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Sample records for cognitively impaired patients

  1. Cognitive impairment and stroke in elderly patients

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    Lo Coco D

    2016-03-01

    Full Text Available Daniele Lo Coco,1 Gianluca Lopez,1 Salvatore Corrao,2,31Neurology and Stroke Unit, 2Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, 3Centre of Research for Effectiveness and Appropriateness in Medicine (C.R.E.A.M., Di.Bi.M.I.S., University of Palermo, Palermo, Italy Abstract: We reviewed current knowledge about the interaction between stroke and vascular risk factors and the development of cognitive impairment and dementia. Stroke is increasingly recognized as an important cause of cognitive problems and has been implicated in the development of both Alzheimer's disease and vascular dementia. The prevalence of cognitive impairment after stroke is high, and their combined effects significantly increase the cost of care and health resource utilization, with reflections on hospital readmissions and increased mortality rates. There is also substantial evidence that vascular risk factors (such as hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking are independently associated with an increased risk of cognitive decline and dementia. Thus, a successful management of these factors, as well as optimal acute stroke management, might have a great impact on the development of cognitive impairment. Notwithstanding, the pathological link between cognitive impairment, stroke, and vascular risk factors is complex and still partially unclear so that further studies are needed to better elucidate the boundaries of this relationship. Many specific pharmacological treatments, including anticholinergic drugs and antihypertensive medications, and nonpharmacological approaches, such as diet, cognitive rehabilitation, and physical activity, have been studied for patients with vascular cognitive impairment, but the optimal care is still far away. Meanwhile, according to the most recent knowledge, optimal stroke care should also include cognitive assessment in the

  2. Cognitive impairment in heart failure patients

    Institute of Scientific and Technical Information of China (English)

    Laura Leto; Mauro Feola

    2014-01-01

    Cognitive damage in heart failure (HF) involves different domains thus interfering with the ability for single patient to self-care and to cope with treatment regimens, modifying symptoms and health behaviours. Many cerebral and functional changes were detected in brain imaging, involving areas of both grey and white matter deputed to cognition. Although various instruments are available to explore cognition, no consensus was obtained on better tools to be used in HF population. Reduction in cerebral blood flow, decreased cardiac output, altera-tions of cerebrovascular reactivity and modification of blood pressure levels are the main features involved in the etiopathogenetic mecha-nisms of cognitive deficit. Several cardiac variables, laboratory parameters, demographic and clinical elements were studied for their possible relation with cognition and should be properly evaluated to define patients at increased risk of impairment. The present review gathers avail-able data pointing out assured information and discussing possible areas of research development.

  3. Cognitive impairments in patients with brain injury

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    Vladimir Vladimirovich Zakharov

    2013-01-01

    Full Text Available The paper gives the data of Russian and foreign authors and the results of this paper authors’ investigation of higher cerebral functions in patients who have sustained brain injury (BI. It shows their high prevalence, the predominance of cognitive impairments (CI over neurological disorders in patients with mild and moderate injury, presents their quantitative and qualitative features (a preponderance of focal symptoms in severe injury and neurodynamic disorders in mild injury, describes the predictors of their course and prognosis (the degree of injury is one of the most important predictors, and discusses current trends in the medical correction of detected abnormalities.

  4. Piracetam treatment in patients with cognitive impairment.

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    Rao, Mukund G; Holla, Bharath; Varambally, Shivarama; Raveendranathan, Dhanya; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2013-01-01

    Piracetam is a cognitive-enhancing agent that is used for the treatment of cognitive impairments of various etiologies. Little is known about its side effect profile, especially in those with psychiatric illness. We herewith present two cases with cognitive impairment who had contrasting responses to piracetam. One of them with organic amnestic syndrome had significant improvement, whereas the other who had an organic personality change as well as a family history of mental illness had significant worsening of behavioral problems after piracetam was introduced. This report highlights the need for caution in the use of piracetam, especially in those with past or family history of psychiatric illness. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Quantitative analysis of brain metabolites in patients,with non-dementia vascular cognitive impairment and mild cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    刘艳艳

    2013-01-01

    Objective To investigate metabolite changes in the brain of patients with non-dementia vascular cognitive impairment(VCIND) and mild cognitive impairment(MCI) using magnetic resonance spectroscopy(MRS)

  6. Correlative factors of cognitive impairment in patients with lacunar infarcts

    Institute of Scientific and Technical Information of China (English)

    Zhang Qiujuan; Yao Xiaoxin; Guo Youmin; Zhang Gejuan; Yang Junle

    2007-01-01

    Objective To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).

  7. Cognitive impairment in transient ischemic attack patients: A systematic review

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    Rooij, F.G. van; Kessels, R.P.C.; Richard, E.; Leeuw, H.F. de; Dijk, E.J. van

    2016-01-01

    Background: Although by definition a transient ischemic attack (TIA) lasts less than 24 h, many patients experience cognitive complaints beyond focal symptom resolution. However, their prevalence, causes and profile are unclear. We therefore performed a systematic review on cognitive impairment afte

  8. Efficacy of Cellex in patients with mild cognitive impairment

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    B. A. Abusueva; M. A. Evzel’man; P R Kamchatnov; Kh. Yu. Umarova

    2016-01-01

    Background. Cognitive disorders may often lead to professional invalidisation and increasing dependence on the external assistance in every day life. Identification of patients with preserved intellectual status and social adaptation but with mild cognitive impairment (MCI) is considered to be an effective measure. MCI detection and timely initiation of treatment in most patients is essential to delay the onset of severe dementia.Objective. Investigating influence of Cellex in patients with c...

  9. Cognitive and psychosocial impairment in remitted bipolar patients

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    Flávia Moreira Lima

    2015-07-01

    Full Text Available There is growing evidence showing that bipolar disorder is associated with persistent cognitive deficits. However, the exact meaning and impact of cognitive deficits in bipolar disorder is still not entirely known, even though they have been associated with poor psychosocial functioning. This study aims to summarize cognitive and psychosocial functioning findings of remitted bipolar patients. We conducted an extensive Medline search of the published English literature for the period January 2000– March 2014 using a variety of search terms to find relevant articles. Bibliographies of retrieved papers were further analysed for publications of interest. Our results showed that: (1 all mood states of bipolar disorder are associated with cognitive impairment. However, the euthymic state is associated with less impairment than the other states; (2 there is a strong association between clinical factors (i.e, duration of illness, number of episodes, residual mood symptoms, comorbidities and cognitive impairment in euthymic bipolar patients, although these factors do not account fully for these deficits; (3 cognitive deficits, in particular, verbal learning and executive dysfunctions may contribute to poor functioning. In conclusion, our review suggests that cognitive deficits are strongly associated with mood episodes; such deficits persist, in lower degree, during remission. Impairment on cognitive performance may explain, in part, poor long–term functioning in remitted bipolar patients. It highlights that psychosocial interventions in combination with pharmacotherapy should be considered to improve cognition and enhance the level of functioning. Therefore, studies assessing the efficacy of novel strategies focused on cognitive and functional status are an important area of future investigation in bipolar disorder.

  10. Stroke occurring in patients with cognitive impairment or dementia

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    Solène Moulin

    Full Text Available ABSTRACT One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.

  11. Cognitive Profiles of Patients with Mild Cognitive Impairment or Dementia in Alzheimer's or Parkinson's Disease

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    Hildebrandt, H.; Fink, F.K.; Kastrup, A.; Haupts, M.; Eling, P.A.T.M.

    2013-01-01

    Background: Alzheimer's disease (AD) and Parkinson's disease (PD) are associated with severe cognitive decline, but it is still unclear to what extent they become functionally more similar over time. Methods: We compared amnestic mild cognitively impaired (aMCI; n = 29) patients to mild cognitively

  12. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

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    Yen-Hsuan Hsu

    2015-06-01

    Conclusion: Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state.

  13. Cognitive impairment in patients with stress-related exhaustion.

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    Jonsdottir, I H; Nordlund, A; Ellbin, S; Ljung, T; Glise, K; Währborg, P; Wallin, A

    2013-03-01

    Patients who seek medical care for stress-related mental health problems frequently report cognitive impairments as the most pronounced symptom. The purpose of the present study was to compare cognitive function in patients with stress-related exhaustion with that in healthy controls, using a comprehensive battery of cognitive tests. We also explored whether neuropsychological findings were related to severity of illness measured using the Shirom-Melamed burnout questionnaire and hospital anxiety and depression scale. Thirty-three patients (15 males) and 37 healthy controls (11 males), mean age 46 years [standard deviation (SD) 3.9] and 47 years (SD 4.3), respectively, were included in the final analysis. Five cognitive domains were assessed: (1) speed, attention and working memory, (2) learning and episodic memory, (3) executive functions, (4) visuospatial functions and (5) language. The most pronounced difference between patients and controls was seen on executive function, when tested with a multidimensional test, including aspects of speed, control and working memory. The patients also performed poorer on Digit span, measuring attention span and working memory as well as on learning and episodic memory, when measured as delayed recall and the difference between immediate and delayed recall. Delayed recall was the only test that was significantly related to severity of burnout symptoms among the patients. This could reflect poor cognitive sustainability in the patients with the highest burnout scores, as this particular test was the last one performed during the test session. This study clearly shows that cognitive impairment should be considered when evaluating and treating patients who seek medical care for stress-related exhaustion.

  14. Detecting cognitive impairment in patients with Parkinson's disease using a brief cognitive screening tool: Addenbrooke's Cognitive Examination (ACE

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    Anabel Chade

    Full Text Available Abstract Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial. Objective: The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia. Methods: 77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia, 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE. Results: Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score. Conclusions: This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

  15. [Pain measurement in cognitively impaired patients with the Doloshort scale].

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    Likar, R; Pipam, W; Neuwersch, S; Köstenberger, M; Pinter, G; Gatternig, C; Marksteiner, J

    2015-08-01

    Until recently the measurement of pain in cognitively impaired patients represented a neglected field in the diagnostics and treatment of pain. Investigations indicate a prevalence of pain in nursing home residents of between 45 % and 80 %. This study investigated the reliability of the German translation of the Doloshort scale and compared it with the visual analog scale (VS). The aim of this study was to determine the practical applicability of this scale in the clinical routine and to calculate the intrarater reliability (retest) and interrater reliability. The interrater and intrarater reliability of the Doloshort scale was between 0.949 and 0.970. There was a highly significant correlation between the values of the Doloshort scale and the VAS. The Doloshort scale is a well suited measurement instrument for the evaluation of pain in cognitively impaired patients. Because of the short form only simple instructions are necessary and it has a high acceptance with users.

  16. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

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    Rise, Ida Vikan; Haro, Josep Maria; Gjervan, Bjørn

    2016-01-01

    Introduction Data specific to late-life bipolar disorder (BD) are limited. Current research is sparse and present guidelines are not adapted to this group of patients. Objectives We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment. Methods Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015. Results From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested. Conclusion There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that this group needs an adapted clinical assessment and specific clinical guidelines need to be established. PMID:27274256

  17. Cognitive Profiles of Patients with Mild Cognitive Impairment or Dementia in Alzheimer's or Parkinson's Disease

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    Helmut Hildebrandt

    2013-04-01

    Full Text Available Background: Alzheimer's disease (AD and Parkinson's disease (PD are associated with severe cognitive decline, but it is still unclear to what extent they become functionally more similar over time. Methods: We compared amnestic mild cognitively impaired (aMCI; n = 29 patients to mild cognitively impaired (MCI PD patients (n = 25, and patients with AD (n = 34 to patients with PD dementia (PDD; n = 15 with respect to cognitive functioning and mood. Results: aMCI patients were impaired in episodic memory, while MCI PD patients showed deficits in visuoconstruction and attention. AD and PDD patients showed comparable deficits on tests for language, attention and visuoconstruction. However, unlike PDD patients but similar to aMCI patients, AD patients showed a characteristic memory impairment, especially commission errors on recognition tasks, whereas PDD patients scored higher on the depressive mood questionnaire. Conclusions: In advanced stages of both diseases, the pattern of functional deficits associated with parietal and temporal lobe functions (attention, visuoconstruction and language is similar. However, specific differences, already present in the early stage (recognition errors in AD, associated with mediobasal temporal lobe functioning, and depressed mood in PDD, associated with non-motor basal ganglia loops, are also observed in the late stage.

  18. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

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    Federerico Filipin; Mónica Feldman; María Martelli; Viviana Sánchez; Virginia García; Graciela Tufro; Cecilia Serrano; Taragano,Fernando E.; Silvina Heisecke; Carol Dillon

    2015-01-01

    Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5) and dementia (CDR = 1). Methods: A retrospective ...

  19. Paramedic assessment of pain in the cognitively impaired adult patient

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    Lord Bill

    2009-10-01

    Full Text Available Abstract Background Paramedics are often a first point of contact for people experiencing pain in the community. Wherever possible the patient's self report of pain should be sought to guide the assessment and management of this complaint. Communication difficulty or disability such as cognitive impairment associated with dementia may limit the patient's ability to report their pain experience, and this has the potential to affect the quality of care. The primary objective of this study was to systematically locate evidence relating to the use of pain assessment tools that have been validated for use with cognitively impaired adults and to identify those that have been recommended for use by paramedics. Methods A systematic search of health databases for evidence relating to the use of pain assessment tools that have been validated for use with cognitively impaired adults was undertaken using specific search criteria. An extended search included position statements and clinical practice guidelines developed by health agencies to identify evidence-based recommendations regarding pain assessment in older adults. Results Two systematic reviews met study inclusion criteria. Weaknesses in tools evaluated by these studies limited their application in assessing pain in the population of interest. Only one tool was designed to assess pain in acute care settings. No tools were located that are designed for paramedic use. Conclusion The reviews of pain assessment tools found that the majority were developed to assess chronic pain in aged care, hospital or hospice settings. An analysis of the characteristics of these pain assessment tools identified attributes that may limit their use in paramedic practice. One tool - the Abbey Pain Scale - may have application in paramedic assessment of pain, but clinical evaluation is required to validate this tool in the paramedic practice setting. Further research is recommended to evaluate the Abbey Pain Scale and to

  20. Efficacy of Cellex in patients with mild cognitive impairment

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    B. A. Abusueva

    2016-01-01

    Full Text Available Background. Cognitive disorders may often lead to professional invalidisation and increasing dependence on the external assistance in every day life. Identification of patients with preserved intellectual status and social adaptation but with mild cognitive impairment (MCI is considered to be an effective measure. MCI detection and timely initiation of treatment in most patients is essential to delay the onset of severe dementia.Objective. Investigating influence of Cellex in patients with chronic cerebral ischemia and MCI.Materials and methods. As a part of non-interventional observational comparative study we evaluated the results of Cellex administration in 90 patients with MCI. Patients were divided into 2 groups. Patients from both groups received 1 course of 10 subcutaneous injections of Cellex drug at the dose of 1 mL, and patients from group 2 received two identical courses with an interval of two months. The survey, which included psychometric testing by using special questionnaires (Mini-Mental State Examination, “Frontal Assessment Battery” and “Clock Drawing” tests, Schulte test was performed before treatment, and at months 1 and 2 after its completion.Results. Neuropsychological examination revealed improvement in the patients state, more pronounced after the 2nd course of therapy.Discussion. Our results provide a basis for using Cellex in patients with chronic cerebral ischemia and MCI, allowing to proceede with further studies on the optimal dosage of that drug.

  1. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Federerico Filipin

    2015-12-01

    Full Text Available Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5 and dementia (CDR = 1. Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5. Patients were grouped as 11 amnesic mild cognitive impairment (aMCI, 23 multi domain mild cognitive impairment (mMCI and 8 Mild Alzheimer's Dementia (CDR 1. None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ into two groups: low (IQ < 98.5 and high (IQ > 98.5. Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05. Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural

  2. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

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    Rise IV

    2016-05-01

    Full Text Available Ida Vikan Rise,1 Josep Maria Haro,2–4 Bjørn Gjervan,5,61Department of Psychiatry, Sorlandet Hospital, Arendal, Norway; 2Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; 3Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; 4CIBERSAM (Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain; 5Department of Psychiatry, North-Trondelag Hospital Trust, Levanger, Norway; 6Department of Medicine, Institute of Neuromedicine, Norwegian University of Science and Technology, Trondheim, NorwayIntroduction: Data specific to late-life bipolar disorder (BD are limited. Current research is sparse and present guidelines are not adapted to this group of patients.Objectives: We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment.Methods: Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015.Results: From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested.Conclusion: There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that

  3. Domain-specific cognitive impairment in patients with COPD and control subjects

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    Cleutjens, Fiona AHM; Franssen, Frits ME; Spruit, Martijn A; Vanfleteren, Lowie EGW; Gijsen, Candy; Dijkstra, Jeanette B; Ponds, Rudolf WHM; Wouters, Emiel FM; Janssen, Daisy JA

    2017-01-01

    Impaired cognitive function is increasingly recognized in COPD. Yet, the prevalence of cognitive impairment in specific cognitive domains in COPD has been poorly studied. The aim of this cross-sectional observational study was to compare the prevalence of domain-specific cognitive impairment between patients with COPD and non-COPD controls. A neuropsychological assessment was administered in 90 stable COPD patients and 90 non-COPD controls with comparable smoking status, age, and level of education. Six core tests from the Maastricht Aging Study were used to assess general cognitive impairment. By using Z-scores, compound scores were constructed for the following domains: psychomotor speed, planning, working memory, verbal memory, and cognitive flexibility. General cognitive impairment and domain-specific cognitive impairment were compared between COPD patients and controls after correction for comorbidities using multivariate linear and logistic regression models. General cognitive impairment was found in 56.7% of patients with COPD and in 13.3% of controls. Deficits in the following domains were more often present in patients with COPD after correction for comorbidities: psychomotor speed (17.8% vs 3.3%; P<0.001), planning (17.8% vs 1.1%; P<0.001), and cognitive flexibility (43.3% vs 12.2%; P<0.001). General cognitive impairment and impairments in the domains psychomotor speed, planning, and cognitive flexibility affect the COPD patients more than their matched controls. PMID:28031706

  4. Evidence for cognitive vestibular integration impairment in idiopathic scoliosis patients

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    Mercier Pierre

    2009-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis is characterized by a three-dimensional deviation of the vertebral column and its etiopathogenesis is unknown. Various factors cause idiopathic scoliosis, and among these a prominent role has been attributed to the vestibular system. While the deficits in sensorimotor transformations have been documented in idiopathic scoliosis patients, little attention has been devoted to their capacity to integrate vestibular information for cognitive processing for space perception. Seated idiopathic scoliosis patients and control subjects experienced rotations of different directions and amplitudes in the dark and produced saccades that would reproduce their perceived spatial characteristics of the rotations (vestibular condition. We also controlled for possible alteration of the oculomotor and vestibular systems by measuring the subject's accuracy in producing saccades towards memorized peripheral targets in absence of body rotation and the gain of their vestibulo-ocular reflex. Results Compared to healthy controls, the idiopathic scoliosis patients underestimated the amplitude of their rotations. Moreover, the results revealed that idiopathic scoliosis patients produced accurate saccades to memorized peripheral targets in absence of body rotation and that their vestibulo-ocular reflex gain did not differ from that of control participants. Conclusion Overall, results of the present study demonstrate that idiopathic scoliosis patients have an alteration in cognitive integration of vestibular signals. It is possible that severe spine deformity developed partly due to impaired vestibular information travelling from the cerebellum to the vestibular cortical network or alteration in the cortical mechanisms processing the vestibular signals.

  5. Evaluation of premorbid intelligence in patients with cognitive impairment

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    Yang ZOU

    2016-09-01

    Full Text Available The result of neuropsychological tests is crucial to confirm a diagnosis of dementia or cognitive impairment. It might be improper judging individuals with different basic cognitive function using the same standard. The evaluation of premorbid intelligence is an effective way for error correction, but not enough attention has been paid during clinical practice. Here we present a review of the existing methods of premorbid intelligence evaluation and their application in cognitive impairment. DOI: 10.3969/j.issn.1672-6731.2016.09.016

  6. Abstract Word Definition in Patients with Amnestic Mild Cognitive Impairment

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    Soo Ryon Kim

    2015-01-01

    Full Text Available The aims of this study were to investigate concrete and abstract word definition ability (1 between patients with amnestic mild cognitive impairment (aMCI and normal adults and (2 between the aMCI subtypes (i.e., amnestic single-domain MCI and amnestic multidomain MCI; asMCI and amMCI and normal controls. The 68 patients with aMCI (29 asMCI and 39 amMCI and 93 age- and education-matched normal adults performed word definition tasks composed of five concrete (e.g., train and five abstract nouns (e.g., jealousy. Task performances were analyzed on total score, number of core meanings, and number of supplementary meanings. The results were as follows. First, the aMCI patients scored significantly poorer than the normal controls in only abstract word definition. Second, both subtypes of aMCI performed worse than the controls in only abstract word definition. In conclusion, a definition task of abstract rather than concrete concepts may provide richer information to show semantic impairment of aMCI.

  7. Chronic renal dysfunction and anaemia are associated with cognitive impairment in older patients with heart failure.

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    Pulignano, Giovanni; Del Sindaco, Donatella; Di Lenarda, Andrea; Tinti, Maria Denitza; Tarantini, Luigi; Cioffi, Giovanni; Tolone, Stefano; Pero, Gaetano; Minardi, Giovanni

    2014-06-01

    Cognitive impairment, anaemia and chronic kidney disease (CKD) are associated with mortality and disability in chronic heart failure patients. We hypothesized that anaemia and CKD are independent predictors of cognitive impairment in older patients with heart failure. One hundred and ninety community-living elderly patients aged at least 70 years, treated with optimized therapy for heart failure in stable clinical conditions, were prospectively studied. They underwent clinical and multidimensional assessment. Cognitive status was assessed by the Mini Mental State Examination. Cognitive impairment was defined as the Mini Mental State Examination score adjusted by age and educational level below 24. CKD was defined as the Cockcroft-Gault glomerular filtration rate below 60  ml/min and anaemia as haemoglobin below 12  g/dl. Cognitive impairment was diagnosed in 38.9% of patients, CKD in 85.7% and anaemia in 42.6%. Age, female sex, BMI, education less than 5 years, depressive symptoms, anaemia, CKD, disability and worse quality of life were significantly associated with cognitive impairment. Cognitive impairment involved primarily global cognitive deficit, memory, mental speed, attention, calculation and language. A significant relationship between haemoglobin levels and cognitive impairment was found, with the range of 15-16.5  g/dl having the lower prevalence of cognitive impairment (19.4%). At multivariate analysis, advanced age, low education level, anaemia and CKD were independently associated with cognitive impairment. Cox analysis showed that cognitive impairment was an independent predictor of hospitalization for worsening heart failure alone and combined with all-cause death. Cognitive impairment is common in elderly heart failure patients and is independently associated with anaemia and renal dysfunction. Further studies are needed to assess whether optimal treatment of anaemia and CKD may prevent the development of cognitive impairment in heart failure

  8. Abnormal organization of white matter networks in patients with subjective cognitive decline and mild cognitive impairment

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    Chen, Guan-Qun; Zhang, Yi-He; Li, Xuan-Yu; Hao, Xu-Yang; Yu, Yang; Zhang, Meng; Sheng, Can; Li, Yu-Xia; Sun, Yu; Li, Hong-Yan; Song, Yang; Li, Kun-Cheng; Yan, Tian-Yi; Tang, Xiao-Ying; Han, Ying

    2016-01-01

    Network analysis has been widely used in studying Alzheimer's disease (AD). However, how the white matter network changes in cognitive impaired patients with subjective cognitive decline (SCD) (a symptom emerging during early stage of AD) and amnestic mild cognitive impairment (aMCI) (a pre-dementia stage of AD) is still unclear. Here, structural networks were constructed respectively based on FA and FN for 36 normal controls, 21 SCD patients, and 33 aMCI patients by diffusion tensor imaging and graph theory. Significantly lower efficiency was found in aMCI patients than normal controls (NC). Though not significant, the values in those with SCD were intermediate between aMCI and NC. In addition, our results showed significantly altered betweenness centrality located in right precuneus, calcarine, putamen, and left anterior cingulate in aMCI patients. Furthermore, association was found between network metrics and cognitive impairment. Our study suggests that the structural network properties might be preserved in SCD stage and disrupted in aMCI stage, which may provide novel insights into pathological mechanisms of AD. PMID:27418146

  9. Stress-related cognitive and non-cognitive impairments in elderly patients

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    G. R. Tabeeva

    2015-01-01

    Full Text Available Aging is a physiological process that may develop long without manifestations of comorbidities. In the meantime a high proportion of elderly people very often experience limitations in daily life due to impairments in memory and other cognitive functions. Non-cognitive neuropsychiatric disorders, most commonly stress-related anxiety disorders, are a major contribution to maladaptation in these patients. The present studies of the neurobiology of aging enable one to decipher not only the mechanisms that underlie the physiology of brain aging, but also the factors that influence cognitive aging and aggravate the manifestations of cognitive dysfunction and neurodegenerative disease. The process of brain aging is known to presume the long-term preservation of functional neuroplasticity that is greatly influenced by different lifestyle factors, such as daily social and physical activities, the pattern and amount of food taken, cognitive activity, and stressful life events. These lifestyle factors are supposedly a potent tool to maintain physiological brain aging and a delayed cognitive diminution in elderly people. At the same time, studies of the possibility of pharmacologically correcting age-related (both cognitive and non-cognitive impairments are promising to improve everyday function in elderly people. 

  10. Comparison of efficacy of telmisartan with losartan in patients of essential hypertension with cognitive impairment

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    Nitin Natthuji Puram

    2016-06-01

    Conclusions: Telmisartan is as effective as losartan in controlling blood pressure and improving cognitive function in hypertensive patients with cognitive impairment. [Int J Basic Clin Pharmacol 2016; 5(3.000: 702-706

  11. Cognitive impairment in patients with AIDS – prevalence and severity

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    Watkins CC

    2015-01-01

    Full Text Available Crystal C Watkins,1,2 Glenn J Treisman2 1The Memory Center in Neuropsychiatry, Sheppard Pratt Health System, 2Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: The advent of highly active antiretroviral therapy has prolonged the life expectancy of HIV patients and decreased the number of adults who progress to AIDS and HIV-associated dementia. However, neurocognitive deficits remain a pronounced consequence of HIV/AIDS. HIV-1 infection targets the central nervous system in subcortical brain areas and leads to high rates of delirium, depression, opportunistic central nervous system infections, and dementia. Long-term HIV replication in the brain occurs in astrocytes and microglia, allowing the virus to hide from antiviral medication and later compromise neuronal function. The associated cognitive disturbance is linked to both viral activity and inflammatory and other mediators from these immune cells that lead to the damage associated with HIV-associated neurocognitive disorders, a general term given for these disturbances. We review the severity and prevalence of the neuropsychiatric complications of HIV including delirium, neurobehavioral impairments (depression, minor cognitive-motor dysfunction, and HIV-associated dementia. Keywords: HIV, delirium, depression, HAND, dementia; HIV-associated neurocognitive disorder

  12. Effect of the cognitive rehabilitation in patients with mild cognitive impairment and identified brain atrophy

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    Petr Nilius

    2015-12-01

    Full Text Available Aim: The main objective of this study was to analyse the development of cognitive functions and effect of cognitive rehabilitation on patients diagnosed with mild cognitive impairment (MCI, as a result of brain atrophy. Design: A quantitative non-randomized intervention study on a control sample of patients. Methods: The effect was observed in a group of patients ranging 59-91 years of age (N = 36. Only patients fulfilling the diagnostic criteria of mild cognitive disorder diagnosed by tomography (CT that had undergone 22 sessions, were involved in the clinical sample (n = 21. The control sample (n = 15 consisted of patients without any neurological diagnosis and who did not undergo cognitive sessions. Results: The effect of cognitive rehabilitation was measured by Addenbrooke's cognitive test, revised in 2010 (ACE-R; affective changes were measured by Beck´s scale of depression BDI-2 and by a scale used to detect anxiety and depression: the Hospital Anxiety and Depression Scale (HADS. Subjective change and improvement were observed using the Clinical Global Impression (CGI psychiatric scale. Changes in the functional state of patients were measured by means of the activities of daily living scale (ADL, including the instrumental version (IADL. The effect was examined in the form of entry and output tests, which were verified by statistical analysis, a significant level being p > 0.05. Conclusions: Significant differences in verbal tests and ACE-R were observed in the clinical sample of patients. Some significant changes were observed in the field of affective symptoms, according to the HADS and BDI-2. The clinical sample showed a significant improvement in subjective clinical state (CGI. The ADL and IADL questionnaires seem to have been inadequate for purpose due to their low sensitivity. The effect of cognitive rehabilitation in patients diagnosed with mild cognitive disorder can be seen and verified in comparison with the control sample

  13. Making sense of mild cognitive impairment: a qualitative exploration of the patient's experience.

    Science.gov (United States)

    Lingler, Jennifer Hagerty; Nightingale, Marcie C; Erlen, Judith A; Kane, April L; Reynolds, Charles F; Schulz, Richard; DeKosky, Steven T

    2006-12-01

    The proposed dementia precursor state of mild cognitive impairment is emerging as a primary target of aging research. Yet, little is known about the subjective experience of living with a diagnosis of mild cognitive impairment. This study examines, from the patient's perspective, the experience of living with and making sense of the diagnosis. We recruited 12 older adults with amnestic or nonamnestic mild cognitive impairment from a university-based memory disorders clinic. We conducted in-home, semistructured interviews in order to elicit rich descriptions of the personal experience of having mild cognitive impairment. We used the qualitative method of grounded theory to analyze narrative data. Understanding and coming to terms with the syndrome, or assigning meaning, constituted a fundamental aspect of living with a diagnosis of mild cognitive impairment. This process comprised interrelated emotional and cognitive dimensions. Participants employed a range of positive, neutral, and negative phrasing in order to depict their emotional reactions to receiving a diagnosis. Cognitive representations of mild cognitive impairment included both prognosis-focused and face-value appraisals. Expectations of normal aging, personal experience with dementia, and concurrent health problems were key contextual factors that provided the backdrop against which participants assigned meaning to a diagnosis of mild cognitive impairment. Clinicians who disclose diagnoses of mild cognitive impairment need to be mindful of the potential for varying interpretations of the information that is conveyed. Future research needs to include systematic, longitudinal investigations of illness representation and its impact on health behaviors among individuals with mild cognitive impairment.

