1.

  13. Multifactorial Determinants of the Neurocognitive Effects of Electroconvulsive Therapy

    Science.gov (United States)

    McClintock, Shawn M.; Choi, Jimmy; Deng, Zhi-De; Appelbaum, Lawrence G.; Krystal, Andrew D.; Lisanby, Sarah H.

    2014-01-01

    For many patients with neuropsychiatric illnesses, standard psychiatric treatments with mono or combination pharmacotherapy, psychotherapy, and transcranial magnetic stimulation are ineffective. For these patients with treatment resistant neuropsychiatric illnesses, a main therapeutic option is electroconvulsive therapy (ECT). Decades of research have found ECT to be highly effective; however, it can also result in adverse neurocognitive effects. Specifically, ECT results in disorientation after each session, anterograde amnesia for recently learned information, and retrograde amnesia for previously learned information. Unfortunately, the neurocognitive effects and underlying mechanisms of action of ECT remain poorly understood. The purpose of this paper is to synthesize the multiple moderating and mediating factors that are thought to underlie the neurocognitive effects of ECT into a coherent model. Such factors include demographic and neuropsychological characteristics, neuropsychiatric symptoms, ECT technical parameters, and ECT associated neurophysiological changes. Future research is warranted to evaluate and test this model, so that these findings may support the development of more refined clinical seizure therapy delivery approaches and efficacious cognitive remediation strategies to improve the utility of this important and widely used intervention tool for neuropsychiatric diseases. PMID:24820942

  14. Handedness, heritability, neurocognition and brain asymmetry in schizophrenia.

    Science.gov (United States)

    Deep-Soboslay, Amy; Hyde, Thomas M; Callicott, Joseph P; Lener, Marc S; Verchinski, Beth A; Apud, José A; Weinberger, Daniel R; Elvevåg, Brita

    2010-10-01

    Higher rates of non-right-handedness (i.e. left- and mixed-handedness) have been reported in schizophrenia and have been a centrepiece for theories of anomalous lateralization in this disorder. We investigated whether non-right-handedness is (i) more prevalent in patients as compared with unaffected siblings and healthy unrelated control participants; (ii) familial; (iii) associated with disproportionately poorer neurocognition; and (iv) associated with grey matter volume asymmetries. We examined 1445 participants (375 patients with schizophrenia, 502 unaffected siblings and 568 unrelated controls) using the Edinburgh Handedness Inventory, a battery of neuropsychological tasks and structural magnetic resonance imaging data. Patients displayed a leftward shift in Edinburgh Handedness Inventory laterality quotient scores as compared with both their unaffected siblings and unrelated controls, but this finding disappeared when sex was added to the model. Moreover, there was no evidence of increased familial risk for non-right-handedness. Non-right-handedness was not associated with disproportionate neurocognitive disadvantage or with grey matter volume asymmetries in the frontal pole, lateral occipital pole or temporal pole. Non-right-handedness was associated with a significant reduction in left asymmetry in the superior temporal gyrus in both patients and controls. Our data neither provide strong support for 'atypical' handedness as a schizophrenia risk-associated heritable phenotype nor that it is associated with poorer neurocognition or anomalous cerebral asymmetries.

  15. Gestational length affects neurocognition in early-onset schizophrenia.

    Science.gov (United States)

    Teigset, Charlotte M; Mohn, Christine; Rund, Bjørn Rishovd

    2016-10-30

    Obstetric complications (OC) have been linked to an increased risk for schizophrenia in offspring, especially in early-onset schizophrenia (EOS). Extensive cognitive deficits occur in EOS, although no study has yet to investigate the relationship between OC and cognition in EOS. This study aims to examine the frequency of OC in EOS compared to controls, and also investigates the relationship between OC and neurocognitive dysfunction in the two groups. Nineteen EOS patients and 53 healthy controls were tested with the MATRICS Consensus Cognitive Battery (MCCB), and the cognitive measures were combined with OC data from the Norwegian Birth Registry. The results indicated no group differences in OC in EOS and healthy controls, but a shorter gestational length in the EOS group led to significant decreases in the overall neurocognitive composite score, and in processing speed. This suggests that the poorer neuropsychological performances commonly found in EOS may be partly attributable to the length of gestation. The worsened neurocognitive functioning did not appear among controls, so gestational length had a different impact on the two groups. Our findings indicated that a shorter gestational length did not increase the risk for developing EOS, but did significantly affect the cognitive difficulties in this group.

  16. Theory of mind and neurocognition in early psychosis: a quasi-experimental study.

    Science.gov (United States)

    Langdon, Robyn; Connors, Michael H; Still, Megan; Ward, Philip B; Catts, Stanley

    2014-12-04

    People with chronic psychosis often display theory of mind impairments that are not fully accounted for by other, more general neurocognitive deficits. In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms. In young people with recent-onset psychosis, however, it is unclear the extent to which theory of mind impairment is independent of neurocognitive deficits. The primary aim of this study was to examine the evidence for specific theory of mind impairments in early psychosis. A secondary aim was to explore the relations between theory of mind, neurocognition, symptom severity, and functional outcomes. Twenty-three patients who were within two years of their first psychotic episode and 19 healthy controls completed theory of mind and neurocognitive batteries. Social functioning, quality of life, and symptom severity were also assessed in patients. Patients demonstrated deficits in tasks assessing theory of mind and neurocognition relative to controls. Patients' deficits in theory of mind were evident even after adjusting for their deficits in neurocognition. Neither theory of mind nor neurocognition predicted social functioning or quality of life in this early psychosis sample. Severity of negative symptoms, however, was a significant predictor of both outcomes. While a specific theory of mind impairment was evident in this early psychosis sample, severity of negative symptoms emerged as the best predictor of poor functional outcome. Further early psychosis research is needed to examine the longitudinal progression of theory of mind impairments - independent of neurocognitive deficits - and their impact on psychosocial function.

  17. Performance on naturalistic virtual reality tasks depends on global cognitive functioning as assessed via traditional neurocognitive tests.

    Science.gov (United States)

    Oliveira, Jorge; Gamito, Pedro; Alghazzawi, Daniyal M; Fardoun, Habib M; Rosa, Pedro J; Sousa, Tatiana; Picareli, Luís Felipe; Morais, Diogo; Lopes, Paulo

    2017-08-14

    This investigation sought to understand whether performance in naturalistic virtual reality tasks for cognitive assessment relates to the cognitive domains that are supposed to be measured. The Shoe Closet Test (SCT) was developed based on a simple visual search task involving attention skills, in which participants have to match each pair of shoes with the colors of the compartments in a virtual shoe closet. The interaction within the virtual environment was made using the Microsoft Kinect. The measures consisted of concurrent paper-and-pencil neurocognitive tests for global cognitive functioning, executive functions, attention, psychomotor ability, and the outcomes of the SCT. The results showed that the SCT correlated with global cognitive performance as measured with the Montreal Cognitive Assessment (MoCA). The SCT explained one third of the total variance of this test and revealed good sensitivity and specificity in discriminating scores below one standard deviation in this screening tool. These findings suggest that performance of such functional tasks involves a broad range of cognitive processes that are associated with global cognitive functioning and that may be difficult to isolate through paper-and-pencil neurocognitive tests.

  18. The clinical features of patients with amenorrhea after induced abortion%人工流产术后闭经的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    曾华; 陈志

    2011-01-01

    目的:分析人工流产术后并发闭经患者的临床特点.方法:回顾性分析我院近5年来人工流产术后并发闭经患者的临床资料,记录性激素检查情况、宫腔镜检查结果、以及诊断性刮宫病理学检查结果,同时记录其治疗预后.结果:5年来我院共发生人流后闭经37例,占总人流患者的1.4%.发生距人流时间2-16个月,闭经时间2-5个月.人流次数越多,越易发生(x2=13.440,p=0.001);是否生产和术后闭经无关(x才=0.037,P=0.847).性激素检查显示卵巢早衰者或下丘脑功能失调性闭经共8例(21.6%).宫腔镜检查显示宫颈内口粘连11例(29.7%),宫腔粘连18例(48.6%).刮出物中有炎性细胞浸润者占64.0%.经过积极治疗,35例患者恢复周期,另2例效果不佳.结论:人工流产术可能导致一定的术后闭经并发症发生;宫颈内口和宫腔粘连以及性激素异常是造成术后闭经的主要原因,而炎症反应在其中也可能起到一定的作用;人工流产术后闭经治疗预后尚可.%Objective: To analyze the clinical characteristics of patients with amenorrhea after induced abortion. Methods: The patients with amenorrhea after induced abortion in our hospital of the past 5 years were analyzed retrospectively. Some characteristics of the patients were recorded, including sex hormone level, results of hysteroscopy, diagnostic curettage pathological Results ,as well as prognosis.Results: A total of 37 patients (1.4%) suffered amenorrhea 2 to 16 months after induced abortion, which sustained for 2 to 5 months. The occurrence of amenorrhea was positively related to the frequeney of induced abortion (x2 = 13.440, P = 0.001 ), but had nothing to do with delivery (x2 = 0.037, P = 0.847). Sex hormone level revealed premature ovarian failure or hypothalamic amenorrhea dysfunction in 8 patients (21.6%). Hysteroscopic examination revealed 11 patients had cervical adhesions (29.7%), and 18 patients had intrauterine adhesions (48.6

  19. A investigation in psychiatric outpatients with amenorrhea induced by antipsychotics%精神科门诊患者药源性闭经调查

    Institute of Scientific and Technical Information of China (English)

    罗维肖; 刘姝婷; 甘少兵; 覃宇; 谭健能

    2011-01-01

    Objective:To investigate the incidence of amenorrhea induced by antipsychotics and the related factors in female schizophrenia. Method :374 outpatients with schizophrenia taking antipsychotics were investigated by serf-made questionnaire. Results: Among the 374 outpatients, amenorrhea and galactorrhoea were reported by 99 and 31 patients, respectively, with amenorrhea incidence 26.5% and the incidence of amenorrhea companying with galactorrhoea 8.3%. The incidence of amenorrhea were 57.9% for combined antipsychotics use, which was the hi.est one and, 35.6% for sulpiride and 2.5.7% for risperidone which was the first and the second highest one for single antipaychotics use. The occurrence of amenorrhea induced by antipsychotics were not related to age, marriage, education level, illness course, time of medicine-taking, amounts of medicine-taking. The female schizophrenia who hadn't given birth to a child had the significantly higher incidence of amenorrhea compared with those female schizophrenia who had given birth to a child 69.7% vs 53.8% (P <0.01 ). Conclusion: Amenorrhea is very prevalent among patients with schizophrenia on antipaychotic medications. The therapeutic strategy for female schizophrenia is needed to avoid choosing sulpiride and risperidone in the long-term treatment; moreover, antipsychotic polypharmacy should be used as low as possible, espocially for those without reproduction.%目的:调查各种抗精神病药所致女性患者闭经的发生率及相关因素.方法:用自制调查表对门诊374例复诊的女性精神分裂症患者进行调查.结果:374例服用抗精神病药的女性患者中,99例出现闭经,发生率为26.5%;31例出现泌乳,闭经伴泌乳发生率为8.3%.闭经在联合用药中的发生率最高(57.9%),单一用药中闭经发生率最高的是舒必利(35.6%),其次是利培酮(25.7%).药源性闭经的发生与年龄、病程、服药时间、药量、学历、婚否等因素无关(P>0.05).

  20. 闭经患者细胞遗传学检查的临床意义%The analysis of cytogenetic abnormalities for patients with amenorrhea

    Institute of Scientific and Technical Information of China (English)

    杨瑞芳; 王明毅; 王济周

    2001-01-01

    目的:分析闭经患者细胞遗传学的检查结果及其临床意义。方法:对每例闭经患者进行常规妇科检查及细胞遗传学检查,包括外周血淋巴细胞培养制备染色体,G显带与C显带,必要时进行高分辨显带或银染处理,或同时用内分泌及超声检查。结果:233例闭经患者中,88例染色体异常,占37.78%,包括染色体数异常、缺失、倒位及嵌合。结论:染色体异常是闭经的主要原因之一,染色体核型分析对确诊闭经的病因、治疗及确定预后必不可少。%Objective: To analyse the cytogenetic examinations and their clinical significance for patients with amenorrhea. Methods: The routing gynecologic examination and cytogenetics were performed including pheripheral blood lymphocytes culture for chromosome, and G-banding, C-banding, or ifnecessary, high resolution banding and silver-staining were treated. In sometimes, endocrine and ultrasound examination were performed simultaneously. Results: There were 88 cases with chromosome abnormally in 233 cases of amenorrhea,account for 37.78%, including number abnormality, deletion, inversion andmosaic type. Conclusions: Chromosome abnormality is one of the main causes of amenorrhea. Karyotype analysis of chromosome are absolutely necessary methods for seeking the cause, therapy and prognosis of patients with amenorrhea.

  1. Molecular Cytogenetic Characterization of a Non-Robertsonian Dicentric Chromosome 14;19 Identified in a Girl with Short Stature and Amenorrhea

    OpenAIRE

    Dutta, Usha R.; Vijaya Kumar Pidugu; Ashwin Dalal

    2012-01-01

    We report a 16-year-old girl who presented with short stature and amenorrhea. Initially the cytogenetic analysis showed the presence of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19. Subsequent molecular cytogenetic analysis by fluorescence in situ hybridization (FISH) using whole chromosome paints, centromeric probes, as well as gene specific probes confirmed the dicentric nature of the derivative chromosome and indicated that the rearrangement involved the s...

  2. Beneficial neurocognitive effects of transcranial laser in older adults.

    Science.gov (United States)

    Vargas, Enrique; Barrett, Douglas W; Saucedo, Celeste L; Huang, Li-Da; Abraham, Jacob A; Tanaka, Hirofumi; Haley, Andreana P; Gonzalez-Lima, F

    2017-07-01

    Transcranial infrared laser stimulation (TILS) at 1064 nm, 250 mW/cm(2) has been proven safe and effective for increasing neurocognitive functions in young adults in controlled studies using photobiomodulation of the right prefrontal cortex. The objective of this pilot study was to determine whether there is any effect from TILS on neurocognitive function in older adults with subjective memory complaint at risk for cognitive decline (e.g., increased carotid artery intima-media thickness or mild traumatic brain injury). We investigated the cognitive effects of TILS in older adults (ages 49-90, n = 12) using prefrontal cortex measures of attention (psychomotor vigilance task (PVT)) and memory (delayed match to sample (DMS)), carotid artery intima-media thickness (measured by ultrasound), and evaluated the potential neural mechanisms mediating the cognitive effects of TILS using exploratory brain studies of electroencephalography (EEG, n = 6) and functional magnetic resonance imaging (fMRI, n = 6). Cognitive performance, age, and carotid artery intima-media thickness were highly correlated, but all participants improved in all cognitive measures after TILS treatments. Baseline vs. chronic (five weekly sessions, 8 min each) comparisons of mean cognitive scores all showed improvements, significant for PVT reaction time (p < 0.001), PVT lapses (p < 0.001), and DMS correct responses (p < 0.05). The neural studies also showed for the first time that TILS increases resting-state EEG alpha, beta, and gamma power and promotes more efficient prefrontal blood-oxygen-level-dependent (BOLD)-fMRI response. Importantly, no adverse effects were found. These preliminary findings support the use of TILS for larger randomized clinical trials with this non-invasive approach to augment neurocognitive function in older people to combat aging-related and vascular disease-related cognitive decline.

  3. Neurocognitive functions in obsessive-compulsive disorder patients and their unaffected first-degree relatives

    Institute of Scientific and Technical Information of China (English)

    张龙

    2012-01-01

    Objective To find the common neurocognitive deficits in patients with obsessive-compulsive disorder (OCD) and their unaffected first-degree relatives (UFDR) and to identify neurocognitive endophenotypes for OCD. Methods Forty patients with OCD,forty UFDR of OCD probands and forty healthy

  4. The "value added" of neurocognitive testing after sports-related concussion

    NARCIS (Netherlands)

    Van Kampen, Derk A.; Lovell, Mark R.; Pardini, Jamie E.; Collins, Michael W.; Fu, Freddie H.

    2006-01-01

    Background: Neurocognitive testing has been endorsed as a "cornerstone" of concussion management by recent Vienna and Prague meetings of the Concussion in Sport Group. Neurocognitive testing is important given the potential unreliability of athlete self-report after injury. Relying only on athletes'

  5. Pathways between neurocognition, social cognition and emotion regulation in bipolar disorder.

    Science.gov (United States)

    Van Rheenen, T E; Meyer, D; Rossell, S L

    2014-11-01

    Converging evidence suggests that in bipolar disorder (BD), social cognition and emotion regulation are affected by the capacity for effective neurocognitive function. Adaptive emotion regulation may also rely on intact social cognition, and it is possible that social cognition acts as a mediator in its relationship with neurocognition. We aimed to address this hypothesis by explicitly examining interrelationships among neurocognition, social cognition and emotion regulation in an out-patient sample meeting criteria for a DSM-IV-TR diagnosis of BD compared with controls. Fifty-one BD patients and 52 healthy controls completed a battery of tests assessing neurocognition, social cognition (emotion perception and theory of mind) and emotion regulation. Path analysis revealed that in BD, neurocognition was associated with social cognition, but social cognition was not associated with emotion regulation as expected. In contrast, a component of social cognition was found to mediate the relationship between neurocognition and emotion regulation in healthy controls. These findings highlight differences in the pattern of associations between neurocognition, social cognition and emotion regulation across BD patients and controls. In the present data, these results appear to indicate that neurocognitive and social cognitive abilities generally operate in isolation from emotion regulation in BD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Neurocognitive mechanisms for processing inflectional and derivational complexity in English

    Directory of Open Access Journals (Sweden)

    Božić Mirjana

    2013-01-01

    Full Text Available In the current paper we discuss the mechanisms that underlie the processing of inflectional and derivational complexity in English. We address this issue from a neurocognitive perspective and present evidence from a new fMRI study that the two types of morphological complexity engage the language processing network in different ways. The processing of inflectional complexity selectively activates a left-lateralised frontotemporal system, specialised for combinatorial grammatical computations, while derivational complexity primarily engages a distributed bilateral system, argued to support whole-word, stem based lexical access. We discuss the implications of our findings for theories of the processing and representation of morphologically complex words.

  7. Exercise to enhance neurocognitive function after traumatic brain injury.

    Science.gov (United States)

    Fogelman, David; Zafonte, Ross

    2012-11-01

    Vigorous exercise has long been associated with improved health in many domains. Results of clinical observation have suggested that neurocognitive performance also is improved by vigorous exercise. Data derived from animal model-based research have been emerging that show molecular and neuroanatomic mechanisms that may explain how exercise improves cognition, particularly after traumatic brain injury. This article will summarize the current state of the basic science and clinical literature regarding exercise as an intervention, both independently and in conjunction with other modalities, for brain injury rehabilitation. A key principle is the factor of timing of the initiation of exercise after mild traumatic brain injury, balancing potentially favorable and detrimental effects on recovery.

  8. Interactive Effects of Neurocognitive Impairment and Substance Use on Antiretroviral Non-adherence in HIV Disease

    Science.gov (United States)

    Thaler, Nicholas S.; Sayegh, Philip; Kim, Michelle S.; Castellon, Steven A.; Hinkin, Charles H.

    2015-01-01

    While numerous studies have established the adverse independent effects of clinical conditions including neurocognitive dysfunction, psychiatric illness, and substance abuse/dependence on medication adherence among HIV-infected adults, fewer have studied their interactive effects. The current study examined this issue among 204 HIV-infected participants based upon current neurocognitive functioning and DSM-IV-diagnosed psychiatric illness and current substance abuse or dependence. Results confirmed that participants with any of these risk factors demonstrated poorer adherence than individuals with no risk factors. A neurocognitive status × substance abuse/dependence interaction was also identified such that participants with impaired neurocognition and a co-occurring substance abuse/dependence diagnosis demonstrated the poorest adherence. Results confirm the deleterious impact of these risk factors in isolation and also identify a specific interactive effect for individuals with comorbid neurocognitive impairment and a substance abuse/dependence disorder. Findings highlight the need for interventions that simultaneously address these problems. PMID:25589442

  9. Neurocognitive Deficits in Borderline Personality Disorder: Associations With Childhood Trauma and Dimensions of Personality Psychopathology.

    Science.gov (United States)

    Thomsen, Marianne S; Ruocco, Anthony C; Carcone, Dean; Mathiesen, Birgit B; Simonsen, Erik

    2016-09-12

    The present study evaluates the severity of neurocognitive deficits and assesses their relations with self-reported childhood trauma and dimensions of personality psychopathology in 45 outpatients with borderline personality disorder (BPD) matched to 56 non-psychiatric controls. Participants completed a comprehensive battery of neurocognitive tests, a retrospective questionnaire on early life trauma and a dimensional measure of personality psychopathology. Patients with BPD primarily showed deficits in verbal comprehension, sustained visual attention, working memory and processing speed. Comorbid posttraumatic stress disorder (PTSD) and an elevated childhood history of physical trauma were each accompanied by more severe neurocognitive deficits. There were no statistically significant associations between neurocognitive function and dimensions of personality psychopathology. These results suggest that patients with BPD display deficits mainly in higher-order thinking abilities that may be exacerbated by PTSD and substantial early life trauma. Potential relationships between neurocognitive deficits and dimensions of personality psychopathology in BPD need further examination.

  10. A new logical insight and putative mechanism behind fluoxetine-induced amenorrhea, hyperprolactinemia and galactorrhea in a case series

    Science.gov (United States)

    Saha, Indranil; Das, Saibal; Ganguly, Abhrajit; Das, Debasis; Tripathi, Santanu Kumar

    2013-01-01

    With the exception of fluoxetine, all selective serotonin reuptake inhibitors (SSRIs) commonly cause hyperprolactinemia through presynaptic mechanisms indirectly via 5-hydroxytryptamine (5-HT)-mediated inhibition of tuberoinfundibular dopaminergic neurons. However, there is little insight regarding the mechanisms by which fluoxetine causes hyperprolactinemia via the postsynaptic pathway. In this text, analysis of five spontaneously reported clinical cases of hyperprolactinemia resulting in overt symptoms of amenorrhea with or without galactorrhea, were scrupulously analyzed after meticulously correlating relevant literature and an attempt was made to explore the putative postsynaptic pathway of fluoxetine inducing hyperprolactinemia. Hypothetically, serotonin regulates prolactin release either by increasing oxytocin (OT) level via direct stimulation of vasoactitive intestinal protein (VIP) or indirectly through stimulation of GABAergic neurons. The pharmacodynamic exception and pharmacokinetic aspect of fluoxetine are highlighted to address the regulation of prolactin release via serotonergic pathway, either directly through stimulation of prolactin releasing factors (PRFs) VIP and OT via 5-HT2A receptors predominantly on PVN (neurosecretory magnocellular cell) or through induction of 5-HT1A-mediated direct and indirect GABAergic actions. Prospective molecular and pharmacogenetic studies are warranted to visualize how fluoxetine regulate neuroendocrine system and cause adverse consequences, which in turn may explore new ways of approach of drug development by targeting the respective metabolic pathways to mitigate these adverse impacts. PMID:24294485

  11. Neurocognitive functioning in schizophrenia and bipolar disorder: Clarifying concepts of diagnostic dichotomy versus continuum

    Directory of Open Access Journals (Sweden)

    Carissa Nadia Kuswanto

    2013-12-01

    Full Text Available The Kraepelinian dichotomy posits that patients with schizophrenia (SCZ and bipolar disorder (BD present as two separate psychotic entities such that they differ in terms of clinical severity including neurocognitive functioning. Our study aimed to specifically compare and contrast the level of neurocognitive functioning between SCZ and BD patients and identify predictors of their poor neurocognitive functioning. We hypothesized that patients with SCZ had a similar level of neurcognitive impairment compared with BD. Forty-nine healthy controls (HC, 72 SCZ and 42 BD patients who were matched for age, gender, and premorbid IQ were administered the Brief Assessment of Cognition battery (BAC. Severity of psychopathology and socio-occupational functioning were assessed for both patients groups. Both BD and SCZ groups demonstrated similar patterns of neurocognitive deficits across several domains (verbal memory, working memory, semantic fluency, processing speed compared with HC subjects. However, no significant difference was found in neurocognitive functioning between BD and SCZ patients, suggesting that both patient groups suffer the same degree of neurocognitive impairment. Patients with lower level of psychosocial functioning (F(1,112 = 2.661, p = 0.009 and older age (F(1,112 = -2.625, p = 0.010, not diagnosis or doses of psychotropic medications, predicted poorer overall neurocognitive functioning as measured by the lower BAC composite score. Our findings of comparable neurocognitive impairments between SCZ and BD affirm our hypothesis and support less the Kraepelinian concept of dichotomy but more of a continuum of psychotic spectrum conditions. This should urge clinicians to investigate further the underlying neural basis of these neurocognitive deficits, and be attentive to the associated socio-demographic and clinical profile in order to recognize and optimize early the management of the widespread neurocognitive deficits in patients with

  12. Social working memory: Neurocognitive networks and directions for future research

    Directory of Open Access Journals (Sweden)

    Meghan L Meyer

    2012-12-01

    Full Text Available Navigating the social world requires the ability to maintain and manipulate information about people’s beliefs, traits, and mental states. We characterize this capacity as social working memory. To date, very little research has explored this phenomenon, in part because of the assumption that general working memory systems would support working memory for social information. Various lines of research, however, suggest that social cognitive processing relies on a neurocognitive network (i.e., the ‘mentalizing network’ that is functionally distinct from, and considered antagonistic with, the canonical working memory network. Here, we review evidence suggesting that demanding social cognition requires social working memory and that both the mentalizing and canonical working memory neurocognitive networks support social working memory. The neural data run counter to the common finding of parametric decreases in mentalizing regions as a function of working memory demand and suggest that the mentalizing network can support demanding cognition, when it is demanding social cognition. Implications for individual differences in social cognition and pathologies of social cognition are discussed.

  13. An Envisioned Bridge: Schooling as a Neurocognitive Developmental Institution

    Science.gov (United States)

    Baker, David P.; Salinas, Daniel; Eslinger, Paul J.

    2013-01-01

    The potential contribution of social science research to close the gap of knowledge between cognitive neuroscience and educational research has been underappreciated. Despite their virtual absence in the interdisciplinary dialog of neuroscience, sociology of education and related study of the cultural impact of formal education have generated research relevant to an understanding of how the social environment, such as widespread schooling, co-evolves with, and enhances neurocognitive development. Two clusters of isolated research literatures are synthesized that taken together anticipates a dynamic integration of neuroscience and education. The first cluster is on the social construction of cognition through formal education in contemporary society, including the effects of schooling on neurological and cognitive development; the demographic expansion of exposure to the developmental influence of schooling; and education’s cultural impact on the meaning of the learning experience and reinforcement of cognition as the key human capability across ever more key institutions in postindustrial society. The second cluster turns the issue around by examining current investigations from neuroscience that support neurological hypotheses about the causes behind the schooling effect on neurocognitive development. We propose that further integration of these literatures will provide a more ecologically valid context in which to investigate the evolving functional architecture of the contemporary brain. PMID:22682912

  14. Pathological gambling and the loss of willpower: a neurocognitive perspective

    Directory of Open Access Journals (Sweden)

    Damien Brevers

    2013-09-01

    Full Text Available The purpose of this review is to gain more insight on the neurocognitive processes involved in the maintenance of pathological gambling. Firstly, we describe structural factors of gambling games that could promote the repetition of gambling experiences to such an extent that some individuals may become unable to control their gambling habits. Secondly, we review findings of neurocognitive studies on pathological gambling. As a whole, poor ability to resist gambling is a product of an imbalance between any one or a combination of three key neural systems: (1 an hyperactive ‘impulsive’ system, which is fast, automatic, and unconscious and promotes automatic and habitual actions; (2 a hypoactive ‘reflective’ system, which is slow and deliberative, forecasting the future consequences of a behavior, inhibitory control, and self-awareness; and (3 the interoceptive system, translating bottom-up somatic signals into a subjective state of craving, which in turn potentiates the activity of the impulsive system, and/or weakens or hijacks the goal-driven cognitive resources needed for the normal operation of the reflective system. Based on this theoretical background, we focus on certain clinical interventions that could reduce the risks of both gambling addiction and relapse.

  15. Pathological gambling and the loss of willpower: a neurocognitive perspective.

    Science.gov (United States)

    Brevers, Damien; Noël, Xavier

    2013-01-01

    The purpose of this review is to gain more insight on the neurocognitive processes involved in the maintenance of pathological gambling. Firstly, we describe structural factors of gambling games that could promote the repetition of gambling experiences to such an extent that some individuals may become unable to control their gambling habits. Secondly, we review findings of neurocognitive studies on pathological gambling. As a whole, poor ability to resist gambling is a product of an imbalance between any one or a combination of three key neural systems: (1) an hyperactive 'impulsive' system, which is fast, automatic, and unconscious and promotes automatic and habitual actions; (2) a hypoactive 'reflective' system, which is slow and deliberative, forecasting the future consequences of a behavior, inhibitory control, and self-awareness; and (3) the interoceptive system, translating bottom-up somatic signals into a subjective state of craving, which in turn potentiates the activity of the impulsive system, and/or weakens or hijacks the goal-driven cognitive resources needed for the normal operation of the reflective system. Based on this theoretical background, we focus on certain clinical interventions that could reduce the risks of both gambling addiction and relapse.

  16. Literature analysis of diagnosis and treatment of acupuncture and moxibustion for amenorrhea%针灸治疗闭经诊疗特点的文献分析

    Institute of Scientific and Technical Information of China (English)

    王伟明; 刘志顺

    2012-01-01

    目的 探讨针灸治疗闭经的诊疗特点和规律.方法 电子检索中国知网(CNKI,1979~2012年)、中文科技期刊全文数据库(VIP,1989~2012年)、中国生物医学光盘数据库(CBM,1979~2012年)、PUBMED(1966~2012年)中针灸治疗闭经的文献,分析总结常用的针灸干预措施、闭经证型分布,针灸对其治疗时的辨证和选穴特点、针灸频次、疗程、疗效、随访、安全性.结果 纳入18篇文献中,体针治疗闭经占61.11%(11/18);针灸临床辨治闭经时常用的证型有气血不足(27.78%,5/18)、气滞血瘀(22.22%,4/18);入选的文献中使用辨病选穴的文献有8篇,占44.44%(8/18),出现频次较高的穴位是关元(8/18,44.44%)、三阴交(7/18,38.89%)、中极(5/18,27.78%)、气海(5/18,27.78%)、肾俞(5/18,27.78%)、中脘(5/18,27.78%),基于中医证型的取穴或配穴所选穴位集中来自于脾经、胃经、任脉;针灸治疗频次每天1次占55.56%(10/18);针灸治疗1个月经周期后观察疗效占38.89%(7/18);针灸治疗闭经的有效率随不同干预措施存在差异,在72.72%~100%之间;针灸治疗闭经的文献随访率不高,仅占5.56%(1/18).入选文献中未见到对针灸治疗闭经的不良反应的报道.结论 针灸临床治疗闭经以体针常见;针灸临床辨治闭经时常用的证型有气血不足、气滞血瘀;针灸治疗闭经取穴方式常见为辨病选穴,具体是关元、三阴交、中极、气海、肾俞、中脘;基于中医证型的取穴或配穴所选穴位多取自脾经、胃经、任脉;针灸每天1次,一般治疗1个月经周期后评价疗效,在临床上多被采用.针灸治疗闭经疗效肯定,安全性较好.%Objective To explore the diagnosis and treatment of acupuncture and moxibustion for amenorrhea. Methods we searched the literatures related to amenorrhea treated by acupuncture and moxibustion in CNKI( 1979 ~ 2012 ), VIP( 1989 ~ 2012 ), CBM( 1979 ~ 2012 ), PUBMED( 1966 ~ 2012 ), then summarized the

  17. International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271.

    Science.gov (United States)

    Robertson, K; Jiang, H; Evans, S R; Marra, C M; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, T B; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S; Kumarasamy, N; la Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L; Amod, F; Walawander, A

    2016-08-01

    Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.

  18. Longitudinal Relationships between Neurocognition, Theory of Mind, and Community Functioning in Outpatients with Serious Mental Illness (SMI)

    Science.gov (United States)

    Cook, Elizabeth A.; Liu, Nancy H.; Tarasenko, Melissa; Davidson, Charlie A.; Spaulding, William D.

    2013-01-01

    The purpose of this study was to examine relationships between neurocognition, theory of mind, and community functioning in a sample of 43 outpatients with serious mental illness (SMI). Relationships between baseline values and changes over time were analyzed using multilevel modeling. Results showed that: 1. Neurocognition and theory of mind were each associated with community functioning at baseline. 2. Community functioning improved over approximately 12 months of treatment. 3. Greater improvement in neurocognition over time predicted higher rates of improvement in community functioning. 4. Theory of mind did not predict change in community functioning after controlling for neurocognition. 5. The effect of change in neurocognition on community functioning did not depend on the effect of baseline neurocognition. This study provides empirical support that individuals with SMI may experience improvement in community functioning, especially when they also experience improvement in neurocognition. Limitations and recommendations for future research are discussed. PMID:23995035

  19. Neurocognition, Insight into Illness and Subjective Quality-of-Life in Schizophrenia: What is Their Relationship?

    Science.gov (United States)

    Kurtz, Matthew M.; Tolman, Arielle

    2010-01-01

    Subjective quality-of-life (SQOL) has been recognized as a crucial domain of outcome in schizophrenia treatment, and yet its determinants are not well understood. In a recent meta-analytic investigation of 10 studies of neurocognition and SQOL in schizophrenia (Tolman & Kurtz, Scz Bull, in press) measures of crystallized verbal ability and processing speed were moderately negatively correlated with SQOL. One potential explanation for inverse relationships between measures of elementary neurocognition and SQOL is that higher levels of cognition may serve as a proxy for better insight into the illness, and better consequent recognition of illness-related functional impairment. This study sought to determine whether: (1) symptoms, neurocognitive variables, and insight into illness influence SQOL; and, (2) whether insight mediated or moderated a relationship between elementary neurocognitive function and SQOL. Seventy-one stabilized clients with schizophrenia or schizoaffective disorder were administered a neuropsychological test battery, symptom and subjective quality-of-life measures. Elementary neuropsychological measures of crystallized verbal ability, attention and working memory, and problem-solving were all inversely related to SQOL. Insight into illness and depression severity, but not positive and negative symptoms, were also inversely related to SQOL. Insight was not found to mediate or moderate any of the relationships between elementary neurocognition and SQOL. Taken together, these findings suggest that neurocognition and insight into illness have inverse relationships to SQOL and that elementary neurocognition does not influence SQOL through its link with illness insight. PMID:21211943

  20. Conceptual disorganization weakens links in cognitive pathways: Disentangling neurocognition, social cognition, and metacognition in schizophrenia.

    Science.gov (United States)

    Minor, Kyle S; Marggraf, Matthew P; Davis, Beshaun J; Luther, Lauren; Vohs, Jenifer L; Buck, Kelly D; Lysaker, Paul H

    2015-12-01

    Disentangling links between neurocognition, social cognition, and metacognition offers the potential to improve interventions for these cognitive processes. Disorganized symptoms have shown promise for explaining the limiting relationship that neurocognition holds with both social cognition and metacognition. In this study, primary aims included: 1) testing whether conceptual disorganization, a specific disorganized symptom, moderated relationships between cognitive processes, and 2) examining the level of conceptual disorganization necessary for links between cognitive processes to break down. To accomplish these aims, comprehensive assessments of conceptual disorganization, neurocognition, social cognition, and metacognition were administered to 67 people with schizophrenia-spectrum disorders. We found that conceptual disorganization significantly moderated the relationship between neurocognition and metacognition, with links between cognitive processes weakening when conceptual disorganization is present even at minimal levels of severity. There was no evidence that conceptual disorganization-or any other specific disorganized symptom-drove the limiting relationship of neurocognition on social cognition. Based on our findings, conceptual disorganization appears to be a critical piece of the puzzle when disentangling the relationship between neurocognition and metacognition. Roles of specific disorganized symptoms in the neurocognition - social cognition relationship were less clear. Findings from this study suggest that disorganized symptoms are an important treatment consideration when aiming to improve cognitive impairments. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Neurological abnormalities and neurocognitive functions in healthy elder people: A structural equation modeling analysis

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    Chan Raymond CK

    2011-08-01

    Full Text Available Abstract Background/Aims Neurological abnormalities have been reported in normal aging population. However, most of them were limited to extrapyramidal signs and soft signs such as motor coordination and sensory integration have received much less attention. Very little is known about the relationship between neurological soft signs and neurocognitive function in healthy elder people. The current study aimed to examine the underlying relationships between neurological soft signs and neurocognition in a group of healthy elderly. Methods One hundred and eighty healthy elderly participated in the current study. Neurological soft signs were evaluated with the subscales of Cambridge Neurological Inventory. A set of neurocognitive tests was also administered to all the participants. Structural equation modeling was adopted to examine the underlying relationship between neurological soft signs and neurocognition. Results No significant differences were found between the male and female elder people in neurocognitive function performances and neurological soft signs. The model fitted well in the elderly and indicated the moderate associations between neurological soft signs and neurocognition, specifically verbal memory, visual memory and working memory. Conclusions The neurological soft signs are more or less statistically equivalent to capture the similar information done by conventional neurocognitive function tests in the elderly. The implication of these findings may serve as a potential neurological marker for the early detection of pathological aging diseases or related mental status such as mild cognitive impairment and Alzheimer's disease.

  2. High acceptability of cognitive screening in HIV-infected patients: a pilot study

    Directory of Open Access Journals (Sweden)

    D Fasel

    2012-11-01

    Full Text Available With combined antiretroviral therapy (cART life expectancy of HIV-infected persons is close to the one of non-infected persons. Identifying neurocognitive deficits in ageing HIV-infected individuals is important. This study aimed to evaluate the acceptability of screening neurocognitive deficits in HIV-infected patients. Thirty patients (26 men, 4 women from the HIV clinic were examined with a new screening test and an in-depth neuropsychological examination. The screening tests consisted of questions and examinations on cognition in everyday situations, mood and selected cognitive functions (word list memory, grooved pegboard, psychomotor speed, trail-making test, psychomotor speed and executive functions, digit symbol test. Also, patients received a questionnaire to evaluate test acceptance. The mean age of the patients was 52.5 (30–74 years, mean education 12.5 (8–18 years. Seven patients had HIV-stage CDC A, 12 B and 11 CDC stage C. The mean CD4 count was 657 cells/µl, the mean HIV viral load<20 cop./µl. All patients were treated with cART (7 with efavirenz. The screening test was done assisted by a nurse and lasted 26 minutes (mean. The screening indicated pathological signs of neurocognitive function in 11 (42% patients. The in-depth neuropsychological assessment revealed pathological conditions in 25 (83% of patients; i.e. 16 (53% patients had ANI (asymptomatic neurocognitive impairment, 8 (27% had MND (mild neurocognitive disorder and 1 (3% had HAD (HIV-associated dementia. Most patients (43.3% judged the test as not too difficult and 56.6% as partly difficult. 96.6% of patients viewed the instructions of nurses as clear, 3.3% as unclear. 93.3% felt the test has not affected privacy and 83.3% estimated the screening as valuable and not worriesome. 83.4% of all patients were interested in their results and for none of the patients the test was too long. The test acceptability by the study nurses was also good. Only in 3.4% of tested

  3. The Lithium Battery: assessing the neurocognitive profile of lithium in bipolar disorder.

    Science.gov (United States)

    Malhi, Gin S; McAulay, Claire; Gershon, Samuel; Gessler, Danielle; Fritz, Kristina; Das, Pritha; Outhred, Tim

    2016-03-01

    The aim of the present study was to characterize the neurocognitive effects of lithium in bipolar disorder to inform clinical and research approaches for further investigation. Key words pertaining to neurocognition in bipolar disorder and lithium treatment were used to search recognized databases to identify relevant literature. The authors also retrieved gray literature (e.g., book chapters) known to them and examined pertinent articles from bibliographies. A limited number of studies have examined the effects of lithium on neurocognition in bipolar disorder and, although in some domains a consistent picture emerges, in many domains the findings are mixed. Lithium administration appears to reshape key components of neurocognition - in particular, psychomotor speed, verbal memory, and verbal fluency. Notably, it has a sophisticated neurocognitive profile, such that while lithium impairs neurocognition across some domains, it seemingly preserves others - possibly those vulnerable to the effects of bipolar disorder. Furthermore, its effects are likely to be direct and indirect (via mood, for example) and cumulative with duration of treatment. Disentangling the components of neurocognition modulated by lithium in the context of a fluctuating and complex illness such as bipolar disorder is a significant challenge but one that therefore demands a stratified and systematic approach, such as that provided by the Lithium Battery. In order to delineate the effects of lithium therapy on neurocognition in bipolar disorder within both research and clinical practice, a greater understanding and measurement of the relatively stable neurocognitive components is needed to examine those that indeed change with lithium treatment. In order to achieve this, we propose a Lithium Battery-Clinical and a Lithium Battery-Research that can be applied to these respective settings. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Neurocognition and occupational functioning in patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Tandberg, Marte; Ueland, Torill; Sundet, Kjetil

    2011-01-01

    Neurocognitive deficits are a core feature of schizophrenia that is associated with poor occupational functioning. Few studies have investigated this relationship in patients with first-episode psychosis. The current study examined the characteristics of employed and unemployed patients with first......-episode psychosis at baseline and 2-year follow-up, and the predictive value of neurocognition on employment status. One-hundred and twenty-two first-episode psychosis patients were assessed with clinical and neurocognitive measures at baseline. Occupational status was assessed at baseline and 2-year follow...

  5. Neurocognitive performance in drug-dependent males and females with posttraumatic stress disorder symptoms.

    Science.gov (United States)

    Paxton, Jessica L; Vassileva, Jasmin; Gonzalez, Raul; Maki, Pauline M; Martin, Eileen M

    2012-01-01

    Sex differences in neurobiological mechanisms of substance dependence are well documented but studies of sex differences in associated neurocognitive deficits have produced inconsistent results. Posttraumatic stress disorder (PTSD) is comorbid with substance dependence and frequently affects neurocognition. Thus, we investigated the effects of sex and PTSD symptoms on sustained attention and inhibition abilities among 126 female and 297 male substance-dependent individuals (SDIs) using the Immediate Memory Test (IMT). Females with significant PTSD (PTSD+) symptoms demonstrated significantly impaired IMT performance relative to other participants. These results represent progress in efforts to delineate sex-specific risk factors for neurocognitive deficits among SDIs.

  6. Prognostic Effects of Adjuvant Chemotherapy-Induced Amenorrhea and Subsequent Resumption of Menstruation for Premenopausal Breast Cancer Patients.

    Science.gov (United States)

    Jeon, Se Jeong; Lee, Jae Il; Jeon, Myung Jae; Lee, Maria

    2016-04-01

    Chemotherapy-induced amenorrhea (CIA) is a side effect that occurs in patients with breast cancer (BC) as a result of chemotherapy. These patients require special treatments to avoid infertility and menopause. However, the factors controlling CIA, resumption of menstruation (RM), and persistence of menstruation after chemotherapy are unknown. The long-term prognosis for premenopausal patients with BC and the prognostic factors associated with CIA and RM are subject to debate. We performed a retrospective study by reviewing the medical records of 249 patients with BC (stage I to stage III) who were treated with cytotoxic chemotherapy. The median patient age was 43 (range, 26-55 years) and the median duration of follow-up was 64 months (range, 28-100 months). The medical records indicated that 219 patients (88.0%) scored as positive for the hormone receptor (HR); the majority of these patients completed chemotherapy and then received additional therapy of tamoxifen. Our analyses revealed that 88.0% (n = 219) of patients experienced CIA, and the percentage of RM during follow-up was 48.6% (n = 121). A total of 30 patients (12.0%) did not experience CIA. Disease-free survival (DFS) was affected by several factors, including tumour size ≥2 cm, node positivity, HR negative status, and body mass index ≥23 kg/m. Multivariate analysis indicated that tumour size ≥2 cm remained as a significant factor for DFS (hazard ratio = 3.3, P = 0.034). In summary, this study finds that the majority of premenopausal patients with BC (stage I to stage III) who receive chemotherapy experience CIA and subsequent RM. Although tumour size ≥2 cm is negatively associated with DFS, RM after CIA is not associated with poor prognosis.

  7. Biomarker prediction of chemotherapy-related amenorrhea in premenopausal women with breast cancer participating in E5103.