  14. Drug therapy and cognitive stimulation in patients with poststroke cognitive impairments

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    D.R. Khasanova

    2014-01-01

    Full Text Available Objective: to compare a multimodal drug approach to treating poststroke cognitive impairments (CI.Patients and methods. Eighty patients with postroke CI in the early recovery period were examined. They were allocated to 4 groups:1 secondary stroke prevention only (a comparison nontreatment group; 2 actovegin infusions; 3 cerebrolysin infusions; 4 drug therapy in combination with non-drug cognitive training using the standard procedure. Follow-ups and neuropsychological assessments were made at the inclusion in the study and 3 and 6 months after stroke. The state of cognitive functions 6 months after stroke was considered to be an endpoint of the study.Results and discussion. At the inclusion in the study, the mini-mental state examination and the frontal lobe dysfunction scale showed no statistical differences in cognitive functions in different patient groups. At a 3-month follow-up, the cognitive status in the neuronal plasticity stimulation groups was significantly better than in the comparison group (p≤0.05. At a 6-month follow-up, there was a significant cognitive improvement in the combined stimulation group versus the drug-therapy and comparison groups (p≤0.05. Day-to-day activities and independent functioning also improved significantly more promptly in the patients receiving drug or combined therapies. More complex instrumental activities of daily living recovered significantly better during combined cognitive function stimulation than during pharmacological stimulation only. There was evidence that the drugs with proven stimulating effects on neuronal plasticity and nondrug cognitive training were effective in treating CI in the early recovery period of stroke. The combined drug and nondrug poststroke CI treatments reflecting the multimodal approach versus drug therapy were found to be most effective in these patients.

  15. Unspeakable motion: Selective action-verb impairments in Parkinson's disease patients without mild cognitive impairment.

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    Bocanegra, Yamile; García, Adolfo M; Lopera, Francisco; Pineda, David; Baena, Ana; Ospina, Paula; Alzate, Diana; Buriticá, Omar; Moreno, Leonardo; Ibáñez, Agustín; Cuetos, Fernando

    2017-05-01

    Parkinson's disease (PD) patients show marked impairments in processing action verbs, and to a lesser extent, concrete (specially, manipulable) nouns. However, it is still unclear to what extent deficits in each of these categories are influenced by more general cognitive dysfunctions, and whether they are modulated by the words' implied motility. To examine these issues, we evaluated 49 non-demented PD patients and 49 healthy volunteers in an oral production task. The patients were divided into two groups depending on the presence or absence of mild cognitive impairment (PD-MCI and PD-nMCI, respectively). Participants named pictures of actions varying in motion content (low and high) and of objects varying in manipulability (low and high). The PD-MCI group showed deficits across all four categories. However, PD-nMCI patients exhibited a selective difficulty for high-motion action verbs. This finding corroborates and refines previous results suggesting that disturbances of action-related lexico-semantic information in PD constitute a sui generis alteration manifested early in the course of the disease's physiopathology. Moreover, it suggests that the grounding of action verbs on motor circuits could depend on fine-grained intracategorical semantic distinctions.

  16. Low 25-hydroxyvitamin D levels and cognitive impairment in hemodialysis patients

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    25-hydroxyvitamin D (25[OH]D) deficiency and cognitive impairment are both prevalent in hemodialysis patients in the United States. This study tested the hypothesis that 25(OH)D deficiency may be associated with cognitive impairment because of its vasculoprotective, neuroprotective, and immune-modul...

  17. Cognitive impairments in patients with intractable temporal lobe epilepsy

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    Mahgol Tavakoli

    2011-01-01

    Conclusions: These findings indicated that WMS-III and WAIS-R can differentiate patients with refractory temporal lobe epilepsy from normal subjects. However, the obtained cognitive profile could not differentiate between the right and the left TLE.

  18. Identification of the predictors of cognitive impairment in patients with cancer in palliative care

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Benthien, Kirstine Skov; Sjøgren, Per;

    2017-01-01

    care. METHODS: Prospective longitudinal investigation derived from the European Palliative Care Cancer Symptom study (2011-2013) including patients with cancer in palliative care, ≥18 years, and with at least one assessment post-inclusion. For cognitive assessment, a 4-item version of the Mini Mental......) showed that those with low KPS (OR = 1.6, 95% CI 1.0-2.5) most often developed cognitive impairment, while patients with breast cancer (OR = 0.4, 95% CI 0.2-0.7) had lower odds for impairment. CONCLUSIONS: During palliative care, a substantial number of patients remained cognitively impaired or developed......PURPOSE: Studies with neuropsychological assessments in patients with cancer are sparse, and the evidence is very limited regarding their status of cognitive function over time. This study aimed at assessing the prevalence and predictors of cognitive impairment in patients with cancer in palliative...

  19. Correlative factors of cognitive impairment in patients with lacunar infarcts

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Patients with lacunar infarcts are thought tohave an increased risk of cognitive i mpair ment anddementia[1].Cognitive i mpair ment is a predictor ofpoor functional outcome in stroke survivors[2].However,in patients with lacunar infarcts,thepathway leading to cognitive i mpair ment is notclear.According to the lacunar hypothesis,cogni-tive i mpair ment results fromincreased number andvolume of lacunes,especially whenlocated strategi-cally within frontal subcortical loops[3];while Feinet al[4]found that cogn...

  20. Profiling cognitive impairment in treatment-resistant schizophrenia patients.

    Science.gov (United States)

    Frydecka, Dorota; Beszłej, Jan Aleksander; Gościmski, Piotr; Kiejna, Andrzej; Misiak, Błażej

    2016-01-30

    The aim of this study was to compare cognitive performance between schizophrenia patients with and without treatment resistance (TRS and non-TRS patients) taking into account psychopathological symptoms and antipsychotic treatment. The following cognitive tests were administered to 53 TRS patients and 32 non-TRS subjects: Rey Auditory Verbal Learning Test (RAVLT), Trail Making Tests (TMT-A and TMT-B), verbal fluency tests (FAS test and Supermarket), as well as selected Wechsler Adults Intelligence Scale (WAIS-R-PI) subtests: Digit Symbol Coding Test, Digit Span Forward and Backward and Similarities. TRS patients performed significantly worse in comparison with non-TRS patients on the measures of processing speed (TMT-A, Stroop test, FAS test, Supermarket test, Digit Symbol Coding test), verbal fluency (FAS test, Supermarket test), cognitive flexibility and executive functions (Stroop test) after controlling for age, illness duration, clinical symptoms severity, the number of years of completed education and antipsychotics' dose. Cognitive performance was associated with negative and general symptomatology. Anticholinergic activity of antipsychotics had debilitating effect on cognitive functioning in non-TRS patients (FAS test) and in TRS patients (TMT-B test, Stroop test, RAVLT subtests, Digit Coding test and Similarities test), while low anticholinergic activity of antipsychotics was associated with better cognitive performance in non-TRS patients (Backward Digit Span test) and in TRS patients (Similarities test). Results of this study indicate that cognitive deficits are more robust in TRS patients than in non-TRS subjects, and are associated with clinical symptoms as well as the treatment with antipsychotics that exert high anticholinergic activity.

  1. Impaired Cerebral Hemodynamics and Cognitive Performance in Patients with Atherothrombotic Disease.

    Science.gov (United States)

    Haratz, Salo; Weinstein, Galit; Molshazki, Noa; Beeri, Michal Schnaider; Ravona-Springer, Ramit; Marzeliak, Oleg; Goldbourt, Uri; Tanne, David

    2015-01-01

    Patients with pre-existing atherothrombotic disease are prone to cognitive impairment. We tested whether impaired cerebrovascular reactivity (CVR), a marker of cerebral microvascular hemodynamic dysfunction, is associated with poorer cognitive scores among patients with and without carotid large-vessel disease. A subgroup of non-demented patients with chronic coronary heart disease followed-up for 15 ± 3 years was assessed for cognitive function (Neurotrax Computerized Cognitive Battery; scaled to an IQ style scale with a mean of 100 and SD of 15) and for CVR using the breath-holding index (BHI) with transcranial Doppler and for carotid plaques using ultrasound. We assessed cognitive scores in specific domains in patients with and without impaired CVR (BHI hemodynamics in cognitive performance.

  2. Grey matter changes in cognitively impaired Parkinson's disease patients.

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    Irena Rektorova

    Full Text Available BACKGROUND: Cortical changes associated with cognitive decline in Parkinson's disease (PD are not fully explored and require investigations with established diagnostic classification criteria. OBJECTIVE: We used MRI source-based morphometry to evaluate specific differences in grey matter volume patterns across 4 groups of subjects: healthy controls (HC, PD with normal cognition (PD-NC, PD with mild cognitive impairment (MCI-PD and PD with dementia (PDD. METHODS: We examined 151 consecutive subjects: 25 HC, 75 PD-NC, 29 MCI-PD, and 22 PDD at an Italian and Czech movement disorder centre. Operational diagnostic criteria were applied to classify MCI-PD and PDD. All structural MRI images were processed together in the Czech centre. The spatial independent component analysis was used to assess group differences of local grey matter volume. RESULTS: We identified two independent patterns of grey matter volume deviations: a Reductions in the hippocampus and temporal lobes; b Decreases in fronto-parietal regions and increases in the midbrain/cerebellum. Both patterns differentiated PDD from all other groups and correlated with visuospatial deficits and letter verbal fluency, respectively. Only the second pattern additionally differentiated PD-NC from HC. CONCLUSION: Grey matter changes in PDD involve areas associated with Alzheimer-like pathology while fronto-parietal abnormalities are possibly an early marker of PD cognitive decline. These findings are consistent with a non-linear cognitive progression in PD.

  3. Cognitive impairments in patients with cerebrovascular steno-occlusive disease

    Institute of Scientific and Technical Information of China (English)

    石丹

    2012-01-01

    Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment. Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular

  4. Assessment of cognitive impairment in patients with Parkinson's disease: prevalence and risk factors

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    Wang Q

    2014-02-01

    Full Text Available Qiumei Wang,1 Zhenxin Zhang,2 Ling Li,2 Hongbo Wen,2 Qun Xu3,4 1Department of Geriatrics, 2Department of Neurology, 3School of Basic Medicine, Peking Union Medical College Hospital, 4Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, People's Republic of China Background: Although Parkinson's disease (PD is clinically characterized by motor symptoms, cognitive impairment is one of the most disabling non-motor symptoms. Despite it attracting increasing attention worldwide, less is known about its prevalence in the Chinese population. The objective of this study was to assess cognitive impairment and related risk factors in Chinese PD patients. Methods: We collected the demographic, diagnostic, and treatment information of 901 PD patients from 42 centers throughout the People's Republic of China, then administered a battery of neuropsychological tests, to assess motor, cognitive, and neuropsychiatric symptoms. Results: Overall, 193 of 901 (21.4% PD patients met the criteria for dementia (PD-D, and 206 (22.8% met the criteria for mild cognitive impairment (PD-MCI. Visuospatial dysfunction and attention/executive impairment predominated. Increased severity of cognitive impairment was associated with greater motor impairment. Patients with psychiatric symptoms, such as depression and hallucinations, were more likely to have dementia. Potentially, the younger-aged and more educated are shown less cognitive impairment, but age at onset, and levodopa equivalent dose, were not associated with the presence of cognitive dysfunction. Conclusion: The prevalence and profile of cognitive impairment in Chinese PD patients, as well as the risk factors, are similar as those reported for other races, but the frequency of nonamnestic cognitive domains differs. Keywords: cognitive impairment, risk factor, prevalence, Parkinson's disease

  5. Cognitive Impairment and Tramadol Dependence.

    Science.gov (United States)

    Bassiony, Medhat M; Youssef, Usama M; Hassan, Mervat S; Salah El-Deen, Ghada M; El-Gohari, Hayam; Abdelghani, Mohamed; Abdalla, Ahmed; Ibrahim, Dalia H

    2017-02-01

    Cognitive impairment is one of the consequences of substance abuse. Tramadol abuse is a public health problem in Egypt. The objective of this study was to estimate the prevalence and correlates of cognitive impairment among tramadol-abuse patients and control subjects. This study included 100 patients with tramadol abuse and 100 control subjects (matched for age, sex, and education) who were recruited from Zagazig University Hospital, Egypt. Patients were divided into 2 groups: patients who used tramadol only (tramadol-alone group) and patients who used tramadol and other substances (polysubstance group). The participants were interviewed using Montreal Cognitive Assessment test and had urine screening for drugs. Twenty-four percent of the cases used tramadol alone, whereas the remaining used tramadol and other substances, mainly cannabis (66%) and benzodiazepines (27%). Tramadol-abuse patients were about 3 times more likely to have cognitive impairment than control subjects (81% vs 28%). Tramadol-alone patients were more than 2 times more likely to have cognitive impairment than control subjects (67% vs 28%). Cognitive impairment was significantly associated with polysubstance abuse. There was no association between cognitive impairment and sociodemographic or clinical factors. Cognitive impairment occurs commonly among tramadol-abuse patients. Memory impairment is the most common cognitive domain to be affected. There is a significant association between cognitive impairment and polysubstance abuse.

  6. Spectrum of cognitive impairment in Korean ALS patients without known genetic mutations.

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    Seong-il Oh

    Full Text Available BACKGROUND: Cognitive impairment is associated with a negative prognosis in amyotrophic lateral sclerosis (ALS, as well as with clinical specificity. We investigate neuropsychological function in ALS patients without known genetic mutations in a Korean tertiary clinic. METHODS: Three hundred and eighteen patients were enrolled in a prospective longitudinal cohort from September 2008 to February 2012. At the time of diagnosis of sporadic ALS, we carried out genetic and comprehensive neuropsychological tests on all patients, and collected demographic and clinical characteristics. Six cognitive domains, namely executive function, attention, language, calculation, visuospatial function and memory were evaluated. ANOVA and t-tests were used to assess differences in clinical characteristics and neuropsychological parameters between sporadic ALS patients. The Kaplan-Meier method and Cox proportional hazard model were used for survival analysis. RESULTS: One hundred and sixty-six patients were categorized into five subtypes: normal cognition (ALS pure, cognitive impairment (ALSci, behavioral impairment (ALSbi, frontotemporal dementia (ALS-FTD, and other types of dementia. Seventy patients (70/166, 42.2% were cognitively or behaviorally impaired. Among the impaired patients, eight (8/166, 4.8% had FTD-type dementia and one (1/166, 0.6% was Alzheimer's disease-type. The ALS patients with cognitive impairment (ALSci and with FTD (ALS-FTD were more severely impaired in executive function, attention, language and memory than the cognitively intact ALS patients (ALS pure. In a survival analysis, ALSci (β = 1.925, p = 0.025 and ALS-FTD groups (β = 4.150, p = 0.019 tended to have shorter survival than the ALS pure group. CONCLUSIONS: About half of ALS patients without known genetic variation have cognitive or behavioral impairment. ALS patients with cognitive abnormalities, especially FTD, have a poorer prognosis than those without cognitive impairment. In

  7. Structural and Functional Brain Correlates of Cognitive Impairment in Euthymic Patients with Bipolar Disorder

    Science.gov (United States)

    Goikolea, José M.; Bonnin, Caterina M.; Sarró, Salvador; Segura, Barbara; Amann, Benedikt L.; Monté, Gemma C.; Moro, Noemi; Fernandez-Corcuera, Paloma; Maristany, Teresa; Salvador, Raymond; Vieta, Eduard; Pomarol-Clotet, Edith; McKenna, Peter J.

    2016-01-01

    Introduction Cognitive impairment in the euthymic phase is a well-established finding in bipolar disorder. However, its brain structural and/or functional correlates are uncertain. Methods Thirty-three euthymic bipolar patients with preserved memory and executive function and 28 euthymic bipolar patients with significant memory and/or executive impairment, as defined using two test batteries, the Rivermead Behavioural Memory Test (RBMT) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS), plus 28 healthy controls underwent structural MRI using voxel-based morphometry (VBM). Twenty-seven of the cognitively preserved patients, 23 of the cognitively impaired patients and 28 controls also underwent fMRI during performance of the n-back working memory task. Results No clusters of grey or white matter volume difference were found between the two patient groups. During n-back performance, the cognitively impaired patients showed hypoactivation compared to the cognitively preserved patients in a circumscribed region in the right dorsolateral prefrontal cortex. Both patient groups showed failure of de-activation in the medial frontal cortex compared to the healthy controls. Conclusions Cognitive impairment in euthymic bipolar patients appears from this study to be unrelated to structural brain abnormality, but there was some evidence for an association with altered prefrontal function. PMID:27448153

  8. 'Like a sieve': an exploratory study on cognitive impairments in patients with multiple myeloma.

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    Potrata, B; Cavet, J; Blair, S; Howe, T; Molassiotis, A

    2010-11-01

    The aim of this study was to obtain a more in-depth understanding of cognitive impairments and concerns as described by patients with multiple myeloma and the strategies used to cope with them. Semi-structured qualitative interviews were undertaken with 15 multiple myeloma patients of differing age ranges and at various stages of their disease. Various cognitive impairments, such as problems with short-term memory, poor recall and lack of concentration were observed and/or expressed in at least 10 out of 15 patients, all of them long(er)-term survivors. In some patients cognitive impairments significantly interfered with their personal and professional lives, and for some patients these were described as permanent. The patients used various coping strategies, from denial, taking notes, writing diaries, reading simpler texts, using talking books and videos, to using systems for counting medication to cope with the results of their cognitive impairment. Our findings differ from much of the contemporary literature which states that if cognitive impairments in cancer patients occur, they are mostly mild and transient. More proactive supportive care is needed to help patients with multiple myeloma to cope with poorer cognitive functioning.

  9. Cognitive Impairment and Structural Neuroimaging Abnormalities Among Patients with Chronic Kidney Disease

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    Hai-Chen Pi

    2016-12-01

    Full Text Available Background/Aims: Cognitive impairment and abnormal structural neuroimaging is common in chronic kidney disease patients. We aimed to explore its association with dialysis modality and the relationship between cognitive impairment and abnormal structural neuroimaging. Methods: Sixty peritoneal dialysis patients and 30 hemodialysis and 30 non-dialyzed stage 3-5 chronic kidney disease patients without history of stroke were enrolled for the study. Participants were matched for age, gender, education, diabetes status, and dialysis duration (if appropriate. Cognitive functions were measured using a battery of recognized instruments. Brain features were examined with 3-dimensional magnetic resonance imaging. Results: Cognitive impairment was significantly more severe in dialysis patients than in non-dialyzed patients. The global and specific cognitive function were not significantly different between patients on peritoneal dialysis and hemodialysis. Hemodialysis patients had more severe white matter hyperintensity, sulcal and ventricular atrophy, and SVIs than other patients. In all groups, higher white matter grade, ventricular grade, and hippocampal atrophy were significantly associated with global cognitive impairment, with hazard ratios of 1.80 (1.22-2.64, 1.67 (1.09-2.57, and 2.49 (1.07-5.77, respectively. White matter grade was also significantly associated with delayed memory (hazard ratio 1.63; 1.12-2.39. Conclusion: Dialysis modality showed no association with cognitive impairment, although hemodialysis patients had more severe neuroimaging abnormalities. For the whole group, white matter hyperintensity, and ventricular and hippocampal atrophy, were independently associated with global cognitive impairment in chronic kidney disease patients.

  10. Structural MRI correlates of cognitive impairment in patients with multiple sclerosis: A Multicenter Study.

    Science.gov (United States)

    Preziosa, Paolo; Rocca, Maria A; Pagani, Elisabetta; Stromillo, Maria Laura; Enzinger, Christian; Gallo, Antonio; Hulst, Hanneke E; Atzori, Matteo; Pareto, Deborah; Riccitelli, Gianna C; Copetti, Massimiliano; De Stefano, Nicola; Fazekas, Franz; Bisecco, Alvino; Barkhof, Frederik; Yousry, Tarek A; Arévalo, Maria J; Filippi, Massimo

    2016-04-01

    In a multicenter setting, we applied voxel-based methods to different structural MR imaging modalities to define the relative contributions of focal lesions, normal-appearing white matter (NAWM), and gray matter (GM) damage and their regional distribution to cognitive deficits as well as impairment of specific cognitive domains in multiple sclerosis (MS) patients. Approval of the institutional review boards was obtained, together with written informed consent from all participants. Standardized neuropsychological assessment and conventional, diffusion tensor and volumetric brain MRI sequences were collected from 61 relapsing-remitting MS patients and 61 healthy controls (HC) from seven centers. Patients with ≥2 abnormal tests were considered cognitively impaired (CI). The distribution of focal lesions, GM and WM atrophy, and microstructural WM damage were assessed using voxel-wise approaches. A random forest analysis identified the best imaging predictors of global cognitive impairment and deficits of specific cognitive domains. Twenty-three (38%) MS patients were CI. Compared with cognitively preserved (CP), CI MS patients had GM atrophy of the left thalamus, right hippocampus and parietal regions. They also showed atrophy of several WM tracts, mainly located in posterior brain regions and widespread WM diffusivity abnormalities. WM diffusivity abnormalities in cognitive-relevant WM tracts followed by atrophy of cognitive-relevant GM regions explained global cognitive impairment. Variable patterns of NAWM and GM damage were associated with deficits in selected cognitive domains. Structural, multiparametric, voxel-wise MRI approaches are feasible in a multicenter setting. The combination of different imaging modalities is needed to assess and monitor cognitive impairment in MS.

  11. Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients

    NARCIS (Netherlands)

    Zuidema, Sytse; Koopmans, Raymond; Verhey, Frans

    2007-01-01

    The prevalence of neuropsychiatric symptoms and the influence of predictive factors in cognitively impaired nursing home patients were reviewed. Articles were identified by means of a MEDLINE and PsychInfo literature search. Neuropsychiatric symptoms were present in more than 80% of the cognitively

  12. Presence and significant determinants of cognitive impairment in a large sample of patients with multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Martina Borghi

    Full Text Available OBJECTIVES: To investigate the presence and the nature of cognitive impairment in a large sample of patients with Multiple Sclerosis (MS, and to identify clinical and demographic determinants of cognitive impairment in MS. METHODS: 303 patients with MS and 279 healthy controls were administered the Brief Repeatable Battery of Neuropsychological tests (BRB-N; measures of pre-morbid verbal competence and neuropsychiatric measures were also administered. RESULTS: Patients and healthy controls were matched for age, gender, education and pre-morbid verbal Intelligence Quotient. Patients presenting with cognitive impairment were 108/303 (35.6%. In the overall group of participants, the significant predictors of the most sensitive BRB-N scores were: presence of MS, age, education, and Vocabulary. The significant predictors when considering MS patients only were: course of MS, age, education, vocabulary, and depression. Using logistic regression analyses, significant determinants of the presence of cognitive impairment in relapsing-remitting MS patients were: duration of illness (OR = 1.053, 95% CI = 1.010-1.097, p = 0.015, Expanded Disability Status Scale score (OR = 1.247, 95% CI = 1.024-1.517, p = 0.028, and vocabulary (OR = 0.960, 95% CI = 0.936-0.984, p = 0.001, while in the smaller group of progressive MS patients these predictors did not play a significant role in determining the cognitive outcome. CONCLUSIONS: Our results corroborate the evidence about the presence and the nature of cognitive impairment in a large sample of patients with MS. Furthermore, our findings identify significant clinical and demographic determinants of cognitive impairment in a large sample of MS patients for the first time. Implications for further research and clinical practice were discussed.

  13. Influence of Cognitive Impairment on Mobility Recovery of Patients With Hip Fracture.

    Science.gov (United States)

    Ariza-Vega, Patrocinio; Lozano-Lozano, Mario; Olmedo-Requena, Rocío; Martín-Martín, Lydia; Jiménez-Moleón, José Juan

    2017-02-01

    The aims of this study were to study the mobility recovery in hip fracture patients and determine the influence of cognitive impairment on mobility within the first 3 months after surgery. This prospective cohort study was carried out in an acute public hospital in southern Spain and included 275 patients, 65 years or older, with a hip fracture. Mobility and Cognitive status were measured by Tinetti Performance-Oriented Mobility Assessment and Pfeiffers' Scale (Short Portable Mental State Questionnaire), respectively. Multiple linear regression was used to examine the influence of cognitive impairment on mobility. The median Performance-Oriented Mobility Assessment score changed from 4 (3-4) points at discharge to 17 (7-22) at 3 months. All degrees of cognitive impairment were negatively associated with gait and balance at 1 and 3 months after surgery (P < 0.01). Age, weight bearing, length of hospital stay, and postsurgical complications were also identified as independent predictors of mobility outcome at 3 months. Cognitive impairment is a negative prognostic factor for the recovery of mobility in elderly patients with a hip fracture. New treatment strategies are needed for hip fracture patients with cognitive impairment.

  14. Informed consent procedures with cognitively impaired patients: A review of ethics and best practices.

    Science.gov (United States)

    Fields, Lindy Marie; Calvert, James Douglas

    2015-08-01

    The objectives of this article are to discuss ethical issues of informed consent in cognitively impaired patients and review considerations for capacity determination. We will also discuss how to evaluate capacity, determine competence, and obtain informed consent when a patient is deemed incompetent. This review emphasizes how to carry out informed consent procedures when capacity is questionable and discusses measures supported for use when determining cognitively impaired patients' ability to consent. Information was gathered from medical and psychological codes of ethics, peer-reviewed journals, published guidelines from health-care organizations (e.g., American Medical Association), and scholarly books. Google Scholar and PsycINFO were searched for articles related to 'informed consent' and 'cognitive impairment' published in English between 1975 and 2014. Relevant sources referenced in retrieved publications were subsequently searched and reviewed. We selected 49 sources generated by our search. Sources were included in our review if they presented information related to at least one of our focus areas. These areas included: review of informed consent ethics and procedures, review of cognitive impairment evaluations, recommendations for measuring cognitive capacity, and alternative forms of informed consent. Patients' cognitive impairments can hinder the ability of patients to understand treatment options. Evaluating the capacity of patients with cognitive impairment to understand treatment options is vital for valid informed consent and should be guided by best practices. Thus, proper identification of patients with questionable capacity, capacity evaluation, and determination of competence, as well as reliance upon appropriate alternative consent procedures, are paramount. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

  15. Do CSF Biomarkers Predict Progression to Cognitive Impairment in Parkinson's disease patients? A Systematic Review.

    Science.gov (United States)

    Leaver, Katherine; Poston, Kathleen L

    2015-12-01

    Many patients with Parkinson's disease (PD) will develop cognitive impairment. Cross-sectional studies have shown that certain protein levels are altered in the cerebrospinal fluid (CSF) of PD patients with dementia and are thought to represent potential biomarkers of underlying pathogenesis. Recent studies suggest that CSF biomarker levels may be predictive of future risk of cognitive decline in non-demented PD patients. However, the strength of this evidence and difference between specific CSF biomarkers is not well delineated. We therefore performed a systematic review to assess if levels of specific CSF protein biomarkers are predictive of progression to cognitive impairment. Nine articles were identified that met inclusion criteria for the review. Findings from the review suggest a convergence of evidence that a low baseline Aβ42 in the CSF of non-demented PD patients predicts development of cognitive impairment over time. Conversely, there is limited evidence that CSF levels of tau, either total tau or phosphorylated tau, is a useful predictive biomarker. There are mixed results for other CSF biomarkers such as α-synuclein, Neurofilament light chain, and Heart fatty acid-binding protein. Overall the results of this review show that certain CSF biomarkers have better predictive ability to identify PD patients who are at risk for developing cognitive impairment. Given the interest in developing disease-modifying therapies, identifying this group will be important for clinical trials as initiation of therapy prior to the onset of cognitive decline is likely to be more efficacious.

  16. Prevalence and prognostic value of CSF markers of Alzheimer's disease pathology in patients with subjective cognitive impairment or mild cognitive impairment in the DESCRIPA study: a prospective cohort study.

    NARCIS (Netherlands)

    Visser, P.J.; Verhey, F.; Knol, D.L.; Scheltens, P.; Wahlund, L.O.; Freund-Levi, Y.; Tsolaki, M.; Minthon, L.; Wallin, A.K.; Hampel, H.; Burger, K.; Pirttila, T.; Soininen, H.; Olde Rikkert, M.G.M.; Verbeek, M.M.; Spiru, L.; Blennow, K.