    Science.gov (United States)

    Ruddy, Kathryn J; O'Neill, Anne; Miller, Kathy D; Schneider, Bryan P; Baker, Emily; Sparano, Joseph A; Dang, Chau; Northfelt, Donald W; Sledge, George W; Partridge, Ann H

    2014-04-01

    This study aimed to investigate whether pre-chemotherapy anti-mullerian hormone (AMH) is a biomarker for chemotherapy-related amenorrhea (CRA) in breast cancer patients. A multicenter randomized controlled trial, ECOG5103, assigned patients with early stage breast cancer to standard doxorubicin-cyclophosphamide followed by paclitaxel with either placebo or one of two durations of bevacizumab therapy. Five hundred ninety-one patients were part of the decision-making/quality of life substudy, in which there were surveys from baseline through 18-month follow-up. One hundred twenty-four women were included in this analysis of menses data because they were premenopausal at enrollment, responded to the 12-month survey, had not undergone bilateral oophorectomy or ovarian function suppression before that survey, and had serum banked for research before chemotherapy. One hundred of the 124 also responded to the 18-month survey. Median age was 45 years (range 25-55), and median serum AMH level was 0.11 ng/mL (range 0.01-8.63) prior to treatment. Eighty-two percent had CRA at 12 months, and 81 % at 18 months. In multivariate analyses, older age (p = 0.0003) was the only statistically significant predictor of 12-month CRA, but at 18-months, lower pre-chemotherapy AMH (p = 0.04) and older age (p = 0.008) were both statistically significant predictors of CRA. Race, bevacizumab therapy, and tamoxifen use were not statistically significantly associated with CRA after adjustment for AMH and age. Pre-chemotherapy AMH level is a potential novel biomarker for CRA in premenopausal women with early stage breast cancer. Further research to evaluate the clinical utility of AMH testing is warranted.

  8. Intrauterine Exposure to Methylmercury and Neurocognitive Functions: Minamata Disease.

    Science.gov (United States)

    Yorifuji, Takashi; Kato, Tsuguhiko; Kado, Yoko; Tokinobu, Akiko; Yamakawa, Michiyo; Tsuda, Toshihide; Sanada, Satoshi

    2015-01-01

    A large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s. The severe intrauterine exposure cases are well known, although the possible impact of low-to-moderate methylmercury exposure in utero are rarely investigated. We examined neurocognitive functions among 22 participants in Minamata, mainly using an intelligence quotient test (Wechsler Adults Intelligent Scale III), in 2012/2013. The participants tended to score low on the Index score of processing speed (PS) relative to full-scale IQ, and discrepancies between PS and other scores within each participant were observed. The lower score on PS was due to deficits in digit symbol-coding and symbol search and was associated with methylmercury concentration in umbilical cords. The residents who experienced low-to-moderate methylmercury exposure including prenatal one in Minamata manifested deficits in their cognitive functions, processing speed in particular.

  9. Hashimoto's encephalopathy presenting with neurocognitive symptoms: a case report

    Directory of Open Access Journals (Sweden)

    Cuadra-Urteaga Jose

    2010-10-01

    Full Text Available Abstract Introduction Hashimoto's encephalopathy is a neurological disorder of unknown cause associated with thyroid autoimmunity. The disease occurs primarily in the fifth decade of life and may present in two types - a sudden vasculitic type or a progressive subacute type associated to cognitive dysfunction, confusion and memory loss. Case presentation We report the case of a 62-year-old Hispanic woman, previously healthy, who developed a subacute onset of declining upper brain function. Serologic studies demonstrated high levels of antithyroid antibodies. Electroencephalographic and magnetic resonance image findings were consistent with Hashimoto's encephalopathy. Conclusion Hashimoto's encephalopathy is a diagnosis of exclusion. This unusual disorder is often under-recognized because of the multiple and protracted neurocognitive manifestations; therefore, it is important to be aware of the clinical manifestations to make a correct diagnosis.

  10. Neurocognitive mechanisms of mathematical giftedness: A literature review.

    Science.gov (United States)

    Zhang, Li; Gan, John Q; Wang, Haixian

    2017-01-01

    Mathematically gifted children/adolescents have demonstrated exceptional abilities and traits in logical reasoning, mental imagery, and creative thinking. In the field of cognitive neuroscience, the past studies on mathematically gifted brains have concentrated on investigating event-related brain activation regions, cerebral laterality of cognitive functions, functional specialization that is uniquely dedicated for specific cognitive purposes, and functional interactions among discrete brain regions. From structural and functional perspectives, these studies have witnessed both "general" and "unique" neural characteristics of mathematically gifted brains. In this article, the theoretical background, empirical studies, and neurocognitive mechanisms of mathematically gifted children/adolescents are reviewed. Based on the integration of the findings, some potential directions for the future research are identified and discussed.

  11. Neurocognitive impairment in children and adolescents with systemic lupus erythematosus.

    Science.gov (United States)

    Levy, Deborah M; Ardoin, Stacy P; Schanberg, Laura E

    2009-02-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease, in which neuropsychiatric manifestations are a common cause of significant morbidity. The American College of Rheumatology has identified 19 distinct neuropsychiatric syndromes associated with SLE, although the 1982 American College of Rheumatology classification criteria for SLE recognize only two: seizures and psychosis. Neurocognitive impairment (NCI) is one of the most common and clinically challenging manifestations of SLE, but its pathophysiology remains poorly understood. This Review examines the epidemiology and pathophysiology of NCI in children and adolescents with SLE, as well as the diagnostic and therapeutic approaches that are available for these patients. As few published studies specifically address NCI in pediatric SLE, new directions for research are also discussed.

  12. Relationships between neurocognition, emotional processing and social functioning in schizophrenia

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    Paola Jaramillo

    2011-11-01

    Full Text Available A series of cognitive deficits in schizophrenia have led to a focus on neuro- and social cognition in current research and professional practice. These deficits have significant implications for social functioning. The aim of the current study is to analyse the relationships between neurocognition, social cognition (evaluated via emotional recognition tasks and social functioning. Sixty people diagnosed with schizophrenia made up the sample and the following areas were evaluated: executive functioning and cognitive flexibility, attention and vigilance, processing speed, emotion identification and discrimination and community functioning. Results indicate that measures of basic cognition correlate significantly with communal functioning while measures of emotion recognition, especially those identifying facial emotions only correlate positively with one area of communal functioning, namely that of communication and social contact.

  13. Exploring the factor structure of neurocognitive measures in older individuals.

    Science.gov (United States)

    Santos, Nadine Correia; Costa, Patrício Soares; Amorim, Liliana; Moreira, Pedro Silva; Cunha, Pedro; Cotter, Jorge; Sousa, Nuno

    2015-01-01

    Here we focus on factor analysis from a best practices point of view, by investigating the factor structure of neuropsychological tests and using the results obtained to illustrate on choosing a reasonable solution. The sample (n=1051 individuals) was randomly divided into two groups: one for exploratory factor analysis (EFA) and principal component analysis (PCA), to investigate the number of factors underlying the neurocognitive variables; the second to test the "best fit" model via confirmatory factor analysis (CFA). For the exploratory step, three extraction (maximum likelihood, principal axis factoring and principal components) and two rotation (orthogonal and oblique) methods were used. The analysis methodology allowed exploring how different cognitive/psychological tests correlated/discriminated between dimensions, indicating that to capture latent structures in similar sample sizes and measures, with approximately normal data distribution, reflective models with oblimin rotation might prove the most adequate.

  14. Neurocognitive Correlates of Apathy and Anxiety in Parkinson's Disease

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    Yelena Bogdanova

    2012-01-01

    Full Text Available Parkinson's disease (PD is associated with various nonmotor symptoms including neuropsychiatric and cognitive dysfunction. We examined the relation between apathy, anxiety, side of onset of motor symptoms, and cognition in PD. We hypothesized that PD patients would show different neuropsychiatric and neurocognitive profiles depending on the side of onset. 22 nondemented PD patients (11 right-side onset (RPD with predominant left-hemisphere pathology, and 11 LPD and 22 matched healthy controls (NC were administered rating scales assessing apathy and anxiety, and a series of neuropsychological tests. PD patients showed a higher anxiety level than NC. There was a significant association between apathy, anxiety, and disease duration. In LPD, apathy but not anxiety was associated with performance on nonverbally mediated executive function and visuospatial measures, whereas, in RPD, anxiety but not apathy correlated with performance on verbally mediated tasks. Our findings demonstrated a differential association of apathy and anxiety to cognition in PD.

  15. Exercise Modality Is Differentially Associated with Neurocognition in Older Adults

    Directory of Open Access Journals (Sweden)

    Yu-Kai Chang

    2017-01-01

    Full Text Available This study explored the effects of exercise modality and type of fitness index on cognitive function in the older adults as assessed via behavioral and neuroelectrical approaches. Sixty older adults were assigned to an aerobic exercise, a coordination exercise, or a control group based on their previous exercise experience. The participants completed congruent and incongruent trials of a modified Stroop Test, during which, event-related potentials were recorded. The participants also completed multiple physical tests that assessed health- and skill-related fitness. Our findings suggest that, in general, both aerobic and coordination exercise, as well as higher scores on health- and skill-related fitness indices, are positively associated with better performance of various cognitive functions in the elderly population. The mechanisms underlying these relationships may be differentially related to specific neuroelectrical processes involved in neurocognitive control.

  16. Exploring the factor structure of neurocognitive measures in older individuals.

    Directory of Open Access Journals (Sweden)

    Nadine Correia Santos

    Full Text Available Here we focus on factor analysis from a best practices point of view, by investigating the factor structure of neuropsychological tests and using the results obtained to illustrate on choosing a reasonable solution. The sample (n=1051 individuals was randomly divided into two groups: one for exploratory factor analysis (EFA and principal component analysis (PCA, to investigate the number of factors underlying the neurocognitive variables; the second to test the "best fit" model via confirmatory factor analysis (CFA. For the exploratory step, three extraction (maximum likelihood, principal axis factoring and principal components and two rotation (orthogonal and oblique methods were used. The analysis methodology allowed exploring how different cognitive/psychological tests correlated/discriminated between dimensions, indicating that to capture latent structures in similar sample sizes and measures, with approximately normal data distribution, reflective models with oblimin rotation might prove the most adequate.

  17. Creative thinking deficits in patients with schizophrenia: neurocognitive correlates.

    Science.gov (United States)

    Jaracz, Jan; Patrzała, Amelia; Rybakowski, Janusz K

    2012-07-01

    The aim of this study was to investigate selected measures of creativity in schizophrenic patients and their relationship with neurocognitive executive functions Forty-three inpatients with paranoid schizophrenia who were in symptomatic remission (a total of 60) and 45 healthy control participants were included. Creativity was assessed using the Barron-Welsh Art Scale (BWAS) and the inventiveness part of the Berlin Intelligence Structure Test (BIS). Executive functions were measured by means of the Wisconsin Card Sorting Test (WCST). Schizophrenic patients gave responses on the BWAS, had lower total score on the BIS and in the figural test, and performed worse on all domains of the WCST compared with control subjects. Their lower scores on the BIS correlated with lower scores on the WCST. Our results indicate that remitted schizophrenic patients perform worse on selected measures of creativity than healthy subjects and that executive dysfunctions may partially explain these deficits.

  18. The Clinical Relevance of Neurocognitive Measures in Addiction

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    Reshmi eMarhe

    2014-01-01

    Full Text Available One of the major challenges in addiction treatment is relapse prevention, as rates of relapse following treatment remain very high across the main classes of drugs of abuse. Relapse prevention could be improved by a better understanding of the factors that influence treatment outcomes, including better predictors of risk of relapse following treatment. Recent developments in cognitive neuroscience point to neurocognitive measures (i.e., brain-imaging measures during cognitive task performance as potential predictors of relapse. These might even be better predictors than self-report measures, such as craving. We first give an overview of the current state of the field, and then discuss the outstanding challenges and future directions in this area of research.

  19. Mathematics intervention for prevention of neurocognitive deficits in childhood leukemia.

    Science.gov (United States)

    Moore, Ida M; Hockenberry, Marilyn J; Anhalt, Cynthia; McCarthy, Kathy; Krull, Kevin R

    2012-08-01

    Despite evidence that CNS treatment is associated with cognitive and academic impairment, interventions to prevent or mitigate these problems are limited. The purpose was to determine if early intervention can prevent declines in mathematics abilities. Fifty-seven children with ALL were enrolled and randomized to a Mathematics Intervention or Standard Care. Subjects completed neurocognitive assessments prior to the intervention, post-intervention, and 1 year later. Parents received written results and recommendations for use with their school. The Mathematics Intervention was based on Multiple Representation Theory and delivered individually over 1 year. Thirty-two of 57 subjects completed the study and were included in data analyses. These 32 subjects completed all neurocognitive assessments and, for those in the Intervention Group, 40-50 hours of the Mathematics Intervention. There were no group differences on relevant demographic variables; risk stratification; number of intrathecal methotrexate injections; or high dose systemic methotrexate. Significant improvements in calculation and applied mathematics from Baseline to Post-Intervention (P = 0.003 and 0.002, respectively) and in visual working memory from Baseline to 1 year Follow-up (P = 0.02) were observed in the Intervention but not the Standard Care Group. Results from repeated measures ANOVA demonstrated significant between group differences for applied mathematics [F(2,29) = 12.47, P Mathematics Intervention improved mathematics abilities and visual working memory compared to standard care. Future studies are needed to translate the Mathematics Intervention into a "virtual" delivery method more readily available to parents and children. Copyright © 2011 Wiley Periodicals, Inc.

  20. A telehealth behavioral coaching intervention for neurocognitive disorder family carers

    Science.gov (United States)

    Gant, Judith R.

    2015-01-01

    Objectives This study examined the differential impact of two telehealth programs for women caring for an older adult with a neurocognitive disorder. Outcomes examined were depressive symptoms, upset following disruptive behaviors, anxious and angry mood states, and caregiving self‐efficacy. Methods Women cohabitating with a family member diagnosed with a neurocognitive disorder were assigned via random allocation to either of the following: (1) a 14‐week behavioral intervention using video instructional materials, workbook and telephone coaching in behavioral management, pleasant events scheduling, and relaxation or (2) a basic education guide and telephone support comparison condition. Telephone assessments were conducted by interviewers blind to treatment condition at pre‐intervention, post‐intervention, and 6 months following intervention. Results For those providing in‐home care at post‐treatment, depressive symptoms, upset following disruptive behaviors, and negative mood states were statistically lower in the behavioral coaching condition than in the basic education and support condition. Reliable change index analyses for Beck Depression Inventory II scores favored the behavioral coaching condition. Caregiving self‐efficacy scores for obtaining respite and for managing patient behavioral disturbances were significantly higher in the coaching condition. Effect sizes were moderate but not maintained at the 6‐month follow‐up. Conclusions This study provides some initial evidence for the efficacy of a telehealth behavioral coaching intervention compared with basic education and telephone support. Carers' abilities to maintain strategy use during progressive disorders such as Alzheimer's disease likely require longer intervention contact than provided in the current study. Dementia carers, including those living in rural areas, can benefit from accessible and empirically supported interventions that can be easily disseminated across distances

  1. [Neurocognitive markers of suicide vulnerability in the elderly: a review].

    Science.gov (United States)

    Richard-Devantoy, Stéphane; Jollant, Fabrice; Deguigne, Florence; Letourneau, Geneviève

    2013-12-01

    a comprehensive literature review suggests that suicidal behaviour results from a complex interplay between stressful events and vulnerability factors including cognitive deficits. The aim of this systematic literature review was to identify the neurocognitive markers associated with suicide vulnerability in elderly people. a systematic English Medline literature search of cohort studies, case-control studies and cross-sectional studies published between January 1960 and December 2012 was performed, combining the MeSH terms "Suicide", "Neuropsychology", "Neuropsychological Tests", "Executive Function", "Magnetic Resonance Imaging", "Diffusion Magnetic Resonance Imaging", "Positron-Emission Tomography", "Prefrontal Cortex", "Tomography, Emission-Computed, Single-Photon", and "Diffusion Tensor Imaging". The abstract selection was based on the Strobe checklist for observational studies. of the 446 original articles, 10 neuropsychological and 4 brain imaging studies were selected. The number of suicidal subjects ranged from 10 to 29 (mean age=66.8 to 79.1 years old, 0-85% women). Executive functions, in particular decision-making and cognitive inhibition, were more impaired in the depressed elderly with a history of suicide attempts compared to those without such a history. fMRI data, which need to be confirmed in further details, showed abnormalities of fronto-limbic circuits which are involved in suicide vulnerability in the elderly independently of any associated psychopathological conditions including depression. this literature review confirms the existence of neurocognitive markers of suicide vulnerability in elderly people. A neuropsychological assessment could thus help to identify the suicide vulnerability of a depressed elderly person, a first step for both pharmacological and psychotherapeutic cares.

  2. Neurocognitive impairment in the deficit subtype of schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Agid, Ofer; Foussias, George; Siddiqui, Ishraq; Takeuchi, Hiroyoshi; Remington, Gary

    2016-08-01

    Schizophrenia is a heterogeneous disorder characterized by numerous diverse signs and symptoms. Individuals with prominent, persistent, and idiopathic negative symptoms are thought to encompass a distinct subtype of schizophrenia. Previous work, including studies involving neuropsychological evaluations, has supported this position. The present study sought to further examine whether deficit patients are cognitively distinct from non-deficit patients with schizophrenia. A comprehensive neurocognitive battery including tests of verbal memory, vigilance, processing speed, reasoning, and working memory was administered to 657 patients with schizophrenia. Of these, 144 (22 %) patients were classified as deficit patients using a proxy identification method based on severity, persistence over time, and possible secondary sources (e.g., depression) of negative symptoms. Deficit patients with schizophrenia performed worse on all tests of cognition relative to non-deficit patients. These patients were characterized by a generalized cognitive impairment on the order of about 0.4 standard deviations below that of non-deficit patients. However, when comparing deficit patients to non-deficit patients who also present with negative symptoms, albeit not enduring or primary, no group differences in cognitive performance were found. Furthermore, a discriminant function analysis classifying patients into deficit/non-deficit groups based on cognitive scores demonstrated only 62.3 % accuracy, meaning over one-third of individuals were misclassified. The deficit subtype of schizophrenia is not markedly distinct from non-deficit schizophrenia in terms of neurocognitive performance. While deficit patients tend to have poorer performance on cognitive tests, the magnitude of this effect is relatively modest, translating to over 70 % overlap in scores between groups.

  3. Neurocognitive systems related to real-world prospective memory.

    Directory of Open Access Journals (Sweden)

    Grégoria Kalpouzos

    Full Text Available BACKGROUND: Prospective memory (PM denotes the ability to remember to perform actions in the future. It has been argued that standard laboratory paradigms fail to capture core aspects of PM. METHODOLOGY/PRINCIPAL FINDINGS: We combined functional MRI, virtual reality, eye-tracking and verbal reports to explore the dynamic allocation of neurocognitive processes during a naturalistic PM task where individuals performed errands in a realistic model of their residential town. Based on eye movement data and verbal reports, we modeled PM as an iterative loop of five sustained and transient phases: intention maintenance before target detection (TD, TD, intention maintenance after TD, action, and switching, the latter representing the activation of a new intention in mind. The fMRI analyses revealed continuous engagement of a top-down fronto-parietal network throughout the entire task, likely subserving goal maintenance in mind. In addition, a shift was observed from a perceptual (occipital system while searching for places to go, to a mnemonic (temporo-parietal, fronto-hippocampal system for remembering what actions to perform after TD. Updating of the top-down fronto-parietal network occurred at both TD and switching, the latter likely also being characterized by frontopolar activity. CONCLUSION/SIGNIFICANCE: Taken together, these findings show how brain systems complementary interact during real-world PM, and support a more complete model of PM that can be applied to naturalistic PM tasks and that we named PROspective MEmory DYnamic (PROMEDY model because of its dynamics on both multi-phase iteration and the interactions of distinct neurocognitive networks.

  4. A telehealth behavioral coaching intervention for neurocognitive disorder family carers.

    Science.gov (United States)

    Steffen, Ann M; Gant, Judith R

    2016-02-01

    This study examined the differential impact of two telehealth programs for women caring for an older adult with a neurocognitive disorder. Outcomes examined were depressive symptoms, upset following disruptive behaviors, anxious and angry mood states, and caregiving self-efficacy. Women cohabitating with a family member diagnosed with a neurocognitive disorder were assigned via random allocation to either of the following: (1) a 14-week behavioral intervention using video instructional materials, workbook and telephone coaching in behavioral management, pleasant events scheduling, and relaxation or (2) a basic education guide and telephone support comparison condition. Telephone assessments were conducted by interviewers blind to treatment condition at pre-intervention, post-intervention, and 6 months following intervention. For those providing in-home care at post-treatment, depressive symptoms, upset following disruptive behaviors, and negative mood states were statistically lower in the behavioral coaching condition than in the basic education and support condition. Reliable change index analyses for Beck Depression Inventory II scores favored the behavioral coaching condition. Caregiving self-efficacy scores for obtaining respite and for managing patient behavioral disturbances were significantly higher in the coaching condition. Effect sizes were moderate but not maintained at the 6-month follow-up. This study provides some initial evidence for the efficacy of a telehealth behavioral coaching intervention compared with basic education and telephone support. Carers' abilities to maintain strategy use during progressive disorders such as Alzheimer's disease likely require longer intervention contact than provided in the current study. Dementia carers, including those living in rural areas, can benefit from accessible and empirically supported interventions that can be easily disseminated across distances at modest cost. © 2015 The Authors. International

  5. Intra-individual Neurocognitive Variability Confers Risk of Dependence in Activities of Daily Living among HIV-Seropositive Individuals without HIV-Associated Neurocognitive Disorders

    Science.gov (United States)

    Morgan, Erin E.; Woods, Steven Paul; Grant, Igor

    2012-01-01

    Although HIV-associated neurocognitive disorders (HAND) are the strong predictors of everyday functioning difficulties, approximately half of all functionally impaired individuals are labeled “neurocognitively normal” according to the standard neuropsychological measures, suggesting that novel predictors of functional problems in this prevalent subgroup are needed. The present study hypothesized that increased neurocognitive intra-individual variability as indexed by dispersion would be associated with poor daily functioning among 82 persons with HIV infection who did not meet research criteria for HAND. An intra-individual standard deviation was calculated across the demographically adjusted T-scores of 13 standard neuropsychological tests to represent dispersion, and functional outcomes included self-reported declines in basic and instrumental activities of daily functioning (basic activity of daily living [BADL] and instrumental activity of daily living [IADL], respectively) and medication management. Dispersion was a significant predictor of medication adherence and dependence in both BADL and IADL, even when other known predictors of functional status (i.e., age, affective distress, and indices of disease severity) were included in the models. As a significant and unique predictor of a performance on the range of daily functioning activities, neurocognitive dispersion may be indicative of deficient cognitive control expressed as inefficient regulation of neurocognitive resources in the context of competing functional demands. As such, dispersion may have clinical utility in detecting risk for functional problems among HIV-infected individuals without HAND. PMID:22337933

  6. Analysis of professor ZHOU Ming-xin's treatment strategies about amenorrhea%周铭心教授辨治闭经方略分析

    Institute of Scientific and Technical Information of China (English)

    伍镝; 周铭心

    2013-01-01

    周铭心教授是国家级名老中医,中医临床经验丰富.周教授认识到闭经基本病机可分为血虚及血瘀两端,郁火积热也是闭经的另一重要病机,因病情的复杂性,临证需辨证认识虚瘀的关系;在治疗方法上通过“达冲”、“注冲”两种方法有层次的安排,观察病情“应”与“不应”,再采取相应的“达冲”与“注冲”的治疗方法;在用药方面,根据既往经验预先配伍治疗闭经有效的单元药组,临证时根据病情变化将这些单元药组联缀组方.策略得当,疗效满意.%Professor ZHOU Ming-xin is a prominent doctors of traditional Chinese medicine with rich clinical experience. Professor Zhou recognizes basic pathogenesis of amenorrhea can be divided into two sides: blood deficiency and blood stasis, in addition stagnated fire is also another important pathogenesis of amenorrhea. Due to complexity of disease, it is necessary to dialectical understand of the relationship of blood deficiency and blood stasis. Through the two treatment methods of ' Dredging Chong Vessel' and ' Irrigating Chong Vessel' with arrangement in sequence, disease improvement can be observed, then according to the result of observation, the two treatment methods above can be further used. Effective unit medicine groups, based on previous experience in treatment of amenorrhea, are connected and form TCM Prescription according to disease changes, the proper strategy curatives effect satisfaction.

  7. Neurocognition and quality of life after reinitiating antiretroviral therapy in children randomized to planned treatment interruption

    NARCIS (Netherlands)

    Ananworanich, J.; Melvin, D.; Amador, J.T.; Childs, T.; Medin, G.; Boscolo, V.; Compagnucci, A.; Kanjanavanit, S.; Montero, S.; Gibb, D.M.; Burger, D.M.; Groot, R. de

    2016-01-01

    OBJECTIVE: Understanding the effects of antiretroviral treatment (ART) interruption on neurocognition and quality of life (QoL) are important for managing unplanned interruptions and planned interruptions in HIV cure research. DESIGN: Children previously randomized to continuous (continuous ART, n =

  8. Neurocognitive performance in children and adolescents with bipolar disorder: a review.

    Science.gov (United States)

    Horn, Karin; Roessner, Veit; Holtmann, Martin

    2011-09-01

    A number of studies have reported the evidence of cognitive deficits in adult bipolar patients. Recently, there has been a shift in research on neurocognitive performance in bipolar disorder (BD) towards examining younger age groups. A review of the literature on neurocognitive impairments in BD in childhood and adolescence was conducted. We searched systematically for studies in samples of age groups younger than 18 years of age in average that included either a healthy control group or normative data for the cognitive tests used. Twenty-one original articles were found and reviewed. Children and adolescents with BD show deficits in a variety of cognitive areas. The most consistent results were found for impairments in verbal memory. A majority of studies also indicated impairments in working memory. Similar pattern of neurocognitive impairment was found in children and adolescents as compared to adults suffering from BD. The neurocognitive deficits need to be recognized and incorporated into individual treatment programs.

  9. Relationship between HIV stage and psychomotor speed neurocognitive score at a Kenyan sub-county hospital

    National Research Council Canada - National Science Library

    Kinuthia, Rachael N; Gakinya, Benson N; Thigiti, Joseph M

    2016-01-01

    .... The purpose of this study was to assess the relationship between HIV disease stage and psychomotor speed neurocognitive score which will add to the body of knowledge required to manage patients with HIV and AIDS...

  10. Historical Perspectives on Ancient Greek Derived "a" Prefixed Nomenclature for Acquired Neurocognitive Impairment.

    Science.gov (United States)

    Gasquoine, Philip Gerard

    2017-06-01

    Distinct forms of acquired neurocognitive impairment are often described by "a" prefixed terms that derive from ancient Greek (and in one case Latin). Two modern English language neurological and neuropsychological reference books were searched to identify 17 such terms in contemporary usage: amnesia, akinesia, ataxia, aphasia, agraphia, anosmia, apraxia, athetosis, ageusia, achromatopsia, agnosia, alexia, amusia, anomia, anarthria, anosognosia, and acalculia. These were traced to their initial association with acquired neurocognitive impairment in German, English, and French language medical publications from the late 18th, 19th, and early 20th centuries (1770 through 1920). Some of these terms (e.g., agnosia) were used in ancient Greek, although not associated with neurocognitive impairment. The remainder constitute novel semantically plausible (e.g., anosmia) and unclear (e.g., alexia) formulations. In the localizationist thinking of the time, neurocognition was conceived as being organized within specialized "centers" in specific locations connected by pathways within the brain.

  11. Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment

    NARCIS (Netherlands)

    Schulte, M.H.J.; Cousijn, J.; den Uyl, T.E.; Goudriaan, A.E.; van den Brink, W.; Veltman, D.J.; Schilt, T.; Wiers, R.W.

    2014-01-01

    Background: Substance Use Disorders (SUDs) have been associated with impaired neurocognitive functioning, which may (partly) improve with sustained abstinence. New treatments are emerging, aimed at improving cognitive functions, and being tested. However, no integrated review is available regarding

  12. Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment

    NARCIS (Netherlands)

    Schulte, Mieke H J; Cousijn, Janna; den Uyl, Tess E; Goudriaan, Anna E; van den Brink, Wim; Veltman, Dick J; Schilt, Thelma; Wiers, Reinout W

    2014-01-01

    BACKGROUND: Substance Use Disorders (SUDs) have been associated with impaired neurocognitive functioning, which may (partly) improve with sustained abstinence. New treatments are emerging, aimed at improving cognitive functions, and being tested. However, no integrated review is available regarding

  13. The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder

    OpenAIRE

    Nijdam, Mirjam J.; Gersons, Berthold P R; Olff, Miranda

    2013-01-01

    Background: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) frequently co-occur after traumatic experiences and share neurocognitive disturbances in verbal memory and executive functioning. However, few attempts have been made to systematically assess the role of a comorbid MDD diagnosis in neuropsychological studies in PTSD.Objective: The purpose of the current study is to investigate neurocognitive deficits in PTSD patients with and without MDD. We hypothesized that...

  14. Neurocognitive function in acromegaly after surgical resection of GH-secreting adenoma versus naive acromegaly.

    Directory of Open Access Journals (Sweden)

    Juan Francisco Martín-Rodríguez

    Full Text Available Patients with active untreated acromegaly show mild to moderate neurocognitive disorders that are associated to chronic exposure to growth hormone (GH and insulin-like growth factor (IGF-I hypersecretion. However, it is unknown whether these disorders improve after controlling GH/IGF-I hypersecretion. The aim of this study was to compare neurocognitive functions of patients who successfully underwent GH-secreting adenoma transsphenoidal surgery (cured patients with patients with naive acromegaly. In addition, we wanted to determine the impact of different clinical and biochemical variables on neurocognitive status in patients with active disease and after long-term cure. A battery of six standardized neuropsychological tests assessed attention, memory and executive functioning. In addition, a quantitative electroencephalography with Low-Resolution Electromagnetic Tomography (LORETA solution was performed to obtain information about the neurophysiological state of the patients. Neurocognitive data was compared to that of a healthy control group. Multiple linear regression analysis was also conducted using clinical and hormonal parameters to obtain a set of independent predictors of neurocognitive state before and after cure. Both groups of patients scored significantly poorer than the healthy controls on memory tests, especially those assessing visual and verbal recall. Patients with cured acromegaly did not obtain better cognitive measures than naïve patients. Furthermore memory deficits were associated with decreased beta activity in left medial temporal cortex in both groups of patients. Regression analysis showed longer duration of untreated acromegaly was associated with more severe neurocognitive complications, regardless of the diagnostic group, whereas GH levels at the time of assessment was related to neurocognitive outcome only in naïve patients. Longer duration of post-operative biochemical remission of acromegaly was associated with

  15. A Turner syndrome neurocognitive phenotype maps to Xp22.3

    Directory of Open Access Journals (Sweden)

    Elder Frederick F

    2007-05-01

    Full Text Available Abstract Background Turner syndrome (TS is associated with a neurocognitive phenotype that includes selective nonverbal deficits, e.g., impaired visual-spatial abilities. We previously reported evidence that this phenotype results from haploinsufficiency of one or more genes on distal Xp. This inference was based on genotype/phenotype comparisons of individual girls and women with partial Xp deletions, with the neurocognitive phenotype considered a dichotomous trait. We sought to confirm our findings in a large cohort (n = 47 of adult women with partial deletions of Xp or Xq, enriched for subjects with distal Xp deletions. Methods Subjects were recruited from North American genetics and endocrinology clinics. Phenotype assessment included measures of stature, ovarian function, and detailed neurocognitive testing. The neurocognitive phenotype was measured as a quantitative trait, the Turner Syndrome Cognitive Summary (TSCS score, derived from discriminant function analysis. Genetic analysis included karyotyping, X inactivation studies, fluorescent in situ hybridization, microsatellite marker genotyping, and array comparative genomic hybridization. Results We report statistical evidence that deletion of Xp22.3, an interval containing 31 annotated genes, is sufficient to cause the neurocognitive phenotype described by the TSCS score. Two other cardinal TS features, ovarian failure and short stature, as well as X chromosome inactivation pattern and subject's age, were unrelated to the TSCS score. Conclusion Detailed mapping suggests that haploinsufficiency of one or more genes in Xp22.3, the distal 8.3 megabases (Mb of the X chromosome, is responsible for a TS neurocognitive phenotype. This interval includes the 2.6 Mb Xp-Yp pseudoautosomal region (PAR1. Haploinsufficiency of the short stature gene SHOX in PAR1 probably does not cause this TS neurocognitive phenotype. Two genes proximal to PAR1 within the 8.3 Mb critical region, STS and NLGN4X, are

  16. Elementary Neurocognitive Function, Facial Affect Recognition and Social-skills in Schizophrenia

    OpenAIRE

    Meyer, Melissa B.; Kurtz, Matthew M.

    2009-01-01

    Social-skill deficits are pervasive in schizophrenia and negatively impact many key aspects of functioning. Prior studies have found that measures of elementary neurocognition and social cognition are related to social-skills. In the present study we selected a range of neurocognitive measures and examined their relationship with identification of happy and sad faces and performance-based social-skills. Fifty-three patients with schizophrenia or schizoaffective disorder participated. Results ...

  17. Sleep, stress, neurocognitive profile and healthrelated quality of life in adolescents with idiopathic musculoskeletal pain

    OpenAIRE

    Juliana Molina; Flávia Heloísa Dos Santos; Terreri,Maria Teresa R. A.; Melissa Mariti Fraga; Simone Guerra Silva; Hilário,Maria Odete E.; Len, Claudio A. [UNIFESP

    2012-01-01

    OBJECTIVES: The aims of this study were to measure levels of sleep, stress, and depression, as well as health-related quality of life, and to assess the neurocognitive profiles in a sample of adolescents with idiopathic musculoskeletal pain. METHODS: Nineteen adolescents with idiopathic musculoskeletal pain and 20 age-matched healthy control subjects were evaluated regarding their levels of sleep and stress, as well as quality of life, and underwent neurocognitive testing. RESULTS: The sample...

  18. The relation between neurocognition and symptomatology in people with schizophrenia: social cognition as the mediator

    OpenAIRE

    Lam, Bess YH; Raine, Adrian; Lee, Tatia MC

    2014-01-01

    BACKGROUND: The relationship between neurocognition and symptomatology in people with schizophrenia has been established. The present study examined whether social cognition could mediate this relationship. METHODS: There were 119 participants (58 people with paranoid schizophrenia and 61 healthy controls) participated in this study. Neurocognition was assessed by Raven's Progressive Matrices Test, the Judgment of Line Orientation Test, and the Tower of London Test. Psychiatric symptoms in pe...

  19. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence?

    OpenAIRE

    Gisslén Magnus; Price Richard W; Nilsson Staffan

    2011-01-01

    Abstract Background A substantial prevalence of mild neurocognitive disorders has been reported in HIV, also in patients treated with combination antiretroviral therapy (cART). This includes a new disorder that has been termed asymptomatic neurocognitive impairment (ANI). Discussion ANI is identified by performance on formal neuropsychological testing that is at least 1 SD below the mean of normative scores in at least two cognitive domains out of at least five examined in patients without as...

  20. The Relationship Between Neurocognitive Functioning and Occupational Functioning in Bipolar Disorder: A Literature Review

    Directory of Open Access Journals (Sweden)

    Walace Duarte

    2016-11-01

    Full Text Available Neurocognitive impairment in Bipolar Disorder (BD has been widely reported, even during remission. Neurocognitive impairment has been identified as a contributing factor towards unfavourable psychosocial functioning within this population. The objective of this review was to investigate the association between neurocognitive impairment and occupational functioning in BD. A literature review of English-language journal articles from January 1990 to November 2013 was undertaken utilising the PsychINFO, Scopus and Web of Knowledge databases. Studies that made specific reference to occupational outcomes were included, and those that reported on global psychosocial measures were excluded. Majority of the papers reviewed (20 out of 23 identified an association between neurocognitive impairment (particularly in executive functioning, verbal learning and memory, processing speed and attention and occupational functioning. Several methodological issues were identified. There was a discrepancy in the measures used to assess neurocognitive function across studies and also the definition and measurement of occupational functioning. The clinical features of the samples varied across studies, and confounding variables were intermittently controlled. The review focused on English-language papers only and hence there is a bias toward the Western labour market. These limitations therefore influence the generalizability of the interpreted findings and the reliability of comparisons across studies. Neurocognitive impairment in BD appears to play a role in occupational outcomes. The findings of this review highlight the challenges for future research in this area, particularly in the measurement of neurocognitive and occupational functioning. Incorporating neurocognitive interventions in the treatment of BD, which has traditionally focussed solely on symptomatic recovery, may advance the vocational rehabilitation of these patients.

  1. Genetic screening for infertility: When should it be done?

    Directory of Open Access Journals (Sweden)

    Elda Kara

    2010-07-01

    Primary amenorrhea should be investigated by karyotype analysis and selected mutation screening according to the patient's clinical features. Karyotype analyses and FMR1 gene screening is recommended in cases of POF. At present the infertility of patients with POF cannot be restored if the diagnosis is made after complete follicular depletion, but in some cases, early diagnosis by genetic investigation may instead lead to the advice of early conception or oocyte harvesting and preservation. In addition, the accumulation and annotation of array comparative genomic hybridization data might, in the near future, lead to the identification of pathogenetic copy number variations and genes involved in POF. Karyotype analysis of both partners is recommended in all couples with recurrent pregnancy loss. No routine genetic test can be recommended so far in patients with PCOS.

  2. Neurocognitive deficits in children and adolescents following maltreatment: Neurodevelopmental consequences and neuropsychological implications of traumatic stress.

    Science.gov (United States)

    Kavanaugh, Brian C; Dupont-Frechette, Jennifer A; Jerskey, Beth A; Holler, Karen A

    2017-01-01

    Childhood maltreatment is a significant risk factor for a host of psychiatric, developmental, medical, and neurocognitive conditions, often resulting in debilitating and long-term consequences. However, there is no available neuropsychological resource reviewing the literature on the associated neurocognitive deficits in children and adolescents. This review comprehensively examines the 23 prior studies that evaluated the intellectual, language, visual-spatial, memory, motor, and/or attention/executive functions in children and adolescents following an experience of childhood abuse and/or neglect. Neurocognitive impairments were frequently reported. Impairments in executive functions were the most frequent and severe reported impairments, although intelligence, language, visual-spatial skills, and memory are also at serious risk for compromised development following maltreatment. However, specific factors such as abuse/neglect duration, severity, type, and timing during development were all associated with neurocognition. This indicates that these factors are of greater importance than just the presence of abuse/neglect in identifying risk for neurocognitive compromise. Such neurocognitive deficits appear to be a consequence to the known neurobiological and brain development abnormalities of this population, suggesting traumatic stress can be a potential cause of neurodevelopmental disorders. These findings have critical implications for the clinical practice and research involving children following childhood maltreatment and other types of traumatic stress.

  3. Neuropathologic confirmation of definitional criteria for human immunodeficiency virus-associated neurocognitive disorders.

    Science.gov (United States)

    Cherner, Mariana; Cysique, Lucette; Heaton, Robert K; Marcotte, Thomas D; Ellis, Ronald J; Masliah, Eliezer; Grant, Igor

    2007-01-01

    Research findings have suggested a need for modifications to the original nomenclature for human immunodeficiency virus (HIV)-associated neurocognitive disorders issued in 1991 by the American Academy of Neurology (AAN). The HIV Neurobehavioral Research Center (HNRC) proposed a diagnostic scheme that departs from the AAN 1991 criteria primarily in the inclusion of an asymptomatic neurocognitive impairment (ANI) category that relies on cognitive disturbances as a necessary criterion for diagnosis, without requiring declines in daily functioning, motor, or other behavioral abnormalities. In order to test the predictive validity of these two nomenclatures, the authors compared the correspondence between antemortem neurocognitive diagnoses resulting from AAN and HNRC criteria to a neuropathological diagnosis of HIV encephalitis (HIVE) made at autopsy. Agreement between the two sets of definitional criteria was 79% regarding the classification of cases as either neurocognitively normal or impaired, and 54% with regard to specific neurocognitive diagnoses. When pathological evidence of HIVE was considered as the external indicator of HIV-related brain involvement, 64% of cases were correctly classified by AAN criteria, compared to 72% by HNRC criteria. HNRC criteria had better positive predictive power (95% versus 88%), sensitivity (67% versus 56%), and specificity (92% versus 83%). Three cases with HIVE and were correctly identified by HNRC criteria for ANI but called normal by AAN criteria, supporting inclusion of an asymptomatic neurocognitive condition. The modifications to the AAN 1991 criteria proposed by the HNRC and others in the field have served as a point of departure for a recently revised consensus nomenclature.

  4. Significance of luteinizing hormone in the diagnosis of secondary amenorrhea%促黄体生成激素水平诊断继发性闭经的意义

    Institute of Scientific and Technical Information of China (English)

    刘菲; 王承伟

    2013-01-01

    Objective: To observe the differences of changes of luteinizing hormone (LH), follicle -stimulating hormone (FSH) and prolactin (PRL) levels in patients with secondary amenorrhea, normal women, women with amenorrhea during gestational period, and postmenopausal women, and analyze the relationship between changes of hormones and secondary amenorrhea. Methods: The normal women, women with amenorrhea during gestational period, patients with secondary amenorrhea, and postmenopausal women were selected as study objects, then the women in secondary amenorrhea group and postmenopausal group were divided into FSH >40 mIU/ml subgroup, FSH 25 mIU/ml subgroup, and LH 25 mTU/ml subgroup of secondary amenorrhea group were higher than those in postmenopausal group. Conclusion: Abnormal increase of LH is a pointcut to diagnose, study, and treat secondary amenorrhea.%目的:观察继发性闭经患者、正常对照人群、孕期闭经人群和绝经期人群促卯泡成熟激素(FSH)、促黄体生成激素(LH)和催乳素(PRL)水平变化的差异,分析激素变化与继发性闭经之间的关系.方法:以正常对照人群、孕期闭经人群、继发性闭经人群和绝经期人群为研究对象,将继发性闭经组和绝经组的FSH和LH激素水平按FSH> 40 mIU/ml、FSH<5 mIU/ml、LH> 25 mIU/ml和LH <5 mIU/ml分为4个亚组,分析其FSH和LH激素水平差异.结果:继发性闭经组和绝经组的FSH和LH激素水平显著高于正常对照组和孕期闭经组,而PRL激素水平与正常对照组无显著性差异.继发性闭经人群LH>25 mIU/ml亚组的激素水平显著高于绝经期人群.结论:LH异常升高是诊断、研究和治疗继发性闭经的切入点.

  5. A literature review on Study’s methodology of nursing care for Patients with schizophrenia considering their neurocognitive functions

    Directory of Open Access Journals (Sweden)

    Yusuke Kurebayashi

    2016-04-01

    Full Text Available INTRODUCTION; Cognitive dysfunctions of schizophrenia predict daily living problems in patients, and psychiatric nurses should consider neurocognitive abilities of schizophrenic patients. However, development of nursing care considering their neurocognitive function is remains preliminary. To facilitate the development, clarifying the methodology of recent studies is required. AIM; To clarify the methodology of the study of nursing care considering neurocognitive functions of schizophrenic patients and to obtain suggestions for further studies. METHOD; Electronic databases were searched using key terms. RESULTS; Nine articles were eligible. Seven articles discussed enhancing neurocognitive functions and only investigated inpatients. The measurement methods used to determine neurocognitive functions varied among the nine articles. Some articles introduced video games or dedicated rooms, while some used structured methods as nursing intervention. DISCUSSION; Future studies are required to use methods that measure several neurocognitive domains, examine intervention efficacy in outpatients and first-episode patients and develop feasible interventional methods in clinical settings.

  6. Ovulation induction with pulsatile gonadotropin-releasing hormone (GnRH) or gonadotropins in a case of hypothalamic amenorrhea and diabetes insipidus.

    Science.gov (United States)

    Georgopoulos, N A; Markou, K B; Pappas, A P; Protonatariou, A; Vagenakis, G A; Sykiotis, G P; Dimopoulos, P A; Tzingounis, V A

    2001-12-01

    Hypothalamic amenorrhea is a treatable cause of infertility. Our patient was presented with secondary amenorrhea and diabetes insipidus. Cortisol and prolactin responded normally to a combined insulin tolerance test (ITT) and thyrotropin-releasing hormone (TRH) challenge, while thyroid-stimulating hormone (TSH) response to TRH was diminished, and no response of growth hormone to ITT was detected. Both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels increased following gonadotropin-releasing hormone (GnRH) challenge. No response of LH to clomiphene citrate challenge was detected. Magnetic resonance imaging findings demonstrated a midline mass occupying the inferior hypothalamus, with posterior lobe not visible and thickened pituitary stalk. Ovulation induction was carried out first with combined human menopausal gonadotropins (hMG/LH/FSH) (150 IU/day) and afterwards with pulsatile GnRH (150 ng/kg/pulse). Ovulation was achieved with both pulsatile GnRH and combine gonadotropin therapy. Slightly better results were achieved with the pulsatile GnRH treatment.

  7. Prevalence of X-aneuploidies, X-structural abnormalities and 46,XY sex reversal in Turkish women with primary amenorrhea or premature ovarian insufficiency.

    Science.gov (United States)

    Geckinli, B B; Toksoy, G; Sayar, C; Soylemez, M A; Yesil, G; Aydın, H; Karaman, A; Devranoglu, B

    2014-11-01

    Our objective was to identify the distribution of cytogenetic abnormalities of 175 Turkish women with primary amenorrhea (PA) or premature ovarian insufficiency (POI). A retrospective study was performed using medical records of 94 patients with PA and 81 patients with POI at the Genetics Department, Zeynep Kamil Women's and Children's Research and Training Hospital, Istanbul, Turkey. G-banded metaphase karyotype analysis were prepared and analyzed. Chromosomal abnormalities were present in 44 of 175 cases (25%). 15 were full blown or mosaic numerical X chromosome abnormalities (8.5%), 10 were full blown or mosaic X-chromosome structural anomalies (5.7%), one was X-autosome translocation (0.5%), 3 were autosomal anomalies (1.7%), 12 were XY karyotype (6.8%), one was 45,X/46,XY mosaic and 2 were full blown or mosaic structural anomalies of Y chromosome (1.7%). The prevalence of chromosomal abnormalities was 25% in this large series of Turkish women with primary amenorrhea or premature ovarian insufficiency, most cases involving X-aneuploidy or X-structural abnormalities or 46,XY karyotype. High prevalence of chromosomal abnormalities is associated with POI starting at an early age (average age: 26 years).

  8. [Gait speed and the appearance of neurocognitive disorders in older adults: Results of a Peruvian cohort].

    Science.gov (United States)

    Parodi, José F; Nieto-Gutierrez, Wendy; Tellez, Walter A; Ventocilla-Gonzales, Iris; Runzer-Colmenares, Fernando M; Taype-Rondan, Alvaro

    2017-09-07

    The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults. Cohort conducted in older adults who attended the geriatrics service of Naval Medical Center (Callao, Peru). During the baseline assessment, participants' gait speed was recorded. Subsequently, participants were followed-up annually for 5 years, with a mean of 21 months. NCD onset was defined as the occurrence of a score ≤24 points on the Mini Mental State Examination (screening test) during follow-up. The hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated using Cox regression. The study included 657 participants, with a mean age of 73.4±9.2 (SD) years, of whom 47.0% were male, 47.8% had a gait speed <0.8 m/s, and 20.1% developed NCD during the follow up. It was found that older adults who had gait speed <0.8 m/s at baseline were more likely to develop NCD than those who had a gait speed ≥0.8 m/s (adjusted HR=1.41, 95% CI=1.34-1.47). A longitudinal association was found between decreased gait speed and NCD onset, suggesting that gait speed could be useful to identify patients at risk of NCD onset. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Chromosome analysis of 427 cases with primary amenorrhea%原发性闭经427例患者染色体核型分析

    Institute of Scientific and Technical Information of China (English)

    彭琳; 王楠; 邓东锐; 左伟; 程琛; 党静; 郝海燕; 周媛; 蒋敏; 凌霞珍

    2012-01-01

    目的 对原发性闭经患者进行细胞遗传学分析,探讨原发性闭经与染色体异常的关系,用以指导临床诊断及处理.方法 对427例原发性闭经患者进行外周血淋巴细胞培养、染色体制备及核型分析.结果 427例原发性闭经患者中共检出染色体异常核型118例,异常检出率为27.6℅﹙118∕427﹚.性染色体异常中,X染色体数目异常59例、结构异常25例、嵌合体24例,其中有单纯X染色体与常染色体平衡易位1例,合并X的部分缺失2例.常染色体结构异常10例,包括染色体倒位﹙4例﹚、平衡易位﹙4例﹚以及染色体大小异常﹙2例﹚,涉及到第6、7、9、14、15、16、22号常染色体.结论 结合临床表现、影像学检查以及染色体核型检查,可以为原发性闭经患者寻找病因提供理论依据,同时有利于处理措施的制定.%Objective To carry out chromosome analysis of patients with primary amenorrhea and investigate the relationship between primary amenorrhea and chromosome abnormalities, so as to guide clinical diagnosis and treatment. Methods Peripheral blood lymphocyte culture, chromosome preparation and karyotype analysis were done to 427 cases of patients with primary amenorrhea. Results There were 118 cases of abnormal chromosome karyotype with primary amenorrhea, and the anomaly detection rate was 27. 6% ( 118/427 ). In cases with sex chromosome abnormalities, there were 59 patients with numerical abnormalities of X chromosome, 25 patients with X chromosome structural abnormality, and 24 cases of mosaicism. Among them, there was one case of simple reciprocal translocation between X chromosome and autosome, and two cases of consolidation with terminal deletion of X chromosome. There were cases of autosomal structural abnormalities, including chromosomal inversion ( 4 cases ), balanced translocation ( 4 cases ) and abnormal chromosome size ( 2 cases ). Autosomal abnormalities happened on the sixth, seventh, ninth

  10. 原发闭经表型的细胞遗传学病因研究%Cytogenetic Investigation of Primary Amenorrhea Phenotype

    Institute of Scientific and Technical Information of China (English)

    曾寰; 周裕林; 陈小苑; 孔辉; 韩璐; 吴琼; 吴慧南; 沈艳艳; 陈佳燕; 江雨

    2011-01-01

    Objective: To investigate the cytogengetic etiology of primary amenorrhea phenotype.Methods: Regular G-banding karyotyping methods,fluorescence in situ hybridization(FISH), C-banding and Q-banding techniques were applied to analyze to verify the peripheral blood lymphocytes chromosomes and their abnormities of 25 primary amenorrhea patients. Results: Eighteen out of total 25 primary amenorrhea patients were karyotype abnormal. That was 72.0%. All the chromosome abnormalities patients included 8 cases of 45,X,2 cases of 46,XY, 1 case of i(X)(ql0), 1 case of X long arm terminal deletion, 2 cases of X-autosome balanced translocation, as well as 4 cases of mosaics, all were 45,X cell line and 46 cell lines with 4 diferent kinds of sex chromosomes structure abnormalities mosaicism. The rest 7 females with no uterus and no vagina in congenital,were detected karyotypely normal. Conclusion: X monosome, X structural anomalies, X monosome cell strain and structural anomalies cell strain mosaic, and 46,XY disorder of sex development (DSD), X-autosome reciprocal translocation are responsible for 18 patients' primary amenorrhea phenotype, individually. FISH, C-banding and, Q-banding techniques in addition to G-banding methods are very useful techniques in accurate diagnosis of the karyotypes of primary amenorrhea patients.%目的:探讨原发闭经表型的细胞遗传学病因.方法:运用常规的染色体核型分析技术及FISH、C-带和Q-带技术,分析25例原发闭经表型患者的染色体核型.结果:25例原发闭经表型病例中,18例核型异常,占72.0%.异常核型病例分别为:45,X 8例、46,XY 2例,等臂X1例、嵌合核型4例(分别为45,X细胞系与不同的结构异常性染色体细胞系的嵌合体)、X长臂末端缺失1例、X-常染色体平衡易位2例.除这18例异常核型患者外,尚有7例为先天性无子宫、无阴道的原发闭经患者未检出核型异常.结论:X染色体数目单体、X结构异常、X染色体数目单

  11. Vision Screening

    Science.gov (United States)

    ... of Prematurity Strabismus Stye (defined) Vision Screening Vision Screening Recommendations Loading... Most Common Searches Adult Strabismus Amblyopia Cataract Conjunctivitis Corneal Abrasions Dilating Eye ...

  12. Clinical manifestations of low bone mass in amenorrhea patients with elevated follicular stimulating hormone%高促卵泡激素闭经患者低骨量的临床表现

    Institute of Scientific and Technical Information of China (English)

    郁琦; 林守清; 何方方; 李包罗; 林元; 张涛; 张颖

    2002-01-01

    Objective To study the characteristics of low bone mass in amenorrhea patients with elevated follicular stimulating hormone (FSH). Methods Amenorrhea patients with elevated FSH: Primary amenorrhea 18 cases, secondary amenorrhea 171 cases and age matched controls with normal menstruation, 180 cases. The descriptive parameters were: estrogen, alkaline phosphatase, urinary excretion of calcium to creatine ratio, cortical bone mineral density at the right radius measured by single photon absorptiometry and trabecular bone mineral density at the lumbar vertebra body measured by quantitative computerized tomography. Results Average E2 levels in amenorrhea patients is under 150 pmol/L with significantly higher alkaline phosphatase and urine calcium to creatine ratio values than the normal menstruation group. Cortical bone mineral density in the secondary amenorrhea group (655±69 mg/cm2) was significantly lower than that of the normal menstruation group (677±56 mg/cm2, P<0.01). Trabecular bone mineral density in the secondary amenorrhea group (145±26 mg/cm3) was significantly lower than that of the NOR group (192±28 mg/cm3, P<0.001). The disparity with the normal menstruation group is even greater in the primary amenorrhea group. Bone mineral density of the amenorrhea patients was negatively correlated with duration of the menopause. Conclusions Serum estrodiol levels in amenorrhea patients was so low that bone turnover was accelerated. This led to insufficient bone accumulation and a dramatically drop in trabecular bone mineral density. The extent was closely related to age of onset of amenorrhea and the duration of ovarian failure.%目的了解高促卵泡激素(FSH)卵巢性闭经患者低骨量的特点.方法对18例高 FSH原发闭经(PA组)、171例高FSH继发闭经(SA组)患者,采用放射免疫法测定血清雌二醇(E2);生化法测定血清碱性磷酸酶(ALP)、尿钙/肌酐(Ca/Cr)比值;单光子吸收测量法测定右侧桡骨

  13. Using Acute Performance on a Comprehensive Neurocognitive, Vestibular, and Ocular Motor Assessment Battery to Predict Recovery Duration After Sport-Related Concussions.

    Science.gov (United States)

    Sufrinko, Alicia M; Marchetti, Gregory F; Cohen, Paul E; Elbin, R J; Re, Valentina; Kontos, Anthony P

    2017-04-01

    A sport-related concussion (SRC) is a heterogeneous injury that requires a multifaceted and comprehensive approach for diagnosis and management, including symptom reports, vestibular/ocular motor assessments, and neurocognitive testing. To determine which acute (eg, within 7 days) vestibular, ocular motor, neurocognitive, and symptom impairments predict the duration of recovery after an SRC. Cohort study (prognosis); Level of evidence, 2. Sixty-nine patients with a mean age of 15.3 ± 1.9 years completed a neurocognitive, vestibular/ocular motor, and symptom assessment within 7 days of a diagnosed concussion. Patients were grouped by recovery time: ≤14 days (n = 27, 39.1%), 15-29 days (n = 25, 36.2%), and 30-90 days (n = 17, 24.6%). Multinomial regression was used to identify the best subset of predictors associated with prolonged recovery relative to ≤14 days. Acute visual motor speed and cognitive-migraine-fatigue symptoms were associated with an increased likelihood of recovery times of 30-90 days and 15-29 days relative to a recovery time of ≤14 days. A model with visual motor speed and cognitive-migraine-fatigue symptoms within the first 7 days of an SRC was 87% accurate at identifying patients with a recovery time of 30-90 days. The current study identified cognitive-migraine-fatigue symptoms and visual motor speed as the most robust predictors of protracted recovery after an SRC according to the Post-concussion Symptom Scale, Immediate Post-concussion Assessment and Cognitive Testing, and Vestibular/Ocular Motor Screening (VOMS). While VOMS components were sensitive in identifying a concussion, they were not robust predictors for recovery. Clinicians may consider particular patterns of performance on clinical measures when providing treatment recommendations and discussing anticipated recovery with patients.

  14. Vitamin D and Alzheimer’s Disease: Neurocognition to Therapeutics

    Directory of Open Access Journals (Sweden)

    Anindita Banerjee

    2015-01-01

    Full Text Available Alzheimer’s disease (AD, the major cause of dementia worldwide, is characterized by progressive loss of memory and cognition. The sporadic form of AD accounts for nearly 90% of the patients developing this disease. The last century has witnessed significant research to identify various mechanisms and risk factors contributing to the complex etiopathogenesis of AD by analyzing postmortem AD brains and experimenting with animal and cell culture based models. However, the treatment strategies, as of now, are only symptomatic. Accumulating evidences suggested a significant association between vitamin D deficiency, dementia, and AD. This review encompasses the beneficial role of vitamin D in neurocognition and optimal brain health along with epidemiological evidence of the high prevalence of hypovitaminosis D among aged and AD population. Moreover, disrupted signaling, altered utilization of vitamin D, and polymorphisms of several related genes including vitamin D receptor (VDR also predispose to AD or AD-like neurodegeneration. This review explores the relationship between this gene-environmental influence and long term vitamin D deficiency as a risk factor for development of sporadic AD along with the role and rationale of therapeutic trials with vitamin D. It is, therefore, urgently warranted to further establish the role of this potentially neuroprotective vitamin in preventing and halting progressive neurodegeneration in AD patients.

  15. Examining Neurocognitive Function in Previously Concussed Interscholastic Female Soccer Players.

    Science.gov (United States)

    Forbes, Cameron R; Glutting, Joseph J; Kaminski, Thomas W

    2016-01-01

    Awareness of sport-related concussions in soccer has gained recent attention in the medical community. Interestingly, purposeful heading-a unique yet strategic and inherent part of soccer-involves repeated subconcussive blows to the head. We divided 210 female interscholastic soccer players into control (CON [never concussed]) and experimental (EXP [previously concussed]) groups. We assessed neurocognitive performance using the Automated Neuropsychological Assessment Metrics computer program before and after the players' competitive season. Headers were recorded at all sanctioned matches. Data were analyzed using a series of one-way analyses of covariance and t tests. Both groups essentially played in the same number of games (EXP = 16.1 vs. CON = 16.1) and had an equal number of total headers (EXP = 24.9 vs. CON = 24.3). Additionally, headers per game were surprisingly low in both groups (1.4 in EXP vs. 1.3 in CON). Unexpectedly, there were no significant differences between the EXP and CON groups across all dependent variables measured (p > .05). This study suggests that although previously concussed players involve themselves in purposeful heading (i.e., subconcussive insults) throughout a competitive season, there appear to be no negative consequences on neuropsychological test performance or concussion-related symptoms. Additional research is needed to determine what may result during the course of a playing career.

  16. Oligodendrocyte Injury and Pathogenesis of HIV-1-Associated Neurocognitive Disorders

    Directory of Open Access Journals (Sweden)

    Han Liu

    2016-07-01

    Full Text Available Oligodendrocytes wrap neuronal axons to form myelin, an insulating sheath which is essential for nervous impulse conduction along axons. Axonal myelination is highly regulated by neuronal and astrocytic signals and the maintenance of myelin sheaths is a very complex process. Oligodendrocyte damage can cause axonal demyelination and neuronal injury, leading to neurological disorders. Demyelination in the cerebrum may produce cognitive impairment in a variety of neurological disorders, including human immunodeficiency virus type one (HIV-1-associated neurocognitive disorders (HAND. Although the combined antiretroviral therapy has markedly reduced the incidence of HIV-1-associated dementia, a severe form of HAND, milder forms of HAND remain prevalent even when the peripheral viral load is well controlled. HAND manifests as a subcortical dementia with damage in the brain white matter (e.g., corpus callosum, which consists of myelinated axonal fibers. How HIV-1 brain infection causes myelin injury and resultant white matter damage is an interesting area of current HIV research. In this review, we tentatively address recent progress on oligodendrocyte dysregulation and HAND pathogenesis.

  17. Neurocognition in individuals with incidentally-identified meningioma.

    Science.gov (United States)

    Butts, Alissa M; Weigand, Stephen; Brown, Paul D; Petersen, Ronald C; Jack, Clifford R; Machulda, Mary M; Cerhan, Jane H

    2017-08-01

    Meningiomas are primary intracranial tumors that are often asymptomatic. To our knowledge, no study has attempted to describe neurocognitive function in patients with incidentally-discovered meningioma. We utilized the Mayo Clinic Study of Aging (MCSA), which is a population-based sample of Olmsted County, Minnesota residents that includes neuropsychological testing and brain MRI approximately every 15 months. Using a text search of radiologists' notes of 2402 MCSA individuals (mean age 77 years, scanned between 2004 and 2014) we identified 48 eligible subjects (2%) who had at least one meningioma. Most meningiomas were small (90% age, sex, and education. Cognitive domains assessed included memory, attention-executive function, language, and visuospatial. More women (67%) had a meningioma than men (33%). Groups did not differ on prevalence of Mild Cognitive Impairment (Meningioma = 19%, Controls = 13%). Across cognitive domains, we observed similar performance for the two groups (p's ≥ 0.21). Subtle differences emerged in memory and language domains (p = 0.05 and p = 0.11) when we divided the Meningioma group by tumor location, wherein the small group with an infratentorial tumor performed more poorly than controls globally as well as on select memory and language measures. Our findings suggest that small meningiomas are generally cognitively benign, but that may change as the tumor evolves, and might be impacted by other factors such as meningioma location.

  18. Oligodendrocyte Injury and Pathogenesis of HIV-1-Associated Neurocognitive Disorders

    Science.gov (United States)

    Liu, Han; Xu, Enquan; Liu, Jianuo; Xiong, Huangui

    2016-01-01

    Oligodendrocytes wrap neuronal axons to form myelin, an insulating sheath which is essential for nervous impulse conduction along axons. Axonal myelination is highly regulated by neuronal and astrocytic signals and the maintenance of myelin sheaths is a very complex process. Oligodendrocyte damage can cause axonal demyelination and neuronal injury, leading to neurological disorders. Demyelination in the cerebrum may produce cognitive impairment in a variety of neurological disorders, including human immunodeficiency virus type one (HIV-1)-associated neurocognitive disorders (HAND). Although the combined antiretroviral therapy has markedly reduced the incidence of HIV-1-associated dementia, a severe form of HAND, milder forms of HAND remain prevalent even when the peripheral viral load is well controlled. HAND manifests as a subcortical dementia with damage in the brain white matter (e.g., corpus callosum), which consists of myelinated axonal fibers. How HIV-1 brain infection causes myelin injury and resultant white matter damage is an interesting area of current HIV research. In this review, we tentatively address recent progress on oligodendrocyte dysregulation and HAND pathogenesis. PMID:27455335

  19. Monitoring the mind: the neurocognitive correlates of metamemory.

    Directory of Open Access Journals (Sweden)

    Anne T A Do Lam

    Full Text Available Memory performance in everyday life is often far from perfect and therefore needs to be monitored and controlled by metamemory evaluations, such as judgments of learning (JOLs. JOLs support monitoring for goal-directed modification of learning. Behavioral studies suggested retrieval processes as providing a basis for JOLs. Previous functional imaging research on JOLs found a dissociation between processes underlying memory prediction, located in the medial prefrontal cortex (mPFC, and actual encoding success, located in the medial temporal lobe. However, JOL-specific neural correlates could not be identified unequivocally, since JOLs were given simultaneously with encoding. Here, we aimed to identify the neurocognitive basis of JOLs, i.e., the cognitive processes and neural correlates of JOL, separate from initial encoding. Using functional magnetic resonance imaging (fMRI, we implemented a face-name paired associative design. In general, we found that actual memory success was associated with increased brain activation of the hippocampi bilaterally, whereas predicted memory success was accompanied by increased activation in mPFC, orbital frontal and anterior cingulate cortices. Masking brain activation during predicted memory success with activation during retrieval success revealed BOLD increases of the mPFC. Our findings indicate that JOLs actually incorporate retrieval processes.

  20. Neurocognitive and social cognition deficits in patients with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Kułakowska, Dorota

    2014-06-01

    Full Text Available In the first part of the article the authors present a set of the actual concepts explaining problems of cognitive functions and social cognition currently observed in patients with anorexia nervosa (AN. It is possible; through the neuroimaging research, to get better understanding of the brain specifics in these individuals. Even though, the AN remains a disease with very complex and multifactorial etiology which remains a huge medical challenge. Currently, popular is the view that takes into consideration the integrating role of the insula and subcortical structures (such as hippocampus, amygdala, thalamus in the regulation of cognitive and emotional processes in people suffering from AN. There is still an open problem, however, of the selection of therapeutic interventions targeting these deficits. The second part of the article presents the attempt to describe deficits in neurocognitive and social cognition in people with AN occurring prior to illness, during and after the recovery. Particular attention has been paid to the most frequently described in the literature – neuro- cognitive deficits such as rigidity of thinking, weak central coherence, and deficits in social cognition, including mental processes of perception and expression of emotions, disorders of the theory of mind (ToM and empathy. The results of previous studies, their scarcity in Poland, do not give a satisfactory answer to the question whether the above mentioned disorders are a feature of endophenotype or condition in an episode of the disease. Research point to the more permanent nature, which may be more resistant to therapeutic modifications.

  1. The neurocognitive bases of human multimodal food perception: consciousness.

    Science.gov (United States)

    Verhagen, Justus V

    2007-02-01

    This review explores how we become aware of the (integrated) flavor of food. In recent years, progress has been made understanding the neural correlates of consciousness. Experimental and computational data have been largely based on the visual system. Contemporary neurobiological frameworks of consciousness are reviewed, concluding that neural reverberation among forward- and back-projecting neural ensembles across brain areas is a common theme. In an attempt to extrapolate these concepts to the oral-sensory and olfactory systems involved with multimodal flavor perception, the integration of the sensory information of which into a flavor gestalt has been reviewed elsewhere (Verhagen, J.V., Engelen, L., 2006. The neurocognitive bases of human multimodal food perception: Sensory integration. Neurosci. Biobehav. Rev. 30(5): 613_650), I reconceptualize the flavor-sensory system by integrating it into a larger neural system termed the Homeostatic Interoceptive System (HIS). This system consists of an oral (taste, oral touch, etc.) and non-oral part (non oral-thermosensation, pain, etc.) which are anatomically and functionally highly similar. Consistent with this new concept and with a large volume of experimental data, I propose that awareness of intraoral food is related to the concomitant reverberant self-sustained activation of a coalition of neuronal subsets in agranular insula and orbitofrontal cortex (affect, hedonics) and agranular insula and perirhinal cortex (food identity), as well as the amygdala (affect and identity) in humans. I further discuss the functional anatomy in relation essential nodes. These formulations are by necessity to some extent speculative.

  2. Spaceflight Effects on Neurocognitive Performance: Extent, Longevity and Neural Bases

    Science.gov (United States)

    Seidler, R. D.; Mulavara, A. P.; Koppelmans, V.; Kofman, I. S.; Cassady, K.; Yuan, P.; De Dios, Y. E.; Gadd, N.; Riascos, R. F.; Wood, S. J.; Bloomberg, J. J.

    2017-01-01

    We are conducting ongoing experiments in which we are performing structural and functional magnetic resonance brain imaging to identify the relationships between changes in neurocognitive function and neural structural alterations following a six month International Space Station mission. Our central hypothesis is that measures of brain structure, function, and network integrity will change from pre to post spaceflight. Moreover, we predict that these changes will correlate with indices of cognitive, sensory, and motor function in a neuroanatomically selective fashion. Our interdisciplinary approach utilizes cutting edge neuroimaging techniques and a broad ranging battery of sensory, motor, and cognitive assessments that are conducted pre flight, during flight, and post flight to investigate potential neuroplastic and maladaptive brain changes in crewmembers following long-duration spaceflight. Success in this endeavor would 1) result in identification of the underlying neural mechanisms and operational risks of spaceflight-induced changes in behavior, and 2) identify whether a return to normative behavioral function following re-adaptation to Earth's gravitational environment is associated with a restitution of brain structure and function or instead is supported by substitution with compensatory brain processes. We have collected data on several crewmembers and preliminary findings will be presented. Eventual comparison to results from our parallel bed rest study will enable us to parse out the multiple mechanisms contributing to any spaceflight-induced neural structural and behavioral changes that we observe.

  3. Effects of One Year of Spaceflight on Neurocognitive Function

    Science.gov (United States)

    Seidler, R. D.; Mulavara, A. P.; Koppelmans, V.; Kofman, I. S.; Cassady, K.; Yuan , P.; De Dios, Y. E.; Gadd, N.; Riascos, R. F.; Wood, S. J.; hide

    2017-01-01

    It is known that spaceflight adversely affects human sensorimotor function. With interests in longer duration deep space missions it is important to understand microgravity dose-response relationships. NASA's One Year Mission project allows for comparison of the effects of one year in space with those seen in more typical six month missions to the International Space Station. In the Neuromapping project we are performing structural and functional magnetic resonance brain imaging to identify the relationships between changes in neurocognitive function and neural structural alterations following a six month International Space Station mission. Our central hypothesis is that measures of brain structure, function, and network integrity will change from pre- to post-spaceflight. Moreover, we predict that these changes will correlate with indices of cognitive, sensory, and motor function in a neuroanatomically selective fashion. Our interdisciplinary approach utilizes cutting edge neuroimaging techniques and a broad-ranging battery of sensory, motor, and cognitive assessments that are conducted pre-flight, during flight, and post-flight to investigate potential neuroplastic and maladaptive brain changes in crewmembers following long-duration spaceflight. With the one year mission we had one crewmember participate in all of the same measures pre-, per- and post-flight as in our ongoing study. During this presentation we will provide an overview of the magnitude of changes observed with our brain and behavioral assessments for the one year crewmember in comparison to participants that have completed our six month study to date.

  4. [Neurocognitive and pharmacological approach to specific learning disorders].

    Science.gov (United States)

    Etchepareborda, M C

    1999-02-01

    Specific learning disorders are distinguished from general development disorders since, in general, only a certain number of processing mechanisms are involved whilst the remainder are unaffected. The classification proposed by the DSM-IV takes a step towards clinical understanding and use of a common nomenclature. However, neuropsychological assessment is essential to understanding clinical subtypes. The neuro-cognitive approach, when taking into account the processing systems affected or involved, should include the strategies and principles of a cognitive-behavioural approach, accompanied by computerized cognitive training. Pharmacological treatment uses drugs with different modes of action depending on the specific neuropsychological characteristics of each type of disorder of nerve development. We discuss the clinical use of various drugs in view of investigations, present and past: methylphenidate for the dys-attentional subtype of ADHD; piracetam in developmental dyslexia of dysideatic type; citocolina in the infantile dysphasias of sensory input predominance, thiapride in dysfluencial and combined subtype of ADHD; pipamperona in behaviour disorders and the hyperactive-impulsive subtype of ADHD, with or without associated and selegilina in the dysattention subtype of ADHD and the dysgraphias of the subtype with predominance of calligraphy and spatial disorders.

  5. A triadic neurocognitive approach to addiction for clinical interventions.

    Science.gov (United States)

    Noël, Xavier; Brevers, Damien; Bechara, Antoine

    2013-12-27

    According to the triadic neurocognitive model of addiction to drugs (e.g., cocaine) and non-drugs (e.g., gambling), weakened "willpower" associated with these behaviors is the product of an abnormal functioning in one or more of three key neural and cognitive systems: (1) an amygdala-striatum dependent system mediating automatic, habitual, and salient behaviors; (2) a prefrontal cortex dependent system important for self-regulation and forecasting the future consequences of a behavior; and (3) an insula dependent system for the reception of interoceptive signals and their translation into feeling states (such as urge and craving), which in turn plays a strong influential role in decision-making and impulse control processes related to uncertainty, risk, and reward. The described three-systems account for poor decision-making (i.e., prioritizing short-term consequences of a decisional option) and stimulus-driven actions, thus leading to a more elevated risk for relapse. Finally, this article elaborates on the need for "personalized" clinical model-based interventions targeting interactions between implicit processes, interoceptive signaling, and supervisory function aimed at helping individuals become less governed by immediate situations and automatic pre-potent responses, and more influenced by systems involved in the pursuit of future valued goals.

  6. Neurocognitive predictors of social cognition in remitted schizophrenia.

    Science.gov (United States)

    Mehta, Urvakhsh Meherwan; Bhagyavathi, Haralahalli D; Thirthalli, Jagadisha; Kumar, Keshav J; Gangadhar, Bangalore N

    2014-10-30

    Knowledge of how specific neurocognition (NC) abilities predict social cognition (SC) in schizophrenia has potential to guide novel integrated cognitive-remediation therapies. The scope of studies conducted in this field is limited as they have not examined a comprehensive set of SC domains and they employ small sample sizes of heterogeneous patient groups. We studied a broad range of NC (sustained attention, processing speed, verbal/visual memory and visual processing/encoding, cognitive flexibility and planning) and SC [different levels of theory of mind (ToM)], attributional bias, emotion recognition and social perception] abilities in 170 remitted schizophrenia patients. Multivariate regression analyses revealed attention and planning as predictors of 1st order ToM. Memory encoding was the strongest predictor of 2nd order ToM. Faux-pas recognition, social perception and emotion recognition were influenced by a combination of cognitive flexibility and memory encoding abilities. Overall, NC predicted anywhere between ~4% and 40% of variance observed in specific SC sub-dimensions of attributional bias (4%), 1st order (19%) and 2nd order (12%) theory of mind, faux-pas recognition (28%), social perception (29%) and emotion recognition (39%). Individual SC abilities are predicted by distinctive as well as shared NC abilities. These findings have important implications for integrated cognitive remediation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. 'Cost in transliteration': the neurocognitive processing of Romanized writing.

    Science.gov (United States)

    Rao, Chaitra; Mathur, Avantika; Singh, Nandini C

    2013-03-01

    Romanized transliteration is widely used in internet communication and global commerce, yet we know little about its behavioural and neural processing. Here, we show that Romanized text imposes a significant neurocognitive load. Readers faced greater difficulty in identifying concrete words written in Romanized transliteration (Romanagari) compared to L1 and L2. Functional neuroimaging revealed that the neural cost of processing transliterations arose from significantly greater recruitment of language (left precentral gyrus, left inferior parietal lobule) and attention networks (left mid-cingulum). Additionally, transliterated text uniquely activated attention and control areas compared to both L1 (cerebellar vermis) and L2 (pre-supplementary motor area/pre-SMA). We attribute the neural effort of reading Romanized transliteration to (i) effortful phonological retrieval from unfamiliar orthographic forms and (ii) conflicting attentional demands imposed by mapping orthographic forms of one language to phonological-semantic representations in another. Finally, significant brain-behaviour correlation suggests that the left mid-cingulum modulates cognitive-linguistic conflict.

  8. What are the neurocognitive correlates of basic self-disturbance in schizophrenia?: Integrating phenomenology and neurocognition. Part 1 (Source monitoring deficits).

    Science.gov (United States)

    Nelson, B; Whitford, T J; Lavoie, S; Sass, L A

    2014-01-01

    Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. Little is known about the neurocognitive underpinnings of basic self-disturbance. In these two theoretical papers (of which this is Part 1), we review some recent phenomenological and neurocognitive research and point to a convergence of these approaches around the concept of self-disturbance. Specifically, we propose that subjective anomalies associated with basic self-disturbance may be associated with: 1. source monitoring deficits, which may contribute particularly to disturbances of "ownership" and "mineness" (the phenomenological notion of presence or self-affection) and 2. aberrant salience, and associated disturbances of memory, prediction and attention processes, which may contribute to hyper-reflexivity, disturbed "grip" or "hold" on the perceptual and conceptual field, and disturbances of intuitive social understanding ("common sense"). In this paper (Part 1) we focus on source monitoring deficits. Part 2 (this issue) addresses aberrant salience. Empirical studies are required in a variety of populations in order to test these proposed associations between phenomenological and neurocognitive aspects of self-disturbance in schizophrenia. An integration of findings across the phenomenological and neurocognitive "levels" would represent a significant advance in the understanding of schizophrenia and possibly enhance early identification and intervention strategies.

  9. Effects of HIV and childhood trauma on brain morphometry and neurocognitive function.

    Science.gov (United States)

    Spies, Georgina; Ahmed-Leitao, Fatima; Fennema-Notestine, Christine; Cherner, Mariana; Seedat, Soraya

    2016-04-01

    A wide spectrum of neurocognitive deficits characterises HIV infection in adults. HIV infection is additionally associated with morphological brain abnormalities affecting neural substrates that subserve neurocognitive function. Early life stress (ELS) also has a direct influence on brain morphology. However, the combined impact of ELS and HIV on brain structure and neurocognitive function has not been examined in an all-female sample with advanced HIV disease. The present study examined the effects of HIV and childhood trauma on brain morphometry and neurocognitive function. Structural data were acquired using a 3T Magnetom MRI scanner, and a battery of neurocognitive tests was administered to 124 women: HIV-positive with ELS (n = 32), HIV-positive without ELS (n = 30), HIV-negative with ELS (n = 31) and HIV-negative without ELS (n = 31). Results revealed significant group volumetric differences for right anterior cingulate cortex (ACC), bilateral hippocampi, corpus callosum, left and right caudate and left and right putamen. Mean regional volumes were lowest in HIV-positive women with ELS compared to all other groups. Although causality cannot be inferred, findings also suggest that alterations in the left frontal lobe, right ACC, left hippocampus, corpus callosum, left and right amygdala and left caudate may be associated with poorer neurocognitive performance in the domains of processing speed, attention/working memory, abstraction/executive functions, motor skills, learning and language/fluency with these effects more pronounced in women living with both HIV and childhood trauma. This study highlights the potential contributory role of childhood trauma to brain alterations and neurocognitive decline in HIV-infected individuals.

  10. Neurocognition, insight and medication nonadherence in schizophrenia: a structural equation modeling approach.

    Directory of Open Access Journals (Sweden)

    Laurent Boyer

    Full Text Available OBJECTIVE: The aim of this study was to examine the complex relationships among neurocognition, insight and nonadherence in patients with schizophrenia. METHODS: DESIGN: Cross-sectional study. INCLUSION CRITERIA: Diagnosis of schizophrenia according to the DSM-IV-TR criteria. DATA COLLECTION: Neurocognition was assessed using a global approach that addressed memory, attention, and executive functions; insight was analyzed using the multidimensional 'Scale to assess Unawareness of Mental Disorder;' and nonadherence was measured using the multidimensional 'Medication Adherence Rating Scale.' ANALYSIS: Structural equation modeling (SEM was applied to examine the non-straightforward relationships among the following latent variables: neurocognition, 'awareness of positive symptoms' and 'negative symptoms', 'awareness of mental disorder' and nonadherence. RESULTS: One hundred and sixty-nine patients were enrolled. The final testing model showed good fit, with normed χ(2 = 1.67, RMSEA = 0.063, CFI = 0.94, and SRMR = 0.092. The SEM revealed significant associations between (1 neurocognition and 'awareness of symptoms,' (2 'awareness of symptoms' and 'awareness of mental disorder' and (3 'awareness of mental disorder' and nonadherence, mainly in the 'attitude toward taking medication' dimension. In contrast, there were no significant links between neurocognition and nonadherence, neurocognition and 'awareness of mental disorder,' and 'awareness of symptoms' and nonadherence. CONCLUSIONS: Our findings support the hypothesis that neurocognition influences 'awareness of symptoms,' which must be integrated into a higher level of insight (i.e., the 'awareness of mental disorder' to have an impact on nonadherence. These findings have important implications for the development of effective strategies to enhance medication adherence.

  11. Characteristics of Resting-State Functional Connectivity in HIV-Associated Neurocognitive Disorder.

    Directory of Open Access Journals (Sweden)

    Hea Won Ann

    Full Text Available HIV-associated neurocognitive disorder (HAND can occur in patients without prior AIDS defining illness and can be debilitating. This study aimed to evaluate the difference in the patterns of intrinsic brain activity between patients with or without HAND for deepening our understanding of HAND.We evaluated 24 HIV-infected individuals, 12 with previously diagnosed HAND and 12 previously diagnosed without HAND, and 11 seronegative individuals. These individuals then underwent repeat NP testing and a functional brain MRI scan. For functional MRI analysis, seed-based analysis with bilateral precuneus cortex seed was applied.Among the 12 individuals with previously diagnosed HAND, 3 showed improvement of their neurocognitive function and 1 was excluded for worsening liver disease. Among the 12 patients who previously had normal neurocognitive function, 2 showed neurocognitive impairment. Overall, the HAND group, who had impaired cognitive function at the time of MRI scan, showed significant decrease of resting status functional connectivity between bilateral precuneus and prefrontal cortex (PFC compared with nonHAND group, those who had normal neurocognitive function (Corrected P<0.05. The functional connectivity with the right inferior frontal operculum and right superior frontal gyrus was positively correlated with memory and learning ability.This cross-sectional study found a significant difference in fMRI patterns between patients with and without HAND. Decreased functional connectivity between precuneus and PFC could be possible functional substrate for cognitive dysfunction in HIV patients, which should be characterized in a longitudinal study.

  12. Asymptomatic neurocognitive disorders in patients infected by HIV: fact or fiction?

    Directory of Open Access Journals (Sweden)

    Torti Carlo

    2011-12-01

    Full Text Available Abstract Neurocognitive disorders are emerging as a possible complication in patients infected with HIV. Even if asymptomatic, neurocognitive abnormalities are frequently detected using a battery of tests. This supported the creation of asymptomatic neurocognitive impairment (ANI as a new entity. In a recent article published in BMC Infectious Diseases, Magnus Gisslén and colleagues applied a statistical approach, concluding that there is an overestimation of the actual problem. In fact, about 20% of patients are classified as neurocognitively impaired without a clear impact on daily activities. In the present commentary, we discuss the clinical implications of their findings. Although a cautious approach would indicate a stricter follow-up of patients affected by this disorder, it is premature to consider it as a proper disease. Based on a review of the data in the current literature we conclude that it is urgent to conduct more studies to estimate the overall risk of progression of the asymptomatic neurocognitive impairment. Moreover, it is important to understand whether new biomarkers or neuroimaging tools can help to identify better the most at risk population. Please see related article: http://www.biomedcentral.com/1471-2334/11/356

  13. Study of Neurocognitive correlates of Schizotypy Personality Clusters in healthy individuals

    Directory of Open Access Journals (Sweden)

    M. Carmen Aguilera Ruíz

    2008-03-01

    Full Text Available Background and Objectives: Inconsistencies in the relationship between schizotypy dimensions and neurocognitive functions found in correlational studies may be clarified with the use of alternative methodological approaches. The aim of this study was to examine the existence of different profiles of schizotypal traits and their neurocognitIve correlates in non-clinical subjects by means of cluster analysis. Methods: We examined seventy six healthy adults from the general population with a comprehensive neurocognitive battery and a schizotypal personality self-report. Results: Four neurocognitive factors were extracted: visuospatial, semantic evocation, verbal memory, and set-shifting. A three cluster model yielded the following clusters: "lowschizotypy", "positive schizotypy", and "negative/disorganized schizotypy". The positive and negative/disorganized schizotypy clusters showed poorer performance on semantic evocation compared with the low schizotypy cluster. Conclusions: We found different patterns of specific schizotypy features in a healthy adult community sample and these clusters presented differential performance in relation with the ability to evoke semantic information.

  14. Neurocognitive function impairment after whole brain radiotherapy for brain metastases: actual assessment

    Directory of Open Access Journals (Sweden)

    Tallet Agnes V

    2012-05-01

    Full Text Available Abstract Whole brain radiation therapy (WBRT is an effective treatment in brain metastases and, when combined with local treatments such as surgery and stereotactic radiosurgery, gives the best brain control. Nonetheless, WBRT is often omitted after local treatment due to its potential late neurocognitive effects. Publications on radiation-induced neurotoxicity have used different assessment methods, time to assessment, and definition of impairment, thus making it difficult to accurately assess the rate and magnitude of the neurocognitive decline that can be expected. In this context, and to help therapeutic decision making, we have conducted this literature review, with the aim of providing an average incidence, magnitude and time to occurrence of radio-induced neurocognitive decline. We reviewed all English language published articles on neurocognitive effects of WBRT for newly diagnosed brain metastases or with a preventive goal in adult patients, with any methodology (MMSE, battery of neurcognitive tests with which baseline status was provided. We concluded that neurocognitive decline is predominant at 4 months, strongly dependant on brain metastases control, partially solved at later time, graded 1 on a SOMA-LENT scale (only 8% of grade 2 and more, insufficiently assessed in long-term survivors, thus justifying all efforts to reduce it through irradiation modulation.

  15. Development, Administration, and Structural Validity of a Brief, Computerized Neurocognitive Battery.

    Science.gov (United States)

    Moore, Tyler M; Gur, Ruben C; Thomas, Michael L; Brown, Gregory G; Nock, Matthew K; Savitt, Adam P; Keilp, John G; Heeringa, Steven; Ursano, Robert J; Stein, Murray B

    2017-01-01

    The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a research project aimed at identifying risk and protective factors for suicide and related mental health outcomes among Army Soldiers. The New Soldier Study component of Army STARRS included the assessment of a range of cognitive- and emotion-processing domains linked to brain systems related to suicidal behavior including posttraumatic stress disorder, mood disorders, substance use disorders, and impulsivity. We describe the design and application of the Army STARRS neurocognitive test battery to a sample of 56,824 soldiers. We investigate its structural and concurrent validity through factor analysis and correlation of scores with demographics. We conclude that, in addition to being composed of previously well-validated measures, the Army STARRS neurocognitive battery as a whole demonstrates good psychometric properties. Correlations of scores with age and sex differences mostly replicate previously published findings, highlighting moderate to large effect sizes even within this restricted age range. Factor structures of scores conform to theoretical expectations. This neurocognitive battery provides a brief, valid measurement of neurocognition that may be helpful in predicting mental health and military performance. These measures can be integrated with neuroimaging to offer a powerful tool for assessing neurocognition in Servicemembers.

  16. Treating 206 cases of amenorrhea galactorrhea syndrome infertility in the integrative medicine%中西医结合治疗闭经溢乳综合征之不孕206例

    Institute of Scientific and Technical Information of China (English)

    张华

    2013-01-01

    Objective: To investigate amenorrhea galactorrhea syndrome caused infertility in the integrative medicine treatment. Methods:Clinical admitted due to amenorrhea galactorrhea syndrome caused infertility patients in modern medicine treatment of 206 cases and analyze. Results: The cure rate and total efficiency of the integrative treatment due to amenorrhea galactorrhea syndrome caused infertility patients than purely modern medicine treatment group. Conclusion: Integrative medicine amenorrhea galactorrhea syndrome infertility treatment is worth promoting.%  目的:探讨闭经溢乳综合征引起的不孕症的中西医综合治疗方法。方法:通过临床收治的因闭经溢乳综合征引起的不孕症患者206例的中西医综合治疗并进行分析总结。结果:中西医综合治疗因闭经溢乳综合征引起的不孕症患者的治愈率及总有效率均高于单纯西医治疗组。结论:中西医结合治疗闭经溢乳综合征不孕症是值得推广的治疗方法。

  17. 无痛人流术后闭经的临床护理体会%The Clinical Nursing Experience of Amenorrhea Patients After Painless Abortion Operation

    Institute of Scientific and Technical Information of China (English)

    叶艳萍

    2015-01-01

    目的:分析无痛人流术后闭经的临床护理方法及效果。方法搜集2013年9月~2014年9月我院接收的无痛人流术后闭经39例患者,按照护理方法不同分为两组。给予对照组19例常规护理,给予实验组20例综合护理。观察对照组与实验组的护理效果,并比较分析。结果与对照组相比,实验组护理有效率和满意度较高,有明显差异,有统计学意义(P<0.05)。结论无痛人流术后闭经综合护理效果较好。%Objective The clinical nursing approach and its application efficacy in treatment of amenorrhea patients after painless abortion operation are to be investigated. Methods Choose 39 amenorrhea patients after painless abortion operation who are treated in hospital from September 2013 to September 2014 and separate them into two groups according to different nursing approaches,19 patients in control group are given conventional treatment,while 20 patients in study group are given comprehensive nursing,and then observe and compare nursing efficacy of the two groups. Results Compared to control group,the treatment efficacy and patients’ rate of satisfaction with nursing in study group are much higher; there is a treatment efficacy differential between the two groups,and such a differential has statistic value(P<0.05). Conclusion The comprehensive nursing is of efficiency in clinical treatment of amenorrhea patients after painless abortion operation;thus,it is quite worthwhile to be promoted.