    2009-01-01

    BACKGROUND: Alzheimer's disease (AD) pathology is common in patients with amnestic mild cognitive impairment (aMCI) without dementia, but the prevalence of AD pathology in patients with subjective cognitive impairment (SCI) and non-amnestic mild cognitive impairment (naMCI) is unknown. AD is charact

  17. The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients

    Directory of Open Access Journals (Sweden)

    Dubljanin-Raspopović Emilija

    2010-01-01

    Full Text Available Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission. Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01. Absolute functional gain, however, was higher in 1 cognitively intact compared to cognitively impaired patients (p<0.01, and 2 cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01. No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05. Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best

  18. Cognitive Impairment and Whole Brain Diffusion in Patients with Neuromyelitis Optica after Acute Relapse

    Science.gov (United States)

    He, Diane; Wu, Qizhu; Chen, Xiuying; Zhao, Daidi; Gong, Qiyong; Zhou, Hongyu

    2011-01-01

    The objective of this study investigated cognitive impairments and their correlations with fractional anisotropy (FA) and mean diffusivity (MD) in patients with neuromyelitis optica (NMO) without visible lesions on conventional brain MRI during acute relapse. Twenty one patients with NMO and 21 normal control subjects received several cognitive…

  19. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    2000-01-01

    PURPOSE: The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. METHOD: A group of 33 patients with apraxia were treated according to the guidelines of a therapy prog

  20. Rehabilitation of stroke patients with apraxia : the role of additional cognitive and motor impairments

    NARCIS (Netherlands)

    van Heugten, CM; Dekker, J; Deelman, BG; Stehmann-Saris, JC; Kinebanian, A

    2000-01-01

    Purpose : The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. Method: A group of 33 patients with apraxia were treated according to the guidelines of a therapy pro

  1. Cognitive Impairment and Whole Brain Diffusion in Patients with Neuromyelitis Optica after Acute Relapse

    Science.gov (United States)

    He, Diane; Wu, Qizhu; Chen, Xiuying; Zhao, Daidi; Gong, Qiyong; Zhou, Hongyu

    2011-01-01

    The objective of this study investigated cognitive impairments and their correlations with fractional anisotropy (FA) and mean diffusivity (MD) in patients with neuromyelitis optica (NMO) without visible lesions on conventional brain MRI during acute relapse. Twenty one patients with NMO and 21 normal control subjects received several cognitive…

  2. Rehabilitation of stroke patients with apraxia : the role of additional cognitive and motor impairments

    NARCIS (Netherlands)

    van Heugten, C.M.; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C; Kinebanian, A

    Purpose : The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. Method: A group of 33 patients with apraxia were treated according to the guidelines of a therapy

  3. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    2000-01-01

    PURPOSE: The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. METHOD: A group of 33 patients with apraxia were treated according to the guidelines of a therapy

  4. Patients with bipolar disorder show impaired performance on complex tests of social cognition.

    Science.gov (United States)

    Cusi, Andrée M; Macqueen, Glenda M; McKinnon, Margaret C

    2012-12-30

    The literature concerning social cognitive performance in people with bipolar disorder (BD) reveals a mixed pattern of findings. We compared performance between patients with BD and matched controls on two social cognitive tasks that involved: (i) the decoding of mental states from pictures of eyes (Reading the Mind in the Eyes Test), and (ii) a video-based test that requires participants to discriminate social cues to make interpersonal judgments (Interpersonal Perception Task-15; IPT-15). We also sought to evaluate the association between symptom severity, social functioning, and social cognitive ability in patients with BD. Relative to controls, patients with BD were impaired at discriminating mental states from pictures of eyes and in making complex social judgments. Impaired responding on the IPT-15 was also associated with reduced psychosocial functioning. These results provide evidence of impaired performance on complex tests of social cognition in patients with BD. Impairments in social cognition may be associated with well-documented declines in the frequency of social interactions and development of interpersonal relationships found in this patient population.

  5. Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

    Directory of Open Access Journals (Sweden)

    Emmanuelle Sobreira

    2015-11-01

    Full Text Available ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA and the Addenbrooke's Cognitive Examination-Revised (ACE-R to screen for mild cognitive impairment (PDMCI and dementia (PDD in patients with Parkinson's disease (PD.Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests.Results There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others.Conclusion Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

  6. Association between Carotid Artery Stenosis and Cognitive Impairment in Stroke Patients: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Wei Yue

    Full Text Available To investigate potential associations between carotid artery stenosis and cognitive impairment among patients with acute ischemic stroke and to provide important clinical implications. We measured the degree of carotid artery stenosis and recorded the Mini-Mental State Examination score (MMSE at admission in 3116 acute ischemic stroke patients. The association between carotid stenosis and cognitive impairment assessed by MMSE was tested using multivariate regression analysis. Other clinical variables of interest were also studied. After adjusting for age, gender, education level, marriage, alcohol use, tobacco use, physical activity, hypertension, diabetes, hypercholesterolemia, atrial fibrillation, myocardial infarction and NIHSS (National Institutes of Health Stroke Scale score, we found that participants with high-grade stenosis of the carotid artery had a higher likelihood of cognitive impairment compared to those without carotid artery stenosis (OR = 1.49, 95%CI: 1.05-2.11, p<0.001. Left common carotid artery stenosis was associated with cognitive impairment in the univariate analysis, although this effect did not persist after adjustment for the NIHSS score. Cognitive impairment was associated with high-grade stenosis of the right carotid artery.

  7. Association between Carotid Artery Stenosis and Cognitive Impairment in Stroke Patients: A Cross-Sectional Study

    Science.gov (United States)

    Zhu, Runxiu; Yan, Zhongrui; Zheng, Shouhuan; Wang, Jingwei; Huo, Jia; Liu, Yunlin; Li, Xin; Ji, Yong

    2016-01-01

    To investigate potential associations between carotid artery stenosis and cognitive impairment among patients with acute ischemic stroke and to provide important clinical implications. We measured the degree of carotid artery stenosis and recorded the Mini-Mental State Examination score (MMSE) at admission in 3116 acute ischemic stroke patients. The association between carotid stenosis and cognitive impairment assessed by MMSE was tested using multivariate regression analysis. Other clinical variables of interest were also studied. After adjusting for age, gender, education level, marriage, alcohol use, tobacco use, physical activity, hypertension, diabetes, hypercholesterolemia, atrial fibrillation, myocardial infarction and NIHSS (National Institutes of Health Stroke Scale) score, we found that participants with high-grade stenosis of the carotid artery had a higher likelihood of cognitive impairment compared to those without carotid artery stenosis (OR = 1.49, 95%CI: 1.05–2.11, p<0.001). Left common carotid artery stenosis was associated with cognitive impairment in the univariate analysis, although this effect did not persist after adjustment for the NIHSS score. Cognitive impairment was associated with high-grade stenosis of the right carotid artery. PMID:26751070

  8. [Cognitive impairment in patients with coronary disease: relationship with clinical variables].

    Science.gov (United States)

    Pérez-Belmonte, Luis M; Lara, J Pablo; Olalla-Mercadé, Eduardo; Gutiérrez de Loma, Julio; Barbancho, Miguel A; San Román-Terán, Carlos M

    2014-08-04

    Coronary disease has been associated with cognitive disorders. We studied the presence of dysexecutive mild cognitive impairment in patients scheduled for coronary surgery. The executive function of 35 patients was evaluated (Trail Making Test). They were classified into 2 groups: normal performance or cognitive impairment, and we assessed the relationship with others variables (Mann-Whitney, chi-square and multiple regression analysis). The dysexecutive cognitive impairment group (n=7; 20%) showed greater degree of angina (odds ratio [OR] 1.4, 95% confidence interval [95% CI] 1.1-2.6; P=.04), 3-vessels coronary artery disease (OR 1.3, 95% CI 1.08-3.6; P=.04) and body mass index (OR 1.56, 95% CI 1.16-3.65; P=.03) and lower diastolic blood pressure (OR 1.56, 95% CI 1.2-2.98; P=.02), hemoglobin (OR 2.03, 95% CI 1.18-4.05; P=.02) and hematocrit (OR 2.45, 95% CI 1.67-3.99; P<.001); these variables proved to be significant in the test performance considered as a dependent variable (R(2)=0.62). We found a significant prevalence of dysexecutive mild cognitive impairment, which was associated with cardiovascular risk factors. We recommend assessment and monitoring of cognitive performance for probable neurological complications after cardiac surgery. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  9. Mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Pavlović Dragan M.

    2009-01-01

    Full Text Available Mild cognitive impairment (MCI is a syndrome that spans the area between normal ageing and dementia. It is classified into amnestic and non-amnestic types, both with two subtypes: single domain and multiple domains. Prevalence of MCI depends on criteria and population and can vary from 0.1 to 42% persons of older age. In contrast to dementia, cognitive deterioration is less severe and activities of daily living are preserved. Most impaired higher cognitive functions in MCI are memory, executive functions, language, visuospatial functions, attention etc. Also there are depression, apathy or psychomotor agitation, and signs of psychosis. Aetiology of MCI is multiple, mostly neurodegenerative, vascular, psychiatric, internistic, neurological, traumatic and iatrogenic. Persons with amnestic MCI are at a higher risk of converting to Alzheimer's disease, while those with a single non-memory domain are at risk of developing frontotemporal dementia. Some MCI patients also progress to other dementia types, vascular among others. In contrast, some patients have a stationary course, some improve, while others even normalize. Every suspicion of MCI warrants a detailed clinical exploration to discover underlying aetiology, laboratory analyses, neuroimaging methods and some cases require a detailed neuropsychological assessment. At the present time there is no efficacious therapy for cognitive decline in MCI or the one that could postpone conversion to dementia. The treatment of curable causes, application of preventive measures and risk factor control are reasonable measures in the absence of specific therapy.

  10. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy.

    Science.gov (United States)

    Hsu, Yen-Hsuan; Lin, Feng-Sheng; Yang, Chi-Cheng; Lin, Chih-Peng; Hua, Mau-Sun; Sun, Wei-Zen

    2015-06-01

    Midazolam is a widely used sedative agent during colonoscopy, with cognitive toxicity. However, the potential cognitive hazard of midazolam-based light sedation has not been sufficiently examined. We aimed to examine the cognitive safety and vulnerability profile under midazolam light sedation, with a particular focus on individual variations. We conducted a prospective case-controlled study in an academic hospital. In total, 30 patients undergoing sedative colonoscopy as part of a health check-up were recruited. Neuropsychological testing on the full cognitive spectrum was evaluated at 15 minutes and 120 minutes after low-dose midazolam administration. The modified reliable change index (RCI) was used for intrapersonal comparisons and controlling for practice effects. Midazolam affected psychomotor speed (48%), memory (40%), learning (32%), working memory (17%), and sustained attention (11%), while sparing orientation and the fluency aspect of executive function at the acute stage. Residual memory (10%) and learning (10%) impairments at 2 hours after administration were evidenced in some patients. The three object recall and digit symbol coding tests can serve as useful screening tools. Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state. Copyright © 2013. Published by Elsevier B.V.

  11. Social Cognition Impairments in Relation to General Cognitive Deficits, Injury Severity, and Prefrontal Lesions in Traumatic Brain Injury Patients

    NARCIS (Netherlands)

    Spikman, Jacoba M.; Timmerman, Marieke E.; Milders, Maarten V.; Veenstra, Wencke S.; van der Naalt, Joukje

    2012-01-01

    Impairments in social behavior are frequently found in moderate to severe traumatic brain injury (TBI) patients and are associated with an unfavorable outcome with regard to return to work and social reintegration. Neuropsychological tests measuring aspects of social cognition are thought to be sens

  12. Assessment of cognitive impairment in long-term oxygen therapy-dependent COPD patients.

    Science.gov (United States)

    Karamanli, Harun; Ilik, Faik; Kayhan, Fatih; Pazarli, Ahmet Cemal

    2015-01-01

    A number of studies have shown that COPD, particularly in its later and more severe stages, is associated with various cognitive deficits. Thus, the primary goal of the present study was to elucidate the extent of cognitive impairment in patients with long-term oxygen therapy-dependent (LTOTD) COPD. In addition, this study aimed to determine the effectiveness of two cognitive screening tests, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), for COPD patients and the ability of oxygen therapy to mitigate COPD-related deficits in cognitive function. The present study enrolled 45 subjects: 24 nonuser and 21 regular-user LTOTD-COPD patients. All subjects had a similar grade of education, and there were no significant differences regarding age or sex. The MoCA (cutoff: therapy increased the risk of cognitive impairment (MoCA, P=0.007 and MMSE, P=0.014), and the MoCA and MMSE scores significantly correlated with the number of emergency admissions and the number of hospitalizations in the last year. In the present study, the nonuser LTOTD-COPD group exhibited a significant decrease in cognitive status compared with the regular-user LTOTD-COPD group. This suggests that the assessment of cognitive function in nonuser LTOTD-COPD patients and the use of protective strategies, such as continuous supplemental oxygen treatment, should be considered during the management of COPD in this population. In addition, the MoCA score was superior to the MMSE score for the determination of cognitive impairment in the nonuser LTOTD-COPD patients.

  13. The Montreal Cognitive Assessment (MoCA - a sensitive screening instrument for detecting cognitive impairment in chronic hemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Frances E Tiffin-Richards

    Full Text Available BACKGROUND: Chronic kidney disease (CKD patients undergoing hemodialysis (HD therapy have an increased risk of developing cognitive impairment and dementia, which are known relevant factors in disease prognosis and therapeutic success, but still lack adequate screening in clinical routine. We evaluated the Montreal Cognitive Assessment (MoCA for suitability in assessing cognitive performance in HD patients in comparison to the commonly used Mini-Mental State Examination (MMSE and a detailed neuropsychological test battery, used as gold standard. METHODS: 43 HD patients and 42 healthy controls with an average age of 58 years, were assessed with the MoCA, the MMSE and a detailed neuropsychological test battery, covering the domains of memory, attention, language, visuospatial and executive functions. Composite scores were created for comparison of cognitive domains and test results were analyzed using Spearman's correlation and linear regression. Cognitive dysfunction was defined using z-score values and predictive values were calculated. Sensitivity and specificity of the MoCA were determined using receiver operating characteristic (ROC analysis. RESULTS: HD patients performed worse in all cognitive domains, especially in memory recall and executive functions. The MoCA correlated well with the detailed test battery and identified patients with cognitive impairment with a sensitivity of 76.7% and specificity of 78.6% for a cut-off value of ≤24 out of 30 points. In the detailed assessment executive functions accounted significantly for performance in the MoCA. The MMSE only discriminated weakly between groups. CONCLUSIONS: The MoCA represents a suitable cognitive screening tool for hemodialysis patients, demonstrating good sensitivity and specificity levels, and covering executive functions, which appear to play an important role in cognitive performance of HD patients.

  14. White matter changes in 80 mild cognitive impairment patients using magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Hyun Cho; Jee-Hyun Kwon; Sun-Young Kim

    2009-01-01

    BACKGROUND: Many studies have suggested that one possible etiology of mild cognitive impairment is small vessel cerebrovascular disease, which is associated with small subcortical infarcts and white matter abnormalities. These white matter changes have been detected as white matter hyperintensity (WMH) using magnetic resonance imaging. WMH may be associated with frontal lobe dysfunction. OBJECTIVE: To examine white matter changes in mild cognitive impairment patients of different subtypes, and to evaluate the correlation between white matter changes and neuropsychological characteristics, demographic information, vascular risk factors, and mild cognitive impairment subtypes. DESIGN, TIME AND SETTING: The neurophysiological, comparison study was performed at the Department of Neurology Memory Clinic, Ulsan University Hospital, South Korea, between March 2007 and March 2008.PARTICIPANTS: Out of a total of 83 subjects with clinically diagnosed mild cognitive impairment at the out-patient clinic, 3 subjects with severe WMH were excluded. A total of 80 subjects were included in this study. No patients suffered from cognitive impairment induced by neurological diseases, mental disorders, or somatic diseases. In accordance with magnetic resonance imaging results, the patients were assigned to two subtypes: 56 subjects without WMH and 24 subjects with WMH. METHODS: All patients were subjected to a standard neuropsychological battery using the Korean version of the Mini-Mental State Examination, Clinical Dementia Rating, and comprehensive Seoul Neuropsychological Screening Battery. The Clinical Dementia Rating reflected general cognitive function of patients. Results from the Seoul Neuropsychological Screening Battery reflected attention, language function, visuospatial function, verbal memory, nonverbal memory, long-term memory, and frontal/executive function. Magnetic resonance imaging was used to map changes in the brain. MAIN OUTCOME MEASURES: The association between

  15. Vascular Cognitive Impairment.

    Science.gov (United States)

    Dichgans, Martin; Leys, Didier

    2017-02-03

    Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder associated with cerebrovascular disease, regardless of the specific mechanisms involved. It encompasses the full range of cognitive deficits from mild cognitive impairment to dementia. In principle, any of the multiple causes of clinical stroke can cause vascular cognitive impairment. Recent work further highlights a role of microinfarcts, microhemorrhages, strategic white matter tracts, loss of microstructural tissue integrity, and secondary neurodegeneration. Vascular brain injury results in loss of structural and functional connectivity and, hence, compromise of functional networks within the brain. Vascular cognitive impairment is common both after stroke and in stroke-free individuals presenting to dementia clinics, and vascular pathology frequently coexists with neurodegenerative pathology, resulting in mixed forms of mild cognitive impairment or dementia. Vascular dementia is now recognized as the second most common form of dementia after Alzheimer's disease, and there is increasing awareness that targeting vascular risk may help to prevent dementia, even of the Alzheimer type. Recent advances in neuroimaging, neuropathology, epidemiology, and genetics have led to a deeper understanding of how vascular disease affects cognition. These new findings provide an opportunity for the present reappraisal of vascular cognitive impairment. We further briefly address current therapeutic concepts.

  16. Cognitive impairment in patients with Parkinson's disease: diagnosis, biomarkers, and treatment.

    Science.gov (United States)

    Svenningsson, Per; Westman, Eric; Ballard, Clive; Aarsland, Dag

    2012-08-01

    Dementia is one of the most common and important aspects of Parkinson's disease and has consequences for patients and caregivers, and has health-related costs. Mild cognitive impairment is also common and frequently progresses to dementia. The underlying mechanisms of dementia associated with Parkinson's disease are only partly known and no mechanism-based treatments are available. Both dysmetabolism of α-synuclein and amyloid-protein and cholinergic deficits contribute to cognitive impairment in Parkinson's disease, and preliminary findings show that imaging and neurophysiological and peripheral biomarkers could be useful in diagnosis and prognosis. Rivastigmine is the only licensed treatment for dementia in Parkinson's disease, but emerging evidence suggests that memantine might also be useful. Whether these or other treatments can delay the progression from mild cognitive impairment to dementia in Parkinson's disease is a key research question.

  17. Rawls and research on cognitively impaired patients: a reply to Maio.

    Science.gov (United States)

    Bell, Derek R

    2003-01-01

    In his paper, "The Relevance of Rawls' Principle of Justice for Research on Cognitively Impaired Patients" (Theoretical Medicine and Bioethics 23 (2002): 45-53), Giovanni Maio has developed a thought-provoking argument for the permissibility of non-therapeutic research on cognitively impaired patients. Maio argues that his conclusion follows from the acceptance of John Rawls's principles of justice, specifically, Rawls's "liberty principle". Maio has misinterpreted Rawls's "liberty principle"--correctly interpreted it does not support non-therapeutic research on cognitively impaired patients. Three other 'Rawlsian' arguments are suggested by Maio's discussion--two "self-respect" arguments and a "presumed consent" argument--but none of them are convincing. However, an alternative argument developed from Rawls's discussion of "justice in health care" in his most recent book, Justice as Fairness: A Restatement, may justify certain kinds of non-therapeutic research on some cognitively impaired patients in special circumstances. We should not expect anything more permissive from a liberal theory of justice.

  18. Assessing fitness to drive : a validation study on patients with mild cognitive impairment.

    NARCIS (Netherlands)

    Fuermaier, A.B.M. Piersma, D. Waard, D. de Davidse, R.J. Groot, J. de Doumen, M.J.A. Bredewoud, R.A. Claesen, R. Lemstra, A.W. Scheltens, P. Vermeeren, A. Ponds, R. Verhey, F. Brouwer, W.H. & Tucha, O.

    2017-01-01

    There is no consensus yet on how to determine which patients with cognitive impairment are able to drive a car safely and which are not. Recently, a strategy was composed for the assessment of fitness to drive, consisting of clinical interviews, a neuropsychological assessment, and driving simulator

  19. Cognitive Impairment and Brain Imaging Characteristics of Patients with Congenital Cataracts, Facial Dysmorphism, Neuropathy Syndrome

    Directory of Open Access Journals (Sweden)

    Teodora Chamova

    2015-01-01

    Full Text Available Congenital cataracts, facial dysmorphism, neuropathy (CCFDN syndrome is a complex autosomal recessive multisystem disorder. The aim of the current study is to evaluate the degree of cognitive impairment in a cohort of 22 CCFDN patients and its correlation with patients’ age, motor disability, ataxia, and neuroimaging changes. Twenty-two patients with genetically confirmed diagnosis of CCFDN underwent a detailed neurological examination. Verbal and nonverbal intelligence, memory, executive functions, and verbal fluency wеre assessed in all the patients aged 4 to 47 years. Brain magnetic resonance imaging was performed in 20 affected patients. Eighteen affected were classified as having mild intellectual deficit, whereas 4 had borderline intelligence. In all psychometric tests, evaluating different cognitive domains, CCFDN patients had statistically significant lower scores when compared to the healthy control group. All cognitive domains seemed equally affected. The main abnormalities on brain MRI found in 19/20 patients included diffuse cerebral atrophy, enlargement of the lateral ventricles, and focal lesions in the subcortical white matter, different in number and size, consistent with demyelination more pronounced in the older CCFDN patients. The correlation analysis of the structural brain changes and the cognitive impairment found a statistically significant correlation only between the impairment of short-term verbal memory and the MRI changes.

  20. Mnemonic strategy training partially restores hippocampal activity in patients with mild cognitive impairment

    OpenAIRE

    2012-01-01

    Learning and memory deficits typify patients with mild cognitive impairment (MCI) and are generally attributed to medial temporal lobe dysfunction. Although the hippocampus is perhaps the most commonly studied neuroanatomical structure in these patients, there have been few attempts to identify rehabilitative interventions that facilitate its functioning. Here, we present results from a randomized, controlled, single-blind study in which patients with MCI and healthy elderly controls (HEC) we...

  1. Complexity analysis of electroencephalogram in patients with Alzheimer’s disease and mild cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    徐梅松

    2013-01-01

    Objective To investigate the Lemple-Zie complexity (LZC) characteristics in patients with Alzheimer’s disease (AD) ,mild cognitive impairment (MCI) and normal elderly,and the possibility of differentiating AD,MCI and normal elderly by LZC.Methods Electroencephalogram (EEG) of 30 AD patients,30 MCI patients and 20normal elderly with eyes closed in rest state were recorded.In acquired EEG data,2 048 points (10.14 s) of

  2. Cognitive and functional impairment in patients suffering from stroke: the importance of cognitive assessment for Occupational Therapy intervention

    Directory of Open Access Journals (Sweden)

    Andressa de Oliveira Ferro

    2013-12-01

    Full Text Available Abstract: Introduction: Stroke (CVA can generate motor, sensory and cognitive development deficits, affecting the individual’s performance in daily activities. Changes in any cognitive area can affect the individual’s occupational engagement. Objective: To evaluate the cognitive and functional capacity in patients suffering from stroke, showing the importance of cognitive assessment for occupational therapy intervention. Method: A comparative study with cross-sectional sampling of 44 subjects aged 30-80 years, both sexes. The subjects were divided in three groups: Adult: 11 individuals affected by stroke, 30-59 years old; Elderly: 10 individuals affected by stroke, 60-80 years old; Control: 23 normal subjects, 30-80 years old. Tests applied: MMSE, Clock Test, Test of tracks A and B, and functional capacity (BOMFAQ. Results: Cognitive changes were identified in the Adult and Elderly groups. The Adult group showed poorer performance on the Clock test (visuospatial and executive functions compared with the Control group. The Adult and Elderly groups presented worse performance in the Track A test (attention compared with the Control group. In the Track B test (visual attention, graphomotor skills, and mental flexibility, applied with absolute numbers, no significant differences were observed between the Adult and Elderly groups and the Control group, but cognitive impairment was perceived when the test was applied with categories. The Adult group showed higher prevalence of moderate/severe impairment in the carrying out of daily activities. Conclusion: As a rule, individuals suffering from stroke, in addition to having impaired functional capacity, present cognitive impairments that can negatively impact the performance of daily tasks, whether they are occupational, leisure or self-care activities. Accordingly, we observed the need to evaluate cognitive rehabilitation for better targeting and quality of life improvement.

  3. The correlation between EDSS and cognitive impairment in MS patients. Assessment of a Brazilian population using a BICAMS version.

    Science.gov (United States)

    Caneda, Marco A G de; Vecino, Maria Cecília A de

    2016-12-01

    To investigate the correlation between the disabilities of MS patients and their cognitive impairment assessed by the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Forty patients with definitive diagnoses of MS were selected. The correlation coefficient (r) between the Expanded Disability Status Scale (EDSS) and the neuropsychological tests of BICAMS were calculated. The correlation was clinically substantial and significant with r = 0.55 (p EDSS. Its use may be indicated for screening and monitoring of cognitive impairment in patients with MS.

  4. The perceptions of cognitively impaired patients and their caregivers of a home telecare system

    Directory of Open Access Journals (Sweden)

    Mehrabian S

    2014-12-01

    Full Text Available Shima Mehrabian,1 Jocelyne Extra,2 Ya-Huei Wu,2 Maribel Pino,2 Latchezar Traykov,1 Anne-Sophie Rigaud2 1Department of Neurology, University Hospital (UH “Alexandrovska”, Sofia, Bulgaria; 2Department of Gerontology, Hôpital Broca, Assitance Publique-Hôpitaux de Paris, EA 4468, Faculte de Médecine, Université Paris Descartes, Paris, France Abstract: Assistive and telecare technologies have been developed to support older adults with cognitive impairments, as well as their caregivers, from their homes. The way potential users perceive telecare and smart home systems plays a key role in their acceptance of this new technology. We evaluate the acceptance of home telecare technologies among patients suffering from cognitive impairment and their caregivers. Prototypes of telecare devices were developed to demonstrate their features and capabilities and to train patients, families, and health care professionals in their use. We conducted semistructured interviews to elicit the perceptions of 30 patients with mild cognitive impairment, 32 patients with Alzheimer’s disease, and 30 caregivers, regarding the risks and advantages of home telecare and smart houses. Survey results reflected participants' largely positive reactions to these technologies. Regarding home telecare, the cognitive stimulation program earned the highest proportion of positive responses, followed by the devices' care of emergencies. The participants generally agreed that home telecare and smart houses could significantly improve their quality of life. However, some technical and ethical concerns, such as the way of provision, installation, and monitoring of the systems, were reported to be in need of addressing before implementation of this system. Keywords: home telecare, Alzheimer’s disease, mild cognitive impairment, caregiver, cognitive stimulation

  5. Risk of cognitive impairment or dementia in relatives of patients with Parkinson disease.

    Science.gov (United States)

    Rocca, Walter A; Bower, James H; Ahlskog, J Eric; Elbaz, Alexis; Grossardt, Brandon R; McDonnell, Shannon K; Schaid, Daniel J; Maraganore, Demetrius M

    2007-10-01

    The evidence for increased risk of dementia in relatives of patients with Parkinson disease (PD) remains conflicting. To study the risk of cognitive impairment or dementia in first-degree relatives of patients with PD. We conducted a historical cohort study of 1019 first-degree relatives of 162 patients with PD and of 858 relatives of 147 matched controls representative of the population of Olmsted County, Minnesota. In addition, we studied 2716 first-degree relatives of 411 patients with PD referred to Mayo Clinic. We administered via telephone a cognitive test directly to relatives or a dementia questionnaire to proxies. For relatives reported by proxies to have dementia, we obtained copies of their medical records to confirm the diagnosis. We also obtained dementia information from a medical records-linkage system. In the overall population-based sample, the risk of cognitive impairment or dementia was increased in relatives of patients with PD compared with relatives of controls (hazard ratio, 1.37; 95% confidence interval, 1.03-1.81; P = .03) and was particularly increased in relatives of patients with onset of PD at age 66 years or younger (youngest tertile; hazard ratio, 1.73; 95% confidence interval, 1.21-2.46; P = .003). The findings were consistent in several sensitivity analyses. In the referral-based sample, the risk of cognitive impairment or dementia in relatives increased with younger age at onset of PD but did not vary by other clinical characteristics. Cognitive impairment or dementia may share familial susceptibility factors with PD (genetic or nongenetic).