  18. Neurocognitive effects of chronic lead intoxication in Andean children.

    Science.gov (United States)

    Counter, S A; Buchanan, L H; Rosas, H D; Ortega, F

    1998-09-18

    Lead (Pb) intoxication in children has been associated with neurodevelopmental disabilities which may result in motor and cognitive impairment. We conducted blood lead (PbB) measurements, neurological examinations and cognitive tests on children living in Ecuadorian villages where Pb is used extensively in the glazing of ceramics. Group I consisted of 55 children with a mean PbB level of 48.0 microg/dl (SD: 26.4, range: 9.2-119.1 microg/dl) who received PbB tests and complete neurological examinations. An appreciable number of the children with elevated PbB levels were normal on specific components of the neurological examination. Among the children who showed neurological deficits, higher PbB levels were associated with abnormal tendon reflexes, finger tapping, visual pursuit, size discrimination, draw-a-person, and math calculation skills. Group II consisted of 41 children with a mean PbB level of 47.4 microg/dl (SD: 22.0, range: 6.6-84.7 microg/dl) who were administered Raven's Coloured Progressive Matrices (RCPM) non-verbal reasoning test. Performance on RCPM was abnormal in 22 (53.7%) of 41 children. Children with abnormal RCPM scores had higher PbB levels (t-test: P=0.030). There was a significant inverse correlation between RCPM scores and PbB levels for children ages 9 years and older (r=-0.618, P=0.011). Males had higher mean PbB levels as a function of age than females (t-test: P=0.037), and more males showed neurocognitive deficits. The results demonstrate a range of neurological responses in children with chronically elevated PbB levels from apparent exceptional neuro-physiological tolerance of PbB intoxication, to some fine motor and cognitive deficits.

  19. Effect of a Hypocretin/Orexin Antagonist on Neurocognitive Performance

    Science.gov (United States)

    2011-09-01

    amphetamines, cocaine, cannabis , or any other illicit drugs within 30 days of screening by self report or a urine toxicology screen; 20.) Known...per week or ≥ 4 standard drinks on any day (women). 19.) Use of opioids, benzodiazepines, amphetamines, cocaine, cannabis , or any other illicit...membrane. The drug characteristics and permeation rate of ALM and ZOL depend upon the concentration of drug, the oil /water partition coefficient of

  20. NEUROCOGNITIVE DEFICITS IN HIV-INFECTED WOMEN AND VICTIMS OF CHILDHOOD TRAUMA

    Science.gov (United States)

    Spies, G; Fennema-Notestine, C; Archibald, SL; Cherner, M; Seedat, S

    2015-01-01

    Objectives The study investigated the behavioral and brain effects of childhood trauma and HIV-infection, both separately and in combination, and assessed potential interactions in women who were dually affected. Methods 83 HIV-positive and 47 matched HIV-negative South African women underwent neuromedical, neuropsychiatric and neurocognitive assessments. Univariate tests of significance assessed if either HIV infection or childhood trauma, or the combination, had a significant effect on neurocognitive performance. Results The majority of women were Black (96%) and had an average age of 30. An analysis of covariance revealed significant HIV effects for the Hopkins Verbal Learning Test (HVLT) learning and delay trials (p < .01) and the Halstead Category test (p < .05). A significant trauma effect was seen on the HVLT delay trial (p < .05). Conclusion The results provide evidence for neurocognitive dysfunction in memory and executive functions in HIV-infected women and memory disturbances in trauma exposed women. PMID:22672200

  1. A multicenter study of neurocognition in children with hypertension: methods, challenges, and solutions.

    Science.gov (United States)

    Lande, Marc B; Adams, Heather R; Kupferman, Juan C; Hooper, Stephen R; Szilagyi, Peter G; Batisky, Donald L

    2013-01-01

    Hypertensive adults demonstrate decreased performance on neurocognitive testing compared with that of normotensive controls. There is now emerging, preliminary evidence that children with hypertension also manifest neurocognitive differences when compared with normotensive controls, findings postulated to potentially represent early signs of hypertensive target organ damage to the brain. However, reports in children to date have been limited to database and single-center studies. We have established an ongoing, prospective, multicenter study of neurocognition in children with primary hypertension. This article outlines the study methods, with particular attention to the unique challenges in this area of clinical research. We highlight aspects of the study design that are specifically designed as solutions to these challenges.

  2. Changes in Neurocognitive Functioning After 6 Months of Mentalization-Based Treatment for Borderline Personality Disorder

    DEFF Research Database (Denmark)

    Thomsen, Marianne Skovgaard; Ruocco, Anthony C; Uliaszek, Amanda A

    2016-01-01

    Patients with borderline personality disorder (BPD) have deficits in neurocognitive function that could affect their ability to engage in psychotherapy and may be ameliorated by improvements in symptom severity. In the current study, 18 patients with BPD completed neurocognitive tests prior...... working memory. After 6 months of treatment, patients showed significantly greater increases in sustained attention and perceptual reasoning than controls, with initial deficits in sustained attention among patients resolving after treatment. Improved emotion regulation over the follow-up period...... was associated with increased auditory-verbal working memory capacity, whereas interpersonal functioning improved in parallel with perceptual reasoning. These findings suggest that changes in neurocognitive functioning may track improvements in clinical symptoms in mentalization-based treatment for BPD....

  3. Atypical benign partial epilepsy of childhood with acquired neurocognitive, lexical semantic, and autistic spectrum disorder.

    Science.gov (United States)

    Allen, Nicholas M; Conroy, Judith; Deonna, Thierry; McCreary, Dara; McGettigan, Paul; Madigan, Cathy; Carter, Imogen; Ennis, Sean; Lynch, Sally A; Shahwan, Amre; King, Mary D

    2016-01-01

    Atypical benign partial epilepsy (ABPE) of childhood or pseudo-Lennox syndrome is a form of idiopathic focal epilepsy characterized by multiple seizure types, focal and/or generalized epileptiform discharges, continuous spike-wave during sleep (CSWS), and sometimes reversible neurocognitive deficits. There are few reported cases of ABPE describing detailed correlative longitudinal follow-up of the various associated neurocognitive, language, social communicative, or motor deficits, in parallel with the epilepsy. Furthermore, the molecular inheritance pattern for ABPE and the wider spectrum of epilepsy aphasia disorders have yet to be fully elucidated. We describe the phenotype-genotype study of a boy with ABPE with follow-up from ages 5 to 13 years showing acquired oromotor and, later, a specific lexical semantic and pervasive developmental disorder. Exome sequencing identified variants in SCN9A, CPA6, and SCNM1. A direct role of the epilepsy in the pathogenesis of the oromotor and neurocognitive deficits is apparent.

  4. Educational games for brain health: revealing their unexplored potential through a neurocognitive approach

    Directory of Open Access Journals (Sweden)

    Patrick eFissler

    2015-07-01

    Full Text Available Educational games link the motivational nature of games with learning of knowledge and skills. Here, we go beyond effects on these learning outcomes. We review two lines of evidence which indicate the currently unexplored potential of educational games to promote brain health: First, gaming with specific neurocognitive demands (e.g., executive control, and second, educational learning experiences (e.g., studying foreign languages improve brain health markers. These markers include cognitive ability, brain function, and brain structure. As educational games allow the combination of specific neurocognitive demands with educational learning experiences, they seem to be optimally suited for promoting brain health. We propose a neurocognitive approach to reveal this unexplored potential of educational games in future research.

  5. Association of metabolic syndrome and inflammation with neurocognition in patients with schizophrenia.

    Science.gov (United States)

    Boyer, Laurent; Richieri, Raphaëlle; Dassa, Daniel; Boucekine, Mohamed; Fernandez, Jessica; Vaillant, Florence; Padovani, Romain; Auquier, Pascal; Lancon, Christophe

    2013-12-15

    The aim of this study is to assess the relationships of metabolic syndrome (MetS) and inflammation with neurocognition in schizophrenia. In this cross-sectional study, we included patients with diagnosis of schizophrenia according to the DSM-IV-TR criteria. We collected socio-demographic information, clinical characteristics, anthropometric measurements, blood tests, and neurocognition measures. A multivariate analysis using multiple linear regressions was performed to determine variables that are potentially associated with neurocognition. The analyses were repeated using MetS as a dichotomised variable (inflammation was not associated with cognitive impairment. In conclusion, our findings suggest that MetS, alcohol use and non-smoking status are associated with cognitive impairment. These findings may support complementary therapeutic approaches in cognitive remediation that lessen the severity of cognitive impairment in schizophrenia. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Educational games for brain health: revealing their unexplored potential through a neurocognitive approach.

    Science.gov (United States)

    Fissler, Patrick; Kolassa, Iris-Tatjana; Schrader, Claudia

    2015-01-01

    Educational games link the motivational nature of games with learning of knowledge and skills. Here, we go beyond effects on these learning outcomes. We review two lines of evidence which indicate the currently unexplored potential of educational games to promote brain health: First, gaming with specific neurocognitive demands (e.g., executive control), and second, educational learning experiences (e.g., studying foreign languages) improve brain health markers. These markers include cognitive ability, brain function, and brain structure. As educational games allow the combination of specific neurocognitive demands with educational learning experiences, they seem to be optimally suited for promoting brain health. We propose a neurocognitive approach to reveal this unexplored potential of educational games in future research.

  7. 傅友丰教授治疗闭经经验%Experience of FU You-feng Professor Treatment Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    周红光

    2012-01-01

    对傅友丰教授治疗闭经临床经验进行总结,介绍其治病特色.傅友丰教授治疗闭经强调辨证分虚实;补肾调周,采用中药建立人工周期;补肾填精,健脾和中贯穿始终等方法,取得很好的临床效果,值得临床推广应用.%This paper summarized FU You-feng professor of clinical experience in the treatment of amenorrhea, introduced her Cure characteristics. FUYou-feng professor emphasize that syndrome differentiation distinguish deficiency and exces; nourish kidney use of Chinese medicine build artificial cycle and nourish kidney replenishing essence. Acquired very good clinical effect and deserved clinical application.

  8. Molecular cytogenetic characterization of a non-robertsonian dicentric chromosome 14;19 identified in a girl with short stature and amenorrhea.

    Science.gov (United States)

    Dutta, Usha R; Pidugu, Vijaya Kumar; Dalal, Ashwin

    2012-01-01

    We report a 16-year-old girl who presented with short stature and amenorrhea. Initially the cytogenetic analysis showed the presence of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19. Subsequent molecular cytogenetic analysis by fluorescence in situ hybridization (FISH) using whole chromosome paints, centromeric probes, as well as gene specific probes confirmed the dicentric nature of the derivative chromosome and indicated that the rearrangement involved the short arms of both of these chromosomes. Furthermore, we also determined that the chromosome 19p13.3 breakpoint occurred within the terminal 1 Mb region. This is the first report of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19 with the karyotype determined as 45,XX,dic(14;19)(p11.2;p13.3)[35]/46,XX[15], and we suggest that the chromosome rearrangement could be the cause of clinical phenotype.

  9. Molecular Cytogenetic Characterization of a Non-Robertsonian Dicentric Chromosome 14;19 Identified in a Girl with Short Stature and Amenorrhea

    Directory of Open Access Journals (Sweden)

    Usha R. Dutta

    2012-01-01

    Full Text Available We report a 16-year-old girl who presented with short stature and amenorrhea. Initially the cytogenetic analysis showed the presence of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19. Subsequent molecular cytogenetic analysis by fluorescence in situ hybridization (FISH using whole chromosome paints, centromeric probes, as well as gene specific probes confirmed the dicentric nature of the derivative chromosome and indicated that the rearrangement involved the short arms of both of these chromosomes. Furthermore, we also determined that the chromosome 19p13.3 breakpoint occurred within the terminal 1 Mb region. This is the first report of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19 with the karyotype determined as 45,XX,dic(14;19(p11.2;p13.3[35]/46,XX[15], and we suggest that the chromosome rearrangement could be the cause of clinical phenotype.

  10. Feasibility and safety of virtual-reality-based early neurocognitive stimulation in critically ill patients.

    Science.gov (United States)

    Turon, Marc; Fernandez-Gonzalo, Sol; Jodar, Mercè; Gomà, Gemma; Montanya, Jaume; Hernando, David; Bailón, Raquel; de Haro, Candelaria; Gomez-Simon, Victor; Lopez-Aguilar, Josefina; Magrans, Rudys; Martinez-Perez, Melcior; Oliva, Joan Carles; Blanch, Lluís

    2017-12-01

    Growing evidence suggests that critical illness often results in significant long-term neurocognitive impairments in one-third of survivors. Although these neurocognitive impairments are long-lasting and devastating for survivors, rehabilitation rarely occurs during or after critical illness. Our aim is to describe an early neurocognitive stimulation intervention based on virtual reality for patients who are critically ill and to present the results of a proof-of-concept study testing the feasibility, safety, and suitability of this intervention. Twenty critically ill adult patients undergoing or having undergone mechanical ventilation for ≥24 h received daily 20-min neurocognitive stimulation sessions when awake and alert during their ICU stay. The difficulty of the exercises included in the sessions progressively increased over successive sessions. Physiological data were recorded before, during, and after each session. Safety was assessed through heart rate, peripheral oxygen saturation, and respiratory rate. Heart rate variability analysis, an indirect measure of autonomic activity sensitive to cognitive demands, was used to assess the efficacy of the exercises in stimulating attention and working memory. Patients successfully completed the sessions on most days. No sessions were stopped early for safety concerns, and no adverse events occurred. Heart rate variability analysis showed that the exercises stimulated attention and working memory. Critically ill patients considered the sessions enjoyable and relaxing without being overly fatiguing. The results in this proof-of-concept study suggest that a virtual-reality-based neurocognitive intervention is feasible, safe, and tolerable, stimulating cognitive functions and satisfying critically ill patients. Future studies will evaluate the impact of interventions on neurocognitive outcomes. Trial registration Clinical trials.gov identifier: NCT02078206.

  11. Neurocognitive and personality factors in homo- and heterosexual pedophiles and controls.

    Science.gov (United States)

    Kruger, Tillmann H C; Schiffer, Boris

    2011-06-01

    Several neuropsychological studies have suggested an association between pedophilia, neurocognitive disturbances, and specific personality profiles. However, inconsistencies in the findings have not been explained sufficiently, because many studies did not control for possible confounding factors, such as age, education level, or gender orientation. Therefore, the present investigation examined neurocognitive performance and personality profiles in pedophiles in dependence of sexual gender preferences and sexual deviance, as well as with regard to age and education level. Scores on the different neurocognitive tests, personality questionnaires, and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (SCID) interviews. An extensive neurocognitive test battery (including a reduced version of the German Wechsler Adult Intelligence Scale, the Wisconsin card-sorting test, d2 Attention-Deficit Test, and the Corsi block-tapping test) as well as two personality questionnaires (Minnessota Multiphasic Personality Inventory [MMPI-2] and the Multiphasic Sex Inventory [MSI]) were used to examine a consecutive sample of 20 psychiatrically assessed (SCID I and II) pedophile inpatients (nine exclusively attracted to females and 11 to males) from two high security forensic hospitals and 28 healthy controls (14 heterosexual, 14 homosexual). Compared with controls, pedophiles showed neurocognitive impairments and personality specifics in the majority of tests and questionnaires, such as reduced values on the intelligence scale and weaker performances in information processing, together with high scores for psychopathy and paranoia, and signs of sexual obsessiveness and sexual dysfunction. In contrast to previous reports, some of these alterations were at least partly explained by factors other than pedophilia, such as education level or age. These alterations may be seen to be in line with the hypothesis of a perturbation of

  12. Predictors of neurocognitive outcomes on antiretroviral therapy after cryptococcal meningitis: a prospective cohort study.

    Science.gov (United States)

    Carlson, Renee Donahue; Rolfes, Melissa A; Birkenkamp, Kate E; Nakasujja, Noeline; Rajasingham, Radha; Meya, David B; Boulware, David R

    2014-06-01

    Cryptococcal meningitis is the most common cause of adult meningitis in Africa, yet neurocognitive outcomes are unknown. We investigated the incidence and predictors of neurologic impairment among cryptococcal survivors. HIV-infected, antiretroviral-naive Ugandans with cryptococcal meningitis underwent standardized neuropsychological testing at 1, 3, 6, and 12 months. A quantitative neurocognitive performance z-score (QNPZ) was calculated based on population z-scores from HIV-negative Ugandans (n = 100). Comparison was made with an HIV-infected, non-meningitis cohort (n = 110). Among 78 cryptococcal meningitis survivors with median CD4 count of 13 cells/μL (interquartile range: 6-44), decreased global cognitive function occurred through 12 months compared with the HIV-infected, non-cryptococcosis cohort (QNPZ-6 at 12 months, P = 0.036). Tests of performance in eight cognitive domains was impaired 1 month after cryptococcal diagnosis; however, cryptococcal meningitis survivors improved their global neurocognitive function over 12 months with residual impairment (mean z-scores meningitis severity. Paradoxically, persons with sterile CSF cultures after 14 days of induction amphotericin therapy had worse neurocognitive outcomes than those still culture-positive at 14 days (P = 0.002). Cryptococcal meningitis survivors have significant short-term neurocognitive impairment with marked improvement over the first 12 months. Few characteristics related to severity of cryptococcosis, including Cryptococcus burden, were associated with neurocognitive outcome.

  13. The risk of amenorrhea is related to chemotherapy-induced leucopenia in breast cancer patients receiving epirubicin and taxane based chemotherapy.

    Directory of Open Access Journals (Sweden)

    Wenbin Zhou

    Full Text Available BACKGROUND: Chemotherapy-induced amenorrhea (CIA is common in young breast cancer patients. The incidence of CIA associated with regimens involving epirubicin and taxane was not well known. Furthermore, previous studies suggested leucopenia and amenorrhea may reflect inter-individual variations in pharmacokinetics. The purpose of this study was to investigate the association between leucopenia after first cycle of chemotherapy and CIA in young breast cancer patients receiving epirubicin and taxane based chemotherapy. Furthermore, the incidence of CIA was also assessed. METHODOLOGY AND PRINCIPAL FINDINGS: Between October 2008 and March 2010, 186 consecutive premenopausal patients, treated with epirubicin and taxane based chemotherapy, were recruited. Information about CIA was collected by telephone and out-patient clinic. Of these 186 patients, data from 165 patients were included and analyzed. Of all 165 patients, CIA occurred in 72 patients (43.64%. In multivariate analysis, age older than 40 y (OR: 16.10, 95% CI: 6.34-40.88, P0.05. The rate of CIA in leucopenia group (52.56% was significantly higher than that in normal leukocyte group (34.62% (P = 0.024. In patients treated with a FEC regimen (cyclophosphamide, epirubicin and 5-fluorouracil, the rate of CIA in leucopenia group (59.57% was significantly higher than that in normal leukocyte group (36.84% (P = 0.037. CONCLUSIONS: Age at diagnosis and previous childbearing were both found to significantly increase the risk of CIA, whereas additional taxane was not associated with increased rate of CIA. Importantly, leucopenia after first cycle of chemotherapy was associated with increased risk of CIA, which suggested that leucopenia may be an early predictor of chemotherapy-induced infertility.

  14. Primary hypertension and neurocognitive and executive functioning in school-age children.

    Science.gov (United States)

    Kupferman, Juan C; Lande, Marc B; Adams, Heather R; Pavlakis, Steven G

    2013-03-01

    Data on neurocognitive function in hypertensive children are limited. In this review, we summarize recent preliminary, early studies that suggest that children with elevated blood pressure demonstrate evidence of worse performance on direct neurocognitive testing, as well as evidence of executive dysfunction based on parent ratings, compared with matched normotensive comparison groups. Furthermore, hypertensive children may have increased prevalence of learning disabilities as well as a blunted cerebrovascular reactivity compared with normotensive controls. Larger, prospective studies are needed to confirm and further explore these emerging but preliminary findings.

  15. Neurocognitive development in first episode psychosis 5 years follow-up

    DEFF Research Database (Denmark)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd

    2013-01-01

    Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity, as meas......Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity...

  16. The use of neurocognitive methods in assessing health communication messages: A systematic review.

    Science.gov (United States)

    Kaye, Sherrie-Anne; White, Melanie J; Lewis, Ioni

    2016-02-01

    We review 20 studies that examined persuasive processing and outcomes of health messages using neurocognitive measures. The results suggest that cognitive processes and neural activity in regions thought to reflect self-related processing may be more prominent in the persuasive process of self-relevant messages. Furthermore, activity in the medial prefrontal cortex, the superior temporal gyrus and the middle frontal gyrus were identified as predictors of message effectiveness, with the medial prefrontal cortex accounting for additional variance in behaviour change beyond that accounted for by self-report measures. Incorporating neurocognitive measures may provide a more comprehensive understanding of the processing and outcomes of health messages.

  17. Depression Screening

    Science.gov (United States)

    ... Centers Diseases + Condition Centers Mental Health Medical Library Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  18. Cancer Screening

    Directory of Open Access Journals (Sweden)

    Krishna Prasad

    2004-10-01

    Full Text Available Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  19. Cancer Screening

    OpenAIRE

    Krishna Prasad

    2004-01-01

    Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  20. HIV-associated neurocognitive disorders: recent advances in pathogenesis, biomarkers, and treatment [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Antonia Carroll

    2017-03-01

    Full Text Available HIV-associated neurocognitive disorders (HAND remain prevalent despite plasma viral suppression by antiretroviral agents. In fact, the prevalence of milder subtypes of cognitive impairment is increasing. Neuropsychologic testing remains the “gold standard” of diagnosis; however, this is time consuming and costly in a resource-poor environment. Recently developed screening tools, such as CogState and the revised HIV dementia scale, have very good sensitivity and specificity in the more severe stages of HAND. However, questions remain regarding the utility of, optimal population for, and insensitivity of tests in mild HAND. Recognition of ongoing viral persistence and the inflammatory milieu in the central nervous system (CNS has advanced our understanding of the pathogenesis of HAND and facilitated the development of biomarkers of CNS disease. The importance of the monocyte-macrophage lineage cell and the astrocyte as viral reservoirs, HIV viral proteins, self-perpetuating CNS inflammation, and CCR5 chemokine receptor neurotropism has been identified. Whilst biomarkers demonstrate monocyte activation, inflammation, and neuronal injury, they remain limited in their clinical utility. The improved understanding of pathogenic mechanisms has led to novel approaches to the treatment of HAND; however, despite these advances, the optimal management is still undefined.

  1. Double screening

    Energy Technology Data Exchange (ETDEWEB)

    Gratia, Pierre [Department of Physics, University of Chicago,South Ellis Avenue, Chicago, IL 60637 (United States); Hu, Wayne [Department of Astronomy and Astrophysics, University of Chicago,South Ellis Avenue, Chicago, IL 60637 (United States); Enrico Fermi Institute and Kavli Institute for Cosmological Physics, University of Chicago,South Ellis Avenue, Chicago, IL 60637 (United States); Joyce, Austin [Enrico Fermi Institute and Kavli Institute for Cosmological Physics, University of Chicago,South Ellis Avenue, Chicago, IL 60637 (United States); Ribeiro, Raquel H. [School of Physics and Astronomy, Queen Mary University of London,Mile End Road, London, E1 4NS (United Kingdom)

    2016-06-15

    Attempts to modify gravity in the infrared typically require a screening mechanism to ensure consistency with local tests of gravity. These screening mechanisms fit into three broad classes; we investigate theories which are capable of exhibiting more than one type of screening. Specifically, we focus on a simple model which exhibits both Vainshtein and kinetic screening. We point out that due to the two characteristic length scales in the problem, the type of screening that dominates depends on the mass of the sourcing object, allowing for different phenomenology at different scales. We consider embedding this double screening phenomenology in a broader cosmological scenario and show that the simplest examples that exhibit double screening are radiatively stable.

  2. Increased Intrathecal Immune Activation in Virally Suppressed HIV-1 Infected Patients with Neurocognitive Impairment.

    Directory of Open Access Journals (Sweden)

    Arvid Edén

    Full Text Available Although milder forms of HIV-associated neurocognitive disorder (HAND remain prevalent, a correlation to neuronal injury has not been established in patients on antiretroviral therapy (ART. We examined the relationship between mild HAND and CSF neurofilament light protein (NFL, a biomarker of neuronal injury; and CSF neopterin, a biomarker of CNS immunoactivation, in virally suppressed patients on antiretroviral therapy (ART.We selected 99 subjects on suppressive ART followed longitudinally from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER study. Based on standardized comprehensive neurocognitive performance (NP testing, subjects were classified as neurocognitively normal (NCN; n = 29 or impaired (NCI; n = 70. The NCI group included subjects with asymptomatic (ANI; n = 37 or mild (MND; n = 33 HAND. CSF biomarkers were analyzed on two occasions.Geometric mean CSF neopterin was 25% higher in the NCI group (p = 0.04 and NFL and neopterin were significantly correlated within the NCI group (r = 0.30; p<0.001 but not in the NCN group (r = -0.13; p = 0.3. Additionally, a trend towards higher NFL was seen in the NCI group (p = 0.06.Mild HAND was associated with increased intrathecal immune activation, and the correlation between neopterin and NFL found in NCI subjects indicates an association between neurocognitive impairment, CNS inflammation and neuronal damage. Together these findings suggest that NCI despite ART may represent an active pathological process within the CNS that needs further characterization in prospective studies.

  3. Increased Intrathecal Immune Activation in Virally Suppressed HIV-1 Infected Patients with Neurocognitive Impairment

    Science.gov (United States)

    Edén, Arvid; Marcotte, Thomas D.; Heaton, Robert K.; Nilsson, Staffan; Zetterberg, Henrik; Fuchs, Dietmar; Franklin, Donald; Price, Richard W.; Grant, Igor; Letendre, Scott L.; Gisslén, Magnus

    2016-01-01

    Objective Although milder forms of HIV-associated neurocognitive disorder (HAND) remain prevalent, a correlation to neuronal injury has not been established in patients on antiretroviral therapy (ART). We examined the relationship between mild HAND and CSF neurofilament light protein (NFL), a biomarker of neuronal injury; and CSF neopterin, a biomarker of CNS immunoactivation, in virally suppressed patients on antiretroviral therapy (ART). Design and Methods We selected 99 subjects on suppressive ART followed longitudinally from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study. Based on standardized comprehensive neurocognitive performance (NP) testing, subjects were classified as neurocognitively normal (NCN; n = 29) or impaired (NCI; n = 70). The NCI group included subjects with asymptomatic (ANI; n = 37) or mild (MND; n = 33) HAND. CSF biomarkers were analyzed on two occasions. Results Geometric mean CSF neopterin was 25% higher in the NCI group (p = 0.04) and NFL and neopterin were significantly correlated within the NCI group (r = 0.30; pNFL was seen in the NCI group (p = 0.06). Conclusions Mild HAND was associated with increased intrathecal immune activation, and the correlation between neopterin and NFL found in NCI subjects indicates an association between neurocognitive impairment, CNS inflammation and neuronal damage. Together these findings suggest that NCI despite ART may represent an active pathological process within the CNS that needs further characterization in prospective studies. PMID:27295036

  4. Neurocognitive Elements of Antisocial Behavior: Relevance of an Orbitofrontal Cortex Account

    Science.gov (United States)

    Seguin, Jean R.

    2004-01-01

    This paper reviews the role of orbitofrontal cortex (OFC) lesions in antisocial behaviors and the adequacy of a strict OFC account of antisocial disorders where there is no evidence of lesion. Neurocognitive accounts of antisocial behaviors are extended beyond the OFC. Several methodological shortcomings specific to this neuroscience approach to…

  5. A neurocognitive approach for recovering upper extremity movement following subacute stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Sallés, Laia; Martín-Casas, Patricia; Gironès, Xavier; Durà, María José; Lafuente, José Vicente; Perfetti, Carlo

    2017-04-01

    [Purpose] This study aims to describe a protocol based on neurocognitive therapeutic exercises and determine its feasibility and usefulness for upper extremity functionality when compared with a conventional protocol. [Subjects and Methods] Eight subacute stroke patients were randomly assigned to a conventional (control group) or neurocognitive (experimental group) treatment protocol. Both lasted 30 minutes, 3 times a week for 10 weeks and assessments were blinded. Outcome measures included: Motor Evaluation Scale for Upper Extremity in Stroke Patients, Motricity Index, Revised Nottingham Sensory Assessment and Kinesthetic and Visual Imagery Questionnaire. Descriptive measures and nonparametric statistical tests were used for analysis. [Results] The results indicate a more favorable clinical progression in the neurocognitive group regarding upper extremity functional capacity with achievement of the minimal detectable change. The functionality results are related with improvements on muscle strength and sensory discrimination (tactile and kinesthetic). [Conclusion] Despite not showing significant group differences between pre and post-treatment, the neurocognitive approach could be a safe and useful strategy for recovering upper extremity movement following stroke, especially regarding affected hands, with better and longer lasting results. Although this work shows this protocol's feasibility with the panel of scales proposed, larger studies are required to demonstrate its effectiveness.

  6. Neurocognitive-genetic and neuroimaging-genetic research paradigms in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Kurnianingsih, Yoanna Arlina; Kuswanto, Carissa Nadia; McIntyre, Roger S; Qiu, Anqi; Ho, Beng Choon; Sim, Kang

    2011-11-01

    Studies examining intermediate phenotypes such as neurocognitive and neuroanatomical measures along with susceptibility genes are important for improving our understanding of the neural basis of schizophrenia (SZ) and bipolar disorder (BD). In this paper, we review extant studies involving neurocognitive-genetic and neuroimaging-genetic perspectives and particularly related to catechol-O-methyltransferase (COMT), brain-derived neurotrophic factor (BDNF) and neuregulin-1 (NRG1) genes in SZ and BD. In terms of neurocognitive-genetic investigations, COMT and BDNF are the two most studied candidate genes especially in patients with SZ. Whereas BDNF Met carriers perform worse on verbal working memory, problem solving and visuo-spatial abilities, COMT Met carriers perform better in working memory, attention, executive functioning with evidence of genotype by diagnosis interactions including high-risk individuals. In terms of genetic-structural MRI studies, patients with SZ are found to have reductions in the frontal, temporal, parietal cortices, and limbic regions, which are associated with BDNF, COMT, and NRGI genes. Genetic-functional MRI studies in psychotic disorders are sparse, especially with regard to BD. These neurocognitive and neuroimaging findings are associated with genes which are implicated in functional pathways related to neuronal signaling, inter-neuronal communication and neuroplasticity.

  7. Timing deficits in attention-deficit/hyperactivity disorder (ADHD) : Evidence from neurocognitive and neuroimaging studies

    NARCIS (Netherlands)

    Noreika, Valdas; Falter, Christine M.; Rubia, Katya

    Relatively recently, neurocognitive and neuroimaging studies have indicated that individuals with attention-deficit/hyperactivity disorder (ADHD) may have deficits in a range of timing functions and their underlying neural networks. Despite this evidence, timing deficits in ADHD are still somewhat

  8. Timing deficits in attention-deficit/hyperactivity disorder (ADHD) : Evidence from neurocognitive and neuroimaging studies

    NARCIS (Netherlands)

    Noreika, Valdas; Falter, Christine M.; Rubia, Katya

    2013-01-01

    Relatively recently, neurocognitive and neuroimaging studies have indicated that individuals with attention-deficit/hyperactivity disorder (ADHD) may have deficits in a range of timing functions and their underlying neural networks. Despite this evidence, timing deficits in ADHD are still somewhat n

  9. The Neurocognitive Consequences of the Wandering Mind: A Mechanistic Account of Sensory-Motor Decoupling

    Directory of Open Access Journals (Sweden)

    Julia W. Y. Kam

    2013-10-01

    Full Text Available A unique human characteristic is our ability to mind wander – a state in which we are free to engage in thoughts that are not directly tied to sensations and perceptions from our immediate physical environment. From a neurocognitive perspective, it has been proposed that during mind wandering, our executive resources are decoupled from the external environment and directed to these internal thoughts. In this review, we examine an underappreciated aspect of this phenomenon – attenuation of sensory-motor processing – from two perspectives. First, we describe the range of widespread sensory, cognitive and motor processes attenuated during mind wandering states, and how this impacts our neurocognitive processing of external events. We then consider sensory-motor attenuation in a class of clinical neurocognitive disorders that have ties to pathological patterns of decoupling, reviews suggesting that mind wandering and these clinical states may share a common mechanism of sensory-motor attenuation. Taken together, these observations suggest the sensory-motor consequences of decoupled thinking are integral to normal and pathological neurocognitive states.

  10. The neurocognitive consequences of the wandering mind: a mechanistic account of sensory-motor decoupling.

    Science.gov (United States)

    Kam, Julia W Y; Handy, Todd C

    2013-10-14

    A unique human characteristic is our ability to mind wander - a state in which we are free to engage in thoughts that are not directly tied to sensations and perceptions from our immediate physical environment. From a neurocognitive perspective, it has been proposed that during mind wandering, our executive resources are decoupled from the external environment and directed to these internal thoughts. In this review, we examine an underappreciated aspect of this phenomenon - attenuation of sensory-motor processing - from two perspectives. First, we describe the range of widespread sensory, cognitive and motor processes attenuated during mind wandering states, and how this impacts our neurocognitive processing of external events. We then consider sensory-motor attenuation in a class of clinical neurocognitive disorders that have ties to pathological patterns of decoupling, reviews suggesting that mind wandering and these clinical states may share a common mechanism of sensory-motor attenuation. Taken together, these observations suggest the sensory-motor consequences of decoupled thinking are integral to normal and pathological neurocognitive states.

  11. Advanced paternal age is associated with impaired neurocognitive outcomes during infancy and childhood.

    Directory of Open Access Journals (Sweden)

    Sukanta Saha

    2009-03-01

    Full Text Available BACKGROUND: Advanced paternal age (APA is associated with an increased risk of neurodevelopmental disorders such as autism and schizophrenia, as well as with dyslexia and reduced intelligence. The aim of this study was to examine the relationship between paternal age and performance on neurocognitive measures during infancy and childhood. METHODS AND FINDINGS: A sample of singleton children (n = 33,437 was drawn from the US Collaborative Perinatal Project. The outcome measures were assessed at 8 mo, 4 y, and 7 y (Bayley scales, Stanford Binet Intelligence Scale, Graham-Ernhart Block Sort Test, Wechsler Intelligence Scale for Children, Wide Range Achievement Test. The main analyses examined the relationship between neurocognitive measures and paternal or maternal age when adjusted for potential confounding factors. Advanced paternal age showed significant associations with poorer scores on all of the neurocognitive measures apart from the Bayley Motor score. The findings were broadly consistent in direction and effect size at all three ages. In contrast, advanced maternal age was generally associated with better scores on these same measures. CONCLUSIONS: The offspring of older fathers show subtle impairments on tests of neurocognitive ability during infancy and childhood. In light of secular trends related to delayed fatherhood, the clinical implications and the mechanisms underlying these findings warrant closer scrutiny.

  12. Effects of Finger Counting on Numerical Development – The Opposing Views of Neurocognition and Mathematics Education

    Science.gov (United States)

    Moeller, Korbinian; Martignon, Laura; Wessolowski, Silvia; Engel, Joachim; Nuerk, Hans-Christoph

    2011-01-01

    Children typically learn basic numerical and arithmetic principles using finger-based representations. However, whether or not reliance on finger-based representations is beneficial or detrimental is the subject of an ongoing debate between researchers in neurocognition and mathematics education. From the neurocognitive perspective, finger counting provides multisensory input, which conveys both cardinal and ordinal aspects of numbers. Recent data indicate that children with good finger-based numerical representations show better arithmetic skills and that training finger gnosis, or “finger sense,” enhances mathematical skills. Therefore neurocognitive researchers conclude that elaborate finger-based numerical representations are beneficial for later numerical development. However, research in mathematics education recommends fostering mentally based numerical representations so as to induce children to abandon finger counting. More precisely, mathematics education recommends first using finger counting, then concrete structured representations and, finally, mental representations of numbers to perform numerical operations. Taken together, these results reveal an important debate between neurocognitive and mathematics education research concerning the benefits and detriments of finger-based strategies for numerical development. In the present review, the rationale of both lines of evidence will be discussed. PMID:22144969

  13. Neurocognitive functioning in euthymic patients with bipolar disorder and unaffected relatives: A review of the literature.

    Science.gov (United States)

    Cardenas, Stephanie A; Kassem, Layla; Brotman, Melissa A; Leibenluft, Ellen; McMahon, Francis J

    2016-10-01

    Neurocognitive deficits are present in bipolar disorder (BD) patients and their unaffected (nonbipolar) relatives, but it is not clear which domains are most often impaired and the extent of the impairment resulting from shared genetic factors. In this literature review, we address these issues and identify specific neurocognitive tasks most sensitive to cognitive deficits in patients and unaffected relatives. We conducted a systematic review in Web of Science, PubMed/Medline and PsycINFO databases. Fifty-one articles assessing cognitive functioning in BD patients (23 studies) and unaffected relatives (28 studies) were examined. Patients and, less so, relatives show impairments in attention, processing speed, verbal learning/memory, and verbal fluency. Studies were more likely to find impairment in patients than relatives, suggesting that some neurocognitive deficits may be a result of the illness itself and/or its treatment. However, small sample sizes, differences among relatives studied (e.g., relatedness, diagnostic status, age), and differences in assessment instruments may contribute to inconsistencies in reported neurocognitive performance among relatives. Additional studies addressing these issues are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

    DEFF Research Database (Denmark)

    Haddow, Lewis J; Laverick, Rosanna; Daskalopoulou, Marina

    2017-01-01

    We conducted a cross-sectional study in 448 HIV positive patients attending five European outpatient clinics to determine prevalence of and factors associated with neurocognitive impairment (NCI) using computerized and pen-and-paper neuropsychological tests. NCI was defined as a normalized Z score...

  15. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence?

    Directory of Open Access Journals (Sweden)

    Gisslén Magnus

    2011-12-01

    Full Text Available Abstract Background A substantial prevalence of mild neurocognitive disorders has been reported in HIV, also in patients treated with combination antiretroviral therapy (cART. This includes a new disorder that has been termed asymptomatic neurocognitive impairment (ANI. Discussion ANI is identified by performance on formal neuropsychological testing that is at least 1 SD below the mean of normative scores in at least two cognitive domains out of at least five examined in patients without associated symptoms or evident functional impairment in daily living. While two tests are recommended to assess each domain, only one is required to fulfill this diagnostic criterion. Unfortunately, this definition necessitates that about 20% of the cognitively normal HIV-infected population is classified as suffering ANI. This liberal definition raises important ethical concerns and has as well diagnostic and therapeutic implications. Since neither its biological substrate, prognostic significance nor therapeutic implications are clearly established, we recommend that this diagnosis be modified or applied cautiously. Summary The diagnoses of less severe forms of neurocognitive disorders in HIV relies on the outcomes of neuropsychological testing, and a high proportion of HIV-infected patients with effective cART may be classified as neurocognitively abnormal using the current criteria. The definition of ANI is not stringent, and results in approximately 20% of the population being classified as abnormal. To us this seems an unacceptable false-positive rate.

  16. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence?

    Science.gov (United States)

    Gisslén, Magnus; Price, Richard W; Nilsson, Staffan

    2011-12-28

    A substantial prevalence of mild neurocognitive disorders has been reported in HIV, also in patients treated with combination antiretroviral therapy (cART). This includes a new disorder that has been termed asymptomatic neurocognitive impairment (ANI). ANI is identified by performance on formal neuropsychological testing that is at least 1 SD below the mean of normative scores in at least two cognitive domains out of at least five examined in patients without associated symptoms or evident functional impairment in daily living. While two tests are recommended to assess each domain, only one is required to fulfill this diagnostic criterion. Unfortunately, this definition necessitates that about 20% of the cognitively normal HIV-infected population is classified as suffering ANI. This liberal definition raises important ethical concerns and has as well diagnostic and therapeutic implications. Since neither its biological substrate, prognostic significance nor therapeutic implications are clearly established, we recommend that this diagnosis be modified or applied cautiously. The diagnoses of less severe forms of neurocognitive disorders in HIV relies on the outcomes of neuropsychological testing, and a high proportion of HIV-infected patients with effective cART may be classified as neurocognitively abnormal using the current criteria. The definition of ANI is not stringent, and results in approximately 20% of the population being classified as abnormal. To us this seems an unacceptable false-positive rate.

  17. 75 FR 5335 - Workshop on Pediatric Neurological and Neurocognitive Assessments for Cardiovascular Devices...

    Science.gov (United States)

    2010-02-02

    ... societies, other government agencies, and industry on various neurological and neurocognitive assessments... restricted growth in the field. Several peer-reviewed journal articles acknowledge that there are no... about lodging, and other relevant information will be posted, as it becomes available, on the Internet...

  18. Elementary neurocognitive function, facial affect recognition and social-skills in schizophrenia.

    Science.gov (United States)

    Meyer, Melissa B; Kurtz, Matthew M

    2009-05-01

    Social-skill deficits are pervasive in schizophrenia and negatively impact many key aspects of functioning. Prior studies have found that measures of elementary neurocognition and social cognition are related to social-skills. In the present study we selected a range of neurocognitive measures and examined their relationship with identification of happy and sad faces and performance-based social-skills. Fifty-three patients with schizophrenia or schizoaffective disorder participated. Results revealed that: 1) visual vigilance, problem-solving and affect recognition were related to social-skill; 2) links between problem-solving and social-skill, but not visual vigilance and social-skill, remained significant when estimates of verbal intelligence were controlled; 3) affect recognition deficits explained unique variance in social-skill after neurocognitive variables were controlled; and 4) affect recognition deficits partially mediated the relationship of visual vigilance and social-skill. These results support the conclusion that facial affect recognition deficits are a crucial domain of impairment in schizophrenia that both contribute unique variance to social-skill deficits and may also mediate the relationship between some aspects of neurocognition and social-skill. These findings may help guide the development and refinement of cognitive and social-cognitive remediation methods for social-skill impairment.

  19. Genetic basis of neurocognitive decline and reduced white-matter integrity in normal human brain aging.

    Science.gov (United States)

    Glahn, David C; Kent, Jack W; Sprooten, Emma; Diego, Vincent P; Winkler, Anderson M; Curran, Joanne E; McKay, D Reese; Knowles, Emma E; Carless, Melanie A; Göring, Harald H H; Dyer, Thomas D; Olvera, Rene L; Fox, Peter T; Almasy, Laura; Charlesworth, Jac; Kochunov, Peter; Duggirala, Ravi; Blangero, John

    2013-11-19

    Identification of genes associated with brain aging should markedly improve our understanding of the biological processes that govern normal age-related decline. However, challenges to identifying genes that facilitate successful brain aging are considerable, including a lack of established phenotypes and difficulties in modeling the effects of aging per se, rather than genes that influence the underlying trait. In a large cohort of randomly selected pedigrees (n = 1,129 subjects), we documented profound aging effects from young adulthood to old age (18-83 y) on neurocognitive ability and diffusion-based white-matter measures. Despite significant phenotypic correlation between white-matter integrity and tests of processing speed, working memory, declarative memory, and intelligence, no evidence for pleiotropy between these classes of phenotypes was observed. Applying an advanced quantitative gene-by-environment interaction analysis where age is treated as an environmental factor, we demonstrate a heritable basis for neurocognitive deterioration as a function of age. Furthermore, by decomposing gene-by-aging (G × A) interactions, we infer that different genes influence some neurocognitive traits as a function of age, whereas other neurocognitive traits are influenced by the same genes, but to differential levels, from young adulthood to old age. In contrast, increasing white-matter incoherence with age appears to be nongenetic. These results clearly demonstrate that traits sensitive to the genetic influences on brain aging can be identified, a critical first step in delineating the biological mechanisms of successful aging.

  20. Apolipoprotein E4 genotype does not increase risk of HIV-associated neurocognitive disorders.

    Science.gov (United States)

    Morgan, E E; Woods, S P; Letendre, S L; Franklin, D R; Bloss, C; Goate, A; Heaton, R K; Collier, A C; Marra, C M; Gelman, B B; McArthur, J C; Morgello, S; Simpson, D M; McCutchan, J A; Ellis, R J; Abramson, I; Gamst, A; Fennema-Notestine, C; Smith, D M; Grant, I; Vaida, F; Clifford, D B

    2013-04-01

    This is a cross-sectional, observational study to evaluate the hypothesis that HIV-seropositive (HIV+) apolipoprotein E4 (APOE4) carriers are at increased risk for HIV-associated neurocognitive disorders (HAND) compared to APOE4 noncarriers with HIV in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Group sample. APOE genotype was determined in 466 CHARTER participants with varying disease stages and histories of antiretroviral treatment who did not have severe psychiatric or medical comorbid conditions that preclude diagnosis of HAND. HAND diagnoses were based on results of comprehensive neurobehavioral evaluation and use of current neuroAIDS diagnostic criteria. HAND status consists of two levels: neuropsychologically normal status (i.e., no HAND) and any HAND diagnosis (i.e., asymptomatic neurocognitive impairment, minor neurocognitive disorder, HIV-associated dementia). Logistic regression analyses revealed no association between APOE4 carrier status and HAND, and there were no interactions between APOE4 carrier status and ethnicity, age, substance use disorders, duration of infection, or nadir CD4. Results did not differ when analysis was restricted to symptomatic HAND, and no APOE4 gene dose-dependent relationship to HAND emerged. APOE4 status was not associated with concurrent HAND in this large, well-characterized sample. This does not preclude emergence of an association between APOE4 status and HAND as this population ages. Prospective, longitudinal studies are needed to examine APOE4 as a risk factor for neurocognitive decline, incident HAND at older ages, and potential associations with cerebrospinal fluid amyloid.

  1. Evidence of Impaired Neurocognitive Functioning in School-Age Children Awaiting Cardiac Surgery

    Science.gov (United States)

    van der Rijken, Rachel; Hulstijn-Dirkmaat, Gerdine; Kraaimaat, Floris; Nabuurs-Kohrman, Lida; Daniels, Otto; Maassen, Ben

    2010-01-01

    Aim: Children with congenital heart disease (CHD) are at risk of developing neurocognitive problems. However, as these problems are usually identified after cardiac surgery, it is unclear whether they resulted from the surgery or whether they pre-existed and hence might be explained by complications and events associated with the heart disease…

  2. Does assessment of personal exposure matter during experimental neurocognitive testing in MRI-related magnetic fields?

    NARCIS (Netherlands)

    van Nierop, Lotte E; Christopher-de Vries, Y.; Slottje, Pauline; Kromhout, Hans

    2015-01-01

    PURPOSE: To determine whether the use of quantitative personal exposure measurements in experimental research would result in better estimates of the associations between static and time-varying magnetic field exposure and neurocognitive test performance than when exposure categories were based sole

  3. Computerized neurocognitive testing in the management of sport-related concussion: an update.

    Science.gov (United States)

    Resch, Jacob E; McCrea, Michael A; Cullum, C Munro

    2013-12-01

    Since the late nineties, computerized neurocognitive testing has become a central component of sport-related concussion (SRC) management at all levels of sport. In 2005, a review of the available evidence on the psychometric properties of four computerized neuropsychological test batteries concluded that the tests did not possess the necessary criteria to warrant clinical application. Since the publication of that review, several more computerized neurocognitive tests have entered the market place. The purpose of this review is to summarize the body of published studies on psychometric properties and clinical utility of computerized neurocognitive tests available for use in the assessment of SRC. A review of the literature from 2005 to 2013 was conducted to gather evidence of test-retest reliability and clinical validity of these instruments. Reviewed articles included both prospective and retrospective studies of primarily sport-based adult and pediatric samples. Summaries are provided regarding the available evidence of reliability and validity for the most commonly used computerized neurocognitive tests in sports settings.

  4. The Influence of Education and Age on Neurocognitive Test Performance in Alzheimer's Disease and Vascular Dementia

    Science.gov (United States)

    DenBesten, Nicholas P.

    2009-01-01

    This research involves an examination of the relationship between education and age on a wide array of neuropsychological test measures among patients diagnosed with Alzheimer's and vascular dementia. The purpose of this study was to investigate the role of education as an attenuating factor to neurocognitive decline in dementia. Although numerous…

  5. Evidence of Impaired Neurocognitive Functioning in School-Age Children Awaiting Cardiac Surgery

    Science.gov (United States)

    van der Rijken, Rachel; Hulstijn-Dirkmaat, Gerdine; Kraaimaat, Floris; Nabuurs-Kohrman, Lida; Daniels, Otto; Maassen, Ben

    2010-01-01

    Aim: Children with congenital heart disease (CHD) are at risk of developing neurocognitive problems. However, as these problems are usually identified after cardiac surgery, it is unclear whether they resulted from the surgery or whether they pre-existed and hence might be explained by complications and events associated with the heart disease…

  6. Insight change in psychosis : relationship with neurocognition, social cognition, clinical symptoms and phase of illness

    NARCIS (Netherlands)

    Quee, P. J.; van der Meer, L.; Krabbendam, L.; de Haan, L.; Cahn, W.; Wiersma, D.; van Beveren, N.; Pijnenborg, G. H. M.; Mulder, C. L.; Bruggeman, R.; Aleman, A.

    2014-01-01

    Objective: Impaired insight is an important and prevalent symptom of psychosis. It remains unclear whether cognitive disturbances hamper improvements in insight. We investigated the neurocognitive, social cognitive, and clinical correlates of changes in insight. Method: One hundred and fifty-four pa

  7. Mindfulness Training Targets Neurocognitive Mechanisms of Addiction at the Attention-Appraisal-Emotion Interface

    Science.gov (United States)

    Garland, Eric L.; Froeliger, Brett; Howard, Matthew O.

    2014-01-01

    Prominent neuroscience models suggest that addictive behavior occurs when environmental stressors and drug-relevant cues activate a cycle of cognitive, affective, and psychophysiological mechanisms, including dysregulated interactions between bottom-up and top-down neural processes, that compel the user to seek out and use drugs. Mindfulness-based interventions (MBIs) target pathogenic mechanisms of the risk chain linking stress and addiction. This review describes how MBIs may target neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface. Empirical evidence is presented suggesting that MBIs ameliorate addiction by enhancing cognitive regulation of a number of key processes, including: clarifying cognitive appraisal and modulating negative emotions to reduce perseverative cognition and emotional arousal; enhancing metacognitive awareness to regulate drug-use action schema and decrease addiction attentional bias; promoting extinction learning to uncouple drug-use triggers from conditioned appetitive responses; reducing cue-reactivity and increasing cognitive control over craving; attenuating physiological stress reactivity through parasympathetic activation; and increasing savoring to restore natural reward processing. Treatment and research implications of our neurocognitive framework are presented. We conclude by offering a temporally sequenced description of neurocognitive processes targeted by MBIs through a hypothetical case study. Our neurocognitive framework has implications for the optimization of addiction treatment with MBIs. PMID:24454293

  8. Neurocognitive and Behavioral Outcomes of Younger Siblings of Children with Autism Spectrum Disorder at Age Five

    Science.gov (United States)

    Warren, Zachary E.; Foss-Feig, Jennifer H.; Malesa, Elizabeth E.; Lee, Evon Batey; Taylor, Julie Lounds; Newsom, Cassandra R.; Crittendon, Julie; Stone, Wendy L.

    2012-01-01

    Later-born siblings of children with Autism Spectrum Disorders (ASD) are at increased risk for ASD as well as qualitatively similar traits not meeting clinical cutoffs for the disorder. This study examined age five neurocognitive and behavioral outcomes of 39 younger siblings of children with ASD (Sibs-ASD) and 22 younger siblings of typically…

  9. Colon cancer screening

    Science.gov (United States)

    Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal ...

  10. Brain-derived neurotrophic factor (BDNF) and neurocognitive deficits in people with schizophrenia: a meta-analysis.

    Science.gov (United States)

    Ahmed, Anthony O; Mantini, Andrew M; Fridberg, Daniel J; Buckley, Peter F

    2015-03-30

    Studies suggest that the BDNF Val66Met (rs6265) polymorphism is associated with the incidence of schizophrenia and neurocognitive functioning. These associations appear to be however somewhat mixed. We conducted two separate meta-analyses to investigate (1) the association between the Val66Met polymorphism and neurocognition in people with schizophrenia and (2) the association between peripheral expression of BDNF and neurocognitive phenotypes. For the first aim, we identified 12 studies and 67 comparisons of Met allele carriers and Val homozygotes. These comparisons included 1890 people with schizophrenia (men=1465, women=553), of whom 972 were Met allele carriers and 918 were Val homozygotes. For the second aim, we identified five studies and 25 correlations of peripheral BDNF and neurocognitive scores. The meta-analysis for the second aim included 414 people with schizophrenia (men=292, women=170). First, we found non-significant difference between the genotype groups on most neurocognitive domains. Second, correlations between peripheral BDNF and neurocognitive phenotypes were minimal but we obtained significant effects for the reasoning and problem-solving domains; thus, higher levels of BDNF expression corresponded to better performance on reasoning/problem-solving tasks. The meta-analyses did not robustly establish an association between BDNF Val66Met polymorphism and neurocognition in schizophrenia.

  11. Neurocognitive functioning and outcome of the Illness Management and Recovery Program for clients with schizophrenia and schizoaffective disorder.

    Science.gov (United States)

    Färdig, Rickard; Fredriksson, Anders; Lewander, Tommy; Melin, Lennart; Mueser, Kim T

    2016-08-01

    The relationship between psychosocial programming and neurocognition has been established in previous research, but has not been explored in the context of the Illness Management and Recovery Program (IMR). This study examined associations between neurocognition and illness self-management skills acquisition, based on two previous trials of IMR. Neurocognitive functioning was assessed at baseline and post-treatment in 53 participants with schizophrenia or schizoaffective disorder who completed the IMR. Illness self-management was measured by the client and clinician versions of the Illness Management and Recovery Scale. Statistical analyses investigated improvements in neurocognitive functioning and possible association between illness self-management skills acquisition and neurocognitive functioning. Speed of processing as measured by the Trail Making Test A, was related to client-reported acquisition of illness self-management skills, before and after controlling for psychiatric symptoms and medication, but did not predict improvement in clinician ratings of client illness self-management skills. However, when controlling for client session attendance rates, the association between speed of processing and client-reported illness self-management skills acquisition ceased to be statistically significant, which suggests that compromised neurocognitive functioning does not reduce response to training in illness self-management in itself. The association between the frequency of attended IMR sessions and outcome of the IMR seems to decrease the negative impact of compromised neurocognition on illness self-management skills acquisition. Also, clients with slower speed of processing may experience less benefit from the IMR and may attend fewer sessions.

  12. The influence of HLA on HIV-associated neurocognitive impairment in Anhui, China.

    Directory of Open Access Journals (Sweden)

    Rachel D Schrier

    Full Text Available BACKGROUND: HLA-DR*04 was identified as a predictor of HIV-Associated neurocognitive disorder (HAND, low CD4 T-cell responses to HIV, and low plasma HIV RNA levels in a U.S. cohort. We hypothesized that low CD4 T-cell activation leads to poor immune control of HIV in the CNS, predisposing to HAND, but also provided fewer target (activated CD4 T-cells for HIV replication. To assess the consistency of these HLA Class II associations in a new cohort and extend analysis to HLA Class I, HLA types, neurocognitive, and virologic status were examined in a cohort of former plasma donors in China. METHODS: 178 HIV infected individuals in Anhui China, were HLA typed and underwent neurocognitive evaluations (using locally standardized norms, neuromedical, treatment and virologic assessments at baseline and at 12 months. RESULTS: HLA DR*04 was associated with a higher rate of baseline neurocognitive impairment (p = 0.04, neurocognitive decline (p = 0.04, and lower levels of HIV RNA in plasma (p = 0.05. HLA Class I alleles (B*27,57,58,A*03,33 that specify a CD8 T-cell response to conserved HIV sequences were neuroprotective, associated with less impairment at baseline (p = 0.037, at month 012 (p = 0.013 and less neurocognitive decline (p = 0.023 in the interval. Consistent with the theory that effective CD8 T-cell responses require CD4 T-cell support, the HLA DR*04 allele reduced the neuroprotective effect of the Class I alleles. The presence of HLA-DR*04 and the Alzheimer associated allele ApoE4 in the same individual had a synergistic negative effect on cognition (p = 0.003. CONCLUSIONS: Despite major background differences between U.S. and Anhui China cohorts, HLA DR*04 predicted neurocognitive impairment and lower plasma HIV RNA levels in both populations. HLA Class I alleles associated with CD8 T-cell control of HIV were associated with protection from HAND, but protection was reduced in the presence of HLA-DR*04.

  13. Neurocognitive function in clinically stable individuals with long-term bipolar I disorder: Comparisons with schizophrenia patients and controls

    Directory of Open Access Journals (Sweden)

    Pei-Yun Lin

    2017-05-01

    Full Text Available This study compared the levels of the five domains of neurocognitive function—executive function, attention, memory, verbal comprehension, and perceptual organization—among clinically stable individuals with long-term bipolar I disorder, individuals with long-term schizophrenia, and a group of controls. We recruited a total of 93 clinically stable individuals with bipolar I disorder, 94 individuals with schizophrenia, and 106 controls in this study. Their neurocognitive function was measured using a series of neurocognitive function tests: the Wechsler Adult Intelligence Scale—Third Edition (WAIS-III, Line Cancellation Test, Visual Form Discrimination, Controlled Oral Word Association Test, Wisconsin Card Sorting Test, Continuous Performance Task, and Wechsler Memory Scale—Third Edition. Neurocognitive function was compared among the three groups through a multivariate analysis of variance. The results indicated that when the effect of age was controlled, clinically stable individuals with bipolar I disorder and those with schizophrenia demonstrated poor neurocognitive function on all tests except for the WAIS-III Similarity and Information and the Line Cancellation Test. The individuals with bipolar I disorder had similar levels of neurocognitive function compared with the schizophrenia group, but higher levels of neurocognitive function on the WAIS-III Comprehension, Controlled Oral Word Association Test, and Wechsler Memory Scale—Third Edition Auditory Immediate and Delayed Index and Visual Immediate and Delayed Index. The conclusions of this study suggest that compared with controls, individuals with long-term bipolar I disorder and those with long-term schizophrenia have poorer neurocognitive function, even when clinically stable. Individuals with long-term bipolar I disorder and those with long-term schizophrenia have similar levels of deficits in several domains of neurocognitive function.

  14. Metacognition as a Mediating Variable Between Neurocognition and Functional Outcome in First Episode Psychosis.

    Science.gov (United States)

    Davies, Geoff; Fowler, David; Greenwood, Kathryn

    2016-09-02

    Neurocognitive and functional outcome deficits have long been acknowledged in schizophrenia and neurocognition has been found to account for functional disability to a greater extent than psychopathology. Much of the variance in functional outcome however still remains unexplained and metacognition may mediate the relationship between neurocognition, functional capacity, and self-reported social and occupational function. Eighty first episode psychosis participants were recruited and completed measures of neurocognition (memory, executive function, and intelligence quotient), metacognition (Beck Cognitive Insight Scale, Metacognitive Awareness Interview), psychopathology (PANSS), and both functional capacity (UPSA) and real-life social and occupational function (The Time Use Survey). Path analyses investigated the relationships between variables through structural equation modeling. A series of path models demonstrated that metacognition partially mediates the relationship between neurocognition and functional capacity, and fully mediates the relationship between functional capacity and social and occupational function. The present study findings identify that metacognition may be critical to translating cognitive and functional skills into real-world contexts, and this relationship is found at early stages of illness. Understanding how individuals translate cognitive and functional skills into the real-world (the competence-performance gap) may offer valuable guidance to intervention programs. This finding is important to models of recovery as it suggests that intervention programs that focus on enhancing metacognition abilities may have a greater impact than traditional rehabilitation programs focusing on cognitive abilities, on social and occupational outcomes. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  15. Characterization of neurophysiologic and neurocognitive biomarkers for use in genomic and clinical outcome studies of schizophrenia.

    Directory of Open Access Journals (Sweden)

    Gregory A Light

    Full Text Available BACKGROUND: Endophenotypes are quantitative, laboratory-based measures representing intermediate links in the pathways between genetic variation and the clinical expression of a disorder. Ideal endophenotypes exhibit deficits in patients, are stable over time and across shifts in psychopathology, and are suitable for repeat testing. Unfortunately, many leading candidate endophenotypes in schizophrenia have not been fully characterized simultaneously in large cohorts of patients and controls across these properties. The objectives of this study were to characterize the extent to which widely-used neurophysiological and neurocognitive endophenotypes are: 1 associated with schizophrenia, 2 stable over time, independent of state-related changes, and 3 free of potential practice/maturation or differential attrition effects in schizophrenia patients (SZ and nonpsychiatric comparison subjects (NCS. Stability of clinical and functional measures was also assessed. METHODS: Participants (SZ n = 341; NCS n = 205 completed a battery of neurophysiological (MMN, P3a, P50 and N100 indices, PPI, startle habituation, antisaccade, neurocognitive (WRAT-3 Reading, LNS-forward, LNS-reorder, WCST-64, CVLT-II. In addition, patients were rated on clinical symptom severity as well as functional capacity and status measures (GAF, UPSA, SOF. 223 subjects (SZ n = 163; NCS n = 58 returned for retesting after 1 year. RESULTS: Most neurophysiological and neurocognitive measures exhibited medium-to-large deficits in schizophrenia, moderate-to-substantial stability across the retest interval, and were independent of fluctuations in clinical status. Clinical symptoms and functional measures also exhibited substantial stability. A Longitudinal Endophenotype Ranking System (LERS was created to rank neurophysiological and neurocognitive biomarkers according to their effect sizes across endophenotype criteria. CONCLUSIONS: The majority of neurophysiological and

  16. Neurocognition and Duration of Psychosis: A 10-year Follow-up of First-Episode Patients.

    Science.gov (United States)

    Rund, Bjørn Rishovd; Barder, Helene Eidsmo; Evensen, Julie; Haahr, Ulrik; ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Langeveld, Johannes; Larsen, Tor Ketil; Melle, Ingrid; Opjordsmoen, Stein; Røssberg, Jan Ivar; Simonsen, Erik; Sundet, Kjetil; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2016-01-01

    A substantial proportion of schizophrenia-spectrum patients exhibit a cognitive impairment at illness onset. However, the long-term course of neurocognition and a possible neurotoxic effect of time spent in active psychosis, is a topic of controversy. Furthermore, it is of importance to find out what predicts the long-term course of neurocognition. Duration of untreated psychosis (DUP), accumulated time in psychosis the first year after start of treatment, relapse rates and symptoms are potential predictors of the long-term course. In this study, 261 first-episode psychosis patients were assessed neuropsychologically on one or more occasions. Patients were tested after remission of psychotic symptoms and reassessed 1, 2, 5, and 10 years after inclusion. The neurocognitive battery consisted of California Verbal Learning Test, Wisconsin Card Sorting Test, Controlled Oral Word Association Task, Trail Making A and B, and Finger Tapping. We calculated a composite score by adding the z-scores of 4 tests that were only moderately inter-correlated, not including Finger Tapping. Data were analyzed by a linear mixed model. The composite score was stable over 10 years. No significant relationship between psychosis before (DUP) or after start of treatment and the composite score was found, providing no support for the neurotoxicity hypothesis, and indicating that psychosis before start of treatment has no significant impact on the course and outcome in psychosis. We found no association between symptoms and the neurocognitive trajectory. Stable remission during the first year predicted neurocognitive functioning, suggesting that the early clinical course is a good predictor for the long-term course. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  17. Increasing orthostatic stress impairs neurocognitive functioning in chronic fatigue syndrome with postural tachycardia syndrome.

    Science.gov (United States)

    Ocon, Anthony J; Messer, Zachary R; Medow, Marvin S; Stewart, Julian M

    2012-03-01

    CFS (chronic fatigue syndrome) is commonly co-morbid with POTS (postural tachycardia syndrome). Individuals with CFS/POTS experience unrelenting fatigue, tachycardia during orthostatic stress and ill-defined neurocognitive impairment, often described as 'mental fog'. We hypothesized that orthostatic stress causes neurocognitive impairment in CFS/POTS related to decreased CBFV (cerebral blood flow velocity). A total of 16 CFS/POTS and 20 control subjects underwent graded tilt table testing (at 0, 15, 30, 45, 60 and 75°) with continuous cardiovascular, cerebrovascular, and respiratory monitoring and neurocognitive testing using an n-back task at each angle. The n-back task tests working memory, concentration, attention and information processing. The n-back task imposes increasing cognitive challenge with escalating (0-, 1-, 2-, 3- and 4-back) difficulty levels. Subject dropout due to orthostatic presyncope at each angle was similar between groups. There were no n-back accuracy or RT (reaction time) differences between groups while supine. CFS/POTS subjects responded less correctly during the n-back task test and had greater nRT (normalized RT) at 45, 60 and 75°. Furthermore, at 75° CFS/POTS subjects responded less correctly and had greater nRT than controls during the 2-, 3- and 4-back tests. Changes in CBFV were not different between the groups and were not associated with n-back task test scores. Thus we conclude that increasing orthostatic stress combined with a cognitive challenge impairs the neurocognitive abilities of working memory, accuracy and information processing in CFS/POTS, but that this is not related to changes in CBFV. Individuals with CFS/POTS should be aware that orthostatic stress may impair their neurocognitive abilities.

  18. Metacognition in schizophrenia spectrum disorders: Methods of assessment and associations with neurocognition and function

    Directory of Open Access Journals (Sweden)

    Paul H. Lysaker

    2010-12-01

    Full Text Available Background and Objectives: Research has confirmed that many with schizophrenia experience deficits in metacognitive capacity defined as impairments in the ability to think about thinking, both with regards to their own thinking and the thinking of others. These difficulties are related to, but not reducible to symptoms. One question posed here regards how these deficits are linked to other forms of cognitive deficits, including deficits in neurocognition, and how they and other forms of cognitive deficits are related to the ability to function. As neurocognition is degraded in schizophrenia, does the ability to think about one´s own thinking diminish? Do deficits in metacognition affect function in a manner semi-independent of deficits in neurocognition? Methods: To explore these possibilities, this paper reviews recent studies of metacognition as assessed within personal narratives of self and illness spontaneously generated by adults with schizophrenia spectrum disorders. Results: Studies are reviewed which suggest that impairments in verbal memory and executive function may interfere with the ability to form and sustain representation of one´s own internal state as well as the internal states of others. Additionally, results are detailed which suggest that metacognitive deficits directly affect function prospectively and may mediate the impact of neurocognitive deficits on functioning. Conclusions: Results are consistent with the possibility that a certain level of neurocognition is needed to think about thinking in a complex manner and that the ability to think about thinking is intimately related to the ability to work and relate to others among persons with schizophrenia.

  19. Relationship between ventricular size, white matter injury, and neurocognition in children with stable, treated hydrocephalus.

    Science.gov (United States)

    Kulkarni, Abhaya V; Donnelly, Ruth; Mabbott, Donald J; Widjaja, Elysa

    2015-09-01

    Larger-than-normal ventricles can persist in children following hydrocephalus treatment, even if they are asymptomatic and clinically well. This study aims to answer the following question: do large ventricles result in brain injuries that are detectable on diffusion tensor imaging (DTI) and/or in measurable neurocognitive deficits in children with stable, treated hydrocephalus that are not seen in children with small ventricles? For this prospective study, we recruited 23 children (age range 8-18 years) with hydrocephalus due to aqueductal stenosis or tectal glioma who were asymptomatic following hydrocephalus treatment that had been performed at least 2 years earlier. All patients underwent detailed DTI and a full battery of neuropsychological tests. Correlation analysis was performed to assess the relationship between DTI parameters, neurocognitive tests, and ventricular size. The false-discovery rate method was used to adjust for multiple comparisons. The median age of these 23 children at the time of assessment was 15.0 years (interquartile range [IQR] 12.1-17.6 years), and the median age at the first hydrocephalus treatment was 5.8 years (IQR 2.2 months-12.8 years). At the time of assessment, 17 children had undergone endoscopic third ventriculostomy and 6 children had received a shunt. After adjusting for multiple comparisons, there were no significant correlations between any neurocognitive test and ventricular volume, any DTI parameter and ventricular volume, or any DTI parameter and neurocognitive test. Our data do not show an association between large ventricular size and additional white matter injury or worse neurocognitive deficits in asymptomatic children with stable, treated hydrocephalus caused by a discrete blockage of the cerebral aqueduct. Further investigations using larger patient samples are needed to validate these results.

  20. Peripheral blood mononuclear cells HIV DNA levels impact intermittently on neurocognition.

    Directory of Open Access Journals (Sweden)

    Lucette A Cysique

    Full Text Available To determine the contribution of peripheral blood mononuclear cells' (PBMCs HIV DNA levels to HIV-associated dementia (HAD and non-demented HIV-associated neurocognitive disorders (HAND in chronically HIV-infected adults with long-term viral suppression on combined antiretroviral treatment (cART.Eighty adults with chronic HIV infection on cART (>97% with plasma and CSF HIV RNA <50 copies/mL were enrolled into a prospective observational cohort and underwent assessments of neurocognition and pre-morbid cognitive ability at two visits 18 months apart. HIV DNA in PBMCs was measured by real-time PCR at the same time-points.At baseline, 46% had non-demented HAND; 7.5% had HAD. Neurocognitive decline occurred in 14% and was more likely in those with HAD (p<.03. Low pre-morbid cognitive ability was uniquely associated with HAD (p<.05. Log10 HIV DNA copies were stable between study visits (2.26 vs. 2.22 per 106 PBMC. Baseline HIV DNA levels were higher in those with lower pre-morbid cognitive ability (p<.04, and higher in those with no ART treatment during HIV infection 1st year (p = .03. Baseline HIV DNA was not associated with overall neurocognition. However, % ln HIV DNA change was associated with decline in semantic fluency in unadjusted and adjusted analyses (p = .01-.03, and motor-coordination (p = .02-.12 to a lesser extent.PBMC HIV DNA plays a role in HAD pathogenesis, and this is moderated by pre-morbid cognitive ability in the context of long-term viral suppression. While the HIV DNA levels in PBMC are not associated with current non-demented HAND, increasing HIV DNA levels were associated with a decline in neurocognitive functions associated with HAND progression.

  1. 汉族女性精神分裂症首发患者利培酮治疗所致闭经的危险因素%Risk factors for medication-induced amenorrhea in first-episode female Chinese patients with schizophrenia treated with risperidone

    Institute of Scientific and Technical Information of China (English)

    陈海支; 任丽华; 沈仲夏; 钱敏才; 沈鑫华; 杨胜良; 杨剑虹; 宋娟芬; 费小聪; 陶百平; 宋宝华

    2013-01-01

    Background:Amenorrhea is a common adverse effect of treatment with antipsychotic medications that influences both fertility and adherence to medication regimens. Most research suggests that medication-induced prolactinemia is the main cause of amenorrhea but few prospective studies have assessed this hypothesis. Aim:Identify risk factors for amenorrhea following treatment with antipsychotic medication. Methods:The study used a prospective, nested case-control design. First-episode, drug naïve female patients with schizophrenia who were in the middle of their menstrual cycle at the time of admission were enrolled. Serum levels of six reproductive hormones were assessed before and after a 12-week course of treatment with risperidone:progesterone, estradiol, prolactin, follicular stimulating hormone, luteinizing hormone, and testosterone. The hormone levels of 31 patients who had no menstruation during the entire 12 weeks of treatment (the amenorrhea group) were compared to those of 31 age-matched subjects who had normal menstrual periods over the 12 weeks of treatment (the control group). Results:We found a dramatic 4-fold increase in prolactin levels in women of childbearing age treated with risperidone, but the pretreatment and posttreatment levels of prolactin were not different between patients who did and did not develop amenorrhea with treatment. However, there were significantly lower pretreatment levels of estradiol and progesterone in patients who subsequently developed amenorrhea with risperidone treatment than in patients who did not develop amenorrhea. A conditional logistic regression analysis found that pretreatment levels of estradiol remained significantly associated with the development of amenorrhea during treatment even when adjusting for the pretreatment levels of the other five reproductive hormones assessed. Conclusion:These findings do not support the suggestion that amenorrhea associated with the use of antipsychotic medication is the result

  2. Carbon Dioxide: Surprising Effects on Decision Making and Neurocognitive Performance

    Science.gov (United States)

    James, John T.

    2013-01-01

    findings on decision making by developing a study to either confirm or refute the published results. In addition, other neurocognitive tests that have been and will be used aboard the ISS will be part of the ground-based study. Further evaluations during the exposures will include ocular and cardiovascular effects of CO2 exposure. In addition, the 1- carbon genetics of the test subjects will be evaluated to determine if any individual subjects are unusually susceptible to CO2 exposure because of genetic factors. Our plan is to extend the published study from Satish by employing a wider series of CO2 exposures to include concentrations of 0.06, 0.12, 0.25, and 0.50%. We believe that our findings will be of keen interest to submariners and to those designing "tight" buildings.

  3. 食疗与艾灸对女性继发性闭经疗效的探讨%Discussion on the Female Secondary Amenorrhea with Moxibustion and Diet Therapy

    Institute of Scientific and Technical Information of China (English)

    黄闯; 顾立众; 郇习高

    2014-01-01

    继发性闭经病因复杂,中医治疗有其独特之处,文章从继发性闭经的病因病机和艾灸以及自拟方治疗两个方面,论述治疗女性继发性闭经,从而用于指导保健康复工作。%Complex causes of secondary amenorrhea, Chinese medicine has its unique characteristics, this article from the secondary amenorrhea disease and its treatment of two aspects of Moxibustion and self Treating, which can be used to guide the Health Care and Rehabiliation.

  4. 闭经患者生存质量及其影响因素的相关研究%INVESTIGATION OF QUALITY OF LIFE AND CORRELATED FACTORS IN PATIENTS WITH AMENORRHEA

    Institute of Scientific and Technical Information of China (English)

    蔡林芮; 牟燕琳; 李宁秀; 徐克惠

    2011-01-01

    [目的]分析原发性闭经和继发性闭经患者的病因分布,评价闭经患者的生存质量.并探讨闭经患者生存质量的主要影响因素,为准确诊治闭经患者、改善病员生活质量提供理论依据.[方法]采用设计的问卷对2008年7~8月间在四川大学华西妇女儿童医院就诊的闭经患者进行相关调查,并用SF-36量表对调查对象进行生存质量评价.[结果]原发性闭经以下丘脑垂体病变最多,多囊卵巢综合征最少,而继发闭经多囊卵巢综合征最多见,最少的是子宫病变;闭经患者的生存质量比四川省常模低;精神压力是影响闭经患者生存质量的最主要因素.[结论]原发性闭经和继发性闭经的病因分布情况不同.在临床工作中,要关注闭经患者的生存质量,尤其是农村患者的生存质量;除了要治疗闭经患者的本身疾病,还应给予患者精神支持,减轻其精神压力,以全面提高其生存质量.%[Objective] To investigate for the etiological distribution of amenorrhea in Sichuan province and evaluate the quality of life in patients with amenorrhea and identify the correlated factors. [Methods] The survey was carried out using questionnaires in the conformed patients, who were recruited from Reproductive Endocrinological Clinic of Sichuan University Affiliated Hospital. [Results] The important reasons of primary amenorrhea were pituitary and hypothalamic diseases, but polycystic ovary syndrome (PCOS) played a key role in the secondary amenorrhea. The patients with amenorrhea had significantly lower scores of QOL than the norm of Sichuan province. Stress was the main factor that affected the quality of life in patients with amenorrhea. [Conclusion] The main etiological distributions of primary and secondary amenorrhea are different. Besides treating with the disease, doctors should manage some interventions to reduce the stress to improve the QOL of the patients with amenorrhea.

  5. Secondary amenorrhea in a woman with spinocerebellar degeneration treated with thyrotropin-releasing hormone: a case report and in vitro analysis

    Directory of Open Access Journals (Sweden)

    Kanasaki Haruhiko

    2011-12-01

    Full Text Available Abstract Introduction While thyrotropin-releasing hormone is known to be a prolactin-release stimulating factor, thyrotropin-releasing hormone-tartrate and its derivative, taltirelin hydrate, are used for the treatment of spinocerebellar degeneration, a degenerative disease characterized mainly by motor ataxia. We report the case of a patient being treated with a thyrotropin-releasing hormone preparation for spinocerebellar degeneration who developed amenorrhea after a dose increase. Her hormonal background was analyzed and the effect of prolonged exposure to thyrotropin-releasing hormone on pituitary prolactin-producing cells was examined in vitro. Case presentation Our patient was a 36-year-old Japanese woman who experienced worsening of gait disturbance at around 23 years of age, and was subsequently diagnosed as having spinocerebellar degeneration. She had been treated with thyrotropin-releasing hormone-tartrate for four years. Taltirelin hydrate was added to the treatment seven months prior to her presentation, followed by an improvement in gait disturbance. Around the same period, she started lactating and subsequently developed amenorrhea three months later. Taltirelin hydrate was discontinued and she was referred to our hospital. She was found to have normal sex hormone levels. A thyrotropin-releasing hormone provocation test showed a normal response of thyroid-stimulating hormone level and an over-response of prolactin at 30 minutes (142.7 ng/mL. Resumption of menstruation was noted three months after dose reduction of thyrotropin-releasing hormone. In our in vitro study, following long-term exposure to thyrotropin-releasing hormone, cells from the rat pituitary prolactin-producing cell line GH3 exhibited an increased basal prolactin promoter activity but showed a marked decrease in responsiveness to thyrotropin-releasing hormone. Conclusions Physicians should be aware of hyperprolactinemia-associated side effects in patients receiving

  6. Fifty-eight cases of amenorrhea treated mainly with Siguan points(四关穴)by acupuncture%针灸四关穴为主治疗闭经58例

    Institute of Scientific and Technical Information of China (English)

    孙朝辉; 许瑞华; 翟亚娟

    2010-01-01

    @@ The combination of Hégǔ(合谷LI 4)and Tàichōng(太冲LR 3)which is applied in the clinic is named as Siguan points(四关穴 Four-gate points).From January 1998 to April 2008,the authors had treated 5 8 cases of amenorrhea by puncturing on Siguan points(四关穴Four-gate points).The report is as follows.

  7. 吴克明教授治疗节食减肥后闭经经验介绍%Brief Introduction to Professor WU Keming′s Experience on Treatment of Amenorrhea after Losing Weight by Dieting

    Institute of Scientific and Technical Information of China (English)

    敖荣娜; 罗娟; 李晶晶; 吴克明

    2013-01-01

    从典型病例入手介绍吴克明教授运用中西医两法诊治减肥后闭经的临床经验,以期为相关临床研究提供参考.%We are discussing professor WU Keming's experience of treating amenorrhea after losing weight with western medicine and traditional Chinese medicine through analyzing classic cases, aiming to provide reference for associated clinical study.

  8. Clinical Observation of AcupunctureT reatment for Female Obesity in the Late Menstruation or Amenorrhea%针灸治疗女性肥胖症合并月经后期或闭经的临床研究

    Institute of Scientific and Technical Information of China (English)

    张安琪; 胡岚; 李熳

    2013-01-01

    目的:评价并比较针灸及药物疗法对女性肥胖合并月经后期或闭经患者的疗效。方法:选取女性肥胖症合并月经后期或闭经患者52例,随机分为针灸治疗组和药物治疗组,观察两组患者治疗前后的体重、腰围、臀围、腰臀比、月经周期、闭经情况。结果:针灸治疗组对肥胖、月经后期和闭经均有显著的改善作用(P<0.05),其临床疗效显著优于药物治疗组(P<0.05)。结论:针灸疗法治疗女性肥胖合并月经后期或闭经疗效显著,值得临床推广应用。%Objective:To evaluate and compare the effect of acupuncture and drug on obese women with late menstruation or amenorrhea .Mte hods:52 female patients were randomly divided into acupuncture treatment group and medication group .Body weight, waist circumference, hip circumference, waist-hip ratio, menstrual cycle , and amenorrhea were observed in two groups before and after treatment .Results:Acupuncture treatment had a significant effect on obesity , late menstruation and amenorrhea ( P<0.05 ) , and its clinical efficacy was better than that in the medication group ( P<0.05 ) .Conclusion:Acupuncture therapy can significantly im-prove obesity and irregular menstruation of obese women with late menstruation or amenorrhea , which is worthy of application in clinic .

  9. Screening CO

    NARCIS (Netherlands)

    Ramírez, A.; Hagedoorn, S.; Kramers, L.; Wildenborg, T.; Hendriks, C.

    2010-01-01

    This paper describes the development and application of a methodology to screen and rank Dutch reservoirs suitable for long-term large scale CO2 storage. The screening focuses on off- and on-shore individual aquifers, gas and oil fields. In total 176 storage reservoirs have been taken int

  10. Magnetic resonance imaging of sella turcica: evaluation of patients with galactorrhea, amenorrhea and hyperprolactinemia; Ressonancia magnetica da sela turca: avaliacao de pacientes com galactorreia, amenorreia e hiperprolactinemia

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Alair Augusto Sarmet M.D. dos [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Dept. de Radiologia; Moreira, Denise Madeira [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Andreiuolo, Pedro Angelo [Beneficencia Portuguesa de Niteroi, RJ (Brazil). Servico de Radiologia Santa Cruz Scan

    1999-08-01

    We have selected 135 cases of patients who have done magnetic resonance imaging of sella region, carried out from September, 1991 to August, 1996, who had galactorrhea (G), amenorrhea(A), and hyperprolactinemia (H), isolated or in association. The patients were divided in seven groups, according to the presence of these symptoms and signs. All examinations were made in a private clinic in the city of Rio de Janeiro, Brazil. Correlating these patients with the results of the magnetic resonance images, we found 57 micro adenomas, 31 normal examinations, 22 macro adenomas, 11 pituitary hyperplasias, 7 empty sella and 7 cases included in other aspects. The micro adenoma predominated in groups 1 (GAH), 2 (GH), 3 (HA) and 5 (H), that is, in all groups whose patients had hyperprolactinemia. In macro adenomas, a bright signal on T 1-weighted images indicates pituitary apoplexy with intratumoral hemorrhage. All in all, the magnetic resonance imaging is excellent method to be used in the evaluation of patients with changes in the hypothalamic-pituitary axis. (author)

  11. Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: barrier analysis and implications for behavior change communication program intervention design.

    Science.gov (United States)

    Kouyaté, Robin Anthony; Ahmed, Salahuddin; Haver, Jaime; McKaig, Catharine; Akter, Nargis; Nash-Mercado, Angela; Baqui, Abdullah

    2015-06-01

    The timely transition from Lactational Amenorrhea Method (LAM)(2) to another modern family planning method contributes to healthy spacing of pregnancies by increasing the adoption of family planning during the first year postpartum. Yet, literature suggests challenges in completing a timely LAM transition. To guide program implementation in Bangladesh, this study identified factors influencing women's transition decisions. Eighty postpartum women, comprising 40 who transitioned from LAM(3) and 40 who did not,(4) participated. Half of each group participated in in-depth interviews to explore the decision-making process. All participants responded to a "Barrier Analysis" questionnaire to identify differences in eight behavioral determinants. More than half of transitioners switched to another modern method before or within the same month that LAM ended. Of the 18 transitioners who delayed,(5) 15 waited for menses to return. For non-transitioners, key barriers included waiting for menses to return, misconceptions on return to fertility, and perceived lack of familial support. The LAM transition can help women prevent unintended pregnancy during the first year postpartum. Increased emphasis on counseling women about the risk of pregnancy, and misconceptions about personal fertility patterns are critical for facilitating the transition. Strategies should also include interventions that train health workers and improve social support. Copyright © 2015. Published by Elsevier Ltd.

  12. Amenorréia primária e cariótipo XY: identificando pacientes em risco Primary amenorrhea and XY karyotype: identifying patients in risk

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano Machado Rosa

    2008-11-01

    ser rotineiramente avaliados em indivíduos com amenorréia primária. Dessa forma, haveria um reconhecimento mais precoce das pacientes 46,XY e, conseqüentemente, um adequado manejo clínico das mesmas.PURPOSE: to verify the prevalence and clinical characteristics of patients with primary amenorrhea and XY caryotype, evaluated in our Service, aiming at identifying findings which could help their recognition. METHODS: from January 1975 to November 2007, 104 patients with amenorrhea were evaluated. All the cases were analyzed by the caryotype by GTG bands. Among them, 21 (20.2% presented a XY 46 constitution. Nevertheless, two of them were excluded from the study, because of incomplete data in their patient's chart. Most of the 19 patients who formed the sample had been referred to us by the gynecology clinics (63.2%. Their ages varied from 16 to 41 years old (an average of 22.1. Data were collected about their family and previous history, physical examination and results of complementary exams and the information was taken into consideration to determine the diagnosis. RESULTS: the predominant diagnosis was resistance to androgens syndrome (n=12; 63.2%; five patients (25.3% presented XY pure gonadal dysgenesis (XY PGD, one (5.3% 17 alpha-hydroxylase deficiency, and one (5.3%, 5 alpha-reductase deficiency. Clinical findings frequently found in these patients included abnormal development of secondary sexual characters (n=19, uterine agenesia with a blind vagina (n=14, family history of amenorrhea (n=8, and palpable gonads in the inguinal canal (n=5. Two of them presented a history of inguinal hernia. Systemic arterial hypertension was only diagnosed in the patient with 17 alpha-hydroxylase deficiency, and gonadal malignization, in the one with XY PGD. CONCLUSIONS: the rate of patients with XY caryotype (20% was higher than the one described in the literature (3 to 11%. It is believed that this fact is related to the way patients are usually referred to our service

  13. Neurocognitive Differences Between Drivers with Type 1 Diabetes with and without a Recent History of Recurrent Driving Mishaps.

    Science.gov (United States)

    Campbell, Laura K; Gonder-Frederick, Linda A; Broshek, Donna K; Kovatchev, Boris P; Anderson, Stacey; Clarke, William L; Cox, Daniel J

    2010-08-01

    OBJECTIVE: A subset of drivers with type 1 diabetes mellitus (T1DM) may be at significant risk of hypoglycemia-related driving collisions and moving vehicle violations due to acute and chronic neurocognitive impairment. The present study compared drivers with T1DM with and without a recent history of multiple driving mishaps on a neurocognitive battery during euglycemia, progressive mild hypoglycemia, and recovery from hypoglycemia, to determine whether neurocognitive measures differentiate the two risk groups. We hypothesized that drivers with a history of multiple recent hypoglycemia-related driving mishaps would demonstrate greater psychomotor slowing, both during hypoglycemia and euglycemia. STUDY DESIGN: Partcipants were 42 adults with T1DM and were assigned to one of two groups: those reporting no driving mishaps in the last year (-History) and those reporting two or more (+History).Neurocognitive testing was conducted before and repeated during a hyper-insulinemic clamping procedure. RESULTS: Not surprisingly, all drivers demonstrated a decrease in functioning across all neurocognitive tasks during hypoglycemia. However, in contrast to the common belief that neurocognitive functions return slowly and gradually following hypoglycemia, baseline neurocognitive functioning immediately recovered upon return of BG to euglycemia for all subjects. Between-group analyses revealed that subjects with a recent history of driving mishaps consistently demonstrated poorer performance on tasks measuring working memory. CONCLUSION: Working memory is a potential neurocognitive indicator that may help differentiate adults with T1DM with and without a history of driving mishaps, predict future risk for driving mishaps, and provide targeted intervention programs to address this critical public health issue.

  14. Specific neuro-cognitive impairments associated with Turner (45,X) and Klinefelter (47,XXY) syndromes: a review.

    Science.gov (United States)

    Money, J

    1993-01-01

    In Turner syndrome, there is a high incidence of neuro-cognitive impairment specific to the mental processing and sequencing of rotational transformations of shapes in the spatial dimensions of left-right, up-down, and back-front. In Klinefelter syndrome, the corresponding neuro-cognitive impairment is specific to the mental processing of sequence and synchrony in the temporal dimension, including the temporal dimension of language.