  6. Dosimetry of patients submitted to cerebral PET/CT for the diagnosis of mild cognitive impairment.

    Science.gov (United States)

    Santana, Priscila do Carmo; Mourão, Arnaldo Prata; de Oliveira, Paulo Márcio Campos; Bernardes, Felipe Dias; Mamede, Marcelo; da Silva, Teógenes Augusto

    2014-01-01

    The present study was aimed at evaluating the effective radiation dose in patients submitted to PET/CT for the diagnosis of mild cognitive impairment. TLD-100 detectors inserted into an Alderson Rando® anthropomorphic phantom were utilized to measure the absorbed dose coming from the CT imaging modality. The anthropomorphic phantoms (male and female adult versions) were submitted to the same technical protocols for patients' images acquisition. The absorbed dose resulting from the radiopharmaceutical injection was estimated by means of the model proposed by the ICRP publication 106. The effective dose in patients submitted to this diagnostic technique was approximately (5.34 ± 1.99) mSv. Optimized protocols for calculation of radioactive activity injected into patients submitted to this diagnostic technique might contribute to reduce the effective radiation dose resulting from PET/CT in the diagnosis of mild cognitive impairment.

  7. Assessment of cognitive impairment in long-term oxygen therapy-dependent COPD patients

    Directory of Open Access Journals (Sweden)

    Karamanli H

    2015-09-01

    Full Text Available Harun Karamanli,1 Faik Ilik,2 Fatih Kayhan,3 Ahmet Cemal Pazarli4 1Department of Pulmonology, 2Department of Neurology, ³Department of Psychiatry, Faculty of Medicine, Mevlana University, Konya, Turkey; 4Department of Pulmonology, Elbistan State Hospital, Elbistan, Turkey Background: A number of studies have shown that COPD, particularly in its later and more severe stages, is associated with various cognitive deficits. Thus, the primary goal of the present study was to elucidate the extent of cognitive impairment in patients with long-term oxygen therapy-dependent (LTOTD COPD. In addition, this study aimed to determine the effectiveness of two cognitive screening tests, the Mini-Mental State Examination (MMSE and the Montreal Cognitive Assessment (MoCA, for COPD patients and the ability of oxygen therapy to mitigate COPD-related deficits in cognitive function. Methods: The present study enrolled 45 subjects: 24 nonuser and 21 regular-user LTOTD-COPD patients. All subjects had a similar grade of education, and there were no significant differences regarding age or sex. The MoCA (cutoff: <26 points and MMSE (cutoff: ≤24 points scores were compared between these two groups.Results: The nonuser LTOTD-COPD group had a significantly lower MoCA score than that of the regular-user LTOTD-COPD group (19.38±2.99 vs 21.68±2.14, respectively as well as a significantly lower MMSE score. Moreover, the absence of supplemental oxygen therapy increased the risk of cognitive impairment (MoCA, P=0.007 and MMSE, P=0.014, and the MoCA and MMSE scores significantly correlated with the number of emergency admissions and the number of hospitalizations in the last year.Conclusion: In the present study, the nonuser LTOTD-COPD group exhibited a significant decrease in cognitive status compared with the regular-user LTOTD-COPD group. This suggests that the assessment of cognitive function in nonuser LTOTD-COPD patients and the use of protective strategies, such as

  8. Mild cognitive impairment and Alzheimer patients display different levels of redox-active CSF iron.

    Science.gov (United States)

    Lavados, Manuel; Guillón, Marta; Mujica, María Cristina; Rojo, Leonel E; Fuentes, Patricio; Maccioni, Ricardo B

    2008-03-01

    Oxidative stress constitutes a hallmark of Alzheimer's disease (AD). Recent studies also point to redox active metals such as iron, copper and zinc in mediating oxidative stress in AD pathogenesis. However, the reactivity of cerebrospinal fluid (CSF) iron and its possible correlation with the severity of cognitive decline in both Alzheimer's patients and subjects with mild cognitive impairment (MCI) is still unknown. Here we show that different stages of cognitive and functional impairment are associated with changes in CSF reactive iron. In this work, we compared CSF samples from 56 elders, classified into 4 groups according to their scores on the Clinical Dementia Rating scale (CDR). Total CSF iron was analyzed by atomic absorption spectrometry. Redox-active iron was analyzed by a novel fluorimetric assay. One-way ANOVA was used to test differences in mean values, and Newman-Keuls Multiple Comparison Test was used for multi group comparisons. No difference in total CSF iron was found between different groups. Significant amounts of redox-active iron were found in CSF and their levels correlated with the extent of cognitive impairment. Redox-active CSF iron levels increased with the degree of cognitive impairment from normal to MCI subjects, while AD patients showed an abrupt decrease to levels close to zero. Given the relevance of oxidative damage in neurodegeneration, it might be possible to associate the development of cognitive and functional decline with the presence of redox-active iron in the CSF. The decrease in redox-active iron found in AD patients may represent a terminal situation, whereby the central nervous system attempts to minimize iron-associated toxicity.

  9. Anxiety and behavioural disturbance as markers of prodromal Alzheimer's disease in patients with mild cognitive impairment.

    LENUS (Irish Health Repository)

    Gallagher, Damien

    2011-02-01

    Depression and anxiety have been reported to be independently predictive of conversion to Alzheimer\\'s disease (AD) in patients with mild cognitive impairment (MCI). Anxiety symptoms have been less well studied and findings in this regard have been inconsistent. The objectives of this study are to determine which symptoms among a range of neuropsychiatric symptoms known to commonly occur in patients with MCI are predictive of later conversion to AD. We also wish to determine whether these symptoms track existing measures of declining cognitive and functional status or may be considered distinct and sensitive biomarkers of evolving Alzheimer\\'s pathology.

  10. Adiponectin, leptin and IL-1 β in elderly diabetic patients with mild cognitive impairment

    OpenAIRE

    2015-01-01

    The aim of the study was to determine the serum levels of adiponectin, leptin and IL-1 β in elderly diabetic patients with and without mild cognitive impairment (MCI) and to examine the associations of these markers with clinical and cognitive parameters. A biochemical evaluation was performed of 62 seniors with type 2 diabetes (T2DM) and MCI, and 132 seniors with T2DM but without MCI (controls). Serum leptin and IL-1 β levels were higher and adiponectin concentration was lower in MCI patient...

  11. Liver fibrosis is associated with cognitive impairment in HIV-positive patients

    Directory of Open Access Journals (Sweden)

    Nicoletta Ciccarelli

    2014-11-01

    Full Text Available Introduction: The aim of our study was to investigate the potential relationship between liver fibrosis (LF and cognitive performance in HIV+ patients. Materials and Methods: We performed a cross-sectional cohort study by consecutively enrolling HIV+ patients during routine outpatient visits at two clinical centres in Italy. Subjects with decompensated liver disease were excluded. All subjects underwent a comprehensive neuropsychological battery exploring memory, attention, psychomotor speed and language; cognitive impairment was defined as at least two abnormal [1.5 SD below the mean for appropriate norms] cognitive domains. LF was explored by calculating FIB4 index; in a subgroup of patients, LF was also assessed by transient elastography. Factors associated with cognitive impairment were investigated by logistic regression models. Results: A total of 413 patients [77% males, median age 46 (IQR 39–52, 17% with past AIDS-defining events, 19% past IDU, 3% with diabetes, 94% on cART, 90% with HIV RNA 3.25 and 14/129 (3% had liver stiffness >14KPa. Forty-seven patients (11% were diagnosed with cognitive impairment. At multivariate analyses patients with FIB4 >1.45 showed a higher risk of cognitive impairment in comparison with those with lower values (OR 2.19, 95% CI 1.02–4.72; p=0.044 after adjusting for education (OR 0.79, 95% CI 0.71–0.88; p14KPa in comparison with fibroscan score <7KPa (OR 285.07; 95% CI 2.42–33574.06; p=0.020 after adjusting for education (OR 0.54, 95% CI 0.31–0.92; p=0.024, age (for 10 years increase (OR 2.03, 95% CI 0.55–7.53; p=0.288, past IDU (OR 4.43, 95% CI 0.35–7.57; p=0.526, HIV RNA <50 copies/mL (OR 0.01, 95% CI 0.00–0.18; p=0.003, HIV history (for 1 year increase (OR 0.96, 95% CI 0.83–1.12; p=0.641, CD4 cells count at nadir (OR 1.10, 95% CI 0.56–2.16; p=0.779, and HCV co-infection (OR 0.06; 95% CI 0.00–1.93; p=0.113. Conclusions: In HIV-infected patients higher LF, estimated through non

  12. Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study

    Directory of Open Access Journals (Sweden)

    Eschbach D

    2016-09-01

    Full Text Available D Eschbach,1 T Kirchbichler,1 T Wiesmann,2 L Oberkircher,1 C Bliemel,1 S Ruchholtz,1 B Buecking1 1Center for Orthopedics and Trauma Surgery, 2Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany Background: Most studies focusing on improving the nutritional status of geriatric trauma patients exclude patients with cognitive impairment. These patients are especially at risk of malnutrition at admission and of worsening during the perioperative fasting period. This study was planned as a feasibility study to identify the difficulties involved in including this high-risk collective of cognitively impaired geriatric trauma patients. Patients and methods: This prospective intervention study included cognitively impaired geriatric patients (Mini–Mental State Examination <25, age >65 years with hip-related fractures. We assessed Mini Nutritional Assessment (MNA, Nutritional Risk Screening (NRS 2002, body mass index, calf circumference, American Society of Anesthesiologists’ classification, and Braden Scale. All patients received parenteral nutritional supplementation of 800 kcal/d for the 96-hour perioperative period. Serum albumin and pseudocholinesterase were monitored. Information related to the study design and any complications in the clinical course were documented. Results: A total of 96 patients were screened, among whom eleven women (median age: 87 years; age range: 74–91 years and nine men (median age: 82 years; age range: 73–89 years were included. The Mini–Mental State Examination score was 9.5 (0–24. All patients were manifestly undernourished or at risk according to MNA and NRS 2002. The body mass index was 23 kg/m2 (13–30 kg/m2, the calf circumference was 29.5 cm (18–34 cm, and the mean American Society of Anesthesiologists’ classification status was 3 (2–4. Braden Scale showed 18 patients at high risk of developing pressure ulcers. In all, 12 patients had nonsurgical

  13. Subtypes of mild cognitive impairment in patients with Parkinson's disease: evidence from the LANDSCAPE study.

    Science.gov (United States)

    Kalbe, Elke; Rehberg, Sarah Petra; Heber, Ines; Kronenbuerger, Martin; Schulz, Jörg B; Storch, Alexander; Linse, Katharina; Schneider, Christine; Gräber, Susanne; Liepelt-Scarfone, Inga; Berg, Daniela; Dams, Judith; Balzer-Geldsetzer, Monika; Hilker, Rüdiger; Oberschmidt, Carola; Witt, Karsten; Schmidt, Nele; Mollenhauer, Brit; Trenkwalder, Claudia; Spottke, Annika; Roeske, Sandra; Wittchen, Hans-Ulrich; Riedel, Oliver; Dodel, Richard

    2016-10-01

    Inconsistent results exist regarding the cognitive profile in patients with Parkinson's disease with mild cognitive impairment (PD-MCI). We aimed at providing data on this topic from a large cohort of patients with PD-MCI. Sociodemographic, clinical and neuropsychological baseline data from patients with PD-MCI recruited in the multicentre, prospective, observational DEMPARK/LANDSCAPE study were analysed. 269 patients with PD-MCI (age 67.8±7.4, Unified Parkinson's Disease Rating Scale (UPDRS-III) scores 23.2±11.6) were included. PD-MCI subtypes were 39.4% non-amnestic single domain, 30.5% amnestic multiple domain, 23.4% non-amnestic multiple domain and 6.7% amnestic single domain. Executive functions were most frequently impaired. The most sensitive tests to detect cognitive dysfunctions were the Modified Card Sorting Test, digit span backwards and word list learning direct recall. Multiple stepwise regression analyses showed that global cognition, gender and age, but not education or disease-related parameters predicted PD-MCI subtypes. This study with the so far largest number of prospectively recruited patients with PD-MCI indicates that non-amnestic PD-MCI is more frequent than amnestic PD-MCI; executive dysfunctions are the most typical cognitive symptom in PD-MCI; and age, gender and global cognition predict the PD-MCI subtype. Longitudinal data are needed to test the hypothesis that patients with PD-MCI with specific cognitive profiles have different risks to develop dementia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Dosimetry of patients submitted to cerebral PET/CT for the diagnosis of mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Santana, Priscila do Carmo; Oliveira, Paulo Marcio Campos de; Bernardes, Felipe Dias; Mamede, Marcelo, E-mail: pridili@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Mourao, Arnaldo Prata [Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET), Belo Horizonte, MG (Brazil); Silva, Teogenes Augusto da [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2014-11-15

    Objective: the present study was aimed at evaluating the effective radiation dose in patients submitted to PET/CT for the diagnosis of mild cognitive impairment. Materials and methods: TLD-100 detectors inserted into an Alderson Rando® anthropomorphic phantom were utilized to measure the absorbed dose coming from the CT imaging modality. The anthropomorphic phantoms (male and female adult versions) were submitted to the same technical protocols for patients’ images acquisition. The absorbed dose resulting from the radiopharmaceutical injection was estimated by means of the model proposed by the ICRP publication 106. Results: the effective dose in patients submitted to this diagnostic technique was approximately (5.34 ± 1.99) mSv. Conclusion: optimized protocols for calculation of radioactive activity injected into patients submitted to this diagnostic technique might contribute to reduce the effective radiation dose resulting from PET/CT in the diagnosis of mild cognitive impairment. (author)

  15. Quantification of relevance of quality of life assessment for patients with cognitive impairment: the suitability indices.

    Science.gov (United States)

    Baumstarck, Karine; Boucekine, Mohamed; Boyer, Laurent; Aghababian, Valérie; Parola, Nathalie; Reuter, Françoise; Loundou, Anderson; Lançon, Christophe; Pelletier, Jean; Auquier, Pascal

    2014-04-08

    The extent to which MS patients with cognitive dysfunction can accurately self-report outcomes has been a crucial issue. The aim of this study was to quantify and compare the relevance of the quality of life (QoL) assessment between two populations with a high occurrence of cognitive dysfunction, specifically in individuals with multiple sclerosis (MS) and in individuals suffering from schizophrenia (SCZ). A cross-sectional study was performed using the following inclusion criteria: MS and SCZ patients were diagnosed according to the McDonald criteria and DSM-IV criteria, respectively. Data on sociodemographic (age, gender, education level) and clinical (disease severity, disease duration) factors, QoL (disease-specific questionnaires, MusiQoL and SQoL) and cognitive performance (executive, memory, and attention functions) were collected. Non-impaired and impaired populations were defined according to the French norms. Psychometric properties were compared to those reported in reference populations, which were assessed in the respective validation studies. Suitability indices were provided used to quantitatively compare how the structures in the different populations matched with the initial structure of the questionnaires (reference populations). One hundred and twenty-four MS patients and 113 SCZ patients were enrolled. Factor analysis was performed on the impaired populations and revealed that the questionnaire structure adequately matched the initial structure of the disease-specific QoL questionnaires. All of the suitability indices of construct and external validity in the non-impaired populations ranged from 70 to 100%. Our study suggested that cognitive dysfunction did not compromise the reliability or validity of the self-reported QoL questionnaires among subjects with cognitive dysfunction, such as MS and SCZ. Thus, this report may clarify the relevance of using self-reported QoL assessments in clinical practice.

  16. Cognitive impairment in hemodialysis patients: What can slow this decline?

    Directory of Open Access Journals (Sweden)

    Mitesh Patel

    2016-04-01

    在 55 歲或以上的血液透析 (HD 病人間, 逾 70% 有中至重度的慢性認知障礙 (CI, 在目前老年化的人口中, 這是必須要解決的問題。在接受 HD 後, CI 可引發病人安全的隱憂, 同時亦限制患者接受資訊如醫囑、及決策的能力。然而, 至今關於 HD 病人認知功能與改善方案的數據仍非常有限。本文探討了認知功能的評估方法、及 CI 發生於 HD 的相關理論, 亦回顧了目前有關慢性病中認知功能改善方案的文獻, 雖然很多並不特定於 HD 病人群。我們注意到一種稱為認知刺激療法 (cognitive stimulation therapy, CST 的心理治療方案, 可望改善 CI 患者的認知功能和社交技能。本文將首度就這種療法對 HD 病人的效應作出探討。事實上, CST 經證實可於 6 個月期間達到認知功能的改善, 亦是英國 NICE (National Institute for Health and Care Excellence 建議的失智症療法, 我們認為有需要研究 CST 對 HD 病人認知功能的影響, 不論是在短期 (日常活動及決策能力、或長期層面 (失智症的預防。

  17. Cognitive impairment in patients with AIDS – prevalence and severity

    OpenAIRE

    Watkins CC; Treisman GJ

    2015-01-01

    Crystal C Watkins,1,2 Glenn J Treisman2 1The Memory Center in Neuropsychiatry, Sheppard Pratt Health System, 2Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: The advent of highly active antiretroviral therapy has prolonged the life expectancy of HIV patients and decreased the number of adults who progress to AIDS and HIV-associated dementia. However, neurocognitive deficits remain a pronounced consequence of HIV/...

  18. [The effectiveness of dynamic proprioceptive correction in patients with cerebral palsy with cognitive impairment].

    Science.gov (United States)

    Nemkova, S A; Maslova, O I

    2013-01-01

    One hundred and sixty-seven patients with cerebral palsy (CP), aged 11-16 years, with spastic diplegia (n=87) and hemiparetic forms (n=80), with subgroups of mental retardation (MR) or intellectual delay (ID) have been studied. Standard treatment and application of a method of dynamic proprioceptive correction (MDPC) in the complex rehabilitation with the use of a medical and loading Adeli suit were used. Cognitive deficit in patients was characterized by the relative integrity of short-term nonverbal memory and marked impairment of verbal memory, verbal and nonverbal intellect. CP patients with intellectual delay demonstrated the predominant impairment of verbal functions. CP patients with mental retardation have the deficiency of both verbal and non-verbal cognitive functions. An individual profile of brain functional asymmetry in patients with CP was more lateralized than in healthy peers that can represent a mechanism for irregular development of cognitive functions in CP. Implementing the MDPC into comprehensive rehabilitation promotes the improvement of postural regulation and cognitive functions in children with CP compared to traditional methods of treatment. This is accompanied by the changes in functioning of the associative brain areas and hemispheric interaction.

  19. Cognitive impairment and antiretroviral treatment in a Peruvian population of patients with human immunodeficiency virus.

    Science.gov (United States)

    Guevara-Silva, E A

    2014-05-01

    HIV-associated cognitive impairment occurs even in the early stages of infection. Short-term memory, psychomotor speed, attention, and executive functioning are the main capacities affected. Controversy exists regarding whether highly active antiretroviral therapy (HAART) is helpful in combating this process. The objective of the present study is to determine the association between cognitive impairment and HAART in HIV-infected patients from Hospital Regional de Huacho. Prospective study of HIV patients meeting criteria to start HAART. Twenty-one HIV-positive patients were recruited between April and July 2011. Researchers administered a standardised neuropsychological test battery before and 4 weeks after onset of HAART. Psychomotor speed, executive function, short term memory (visual and verbal), attention, and visuospatial performance were evaluated. Nineteen patients completed the study (14 males and 5 females). In the pre-HAART evaluation, most patients scored below average on the executive function and psychomotor speed subtests. Psychomotor speed and immediate visual memory improved significantly after four months of treatment with HAART. Some degree of cognitive decline may present even in the early and asymptomatic stages of HIV infection. The benefits of antiretroviral treatment for cognitive performance can be detected after only a few weeks of follow-up. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  20. Neural basis of impaired cognitive flexibility in patients with anorexia nervosa.

    Directory of Open Access Journals (Sweden)

    Yasuhiro Sato

    Full Text Available BACKGROUND: Impaired cognitive flexibility in anorexia nervosa (AN causes clinical problems and makes the disease hard to treat, but its neural basis has yet to be fully elucidated. The purpose of this study was to evaluate the brain activity of individuals with AN while performing a task requiring cognitive flexibility on the Wisconsin Card Sorting Test (WCST, which is one of the most frequently used neurocognitive measures of cognitive flexibility and problem-solving ability. METHODS: Participants were 15 female AN patients and 15 age- and intelligence quotient-matched healthy control women. Participants completed the WCST while their brain activity was measured by functional magnetic resonance imaging during the task. Brain activation in response to set shifting error feedback and the correlation between such brain activity and set shifting performance were analyzed. RESULTS: The correct rate on the WCST was significantly poorer for AN patients than for controls. Patients showed poorer activity in the right ventrolateral prefrontal cortex and bilateral parahippocampal cortex on set shifting than controls. Controls showed a positive correlation between correct rate and ventrolateral prefrontal activity in response to set shifting whereas patients did not. CONCLUSION: These findings suggest dysfunction of the ventrolateral prefrontal cortex and parahippocampal cortex as a cause of impaired cognitive flexibility in AN patients.

  1. Familiarity-based recognition in the young, healthy elderly, mild cognitive impaired and Alzheimer's patients.

    Science.gov (United States)

    Algarabel, Salvador; Escudero, Joaquín; Mazón, José Francisco; Pitarque, Alfonso; Fuentes, Manuel; Peset, Vicente; Lacruz, Laura

    2009-08-01

    This study investigates the possible existence of deficits in familiarity in five samples of participants spanning a broad range of ages and cognitive states. Five groups of 16 participants with a diagnosis of multi-domain cognitive impairment with a slight or no deficit in memory, 16 multi-domain amnestic, and 16 Alzheimer's disease patients were compared in a recognition test with equivalent samples of old and young healthy participants. In one of the tests, participants studied words extracted from a restricted set of letters of the alphabet that were later mixed with new words from a different set. The unconscious use of the fluency produced by the repeated use of the set of letters was compared with a condition in which the same letter set did not play a role. Results indicated that amnestic mild cognitive impaired and Alzheimer's patients were unable to use letter fluency to improve recognition. However, young and old controls did not differ among themselves, whereas the multi-domain sample, whose memory performance was almost at the same level as that of controls showed slight levels of deficit in familiarity in the forced choice test but not in the recognition test. These results contrast sharply with those reported by Westerberg et al. [Westerberg, C. E., Paller, K. E., Holdstock, J. S., Mayes, A. R., & Reber, p. J. (2006). When memory does not fail: Familiarity-based recognition in mild cognitive impairment and Alzheimer's disease. Neuropsychology, 20, 193-205] and Anderson et al. [Anderson, N. D., Ebert, P. L., Jennings, J. M., Grady, C. L., Cabeza, R., & Graham, S. J. (2008). Recollection- and familiarity-based memory in healthy aging and amnestic mild cognitive impairment. Neuropsychology, 22, 177-187], who concluded that there were no deficits in familiarity in these types of pre-dementia and dementia patients.

  2. Characteristics and dynamics of cognitive impairment in patients with primary and recurrent cerebral ischemic hemispheric stroke

    Directory of Open Access Journals (Sweden)

    A. A. Kozyolkin

    2014-08-01

    Full Text Available Acute cerebrovascular disease is a global medical and social problem of the modern angioneurology, occupying leading positions in the structure of morbidity and mortality among adult population of the world. Ischemic stroke – is one of the most common pathology. Today this disease took out the world pandemic. More than 16 million new cases of cerebral infarction recorded in the world each year and it “kills” about 7 million of people. About 111,953 cases of cerebral stroke were registered in 2013 in Ukraine. Cognitive impairment, t hat significantly disrupt daily activities and life of the patient, is one of the most significant post-stroke complications that have social, medical and biological significance. Aim. The purpose of this investigation was to study features and dynamics of cognitive impairments in patients with primary and recurrent cerebral hemispheric ischemic stroke (CHIS in the acute stage of the disease. Materials and methods. To achieve the aim, and the decision of tasks in the clinic of nervous diseases Zaporozhye State Medical University (supervisor - Doctor of Medicine, Professor Kozelkin A. based on the department of acute cerebrovascular disease were performed comparative, prospective cohort study, which included comprehensive clinical and paraclinical examinations of 41 patients (26 men and 15 women aged 45 to 85 years (mean age 66,4 ± 1,4 years with acute left-hemispheric (2 patients and right - hemispheric (39 patients CHIS . First up was a group of 28 patients (19 men and 9 women, mean age 65,6 ± 1,6 years, who suffered from primary CHIS. The second group consisted of 13 patients (7 men and 6 women, mean age 68,1 ± 2,5 years with recurrent CHIS. The groups were matched by age, sex, localization of the lesion and the initial level of neurological deficit. All patients underwent physical examination, neurological examination. Dynamic clinical neurological examination assessing the severity of stroke was conducted

  3. Study on EEG power and coherence in patients with mild cognitive impairment during working memory task*

    OpenAIRE

    Jiang, Zheng-yan

    2005-01-01

    To investigate the features of electroencephalography (EEG) power and coherence at rest and during a working memory task of patients with mild cognitive impairment (MCI). Thirty-five patients (17 males, 18 females; 52~71 years old) and 34 sex-and age-matched controls (17 males, 17 females; 51~63 years old) were recruited in the present study. Mini-Mental State Examination (MMSE) of 35 patients with MCI and 34 normal controls revealed that the scores of MCI patients did not differ significantl...

  4. Mild Cognitive Impairment (MCI)

    Science.gov (United States)

    ... stage between the expected cognitive decline of normal aging and the more-serious decline of dementia. It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes. If you have mild cognitive impairment, you may ...

  5. Cognitive impairment in ALS patients and validation of the Spanish version of the ALS-CBS test.

    Science.gov (United States)

    Turon-Sans, Janina; Gascon-Bayarri, Jordi; Reñé, Ramon; Rico, Imma; Gámez, Cristina; Paipa, Andres; Povedano, Monica

    2016-01-01

    Our aim was to develop and validate the Spanish version of the Amyotrophic Lateral Sclerosis Cognitive Behavioural Screen (ALS-CBS) and investigate behavioural/cognitive impairment in our ALS patients. We enrolled 50 patients with definite or probable ALS, evaluated by the Motor Neuron Disease Unit (using El Escorial criteria) and Dementia Unit, and assessed with the Spanish ALS-CBS. The patients' cognitive/behavioural status was classified according to current criteria. Patients were classified into each diagnostic category: ALS-no impairment, 36%; ALS-mild cognitive impairment, 34%; ALS-mild behavioural impairment, 6%; ALS-mild cognitive/behavioural impairment, 12%; ALS-frontotemporal dementia, 12%. Cognitive impairment was more common in bulbar (90.9%) than spinal (48.7%) forms (p CBS was validated. Performance to differentiate normal vs. impaired individuals was: 1) cognition (cut-off 15; AUC, 84.7%): sensitivity 86.2%, specificity 62%, positive predictive value 75.8%, negative predictive value 76.5%; 2) behaviour (cut-off 36; AUC, 83.3%): sensitivity 93.3%, specificity 74.3%, positive predictive value 61%, negative predictive value 96.3%. Performance to differentiate between patients with and without dementia: 1) cognition (cut-off 8; AUC, 87.3%): sensitivity 83.3%, specificity 75%, positive predictive value 31.3%, negative predictive value 97.1%; 2) behaviour (cut-off 35; AUC, 80.9%): sensitivity 83.3%, specificity 69%, positive predictive value 25%, negative predictive value 96.7%. In conclusion, cognitive impairment is common in ALS patients, particularly in bulbar forms. The Spanish version of the ALS-CBS is useful for screening cognitive/behavioural impairment in this population.

  6. Cognitive impairment in bipolar disorder.

    Science.gov (United States)

    Latalova, Klara; Prasko, Jan; Diveky, Tomas; Velartova, Hana

    2011-03-01

    Provide an overview of how bipolar disorder affects cognitive function in patients. MEDLINE and PsycInfo data bases were searched for articles indexed by the combinations of MESH term or key word "bipolar disorder" with the following terms: "cognition", "memory", "neuropsychology", "neuropsychological tests", "lithium", "anticonvulsants", "antipsychotics", and "schizophrenia". Constraints limiting time period of publications or their language were not applied. Reference lists of publications identified by these procedures were hand-searched for additional relevant citations. There is evidence of stable and lasting cognitive impairment in all phases of bipolar disorder, including the remission phase, particularly in the following domains: sustained attention, memory and executive functions. But research on the cognitive functions has yielded inconsistent results over recent years. There is a growing need for clarification regarding the magnitude, clinical relevance and confounding variables of cognitive impairment in bipolar patients. The impact of bipolar illness on cognition can be influenced by age of onset, pharmacological treatments, individual response, familial risk factors, and clinical features. In addition to the mood state, cognitive performance in bipolar patients is influenced by seasonality. Previous optimistic assumptions about the prognosis of bipolar disorder were based on the success of the control of mood symptoms by pharmacotherapy. However, it is now clear that the "remitted" euthymic bipolar patients have distinct impairments of executive function, verbal memory, psychomotor speed, and sustained attention. Mood stabilizers and atypical antipsychotics may reduce cognitive deficits in certain domains and may have a positive effect on quality of life and social functioning.

  7. Emotional face recognition deficit in amnestic patients with mild cognitive impairment: behavioral and electrophysiological evidence

    OpenAIRE

    Yang L; Zhao X; Wang L; Yu L; Song M; Wang X.

    2015-01-01

    Linlin Yang, Xiaochuan Zhao, Lan Wang, Lulu Yu, Mei Song, Xueyi Wang Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, People’s Republic of China Abstract: Amnestic mild cognitive impairment (MCI) has been conceptualized as a transitional stage between healthy aging and Alzheimer’s disease. Thus, understanding emotional face recognition deficit in patients with amnestic...

  8. Characteristic patterns of cerebral blood perfusion and cognitive impairment in patients with Parkinsons disease

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    Jeong, Y. J.; Park, M. J.; Cha, J. G.; Kim, S. H.; Kim, J. W.; Kang, D. Y. [Dong-A University College of medicine, Pusan (Korea, Republic of)

    2005-07-01

    Parkinsons disease (PD) is a neurodegenerative disorder that represents cognitive impairment as well as motor symptoms. Even in the early stages of PD, cognitive alterations can be demonstrated by careful neuropsychological test. The purposes of this study are to investigate the pattern of cognitive impairment and the regional cerebral blood flow (rCBF) using Tc-99m HMPAO SPECT in patients with PD. One hundred and twenty two patients with PD and 35 control subjects participated in this study. Patients with PD who had dementia clinically or K-MMSE score below 25 points or with severe motor dysfunction to interfere with the tests were also excluded. They were all matched for age (61{+-}10 vs 61{+-}8), education periods (8.8{+-}4.9 vs 8.8{+-}4.5), and K-MMSE score (27{+-}1.6 vs 27{+-}1.5). All subjects were evaluated using the Seoul Neuropsychological Screening Battery (SNSB) and Tc-99m HMPAO SPECT with SPM software to measure rCBF. Patients with PD performed worse in digit span backward, Rey Complex Figure Test, visual memory, semantic fluency, stroop test, and alternating hand movement test(p<0.05) compared with control group. On SNSB test, 100 patients (82.0%) showed some abnormalities. Eighty-six patients (70.5%) showed frontal dysfunction, 47 (38.5%) memory impairment, 33 (27.0%) language dysfunction, 25 (20.5%) attention deficit and 22 (18.3%) visuospatial dysfunction in the order of frequency. Eight patients with PD showed single memory domain MCI and 28 single non-memory domain MCI (20 frontal dysfunction). Multiple domain MCI was found in 64 patients with PD. SPM analysis of the SPECT image revealed multiple perfusion deficit in the both frontal, temporal, both limbic lobes, Lt. parietal and Lt. Putamen. It is concluded that abnormalities of cognitive function be detected very commonly in patients with PD. MCI in PD patients is most frequently involved in the item of frontal lobe function. SPECT image might be helpful to explain cognitive impairment in some

  9. Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer’s Type Dementia

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    Mehmet Bulut

    2016-01-01

    Full Text Available Aim. To asses both choroidal thickness differences among Alzheimer’s type dementia (ATD patients, mild cognitive impairment (MCI patients, and healthy control (C subjects and choroidal thickness relationships with cognitive performance. Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT were measured at seven locations: the fovea, 500-1500-3000 μm temporal and 500-1500-3000 μm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT. Detailed neurological examination including mini mental state examination (MMSE test which evaluates the cognitive function was applied to all participants. Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p<0.05. The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were 19.3±1.8, 24.8±0.9, and 27.6±1.2 in ATD, MCI, and healthy controls, respectively (p<0.001. There were also significant correlation between MMSE score and choroidal thickness at each location (p<0.05. Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients.

  10. Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer's Type Dementia

    Science.gov (United States)

    Bulut, Mehmet; Yaman, Aylin; Erol, Muhammet Kazim; Kurtuluş, Fatma; Toslak, Devrim; Doğan, Berna; Turgut Çoban, Deniz; Kaya Başar, Ebru

    2016-01-01

    Aim. To asses both choroidal thickness differences among Alzheimer's type dementia (ATD) patients, mild cognitive impairment (MCI) patients, and healthy control (C) subjects and choroidal thickness relationships with cognitive performance. Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects) were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT) were measured at seven locations: the fovea, 500-1500-3000 μm temporal and 500-1500-3000 μm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT). Detailed neurological examination including mini mental state examination (MMSE) test which evaluates the cognitive function was applied to all participants. Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p < 0.05). The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were 19.3 ± 1.8, 24.8 ± 0.9, and 27.6 ± 1.2 in ATD, MCI, and healthy controls, respectively (p < 0.001). There were also significant correlation between MMSE score and choroidal thickness at each location (p < 0.05). Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients. PMID:26925259

  11. Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients

    Science.gov (United States)

    Tan, Ting-ting; Wang, Dan; Huang, Ju-ke; Zhou, Xiao-mei; Yuan, Xu; Liang, Jiu-ping; Yin, Liang; Xie, Hong-liang; Jia, Xin-yan; Shi, Jiao; Wang, Fang; Yang, Hao-bo; Chen, Shang-jie

    2017-01-01

    Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong (EX-HN1), Yintang (EX-HN3), Neiguan (PC6), Taixi (KI3), Fenglong (ST40), and Taichong (LR3), or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.

  12. Modulatory effects of acupuncture on brain networks in mild cognitive impairment patients

    Directory of Open Access Journals (Sweden)

    Ting-ting Tan

    2017-01-01

    Full Text Available Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong (EX-HN1, Yintang (EX-HN3, Neiguan (PC6, Taixi (KI3, Fenglong (ST40, and Taichong (LR3, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.

  13. Cognitive impairments in former patients with work-related stress complaints - one year later.

    Science.gov (United States)

    Eskildsen, Anita; Andersen, Lars Peter; Pedersen, Anders Degn; Andersen, Johan Hviid

    2016-11-01

    Patients on sick leave due to work-related stress often present with cognitive impairments. The aim of this prospective cohort study was to examine the long-term consequences of prolonged work-related stress in terms of cognitive functioning one year after initial professional care seeking. We tested a group of patients with work-related stress with a comprehensive neuropsychological test battery at two occasions, one year apart. At both time points, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the one-year follow-up. When adjusting for practice effects, patients improved on measures of prospective memory and processing speed. However, patients continued to perform worse than controls on all tests, though only half of the comparisons reached statistical significance. The effect sizes of the differences between the two groups at one-year follow-up were small to medium. In conclusion, former patients with prolonged work-related stress improved, but they continued to perform worse than controls after one year. In the acute phase, the largest impairments were related to executive function and mental speed but at follow-up memory impairments also became apparent.

  14. Apathy, cognitive dysfunction and impaired social cognition in a patient with bilateral thalamic infarction.

    Science.gov (United States)

    Ioannidis, Anestis E; Kimiskidis, Vasilios K; Loukopoulou, Eleni; Geroukis, Triantafyllos; Vlaikidis, Nikolaos; Kosmidis, Mary H

    2013-01-01

    We describe the case of a patient with bilateral thalamic lesions due to brain infarcts in the paramedian thalamic artery territories. The patient demonstrated symptoms of apathy (e.g., loss of initiative and interest in others, poor motivation, flattened affect). Neuropsychological assessment 3 and 5 years post-infarct revealed severe deficits in verbal and non-verbal immediate and delayed memory, attention, and executive functioning, with minimal improvement over time. Also, he demonstrated difficulties in social cognition (i.e., perception of facial expressions of others and of sarcasm). These findings are discussed and interpreted in light of current theories regarding the neurobiological substrate of apathy.

  15. Impaired automatization of a cognitive skill in first-degree relatives of patients with schizophrenia.

    Science.gov (United States)

    Wagshal, Dana; Knowlton, Barbara Jean; Cohen, Jessica Rachel; Poldrack, Russell Alan; Bookheimer, Susan Yost; Bilder, Robert Martin; Asarnow, Robert Franklin

    2014-02-28

    We studied healthy, first-degree relatives of patients with schizophrenia to test the hypothesis that deficits in cognitive skill learning are associated with genetic liability to schizophrenia. Using the Weather Prediction Task (WPT), 23 healthy controls and 10 adult first-degree Relatives Of Schizophrenia (ROS) patients were examined to determine the extent to which cognitive skill learning was automated using a dual-task paradigm to detect subtle impairments in skill learning. Automatization of a skill is the ability to execute a task without the demand for executive control and effortful behavior and is a skill in which schizophrenia patients possess a deficit. ROS patients did not differ from healthy controls in accuracy or reaction time on the WPT either during early or late training on the single-task trials. In contrast, the healthy control and ROS groups were differentially affected during the dual-task trials. Our results demonstrate that the ROS group did not automate the task as well as controls and continued to rely on controlled processing even after extensive practice. This suggests that adult ROS patients may engage in compensatory strategies to achieve normal levels of performance and support the hypothesis that impaired cognitive skill learning is associated with genetic risk for schizophrenia.

  16. Cognitive impairments in patients with low grade gliomas and high grade gliomas

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    Eliane C. Miotto

    2011-08-01

    Full Text Available OBJECTIVE: The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. METHOD: The low-grade (G1, n=19 and high-grade glioma (G2, n=8 patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. RESULTS: There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. CONCLUSION: These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.

  17. Cognitive Impairment in Multiple Sclerosis

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    Farnaz Etesam

    2014-01-01

    Full Text Available Cognitive impairment can emerge in the earliest phases of multiple sclerosis. It strongly impacts different aspects of Multiple Sclerosis (MS patients' lives, like employment, social relationships and the overall quality of life; thus, its on-time recognition and treatment is mandatory. This paper discusses issues, diagnostic methods and treatment options for cognitive dysfunctions in MS. This paper is a descriptive review of the related studies in the recent 10 years, performing a keyword search in the main databases4T. Cognitive impairment mostly involves aspects of information processing, memory and executive functioning in MS. Neuropsychological tests like MACFIMS and BRB-N are recommended for its assessment. Still, there is no fully efficient treatment for cognitive impairment. Researchers have shown some positive effects, using disease-modifying therapies and cognitive rehabilitation. Depression, pain, fatigue and other factors influencing cognitive functions must be paid attention to4T. Recognizing cognitive impairment as a major symptom for MS, makes studying this subject one of the priorities in dealing with the disease. Therefore, a consecutive research for identification and management of this part of quality of life in MS patients is obligatory4T.4T

  18. Biomarkers Associated with Cognitive Impairment in Treated Cancer Patients: Potential Predisposition and Risk Factors

    Science.gov (United States)

    Castel, Hélène; Denouel, Angeline; Lange, Marie; Tonon, Marie-Christine; Dubois, Martine; Joly, Florence

    2017-01-01

    Purpose: Cognitive impairment in cancer patients induced, at least in part, by treatment are frequently observed and likely have negative impacts on patient quality of life. Such cognitive dysfunctions can affect attention, executive functions, and memory and processing speed, can persist after treatment, and their exact causes remain unclear. The aim of this review was to create an inventory and analysis of clinical studies evaluating biological markers and risk factors for cognitive decline in cancer patients before, during, or after therapy. The ultimate objectives were to identify robust markers and to determine what further research is required to develop original biological markers to enable prevention or adapted treatment management of patients at risk. Method: This review was guided by the PRISMA statement and included a search strategy focused on three components: “cognition disorders,” “predictive factors”/“biological markers,” and “neoplasms,” searched in PubMed since 2005, with exclusion criteria concerning brain tumors, brain therapy, and imaging or animal studies. Results: Twenty-three studies meeting the criteria were analyzed. Potential associations/correlations were identified between cognitive impairments and specific circulating factors, cerebral spinal fluid constituents, and genetic polymorphisms at baseline, during, and at the end of treatment in cancer populations. The most significant results were associations between cognitive dysfunctions and genetic polymorphisms, including APOE-4 and COMT-Val; increased plasma levels of the pro-inflammatory cytokine, IL-6; anemia; and hemoglobin levels during chemotherapy. Plasma levels of specific hormones of the hypothalamo-pituitary-adrenal axis are also modified by treatment. Discussion: It is recognized in the field of cancer cognition that cancer and comorbidities, as well as chemotherapy and hormone therapy, can cause persistent cognitive dysfunction. A number of biological

  19. EEG markers of cognitive impairments in patients with coronary artery disease

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    I. V. Tarasova

    2016-01-01

    Full Text Available Objective: to identify the indicators of bioelectrical activity of the cerebral cortex, which are associated with cognitive impairments in patients with coronary artery disease (CAD.Patients and methods. The study included 122 male patients aged 45 to 69 years with CAD. Sixty of them were found to have mild cognitive impairments (MCI, their average Mini-Mental State Examination (MMSE score was 26.2±0.90; the other 62 patients had no cognitive impairment; their MMSE score was 28.5±0.86. All the patients underwent clinical and instrumental examinations and computer-based multichannel electroencephalography (EEG. Eyes-closed and eyes-open resting EEG monopolarly recorded in 62 standard leads of the 10-20 system. A binary logistic regression analysis was used to identify EEG predictors of MCI in patients with CAD.Results. The high power values of theta1-rhythm biopotentials with closed eyes in the frontal and occipital areas of the left hemisphere and those of alpha2-rhythm ones with open eyes in the frontal areas of the right hemisphere, and the high theta/alpha EEG power ratio are associated with an increased risk of MCI in CAD patients. The most important clinical and anamnestic factors associated with a decreased risk of MCI were higher education level, the lack of type 2 diabetes, and milder coronary bed lesions according to the SYNTAX scale. There was an association of the power values of the biopotentials and theta/alpha EEG power ratio and the development of MCI in CAD patients.

  20. [Working memory for music in patients with mild cognitive impairment and early stage Alzheimer's disease].

    Science.gov (United States)

    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

    2013-01-01

    A variety of studies demonstrated that some forms of memory for music are spared in dementia, but only few studies have investigated patients with early stages of dementia. In this pilot-study we tested working memory for music in patients with mild cognitive impairment (MCI) and early stage Alzheimer's disease (AD) with a newly created test. The test probed working memory using 7 gradually elongated tone-lines and 6 chords which were each followed by 3 similar items and 1 identical item. The participants of the study, namely 10 patients with MCI, 10 patients with early stage AD and 23 healthy subjects were instructed to select the identical tone-line or chord. Subjects with MCI and early AD showed significantly reduced performance than controls in most of the presented tasks. In recognizing chords MCI- participants surprisingly showed an unimpaired performance. The gradual increase of the impairment during the preclinical phase of AD seems to spare this special ability in MCI.

  1. CSF markers in Alzheimer disease patients are not related to the different degree of cognitive impairment.

    Science.gov (United States)

    Stefani, Alessandro; Martorana, Alessandro; Bernardini, Sergio; Panella, Marta; Mercati, Flavio; Orlacchio, Antonio; Pierantozzi, Mariangela

    2006-12-21

    Standard markers in cerebrospinal fluid (CSF), as soluble amyloid beta 1-42 (Abeta1-42) and total tau protein (t-tau), may contribute to dementia subtypes diagnostic accuracy. Yet, their sensitivity to assess the different degree of cognitive deficit is not fully clarified. Our study analyses Abeta1-42 and t-tau CSF levels in different cohorts of Alzheimer's disease (AD) patients, distinguished as early AD (mild cognitively impaired subjects recently converted to AD), mild AD (MMSE or =18), and moderately advanced AD (MMSEstage. In early AD patients, Abeta1-42 levels were already significantly low, if compared to the control group (336 vs 867 ng/L; pdiffer between AD subgroups, and in particular between mild to moderate AD. A significant progressive increase of t-tau concentration was found when comparing early AD (269 ng/L) to more advanced AD stages (468 ng/L and 495 ng/L for mild and moderate AD, respectively). Our findings confirm that the impairment of amyloidogenic cascade is an early, even pre-clinical process, but suggest that soluble Abeta1-42 concentration has a negligible correlation with the clinical progression. Conversely, t-tau concentration correlates with the transition towards marked cognitive impairment.

  2. Cerebral microbleeds in patients with mild cognitive impairment and small vessel disease: The Vascular Mild Cognitive Impairment (VMCI)-Tuscany study.

    Science.gov (United States)

    Valenti, Raffaella; Del Bene, Alessandra; Poggesi, Anna; Ginestroni, Andrea; Salvadori, Emilia; Pracucci, Giovanni; Ciolli, Laura; Marini, Sandro; Nannucci, Serena; Pasi, Marco; Pescini, Francesca; Diciotti, Stefano; Orlandi, Giovanni; Cosottini, Mirco; Chiti, Alberto; Mascalchi, Mario; Bonuccelli, Ubaldo; Inzitari, Domenico; Pantoni, Leonardo

    2016-09-15

    Cerebral microbleeds (CMBs) are a neuroimaging expression of small vessel disease (SVD). We investigated in a cohort of SVD patients with mild cognitive impairment (MCI): 1) the reliability of the Microbleed Anatomical Rating Scale (MARS); 2) the burden and location of CMBs and their association with cognitive performances, independent of other clinical and neuroimaging features. Patients underwent clinical, neuropsychological (4 cognitive domains), and MRI assessments. CMBs were assessed by three raters. Out of the 152 patients (57.2% males; mean age±SD: 75.5±6.7years) with gradient-echo (GRE) sequences, 41 (27%) had at least one CMB. Inter-rater agreement for number and location of CMBs ranged from good to very good [multi-rater Fleiss kappa (95%CI): 0.70-0.95]. Lacunar infarcts and some clinical variables (e.g., hypertension and physical activity) were associated with CMBs in specific regions. Total number of CMBs and of those in deep and lobar regions were associated with attention/executive and fluency domains. MARS is a reliable instrument to assess CMBs in SVD patients with MCI. Nearly one third of these patients had at least one CMB. Total CMBs burden was associated with attention/executive functions and fluency domains impairment, lacunar infarcts, and with some potentially modifiable risk factors. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Inappropriate drugs in elderly patients with severe cognitive impairment: results from the shelter study.

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    Giuseppe Colloca

    Full Text Available BACKGROUND: It has been estimated that Nursing Home (NH residents with impaired cognitive status receive an average of seven to eight drugs daily. The aim of this study was to determine prevalence and factors associated with use of inappropriate drugs in elderly patients with severe cognitive impairment living in NH in Europe. METHODS: Cross-sectional data from a sample of 1449 NH residents with severe cognitive impairment, participating in the Services and Health for Elderly in Long TERm care (SHELTER study were analysed. Inappropriate drug use was defined as the use of drugs classified as rarely or never appropriate in patients with severe cognitive impairment based on the Holmes criteria published in 2008. RESULTS: Mean age of participating residents was 84.2±8.9 years, 1087 (75.0% were women. Inappropriate drug use was observed in 643 (44.9% residents. Most commonly used inappropriate drugs were lipid-lowering agents (9.9%, antiplatelet agents (excluding Acetylsalicylic Acid - ASA - (9.9%, acetylcholinesterase, inhibitors (7.2% and antispasmodics (6.9%. Inappropriate drug use was directly associated with specific diseases including diabetes (OR 1.64; 95% CI 1.21-2.24, heart failure (OR 1.48; 95% CI 1.04-2.09, stroke (OR 1.43; 95% CI 1.06-1.93, and recent hospitalization (OR 1.69; 95% CI 1.20-2.39. An inverse relation was shown between inappropriate drug use and presence of a geriatrician in the facility (OR 0.55; 95% CI 0.39-0.77. CONCLUSION: Use of inappropriate drugs is common among older EU NH residents. Determinants of inappropriate drug use include comorbidities and recent hospitalization. Presence of a geriatrician in the facility staff is associated with a reduced rate of use of these medications.

  4. Memory concerns, memory performance and risk of dementia in patients with mild cognitive impairment.

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    Steffen Wolfsgruber

    Full Text Available Concerns about worsening memory ("memory concerns"; MC and impairment in memory performance are both predictors of Alzheimer's dementia (AD. The relationship of both in dementia prediction at the pre-dementia disease stage, however, is not well explored. Refined understanding of the contribution of both MC and memory performance in dementia prediction is crucial for defining at-risk populations. We examined the risk of incident AD by MC and memory performance in patients with mild cognitive impairment (MCI.We analyzed data of 417 MCI patients from a longitudinal multicenter observational study. Patients were classified based on presence (n = 305 vs. absence (n = 112 of MC. Risk of incident AD was estimated with Cox Proportional-Hazards regression models.Risk of incident AD was increased by MC (HR = 2.55, 95%CI: 1.33-4.89, lower memory performance (HR = 0.63, 95%CI: 0.56-0.71 and ApoE4-genotype (HR = 1.89, 95%CI: 1.18-3.02. An interaction effect between MC and memory performance was observed. The predictive power of MC was greatest for patients with very mild memory impairment and decreased with increasing memory impairment.Our data suggest that the power of MC as a predictor of future dementia at the MCI stage varies with the patients' level of cognitive impairment. While MC are predictive at early stage MCI, their predictive value at more advanced stages of MCI is reduced. This suggests that loss of insight related to AD may occur at the late stage of MCI.

  5. A study on cognitive impairment and gray matter volume abnormalities in silent cerebral infarction patients

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    Luo, Wei; Wei, Xiaofeng; Li, Mengxiong [The First Affiliated Hospital of Yangtze University, Biomedical Engineering Laboratory, Jingzhou, Hubei (China); Jiang, Xun [Renmin Hospital of Wuhan University, Biomedical Engineering Laboratory, Wuhan, Hubei (China); Li, Shanshan [JingZhou City Central Blood Bank, Jingzhou, Hubei (China)

    2015-08-15

    The relationship between silent cerebral infarction (SCI) and the integrity of cognitive function is unknown. We intended to investigate whether cognitive impairment is associated with gray matter volume (GMV) in the SCI patients. Sixty-two patients with SCI and 62 age- and gender-matched healthy controls (HC) were evaluated with P300 test, Montreal Cognitive Assessment (MoCA) test, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HDRS). Whole brain high-resolution T1-weighted images were processed with SPM12b software and analyzed by voxel-based morphometry (VBM). Correlation analysis was performed between the GMV and the scores of MoCA Scale, P300 latency, P300 amplitude, HAMA, HDRS, age, and educational level. The brains of the SCI patients have a significant reduction in GMV in the left superior and inferior frontal gyrus, left superior temporal gyrus, right middle temporal gyrus, and bilateral hippocampus gyrus (p < 0.01, FDR correction). No significant increase of GMV was detected. The GMV of their frontal and temporal lobes is positively correlated with the score of MoCA scale and P300 amplitude (r ≥ 0.62, p < 0.01). The GMV of frontal, temporal, and hippocampus is negatively correlated with P300 latency (r ≤ -0.71, p < 0.05). No significant correlation between the GMV of abnormal brain regions and another two clinical characteristics was found. SCI patients have impaired cognitive function and reduced GMV compared to the HC subjects. The neuropathological basis of such cognitive deficits in SCI patients might be a reduced GMV. (orig.)

  6. Integrative psychotherapeutic nursing home program to reduce multiple psychiatric symptoms of cognitively impaired patients and caregiver burden: randomized controlled trial

    NARCIS (Netherlands)

    Bakker, T.J.; Duivenvoorden, H.J.; Lee, J. van der; Olde Rikkert, M.G.M.; Beekman, A.T.; Ribbe, M.W.

    2011-01-01

    OBJECTIVE: To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB). DESIGN: Randomized controlled trial. SETTIN

  7. Cognitive impairment in patients with Fibromyalgia syndrome as assessed by the Mini-Mental State Examination

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    Rejas Javier

    2009-12-01

    Full Text Available Abstract Background This study evaluated the frequency of cognitive impairment in patients with Fibromyalgia syndrome (FMS using the Mini Mental State Examination (MMSE. Methods We analyzed baseline data from all 46 patients with FMS and 92 age- and sex-matched controls per diagnosis of neuropathic (NeP or mixed pain (MP selected from a larger prospective study. Results FMS had a slight but statistically significant lower score in the adjusted MMSE score (26.9; 95% CI 26.7-27.1 than either NeP (27.3; 95% CI 27.2-27.4 or MP (27.3; 27.2-27.5. The percentage of patients with congnitive impairment (adjusted MMSE ≤ 26 was numerically higher in FMS (15%; 95% CI 6.3-29 compared with NeP (5%; 95% CI 1.8-12.2 or MP (5%; 95% CI 1.8-12.2 and higher than in the same age stratum of the general population (0.05%. Conclusions Compared with the population reference value, patients with FMS showed high frequency of cognitive impairment.

  8. The screen for cognitive impairment in psychiatry: diagnostic-specific standardization in psychiatric ill patients.

    Science.gov (United States)

    Gómez-Benito, Juana; Guilera, Georgina; Pino, Óscar; Rojo, Emilio; Tabarés-Seisdedos, Rafael; Safont, Gemma; Martínez-Arán, Anabel; Franco, Manuel; Cuesta, Manuel J; Crespo-Facorro, Benedicto; Bernardo, Miguel; Vieta, Eduard; Purdon, Scot E; Mesa, Francisco; Rejas, Javier

    2013-05-06

    The Screen for Cognitive Impairment in Psychiatry (SCIP) is a simple and easy to administer scale developed for screening cognitive deficits. This study presents the diagnostic-specific standardization data for this scale in a sample of schizophrenia and bipolar I disorder patients. Patients between 18 and 55 years who are in a stable phase of the disease, diagnosed with schizophrenia, schizoaffective disorder, schizophreniform disorder, or bipolar I disorder were enrolled in this study. The SCIP-S was administered to 514 patients (57.9% male), divided into two age groups (18-39 and 40-55 years) and two educational level groups (less than and secondary or higher education). The performance of the patients on the SCIP-S is described and the transformed scores for each SCIP-S subtest, as well as the total score on the instrument, are presented as a percentile, z-score, T-scores, and IQ quotient. We present the first jointly developed benchmarks for a cognitive screening test exploring functional psychosis (schizophrenia and bipolar disorder), which provide increased information about patient's cognitive abilities. Having guidelines for interpreting SCIP-S scores represents a step forward in the clinical utility of this instrument and adds valuable information for its use.

  9. Reduced 5-HT2A receptor binding in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Hasselbalch, S G; Madsen, K; Svarer, C;

    2008-01-01

    Previous studies of patients with Alzheimer's disease (AD) have described reduced brain serotonin 2A (5-HT(2A)) receptor density. It is unclear whether this abnormality sets in early in the course of the disease and whether it is related to early cognitive and neuropsychiatric symptoms. We assessed...... cerebral 5-HT(2A) receptor binding in patients with mild cognitive impairment (MCI) and related 5-HT(2A) receptor binding to clinical symptoms. Sixteen patients with MCI of the amnestic type (mean age 73, mean MMSE 26.1) and 17 age and sex matched control subjects were studied with MRI and [(18)F......]altanserin PET in a bolus-infusion approach. A significant global reduction of 20-30% in 5-HT(2A) binding (atrophy corrected) was found in most neocortical areas. Reduced 5-HT(2A) binding in the striatum correlated significantly with Neuropsychiatric Inventory depression and anxiety scores. We conclude...

  10. The relevance of Rawls' principle of justice for research on cognitively impaired patients.

    Science.gov (United States)

    Maio, Giovanni

    2002-01-01

    An ethical conflict arises when we must perform research in the interest of future patients, but that this may occasionally injure the interests of today's patients. In the case of cognitively impaired persons, the question arises whether it is compatible with humane healthcare not only to treat, but also to use these patients for research purposes. Some bioethicists and theologians have formulated a general duty of solidarity, also pertaining to cognitively impaired persons, as a justification for research on these persons. If one examines this thesis from the theory of justice according to John Rawls, it is revealed that such a duty of solidarity cannot necessarily be extrapolated from Rawls' conception of justice. This is at least true of Rawls' difference principle, because according to the difference principle only those measures are justifiable which serve the interest of the respective least well off. Those measures which would engender additional injury for the least well off could not be balanced by any utility according to Rawls. However, John Rawls' difference principle is subordinate to the first principle, which is that each person has an equal right to the most extensive basic liberty compatible with the same liberty for others. These "primary goods" are determined by the freedom and integrity of the person. This integrity of decisionally impaired persons would be in danger if one would abstain from research and thus forego the increase in knowledge related to their disease. Thus one could conclude, at least from Rawls' first principle, that society must take on a duty to guarantee the degrees of freedom for cognitively impaired persons and thus also support the efforts for their healing.

  11. Parkinson's Disease and Cognitive Impairment.

    Science.gov (United States)

    Yang, Yang; Tang, Bei-Sha; Guo, Ji-Feng

    2016-01-01

    Parkinson's disease (PD) is a progressive neurodegenerative disease primarily characterized by the hallmarks of motor symptoms, such as tremor, bradykinesia, rigidity, and postural instability. However, through clinical investigations in patients and experimental findings in animal models of Parkinson's disease for years, it is now well recognized that Parkinson's disease is more than just a motor-deficit disorder. The majority of Parkinson's disease patients suffer from nonmotor disabilities, for instance, cognitive impairment, autonomic dysfunction, sensory dysfunction, and sleep disorder. So far, anti-PD prescriptions and surgical treatments have been mainly focusing on motor dysfunctions, leaving cognitive impairment a marginal clinical field. Within the nonmotor symptoms, cognitive impairment is one of the most common and significant aspects of Parkinson's disease, and cognitive deficits such as dysexecutive syndrome and visuospatial disturbances could seriously affect the quality of life, reduce life expectancy, prolong the duration of hospitalization, and therefore increase burdens of caregiver and medical costs. In this review, we have done a retrospective study of the recent related researches on epidemiology, clinical manifestation and diagnosis, genetics, and potential treatment of cognitive deficits in Parkinson's disease, aiming to provide a summary of cognitive impairment in Parkinson's disease and make it easy for clinicians to tackle this challenging issue in their future practice.