  15. Neurocognitive Function in Acromegaly after Surgical Resection of GH-Secreting Adenoma versus Naïve Acromegaly

    Science.gov (United States)

    Martín-Rodríguez, Juan Francisco; Madrazo-Atutxa, Ainara; Venegas-Moreno, Eva; Benito-López, Pedro; Gálvez, María Ángeles; Cano, David A.; Tinahones, Francisco J.; Torres-Vela, Elena; Soto-Moreno, Alfonso; Leal-Cerro, Alfonso

    2013-01-01

    Patients with active untreated acromegaly show mild to moderate neurocognitive disorders that are associated to chronic exposure to growth hormone (GH) and insulin-like growth factor (IGF-I) hypersecretion. However, it is unknown whether these disorders improve after controlling GH/IGF-I hypersecretion. The aim of this study was to compare neurocognitive functions of patients who successfully underwent GH-secreting adenoma transsphenoidal surgery (cured patients) with patients with naive acromegaly. In addition, we wanted to determine the impact of different clinical and biochemical variables on neurocognitive status in patients with active disease and after long-term cure. A battery of six standardized neuropsychological tests assessed attention, memory and executive functioning. In addition, a quantitative electroencephalography with Low-Resolution Electromagnetic Tomography (LORETA) solution was performed to obtain information about the neurophysiological state of the patients. Neurocognitive data was compared to that of a healthy control group. Multiple linear regression analysis was also conducted using clinical and hormonal parameters to obtain a set of independent predictors of neurocognitive state before and after cure. Both groups of patients scored significantly poorer than the healthy controls on memory tests, especially those assessing visual and verbal recall. Patients with cured acromegaly did not obtain better cognitive measures than naïve patients. Furthermore memory deficits were associated with decreased beta activity in left medial temporal cortex in both groups of patients. Regression analysis showed longer duration of untreated acromegaly was associated with more severe neurocognitive complications, regardless of the diagnostic group, whereas GH levels at the time of assessment was related to neurocognitive outcome only in naïve patients. Longer duration of post-operative biochemical remission of acromegaly was associated with better

  16. Effect of hypercarbia and isoflurane on brain cell death and neurocognitive dysfunction in 7-day-old rats.

    Science.gov (United States)

    Stratmann, Greg; May, Laura D V; Sall, Jeffrey W; Alvi, Rehan S; Bell, Joseph S; Ormerod, Brandi K; Rau, Vinuta; Hilton, Joan F; Dai, Ran; Lee, Michael T; Visrodia, Kavel H; Ku, Ban; Zusmer, Emanuel J; Guggenheim, Jeremy; Firouzian, Atoosa

    2009-04-01

    Millions of neonates undergo anesthesia each year. Certain anesthetic agents cause brain cell death and long-term neurocognitive dysfunction in postnatal day (P)7 rats. Despite its intuitive appeal, a causal link between cell death and neurocognitive decline after anesthesia has not been established. If one existed, the degree of cell death would be expected to correlate with the degree of neurocognitive dysfunction caused by anesthesia. The authors therefore tested if cell death caused by various durations of isoflurane at 1 minimum alveolar concentration causes duration-dependent long-term neurocognitive dysfunction. Isoflurane was administered to P7 rats at 1 minimum alveolar concentration for 0, 1, 2, or 4 h. To control for the respiratory depressant effects of anesthesia, a group of rats was treated with 4 h of carbon dioxide. Cell death was assessed by FluoroJade staining 12 h after the end of each intervention, and neurocognitive outcome was assessed 8 weeks later by using fear conditioning, spatial reference memory, and spatial working memory tasks. Widespread brain cell death was caused by 2 h and 4 h of isoflurane and by 4 h of carbon dioxide. The degree and distribution of thalamic cell death was similar in 4 h isoflurane-treated and 4-h carbon dioxide-treated rats. Only 4 h of isoflurane caused a long-term neurocognitive deficit affecting both spatial reference memory and spatial working memory. Working memory was improved in carbon dioxide-treated rats. Isoflurane-induced brain cell death may be partly caused by hypercarbia. The inconsistencies between cell death and neurocognitive outcome suggest that additional or alternative mechanisms may mediate anesthesia-induced long-term neurocognitive dysfunction.

  17. Necessary, but not sufficient: links between neurocognition, social cognition, and metacognition in schizophrenia are moderated by disorganized symptoms.

    Science.gov (United States)

    Minor, Kyle S; Lysaker, Paul H

    2014-10-01

    Intact neurocognition has been posited as a necessary, but not sufficient prerequisite for efficient social cognition and metacognition in schizophrenia. Disorganized symptoms likely play a prominent role in these cognitive processes, given the detrimental effects of disorganization on one's ability to synthesize discrete information into an organized whole. However, the relationship between disorganized symptoms and cognitive processes remains unclear. In this study, we examined whether disorganized symptoms: 1) exhibited stronger inverse relationships with cognitive processes than other symptoms, and 2) moderated links between neurocognition and a) social cognition, and b) metacognition. Trained raters assessed psychotic symptoms, neurocognition, social cognition, and metacognition in patients with schizophrenia from a Midwestern VA Medical Center (n=68) using validated, clinician-rated instruments. We observed significantly greater inverse associations with cognitive processes for disorganized compared to reality distortion symptoms; inverse associations with neurocognition and social cognition were significantly greater for disorganized than negative symptoms. Our hypotheses that disorganized symptoms would moderate relationships between neurocognition and a) social cognition, and b) metacognition were also supported. These findings highlight the importance of disorganized symptoms in elucidating links between neurocognition and social cognitive and metacognitive abilities. Future work should assess whether similar findings occur across the schizophrenia-spectrum, and investigate if targeting disorganization can ameliorate social cognitive and metacognitive impairments in schizophrenia. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Persistent neurocognitive decline in a clinic sample of hepatitis C virus-infected persons receiving interferon and ribavirin treatment.

    Science.gov (United States)

    Cattie, Jordan E; Letendre, Scott L; Woods, Steven Paul; Barakat, Fatma; Perry, William; Cherner, Mariana; Umlauf, Anya; Franklin, Donald; Heaton, Robert K; Hassanein, Tarek; Grant, Igor

    2014-12-01

    Treatment of hepatitis C virus (HCV) with pegylated interferon and ribavirin (IFN/RBV) can be associated with neuropsychiatric side effects, which may necessitate dose reductions or treatment discontinuation. This study aimed to characterize the time course and predictors of cognitive and affective/mood symptoms after IFN/RBV treatment initiation. Forty individuals enrolled in a longitudinal project underwent comprehensive cognitive, medical, and psychiatric assessment at baseline and 10 weeks, 6 months, 12 months, and 18 months after treatment initiation. Analyses were conducted to determine the prevalence of neurocognitive impairment over time; explicate the relationship between neurocognitive impairment, neuropsychiatric symptoms, and liver disease at each time point; and identify predictors of neurocognitive decline as well as cognitive effects of viral clearance. By 10 weeks after initiating IFN/RBV, the prevalence of neurocognitive impairment rose from 22.5 to 47.4% (p  0.10). Results of the current study indicate that IFN/RBV treatment-emergent neurocognitive declines are significant, prevalent, and may persist long after treatment cessation. Clinicians should monitor cognition throughout the course of treatment for HCV, noting that early declines may indicate individuals at elevated risk for persistent neurocognitive impairment. Longer-term studies are needed to determine whether lasting declines may remit over longer intervals or with newer direct acting agents.

  19. Mismatch negativity is a stronger indicator of functional outcomes than neurocognition or theory of mind in patients with schizophrenia.

    Science.gov (United States)

    Lee, Seung-Hwan; Sung, Kyongae; Lee, Kyong-Sang; Moon, Eunok; Kim, Chang-Gyu

    2014-01-03

    Mismatch negativity (MMN) is known to be associated with neurocognition, social cognition, and functional outcomes. The present study explored the relationships of MMN with neurocognition, theory of mind, and functional outcomes in patients with schizophrenia, first-degree relatives of patients with schizophrenia, and healthy controls. Twenty-five patients with schizophrenia, 21 first-degree relatives of patients with schizophrenia, and 29 healthy controls were recruited. We examined symptom severity, neurocognition, theory of mind, functional outcomes, and MMN. MMN amplitudes decreased in order of patients with schizophrenia, then first-degree relatives, then healthy controls. MMN amplitude was significantly correlated with measures of neurocognition, theory of mind, and functional outcome measurements in patients with schizophrenia. However, the most powerful correlations were those between MMN in the frontal region and measures of functional outcomes. The power and frequency of the correlations were weaker in first-degree relatives and healthy controls than in patients with schizophrenia. Hierarchical regression analysis revealed that functional outcomes (relative to measures of neurocognition and theory of mind) constituted the most powerful predictor of MMN. Our results suggest that MMN reflects functional outcomes more efficiently than do measures of neurocognition and theory of mind in patients with schizophrenia. © 2013.

  20. Improving outcomes for youth with ADHD: a conceptual framework for combined neurocognitive and skill-based treatment approaches.

    Science.gov (United States)

    Chacko, Anil; Kofler, Michael; Jarrett, Matthew

    2014-12-01

    Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and chronic mental health condition that often results in substantial impairments throughout life. Although evidence-based pharmacological and psychosocial treatments exist for ADHD, effects of these treatments are acute, do not typically generalize into non-treated settings, rarely sustain over time, and insufficiently affect key areas of functional impairment (i.e., family, social, and academic functioning) and executive functioning. The limitations of current evidence-based treatments may be due to the inability of these treatments to address underlying neurocognitive deficits that are related to the symptoms of ADHD and associated areas of functional impairment. Although efforts have been made to directly target the underlying neurocognitive deficits of ADHD, extant neurocognitive interventions have shown limited efficacy, possibly due to misspecification of training targets and inadequate potency. We argue herein that despite these limitations, next-generation neurocognitive training programs that more precisely and potently target neurocognitive deficits may lead to optimal outcomes when used in combination with specific skill-based psychosocial treatments for ADHD. We discuss the rationale for such a combined treatment approach, prominent examples of this combined treatment approach for other mental health disorders, and potential combined treatment approaches for pediatric ADHD. Finally, we conclude with directions for future research necessary to develop a combined neurocognitive + skill-based treatment for youth with ADHD.

  1. On the utility of within-participant research design when working with patients with neurocognitive disorders.

    Science.gov (United States)

    Steingrimsdottir, Hanna Steinunn; Arntzen, Erik

    2015-01-01

    Within-participant research designs are frequently used within the field of behavior analysis to document changes in behavior before, during, and after treatment. The purpose of the present article is to show the utility of within-participant research designs when working with older adults with neurocognitive disorders. The reason for advocating for these types of experimental designs is that they provide valid information about whether the changes that are observed in the dependent variable are caused by manipulations of the independent variable, or whether the change may be due to other variables. We provide examples from published papers where within-participant research design has been used with patients with neurocognitive disorders. The examples vary somewhat, demonstrating possible applications. It is our suggestion that the within-participant research design may be used more often with the targeted client group than is documented in the literature at the current date.

  2. [Mental health in older adults: major neurocognitive, affective, and sleep disorders].

    Science.gov (United States)

    Tello-Rodríguez, Tania; Alarcón, Renato D; Vizcarra-Escobar, Darwin

    2016-06-01

    Numerous biological, psychological, and social factors influence the mental health of elderly individuals to varying degrees. Apart from components related to the normal aging process and the co-occurrence of various medical conditions, events such as the death of a loved one, retirement, or disability significantly contribute to a variety of mental and emotional problems in this stage of the life cycle. The most frequent problems affect the neurocognitive, emotional, and oneiric spheres. Major neurocognitive disorders reduce one's overall performance and, thus, increase their need for close care. Affective disorders may be exacerbated by the lack of family support and decreased social interactions, which may lead to significant isolation result in suicidal behavior. The increased frequency of sleep disorders such as insomnia and daytime sleepiness and specific disorders such as obstructive apnea significantly alter the quality of life of this population.

  3. Postconcussive symptoms and neurocognitive function after mild traumatic brain injury in children.

    Science.gov (United States)

    Sroufe, Nicole S; Fuller, Douglas S; West, Brady T; Singal, Bonita M; Warschausky, Seth A; Maio, Ronald F

    2010-06-01

    We describe children's postconcussive symptoms (PCSs), neurocognitive function, and recovery during 4 to 5 weeks after mild traumatic brain injury (MTBI) and compare performance and recovery with those of injured control group participants without MTBIs. A prospective, longitudinal, observational study was performed with a convenience sample from a tertiary care, pediatric emergency department. Participants were children 10 to 17 years of age who were treated in the emergency department and discharged. The MTBI group included patients with blunt head trauma, Glasgow Coma Scale scores of 13 to 15, loss of consciousness for Trail-Making Test Part B differed significantly between groups; performance on other neurocognitive measures did not differ. In children 10 to 17 years of age, self-reported PCSs were not exclusive to patients with MTBIs. However, PCSs and recovery patterns for the Trail-Making Test Part B differed significantly between the groups.

  4. Signatures of the neurocognitive basis of culture wars found in moral psychology data

    CERN Document Server

    Caticha, Nestor

    2010-01-01

    Moral Foundation Theory (MFT) states that groups of different observers may rely on partially dissimilar sets of moral foundations, thereby reaching different moral valuations on a subset of issues. With the introduction of functional imaging techniques, a wealth of new data on neurocognitive processes has rapidly mounted and it has become increasingly more evident that this type of data should provide an adequate basis for modeling social systems. In particular, it has been shown that there is a spectrum of cognitive styles with respect to the differential handling of novel or corroborating information. Furthermore this spectrum is correlated to political affiliation. Here we use methods of statistical mechanics to characterize the collective behavior of an agent-based model society whose inter individual interactions due to information exchange in the form of opinions, are in qualitative agreement with neurocognitive and psychological data. The main conclusion derived from the model is that the existence of...

  5. Neurocognitive mechanisms underlying social learning in infancy: infants' neural processing of the effects of others' actions.

    Science.gov (United States)

    Paulus, Markus; Hunnius, Sabine; Bekkering, Harold

    2013-10-01

    Social transmission of knowledge is one of the reasons for human evolutionary success, and it has been suggested that already human infants possess eminent social learning abilities. However, nothing is known about the neurocognitive mechanisms that subserve infants' acquisition of novel action knowledge through the observation of other people's actions and their consequences in the physical world. In an electroencephalogram study on social learning in infancy, we demonstrate that 9-month-old infants represent the environmental effects of others' actions in their own motor system, although they never achieved these effects themselves before. The results provide first insights into the neurocognitive basis of human infants' unique ability for social learning of novel action knowledge.

  6. A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder

    OpenAIRE

    Scott, J. Cobb; Matt, Georg E.; Wrocklage, Kristen M.; Crnich, Cassandra; Jordan, Jessica; Southwick, Steven M.; Krystal, John H.; Schweinsburg, Brian C.

    2014-01-01

    Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data ...

  7. Concussion symptoms and neurocognitive performance of high school and college athletes who incur multiple concussions.

    Science.gov (United States)

    Covassin, Tracey; Moran, Ryan; Wilhelm, Kristyn

    2013-12-01

    Multiple concussions have been associated with prolonged symptoms, recovery time, and risk for future concussions. However, very few studies have examined the effect of multiple concussions on neurocognitive performance and the recently revised symptom clusters using a large database. To examine concussed athletes with a history of 0, 1, 2, or ≥3 concussions on neurocognitive performance and the recently revised symptom clusters. Cohort study (prognosis); Level of evidence, 2. The independent variables were concussion group (0, 1, 2, and ≥3 concussions) and time (baseline, 3 days, and 8 days). The dependent variables were neurocognitive test scores as measured by the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neurocognitive test battery (verbal and visual memory, processing speed, and reaction time) and 4 concussion symptom clusters (migraine-cognitive-fatigue, affective, somatic, and sleep). All concussed athletes (n = 596) were administered the ImPACT test at a mean 2.67 ± 1.98 and 7.95 ± 4.46 days after injury. A series of 4 (concussion group) × 3 (time) repeated-measures analyses of covariance (age = covariate) were performed on ImPACT composite scores and symptom clusters. Concussed athletes with ≥3 concussions were still impaired 8 days after a concussion compared with baseline scores on verbal memory (P Concussed athletes with a history of ≥3 concussions take longer to recover than athletes with 1 or no previous concussion. Future research should concentrate on validating the new symptom clusters on multiple concussed athletes, examining longer recovery times (ie, >8 days) among athletes with multiple concussions.

  8. Intraindividual variability in neurocognitive speed: a comparison of Parkinson's disease and normal older adults.

    Science.gov (United States)

    de Frias, Cindy M; Dixon, Roger A; Fisher, Nancy; Camicioli, Richard

    2007-06-18

    We examined whether intraindividual variability of neurocognitive speed, or inconsistency, is greater in stages of Parkinson's disease (PD) as compared to a matched group of normal older adults. Intraindividual variability was assessed using four reaction time (RT) (simple and complex) tasks. We examined three sets of correlates: executive functioning (Stroop (interference index), Trail Making Test (Part B), and Digit Ordering Test), finger tapping speed, and gait speed. The participants were matched on age, sex, and education, and did not differ in global cognitive functioning. There were 50 patients with a clinical diagnosis of idiopathic PD (29 men and 21 women) who ranged from 65 to 84 years (M=71.5, S.D.=4.7) and 48 matched healthy older adults who ranged from 65 to 84 years (M=71.5, S.D.=4.9). Multiple analyses of variance showed that the PD patients were slower on all three complex RT tasks, and more inconsistent than healthy older adults on the most complex (eight-choice) RT task. Individuals with advanced disease had slower neurocognitive speed and more inconsistency than patients with earlier stage PD. Poorer executive functioning was associated with slower neurocognitive performance in healthy older adults, mild PD patients, and especially severe PD patients. Greater inconsistency in speed was related to poorer executive functioning in late stage PD (for the most complex task) and in healthy older adults (for the simplest task), indicating that motor and cognitive domains have functional coupling (i.e., as one becomes compromised so does the other). Intraindividual variability was not correlated with tapping speed and gait speed in any group. Executive functioning and neurocognitive speed may be valid and distinct clinical markers of disease progression in PD.

  9. Early Viral Suppression Improves Neurocognitive Outcomes in HIV-infected Children

    Science.gov (United States)

    CROWELL, Claudia S.; HUO, Yanling; TASSIOPOULOS, Katherine; MALEE, Kathleen M.; YOGEV, Ram; HAZRA, Rohan; RUTSTEIN, Richard M.; NICHOLS, Sharon L.; SMITH, Renee A.; WILLIAMS, Paige L.; OLESKE, James; MULLER, William J.

    2014-01-01

    Objective To estimate the association of age of viral suppression and central nervous system penetration effectiveness (CPE) score with neurocognitive functioning among school-age children with perinatally-acquired HIV infection (PHIV+). Design We analyzed data from two U.S.-based multisite prospective cohort studies. Methods Multivariable general linear regression models were used to evaluate associations of age at viral suppression and CPE scores [of initial ART regimen and weighted average] with WISC-III or WISC-IV neurocognitive assessments [full scale IQ (FSIQ); performance IQ/ perceptual reasoning index (PIQ/PRI); and verbal IQ/ verbal comprehension index (VIQ/VCI)], adjusted for demographic and clinical covariates. Sensitivity analyses were stratified by birth cohort (before vs after 1996). Results 396 PHIV+ children were included. Estimated differences in mean FSIQ (comparing virally suppressed vs. unsuppressed children) by each age cutoff were 3.7, 2.2, 3.2, 4.4, and 3.9 points at ages 1, 2, 3, 4, and 5, respectively. For PIQ/PRI, estimated mean differences were 3.7, 2.4, 2.2, 4.6, and 4.5 at ages 1 through 5 respectively. In both cases, these differences were significant only at the age 4 and 5 thresholds. After stratifying by birth cohort the association between age at suppression and cognitive function persisted only among those born after 1996. Age at viral suppression was not associated with VIQ/VCI; CPE score was not associated with FSIQ, verbal comprehension or perceptual reasoning indices. Conclusions Virologic suppression during infancy or early childhood is associated with improved neurocognitive outcomes in school-aged PHIV+ children. In contrast, CPE scores showed no association with neurocognitive outcomes. PMID:25686678

  10. Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents

    Science.gov (United States)

    Liang, J.; Matheson, BE.; Kaye, WH.; Boutelle, KN.

    2015-01-01

    Childhood obesity rates have risen dramatically over the past few decades. Although obesity has been linked to poorer neurocognitive functioning in adults, much less is known about this relationship in children and adolescents. Therefore, we conducted a systematic review to examine the relationship between obesity and obesity-related behaviors with neurocognitive functioning in youth. We reviewed articles from 1976 to 2013 using PsycInfo, PubMed, Medline and Google Scholar. Search terms included cognitive function, neurocognitive function/performance, executive function, impulsivity, self-regulation, effortful control, cognitive control, inhibition, delayed gratification, memory, attention, language, motor, visuo-spatial, academic achievement, obesity, overweight, body mass index, waist-hip ratio, adiposity and body fat. Articles were excluded if participants had health problems known to affect cognitive functioning, the study used imaging as the only outcome measure, they were non-peer-reviewed dissertations, theses, review papers, commentaries, or they were non-English articles. Sixty-seven studies met inclusion criteria for this review. Overall, we found data that support a negative relationship between obesity and various aspects of neurocognitive functioning, such as executive functioning, attention, visuo-spatial performance, and motor skill. The existing literature is mixed on the effects among obesity, general cognitive functioning, language, learning, memory, and academic achievement. Executive dysfunction is associated with obesity-related behaviors, such as increased intake, disinhibited eating, and less physical activity. Physical activity is positively linked with motor skill. More longitudinal research is needed to determine the directionality of such relationships, to point towards crucial intervention time periods in the development of children, and to inform effective treatment programs. PMID:23913029

  11. Cerebral Malaria; Mechanisms Of Brain Injury And Strategies For Improved Neuro-Cognitive Outcome

    OpenAIRE

    Idro, Richard; Marsh, Kevin; John, Chandy C.; Newton, Charles RJ

    2010-01-01

    Cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum. With over 575,000 cases annually, children in sub-Saharan Africa are the most affected. Surviving patients have an increased risk of neurological and cognitive deficits, behavioral difficulties and epilepsy making cerebral malaria a leading cause of childhood neuro-disability in the region. The pathogenesis of neuro-cognitive sequelae is poorly understood: coma develops through multiple mech...

  12. Associations of symptoms, neurocognition, and metacognition with insight in schizophrenia spectrum disorders.

    Science.gov (United States)

    Chan, Kevin K S

    2016-02-01

    Many persons with schizophrenia experience poor insight and, as a result, are at risk for treatment non-adherence and numerous negative outcomes. However, to date, the etiology of poor insight has not yet been fully elucidated. One recent theory concerning the roots of poor insight in schizophrenia has proposed that it may result, in part, from impairments in metacognition, or the capacity to think about thinking. The present study thus aims to examine whether metacognition is associated with insight even after controlling for the effects of psychiatric symptomatology and neurocognition. In this study, 95 adults with a schizophrenia spectrum disorder were assessed on measures of insight (i.e., awareness of symptoms, treatment needs, and illness consequences), psychiatric symptoms (i.e., positive symptoms, negative symptoms, and general psychopathology), neurocognitive functions (i.e., executive function, memory, and attention), and metacognitive capacities (i.e., self-reflectivity and theory of mind). Univariate correlations followed by stepwise multiple regressions, which controlled for symptoms and neurocognition, indicated that both self-reflectivity and theory of mind were significantly linked with awareness of symptoms; theory of mind was linked with awareness of treatment needs; and self-reflectivity was linked with awareness of illness consequences. Importantly, these findings suggest that metacognitive capacities may be related to insight independent of concurrent psychiatric symptoms and neurocognitive deficits. Moreover, awareness of different facets of the illness may require contributions from different components of metacognition. Future research should investigate how existing metacognitive skill training programs could potentially be tailored, or modified, to help persons with schizophrenia to develop and enhance insight.

  13. A comparision of neurocognitive function among patients with bipolar depression,recurrent unipolar depression and schizophrenia

    Institute of Scientific and Technical Information of China (English)

    朱玥

    2014-01-01

    Objective To compare neurocognitive function in patients with bipolar depression type I(BD),recurrent unipolar depression(UD)and schizophrenia(SZ).And try to explore the relationship between neuropsychological function and clinical features in bipolar.Methods 29 patients with BD,25 with UD,30 with SZ were consecutively recruited from clinics and wards of Peking University Sixth Hospital between September 2010 and April2011,also including 30 controls

  14. Asymptomatic HIV-associated neurocognitive impairment increases risk for symptomatic decline

    Science.gov (United States)

    Franklin, Donald R.; Deutsch, Reena; Woods, Steven P.; Vaida, Florin; Ellis, Ronald J.; Letendre, Scott L.; Marcotte, Thomas D.; Atkinson, J.H.; Collier, Ann C.; Marra, Christina M.; Clifford, David B.; Gelman, Benjamin B.; McArthur, Justin C.; Morgello, Susan; Simpson, David M.; McCutchan, John A.; Abramson, Ian; Gamst, Anthony; Fennema-Notestine, Christine; Smith, Davey M.; Heaton, Robert K.

    2014-01-01

    Objective: While HIV-associated neurocognitive disorders (HAND) remain prevalent despite combination antiretroviral therapy (CART), the clinical relevance of asymptomatic neurocognitive impairment (ANI), the most common HAND diagnosis, remains unclear. We investigated whether HIV-infected persons with ANI were more likely than those who were neurocognitively normal (NCN) to experience a decline in everyday functioning (symptomatic decline). Methods: A total of 347 human participants from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) cohort were NCN (n = 226) or had ANI (n = 121) at baseline. Neurocognitive assessments occurred approximately every 6 months, with median (interquartile range) follow-up of 45.2 (28.7–63.7) months. Symptomatic decline was based on self-report (SR) or objective, performance-based (PB) problems in everyday functioning. Proportional hazards modeling was used to generate risk ratios for progression to symptomatic HAND after adjusting for baseline and time-dependent covariates, including CD4+ T-lymphocyte count (CD4), virologic suppression, CART, and mood. Results: The ANI group had a shorter time to symptomatic HAND than the NCN after adjusting for baseline predictors: adjusted risk ratios for symptomatic HAND were 2.0 (confidence interval [CI] 1.1–3.6; p = 0.02) for SR, 5.8 (CI 3.2–10.7; p < 0.0001) for PB, and 3.2 (CI 2.0–5.0; p < 0.0001) for either SR or PB. Current CD4 and depression were significant time-dependent covariates, but antiretroviral regimen, virologic suppression, and substance abuse or dependence were not. Conclusions: This longitudinal study demonstrates that ANI conveys a 2-fold to 6-fold increase in risk for earlier development of symptomatic HAND, supporting the prognostic value of the ANI diagnosis in clinical settings. Identifying those at highest risk for symptomatic decline may offer an opportunity to modify treatment to delay progression. PMID:24814848

  15. Quadruple screen test

    Science.gov (United States)

    Quad screen; Multiple marker screening; AFP plus; Triple screen test; AFP maternal; MSAFP; 4-marker screen; Down syndrome - quadruple; Trisomy 21 - quadruple; Turner syndrome - quadruple; Spina bifida - ...

  16. Toxicology screen

    Science.gov (United States)

    Toxicology screening is most often done using a blood or urine sample. However, it may be done soon after the person swallowed the medication, using stomach contents taken through gastric lavage (stomach pumping) or after vomiting.

  17. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  18. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  19. The relationship between impact force, neck strength, and neurocognitive performance in soccer heading in adolescent females.

    Science.gov (United States)

    Gutierrez, Gregory M; Conte, Catherine; Lightbourne, Kristian

    2014-02-01

    Head impacts are common in contact sports, but only recently has there been a rising awareness of the effects of subconcussive impacts in adolescent athletes. A better understanding of how to attenuate head impacts is needed and therefore, this study investigated the relationship between neck strength, impact, and neurocognitive function in an acute bout of soccer heading in a sample of female high school varsity soccer players. Seventeen participants completed the ImPACT neurocognitive test and had their isometric neck strength tested (flexion, extension, and bilateral flexion) before heading drills. Each participant was outfitted with custom headgear with timing switches and a three-dimensional accelerometer affixed to the back of the head, which allowed for measurement of impact during heading. Participants performed a series of 15 directional headers, including 5 forward, 5 left and 5 right headers in a random order, then completed the ImPACT test again. Neurocognitive tests revealed no significant changes following heading. However, there were statistically significant, moderate, negative correlations (r = -0.500:-0.757, p head injury prevention/reduction program.

  20. Longitudinal relations between symptoms, neurocognition and self-concept in schizophrenia

    Directory of Open Access Journals (Sweden)

    Klaus eHesse

    2015-07-01

    Full Text Available Objective: Cognitive models suggest that the self-concept of persons with psychosis can be fundamentally affected. Self-concepts were found to be related to different symptom domains when measured concurrently. Longitudinal investigations to disentangle the possible causal associations are rare. Method: We examined a sample of 160 people with a diagnosis of schizophrenia who took part in a psychotherapy study. All participants had the DSM-IV diagnosis of a schizophrenia and pronounced negative symptoms. Neurocognition, symptoms and self-concepts were assessed at two time points twelve months apart. Structural equation modelling was used to test whether symptoms influence self-concepts (scar-model or self-concepts affect symptoms (vulnerability model. Results: Negative symptoms correlated concurrently with self-concepts. Neurocognitive deficits are associated with more negative self-concepts twelve months later. Interpersonal self-concepts were found to be relevant for paranoia. Conclusion: The findings implicate that if deficits in neurocognition are present, fostering a positive self-concept should be an issue in therapy. Negative interpersonal self-concept indicates an increased risk for paranoid delusions in the course of one year. New aspects for cognitive models in schizophrenia and clinical implications are discussed

  1. A Preliminary Multiple Case Report of Neurocognitive Training for Children With AD/HD in China

    Directory of Open Access Journals (Sweden)

    Han Jiang

    2015-06-01

    Full Text Available This preliminary multiple case study examined the behavioral outcomes of neurocognitive training on children with attention-deficit/hyperactivity disorder (AD/HD in China, as well as parent acceptance of the treatment. The training approach targeted working memory, impulse control, and attention/relaxation (via brain electrical activity. Outcome measures included overt behavior as rated by parents and teachers, AD/HD symptom frequency, and parent opinion/feedback. Training was completed by five individuals and delivered via a themed computer game with electroencephalogram (EEG input via a wireless, single-channel, dry-sensor, portable measurement device. The objective (i.e., training outcomes and EEG and subjective (i.e., parent ratings/feedback and teacher ratings data suggested that use of the neurocognitive training resulted in reduced AD/HD behaviors and improvement in socially meaningful outcomes. The parents expressed satisfaction with the training procedure and outcomes. It is concluded that the innovative neurocognitive training approach is effective for improving behavior and reducing symptoms of AD/HD for children in China.

  2. Social function in schizophrenia and schizoaffective disorder: Associations with personality, symptoms and neurocognition

    Directory of Open Access Journals (Sweden)

    Lysaker Paul H

    2004-03-01

    Full Text Available Abstract Background Research has indicated that stable individual differences in personality exist among persons with schizophrenia spectrum disorders predating illness onset that are linked to symptoms and self appraised quality of life. Less is known about how closely individual differences in personality are uniquely related to levels of social relationships, a domain of dysfunction in schizophrenia more often linked in the literature with symptoms and neurocognitive deficits. This study tested the hypothesis that trait levels of personality as defined using the five-factor model of personality would be linked to social function in schizophrenia. Methods A self-report measure of the five factor model of personality was gathered along with ratings of social function, symptoms and assessments of neurocognition for 65 participants with schizophrenia or schizoaffective disorder. Results Univariate correlations and stepwise multiple regression indicated that frequency of social interaction was predicted by higher levels of the trait of Agreeableness, fewer negative symptoms, better verbal memory and at the trend level, lesser Neuroticism (R2 = .42, p 2 = .67, p Conclusions Taken together, the findings of this study suggest that person-centered variables such as personality, may account for some of the broad differences seen in outcome in schizophrenia spectrum disorders, including social outcomes. One interpretation of the results of this study is that differences in personality combine with symptoms and neurocognitive deficits to affect how persons with schizophrenia are able to form and sustain social connections with others.

  3. Effects of finger counting on numerical development – the opposing views of neurocognition and mathematics education

    Directory of Open Access Journals (Sweden)

    Korbinian eMoeller

    2011-11-01

    Full Text Available Usually children learn the basic principles of number and arithmetic by the help of finger-based representations. However, whether the reliance on finger-based representations is only beneficial or whether it may even become detrimental is the subject of an ongoing debate between neuro-cognitive and mathematics education researchers. From the neuro-cognitive perspective finger counting provides multi-sensory input conveying both cardinal and ordinal aspects of numbers. Recent data indicate that children with good finger-based numerical representations show better arithmetic skills and that training finger gnosis enhances mathematical skills. From this neuro-cognitive researchers conclude that elaborate finger-based numerical representations are beneficial for later numerical development.However, mathematics education research recommends fostering mental numerical representations so as to induce children to abandon finger-counting. More precisely mathematics education recommends moving from finger counting to concrete structured representations and then, finally, to mental representations of numbers.Taken together, there is obviously an important debate between the neuro-cognitve and mathematics education research concerning the benefits or detriments of finger-based strategies for numerical development. In the present review, the rationale of both lines of evidence will be presented and discussed.

  4. Computerized neurocognitive interventions in the context of the brain training controversy.

    Science.gov (United States)

    García-Betances, Rebeca Isabel; Cabrera-Umpiérrez, María Fernanda; Arredondo, María T

    2017-08-19

    This article presents, in the form of an analytic narrative review, a complete picture of the state-of-the-art, challenges, and perspectives in the field of information and communication technology (ICT)-based neurocognitive interventions for older adults. The narrative particularly focuses on applications aimed at mild cognitive impairment and similar age-related cognitive deficits, which are analyzed in the context of the brain training controversy. Clarifying considerations are provided about the nature and present extent of the brain training debate, regarding the possible influence it has on the support received by research and development initiatives dealing with innovative computerized neurocognitive interventions. It is recommended that, because of the preliminary nature of most data currently available in this area, further research initiatives must be supported in the quest for better effectiveness of computer-based interventions intended for age-related cognitive impairment. The conclusion suggests that advanced ICT-based tools, such as virtual and augmented reality technologies, are the most fitting platforms for applying nonpharmacological computerized neurocognitive interventions.

  5. Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes.

    Science.gov (United States)

    Alexander, D G; Shuttleworth-Edwards, A B; Kidd, M; Malcolm, C M

    2015-01-01

    Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents. The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years. A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups. Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group. Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby.

  6. Correlation of neurocognitive function and brain parenchyma volumes in children surviving cancer

    Science.gov (United States)

    Reddick, Wilburn E.; White, Holly A.; Glass, John O.; Mulhern, Raymond K.

    2002-04-01

    This research builds on our hypothesis that white matter damage and associated neurocognitive symptoms, in children treated for cancer with cranial spinal irradiation, spans a continuum of severity that can be reliably probed using non-invasive MR technology. Quantitative volumetric assessments of MR imaging and psychological assessments were obtained in 40 long-term survivors of malignant brain tumors treated with cranial irradiation. Neurocognitive assessments included a test of intellect (Wechsler Intelligence Test for Children, Wechsler Adult Intelligence Scale), attention (Conner's Continuous Performance Test), and memory (California Verbal Learning Test). One-sample t-tests were conducted to evaluate test performance of survivors against age-adjusted scores from the test norms; these analyses revealed significant impairments in all apriori selected measures of intelligence, attention, and memory. Partial correlation analyses were performed to assess the relationships between brain tissues volumes (normal appearing white matter (NAWM), gray matter, and CSF) and neurocognitive function. Global intelligence (r = 0.32, p = 0.05) and global attentional (r = 0.49, p childhood cancer treated with cranial irradiation reveal that loss of NAWM is associated with decreased intellectual and attentional deficits, whereas overall parenchyma loss, as reflected by increased CSF and decreased white matter, is associated with memory-related deficits.

  7. Personality Change Due to Traumatic Brain Injury in Children and Adolescents: Neurocognitive Correlates.

    Science.gov (United States)

    Max, Jeffrey E; Wilde, Elisabeth A; Bigler, Erin D; Hanten, Gerri; Dennis, Maureen; Schachar, Russell J; Saunders, Ann E; Ewing-Cobbs, Linda; Chapman, Sandra B; Thompson, Wesley K; Yang, Tony T; Levin, Harvey S

    2015-01-01

    Personality change due to traumatic brain injury (PC) in children is an important psychiatric complication of injury and is a form of severe affective dysregulation. This study aimed to examine neurocognitive correlates of PC. The sample included 177 children 5-14 years old with traumatic brain injury who were enrolled from consecutive admissions to five trauma centers. Patients were followed up prospectively at baseline and at 6 months, and they were assessed with semistructured psychiatric interviews. Injury severity, socioeconomic status, and neurocognitive function (measures of attention, processing speed, verbal memory, IQ, verbal working memory, executive function, naming/reading, expressive language, motor speed, and motor inhibition) were assessed with standardized instruments. Unremitted PC was present in 26 (18%) of 141 participants assessed at 6 months postinjury. Attention, processing speed, verbal memory, IQ, and executive function were significantly associated with PC even after socioeconomic status, injury severity, and preinjury attention deficit hyperactivity disorder were controlled. These findings are a first step in characterizing concomitant cognitive impairments associated with PC. The results have implications beyond brain injury to potentially elucidate the neurocognitive symptom complex associated with mood instability regardless of etiology.

  8. Perinatal Factors Associated with Poor Neurocognitive Outcome in Early School Age Congenital Diaphragmatic Hernia Survivors

    Science.gov (United States)

    Benjamin, Jennifer R.; Gustafson, Kathryn E.; Smith, P. Brian; Ellingsen, Kirsten M.; Tompkins, K. Brooke; Goldberg, Ronald N.; Cotten, C. Michael; Goldstein, Ricki F.

    2013-01-01

    Objective Determine predictors of neurocognitive outcome in early school age congenital diaphragmatic hernia (CDH) survivors. Study design Prospective study of infants with CDH at Duke University Medical Center. Neurocognitive delay (NCD) at school age (4 to 7 years) was defined as a score < 80 in any of the following areas: Verbal Scale IQ, Performance Scale IQ, Expressive Language, or Receptive Language. Logistic regression, Fisher’s exact, and the Wilcoxon rank sum test were used to examine the relationship between NCD at early school age and 6 demographic and 18 medical variables. Results Of 43 infants with CDH, twenty seven (63%) survived to hospital discharge, and 16 (59%) returned for school age testing at a median age of 4.9 years. Seven (44%) of the children evaluated had NCD. Patch repair (p=0.01), extracorporeal membrane oxygenation (ECMO; p=0.02), days on ECMO (p=0.01), days of mechanical ventilation (p=0.049), and post-operative use of inhaled nitric oxide (p=0.02) were found to be associated with NCD at early school age. Conclusions CDH survivors are at risk for neurocognitive delay persisting into school age. Perinatal factors such as patch repair and ECMO treatment may aid in identifying CDH survivors at high risk for continued learning difficulties throughout childhood. PMID:23583126

  9. Mediators of Physical Activity on Neurocognitive Function: A Review at Multiple Levels of Analysis

    Directory of Open Access Journals (Sweden)

    Chelsea M. Stillman

    2016-12-01

    Full Text Available Physical activity (PA is known to maintain and improve neurocognitive health. However, there is still a poor understanding of the mechanisms by which PA exerts its effects on the brain and cognition in humans. Many of the most widely discussed mechanisms of PA are molecular and cellular and arise from animal models. While information about basic cellular and molecular mechanisms is an important foundation from which to build our understanding of how PA promotes cognitive health in humans, there are other pathways that could play a role in this relationship. For example, PA-induced changes to cellular and molecular pathways likely initiate changes to macroscopic properties of the brain and/or to behavior that in turn influence cognition. The present review uses a more macroscopic lens to identify potential brain and behavioral/socioemotional mediators of the association between PA and cognitive function. We first summarize what is known regarding cellular and molecular mechanisms, and then devote the remainder of the review to discussing evidence for brain systems and behavioral/socioemotional pathways by which PA influences cognition. It is our hope that discussing mechanisms at multiple levels of analysis will stimulate the field to examine both brain and behavioral mediators. Doing so is important, as it could lead to a more complete characterization of the processes by which PA influences neurocognitive function, as well as a greater variety of targets for modifying neurocognitive function in clinical contexts.

  10. The use of stimulant medication to improve neurocognitive and learning outcomes in children diagnosed with brain tumours: a systematic review.

    Science.gov (United States)

    Smithson, Emilie F; Phillips, Robert; Harvey, David W; Morrall, Matthew C H J

    2013-09-01

    Impaired attention is reported in children following treatment for brain tumours (BT). Attention problems impact on information processing and encoding, ultimately leading to academic under-performance. Having been successfully used to manage attention-deficit/hyperactivity disorder (ADHD), stimulants such as methylphenidate (MPH) have been investigated as a beneficial treatment for survivors of childhood BT. In order to develop appropriate strategies to manage late neurocognitive effects, the results of such trials should be evaluated to identify those children most likely to benefit from stimulants. An advanced search was performed across twelve electronic databases for the selection of relevant randomised controlled trials with at least one active stimulant-treated arm. Abstracts were screened for eligibility and data on study design and results were extracted. Of the 5446 records identified, 11 full text articles were assessed for eligibility and seven included in qualitative synthesis. Of the seven papers there were four original trials. Short term outcomes for MPH on objective direct measures of attention and parent/teacher ratings of behaviour were favourable. Observations of side effects indicate that MPH is generally well tolerated. Heterogeneity of study design and outcome measures precluded meta-analysis. Despite yielding only a small number of trials with limited sample size, studies investigating the use of stimulant medication in survivors of childhood BT have provided promising outcomes. Current evidence indicates males, older age when treated, and higher baseline intelligence quotient (IQ) were predictive of greater responsiveness to MPH. While encouraging, additional research using a standardised protocol of outcome measures would be beneficial in identifying those likely to benefit from stimulant use. Further, the available data have yet to establish clear evidence for the effectiveness of MPH being translated into improvements on standardised

  11. Elevated Markers of Vascular Remodeling and Arterial Stiffness Are Associated With Neurocognitive Function in Older HIV+ Adults on Suppressive Antiretroviral Therapy.

    Science.gov (United States)

    Montoya, Jessica L; Iudicello, Jennifer; Fazeli, Pariya L; Hong, Suzi; Potter, Michael; Ellis, Ronald J; Grant, Igor; Letendre, Scott L; Moore, David J

    2017-02-01

    HIV is associated with elevated markers of vascular remodeling that may contribute to arterial fibrosis and stiffening and changes in pulse pressure (PP). These changes may, in turn, deleteriously affect autoregulation of cerebral blood flow and neurocognitive function. To evaluate these mechanisms, we studied markers of vascular remodeling, PP, and neurocognitive function among older (≥50 years of age) HIV-infected (HIV+, n = 72) and HIV-seronegative (HIV-, n = 36) adults. Participants completed standardized neurobehavioral and neuromedical assessments. Neurocognitive functioning was evaluated using a well-validated comprehensive battery. Three plasma biomarkers of vascular remodeling (ie, angiopoietin 2, Tie-2, and vascular endothelial growth factor, VEGF) were collected. HIV+ and HIV- participants had similar levels of plasma angiopoietin 2 (P = 0.48), Tie-2 (P = 0.27), VEGF (P = 0.18), and PP (P = 0.98). In a multivariable regression model, HIV interacted with Tie-2 (β = 0.41, P function, such that lower Tie-2 and higher VEGF values were associated with worse neurocognitive function for HIV+ participants. Greater Tie-2 values were associated with increased PP (r = 0.31, P quadratic association with neurocognitive function (β = -0.33, P = 0.01), such that lower and higher, relative to mean sample, PP values were associated with worse neurocognitive function. These findings indicate that vascular remodeling and altered cerebral blood flow autoregulation contribute to neurocognitive function. Furthermore, HIV moderates the association between vascular remodeling and neurocognitive function but not the association between PP and neurocognitive function.

  12. HCC screening; HCC-Screening

    Energy Technology Data Exchange (ETDEWEB)

    Albrecht, T. [Charite-Unversitaetsmedizin,Freie Universitaet und Humboldt-Universitaet zu Berlin, Klinik und Hochschulambulanz fuer Radiologie und Nuklearmedizin,Campus Benjamin Franklin, Berlin (Germany)

    2008-01-15

    Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed tumour diseases throughout the world. In the vast majority of cases those affected are high-risk patients with chronic viral hepatitis and/or liver cirrhosis, which means there is a clearly identifiable target group for HCC screening. With resection, transplantation, and interventional procedures for local ablation, following early diagnosis curative treatment options are available with which 5-year survival rates of over 60% can be reached. Such early diagnosis is a reality only in a minority of patients, however, and in the majority of cases the disease is already in an advanced stage at diagnosis. One of the objects of HCC screening is diagnosis in an early stage when curative treatment is still possible. Precisely this is achieved by screening, so that the proportion of patients treated with curative intent is decisively higher. There is not yet any clear evidence as to whether this leads to a lowering of the mortality of HCC. As lower mortality is the decisive indicator of success for a screening programme the benefit of HCC screening has so far been neither documented nor refuted. Nonetheless, in large regions of the world it is the practice for high-risk patients to undergo HCC screening in the form of twice-yearly ultrasound examination and determination of AFP. (orig.) [German] Das hepatozellulaere Karzinom (HCC) ist eine der weltweit haeufigsten Tumorerkrankungen. Es tritt in der grossen Mehrzahl der Faelle bei Hochrisikopatienten mit chronischer Virushepatitis bzw. Leberzirrhose auf, woraus sich eine klar identifizierbare Zielgruppe fuer das HCC-Screening ergibt. Mit der Resektion, der Transplantation und interventionellen lokal ablativen Verfahren stehen bei rechtzeitiger Diagnosestellung kurative Therapieoptionen zur Verfuegung, die 5-Jahres-Ueberlebensraten von >60% erreichen. Diese rechtzeitige Diagnosestellung erfolgt jedoch nur bei einer Minderzahl der Patienten, waehrend die

  13. Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders: From cognitive improvement to relapse prevention.

    Science.gov (United States)

    Rezapour, Tara; DeVito, Elise E; Sofuoglu, Mehmet; Ekhtiari, Hamed

    2016-01-01

    Addiction, as a brain disorder, can be defined with two distinct but interacting components: drug dependency and neurocognitive deficits. Most of the therapeutic interventions in addiction medicine, including pharmacological or psychosocial therapies, that are in clinical use have been mainly focused on directly addressing addictive behaviors, especially drug use and urges to use drugs. In the field of addiction treatment, it is often presumed that drug users' neurocognitive deficits will reverse following abstinence. However, in many cases, neurocognitive deficits are not fully ameliorated following sustained abstinence, and neurocognitive function may further deteriorate in early abstinence. It can be argued that many cognitive functions, such as sustained attention and executive control, are essential for full recovery and long-term abstinence from addiction. Recent advances in cognitive neuroscience have provided scientific foundations for neurocognitive rehabilitation as a means of facilitating recovery from drug addiction. Neurocognitive rehabilitation for drug addicted individuals could be implemented as part of addiction treatment, with highly flexible delivery methods including traditional "paper and pencil" testing, or computer-based technology via laptops, web-based, or smartphones in inpatient and outpatient settings. Despite this promise, there has been limited research into the potential efficacy of neurocognitive rehabilitation as a treatment for drug addiction. Further, many questions including the optimum treatment length, session duration, and necessary treatment adherence for treatment efficacy remain to be addressed. In this chapter, we first introduce cognitive rehabilitation as one of the potential areas to bridge the gap between cognitive neuroscience and addiction medicine, followed by an overview of current challenges and future directions.

  14. Correlations between physical activity and neurocognitive domain functions in patients with schizophrenia: a cross-sectional study.

    Science.gov (United States)

    Kurebayashi, Yusuke; Otaki, Junichi

    2017-01-05

    Neurocognitive dysfunction is a critical target symptom of schizophrenia treatment. A positive correlation between physical activity level and neurocognitive function has been reported in healthy individuals, but it is unclear whether such a correlation exists in patients with schizophrenia and whether the relationship is different according to inpatients or outpatients. This study aimed to examine the differences in the correlations between physical activity and multiple neurocognitive domains in inpatients and outpatients with schizophrenia and obtain suggestions for further study to facilitate this field. Twenty-nine patients with schizophrenia were examined (16 inpatients and 13 outpatients, 56.0 ± 11.4 years of age). Current symptoms were assessed using the Positive and Negative Symptom Scale and neurocognitive functions using Cognitrax, which yields a composite neurocognitive index (NCI) and 11 domain scores. After testing, participants wore an HJA-750C accelerometer for one week to measure physical activity levels and durations. Partial correlation analyses were performed between exercise and cognitive parameters. In the outpatient group, higher physical activity was associated with faster Motor and Psychomotor Speeds in outpatients. However, higher physical activity was associated with lower overall NCI, Attention score, and Memory scores in inpatients. Although higher physical activity was associated with better neurocognitive functions of outpatients, in inpatients with non-remitted schizophrenia, higher physical activity was associated with worsening of several cognitive domains. In a future study examining the relationship between physical activity and neurocognitive function for facilitating this research field, separation between inpatients and outpatients are needed because the relationship is different between inpatients and outpatients.

  15. Female athlete triad and its components: toward improved screening and management.

    Science.gov (United States)

    Javed, Asma; Tebben, Peter J; Fischer, Philip R; Lteif, Aida N

    2013-09-01

    As female athletic participation has increased, the positive effects of exercise on health have become evident. However, with this growth in sports activity, a set of health problems unique to the female athlete has emerged. The female athlete triad as first described in 1992 by the American College of Sports Medicine consisted of disordered eating, amenorrhea, and osteoporosis; the definition was updated in 2007 to include a spectrum of dysfunction related to energy availability, menstrual function, and bone mineral density. For this review, a comprehensive search of databases-MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Scopus, from earliest inclusive dates to January 2013-was conducted by an experienced librarian with input from the authors. Controlled vocabulary supplemented with keywords such as female athlete triad, amenorrhea, oligomenorrhea, fracture, osteopenia, osteoporosis, bone disease, anorexia, bulimia, disordered eating, low energy availability was used to search for articles on female athlete triad. Articles addressing the prevalence, screening, and management of the female athlete triad were selected for inclusion in the review. This article reviews the current definitions of the triad components, epidemiology, pathophysiology, and recommended screening and management guidelines. The lack of efficacy of current screening of athletes is highlighted. Low energy availablity, from either dietary restriction or increased expenditure, plays a pivotal role in development of the triad. Athletes involved in "lean sports" (those that emphasize weight categories or aesthetics, such as ballet, gymnastics, or endurance running) are at highest risk. Treatment is centered on restoring energy availability to reverse adverse changes in the metabolic milieu. Prevention and early recognition of triad disorders are crucial to ensure timely intervention

  16. Performance validity test and neuropsychological assessment battery screening module performances in an active-duty sample with a history of concussion.

    Science.gov (United States)

    Grills, Chad E; Armistead-Jehle, Patrick

    2016-01-01

    The current retrospective investigation sought to replicate previous findings demonstrating the significant impact of performance validity test (PVT) performance and evaluation context on neuropsychological testing. We examined differences on performance validity testing between active-duty service members undergoing neurocognitive screening for concussion who were seen in a clinical context and those who were seen in a disability-seeking context, as well as the overall impact of PVT performance on a neurocognitive screening battery. Overall, 38.2% of the sample failed the Word Memory Test (WMT). Of those involved in a disability evaluation, the failure rate was 51.9%, which was significantly higher than the 36.8% failure rate among those evaluated in a clinical context. The effect size of WMT performance on a cognitive screening measure was also large. The current retrospective analysis served to replicate previous work.

  17. Esophageal Cancer Screening

    Science.gov (United States)

    ... Esophageal Cancer Prevention Esophageal Cancer Screening Research Esophageal Cancer Screening (PDQ®)–Patient Version What is screening? Go to ... the esophagus and the stomach). Being overweight . Esophageal Cancer Screening Key Points Tests are used to screen for ...

  18. Relationship of soccer heading to computerized neurocognitive performance and symptoms among female and male youth soccer players.

    Science.gov (United States)

    Kontos, Anthony P; Dolese, Angela; Elbin, R J; Covassin, Tracey; Warren, Barbara L

    2011-01-01

    The purpose of this study was to investigate the relationship between soccer heading and computerized neurocognitive performance and symptoms in female and male youth soccer players. Cross-sectional and prospective design. A total of 63 (27 females, 36 males) youth soccer players aged 13-18 years (M = 15.89, SD = 1.17) participated in the study. Participants completed the Immediate Post-concussion Assessment and Cognitive Test (ImPACT) and symptom report. Computerized neurocognitive performance (e.g., verbal and visual memory, motor processing, and reaction time) and symptoms. There were no differences in neurocognitive performance or symptoms among low-, moderate-, and high-exposure header groups. The current sample outperformed the 10th percentile norms for neurocognitive and symptom scores. Males headed the ball more frequently and reported lower verbal and visual memory and motor processing speed scores than females. The current findings did not support a relationship between soccer heading and computerized neurocognitive performance and symptoms. The researchers suggest that any purported effects of soccer heading in youth are subtle and may affect only a small number of athletes. The reported sex differences in heading exposure warrant further attention.

  19. A neurocognitive model of borderline personality disorder: effects of childhood sexual abuse and relationship to adult social attachment disturbance.

    Science.gov (United States)

    Minzenberg, Michael J; Poole, John H; Vinogradov, Sophia

    2008-01-01

    Borderline personality disorder (BPD) is a paradigmatic disorder of adult attachment, with high rates of antecedent childhood maltreatment. The neurocognitive correlates of both attachment disturbance and maltreatment are both presently unknown in BPD. This study evaluated whether dimensional adult attachment disturbance in BPD is related to specific neurocognitive deficits, and whether childhood maltreatment is related to these dysfunctions. An outpatient BPD group (n=43) performed nearly 1 SD below a control group (n=26) on short-term recall, executive, and intelligence functions. These deficits were not affected by emotionally charged stimuli. In the BPD group, impaired recall was related to attachment-anxiety, whereas executive dysfunction was related to attachment-avoidance. Abuse history was correlated significantly with executive dysfunction and at a trend level with impaired recall. Neurocognitive deficits and abuse history exhibited both independent and interactive effects on adult attachment disturbance. These results suggest that (a) BPD patients' reactivity in attachment relationships is related to temporal-limbic dysfunction, irrespective of the emotional content of stimuli, (b) BPD patients' avoidance within attachment relationships may be a relational strategy to compensate for the emotional consequences of frontal-executive dysregulation, and (c) childhood abuse may contribute to these neurocognitive deficits but may also exert effects on adult attachment disturbance that is both independent and interacting with neurocognitive dysfunction.

  20. Assessing the relationship between neurocognitive performance and brain volume in chronic moderate-severe traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Nikos eKonstantinou

    2016-03-01

    Full Text Available Objectives. Characterize the scale and pattern of long-term atrophy in grey matter (GM, white matter (WM and cerebrospinal (CSF in chronic moderate-severe traumatic brain injury (TBI and its relationship to neurocognitive outcomes.Participants. The TBI group consisted of 17 males with primary diagnosis of moderate-severe closed head injury. Participants had not received any systematic, post-acute rehabilitation and were recruited on average 8.36 years post-injury. The control group consisted of 15 males matched on age and education.Main measures. Neurocognitive battery included widely used tests of verbal memory, visual memory, executive functioning, and attention/organization. GM,WM, and CSF volumes were calculated from segmented T1-weighted anatomical MR images. Voxel-based morphometry was employed to identify brain regions with differences in GM and WM between TBI and control groups.Results. Chronic TBI results in significant neurocognitive impairments, and significant loss of GM and WM volume, and significant increase in CSF volume. Brain atrophy is not widespread, but it is rather distributed in a fronto-thalamic network. The extent of volume loss is predictive of performance on the neurocognitive tests.Conclusion. Significant brain atrophy and associated neurocognitive impairments during the chronic stages of TBI support the notion that TBI results in a chronic condition with lifelong implications.

  1. Clinical experience for treating secondary amenorrhea with the Yijing decoction according to astronomical calendar%结合天文历法服用益经汤治疗继发性闭经临床体会

    Institute of Scientific and Technical Information of China (English)

    刘亚琴; 孙得利

    2015-01-01

    Objective: Combination of astronomical calendar and the Yijing decoction was applied to treat secondary amenorrhea. Methods: 38 patients with secondary amenorrhea were included in the study, to summarize the clinical experience. Results: In one course, 21 cases were menstruation recovery of fancy. In two courses of treatment, 9 cases were menstruation recovery of fancy. In three courses of treatment, 3 cases were menstruation recovery of fancy; there are still 5 patients of fail menstruation; the total efifciency was 86.8%. Conclusion: Combination of astronomical calendar and the Yijing decoction has signiifcant effects on secondary amenorrhea.%目的:服用益经汤结合天文历法治疗继发性闭经。方法:选取38例继发性闭经患者,在满月(每月阴历十五)前一周开始服用益经汤,总结临床体会。结果:38例患者治疗一个疗程后,月经恢复来潮21例,治疗两个疗程后,月经恢复来潮9例,治疗三个疗程后,月经恢复来潮3例,仍然有5例患者月经未来潮,总有效率为86.8%。结论:结合天文历法服用益经汤治疗继发性闭经疗效显著。

  2. 调经1号治疗减肥引起闭经临床观察%Amenorrhea Which Caused by Losing Weight is Treated with TiaoJing 1th 7 Observation

    Institute of Scientific and Technical Information of China (English)

    喻佳

    2011-01-01

    闭经为妇科常见病、多发病,近些年来因减肥引发的闭经患者更是越来越多,治疗难度较大.导师梁学林教授承袭前人"经水出诸于肾"的观点,认为过度减肥脾胃功能低下,气血生化无源,日久累及肾脏,肾精亏虚,冲任失调,血海不能按时满溢而致闭经.在治疗上主张"补后天以养先天",自拟调经1号,随证加减.笔者有幸随师应诊,收集典型病例7例进行临床观察,分析如下.%For the department of gynecology common disease, frequently-occurring disease amenorrhea, in recent years for weight loss caused by the patient is more and more, which is difficult to cure.Professor LIANG Xue-lin approves the predecessor's viewpoint “the menstruation is from the kidney”,she thinks that amenorrhea because of losing weight are first with deficiency of the spleen, then inadequacy of Qi-blood supply and transference of the sickness from the spleen to kidney. Desfunction of Chong and Ren Channels, the bloodshed loses the department is he pathogenesis. In treatment she advocates “the acquiredness nourishing the innateness” and usually takes Tiao. Jing lth, increasing and decreasing some traditional medicine according symptoms. I have the pooprtunity to examine along with the teacher, collect 7cases of amenorrhea on the c1inical observation. Now, I will summarize my teacher's experience as follow.

  3. The Traditional Chinese Medicine Treatment Effect of 20 Cases of Patients With Second Amenorrhea%继发性闭经的20例中医治疗效果分析

    Institute of Scientific and Technical Information of China (English)

    贾立新

    2015-01-01

    目的:探讨继发性闭经的中医辨证治疗。方法选取2010年~2011年我院收治的20例继发性闭经患者为研究对象,回顾临床治疗情况,分析治疗效果。结果经过中医辨证分型治疗,治愈13例,好转6例,无效1例。总有效率95%。结论继发性闭经的治疗,要在中医辨证的基础上给予对症治疗,以利于患者的早日康复。%Objective The traditional Chinese medical and dialectical treatment of secondary amenorrhea to be investigated. Methods Reviewing the treatment data selected from 20 cases of patients with secondary amenorrhea who are treated in hospital from 2010 to 2011,and then analyzing the treatment effect. Results Because of the traditional Chinese medical and dialectical treatment,13 cases of patients are cured and 6 cases of patients show a sign of improvement in their health state,while one case is ineffective. The effectiveness is 95 percent in total. Conclusion The way to treat secondary amenorrhea is to provide patients with symptomatic treatment based on traditional Chinese medical and dialectical treatment,in order to help patients get recovery soon.

  4. SCREEN CUISINE

    National Research Council Canada - National Science Library

    Heather Baysa

    2010-01-01

    ... from the legendary restaurant; the World's First FoodTruck Drive-In Movie on Saturday, where the city's finest food-truck vendors park for the screenings; and the Brooklyn Burger W Beer Garden on Sunday, serving up hearty burgers and brews while you watch Anat Baron's Beer Wars. Tonight at 7, Water Taxi Beach, South Street Seaport.fest...

  5. Airport Screening

    Science.gov (United States)

    ... must be limited to a safe level. An American National Standards Institute/Health Physics Society industry standard states that the maxi- mum ... that does not directly damage DNA. 2 References American National ... Physics Society. Radiation safety for personnel security screening systems ...

  6. Analysis of chromosomal karyotyp in 69 patients with primary amenorrhea in Xiamen%厦门地区69例原发闭经患者的染色体核型分析

    Institute of Scientific and Technical Information of China (English)

    刘芳; 史彩虹; 王厚照; 周友泉

    2012-01-01

    Objective To explore the distribution of abnormal chromosome karyotype in patients with primary amenorrhea in Xiamen area and its clinical signs and significance. Methods Karyotype analysis was performed by peripheral blood lymphocyte chromosomal culture techniques. Results In total 69 patients with primary amenorrhea, there were 28 cases of chromosomal abnormalities , abnormal detection rate was 40. 6% , of which the X chromosomes number abnormalities in 8 cases, accounting for 28. 6% ; number abnormalities and chimera in 6 cases, accounting for 21.4% ; structural abnormalities in 5 cases, accounting for 17.9% ; structural abnormalities and chimera in 3 cases, accounting for 10.7% ; chromosome inversion in 3 cases, accounting for 10.7% ; sex-reversed in 2 cases, accounting for 7.1 % ; autosomal translocation in 1 case, accounting for 3.6%. Conclusion Chromosomal abnormality is one of the major causes of primary amenorrhea, cytogenetic examination in primary amenorrhea patients is important to determine its causes and treatment options.%目的 探讨厦门地区原发性闭经患者各种异常染色体核型的分布情况及其有关临床体征和意义.方法 采用外周血淋巴细胞染色体培养技术进行染色体核型分析.结果 69例原发闭经患者共检出染色体异常28例,异常检出率为40.6%,其中X染色体数目异常8例,占28.6%;X染色体数目异常及嵌合体6例,占21.4%;X染色体结构异常5例,占17.9%;X染色体结构异常及嵌合体3例,占10.7%;染色体倒位3例,占10.7%;性反转2例,占7.1%;与常染色体易位1例,占3.6%.结论 染色体异常是导致原发性闭经的主要病因之一,对原发闭经患者进行细胞遗传学检查,对确定其病因及治疗方案具有重要意义.

  7. The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Mirjam J. Nijdam

    2013-04-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD and major depressive disorder (MDD frequently co-occur after traumatic experiences and share neurocognitive disturbances in verbal memory and executive functioning. However, few attempts have been made to systematically assess the role of a comorbid MDD diagnosis in neuropsychological studies in PTSD. Objective: The purpose of the current study is to investigate neurocognitive deficits in PTSD patients with and without MDD. We hypothesized that PTSD patients with comorbid MDD (PTSD+MDD would have significantly lower performance on measures of verbal memory and executive functioning than PTSD patients without MDD (PTSD–MDD. Method: Participants included in this study were 140 treatment-seeking outpatients who had a diagnosis of PTSD after various single traumatic events and participated in a randomized controlled trial comparing different treatment types. Baseline neuropsychological data were compared between patients with PTSD+MDD (n=84 and patients with PTSD–MDD (n=56. Results: The PTSD+MDD patients had more severe verbal memory deficits in learning and retrieving words than patients with PTSD alone. There were no differences between the groups in recall of a coherent paragraph, recognition, shifting of attention, and cognitive interference. Conclusions: The results of this study suggest that a more impaired neurocognitive profile may be associated with the presence of comorbid MDD, with medium-sized group differences for verbal memory but not for executive functioning. From a clinical standpoint, being aware that certain verbal memory functions are more restricted in patients with comorbid PTSD and MDD may be relevant for treatment outcome of trauma-focused psychotherapy.

  8. Prenatal dioxin exposure and neurocognitive development in Hong Kong 11-year-old children.

    Science.gov (United States)

    Hui, Lai Ling; Lam, Hugh Simon; Lau, Esther Yuet Ying; Nelson, Edmund Anthony Severn; Wong, Tze Wai; Fielding, Richard

    2016-10-01

    In utero exposure to dioxins and related compounds have been associated with adverse neurocognitive development in infants. It is unclear whether neurodevelopmental deficits persist to childhood. We assessed the association of prenatal dioxin exposure with neurocognitive function in 11-year-old children, and to test whether the association is modified by duration of breastfeeding. In this prospective study of 161 children born in Hong Kong in 2002, prenatal dioxin exposure was proxied by the dioxin toxicity equivalence (TEQ) in breast milk collected during the early postnatal period as determined by the Chemical-Activated LUciferase gene eXpression (CALUX) bioassay. We used multivariate linear regression analyses to assess the association of prenatal dioxin exposure with the performance on the Wechsler Intelligence Scale for Children-IV, Hong Kong, the Hong Kong List Learning Test, the Tests for Everyday Attention for Children and the Grooved Pegboard Test, adjusting for child's sex, mother's place of birth, mother's habitual seafood consumption, mother's age at delivery and socioeconomic position. Measures of neurocognitive and intellectual function, including full-scale IQ, fine motor coordination, verbal and non-verbal reasoning, learning ability and attention at 11 years old did not show significant variations with prenatal dioxin exposures (proxied by CALUX-TEQ total dioxin load in early breast milk). None of these associations varied by breastfeeding duration or sex. Neurocongitive function, as measured with psychological tests, in 11-year-old children was not associated with prenatal dioxin exposure to background levels of dioxins in the 2000s in Hong Kong. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Sleep, stress, neurocognitive profile and healthrelated quality of life in adolescents with idiopathic musculoskeletal pain

    Directory of Open Access Journals (Sweden)

    Juliana Molina

    2012-10-01

    Full Text Available OBJECTIVES: The aims of this study were to measure levels of sleep, stress, and depression, as well as health-related quality of life, and to assess the neurocognitive profiles in a sample of adolescents with idiopathic musculoskeletal pain. METHODS: Nineteen adolescents with idiopathic musculoskeletal pain and 20 age-matched healthy control subjects were evaluated regarding their levels of sleep and stress, as well as quality of life, and underwent neurocognitive testing. RESULTS: The sample groups consisted predominantly of females (84%, and the socioeconomic status did not differ between the two groups. In addition, the occurrence of depressive symptoms was similar between the two groups; specifically, 26% of the idiopathic musculoskeletal pain patients and 30% of the control subjects had scores indicative of depression. Teenagers in the group with idiopathic musculoskeletal pain reported poorer quality of life and sleep scores than those in the control group. Regarding stress, patients had worse scores than the control group; whereas 79% of the adolescents with idiopathic musculoskeletal pain met the criteria for a diagnosis of stress, only 35% of the adolescents in the control group met the criteria. In both groups, we observed scores that classified adolescents as being in the resistance phase (intermediate and exhaustion phase (pathological of distress. However, the idiopathic musculoskeletal pain group more frequently reported symptomatic complaints of physical and emotional distress. The neurocognitive assessment showed no significant impairments in either group. CONCLUSION: Adolescents with idiopathic musculoskeletal pain did not exhibit cognitive impairments. However, adolescents with idiopathic musculoskeletal pain did experience intermediate to advanced psychological distress and lower health-related quality of life, which may increase their risk of cognitive dysfunction in the future.

  10. The value of neurocognitive testing for acute outcomes after mild traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Latha Ganti; Yasamin Daneshvar; Sarah Ayala; Pratik Shashikant Patel; Aakash N Bodhit; Keith R Peters

    2015-01-01

    Background:Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-term outcomes after acute traumatic brain injury (TBI). Methods:This is an IRB-approved prospective study of adult patients who came to the emergency department of our Level-1 trauma center with TBI. Patients were enrolled prospectively after providing written informed consent and underwent three separate neurocognitive tests: the Galveston Orientation Amnesia Test (GOAT), the Rivermead Post-Concussion Survey Questionnaire (RPCSQ), and the Mini Mental Status Examination (MMSE). Results:A lower GOAT score was significantly associated with hospitalization (P=0.0212) and the development of post-concussion syndrome (PCS) at late follow-up (P=0.0081). A higher RPCSQ score was significantly associated with hospital admission (P=0.0098), re-admission within 30 days of discharge (P=0.0431) and evidence of PCS at early follow-up (P=0.0004). A higher MMSE score was significantly associated with not being admitted to the hospital (P=0.0002) and not returning to the emergency department (ED) within 72 hours of discharge (P=0.0078). Lower MMSE was also significantly associated with bleeding or a fracture on the brain CT (P=0.0431). Conclusions:While neurocognitive testing is not commonly performed in the ED in the setting of acute head injury, it is both feasible and appears to have value in predicting hospital admission and PCS. These data are especially important in terms of helping patients understand what to expect, thus, aiding in their recovery.

  11. Genetic Mediators of Neurocognitive Outcomes in Survivors of Childhood Acute Lymphoblastic Leukemia

    Science.gov (United States)

    Krull, Kevin R.; Bhojwani, Deepa; Conklin, Heather M.; Pei, Deqing; Cheng, Cheng; Reddick, Wilburn E.; Sandlund, John T.; Pui, Ching-Hon

    2013-01-01

    Purpose Survivors of childhood acute lymphoblastic leukemia (ALL) are at increased risk for neurocognitive problems, with significant interindividual variability in outcome. This study examined genetic polymorphisms associated with variability in neurocognitive outcome. Patients and Methods Neurocognitive outcomes were evaluated at the end of therapy in 243 survivors treated on an institutional protocol featuring risk-adapted chemotherapy without prophylactic cranial irradiation. Polymorphisms in genes related to pharmacokinetics or pharmacodynamics of antileukemic agents, drug metabolism, oxidative stress, and attention problems in noncancer populations were examined as predictors of outcome, using multiple general linear models and controlling for age at diagnosis, sex, race, and treatment intensity. Results Compared with national norms, the cohort demonstrated significantly higher rates of problems on direct assessment of sustained attention (P = .01) and on parent ratings of attention problems (P = .02). Children with the A2756G polymorphism in methionine synthase (MS) were more likely to demonstrate deficits in attentiveness (P = .03) and response speed (P = .02), whereas those with various polymorphisms in glutathione S-transferase demonstrated increased performance variability (P = .01) and reduced attentiveness (P = .003). Polymorphisms in monoamine oxidase (T1460CA) were associated with increased attention variability (P = .03). Parent-reported attention problems were more common in children with the Cys112Arg polymorphism in apoliopoprotein E4 (P = .01). Conclusion These results are consistent with our previous report of association between attention problems and MS in an independent cohort of long-term survivors of childhood ALL treated with chemotherapy only. The results also raise the possibility of an impact from genetic predispositions related to oxidative stress and CNS integrity. PMID:23650422

  12. [The connection between mentalization deficit and pragmatic language skills and neurocognition in schizophrenia].

    Science.gov (United States)

    Herold, Róbert; Tényi, Tamás; Simon, Mária; Trixler, Mátyás

    2004-06-01

    There is an increasing interest in the background of mentalization deficit in schizophrenia. On the one hand, according to developmental psychological studies, mentalization development is connected with the development of pragmatic language skills. On the other hand, studies suggest that mentalization is dependent on the maturation of neurocognitive skills such as executive functions. Our study investigated the role of these domains in the mentalization deficit of schizophrenia. 28 patients with schizophrenia and 20 control patients with depression took part in the first part of the study. Participants were presented first-order and second-order mentalization tasks, metaphor and irony tasks for the assessment of mentalizing skills. The pragmatic language skills were examined by "question and answer" vignettes. 20 patients with schizophrenia took part in the second part of the study. The test battery was completed with a picture recognition task and neurocognitive tests were made by all patients. Patients with schizophrenia performed significantly worse in the irony and pragmatic tasks, but there was no correlation between their performances in the irony and in the pragmatic tasks. Selective attention and verbal working memory showed correlation with the cumulative verbal mentalization index. Selective attention correlated with the recognition of complex mental states from pictures as well, but the successful decoding of complex mental states was dependent on the recognition of basic expressions. Attention correlated with mental state recognition as well. Our results suggest that the mentalization deficits of people with schizophrenia cannot be explained by pragmatic language deficits alone, and the manifest impairment is the consequence of disturbances in multiple cognitive processes. Basic neurocognitive factors such as attention, selective attention and verbal working memory can influence the mentalization skills.

  13. Neurocognitive, mental health, and glucose disorders in farmers exposed to organophosphorus pesticides.

    Science.gov (United States)

    Malekirad, Ali Akbar; Faghih, Mahya; Mirabdollahi, Mansuoreh; Kiani, Mahdi; Fathi, Arezoo; Abdollahi, Mohammad

    2013-01-01

    About 25 million agricultural workers in the developing world suffer from at least one episode of poisoning each year, mainly by anticholinesterase-like organophosphates (OPs). The objective of this cross-sectional study was to establish the OP toxicity in 187 occupationally exposed farmers in terms of neurocognitive impairment, mental health status, clinical symptoms, diabetes, and haematological factors. The exposed group was compared to 187 healthy age-, sex-, and education-matching controls. Neurocognitive impairment was measured using the Subjective Neurocognition Inventory (SNI) and mental health status using the General Health Questionnaire-28 (GHQ-28). The subjects were also tested for fasting blood glucose (FBG), blood urea nitrogen (BUN), cholesterol (CL), triglycerides (TG), creatinine, oral glucose tolerance test (GTT), high-density lipoprotein (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP). The exposed farmers showed higher FBG (pinsomnia and severe depression were also significantly higher in the farmers than in controls (p=0.015 and p<0.001, respectively). Meanwhile, the rate of social dysfunction was significantly lower than in controls (p<0.001). Disorders affecting psychomotor speed, selective attention, divided attention, verbal memory, nonverbal memory, prospective memory, spatial functioning, and initiative/energy were all lower in the farmers (p<0.001). Farmers showed clinical symptoms eczema, saliva secretion, fatigue, headache, sweating, abdominal pain, nausea, superior distal muscle weakness, inferior distal muscle weakness, inferior proximal muscle weakness, breath muscle weakness, hand tingling, foot tingling, epiphoria, polyuria, miosis, dyspnoea, bradycardia, and rhinorrhoea, which all significantly correlated with the number of working years. These findings indicate that farmers who work with OPs are prone to neuropsychological disorders and diabetes.

  14. Neurocognitive performance of a community-based sample of young people at putative ultra high risk for psychosis: support for the processing speed hypothesis.

    LENUS (Irish Health Repository)

    Kelleher, Ian

    2013-01-01

    A wide variety of neurocognitive deficits have been reported for help-seeking individuals who are at clinical or ultra high risk for psychosis based on fulfilling set criteria for prodromal syndromes\\/at risk mental states. We wished to extend this research by conducting the first population-based assessment of prodromal syndromes and associated neurocognition.

  15. Neurocognitive Function Among Middle-aged and Older Hispanic/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

    Science.gov (United States)

    González, Hector M.; Tarraf, Wassim; Gouskova, Natalia; Gallo, Linda C.; Penedo, Frank J.; Davis, Sonia M.; Lipton, Richard B.; Argüelles, William; Choca, James P.; Catellier, Diane J.; Mosley, Thomas H.

    2015-01-01

    We sought to examine and describe neurocognitive function among middle-aged and older Hispanic/Latino Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants. We analyzed baseline cross-sectional data from the middle-aged and older (ages 45–74 years old) participants (n = 9,063) to calculate neurocognitive function scores and their correlates. Older age and higher depressive symptoms scores were associated with lower average neurocognitive performance, whereas greater educational attainment and household income were associated with higher neurocognitive performance. Hispanic/Latino heritage groups significantly varied in neurocognitive performances. Some neurocognitive differences between Hispanics/Latinos were maintained after controlling for language preference, education, household income, and depressive symptoms. We found notable differences in neurocognitive scores between Hispanic/Latino heritage groups that were not fully explained by the cultural and socioeconomic correlates examined in this study. Further investigations into plausible biological and environmental factors contributing to the Hispanic/Latino heritage group differences in neurocognitive found in the HCHS/SOL are warranted. PMID:25451561

  16. Does EEG-Neurofeedback Improve Neurocognitive Functioning in Children with Attention-Deficit/Hyperactivity Disorder? A Systematic Review and a Double-Blind Placebo-Controlled Study

    Science.gov (United States)

    Vollebregt, Madelon A.; van Dongen-Boomsma, Martine; Buitelaar, Jan K.; Slaats-Willemse, Dorine

    2014-01-01

    Background: The number of placebo-controlled randomized studies relating to EEG-neurofeedback and its effect on neurocognition in attention-deficient/hyperactivity disorder (ADHD) is limited. For this reason, a double blind, randomized, placebo-controlled study was designed to assess the effects of EEG-neurofeedback on neurocognitive functioning…

  17. Incidence and impact on mortality of severe neurocognitive disorders in persons with and without HIV infection: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Lescure, François-Xavier; Omland, Lars Haukali Hvass; Engsig, Frederik Neess

    2011-01-01

    The risk of neurocognitive disorders in human immunodeficiency virus (HIV)-infected patients in the era of highly active antiretroviral therapy (HAART) is controversial. We aimed to compare the incidence and impact on mortality of severe neurocognitive disorders (SNCDs) in HIV-infected patients...

  18. Hippocampal-dependent neurocognitive impairment following cranial irradiation observed in pre-clinical models: current knowledge and possible future directions.

    Science.gov (United States)

    Tomé, Wolfgang A; Gökhan, Şölen; Gulinello, Maria E; Brodin, N Patrik; Heard, John; Mehler, Mark F; Guha, Chandan

    2016-01-01

    We reviewed the literature for studies pertaining to impaired adult neurogenesis leading to neurocognitive impairment following cranial irradiation in rodent models. This compendium was compared with respect to radiation dose, converted to equivalent dose in 2 Gy fractions (EQD2) to allow for direct comparison between studies. The effects of differences between animal species and the dependence on animal age as well as for time after irradiation were also considered. One of the major sites of de novo adult neurogenesis is the hippocampus, and as such, this review also focuses on assessing evidence related to the expression and potential effects of inflammatory cytokines on neural stem cells in the subgranular zone of the dentate gyrus and whether this correlates with neurocognitive impairment. This review also discusses potential strategies to mitigate the detrimental effects on neurogenesis and neurocognition resulting from cranial irradiation, and how the rationale for these strategies compares with the current outcome of pre-clinical studies.

  19. A preliminary examination of neurocognitive performance and symptoms following a bout of soccer heading in athletes wearing protective soccer headbands.

    Science.gov (United States)

    Elbin, R J; Beatty, Amanda; Covassin, Tracey; Schatz, Philip; Hydeman, Ana; Kontos, Anthony P

    2015-01-01

    This study compared changes in neurocognitive performance and symptom reports following an acute bout of soccer heading among athletes with and without protective soccer headgear. A total of 25 participants headed a soccer ball 15 times over a 15-minute period, using a proper linear heading technique. Participants in the experimental group completed the heading exercise while wearing a protective soccer headband and controls performed the heading exercise without wearing the soccer headband. Neurocognitive performance and symptom reports were assessed before and after the acute bout of heading. Participants wearing the headband showed significant decreases on verbal memory (p = 0.02) compared with the no headband group, while the no headband group demonstrated significantly faster reaction time (p = 0.03) than the headband group following the heading exercise. These findings suggest that protective soccer headgear likely does not mitigate the subtle neurocognitive effects of acute soccer heading.

  20. Mild test anxiety influences neurocognitive performance among African Americans and European Americans: identifying interfering and facilitating sources.

    Science.gov (United States)

    Thames, April D; Panos, Stella E; Arentoft, Alyssa; Byrd, Desiree A; Hinkin, Charles H; Arbid, Natalie

    2015-01-01

    The current study examined ethnic/racial differences in test-related anxiety and its relationship to neurocognitive performance in a community sample of African American (n = 40) and European American (n = 36) adults. The authors hypothesized the following: (a) Test-anxiety related to negative performance evaluation would be associated with lower neurocognitive performance, whereas anxiety unrelated to negative evaluation would be associated with higher neurocognitive performance. (b) African American participants would report higher levels of anxiety about negative performance evaluation than European Americans. (c) European Americans would report higher levels of anxiety unrelated to negative performance evaluation. The first two hypotheses were supported: Ethnic/racial differences in test-taking anxiety emerged such that African Americans reported significantly higher levels of negative performance evaluation, which was associated with lower cognitive performance. The third hypothesis was not supported: African Americans and European Americans reported similar levels of test-anxiety unrelated to negative evaluation.

  1. [Hypothyroidism during pregnancy risks the child's neurocognitive development. New guidelines and remaining knowledge gaps].

    Science.gov (United States)

    Skalkidou, Alkistis; Bixo, Marie; Sköldebrand Sparre, Ann-Charlotte; Strandell, Annika; Lindén Hirschberg, Angelica; Filipsson Nyström, Helena

    2016-02-05

    Thyroid abnormalities are common during pregnancy and can affect pregnancy outcome. In 2012, the working group for endocrinology was assigned by SFOG to develop evidence based guidelines for their management. There is high quality evidence that untreated clinical hypothyroidism increases the risk of pregnancy and fetal complications. Subclinical hypothyroidism is associated with pregnancy complications. The presence of TPO-antibodies is linked to miscarriage and premature birth. It is uncertain whether subclinical hypothyroidism/maternal TPO-antibodies adversely affect the child's neurocognitive development. Reference intervals for TSH among pregnant women in Sweden need to be established.

  2. HIV-associated neurocognitive disorder: rate of referral for neurorehabilitation and psychiatric co-morbidity.

    LENUS (Irish Health Repository)

    Herlihy, D

    2012-04-01

    Despite advances in antiretroviral therapy, HIV-infected patients continue to present with HIV-associated neurocognitive disorder (HAND) which may be associated with significant psychiatric co-morbidity. We audited our patients with HAND referred for psychiatric assessment against the National Service Framework guidelines that they should receive neurorehabilitation. We found that despite these patients posing a risk to themselves and others due to poor insight and medication adherence, high rates of psychiatric co-morbidity and severely challenging behaviour, few were referred for neurorehabilitation. We recommend that clear referral pathways for psychiatric intervention and neurorehabilitation are established in HIV treatment centres.

  3. Timing deficits in attention-deficit/hyperactivity disorder (ADHD): evidence from neurocognitive and neuroimaging studies.

    Science.gov (United States)

    Noreika, Valdas; Falter, Christine M; Rubia, Katya

    2013-01-01

    Relatively recently, neurocognitive and neuroimaging studies have indicated that individuals with attention-deficit/hyperactivity disorder (ADHD) may have deficits in a range of timing functions and their underlying neural networks. Despite this evidence, timing deficits in ADHD are still somewhat neglected in the literature and mostly omitted from reviews on ADHD. There is therefore a lack of integrative reviews on the up-to-date evidence on neurocognitive and neurofunctional deficits of timing in ADHD and their significance with respect to other behavioural and cognitive deficits. The present review provides a synthetic overview of the evidence for neurocognitive and neurofunctional deficits in ADHD in timing functions, and integrates this evidence with the cognitive neuroscience literature of the neural substrates of timing. The review demonstrates that ADHD patients are consistently impaired in three major timing domains, in motor timing, perceptual timing and temporal foresight, comprising several timeframes spanning milliseconds, seconds, minutes and longer intervals up to years. The most consistent impairments in ADHD are found in sensorimotor synchronisation, duration discrimination, reproduction and delay discounting. These neurocognitive findings of timing deficits in ADHD are furthermore supported by functional neuroimaging studies that show dysfunctions in the key inferior fronto-striato-cerebellar and fronto-parietal networks that mediate the timing functions. Although there is evidence that these timing functions are inter-correlated with other executive functions that are well established to be impaired in the disorder, in particular working memory, attention, and to a lesser degree inhibitory control, the key timing deficits appear to survive when these functions are controlled for, suggesting independent cognitive deficits in the temporal domain. There is furthermore strong evidence for an association between timing deficits and behavioural

  4. Sleep extension improves neurocognitive functions in chronically sleep-deprived obese individuals.

    Directory of Open Access Journals (Sweden)

    Eliane A Lucassen

    Full Text Available BACKGROUND: Sleep deprivation and obesity, are associated with neurocognitive impairments. Effects of sleep deprivation and obesity on cognition are unknown, and the cognitive long-term effects of improvement of sleep have not been prospectively assessed in short sleeping, obese individuals. OBJECTIVE: To characterize neurocognitive functions and assess its reversibility. DESIGN: Prospective cohort study. SETTING: Tertiary Referral Research Clinical Center. PATIENTS: A cohort of 121 short-sleeping (<6.5 h/night obese (BMI 30-55 kg/m(2 men and pre-menopausal women. INTERVENTION: Sleep extension (468±88 days with life-style modifications. MEASUREMENTS: Neurocognitive functions, sleep quality and sleep duration. RESULTS: At baseline, 44% of the individuals had an impaired global deficit score (t-score 0-39. Impaired global deficit score was associated with worse subjective sleep quality (p = 0.02, and lower urinary dopamine levels (p = 0.001. Memory was impaired in 33%; attention in 35%; motor skills in 42%; and executive function in 51% of individuals. At the final evaluation (N = 74, subjective sleep quality improved by 24% (p<0.001, self-reported sleep duration increased by 11% by questionnaires (p<0.001 and by 4% by diaries (p = 0.04, and daytime sleepiness tended to improve (p = 0.10. Global cognitive function and attention improved by 7% and 10%, respectively (both p = 0.001, and memory and executive functions tended to improve (p = 0.07 and p = 0.06. Serum cortisol increased by 17% (p = 0.02. In a multivariate mixed model, subjective sleep quality and sleep efficiency, urinary free cortisol and dopamine and plasma total ghrelin accounted for 1/5 of the variability in global cognitive function. LIMITATIONS: Drop-out rate. CONCLUSIONS: Chronically sleep-deprived obese individuals exhibit substantial neurocognitive deficits that are partially reversible upon improvement of sleep in a non-pharmacological way

  5. Neuro-cognitive mechanisms underlying the emotional modulation of word reading

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    A novel neural model for emotional modulation of word reading is proposed. This model has four principal hypotheses: the dominant activation region hypothesis, the emotional modulation hypothesis, the attentional level hypothesis, and the interaction hypothesis. Four lines of research were reviewed to provide evidence for these hypotheses: (1) neuro-cognitive studies on the mechanisms of word reading (i.e., neural networks for reading); (2) studies on the influence of words' emotional valence on word reading; (3) studies of the effect of attention on word reading; and (4) studies on emotional modulation of word reading under different attentional levels.

  6. Selective vulnerabilities and biomarkers in neurocognitive aging [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Zachariah Reagh

    2017-04-01

    Full Text Available As the world’s population continues to age, an understanding of the aging brain becomes increasingly crucial. This review focuses on several recent ideas and findings in the study of neurocognitive aging, specifically focusing on episodic memory, and discusses how they can be considered and used to guide us moving forward. Topics include dysfunction in neural circuits, the roles of neurogenesis and inhibitory signaling, vulnerability in the entorhinal cortex, individual differences, and comorbidities. These avenues of study provide a brief overview of promising themes in the field and together provide a snapshot of what we believe will be important emerging topics in selective vulnerabilities in the aging brain.

  7. Diffusion tensor imaging and neurocognition in survivors of childhood acute lymphoblastic leukaemia.

    Science.gov (United States)

    Edelmann, Michelle N; Krull, Kevin R; Liu, Wei; Glass, John O; Ji, Qing; Ogg, Robert J; Sabin, Noah D; Srivastava, Deo Kumar; Robison, Leslie L; Hudson, Melissa M; Reddick, Wilburn E

    2014-11-01

    Survivors of childhood acute lymphoblastic leukaemia are at risk for neurocognitive impairment, though little information is available on its association with brain integrity, particularly for survivors treated without cranial radiation therapy. This study compares neurocognitive function and brain morphology in long-term adult survivors of childhood acute lymphoblastic leukaemia treated with chemotherapy alone (n = 36) to those treated with cranial radiation therapy (n = 39) and to healthy control subjects (n = 23). Mean (standard deviation) age at evaluation was 24.9 (3.6) years for the chemotherapy group and 26.7 (3.4) years for the cranial radiation therapy group, while time since diagnosis was 15.0 (1.7) and 23.9 (3.1) years, respectively. Brain grey and white matter volume and diffusion tensor imaging was compared between survivor groups and to 23 healthy controls with a mean (standard deviation) age of 23.1 (2.6) years. Survivors treated with chemotherapy alone had higher fractional anisotropy in fibre tracts within the left (P < 0.05), but not in the right, hemisphere when compared to controls. Survivors of acute lymphoblastic leukaemia, regardless of treatment, had a lower ratio of white matter to intracranial volume in frontal and temporal lobes (P < 0.05) compared with control subjects. Survivors of acute lymphoblastic leukaemia treated with chemotherapy alone performed worse in processing speed (P < 0.001), verbal selective reminding (P = 0.01), and academics (P < 0.05) compared to population norms and performed better than survivors treated with cranial radiation therapy on verbal selective reminding (P = 0.02), processing speed (P = 0.05) and memory span (P = 0.009). There were significant associations between neurocognitive performance and brain imaging, particularly for frontal and temporal white and grey matter volume. Survivors of acute lymphoblastic leukaemia treated with chemotherapy alone demonstrated significant long-term differences in

  8. A comparison of screening batteries in the detection of neurocognitive impairment in HIV-infected Spanish speakers

    OpenAIRE

    Levine, Andrew; Palomo,, L Valencia; Lopez,; Singer, MR; Valdes-Sueiras,; Hinkin, Charles; Mathisen,; S. Donovan

    2011-01-01

    Andrew J Levine1, Manuel Palomo1, Charles H Hinkin2,3, Miguel Valdes-Sueiras1,5, Enrique Lopez3,4, Glenn Mathisen1,5, Suzanne Donovan1,5, Elyse J Singer11National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine at UCLA, 2Veterans Affairs Greater Los Angeles Healthcare System, 3Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine at UCLA, 4Department of Psychiatry and Behavioral Neuroscience, Cedars-Sinai Medical Center, Los Angeles...

  9. Association between the MMPI-2 restructured form (MMPI-2-RF) and malingered neurocognitive dysfunction among non-head injury disability claimants.

    Science.gov (United States)

    Tarescavage, Anthony M; Wygant, Dustin B; Gervais, Roger O; Ben-Porath, Yossef S

    2013-01-01

    The current study examined the over-reporting Validity Scales of the MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) in relation to the Slick, Sherman, and Iverson (1999) criteria for the diagnosis of Malingered Neurocognitive Dysfunction in a sample of 916 consecutive non-head injury disability claimants. The classification of Malingered Neurocognitive Dysfunction was based on scores from several cognitive symptom validity tests and response bias indicators built into traditional neuropsychological tests. Higher scores on MMPI-2-RF Validity Scales, particularly the Response Bias Scale (Gervais, Ben-Porath, Wygant, & Green, 2007), were associated with probable and definite Malingered Neurocognitive Dysfunction. The MMPI-2-RF's Validity Scales classification accuracy of Malingered Neurocognitive Dysfunction improved when multiple scales were interpreted. Additionally, higher scores on MMPI-2-RF substantive scales measuring distress, internalizing dysfunction, thought dysfunction, and social avoidance were associated with probable and definite Malingered Neurocognitive Dysfunction. Implications for clinical practice and future directions are noted.