  12. Parkinson's Disease and Cognitive Impairment

    Science.gov (United States)

    Tang, Bei-sha

    2016-01-01

    Parkinson's disease (PD) is a progressive neurodegenerative disease primarily characterized by the hallmarks of motor symptoms, such as tremor, bradykinesia, rigidity, and postural instability. However, through clinical investigations in patients and experimental findings in animal models of Parkinson's disease for years, it is now well recognized that Parkinson's disease is more than just a motor-deficit disorder. The majority of Parkinson's disease patients suffer from nonmotor disabilities, for instance, cognitive impairment, autonomic dysfunction, sensory dysfunction, and sleep disorder. So far, anti-PD prescriptions and surgical treatments have been mainly focusing on motor dysfunctions, leaving cognitive impairment a marginal clinical field. Within the nonmotor symptoms, cognitive impairment is one of the most common and significant aspects of Parkinson's disease, and cognitive deficits such as dysexecutive syndrome and visuospatial disturbances could seriously affect the quality of life, reduce life expectancy, prolong the duration of hospitalization, and therefore increase burdens of caregiver and medical costs. In this review, we have done a retrospective study of the recent related researches on epidemiology, clinical manifestation and diagnosis, genetics, and potential treatment of cognitive deficits in Parkinson's disease, aiming to provide a summary of cognitive impairment in Parkinson's disease and make it easy for clinicians to tackle this challenging issue in their future practice. PMID:28058128

  13. Cognitive Reserve in Patients with Mild Cognitive Impairment: The Importance of Occupational Complexity as a Buffer of Declining Cognition in Older Adults

    Directory of Open Access Journals (Sweden)

    Feldberg Carolina

    2016-01-01

    Full Text Available Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Work is one of the most important sources of cognitive stimulation during adulthood. Mild cognitive impairment (MCI represents an intermediate status between normal aging and dementia. As a consequence, this is considered a risk group regarding cognition. In order to study the probable association between occupational complexity and cognitive performance in a group of patients with MCI, a non-probabilistic intentional sample was dispensed on a group of 80 patients. Occupational complexity was explored by the Questionnaire on Agency of Labor Activity (CAAL, according to its acronym in Spanish and a set of neuropsychological tests, which assessed cognitive performance in different areas: memory, attention, language and executive function, were administered. Results reveal that occupational complexity is associated to cognitive performance of elderly adults with MCI. With respect to working with Data, an increase in neuropsychological tests that demand high levels of attention and imply processing speed and working memory can be noted. Regarding the complexity of working with People, an association between the level of occupational complexity and an increase in verbal abilities and verbal reasoning can be seen. On the other hand, working with Things could be associated with better performance in specific areas of cognition such as visuospatial abilities. These results add up as empirical evidence to the fields of cognitive neurology and gerontology and to the cognitive reserve hypothesis, showing how complex environments can enhance cognition in old age. It adds evidence that help to understand which psychological, social and labor factors intervene in the cognitive reserve of an elder adult in cognitive risk.

  14. Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs.

    Science.gov (United States)

    Mossello, Enrico; Pieraccioli, Mariachiara; Nesti, Nicola; Bulgaresi, Matteo; Lorenzi, Chiara; Caleri, Veronica; Tonon, Elisabetta; Cavallini, M Chiara; Baroncini, Caterina; Di Bari, Mauro; Baldasseroni, Samuele; Cantini, Claudia; Biagini, Carlo A; Marchionni, Niccolò; Ungar, Andrea

    2015-04-01

    The prognostic role of high blood pressure and the aggressiveness of blood pressure lowering in dementia are not well characterized. To assess whether office blood pressure, ambulatory blood pressure monitoring, or the use of antihypertensive drugs (AHDs) predict the progression of cognitive decline in patients with overt dementia and mild cognitive impairment (MCI). Cohort study between June 1, 2009, and December 31, 2012, with a median 9-month follow-up of patients with dementia and MCI in 2 outpatient memory clinics. Cognitive decline, defined as a Mini-Mental State Examination (MMSE) score change between baseline and follow-up. We analyzed 172 patients, with a mean (SD) age of 79 (5) years and a mean (SD) MMSE score of 22.1 (4.4). Among them, 68.0% had dementia, 32.0% had MCI, and 69.8% were being treated with AHDs. Patients in the lowest tertile of daytime systolic blood pressure (SBP) (≤ 128 mm Hg) showed a greater MMSE score change (mean [SD], -2.8 [3.8]) compared with patients in the intermediate tertile (129-144 mm Hg) (mean [SD], -0.7 [2.5]; P = .002) and patients in the highest tertile (≥ 145 mm Hg) (mean [SD], -0.7 [3.7]; P = .003). The association was significant in the dementia and MCI subgroups only among patients treated with AHDs. In a multivariable model that included age, baseline MMSE score, and vascular comorbidity score, the interaction term between low daytime SBP tertile and AHD treatment was independently associated with a greater cognitive decline in both subgroups. The association between office SBP and MMSE score change was weaker. Other ambulatory blood pressure monitoring variables were not associated with MMSE score change. Low daytime SBP was independently associated with a greater progression of cognitive decline in older patients with dementia and MCI among those treated with AHDs. Excessive SBP lowering may be harmful for older patients with cognitive impairment. Ambulatory blood pressure monitoring can be useful to help

  15. An Open-Label Trial of Memantine for Cognitive Impairment in Patients with Posttraumatic Stress Disorder

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    Sriram Ramaswamy

    2015-01-01

    Full Text Available Background. Studies using standard neuropsychological instruments have demonstrated memory deficits in patients with PTSD. We evaluated the efficacy and safety of the N-methyl-D-aspartate antagonist memantine in veterans with PTSD and cognitive impairment. Methods. Twenty-six veterans with PTSD and cognitive impairment received 16 weeks of memantine in an open-label fashion. Cognition was assessed using the Spatial Span, Logical Memory I, and Letter-Number Sequencing subtests of the Wechsler Memory Scale III and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS. RBANS measures attention, language, visuospatial skills, and immediate and delayed memories. The Clinician Administered PTSD Scale (CAPS, Hamilton Depression Scale (HAM-D, Hamilton Anxiety Scale (HAM-A, Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q, and Sheehan Disability Scale (SDS were secondary outcome measures. Results. There was a significant improvement in RBANS, both total and subscale scores (P<0.05, over time. There was a reduction in total CAPS scores, avoidance/numbing symptoms (CAPS-C and hyperarousal symptoms (CAPS-D, HAM-D, Q-LES-Q, and SDS scores. However, there was no reduction in reexperiencing (CAPS-B and HAM-A scores. Memantine was well tolerated. Conclusions. Memantine improved cognitive symptoms, PTSD symptoms, and mood in veterans with PTSD. Randomized double-blind studies are needed to validate these preliminary observations.

  16. An Open-Label Trial of Memantine for Cognitive Impairment in Patients with Posttraumatic Stress Disorder

    Science.gov (United States)

    Ramaswamy, Sriram; Madabushi, Jayakrishna; Hunziker, John; Bhatia, Subhash C.; Petty, Frederick

    2015-01-01

    Background. Studies using standard neuropsychological instruments have demonstrated memory deficits in patients with PTSD. We evaluated the efficacy and safety of the N-methyl-D-aspartate antagonist memantine in veterans with PTSD and cognitive impairment. Methods. Twenty-six veterans with PTSD and cognitive impairment received 16 weeks of memantine in an open-label fashion. Cognition was assessed using the Spatial Span, Logical Memory I, and Letter-Number Sequencing subtests of the Wechsler Memory Scale III and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RBANS measures attention, language, visuospatial skills, and immediate and delayed memories. The Clinician Administered PTSD Scale (CAPS), Hamilton Depression Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), and Sheehan Disability Scale (SDS) were secondary outcome measures. Results. There was a significant improvement in RBANS, both total and subscale scores (P < 0.05), over time. There was a reduction in total CAPS scores, avoidance/numbing symptoms (CAPS-C) and hyperarousal symptoms (CAPS-D), HAM-D, Q-LES-Q, and SDS scores. However, there was no reduction in reexperiencing (CAPS-B) and HAM-A scores. Memantine was well tolerated. Conclusions. Memantine improved cognitive symptoms, PTSD symptoms, and mood in veterans with PTSD. Randomized double-blind studies are needed to validate these preliminary observations. PMID:26064685

  17. SUBJECTIVE COGNITIVE COMPLAINTS IN A PATIENT WITH KERATOCONUS: COGNITIVE IMPAIRMENT OR

    Directory of Open Access Journals (Sweden)

    Ara G. Kaprelyan

    2012-11-01

    Full Text Available Keratoconus is a disorder affecting the cornea, characterized by its variably progressive central thinning, which results in conically shaped protrusion. Patients with keratoconus are sometimes described as having peculiar personality characteristics. We present the case of a patient with keratoconus, complaining of impairment of concentration and memory disturbances. He reported slow progression of the complaints but was fully capable of performing his professional and social activities. Neuropsychological assessment confirmed fluctuations of active attention and diminished concentration. Long term memory was within normal limits, but closer to the lower level. MMSE score was 27. No significant changes were observed one year after baseline assessment. No major psychiatric disorder was found. In this clinical case we are tempted to discuss the possible role of keratoconus, which, as it has been described in the literature, could lead to some slight changes of behavior, forming a "keratoconic personality".

  18. Posteriorly tunneled dialysis catheters for permanent use in cognitively impaired patients undergoing hemodialysis.

    Science.gov (United States)

    Stroz, Marianne J; Nathoo, Bharat; Stroz, Peter M

    2014-10-01

    Cognitively impaired patients often pull at their dialysis catheters when the catheters are tunneled over the anterior chest. To potentially circumvent this, a technique was developed that tunnels the catheter posteriorly, over the patient's shoulder. A total of 32 posteriorly tunneled catheters were placed in 12 patients. The mean catheter use interval was 164 days, with a total of 5,248 catheter use days. Indications for nonelective catheter removals were catheter dysfunction (n = 7; 23.3%), removal by the patient (n = 7; 23.3%), infection (n = 5; 16.7%), and inadvertent dislodgment (n = 1; 3.3%). Only six of the 12 patients were able to dislodge their catheters. The procedure described here reduced catheter manipulation and extended catheter viability in these patients. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  19. Emotional face recognition deficit in amnestic patients with mild cognitive impairment: behavioral and electrophysiological evidence

    Directory of Open Access Journals (Sweden)

    Yang L

    2015-08-01

    Full Text Available Linlin Yang, Xiaochuan Zhao, Lan Wang, Lulu Yu, Mei Song, Xueyi Wang Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, People’s Republic of China Abstract: Amnestic mild cognitive impairment (MCI has been conceptualized as a transitional stage between healthy aging and Alzheimer’s disease. Thus, understanding emotional face recognition deficit in patients with amnestic MCI could be useful in determining progression of amnestic MCI. The purpose of this study was to investigate the features of emotional face processing in amnestic MCI by using event-related potentials (ERPs. Patients with amnestic MCI and healthy controls performed a face recognition task, giving old/new responses to previously studied and novel faces with different emotional messages as the stimulus material. Using the learning-recognition paradigm, the experiments were divided into two steps, ie, a learning phase and a test phase. ERPs were analyzed on electroencephalographic recordings. The behavior data indicated high emotion classification accuracy for patients with amnestic MCI and for healthy controls. The mean percentage of correct classifications was 81.19% for patients with amnestic MCI and 96.46% for controls. Our ERP data suggest that patients with amnestic MCI were still be able to undertake personalizing processing for negative faces, but not for neutral or positive faces, in the early frontal processing stage. In the early time window, no differences in frontal old/new effect were found between patients with amnestic MCI and normal controls. However, in the late time window, the three types of stimuli did not elicit any old/new parietal effects in patients with amnestic MCI, suggesting their recollection was impaired. This impairment may be closely associated with amnestic MCI disease. We conclude from our data that face recognition processing and emotional memory is

  20. 25-Hydroxyvitamin D3 Deficiency Independently Predicts Cognitive Impairment in Patients with Systemic Lupus Erythematosus.

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    Sen Hee Tay

    Full Text Available Cognitive dysfunction has been reported in 20-80% of SLE patients. Converging evidence has indicated the importance of vitamin D as a neuroimmunomodulator for cognitive function. In this study, we evaluated the relationship between vitamin D and cognitive dysfunction.Consecutive age- and gender-matched SLE patients and healthy controls (HCs were administered Automated Neuropsychological Assessment Metrics in this cross-sectional study. The primary outcome was the total throughput score (TTS. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS. Levels of 25-hydroxyvitamin D [25(OHD3 and total 25(OHD] were measured using Liquid Chromatography-Tandem Mass Spectrometry.In total, 61 SLE patients and 61 HCs were studied. SLE patients scored significantly lower than HCs in the TTS (p = 0.004. There were no statistically significant differences in 25(OHD3 levels, total 25(OHD levels and total 25(OHD deficiency between SLE patients and HCs. However, more SLE patients had 25(OHD3 deficiency compared to HCs [12 (19.7% versus 2 (3.3%, p = 0.003]. Deficiency of 25(OHD3 (β = -63.667, SE = 27.456, p = 0.025, but not other vitamin D variables, independently predicted worse TTS after adjusting for age, education, gender, ethnicity, HADS-Total, duration of SLE, SELENA-SLEDAI, SLICC/ACR Damage Index and cumulative steroid dose in SLE patients. Age (β = -4.261, SE = 0.866, p < 0.001 was the only predictor of TTS after adjusting for education, gender, ethnicity, HADS-Total, vitamin D levels or status in HCs.Deficiency of 25(OHD3, a potentially modifiable risk factor, independently predicted cognitive impairment in SLE patients.

  1. Design of a prototype device for remote patient care with mild cognitive impairment

    Science.gov (United States)

    Sanchez-Ocampo, M.; Segura-Giraldo, B.; Floréz-Hurtado, R.; Cortés-Aguirre, C.

    2016-04-01

    This paper describes the design of a prototype telecare system, which allows to provide home care to patients with mild cognitive impairment and thus ensures their permanence in their usual environment. Telecare is oriented towards people who require constant attention due to conditions of advanced age, illness, physical risk or limited capabilities. Telecare offers these people a greater degree of independence. QFD methodology is used to develop electronic devices intended to monitor the environment and physiological state of the user continuously, providing communication between the telecare system and a monitoring center in order to take the most appropriate actions in any abnormal event.

  2. Fast, but not slow, familiarity is preserved in patients with amnestic mild cognitive impairment.

    Science.gov (United States)

    Besson, Gabriel; Ceccaldi, Mathieu; Tramoni, Eve; Felician, Olivier; Didic, Mira; Barbeau, Emmanuel J

    2015-04-01

    Recognition memory--affected early in the course of Alzheimer Disease (AD)--is supposed to rely on two processes: recollection (i.e., retrieval of details from the encoding episode) and familiarity (i.e., acontextual sense of prior exposure). Recollection has repeatedly been shown to be impaired in patients with amnestic Mild Cognitive Impairment (aMCI)--known to be at high risk for AD. However, studies that evaluated familiarity in these patients have reported conflicting results. Here, we assessed familiarity in single-domain aMCI patients (n = 19) and healthy matched controls (n = 22). All participants underwent a classic yes/no recognition memory paradigm with confidence judgements, allowing an estimation of familiarity and recollection similar to the approach used in previous studies. In addition, they underwent a novel speeded recognition memory task, the Speed and Accuracy Boosting procedure, based on the idea that familiarity is fast and hence that fast answers rely on familiarity. On the classic yes/no task, aMCI patients were found to have impaired performance, reaction times, recollection and familiarity. However, performance and reaction times of aMCI patients did not differ from that of controls in the speeded task. This is noteworthy since this task was comparatively difficult for control subjects. This dissociation within familiarity suggests that a very basic component of declarative memory, probably at the interface between implicit and explicit memory, may be preserved, or possibly released, in patients with aMCI. It is suggested that early subprocesses (e.g., fluency based familiarity) could be preserved in aMCI patients, while delayed ones (e.g., conceptual fluency, post-retrieval monitoring, confidence assessment, or even access to awareness) may be impaired. These findings may provide support for recent suggestions that familiarity may result from the combination of a set of subprocesses, each with its specific temporal signature.

  3. Cognitive impairment in COPD: a systematic review

    Directory of Open Access Journals (Sweden)

    Irene Torres-Sánchez

    2015-04-01

    Full Text Available The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

  4. Effect of high dose fish oil supplementation on cerebral blood flow and cognitive performance in patients with mild cognitive impairment: a proof of concept study

    NARCIS (Netherlands)

    Rest, van de O.; Claassen, J.A.; Kessels, R.P.C.; Geleijnse, J.M.; Olde Rikkert, M.G.M.; Groot, de C.P.G.M.

    2013-01-01

    Objective: The current study aimed to examine the effect of n-3 polyunsaturated fatty acids (PUFAs) on cerebral blood flow and age-related loss of cognitive functioning in subjects diagnosed with mild cognitive impairment (MCI). Design, setting and participants: A total of 20 patients with single or

  5. Model-based physiomarkers of cerebral hemodynamics in patients with mild cognitive impairment.

    Science.gov (United States)

    Marmarelis, V Z; Shin, D C; Orme, M E; Zhang, R

    2014-05-01

    In our previous studies, we have introduced model-based "functional biomarkers" or "physiomarkers" of cerebral hemodynamics that hold promise for improved diagnosis of early-stage Alzheimer's disease (AD). The advocated methodology utilizes subject-specific data-based dynamic nonlinear models of cerebral hemodynamics to compute indices (serving as possible diagnostic physiomarkers) that quantify the state of cerebral blood flow autoregulation to pressure-changes (CFAP) and cerebral CO2 vasomotor reactivity (CVMR) in each subject. The model is estimated from beat-to-beat measurements of mean arterial blood pressure, mean cerebral blood flow velocity and end-tidal CO2, which can be made reliably and non-invasively under resting conditions. In a previous study, it was found that a CVMR index quantifying the impairment in CO2 vasomotor reactivity correlates with clinical indications of early AD, offering the prospect of a potentially useful diagnostic tool. In this paper, we explore the use of the same model-based indices for patients with amnestic Mild Cognitive Impairment (MCI), a preclinical stage of AD, relative to a control subjects and clinical cognitive assessments. It was found that the model-based CVMR values were lower for MCI patients relative to the control subjects.

  6. Neuropsychiatric Symptoms and Executive Functioning in Patients with Mild Cognitive Impairment: Relationship to Caregiver Burden

    Science.gov (United States)

    Ryan, Kelly A.; Weldon, Anne; Persad, Carol; Heidebrink, Judith L.; Barbas, Nancy; Giordani, Bruno

    2013-01-01

    Background Caregivers of patients with mild cognitive impairment (MCI) need similar levels of support services as Alzheimer’s disease (AD) caregivers, but it is unclear if this translates to increased caregiver burden. Methods 135 participants and their caregivers (40 MCI, 55 AD and 40 normal controls, NC) completed questionnaires, and the patients were administered neuropsychological tests. Results The MCI caregivers reported significantly more overall caregiving burden than the NC, but less than the AD. They showed similar levels of emotional, physical and social burden as the AD caregivers. Among the MCI caregivers, the neuropsychiatric symptoms and executive functioning of the patients were related to a greater burden, and the caregivers with a greater burden reported lower life satisfaction and social support, and a greater need for support services. Conclusion These results indicate that MCI caregivers are at increased risk for caregiver stress, and they require enhanced assistance and/or education in caring for their loved ones. PMID:23128102

  7. Categorical spatial memory in patients with mild cognitive impairment and Alzheimer dementia: Positional versus object-location recall

    NARCIS (Netherlands)

    Kessels, R.P.C.; Rijken, S.; Joosten-Weyn Banningh, L.W.A.; Schuylenborgh-van Es, N. van; Olde Rikkert, M.G.M.

    2010-01-01

    Memory for object locations, as part of spatial memory function, has rarely been Studied in patients with Alzheimer dementia (AD), while Studies in patients with Mild Cognitive Impairment (MCI) patients are lacking altogether. The present study examined categorical spatial memory function using the

  8. Categorical spatial memory in patients with mild cognitive impairment and Alzheimer dementia: positional versus object-location recall.

    NARCIS (Netherlands)

    Kessels, R.P.C.; Rijken, S.; Joosten-Weyn Banningh, L.W.A.; Schuylenborgh-van Es, N. van; Olde Rikkert, M.G.M.

    2010-01-01

    Memory for object locations, as part of spatial memory function, has rarely been studied in patients with Alzheimer dementia (AD), while studies in patients with Mild Cognitive Impairment (MCI) patients are lacking altogether. The present study examined categorical spatial memory function using the

  9. Correlations between Cognitive Impairments and Employment Status in Patients with Diffuse Axonal Injury

    Science.gov (United States)

    HIROTA, Shin; INAJI, Motoki; NARIAI, Tadashi; HARA, Mutsuya; TAMAKI, Masashi; MAEHARA, Taketoshi; TOMITA, Hiroki; TONE, Osamu

    2017-01-01

    Patients with diffuse axonal injury (DAI) may initially present with prominent physical impairments, but their cognitive dysfunctions are more persistent and are attributable to later unemployment. In this study, we analyzed how the findings of early and delayed neuropsychological assessments correlated with employment outcome of patients with DAI. A total of 56 patients with DAI without motor or visual dysfunction were included in this study. The neuropsychological battery consisted of the Wechsler Adult Intelligent Scale - Revised (WAIS-R), Wechsler Memory Scale - Revised (WMS-R), Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST), and Word Fluency Test (WFT). This battery of tests was administered twice in early stage after injury and in later stage. The results of all of the neuropsychological tests improved significantly (P <0.001) between the early and later assessments. All scores other than TMT part A and B improved to the normal range (Z-score ≥ 2). The patient characteristics (age, gender, initial Glasgow Coma Scale, and duration of posttraumatic amnesia) had no relationship to the outcome. The results of TMT part B, however, were significantly correlated with employment outcome in both the early and later assessments (P = 0.01, 0.04). Given that TMT evaluates visual attention, we surmise that a lack of attention may be the core symptom of the cognitive deficit and cause the re-employment failure in patients with DAI. TMT part B in both early and later assessments has the potential to accurately predict chronic functional outcome. PMID:28003570

  10. Characteristics of Agraphia in Chinese Patients with Alzheimer's Disease and Amnestic Mild Cognitive Impairment

    Institute of Scientific and Technical Information of China (English)

    Jiong Zhou; Biao Jiang; Xian-Hong Huang; Lin-Lin Kong; Hong-Lei Li

    2016-01-01

    Background:Patients with Alzheimer's disease (AD) manifest progressive decline in writing abilities.Most studies on agraphia in AD have been performed in the alphabetic system,such as English.However,these findings may not be applicable to other written language systems.The unique features of the Chinese written script could affect the patterns of agraphia in Chinese AD patients.The aim of this study was to explore the features of writing errors in Chinese patients with AD and amnestic mild cognitive impairment (a-MCI),as well as to study the relationship between their writing errors and neuropsychological functions.Methods:In this study,we performed an observational study in a group of subjects including 17 AD patients,14 patients with a-MCI,and 16 elderly healthy controls.We analyzed the writing errors in these subjects and also studied the relationship between their writing errors and neuropsychological functions.Results:Our study showed that in patients whose mother tongue is Chinese,writing ability was comparatively well preserved in the MCI phase but significantly impaired when the disease progressed to the stage of AD.The writing errors showed corresponding increase with the severity of cognition decline,both in the types of errors and rate of occurrence.Analysis of the writing errors showed that word substitution and unintelligible words were the most frequent error types that occurred in all the three study groups.The occurrence rate of unintelligible words was significantly higher in the AD group compared with the a-MCI group (P =0.024) and control group (P =0.018).In addition,the occurrence rates of word substitution were also significantly higher in AD (P =0.013) and a-MCI groups (P =0.037) than that of control group.However,errors such as totally no response,visuospatial impairment,paragraph agraphia,ideograph,and perseverative writing errors were only seen in AD group.Besides,we also found a high occurrence rate of visuoconstructional errors (13.3

  11. Brain glucose metabolism and neuropsychological test in patients with mild cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    曹秋云; 江开达; 张明园; 刘永昌; 肖世富; 左传涛; 黄红芳

    2003-01-01

    Objective To investigate the features of regional cerebral metabolic rate of glucose (rCMRglc) in patients with mild cognitive impairment(MCI) by positron emission-tomography and its relationship with neuropsychological test.Methods Positron emission tomography, mini-mental state examination and Wechsler memory scale were applied in 10 patients with MCI and 10 healthy volunteers as the control group.Results Scores of mini-mental state examination and Wechsler memory scale in MCI patients were lower than those in the control group (P<0.01). rCMRglc of the left orbital gyrus, right middle temporal gyrus and right putamen was lower in the MCI group than in the control group (P<0.05). Correlation analysis in the MCI group indicated that rCMRglc of many brain regions such as the orbital gyrus, putamen, left hippocampus and parahippocampal gyrus, cingulate gyrus, left amygdaloid body, precentral gyrus, postcentral gyrus, and medial occipitotemporal gyrus in MCI patients, were correlated negatively with age; while the rCMRglc of many parts of the brain such as the left putamen, temporal lobe, anterior cingulate gyrus, left insular lobe, amygdaloid body, precentral gyrus, postcentral gyrus and medial occipitotemporal gyrus were correlated positively with mini-mental state examination; and rCMRglc of the left putamen, temporal lobe, left insular lobe, precentral gyrus and postcentral gyrus were correlated positively with Wechsler memory scale. The right putamen, the right inferior temporal gyrus, precentral gyrus, and left postcentral gyrus were correlated positively with the length of education. However, only rCMRglc of the left amygdaloid body were correlated positively with gender. Conclusion The rCMRglc was lower in the orbital gyrus and putamen of MCI patients. Their rCMRglc were correlated with their cognitive impairment severity, age, length of education and sex.

  12. Prevalence of CMMSE defined cognitive impairment among peritoneal dialysis patients and its impact on peritonitis.

    Science.gov (United States)

    Shea, Yat Fung; Lam, Man-Fai; Lee, Mi Suen Connie; Mok, Ming Yee Maggie; Lui, Sing-Leung; Yip, Terence P S; Lo, Wai Kei; Chu, Leung Wing; Chan, Tak-Mao

    2016-02-01

    Peritoneal dialysis (PD) exchange procedure is complex. Patients with cognitive impairment (CI) may require assistance. We studied the prevalence of CI among PD patients, its impact on PD-related peritonitis and the outcome of assisted PD. Cantonese version of Mini-Mental State examination (CMMSE) was performed in 151 patients newly started on PD. Data on patient characteristics including demographics, co-morbidities, blood parameters, medications, and number of PD-related peritonitis in the first 6 months were collected. 151 subjects were recruited. The age of studied patients was 60 ± 15.0 years, and 45% were female. The prevalence of CI was 13.9% using education-adjusted cut-off of CMMSE. Patients older than 65-year-old, female, and lower education level were independent risk factors for CI (OR 9.27 p = 0.001, OR 14.84 p = 0.005, and OR 6.10 p = 0.009, respectively). Age greater than 65-year old is an independent risk factor for PD-related peritonitis but CI was not. Patients requiring assisted PD were of older age (p peritonitis (p = 0.07). CI is common among local PD patients. Overall, CI could not be identified as an independent risk factor for PD peritonitis. There is a higher prevalence of CI among assisted PD patients but helpers may not completely eliminate the risk of PD-related peritonitis.