  10. Prospective cohort study of the relationship between neuro-cognition, social cognition and violence in forensic patients with schizophrenia and schizoaffective disorder.

    Science.gov (United States)

    O'Reilly, Ken; Donohoe, Gary; Coyle, Ciaran; O'Sullivan, Danny; Rowe, Arann; Losty, Mairead; McDonagh, Tracey; McGuinness, Lasairiona; Ennis, Yvette; Watts, Elizabeth; Brennan, Louise; Owens, Elizabeth; Davoren, Mary; Mullaney, Ronan; Abidin, Zareena; Kennedy, Harry G

    2015-07-10

    There is a broad literature suggesting that cognitive difficulties are associated with violence across a variety of groups. Although neurocognitive and social cognitive deficits are core features of schizophrenia, evidence of a relationship between cognitive impairments and violence within this patient population has been mixed. We prospectively examined whether neurocognition and social cognition predicted inpatient violence amongst patients with schizophrenia and schizoaffective disorder (n = 89; 10 violent) over a 12 month period. Neurocognition and social cognition were assessed using the MATRICS Consensus Cognitive Battery (MCCB). Using multivariate analysis neurocognition and social cognition variables could account for 34 % of the variance in violent incidents after controlling for age and gender. Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size. Mediation analysis showed that the relationship between neurocognition and violence was completely mediated by each of the following variables independently: social cognition (MSCEIT), symptoms (PANSS Total Score), social functioning (SOFAS) and violence proneness (HCR-20 Total Score). There was no evidence of a serial pathway between neurocognition and multiple mediators and violence, and only social cognition and violence proneness operated in parallel as significant mediators accounting for 46 % of the variance in violent incidents. There was also no evidence that neurocogniton mediated the relationship between any of these variables and violence. Of all the predictors examined, neurocognition was the only variable whose effects on violence consistently showed evidence of mediation. Neurocognition operates as a distal risk factor mediated through more proximal factors. Social cognition in contrast has a direct effect on violence independent of neurocognition, violence proneness and symptom severity. The

  11. Two Medical Cases of Chinese Medicine in the Treatment of Amenorrhea Caused by Premature Ovarian Failure%中药治疗卵巢早衰所致闭经医案2则

    Institute of Scientific and Technical Information of China (English)

    任小梅; 杨丹丹; 桑海莉

    2016-01-01

    The premature ovarian failure refers to ovarian failure due to ovarian follicular depletion or due to iatrogenic injury occurred in women before the age of 40, with low estrogen and higher gonadal hormones ( FSH, LH ) features, and is mainly for the secondary amenorrhea associated with per menopausal symptoms.The “amenorrhea in young women” in theory of Fu Shan is the premature ovarian failure in modern medicine.There are many reasons that cause premature ovarian failure, the main factors that may be related to mental stress is too large for modern women.%卵巢早衰( Prematureovarian failure PoF),是指女性40岁前由于卵巢内卵泡耗竭或因医源性损伤而发生的卵巢功能衰竭,以低雌激素及高促性腺激素( FSH、LH)为特征,主要表现为继发性闭经,可伴有围绝经期症状,傅山所论的“年未老经水断”即为现代医学所说的卵巢早衰。引起卵巢早衰的原因有很多,最主要的因素可能是现代女性精神压力过大。

  12. The Relationship between Tests of Neurocognition and Performance on a Laparoscopic Simulator

    Directory of Open Access Journals (Sweden)

    Oumar Kuzbari

    2010-01-01

    Full Text Available Objective. To estimate if there is a relationship between the results of tests of neurocognition and performance on a laparoscopic surgery simulator. Methods and Materials. Twenty participants with no prior laparoscopic experience had baseline cognitive tests administered (Trail Making Test, Part A and B (TMT-A and TMT-B, Grooved Peg Board Test, Symbol Digit Modalities Test, Symbol Digit Recall Test, and Stroop Interference Test, completed a demographic questionnaire, and then performed laparoscopy using a simulator. We correlated the results of cognitive tests with laparoscopic surgical performance. Results. One cognitive test sensitive to frontal lobe function, TMT-A, significantly correlated with laparoscopic surgical performance on the simulator (correlation coefficient of 0.534 with P<.05. However, the correlation between performance and other cognitive tests (TMT-B, Grooved Peg Board Test, Symbol Digit Modalities Test, Symbol Digit Recall Test, and Stroop Interference Test was not statistically significant. Conclusion. Laparoscopic performance may be related to measures of frontal lobe function. Neurocognitive tests may predict motor skills abilities and performance on laparoscopic simulator.

  13. The 'I' and the 'Me' in self-referential awareness: a neurocognitive hypothesis.

    Science.gov (United States)

    Tagini, Angela; Raffone, Antonino

    2010-02-01

    The nature of the 'self' and self-referential awareness has been one of the most debated issues in philosophy, psychology and cognitive neuroscience. Understanding the neurocognitive bases of self-related representation and processing is also crucial to research on the neural correlates of consciousness. The distinction between an 'I', corresponding to a subjective sense of the self as a thinker and causal agent, and a 'Me', as the objective sense of the self with the unique and identifiable features constituting one's self-image or self-concept, suggested by William James, has been re-elaborated by authors from different theoretical perspectives. In this article, empirical studies and theories about the 'I' and the 'Me' in cognition and self-related awareness are reviewed, including the relationships between self and perception, self and memory, the development of the self, self-referential stimulus processing, as well as related neuroimaging studies. Subsequently, the relations between self and different aspects of consciousness are considered. On the basis of the reviewed literature and with reference to Block's distinction between phenomenal and access consciousness, a neurocognitive hypothesis is formulated about 'I'-related and 'Me'-related self-referential awareness. This hypothesis is extended to metacognitive awareness and a form of non-transitive consciousness, characteristic of meditation experiences and studies, with particular reference to the notion of mindfulness and other Buddhist constructs.

  14. Chronic post-concussion neurocognitive deficits. II. Relationship with persistent symptoms

    Directory of Open Access Journals (Sweden)

    Jun eMaruta

    2016-02-01

    Full Text Available Individuals who sustain a concussion may continue to experience problems long after their injury. However, it has been postulated in the literature that the relationship between a concussive injury and persistent complaints attributed to it is mediated largely by the development of symptoms associated with posttraumatic stress disorder and depression. We sought to characterize cognitive deficits of adult patients who had persistent symptoms after a concussion and determine whether the original injury retains associations with these deficits after accounting for the developed symptoms that overlap with posttraumatic stress disorder and depression. We compared the results of neurocognitive testing from 33 patients of both genders aged 18-55 at three months to five years post-injury with those from 140 control subjects. Statistical comparisons revealed that patients generally produced accurate responses on reaction time-based tests, but with reduced efficiency. On visual tracking, patients increased gaze position error variability following an attention demanding task, an effect that may reflect greater fatigability. When neurocognitive performance was examined in the context of demographic- and symptom-related variables, the original injury retained associations with reduced performance at a statistically significant level. For some patients, reduced cognitive efficiency and fatigability may represent key elements of interference when interacting with the environment, leading to varied paths of recovery after a concussion. Poor recovery may be better understood when these deficits are taken into consideration.

  15. Role of Oxidative Stress in the Neurocognitive Dysfunction of Obstructive Sleep Apnea Syndrome

    Science.gov (United States)

    Chen, Ping

    2016-01-01

    Obstructive sleep apnea syndrome (OSAS) is characterized by chronic nocturnal intermittent hypoxia and sleep fragmentations. Neurocognitive dysfunction, a significant and extraordinary complication of OSAS, influences patients' career, family, and social life and reduces quality of life to some extent. Previous researches revealed that repetitive hypoxia and reoxygenation caused mitochondria and endoplasmic reticulum dysfunction, overactivated NADPH oxidase, xanthine oxidase, and uncoupling nitric oxide synthase, induced an imbalance between prooxidants and antioxidants, and then got rise to a series of oxidative stress (OS) responses, such as protein oxidation, lipid peroxidation, and DNA oxidation along with inflammatory reaction. OS in brain could trigger neuron injury especially in the hippocampus and cerebral cortex regions. Those two regions are fairly susceptible to hypoxia and oxidative stress production which could consequently result in cognitive dysfunction. Apart from continuous positive airway pressure (CPAP), antioxidant may be a promising therapeutic method to improve partially reversible neurocognitive function. Understanding the role that OS played in the cognitive deficits is crucial for future research and therapeutic strategy development. In this paper, recent important literature concerning the relationship between oxidative stress and cognitive impairment in OSAS will be summarized and the results can provide a rewarding overview for future breakthrough in this field.

  16. Establishing a neurocognition-based taxonomy of graphical variables for attention-guiding geovisualisation

    Science.gov (United States)

    Swienty, O.; Zhang, M.; Reichenbacher, T.; Meng, L.

    2007-06-01

    It is a delicate task to design suitable geovisualisations that allow users an efficient visual processing of geographic information. In digital era, such a design task is confronted with a three-fold challenge: the ever growing amount of geospatial data at various granularity levels, the diversified applications and the continuously expanding range of display sizes. A geovisualisation system that strives for a high usability must satisfy the crucial prerequisite of immediately directing the user's gaze to the location of relevant geographic information and of easy decidability of the underlying semantic meanings. To this end, the cognitive skill of visual attention contributes to mnemonic and executive processes. Attention is indispensable for the visual selection. It facilitates the relevant information retrieval, processing and storage. On the basis of neurocognitive visual information processing, the paper addresses the interdisciplinary approach of attention-guiding design of geovisualisations with the intention to establish a taxonomy of scientifically testable variables. The authors try to relate attention-guiding attributes with graphical variables that cartographers apply to encode geographic information. The work is driven by the motivation to enhance the efficiency of geovisualisations and to enable a more precise neurocognition-based evaluation of geovisualisations.

  17. Identifying autism from neural representations of social interactions: neurocognitive markers of autism.

    Directory of Open Access Journals (Sweden)

    Marcel Adam Just

    Full Text Available Autism is a psychiatric/neurological condition in which alterations in social interaction (among other symptoms are diagnosed by behavioral psychiatric methods. The main goal of this study was to determine how the neural representations and meanings of social concepts (such as to insult are altered in autism. A second goal was to determine whether these alterations can serve as neurocognitive markers of autism. The approach is based on previous advances in fMRI analysis methods that permit (a the identification of a concept, such as the thought of a physical object, from its fMRI pattern, and (b the ability to assess the semantic content of a concept from its fMRI pattern. These factor analysis and machine learning methods were applied to the fMRI activation patterns of 17 adults with high-functioning autism and matched controls, scanned while thinking about 16 social interactions. One prominent neural representation factor that emerged (manifested mainly in posterior midline regions was related to self-representation, but this factor was present only for the control participants, and was near-absent in the autism group. Moreover, machine learning algorithms classified individuals as autistic or control with 97% accuracy from their fMRI neurocognitive markers. The findings suggest that psychiatric alterations of thought can begin to be biologically understood by assessing the form and content of the altered thought's underlying brain activation patterns.

  18. Long-term neurophysiologic impact of childhood sleep disordered breathing on neurocognitive performance

    Directory of Open Access Journals (Sweden)

    Quan SF

    2013-09-01

    Full Text Available Study Objective. To determine the impact of sleep disordered breathing (SDB in children on neurocognitive function 5 years later.Design, Setting, and Participants. A subgroup of 43 children from the Tucson Children’s Assessment of Sleep Apnea Study (TuCASA who had SDB (RDI > 6 events/hour at their initial exam (ages 6-11 years were matched on the basis of age (within 1 year, gender and ethnicity (Anglo/Hispanic to 43 children without SDB (Control, RDI < 4 events/hour. The Sustained Working Memory Task (SWMT which combines tests of working memory (1-Back Task, reaction time (Simple Reaction Time and attention (Multiplexing Task with concurrent electroencephalographic monitoring was administered approximately 5 years later.Results. There were no differences in performance on the working memory, reaction time and attention tests between the SDB and Control groups. However, the SDB group exhibited lower P300 evoked potential amplitudes during the Simple Reaction Time and Multiplexing Tasks. Additionally, peak alpha power during the Multiplexing Task was lower in the SDB Group with a similar trend in the Simple Reaction Time Task (p=0.08.Conclusions. SDB in children may cause subtle long-term changes in executive function that are not detectable with conventional neurocognitive testing and are only evident during neuroelectrophysiologic monitoring.

  19. Status of neurocognitive and oxidative stress conditions in iron-steel workers.

    Science.gov (United States)

    Malekirad, Ali Akbar; Mirabdollahi, Mansuoreh; Pilehvarian, Ali Asghar; Nassajpour, Ali Reza; Abdollahi, Mohammad

    2015-07-01

    The aim of this study was to determine oxidative stress status as well as ferrous (Fe) and Copper (Cu) levels in blood, neurocognitive impairment, and clinical markers in iron-steel workers. A comparative cross-sectional analysis was performed in 50 iron-steel workers who have been in contact with Fe and Cu in comparison with a control group containing 50 healthy subjects in the same age group and sex. Blood levels of lipid peroxidation, total antioxidant capacity, Fe, and Cu along with neurocognitive impairment were measured in workers and controls. Clinical examination was accomplished to record any abnormal sign or symptoms. Comparing with controls, the workers showed higher blood levels of lipid peroxidation and Cu and also a lower total antioxidant capacity. There was a positive correlation between work history and interstitial lung disease that strengths the presumption to progress to chronic obstructive lung disease in future. The results indicate that exposure to a combination of Fe and Cu in iron-steel workers induces oxidative stress. Especially, in the present case, toxic effect of Cu has been more than positive effects of Fe, but the combined exposure resulted in no such critical toxicity.

  20. Systemic HMGB1 neutralization prevents postoperative neurocognitive dysfunction in aged rats

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    Niccolo Terrando

    2016-10-01

    Full Text Available Postoperative neurocognitive disorders are common complications in elderly patients following surgery or critical illness. High mobility group box 1 protein (HMGB1 is rapidly released after tissue trauma and critically involved in response to sterile injury. Herein we assessed the role of HMGB1 after liver surgery in aged rats and explored the therapeutic potential of a neutralizing anti-HMGB1 monoclonal antibody in a clinically relevant model of postoperative neurocognitive disorders. 19-22 months Sprague Dawley rats were randomly assigned as: (1 control with saline; (2 surgery, a partial hepatolobectomy under sevoflurane anesthesia and analgesia, + immunoglobulin G as control antibody; (3 surgery + anti-HMGB1. A separate cohort of animals was used to detect His-tagged HMGB1 in the brain. Systemic anti-HMGB1 antibody treatment exerted neuroprotective effects preventing postoperative memory deficits and anxiety in aged rats by preventing surgery-induced reduction of phosphorylated cyclic AMP response element-binding protein in the hippocampus. Although no evident changes in the intracellular distribution of HMGB1 in hippocampal cells were noted after surgery, HMGB1 levels were elevated on day 3 in rat plasma samples. Experiments with tagged HMGB1 further revealed a critical role of systemic HMGB1 to enable an access to the brain and causing microglial activation. Overall, these data demonstrate a pivotal role for systemic HMGB1 in mediating postoperative neuroinflammation. This may have direct implications for common postoperative complications like delirium and postoperative cognitive dysfunction.

  1. Trichotomous processes in early memory development, aging, and neurocognitive impairment: a unified theory.

    Science.gov (United States)

    Brainerd, C J; Reyna, V F; Howe, M L

    2009-10-01

    One of the most extensively investigated topics in the adult memory literature, dual memory processes, has had virtually no impact on the study of early memory development. The authors remove the key obstacles to such research by formulating a trichotomous theory of recall that combines the traditional dual processes of recollection and familiarity with a reconstruction process. The theory is then embedded in a hidden Markov model that measures all 3 processes with low-burden tasks that are appropriate for even young children. These techniques are applied to a large corpus of developmental studies of recall, yielding stable findings about the emergence of dual memory processes between childhood and young adulthood and generating tests of many theoretical predictions. The techniques are extended to the study of healthy aging and to the memory sequelae of common forms of neurocognitive impairment, resulting in a theoretical framework that is unified over 4 major domains of memory research: early development, mainstream adult research, aging, and neurocognitive impairment. The techniques are also extended to recognition, creating a unified dual process framework for recall and recognition.

  2. Attention-Deficit Hyperactivity Disorder Status and Baseline Neurocognitive Performance in High School Athletes.

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    Salinas, Christine M; Dean, Preston; LoGalbo, Anthony; Dougherty, Michael; Field, Melvin; Webbe, Frank M

    2016-01-01

    Approximately 136,000 concussions occur annually in American high school sports. Neuropsychological data indicate that children with preexisting cognitive difficulties, such as attention-deficit hyperactivity disorder (ADHD), may have protracted recovery from concussion. ADHD, with an estimated prevalence of 11% in youth, may increase an athlete's vulnerability to sustaining sports-related traumatic brain injury (TBI). The preponderance of evidence focusing on TBI and ADHD has derived from motor vehicle accidents rather than sports-related incidents. Thus, it is paramount to explore how ADHD may relate to injury in the sports concussion context, as well as to assess how ADHD may affect baseline neurocognitive testing. Adolescent athletes with ADHD (n = 256) demonstrated significantly reduced Verbal Memory, Visual Motor, and Impulse Control index scores compared with their peers without ADHD (n = 256). Athletes with ADHD were nearly twice as likely to have sustained a prior concussion (ADHD, 14.1%; non-ADHD, 7.8%). Knowledge regarding the unique neurocognitive profile of athletes with ADHD may enhance clinical management decisions.

  3. Effects of Adenotonsillectomy on Neurocognitive Function in Pediatric Obstructive Sleep Apnea Syndrome

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    Fumie Horiuchi

    2014-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS in children does not only present with symptoms of sleep disturbances but also with associated symptoms such as growth failure, enuresis, academic learning difficulties, and behavioral problems, including attention deficit/hyperactivity disorder- (ADHD- like symptoms. We evaluated neurocognitive functions before and after adenotonsillectomy in a patient with OSAS. An 11-year-old boy suspected of having ADHD with nocturnal enuresis was referred for evaluation. He was found to have adenotonsillar hypertrophy. Presence of snoring was evident only after detailed medical interview. Polysomnography confirmed the diagnosis of OSAS, which was subsequently treated by adenotonsillectomy. The apnea/hypopnea index decreased from 21.9 at baseline to 1.8 after surgery, and the frequency of enuresis fell from almost nightly to 2-3 times per month. Neurocognitive and behavioral assessment after the treatment of OSAS showed significant improvement in cognitive functions, especially attention capacity and considerable amelioration of behavioral problems including ADHD-like symptoms. As the most common cause of pediatric OSAS is adenotonsillar hypertrophy, medical interview and oropharyngeal examination should always be performed in children suspected of having ADHD. The necessity of sleep evaluation for children with ADHD-like symptoms was also emphasized.

  4. Relationship between social competence and neurocognitive performance in children with epilepsy.

    Science.gov (United States)

    Raud, Triin; Kaldoja, Mari-Liis; Kolk, Anneli

    2015-11-01

    Epilepsy may affect a child's social skills and social cognition. The purpose of the study was to examine associations between sociocognitive skills and neurocognitive performance in children with epilepsy. Thirty-five children with epilepsy between the ages of 7 and 12 years (25 with partial and 10 with generalized epilepsy) and 30 controls participated. Theory of Mind (ToM) tasks, Social Cognition Questionnaire proposed by Saltzman-Benaiah and Lalonde (2007), and Social Skills Rating System were used to assess social competence and sociocognitive skills. Neurocognitive performance was assessed using the NEPSY battery. Children with epilepsy demonstrated more difficulties in understanding false belief (psocial skills were at the same level as typically developing peers. Children with epilepsy performed significantly worse in attention, executive, verbal, and fine motor tasks (pChildren with generalized epilepsy had more problems in memory tasks (pchildren with partial epilepsy. An age of onset over 9.1 years was positively associated with ToM skills (r=.42, pchildren with better executive functions, and language and visuospatial skills was revealed. The type of epilepsy and age of onset significantly affected ToM skills.

  5. [Consensus statement on the clinical management of human immunodeficiency virus-associated neurocognitive disorders].

    Science.gov (United States)

    Podzamczer Palter, Daniel; Muñoz-Moreno, José A; Alcolea Rodríguez, Daniel; Alonso Villaverde, Carlos; Antela López, Antonio; Blanch Andreu, Jordi; Casado Osorio, José Luis; Galindo Puerto, M José; Garolera i Freixa, Maite; Locutura Rupérez, Jaime; Lleó Bisa, Albert; Prats París, Anna; Pérez-Valero, Ignacio; Portilla Sogorb, Joaquín; Rovira Cañellas, Alex; Téllez Molina, M Jesús; Tiraboschi, Juan Manuel; Vergara Moragues, Esperanza; Arribas López, José Ramón; Goenaga Sánchez, Miguel Ángel; de León-Naranjo, Fernando Lozano; Martínez Chamorro, Esteban; Polo Rodríguez, Rosa; Muñoz-Moreno, José A; Podzamczer, Daniel

    2014-01-01

    To develop a consensus document containing clinical recommendations for the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND). We assembled a panel of experts appointed by GeSIDA and the Secretariat of the National AIDS Plan (PNS), including internal medicine physicians with expertise in the field of HIV, neuropsychologists, neurologists and neuroradiologists. Scientific information was reviewed to October 2012 in publications and conference papers. In support of the recommendations using two levels of evidence: the strength of the recommendation in the opinion of the experts (A, B, C) and the level of empirical evidence (I, II, III), two levels based on the criteria of the Infectious Disease Society of America, already used in previous documents GeSIDA/SPNS. Multiple recommendations for the clinical management of these disorders are provided, including two graphics algorithms, considering both the diagnostic and possible therapeutic strategies. Neurocognitive disorders associated with HIV infection is currently highly prevalent, are associated with a decreased quality of life and daily activities, and given the possibility of occurrence of an increase in the coming years, there is a need to adequately manage these disorders, from a diagnostic as well as therapeutic point of view, and always from a multidisciplinary perspective. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  6. Neurocognitive correlates of processing food-related stimuli in a Go/No-go paradigm.

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    Watson, Todd D; Garvey, Katherine T

    2013-12-01

    We examined the neurocognitive correlates of processing food-related stimuli in healthy young adults. Event-related potential (ERP) data were collected while 48 participants completed a computerized Go/No-go task consisting of food and nonfood images. Separately, we assessed participants' self-reported levels of external, restrained, and emotional eating behaviors as well as trait impulsivity, behavioral activation/inhibition, and performance on the Stroop Color-Word Test. We found that across participants, food images elicited significantly enhanced P3(00) and slow-wave ERP components. The difference in slow-wave components elicited by food and nonfood images was correlated with Stroop interference scores. Food images also elicited significantly enhanced N2(00) components, but only in female participants. The difference between N2 components elicited by food and nonfood images was related to body mass index and scores of external eating in females. Overall, these data suggest that processing food-related stimuli recruits distinct patterns of cortical activity, that the magnitude of these effects is related to behavioral and cognitive variables, and that the neurocognitive correlates of processing food-cues may be at least partly dissociable between males and females.

  7. Reduced Dopamine Transporter Availability and Neurocognitive Deficits in Male Patients with Alcohol Dependence.

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    Che-Hung Yen

    Full Text Available Dopamine plays an important role in the development of alcohol dependence, cognitive dysfunction, and is regulated via dopamine transporter activity. Although dopamine transporter activity is critically involved in alcohol dependence, studies observing this relationship are limited. Thus the current study examined whether dopamine transporter availability is associated with developing of alcohol dependence and cognitive dysfunction. Brain imaging with 99mTc-TRODAT-1 as a ligand was used to measure dopamine transporter availability among 26 male patients with pure alcohol dependence and 22 age- and sex- matched healthy volunteers. The Wisconsin Card Sorting Test (WCST and Tridimensional Personality Questionnaire (TPQ were administered to assess neurocognitive functioning and personality traits, respectively. Compared to healthy controls, patients with alcohol dependence showed a significant reduction in dopamine transporter availability (p < 0.001, as well as diminished performance on the WCST (p < 0.001. Dopamine transporter availability was negatively correlated with both total and perseverative WCST errors among healthy controls, but only patients with alcohol dependence showed a positive correlation between dopamine transporter availability and a harm avoidance personality profile. Thus, reductions in dopamine transporter availability may play a pathophysiological role in the development of pure alcohol dependence, given its association with neurocognitive deficits. Moreover, personality may influence the development of pure alcohol dependence; however, additional clinical subgroups should be examined to confirm this possibility.

  8. Role of Oxidative Stress in the Neurocognitive Dysfunction of Obstructive Sleep Apnea Syndrome

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    Li Zhou

    2016-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is characterized by chronic nocturnal intermittent hypoxia and sleep fragmentations. Neurocognitive dysfunction, a significant and extraordinary complication of OSAS, influences patients’ career, family, and social life and reduces quality of life to some extent. Previous researches revealed that repetitive hypoxia and reoxygenation caused mitochondria and endoplasmic reticulum dysfunction, overactivated NADPH oxidase, xanthine oxidase, and uncoupling nitric oxide synthase, induced an imbalance between prooxidants and antioxidants, and then got rise to a series of oxidative stress (OS responses, such as protein oxidation, lipid peroxidation, and DNA oxidation along with inflammatory reaction. OS in brain could trigger neuron injury especially in the hippocampus and cerebral cortex regions. Those two regions are fairly susceptible to hypoxia and oxidative stress production which could consequently result in cognitive dysfunction. Apart from continuous positive airway pressure (CPAP, antioxidant may be a promising therapeutic method to improve partially reversible neurocognitive function. Understanding the role that OS played in the cognitive deficits is crucial for future research and therapeutic strategy development. In this paper, recent important literature concerning the relationship between oxidative stress and cognitive impairment in OSAS will be summarized and the results can provide a rewarding overview for future breakthrough in this field.

  9. Sequenced neurocognitive and behavioral parent training for the treatment of ADHD in school-age children.

    Science.gov (United States)

    Chacko, A; Bedard, A-C V; Marks, D; Gopalan, G; Feirsen, N; Uderman, J; Chimiklis, A; Heber, E; Cornwell, M; Anderson, L; Zwilling, A; Ramon, M

    2017-02-23

    The present study examines the potential of sequencing a neurocognitive intervention with behavioral parent training (BPT) to improve executive functions (EFs), psychiatric symptoms, and multiple indices of functional impairment in school-age children aged 7 to 11 years who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Specifically, in a randomized controlled trial design, 85 children were assigned to either Cogmed Working Memory Training (CWMT) followed by an empirically supported, manualized BPT intervention, or to a placebo version of CWMT followed by the same BPT intervention. Working memory maintenance (i.e., attention control/short-term memory), working memory processing and manipulation, ADHD and oppositional defiant disorder (ODD) symptoms, impairment in parent-child dynamics, familial impairment, and overall functional compromise were evaluated as outcomes. The results suggest specific effects of the combined CWMT and BPT program on verbal and nonverbal working memory storage and nonverbal working memory processing and manipulation but no incremental benefits in regard to ADHD symptoms, ODD symptoms, and functional outcomes. The present findings do not support the hypothesis regarding the complementary and augmentative benefits of sequenced neurocognitive and BPT interventions for the treatment of ADHD. These results, the study's limitations, and future directions for research are further discussed.

  10. Dopamine, cognitive biases and assessment of certainty: A neurocognitive model of delusions.

    Science.gov (United States)

    Broyd, Annabel; Balzan, Ryan P; Woodward, Todd S; Allen, Paul

    2017-06-01

    This paper examines the evidence that delusions can be explained within the framework of a neurocognitive model of how the brain assesses certainty. Here, 'certainty' refers to both low-level interpretations of one's environment and high-level (conscious) appraisals of one's beliefs and experiences. A model is proposed explaining how the brain systems responsible for assigning certainty might dysfunction, contributing to the cause and maintenance of delusional beliefs. It is suggested that delusions arise through a combination of perturbed striatal dopamine and aberrant salience as well as cognitive biases such as the tendency to jump to conclusions (JTC) and hypersalience of evidence-hypothesis matches. The role of emotion, stress, trauma and sociocultural factors in forming and modifying delusions is also considered. Understanding the mechanisms involved in forming and maintaining delusions has important clinical implications, as interventions that improve cognitive flexibility (e.g. cognitive remediation therapy and mindfulness training) could potentially attenuate neurocognitive processes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Altered Oligodendrocyte Maturation and Myelin Maintenance: The Role of Antiretrovirals in HIV-Associated Neurocognitive Disorders.

    Science.gov (United States)

    Jensen, Brigid K; Monnerie, Hubert; Mannell, Maggie V; Gannon, Patrick J; Espinoza, Cagla Akay; Erickson, Michelle A; Bruce-Keller, Annadora J; Gelman, Benjamin B; Briand, Lisa A; Pierce, R Christopher; Jordan-Sciutto, Kelly L; Grinspan, Judith B

    2015-11-01

    Despite effective viral suppression through combined antiretroviral therapy (cART), approximately half of HIV-positive individuals have HIV-associated neurocognitive disorders (HAND). Studies of antiretroviral-treated patients have revealed persistent white matter abnormalities including diffuse myelin pallor, diminished white matter tracts, and decreased myelin protein mRNAs. Loss of myelin can contribute to neurocognitive dysfunction because the myelin membrane generated by oligodendrocytes is essential for rapid signal transduction and axonal maintenance. We hypothesized that myelin changes in HAND are partly due to effects of antiretroviral drugs on oligodendrocyte survival and/or maturation. We showed that primary mouse oligodendrocyte precursor cell cultures treated with therapeutic concentrations of HIV protease inhibitors ritonavir or lopinavir displayed dose-dependent decreases in oligodendrocyte maturation; however, this effect was rapidly reversed after drug removal. Conversely, nucleoside reverse transcriptase inhibitor zidovudine had no effect. Furthermore, in vivo ritonavir administration to adult mice reduced frontal cortex myelin protein levels. Finally, prefrontal cortex tissue from HIV-positive individuals with HAND on cART showed a significant decrease in myelin basic protein compared with untreated HIV-positive individuals with HAND or HIV-negative controls. These findings demonstrate that antiretrovirals can impact myelin integrity and have implications for myelination in juvenile HIV patients and myelin maintenance in adults on lifelong therapy.

  12. Neurocognitive mechanisms of action control: resisting the call of the Sirens.

    Science.gov (United States)

    Richard Ridderinkhof, K; Forstmann, Birte U; Wylie, Scott A; Burle, Borís; van den Wildenberg, Wery P M

    2011-03-01

    An essential facet of adaptive and versatile behavior is the ability to prioritize actions in response to dynamically changing circumstances. The field of potential actions afforded by a situation is shaped by many factors, such as environmental demands, past experiences, and prepotent tendencies. Selection among action affordances can be driven by deliberate, intentional processes as a product of goal-directed behavior and by extraneous stimulus-action associations as established inherently or through learning. We first review the neurocognitive mechanisms putatively linked to these intention-driven and association-driven routes of action selection. Next, we review the neurocognitive mechanisms engaged to inhibit action affordances that are no longer relevant or that interfere with goal-directed action selection. Optimal action control is viewed as a dynamic interplay between selection and suppression mechanisms, which is achieved by an elaborate circuitry of interconnected cortical regions (most prominently the pre-supplementary motor area and the right inferior frontal cortex) and basal ganglia structures (most prominently the dorsal striatum and the subthalamic nucleus). WIREs Cogni Sci 2011 2 174-192 DOI: 10.1002/wcs.99 For further resources related to this article, please visit the WIREs website.

  13. VMAT1 Deletion Causes Neuronal Loss in the Hippocampus and Neurocognitive Deficits in Spatial Discrimination

    Science.gov (United States)

    Multani, Pushpinder K.; Hodge, Rachel; Estévez, Marcel A.; Abel, Ted; Kung, Hank; Alter, Mark; Brookshire, Bethany; Lucki, Irwin; Nall, Aleksandra H.; Talbot, Konrad; Doyle, Glenn A.; Lohoff, Falk W.

    2013-01-01

    Vesicular monoamine transporters (VMAT) are involved in presynaptic storage and release of neurotransmitters. While it was thought initially that only VMAT2 is brain expressed and VMAT1 is present only in the periphery, recent data has challenged the exclusive expression of VMAT2 in brain. To further elucidate the role of VMAT1 brain expression and its potential role in neuropsychiatric disorders, we have investigated mice lacking VMAT1. Comparison of wildtype and knock-out (KO) mice using qPCR and immunohistochemistry documents the expression of VMAT1 in the brain. Deletion of VMAT1 leads to increased hippocampal apoptosis and reduced neurogenesis as assessed by caspase-3-labeling and BrdU-labeling. Behavioral data show that mice lacking VMAT1 have neurocognitive deficits. VMAT2 expression is not altered in VMAT1 KO mice, suggesting a distinct role of VMAT1. Our data support VMAT1 brain expression and suggest that VMAT1 plays a key role in survival of hippocampal neurons and thus might contribute to neurocognitive deficits observed in neuropsychiatric disorders. PMID:23201251

  14. Body–Brain Connections: The Effects of Obesity and Behavioral Interventions on Neurocognitive Aging

    Science.gov (United States)

    Stillman, Chelsea M.; Weinstein, Andrea M.; Marsland, Anna L.; Gianaros, Peter J.; Erickson, Kirk I.

    2017-01-01

    Obesity is a growing public health problem in the United States, particularly in middle-aged and older adults. Although the key factors leading to a population increase in body weight are still under investigation, there is evidence that certain behavioral interventions can mitigate the negative cognitive and brain (“neurocognitive”) health consequences of obesity. The two primary behaviors most often targeted for weight loss are caloric intake and physical activity. These behaviors might have independent, as well as overlapping/synergistic effects on neurocognitive health. To date obesity is often described independently from behavioral interventions in regards to neurocognitive outcomes, yet there is conceptual and mechanistic overlap between these constructs. This review summarizes evidence linking obesity and modifiable behaviors, such as physical activity and diet, with brain morphology (e.g., gray and white matter volume and integrity), brain function (e.g., functional activation and connectivity), and cognitive function across the adult lifespan. In particular, we review evidence bearing on the following question: Are associations between obesity and brain health in aging adults modifiable by behavioral interventions? PMID:28507516

  15. Neurocognitive Change in the Era of HIV Combination Antiretroviral Therapy: The Longitudinal CHARTER Study

    Science.gov (United States)

    Heaton, Robert K.; Franklin, Donald R.; Deutsch, Reena; Letendre, Scott; Ellis, Ronald J.; Casaletto, Kaitlin; Marquine, Maria J.; Woods, Steven P.; Vaida, Florin; Atkinson, J. Hampton; Marcotte, Thomas D.; McCutchan, J. Allen; Collier, Ann C.; Marra, Christina M.; Clifford, David B.; Gelman, Benjamin B.; Sacktor, Ned; Morgello, Susan; Simpson, David M.; Abramson, Ian; Gamst, Anthony C.; Fennema-Notestine, Christine; Smith, David M.; Grant, Igor; Grant, Igor; McCutchan, J. Allen; Ellis, Ronald J.; Marcotte, Thomas D.; Franklin, Donald; Ellis, Ronald J.; McCutchan, J. Allen; Alexander, Terry; Letendre, Scott; Capparelli, Edmund; Heaton, Robert K.; Atkinson, J. Hampton; Woods, Steven Paul; Dawson, Matthew; Smith, David M.; Fennema-Notestine, Christine; Taylor, Michael J.; Theilmann, Rebecca; Gamst, Anthony C.; Cushman, Clint; Abramson, Ian; Vaida, Florin; Marcotte, Thomas D.; Marquie-Beck, Jennifer; McArthur, Justin; Rogalski, Vincent; Morgello, Susan; Simpson, David; Mintz, Letty; McCutchan, J. Allen; Toperoff, Will; Collier, Ann; Marra, Christina; Jones, Trudy; Gelman, Benjamin; Head, Eleanor; Clifford, David; Al-Lozi, Muhammad; Teshome, Mengesha

    2015-01-01

    Background. Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) can show variable clinical trajectories. Previous longitudinal studies of HAND typically have been brief, did not use adequate normative standards, or were conducted in the context of a clinical trial, thereby limiting our understanding of incident neurocognitive (NC) decline and recovery. Methods. We investigated the incidence and predictors of NC change over 16–72 (mean, 35) months in 436 HIV-infected participants in the CNS HIV Anti-Retroviral Therapy Effects Research cohort. Comprehensive laboratory, neuromedical, and NC assessments were obtained every 6 months. Published, regression-based norms for NC change were used to generate overall change status (decline vs stable vs improved) at each study visit. Survival analysis was used to examine the predictors of time to NC change. Results. Ninety-nine participants (22.7%) declined, 265 (60.8%) remained stable, and 72 (16.5%) improved. In multivariable analyses, predictors of NC improvements or declines included time-dependent treatment status and indicators of disease severity (current hematocrit, albumin, total protein, aspartate aminotransferase), and baseline demographics and estimated premorbid intelligence quotient, non-HIV-related comorbidities, current depressive symptoms, and lifetime psychiatric diagnoses (overall model P < .0001). Conclusions. NC change is common in HIV infection and appears to be driven by a complex set of risk factors involving HIV disease, its treatment, and comorbid conditions. PMID:25362201

  16. Neurocognitive deficits in obsessive compulsive disorder: A state or trait phenomenon?

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    Sachin Sharma

    2014-01-01

    Full Text Available Background: Studies have shown that in obsessive-compulsive disorder (OCD, there is impairment of neurocognitive functioning during the symptomatic phase. However, studies that explore the "state or trait" dependent nature of these neurocognitive deficits are largely lacking. By comparing the neuropsychological functions of the clinical and subclinical group of OCD patients and healthy controls; we tried to establish whether neuropsychological deficits in OCD were "state" dependent or independent. Materials and Methods: Twenty "mild to moderate" OCD patients, 15 subclinical (remitted OCD patients, and 20 matched healthy controls were compared and assessed on computerized battery of neuropsychological tests including Wisconsin card sorting test, continuous performance test, and spatial working memory test. The observations were statistically analyzed. Results: Executive functions in both the subclinical and clinical groups performed poorly when compared to healthy controls. The patient groups made significantly more wrong responses, more missed responses and took more time to respond. On the test of spatial working memory, the mild to moderate OCD patients showed significant impairment, but not the subclinical patients group. Conclusion: Thus, we conclude that cognitive dysfunctions are core and enduring deficits of OCD, they seem to continue into the subclinical- well state. Certain cognitive deficits, depending on their presence or absence in subclinical cases, may be identified as "state" or "trait" markers of OCD.

  17. Neurocognitive testing and cochlear implantation: insights into performance in older adults

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    Cosetti MK

    2016-05-01

    Full Text Available Maura K Cosetti,1,2 James B Pinkston,3 Jose M Flores,4 David R Friedmann,5 Callie B Jones,3 J Thomas Roland Jr,5,6 Susan B Waltzman5 1Department of Otolaryngology – Head and Neck Surgery, 2Department of Neurosurgery, 3Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, 5Department of Otolaryngology, 6Department of Neurosurgery, New York University School of Medicine, New York, NY, USA Objective: The aim of this case series was to assess the impact of auditory rehabilitation with cochlear implantation on the cognitive function of elderly patients over time. Design: This is a longitudinal case series of prospective data assessing neurocognitive function and speech perception in an elderly cohort pre- and post-implantation. Setting: University cochlear implant center. Participants: The patients were post-lingually deafened elderly female (mean, 73.6 years; SD, 5.82; range, 67–81 years cochlear implant recipients (n=7. Measurements: A neurocognitive battery of 20 tests assessing intellectual function, learning, short- and long-term memory, verbal fluency, attention, mental flexibility, and processing speed was performed prior to and 2–4.1 years (mean, 3.7 after cochlear implant (CI. Speech perception testing using Consonant–Nucleus–Consonant words was performed prior to implantation and at regular intervals postoperatively. Individual and aggregate differences in cognitive function pre- and post-CI were estimated. Logistic regression with cluster adjustment was used to estimate the association (%improvement or %decline between speech understanding and years from implantation at 1 year, 2 years, and 3 years post-CI. Results: Improvements after CI were observed in 14 (70% of all subtests administered. Declines occurred in five (25% subtests. In 55 individual tests (43%, post-CI performance improved

  18. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  19. Effect of hyperbilirubinaemia on neurocognitive, renal, bone and cardiovascular markers in HIV infection treated with boosted protease inhibitors

    Directory of Open Access Journals (Sweden)

    Tristan J Barber

    2014-11-01

    Full Text Available Introduction: Use of some protease inhibitors (PI is associated with unconjugated hyperbilirubinaemia (HBR, due to inhibition of UGT1A1. As observed in Gilbert's syndrome, HBR may have antioxidant and anti-inflammatory effects. Inflammation may be relevant to neurocognitive (NC impairment, cardiovascular, renal and bone co-morbidities in HIV infection. This study aimed to analyse correlations between antiretroviral associated HBR and NC impairment as well as renal, bone and cardiovascular parameters. Material and Methods: This cross-sectional study included 101 HIV-1-infected individuals stable (>6 months on antiretroviral regimens including tenofovir/emtricitabine or abacavir/lamivudine plus a ritonavir-boosted PI. Patients with >grade 2 HBR were compared to patients with normal bilirubin on NC data collected using CogState. An overall composite score was calculated for each subject. Two-tail P-values were calculated using the Mann-Whitney U test. We measured the following parameters in all participants: Bone – Calcaneal Stiffness Index (CSI, blood bone markers, calculated FRAX score; CV – vascular endothelial function markers (iCAM, vCAM, lipid fractions and sub fractions (Total, HDL and LDL cholesterol, triglycerides, ApoB, Carotid Intimal Thickness (CIT, Pulse Wave Velocity (PWV, glucose and insulin for calculation of HOMA-IR, IL-6, d-dimer, uric acid, and hsCRP; Renal – urea and electrolytes (U&E, urinary protein/creatinine ratio (uPCR, urinary retinal binding protein (RBP/creatinine ratio. Results: Forty-three participants had normal bilirubin (NBR levels and 35 had high bilirubin (HBR; >2.5 times upper limit; the remaining 23 patients had intermediate bilirubin levels or violated the protocol. The mean age of participants was 48 years; 93% were male and 84% Caucasian. Mostly no significant differences were seen in any of the markers when comparing the NBR and HBR groups. Two component tests of the CogState were seen to be different

  20. Clinical features and preliminary studies of virological correlates of neurocognitive impairment among HIV-infected individuals in Nigeria.

    Science.gov (United States)

    Royal, Walter; Cherner, Mariana; Carr, Jean; Habib, Abdulrazaq G; Akomolafe, Abimbola; Abimiku, Alashl'e; Charurat, Manhattan; Farley, John; Oluyemisi, Akinwande; Mamadu, Ibrahim; Johnson, Joyce; Ellis, Ronald; McCutchan, J Allen; McCutchen, J Allen; Grant, Igor; Blattner, William A

    2012-06-01

    In Nigeria, the incidence and prevalence of human immunodeficiency virus (HIV)-related neurocognitive impairment (NCI) are unknown and there currently exists little information related to the viral correlates rates of NCI. Therefore, studies were performed to examine the potential utility of applying an established neuropsychological (NP) screening battery and detailed NP testing to detect NCI and correlations with functional impairment and the presence of specific viral signatures among infected subjects. A total of 60 HIV-1 seropositive antiretroviral-naive individuals and 56 seronegative control subjects were administered the International HIV Dementia Scale (IHDS) and assessed for functional impairment using the Karnofsky performance status scale. Fifteen HIV-infected patients and 11 controls were also administered a detailed NP battery. Blood samples from eight infected subjects, three with evidence of NCI, were obtained for molecular analysis of HIV-1 strain. Unadjusted scores on the IHDS showed that, using a recommended total score cutoff of 10, 28.8% of the HIV-1 seropositive and 16.0% of seropositive individuals scored abnormally. Results from testing using the full NP battery showed that, overall, the HIV seropositive group performed worse than the seronegative group, with effect sizes spanning from small (0.25 on the trail making test A) to large (0.82 on action fluency), and an average effect size across the battery of 0.45, which approaches that which has been recorded in other international settings. Sequencing of partial pol amplicons from viral isolates revealed that two of three patients with NCI were infected with subtype G virus and 1 with the circulating recombinant form (CRF)02_AG; all four individuals without NCI were infected with CRF_02AG. These studies demonstrate the utility of the IHDS in identifying cognitive impairment among HIV infected individuals in Nigeria. Future studies aimed at examining the burden of NCI among the population of