  13. Strategic Variations in Fitts’ Task: Comparison of Healthy Older Adults and Cognitively Impaired Patients

    Science.gov (United States)

    Poletti, Céline; Sleimen-Malkoun, Rita; Decker, Leslie Marion; Retornaz, Frédérique; Lemaire, Patrick; Temprado, Jean-Jacques

    2017-01-01

    The present study aimed at investigating how healthy older adults (HOA) and cognitively impaired patients (CIP) differ in a discrete Fitts’ aiming task. Four levels of task difficulty were used, resulting from the simultaneous manipulation of the size of the target and its distance from home position. We found that movement times (MTs) followed Fitts’ law in both HOA and CIP, with the latter being significantly slower and more affected by increased task difficulty. Moreover, correlation analyses suggest that lower information processing speed (IPS) and deficits in executive functions (EFs) are associated with decline of sensorimotor performance in Fitts’ task. Analyses of strategic variations showed that HOA and CIP differed in strategy repertoire (which strategies they used), strategy distribution (i.e., how often they used each available strategy), and strategy execution (i.e., how quick they were with each available strategy). These findings further our understanding of how strategic variations used in a sensorimotor task are affected by cognitive impairment in older adults. PMID:28163682

  14. An inpatient rehabilitation model of care targeting patients with cognitive impairment

    Directory of Open Access Journals (Sweden)

    McGilton Katherine S

    2012-05-01

    Full Text Available Abstract Background The course and outcomes of hip fracture patients are often complicated by the presence of dementia and delirium, referred to as cognitive impairment (CI, which limits access to in-patient rehabilitation. In response to this concern, members of our team developed and piloted an in-patient rehabilitation model of care (Patient-Centred Rehabilitation Model; PCRM targeting patients with hip fracture and CI (PCRM-CI. We are now conducting a 3-year study comparing an inpatient rehabilitation model of care for community dwelling individuals with hip fracture and CI (PCRM-CI to usual care to determine whether it results in improved mobility at the time of discharge from inpatient rehabilitation. Methods/Design A non-equivalent pre-post design is being used to evaluate the PCRM-CI compared to usual care. All community dwelling (private home or retirement home patients following a hip fracture are eligible to participate. Recruitment of both cohorts is taking place at two facilities. Target accrual is 70 hip fracture patients in the PCRM-CI cohort and 70 patients in the usual care cohort. We are also recruiting 70 health care providers (HCPs, who are being trained to implement the PCRM-CI, and their unit managers. Patient data are collected at baseline, discharge, and 6 months post-discharge from an inpatient rehabilitation program. Evaluations include mobility, physical function, and living arrangement. Additional outcome variables are being collected from medical records and from the patients via their proxies. Data on the prevalence and severity of dementia and delirium are being collected. Staff data are collected at baseline and one year after implementation of the model to determine change in staff knowledge and attitudes toward patients with hip fracture and CI. Bi-monthly semi-structured interviews with unit managers have been conducted to examine factors and barriers influencing the model implementation. Data collection

  15. Self-awareness of cognitive efficiency: Differences between healthy elderly and patients with mild cognitive impairment (MCI).

    Science.gov (United States)

    Fragkiadaki, Stella; Kontaxopoulou, Dionysia; Beratis, Ion N; Andronas, Nikolaos; Economou, Alexandra; Yannis, George; Papanicolaou, Andrew; Papageorgiou, Sokratis G

    2016-12-01

    Self-estimation of performance implies the ability to understand one's own performance with relatively objective terms. Up to date, few studies have addressed this topic in mild cognitive impairment (MCI) patients. The aim of the present study was to compare objective measures of performance with subjective perception of specific performance on cognitive tests and investigate differences in assessment between MCI patients and healthy elderly. Thirty-five participants diagnosed with MCI (women = 16, men = 19, mean age = 65.09 years ±SD = 7.81, mean education = 12.83 years ±SD = 4.32) and 35 control subjects similar in terms of age and education (women = 20, men = 15, mean age = 62.46 years ± SD = 9.35, mean education = 14.26 ± SD = 2.84) were examined with an extended battery of neuropsychological tests. After every test they were asked to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. This self-evaluation was reported on a scale ranging from -100 to +100. Significant differences were found in the self-assessment patterns of the two groups in memory measures of verbal and visual delayed recall, visuospatial perception, and tests of attention. MCI patients overestimated their performance on every cognitive domain while control participants underestimated their performance on measures of verbal memory. The present results indicate that accuracy of self-report is not uniform across groups and functional areas. The discrepancies in the MCI patients indicate unawareness of their memory deficits, which is contradictory to subjective memory complaints as being an important component for clinical diagnosis.

  16. Behavioural symptoms in patients with Alzheimer's disease and their association with cognitive impairment

    Directory of Open Access Journals (Sweden)

    Balañá Montse

    2010-09-01

    Full Text Available Abstract Background Behavioural and psychological symptoms of dementia (BPSD are non-cognitive symptoms commonly associated to Alzheimer's disease (AD. The characterization of the clinical profile of AD patients might help to better understand disease evolution and to improve diagnosis and treatment. Thus, the aim of the present study is to describe the clinical profile of AD patients, and to correlate the presence of BPSD with the severity of the disease. Methods A cross-sectional, observational and multicenter study was conducted at 115 centres in Spain. Patients suffering from AD with higher and lower BPSD scores (ADAS-Noncog score 26-50 and ≤25, respectively were included. Demographic and clinical data were collected, and dementia severity was assessed by the Mini Mental State Examination (MMSE [mild 27-21, moderate 20-11, severe ≤10]. The use of ADAS-Noncog in clinical practice was also explored. Results A total of 1014 patients (463 with higher and 551 with lower BPSD scores were included (mean age 77 ± 7 years, 65% women. Almost all patients (90% had BPSD at inclusion, 17% of which reported psychotic outbreaks. The most prevalent symptoms were lack of concentration (56%, tremors (56%, depression (44%, lack of cooperation (36%, and delusions (32%. Patients with higher BPSD scores showed a significantly higher prevalence of psychotic symptoms (delusions, hallucinations, and delirium and tremors, while emotional symptoms (tearfulness and apathy predominated in patients with lower BPSD scores. MMSE and ADAS-Noncog scores were negatively associated (p = 0.0284, suggesting a correlation between cognitive impairment and BPSD. Lack of concentration and appetite change significantly correlated with MMSE (p = 0.0472 and p = 0.0346, respectively. Rivastigmine and donepezil were the first choice therapies in mild to moderate dementia. ADAS-Noncog was generally considered better or similar to other scales (82%, and 68% of the investigators were

  17. Cognitive impairment in early-stage non-demented Parkinson's disease patients

    DEFF Research Database (Denmark)

    Pfeiffer, Helle Cecilie Viekilde; Løkkegaard, A; Zoetmulder, Marielle

    2013-01-01

    In Parkinson's disease (PD), Parkinson's disease dementia (PDD) and Parkinson's disease-mild cognitive impairment (PD-MCI) are common. PD-MCI is a risk factor for developing PDD. Knowledge of cognition in early-stages PD is essential in understanding and predicting the dementia process....

  18. Perceived stress, disturbed sleep, and cognitive impairments in patients with work-related stress complaints: a longitudinal study.

    Science.gov (United States)

    Eskildsen, Anita; Fentz, Hanne Nørr; Andersen, Lars Peter; Pedersen, Anders Degn; Kristensen, Simon Bang; Andersen, Johan Hviid

    2017-07-01

    Patients on sick leave due to work-related stress often present with cognitive impairments as well as sleep disturbances. The aim of this longitudinal study was to examine the role of perceived stress and sleep disturbances in the longitudinal development in cognitive impairments in a group of patients with prolonged work-related stress (N = 60) during a period of 12 months following initial professional care-seeking. Objective cognitive impairments (neuropsychological tests) were measured on two occasions - at initial professional care-seeking and at 12-month follow-up. Questionnaires on perceived stress, sleep disturbances, and cognitive complaints were completed seven times during the 12 months which facilitated multilevel analysis with segregation of within-person (change) and between-person (baseline level) components of the time-varying predictors (perceived stress and sleep disturbances). Change in perceived stress was associated with concurrent and subsequent change in self-reported cognitive complaints over the period of 12 months and to a lesser extent the change in performance on neuropsychological tests of processing speed from baseline to 12-month follow-up. Change in sleep disturbances was also associated with concurrent and subsequent change in self-reported cognitive complaints over the 12 months but not with change on neuropsychological test performance. Although the mechanism behind the improvement in cognitive impairments in patients with work-related stress should be further explored in future studies, the results could suggest that improvement in cognitive impairments is partly mediated by decreasing levels of perceived stress and, to a lesser extent, decreasing levels of sleep disturbances. Lay summary This study examines the role of perceived stress and sleep disturbances in respect to the development of cognitive impairments (e.g. memory and concentration) in a group of patients with work-related stress. We found that change in

  19. Systemic Oxidative Stress and Conversion to Dementia of Elderly Patients with Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Carlo Cervellati

    2014-01-01

    Full Text Available Mild cognitive impairment (MCI is regarded as a prodromal phase of late onset Alzheimer’s disease (LOAD. It has been proposed that oxidative stress (OxS might be implicated in the pathogenesis of LOAD. The aim of this study was to investigate whether a redox imbalance measured as serum level of hydroperoxides (i.e., by-products of lipid peroxidation and/or serum antioxidant capacity might be predictive of the clinical progression of MCI to LOAD. The levels of these two markers were measured in 111 patients with MCI (follow-up: 2.0 ± 0.6 years, 105 patients with LOAD, and 118 nondemented healthy controls. Multivariate analysis adjusted for potential confounding factors, including age, gender, smoking, and comorbidities, showed a significant increase (P<0.05 in baseline levels of OxS in MCI and LOAD as compared to cognitive healthy controls. No differences in either of OxS markers were found by comparing MCI patients who converted (n = 29 or not converted (n = 82 to LOAD. Overall, these results suggest that systemic OxS might be a precocious feature of MCI and LOAD. However, the role of OxS as an early prognostic marker of progression to LOAD needs further investigations.

  20. ADAM10 gene expression in the blood cells of Alzheimer's disease patients and mild cognitive impairment subjects

    NARCIS (Netherlands)

    Manzine, Patricia Regina; Marcello, Elena; Borroni, Barbara; Kamphuis, Willem; Hol, Elly; Padovani, Alessandro; Nascimento, Carla Crispim; De Godoy Bueno, Patricia; Assis Carvalho Vale, Francisco; Iost Pavarini, Sofia Cristina; Di Luca, Monica; Cominetti, Márcia Regina

    2015-01-01

    ADAM10 is a potential biomarker for Alzheimer's disease (AD). ADAM10 protein levels are reduced in platelets of AD patients. The aim was to verify the total blood and platelet ADAM10 gene expression in AD patients and to compare with mild cognitive impairment (MCI) and healthy subjects. No

  1. Association between obesity and cognition impairment in patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    王婧

    2014-01-01

    Objective To explore the association between obesity and cognition impairment in patients with moderate-tosevere obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 425 eligible patients with moderate-to-severe OSAHS were screened for this retrospective study at Sleep Center,Second Affiliated H

  2. The relationship between mean amplitude of glycemic excursions and cognitive impairment in elderly patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    李新玲

    2013-01-01

    Objective To investigate the relationship between mean amplitude of glycemic excursions(MAGE) and cognitive impairment in elderly patients with type 2 diabetes. Methods Totally 80 patients(aged >60 years) with type 2 diabetes were selected. According to the Montreal

  3. Association between butyrylcholinesterase K variant and mild cognitive impairment in the Thai community-dwelling patients.

    Science.gov (United States)

    Pongthanaracht, Natsalil; Yanarojana, Somchai; Pinthong, Darawan; Unchern, Supeenun; Thithapandha, Amnuay; Assantachai, Prasert; Supavilai, Porntip

    2017-01-01

    To study the association of the butyrylcholinesterase K variant (BChE-K) and the plasma BChE activity with mild cognitive impairment (MCI) in Thai community-dwelling patients. One hundred patients diagnosed with MCI and 100 control subjects were recruited from the community-dwelling setting in Bangkok, Thailand. The genotype and allele distributions of the BChE-K were determined by polymerase chain reaction and subsequent DNA sequencing. The BChE activity was measured in plasma according to the Ellman's method. The BChE-K allele frequencies in the Thai community-dwelling patients were in accordance with other ethnics. The BChE-K allele frequency in the control subjects (12%) was higher than that of MCI patients (5.5%), suggesting a protective role of BChE-K for MCI in the Thai community-dwelling patients. The BChE-K homozygotes were significantly associated with lower BChE activity. Our results suggested that the BChE-K may be implicated as a protective factor for MCI in the Thai community-dwelling patients, although a further study with a large sample size is warranted to confirm this.

  4. Cognitive impairment in patients suffering from relapsing-remitting multiple sclerosis with EDSS < or = 3.5.

    Science.gov (United States)

    Ruggieri, R M; Palermo, R; Vitello, G; Gennuso, M; Settipani, N; Piccoli, F

    2003-11-01

    Previous papers have mainly demonstrated the presence and the frequency of cognitive impairment in patients suffering from relapsing-remitting multiple sclerosis. The purpose of this study was to investigate subjects with the relapsing-remitting form of the disease and mild clinical disability (EDSS Aphasie Test (AAT). They also underwent Clinical Depression Scale (CDQ) and State-Trait Anxiety Inventory (STAI). The results show the presence of significant memory impairment on both WMS (P = 0.000) and BVRT (P = 0.000) in patients compared with controls. Patients were also impaired in abstract reasoning and problem-solving deficit (KT P = 0.003; RCPM P = 0.000) and in FR (P = 0.019). Cognitive decline correlated with illness duration (r = 0.761), but was independent of EDSS (r = 0.085). Cognitive decline was present even when physical disability was not yet severe, but it was mild and did not limit patients' ability to work. The cognitive impairment outlined was of the subcortical type and correlated with illness duration. This study emphasizes the importance of cognitive examination in clinical practice. It is suggested that a complete neurological examination include tests on memory and abstract reasoning.

  5. Cognitive impairment in HIV and HCV co-infected patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Fialho, Renata; Pereira, Marco; Bucur, Mihaela; Fisher, Martin; Whale, Richard; Rusted, Jennifer

    2016-12-01

    Cognitive impairment has been well documented in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) mono-infections. However, in the context of HIV/HCV co-infection the research is more limited. The aim of this systematic review was to describe the characteristics of cognitive impairment in HIV/HCV co-infection and to examine the differences in cognitive performance between HIV/HCV and HIV and HCV mono-infected patients. Of the 437 records initially screened, 24 papers met the inclusion criteria and were included in the systematic review. Four studies were included in the meta-analysis. Most studies indicated that HIV/HCV co-infected patients had a higher level of cognitive impairment than HIV mono-infected patients. Meta-analysis also indicated that HIV mono-infected patients had a significantly lower global deficit score than co-infected patients. The results also indicated that co-infected patients were more likely to be impaired in information processing speed than HIV mono-infected patients. These findings can be challenged by biasing factors such as the small number of included studies, heterogeneity of the samples and a large diversity of methodological procedures. Future research with consistent and comprehensive neuropsychological batteries and covering a greater diversity of risk factors is needed, in order to clarify the effects of both viruses on cognitive function and the mechanisms that underlie these effects. Because cognitive impairments may pose significant challenges to medication adherence, quality of life and overall functioning, such knowledge may have important implications to the planning and implementation of effective interventions aimed at optimising the clinical management of these infections.

  6. Patterns of 11C-PIB cerebral retention in mild cognitive impairment patients.

    Science.gov (United States)

    Banzo, I; Jiménez-Bonilla, J F; Martínez-Rodríguez, I; Quirce, R; de Arcocha-Torres, M; Bravo-Ferrer, Z; Lavado-Pérez, C; Sánchez-Juan, P; Rodríguez, E; Jiménez-Alonso, M; López-Defilló, J; Carril, J M

    2016-01-01

    To evaluate the patterns of cerebral cortical distribution of (11)C-PIB in patients with mild cognitive impairment (MCI). The study included 69 patients (37 male, age range 42-79 years) with MCI, sub-classified as 53 with amnestic-MCI (A-MCI), and 16 with non-amnestic-MCI (NA-MCI). Patients underwent (11)C-PIB PET/CT scan 60min after intravenous injection of the radiotracer. A visual analysis of the images was performed by 2 experienced physicians. (11)C-PIB-positive studies were considered when gray matter uptake was equal to or greater than white matter. According to the regions involved, (11)C-PIB-positive studies were classified into A-pattern (predominant retention in frontal, anterior cingulate, lateral temporal, and basal ganglia) and B-pattern (generalized retention). Thirty-nine of the 69 (56%) patients with MCI showed (11)C-PIB retention. Of the 53 A-MCI patients, 36 (68%) showed (11)C-PIB retention. Eleven out of 36 (30%) positive scans in A-MCI patients showed A-pattern, and 25 out of 36 (70%) patients had a B-pattern. Positive (11)C-PIB was observed in 3 out of 16 (19%) patients with NA-MCI. Regional distribution in these 3 patients showed A-pattern in 1, and B-pattern in 2 patients. Cortical retention of (11)C-PIB was more frequent in A-MCI than in NA-MCI patients, and also B-pattern than A-pattern in the (11)C-PIB positive group. The recognition of (11)C-PIB distribution patterns allows MCI patients to be classified, and the A-pattern may offer a therapeutic window for potential future treatments. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  7. Cognitive impairment in Wilson's disease

    Directory of Open Access Journals (Sweden)

    Norberto Anizio Ferreira Frota

    Full Text Available Abstract Wilson's disease (WD or hepatolenticular degeneration is a rare, genetic and systemic disease, caused by a deficit in the metabolism of copper, leading to its accumulation in different organs, mainly the liver, followed by the central nervous system, especially the basal ganglia. When symptoms begin between the second and third decades of life, approximately 50% of the patients show neurological symptoms. Although dystonia and dysarthria are the most common neurological signs, cognitive changes have been reported since the first cases were described in 1912. Memory change is one of the most common impairments, but other cognitive changes have been reported, including dementia in untreated cases. In this article we review the cognitive changes in WD patients and the occurrence of dementia.

  8. Prevalence of Cognitive Impairment in Recently Diagnosed Type 2 Diabetes Patients: Are Chronic Inflammatory Diseases Responsible for Cognitive Decline?

    Science.gov (United States)

    Lavielle, Pilar; Talavera, Juan O.; Reynoso, Nancy; González, Marissa; Gómez-Díaz, Rita A.; Cruz, Miguel; Vázquez, Felipe; Wacher, Niels H.

    2015-01-01

    Objective To estimate the prevalence of cognitive impairment (CI) among patients recently diagnosed with type 2 diabetes (RDD) and to identify any relationships between CI and RDD comorbidities. Methods: One thousand seven hundred twelve patients with RDD participated in a cross-sectional study. The patients’ sociodemographic and clinical data were registered. Results The sample population had an average age of 51 ± 11 years, and 63.26% of the patients were female. CI was diagnosed in 38 patients (2.2%) and was more common among both females (2.8% vs. 1.3%, p = 0.063) and the elderly (0% at an age ≤ 30 years vs. 10.4% at an age > 70 years, p = 0.0001). Rheumatoid arthritis (present in 15.8% vs. absent in 2.1%) and asthma (13% vs. 2.1%) correlated significantly with CI based on the results of our logistic regression analysis. Conclusion Age, female gender, rheumatoid arthritis and asthma are risk factors for CI in the setting of RDD. PMID:26517541

  9. The influence of impaired processing speed on cognition in first-episode antipsychotic-naïve schizophrenic patients

    DEFF Research Database (Denmark)

    Andersen, Rune; Fagerlund, B; Rasmussen, Hans

    2013-01-01

    BACKGROUND: Impaired cognition is a prominent feature of schizophrenia. To what extent the heterogeneous cognitive impairments can be accounted for by considering only a single underlying impairment or a small number of core impairments remains elusive. This study examined whether cognitive impai...

  10. Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Salzwedel A

    2017-02-01

    Full Text Available Annett Salzwedel,1 Maria-Dorothea Heidler,1,2 Kathrin Haubold,1 Martin Schikora,2 Rona Reibis,3 Karl Wegscheider,4 Michael Jöbges,2 Heinz Völler1,5 1Center for Rehabilitation Research, University of Potsdam, Potsdam, 2Brandenburg Klinik, Bernau, 3Cardiological Outpatient Clinic, Am Park Sanssouci, Potsdam, 4Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, 5Klinik am See, Rüdersdorf, Germany Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR programs. Although the association between cardiovascular diseases and cognitive impairments (CIs is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men with coronary artery disease following an acute coronary event (ACE were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26 was determined in 182 patients (36.7%. Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7%, P = 0.046, heavy (physically demanding workloads (26.4 vs 17.8%, P < 0.001, sick leave longer than 1 month prior to CR (28.6 vs 18.5%, P = 0.026, reduced exercise capacity (102.5 vs 118.8 W, P = 0.006, and a shorter 6-min walking distance

  11. Associations Between Dehydration, Cognitive Impairment, and Frailty in Older Hospitalized Patients: An Exploratory Study.

    Science.gov (United States)

    McCrow, Judy; Morton, Margaret; Travers, Catherine; Harvey, Keren; Eeles, Eamonn

    2016-05-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Associations Between Dehydration, Cognitive Impairment, and Frailty in Older Hospitalized Patients: An Exploratory Study" found on pages 19-27, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until April 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe the incidence of dehydration in older hospitalized

  12. Cognitive impairments in alcohol-dependent subjects

    Directory of Open Access Journals (Sweden)

    Florent eBernardin

    2014-07-01

    Full Text Available Chronic excessive alcohol consumption induces cognitive impairments mainly affecting executive functions, episodic memory, and visuospatial capacities related to multiple brain lesions. These cognitive impairments not only determine everyday management of these patients, but also impact on the efficacy of management and may compromise the abstinence prognosis. Maintenance of lasting abstinence is associated with cognitive recovery in these patients, but some impairments may persist and interfere with the good conduct and the efficacy of management. It therefore appears essential to clearly define neuropsychological management designed to identify and evaluate the type and severity of alcohol-related cognitive impairments. It is also essential to develop cognitive remediation therapy so that the patient can fully benefit from the management proposed in addiction medicine units.

  13. Cognitive Impairment in Heart Failure

    Directory of Open Access Journals (Sweden)

    Efthimios Dardiotis

    2012-01-01

    Full Text Available Cognitive impairment (CI is increasingly recognized as a common adverse consequence of heart failure (HF. Although the exact mechanisms remain unclear, microembolism, chronic or intermittent cerebral hypoperfusion, and/or impaired cerebral vessel reactivity that lead to cerebral hypoxia and ischemic brain damage seem to underlie the development of CI in HF. Cognitive decline in HF is characterized by deficits in one or more cognition domains, including attention, memory, executive function, and psychomotor speed. These deficits may affect patients’ decision-making capacity and interfere with their ability to comply with treatment requirements, recognize and self-manage disease worsening symptoms. CI may have fluctuations in severity over time, improve with effective HF treatment or progress to dementia. CI is independently associated with disability, mortality, and decreased quality of life of HF patients. It is essential therefore for health professionals in their routine evaluations of HF patients to become familiar with assessment of cognitive performance using standardized screening instruments. Future studies should focus on elucidating the mechanisms that underlie CI in HF and establishing preventive strategies and treatment approaches.

  14. Cognition and Cognitive Impairment in Older Adults with Cancer.

    Science.gov (United States)

    Magnuson, Allison; Mohile, Supriya; Janelsins, Michelle

    2016-09-01

    Aging is a risk factor for cognitive impairment as well as cancer. However, the interplay between these three entities - aging, cognition and cancer - is not well understood. Mounting evidence indicates that both cancer and cancer therapies, such as chemotherapy, can negatively affect cognition and that older adults with pre-existing cognitive impairment may be more susceptible to cognitive decline with therapy than younger patients. For an older adult, decline in cognition may significantly compromise their ability to remain independent in the community. Pre-existing cognitive impairment, at the time of a cancer diagnosis, may also carry an increased risk of treatment-related adverse events in older adults receiving chemotherapy. Growing research suggests behavioral interventions may be helpful in improving chemotherapy-related cognitive changes; however, these interventions have been mainly evaluated in younger patients in whom pre-existing cognitive impairment is less prevalent. Here we review the studies on: cognitive changes associated with cancer and cancer therapies with an emphasis on studies conducted in older adults, relevant screening tools to evaluate cognition in the geriatric oncology setting, and possible intervention strategies for managing cognitive impairment.

  15. Adiponectin, leptin and IL-1 β in elderly diabetic patients with mild cognitive impairment.

    Science.gov (United States)

    Gorska-Ciebiada, Malgorzata; Saryusz-Wolska, Malgorzata; Borkowska, Anna; Ciebiada, Maciej; Loba, Jerzy

    2016-04-01

    The aim of the study was to determine the serum levels of adiponectin, leptin and IL-1 β in elderly diabetic patients with and without mild cognitive impairment (MCI) and to examine the associations of these markers with clinical and cognitive parameters. A biochemical evaluation was performed of 62 seniors with type 2 diabetes (T2DM) and MCI, and 132 seniors with T2DM but without MCI (controls). Serum leptin and IL-1 β levels were higher and adiponectin concentration was lower in MCI patients than controls. In MCI subjects, adiponectin level was negatively correlated with leptin, IL-1 β levels and BMI. Leptin concentration was correlated with IL-1 β level. Univariate logistic regression models revealed that the factors which increased the likelihood of diagnosis of MCI in elderly patients with T2DM were higher levels of HbA1c, leptin, IL-1 β and triglycerides, as well as lower levels of adiponectin and HDL cholesterol. Similarly, previous CVD, hypertension, hyperlipidemia, retinopathy, nephropathy, hypoglycemia, longer duration of diabetes, increased number of co-morbidities, older age, fewer years of formal education were found to be associated with MCI. The multivariable model indicated fewer years of formal education, previous CVD, hypertension, increased number of co-morbidities, higher HbA1c and IL-1 β levels and lower adiponectin level. Elderly diabetic patients with MCI have higher levels of leptin and IL-1 β and lower levels of adiponectin. Further prospective studies are needed to determine the role of these markers in the progression to dementia.

  16. Cognitive Impairments Associated with CFS and POTS

    Directory of Open Access Journals (Sweden)

    Leonard A. Jason

    2013-05-01

    Full Text Available Chronic fatigue syndrome (CFS is characterized by fatigue, sleep dysfunction, and cognitive deficits (Fukuda et al., 1994. Research surrounding cognitive functioning among patients with CFS has found difficulty with memory, attention, and information processing. A similar disorder, postural tachycardia syndrome (POTS, is characterized by increased heart rate, fatigue, and mental cloudiness (Raj et al., 2009. Potential implications of cognitive deficits for patients with CFS and/or POTS are discussed, including difficulties with school and/or employment. A few biological theories (i.e., kindling, impairments in the central nervous system, and difficulty with blood flow have emerged as potential explanations for the cognitive deficits reported in both CFS and POTS Future research should continue to examine possible explanations for cognitive impairments in CFS and POTS, and ultimately use this information to try and reduce cognitive impairments for these patients.

  17. Impairment in Proverb Interpretation as an Executive Function Deficit in Patients with Amnestic Mild Cognitive Impairment and Early Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Thomas Leyhe

    2011-01-01

    Full Text Available Background/Aims: Proverb interpretation is assumed to reflect executive functions. We hypothesized that proverb interpretation is impaired in patients with amnestic mild cognitive impairment (aMCI diagnosed as single-domain impairment by common neuropsychological testing. Methods: We compared performance in a proverb interpretation test in single-domain aMCI patients and patients with early Alzheimer’s disease (EAD. Results: The groups with aMCI and EAD performed significantly worse than healthy controls. Both patient groups gave concrete answers with a similar frequency. However, patients with EAD tended to give senseless answers more frequently. Conclusions: Our data suggest that in patients diagnosed as single-domain aMCI, deterioration of executive functions is detectable with subtle and appropriate neuropsychological testing. Implementation of these procedures may improve the early prediction of AD.

  18. Cortical atrophy rates in Alzheimer's patients and subjects with mild cognitive impairment from the AddNeuroMed data collection

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Westman, Eric; Gwadry-Sridhar, Femida;

    Background: The AddNeuroMed project is a multi-centre European project which aims to identify biomarkers in Alzheimer's disease (AD). In this study we measured the rate of cortical atrophy in AD patients, subjects with mild cognitive impairment (MCI), and healthy controls (HC) using MRI. Methods:...

  19. Mild cognitive impairment in Parkinson's disease

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    LUO Xiao-guang

    2013-08-01

    Full Text Available Cognitive impairment is one of the most common non-motor symptoms of Parkinson's disease (PD and a major influencing factor on patients' daily living ability. Mild cognitive impairment (MCI is a cognitive state between normal aging and dementia, and the living capability of MCI patients relatively remains. MCI often occurs in PD, with its clinical features presenting as the impairment in working memory and (or attention, executive function, language ability, memory and visuospatial function. Here we try to depict the general picture of PD-MCI from the view of epidemiology, pathology, clinical presentation, imaging and diagnostic criteria.

  20. Disrupted white matter integrity is associated with cognitive deficits in patients with amnestic mild cognitive impairment: An atlas-based study

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    Duan Liu

    2016-06-01

    Full Text Available Objective: This study investigated white matter integrity in patients with amnestic mild cognitive impairment by diffusion tensor imaging. Methods: A total of 83 patients with amnestic mild cognitive impairment and 85 elderly healthy controls underwent neuropsychological testing and a diffusion tensor imaging scan. Whole-brain white matter data were parcellated into 50 regions based on the anatomical ICBM-DTI-81 atlas, and regional diffusion metrics consisting of fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity were calculated for each region. Diffusion tensor imaging indices were compared between groups, and it was determined that between-group differences were significantly correlated with neurocognitive performance. Results: Relative to the healthy controls group, the amnestic mild cognitive impairment group exhibited poorer cognitive performance in all neuropsychological tests except the complex figure test (p = 0.083 and showed decreased mean fractional anisotropy in the fornix, increased mean diffusivity in the fornix and bilateral uncinate fasciculus, elevated axial diffusivity in the fornix and genu of corpus callosum, and elevated radial diffusivity in the fornix and bilateral uncinate fasciculus (p < 0.05. Behaviorally, integrity of the bilateral uncinate fasciculus was correlated positively with episodic memory function, while left uncinate fasciculus integrity was positively associated with language function in the amnestic mild cognitive impairment group (p < 0.05. Conclusion: White matter abnormalities in neural pathways associated with memory were correlated with neurocognitive deficiencies in amnestic mild cognitive impairment. Given that amnestic mild cognitive impairment is putatively a prodromal syndrome for Alzheimer’s disease, this study furthers our understanding of the white matter changes associated with Alzheimer’s disease pathogenesis in the predementia stage.

  1. Treatment of impaired affective information processing and social cognition in neuropsychiatric patients: A systematic review

    NARCIS (Netherlands)

    Wingbermuhle, Ellen; Roelofs, R.L.; Kessels, R.P.C.; Egger, J.I.M.

    2014-01-01

    Objective: Impairments in affective information processing (AIP) and social cognition (SC) have been associated with psychiatric disorders, inadequate social interaction, and lowered self-esteem. Consequently, problems in AIP and SC impede daily functioning and affect quality of life. Promoting impr

  2. Association of sleep disturbances with cognitive impairment and depression in maintenance memodialysis patients

    Science.gov (United States)

    There are few data on the relationship of sleep with measures of cognitive function and symptoms of depression in dialysis patients. We evaluated the relationship of sleep with cognitive function and symptoms of depression in 168 hemodialysis patients, using multivariable linear and logistic regress...

  3. Levels of glycosaminoglycans in the cerebrospinal fluid of healthy young adults, surrogate-normal children, and Hunter syndrome patients with and without cognitive impairment

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    Christian J. Hendriksz

    2015-12-01

    Full Text Available In mucopolysaccharidoses (MPS, glycosaminoglycans (GAG accumulate in tissues. In MPS II, approximately two-thirds of patients are cognitively impaired. We investigated levels of GAG in cerebrospinal fluid (CSF in different populations from four clinical studies (including NCT00920647 and NCT01449240. Data indicate that MPS II patients with cognitive impairment have elevated levels of CSF GAG, whereas those with the attenuated phenotype typically have levels falling between those of the cognitively affected patients and healthy controls.

  4. The correlation between EDSS and cognitive impairment in MS patients. Assessment of a Brazilian population using a BICAMS version

    Directory of Open Access Journals (Sweden)

    Marco A. G. de Caneda

    Full Text Available ABSTRACT Multiple sclerosis (MS may present with a cognitive impairment as disabling as the physical disabilities. Therefore, routine cognitive evaluation is pivotal. Valid and reliable neuropsychological tests are essential in follow-up and to define future therapeutic interventions. Objectives To investigate the correlation between the disabilities of MS patients and their cognitive impairment assessed by the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS. Methods Forty patients with definitive diagnoses of MS were selected. The correlation coefficient (r between the Expanded Disability Status Scale (EDSS and the neuropsychological tests of BICAMS were calculated. Results The correlation was clinically substantial and significant with r = 0.55 (p < 0.01 in the Symbol Digit Modalities Test (SDMT, 0.54 (p < 0.01 in the Brief Visuospacial Memory Test (BVMT and 0.40 (p < 0.05 in the California Verbal Learning Test (CVLT. Conclusion BICAMS has easy and satisfactory application and evaluation for routine visits and presents a significant correlation with the EDSS. Its use may be indicated for screening and monitoring of cognitive impairment in patients with MS.

  5. Prediction of Incipient Alzheimer's Disease Dementia in Patients with Mild Cognitive Impairment.

    Science.gov (United States)

    Ardekani, Babak A; Bermudez, Elaine; Mubeen, Asim M; Bachman, Alvin H

    2017-01-01

    Mild cognitive impairment (MCI) is a transitional stage from normal aging to Alzheimer's disease (AD) dementia. It is extremely important to develop criteria that can be used to separate the MCI subjects at imminent risk of conversion to Alzheimer-type dementia from those who would remain stable. We have developed an automatic algorithm for computing a novel measure of hippocampal volumetric integrity (HVI) from structural MRI scans that may be useful for this purpose. To determine the utility of HVI in classification between stable and progressive MCI patients using the Random Forest classification algorithm. We used a 16-dimensional feature space including bilateral HVI obtained from baseline and one-year follow-up structural MRI, cognitive tests, and genetic and demographic information to train a Random Forest classifier in a sample of 164 MCI subjects categorized into two groups [progressive (n = 86) or stable (n = 78)] based on future conversion (or lack thereof) of their diagnosis to probable AD. The overall accuracy of classification was estimated to be 82.3% (86.0% sensitivity, 78.2% specificity). The accuracy in women (89.1%) was considerably higher than that in men (78.9%). The prediction accuracy achieved in women is the highest reported in any previous application of machine learning to AD diagnosis in MCI. The method presented in this paper can be used to separate stable MCI patients from those who are at early stages of AD dementia with high accuracy. There may be stronger indicators of imminent AD dementia in women with MCI as compared to men.

  6. Validity of the Montreal Cognitive Assessment and the HIV Dementia Scale in the assessment of cognitive impairment in HIV-1 infected patients

    NARCIS (Netherlands)

    Janssen, M.A.M.; Bosch, M.; Koopmans, P.P.; Kessels, R.P.C.

    2015-01-01

    The gold standard for evaluating cognitive impairments in HIV-infected patients is to administer an extensive neuropsychological assessment. This may, however, be time-consuming and hence not always feasible in the clinic. Therefore, several brief screening tools have been developed. This study dete

  7. Intracerebral hemorrhage and cognitive impairment.

    Science.gov (United States)

    Xiong, Li; Reijmer, Yael D; Charidimou, Andreas; Cordonnier, Charlotte; Viswanathan, Anand

    2016-05-01

    Vascular cognitive impairment and vascular dementia are composed of cognitive deficits resulted from a range of vascular lesions and pathologies, including both ischemic and hemorrhagic. However the contribution of spontaneous intracerebral hemorrhage presumed due to small vessel diseases on cognitive impairment is underestimated, in contrast to the numerous studies about the role of ischemic vascular disorders on cognition. In this review we summarize recent findings from clinical studies and appropriate basic science research to better elucidate the role and possible mechanisms of intracerebral hemorrhage in cognitive impairment and dementia. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

  8. Effects of Lacunar Infarctions on Cognitive Impairment in Patients with Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy

    Science.gov (United States)

    Choi, Jay Chol; Kang, Sa-Yoon; Kang, Ji-Hoon; Na, Hae Ri; Park, Ji-Kang

    2011-01-01

    Background and Purpose Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by mutations in the Notch3 gene. Although previous studies have shown an association between lacunar infarction and cognitive impairment, the relationship between MRI parameters and cognition remains unclear. In this study we investigated the influence of MRI parameters on cognitive impairment in CADASIL. Methods We applied a prospective protocol to 40 patients. MRI analysis included the normalized volume of white-matter hyperintensities (nWMHs), number of lacunes, and number of cerebral microbleeds. Cognition was assessed with the aid of psychometric tests [Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognition (ADAS-cog), Trail-Making Test, and Stroop interference (Stroop IF)]. Results A multivariate regression analysis revealed that the total number of lacunes influenced the performance in the MMSE, ADAS-cog, and Stroop IF, while nWMHs had a strong univariate association with ADAS-cog and Stroop IF scores. However, this association disappeared in the multivariate analysis. Conclusions These findings demonstrate that the number of lacunes is the main predictive factor of cognitive impairment in CADASIL. PMID:22259617

  9. Cognitive impairment and preferences for current health

    Directory of Open Access Journals (Sweden)

    Tsevat Joel

    2009-01-01

    Full Text Available Abstract Background We assessed preferences for current health using the visual analogue scale (VAS, standard gamble (SG, time trade-off (TTO, and willingness to pay (WTP in patients with cerebral aneurysms, a population vulnerable to cognitive deficits related to aneurysm bleeding or treatment. Methods We measured VAS, SG, TTO, and WTP values for current health in 165 outpatients with cerebral aneurysms. We assessed cognitive impairment with the Mini Mental State Examination (MMSE; scores Results Eleven patients (7% had MMSE scores Conclusion Cognitive impairment is associated with lower preferences for current health in patients with cerebral aneurysms. Cognitively impaired patients have poor inter-preference test correlations and different response distributions compared to unimpaired patients.

  10. Application of the PredictAD Software Tool to Predict Progression in Patients with Mild Cognitive Impairment

    DEFF Research Database (Denmark)

    Simonsen, Anja H; Mattila, Jussi; Hejl, Anne-Mette

    2012-01-01

    Background: The PredictAD tool integrates heterogeneous data such as imaging, cerebrospinal fluid biomarkers and results from neuropsychological tests for compact visualization in an interactive user interface. This study investigated whether the software tool could assist physicians in the early...... diagnosis of Alzheimer's disease. Methods: Baseline data from 140 patients with mild cognitive impairment were selected from the Alzheimer's Disease Neuroimaging Study. Three clinical raters classified patients into 6 categories of confidence in the prediction of early Alzheimer's disease, in 4 phases...

  11. [11C]PIB, [18F]FDG and MR imaging in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Brück, A; Virta, J R; Koivunen, J

    2013-01-01

    Cortical glucose metabolism, brain amyloid β accumulation and hippocampal atrophy imaging have all been suggested as potential biomarkers in predicting which patients with mild cognitive impairment (MCI) will convert to Alzheimer's disease (AD). The aim of this study was to compare the prognostic...... ability of [11C]PIB PET, [18F]FDG PET and quantitative hippocampal volumes measured with MR imaging in predicting conversion to AD in patients with MCI....

  12. Association between serum non-high-density lipoprotein cholesterol and cognitive impairment in patients with acute ischemic stroke.

    Science.gov (United States)

    Lu, Da; Li, Pan; Zhou, Yuying; Xu, Xiaolin; Zhang, Huihong; Liu, Liping; Tian, Zhiyan

    2016-08-26

    Non-high density lipoprotein cholesterol (HDL-C) could be a good predictor of vascular disease outcomes. To evaluate the association between serum non-HDL-C and cognitive impairment in patients with acute ischemic stroke. A total of 725 hospitalized patients with acute ischemic stroke were enrolled. They received conventional treatment. Cognitive function was assessed on the 3rd day after admission using mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Activity of Daily Living Scale (ADL), and Neuropsychiatric Inventory (NPI, and Hamilton depression rating scale 21-item (HAMD-21). Lipid profile and biochemical markers were measured, and non-HDL-C was calculated. Compared with patients with normal non-HDL-C, those with high non-HDL-C showed lower MMSE (23.1 ± 4.9 vs. 26.0 ± 4.6, P acute ischemic stroke (P = 0.034, odds ratio = 3.115, 95 % confidence interval: 1.088-8.917). High serum non-HDL-C levels, age, education, homocysteine levels, and HAMD score were independent risk factors of cognitive impairment in patients with acute ischemic stroke. The risk of cognitive disorders after acute ischemic stroke increased with increasing non-HDL-C levels. This parameter is easy to assess in the clinical setting.

  13. Anti-MuSK-Positive Myasthenia Gravis in a Patient with Parkinsonism and Cognitive Impairment

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    S. Lanfranconi

    2011-01-01

    Full Text Available Muscle-specific tyrosine kinase- (MuSK- antibodies-positive Myasthenia Gravis accounts for about one third of Seronegative Myasthenia Gravis and is clinically characterized by early onset of prominent bulbar, neck, shoulder girdle, and respiratory weakness. The response to medical therapy is generally poor. Here we report a case of late-onset MuSK-antibodies-positive Myasthenia Gravis presenting with signs of cognitive impairment and parkinsonism in addition to bulbar involvement and external ophthalmoplegia. The pattern of involvement of both peripheral and central nervous system dysfunction might suggest a common pathogenic mechanism, involving impaired cholinergic transmission.

  14. Association of Chronic Kidney Disease and Cerebral Small Vessel Disease with Cognitive Impairment in Elderly Patients with Type 2 Diabetes

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    Toshitaka Umemura

    2013-07-01

    Full Text Available Background/Aims: In recent years, the relationship between chronic kidney disease (CKD and cognitive impairment has been attracting attention. Cerebral small vessel disease (SVD is also associated with an increased risk of cognitive impairment. However, it is still unknown whether CKD markers are associated with cognitive impairment independently of SVD in elderly diabetic patients. Methods: Seventy-nine type 2 diabetic patients (mean age, 76.0 years were enrolled in the present study. CKD was defined as the presence of albuminuria and/or a low estimated glomerular filtration rate (eGFR 2. SVD was evaluated by the presence and severity of silent brain infarcts (SBIs and white matter lesions (WMLs on brain magnetic resonance imaging. Neuropsychological tests were assessed using four validated cognitive instruments. Results: In multiple linear regression analyses, albuminuria was associated with worse modified Stroop Color Word scores (β = 0.284, p = 0.017 and low eGFR was associated with reduced Digit Symbol Substitution scores (β = -0.224, p = 0.026 after adjustment for age, sex, education years, diabetes duration, hypertension, multiple SBIs, and advanced WMLs. In contrast, there were no significant associations between CKD markers and Mini-Mental State Examination or Word Recall scores. Conclusion: Our findings suggest that albuminuria and low eGFR are associated with frontal lobe dysfunction independently of SVD in elderly type 2 diabetic patients.

  15. Measuring and managing cognitive impairment in HIV.

    Science.gov (United States)

    Nightingale, Sam; Winston, Alan

    2017-06-01

    : Cognitive impairment remains a frequently reported complaint in HIV-positive patients despite virologically suppressive antiretroviral therapy. Rates of cognitive impairment in antiretroviral treated HIV-positive cohorts vary and strongly depend on definitions utilized.The underlying pathogenesis is likely to be multifactorial and includes immune activation, neuroinflammation, antiretroviral neurotoxicity, the presence of noninfectious comorbidities such as vascular disease and depression and patient lifestyle factors such as recreational drug use.Contributing factors to cognitive impairment may change over time with ageing HIV-positive populations. Cerebrovascular disease and neurodegenerative causes of cognitive impairment may become more common with advancing age; how these factors interact with HIV-associated cognitive impairment is not yet known.Cerebrospinal fluid HIV RNA escape may occur in up to 10% of patients undergoing lumbar puncture clinically and can be associated with compartmentalized and resistant virus.Changes in antiretroviral therapy in patients with cognitive impairment should be based on current and historic resistance profiles of cerebrospinal fluid and plasma virus, or on potential antiretroviral drug neurotoxicity. Whether and how antiretroviral therapy should be changed in the absence of these factors is not known and requires study in adequately powered randomized trials in carefully selected clinical cohorts.

  16. Study on EEG power and coherence in patients with mild cognitive impairment during working memory task

    Institute of Scientific and Technical Information of China (English)

    JIANG Zheng-yan

    2005-01-01

    To investigate the features of electroencephalography (EEG) power and coherence at rest and during a working memory task of patients with mild cognitive impairment (MCI). Thirty-five patients (17 males, 18 females; 52~71 years old) and 34 sex- and age-matched controls (17 males, 17 females; 51~63 years old) were recruited in the present study. Mini-Mental State Examination (MMSE) of 35 patients with MCI and 34 normal controls revealed that the scores of MCI patients did not differ significantly from those of normal controls (P>0.05). Then, EEGs at rest and during working memory task with three levels of working memory load were recorded. The EEG power was computed over 10 channels: right and left frontal (F3, F4), central (C3,C4), parietal (P3, P4), temporal (TS, T6) and occipital (O1, O2); inter-hemispheric coherences were computed from five electrode pairs of F3-F4, C3-C4, P3-P4, T5-T6 and O1-O2 for delta (1.0~3.5 Hz), theta (4.0~7.5 Hz), alpha-1 (8.0~10.0 Hz), alpha-2 (10.5~13.0 Hz), beta-1 (13.5~18.0 Hz) and beta-2 (18.5~30.0 Hz) frequency bands. All values of the EEG power of MCI patients were found to be higher than those of normal controls at rest and during working memory tasks. Furthermore, the values of EEG power in the theta, alpha-1, alpha-2 and beta-1 bands of patients with MCI were significantly high (P<0.05) in comparison with those of normal controls. Correlation analysis indicated a significant negative correlation between the EEG powers and MMSE scores. In addition, during working memory tasks, the EEG coherences in all bands were significantly higher in the MCI group in comparison with those in the control group (P<0.05). However, there was no significant difference in EEG coherences between two groups at rest. These findings comprise evidence that MCI patients have higher EEG power at rest, and higher EEG power and coherence during working conditions. It suggests that MCI may be associated with compensatory processes at

  17. Enrichment through biomarkers in clinical trials of Alzheimer's drugs in patients with mild cognitive impairment.

    Science.gov (United States)

    Lorenzi, M; Donohue, M; Paternicò, D; Scarpazza, C; Ostrowitzki, S; Blin, O; Irving, E; Frisoni, G B

    2010-08-01

    Clinical trials of disease modifying drugs for Alzheimer's disease (AD) in patients with mild cognitive impairment (MCI) might benefit from enrichment with true AD cases. Four hundred five MCI patients (143 converters and 262 nonconverters to AD within 2 years) of the Alzheimer's disease Neuroimaging Initiative (ADNI) were used. Markers for enrichment were hippocampal atrophy on magnetic resonance (MRI), temporoparietal hypometabolism on FDG PET, cerebrospinal fluid (CSF) biomarkers (Abeta42, tau, and phospho-tau), and cortical amyloid deposition (11C-PIB positron emission tomography (PET)). Two separate enrichment strategies were tested to A) maximize the proportion of MCI converters screened in, and B) minimize the proportion of MCI converters screened out. Based on strategy A, when compared with no enrichment and ADAS-Cog as an outcome measure (sample size of 834), enrichment with 18F-FDG PET and hippocampal volume lowered samples size to 260 and 277 cases per arm, but at the cost of screening out 1,597 and 434 cases per arm. When compared with no enrichment and clinical dementia rating (CDR-SOB) as an outcome measure (sample size of 674), enrichment with hippocampal volume and Abeta42 lowered sample sizes to 191 and 291 cases per arm, with 639 and 157 screened out cases. Strategy B reduced the number of screened out cases (740 for [11C]-PIB PET, 101 hippocampal volume, 82 ADAS-COG and 330 for [18F]-FDG PET) but at the expense of decreased power and a relative increase size (740 for [11C]-PIB PET, 676 for hippocampal volume, 744 for ADAS-Cog, and 517 for [18F]-FDG PET). Enrichment comes at the price of an often relevant proportion of screened out cases, and in clinical trial settings, the balance between enrichment of screened in and loss of screened out patients should be critically discussed. 2010 Elsevier Inc. All rights reserved.

  18. Amyloid-aβ Peptide in olfactory mucosa and mesenchymal stromal cells of mild cognitive impairment and Alzheimer's disease patients.

    Science.gov (United States)

    Ayala-Grosso, Carlos A; Pieruzzini, Rosalinda; Diaz-Solano, Dylana; Wittig, Olga; Abrante, Ligia; Vargas, Leslie; Cardier, Jose

    2015-03-01

    Patients with mild cognitive impairment (MCI) or Alzheimer's disease (AD) might develop olfactory dysfunction that correlates with progression of disease. Alteration of olfactory neuroepithelium associated with MCI may be useful as predictor of cognitive decline. Biomarkers with higher sensitivity and specificity would allow to understand the biological progression of the pathology in association with the clinical course of the disease. In this study, magnetic resonance images, apolipoprotein E (ApoE) load, Olfactory Connecticut test and Montreal Cognitive Assessment (MoCA) indices were obtained from noncognitive impaired (NCI), MCI and AD patients. We established a culture of patient-derived olfactory stromal cells from biopsies of olfactory mucosa (OM) to test whether biological properties of mesenchymal stromal cells (MSC) are concurrent with MCI and AD psychophysical pathology. We determined the expression of amyloid Aβ peptides in the neuroepithelium of tissue sections from MCI and AD, as well as in cultured cells of OM. Reduced migration and proliferation of stromal (CD90(+) ) cells in MCI and AD with respect to NCI patients was determined. A higher proportion of anosmic MCI and AD cases were concurrent with the ApoE ε4 allele. In summary, dysmetabolism of amyloid was concurrent with migration and proliferation impairment of patient-derived stem cells. © 2014 International Society of Neuropathology.

  19. [Concomitant impact of organic pathology on the development of cognitive impairment in patients with attack-like paranoid schizophrenia].

    Science.gov (United States)

    Libin, L Ia; Tagil'tseva, A V; Lifanova, D E; Ganzenko, M A; Gritsevskaia, T M; Ivanov, M B

    2014-01-01

    The study included 47 patients (23 men, 24 women) with ICD-10 diagnosis of attack-like paranoid schizophrenia. Patients were divided into two groups: with- (25 patients) or without (22 patients) a concomitant organic disease. Memory, attention and thinking were assessed with psychometric tests. Inter- and intra-group differences were identified that indicated a considerable impact of a concomitant CNS organic pathology on the development of cognitive impairment in the schizophrenic process and active antipsychotic therapy. The data obtained can be used in the development of a differentiated approach to the treatment of patients with concomitant organic pathology.

  20. Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Wen; Ningyu Wang; Jinfeng Liu; Zhanfeng Yan; Zhonghai Xin

    2012-01-01

    In this experiment, 97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups (mild, moderate, severe) according to minimum oxygen saturation, and 35 healthy subjects were examined as controls. Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment. The results revealed that as the disease worsened, the mismatch negativity latency was gradually extended, and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome. Importantly, mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation 60 seconds. Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores. These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montreal Cognitive Assessment scores. As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients, the sensitivity of mismatch negativity is 82.93%, the specificity is 73.33%, the accuracy rate is 81.52%, the positive predictive value is 85.00%, the negative predictive value is 70.21%, the positive likelihood ratio is 3, and the negative likelihood ratio is 0.23. These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.

  1. Cognitive Impairment Involving Social Cognition in SPG4 Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Ludivine Chamard

    2016-01-01

    Full Text Available Objectives. To describe cognitive assessment including social cognition in SPG4 patients. Methods. We reported a series of nine patients with SPG4 mutation with an extensive neuropsychological examination including social cognition assessment. Results. None of our patients presented with mental retardation or dementia. All presented with mild cognitive impairment with a high frequency of attention deficit (100%, executive disorders (89%, and social cognition impairment (78%. An asymptomatic patient for motor skills presented with the same cognitive profile. No correlation was found in this small sample between cognitive impairment and motor impairment, age at disease onset, or disease duration. Conclusions. SPG4 phenotypes share some cognitive features of frontotemporal lobar degeneration and amyotrophic lateral sclerosis. Cognitive disorders including executive disorders and social cognition impairment are frequent in SPG4 patients and might sometimes occur before motor disorders. Therefore, cognitive functions including social cognition should be systematically assessed in order to improve the clinical management of this population.

  2. Investigating medical decision-making capacity in patients with cognitive impairment using a protocol based on linguistic features.

    Science.gov (United States)

    Tallberg, Ing-Mari; Stormoen, Sara; Almkvist, Ove; Eriksdotter, Maria; Sundström, Erik

    2013-10-01

    A critical question is whether cognitively impaired patients have the competence for autonomous decisions regarding participation in clinical trials. The present study aimed to investigate medical decision-making capacity by use of a Swedish linguistic instrument for medical decision-making (LIMD) in hypothetical clinical trials in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Three comparable groups (age, education) participated in the study: AD (n = 20; MMSE: 24.1 ± 3.3) and MCI (n = 22; MMSE: 26.7 ± 2.4) patients and healthy controls (n = 37; MMSE: 29.1 ± 1.0). Medical decision-making capacity was operationalized as answers to questions regarding participation in three hypothetical clinical trials. Answers were scored regarding comprehension, evaluation and intelligibility of decisions, and a total LIMD score was used as the measure of medical decision-making ability. Groups differed significantly in LIMD with AD patients performing worst and MCI poorer than the control group. A strong association was found between all LIMD scores and diagnosis which supported the assertion that LIMD as it is designed is a one-dimensional instrument of medical decision-making capacity (MDMC). The results indicate that a fundamental communicative ability has an impact on the competence for autonomous decisions in cognitive impairment. © 2013 The Scandinavian Psychological Associations.

  3. [Platelet cytochrome c-oxidase and glutamine synthetase-like protein in patients with mild cognitive impairment].

    Science.gov (United States)

    Burbaeva, G Sh; Boksha, I S; Savushkina, O K; Turishcheva, M S; Tereshkina, E B; Starodubtseva, L I; Gavrilova, S I; Fedorova, Ia B; Zhuravin, I A

    2012-01-01

    The study aimed to develop pre-clinical diagnosis of Alzheimer's disease (AD) and - in future - preventive therapy in patients with mild cognitive impairment (MCI). The MCI group (n=44) and AD group (n=42, including 18 patients with soft dementia and 24 patients with mild dementia) were studied. The groups were matched for age (median 70 and 69 years for MCI and AD groups, respectively). The control group comprised 24 mentally healthy relatives of the patients. Correlations between the activity/amounts of platelet enzymes: cytochrome c-oxidase (COX), glutamine synthetase-like protein (GSLP) and the extent of cognitive impairment were studied. The COX activity in MCI and AD groups was significantly lower than in the control group (Kruskal-Wallis test p=0.0001, χ²=11.6, p=0.003). These tests showed significant differences in GSLP amount between three groups (p=0.04 and χ²=9.38, p=0.01, respectively). Significant reverse correlation (Spearman R= -0.43, p=0.007) was found between GSLP amount and MMSE scores for MCI+AD group, i.e., the lower MMSE scores, the higher platelet GSLP level. Platelet COX and GSLP may be considered as early markers of cognitive impairment.

  4. Positron emission tomography in at risk patients and in the progression of mild cognitive impairment to Alzheimer's disease

    DEFF Research Database (Denmark)

    Rinne, Juha O; Någren, Kjell

    2010-01-01

    Mild cognitive impairment (MCI) is considered a transitional state between the cognitive changes of normal aging and the earliest clinical features of Alzheimer's disease (AD). An important goal is to find features that predict which MCI patients will later convert to AD. Identification...... disorders. Dopamine transporter imaging to aid in the differential diagnosis between AD and dementia with Lewy bodies seems promising. Amyloid imaging is an example of "pathology specific" imaging that has great potential to enhance early detection of AD processes and to help in differential diagnosis...

  5. Autonomic Dysregulation, Cognitive Impairment, and Symptoms of Psychosis as an Unusual Presentation in an Anti-Aquaporin 4-Positive Patient

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    Annabel M. Ruiter

    2017-02-01

    Full Text Available We present the unusual case of a patient with an aquaporin 4 antibody-seropositive neuromyelitis optica spectrum disorder who presented with autonomic dysregulation, cognitive impairment, and symptoms of psychosis. Only a few previous cases have been described with similar psychiatric symptoms. Brain MRI showed an abnormal hyperintense T2 signal of the hypothalamus and, to a lesser extent, a minor hyperintense signal of the right optic nerve. Her symptoms and MR abnormalities improved after high-dose methylprednisolone.

  6. Autonomic Dysregulation, Cognitive Impairment, and Symptoms of Psychosis as an Unusual Presentation in an Anti-Aquaporin 4-Positive Patient

    Science.gov (United States)

    Ruiter, Annabel M.; Meilof, Jan F.; Somanje-Bolweg, Rosemarijn R.J.; van Gorsel, Erik; Kalkers, Nynke F.

    2017-01-01

    We present the unusual case of a patient with an aquaporin 4 antibody-seropositive neuromyelitis optica spectrum disorder who presented with autonomic dysregulation, cognitive impairment, and symptoms of psychosis. Only a few previous cases have been described with similar psychiatric symptoms. Brain MRI showed an abnormal hyperintense T2 signal of the hypothalamus and, to a lesser extent, a minor hyperintense signal of the right optic nerve. Her symptoms and MR abnormalities improved after high-dose methylprednisolone. PMID:28413400

  7. Changing pattern of agitated impaired mental status in patients with advanced cancer: association with cognitive monitoring, hydration, and opioid rotation.

    Science.gov (United States)

    Bruera, E; Franco, J J; Maltoni, M; Watanabe, S; Suarez-Almazor, M

    1995-05-01

    In late 1990, it became standard practice at the palliative care unit of the Edmonton General Hospital to regularly administer the Mini-Mental State Questionnaire (MMSQ) and to undertake opioid rotation and hydration upon detection of cognitive failure. We retrospectively reviewed the charts of 117 and 162 patients admitted in 1988-1989 and 1991-1992, respectively, to assess the impact of these maneuvers on the prevalence of agitated impaired mental status (IMS). All patients underwent regular cognitive assessment in 1991-1992 versus none in 1988-1989. Seventy-three percent of patients received hydration in the second period versus 32% in the first (P prescriptions per patient, P monitoring, opioid rotation, and hydration may reduce the incidence of agitated IMS in terminal cancer patients.

  8. Multidisciplinary rehabilitation program: effects of a multimodal intervention for patients with Alzheimer’s disease and cognitive impairment without dementia

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    Glenda Dias Santos

    2015-12-01

    Full Text Available Abstract Background Non-pharmalogical interventions represent an important complement to standard pharmalogical treatment in dementia. Objective This study aims to evaluate the effects of a multidisciplinary rehabilitation program on cognitive ability, quality of life and depression symptoms in patients with Alzheimer’s disease (AD and cognitive impairment without dementia (CIND. Methods Ninety-seven older adults were recruited to the present study. Of these, 70 patients had mild AD and were allocated into experimental (n = 54 or control (n = 16 groups. Two additional active comparison groups were constituted with patients with moderate AD (n = 13 or with CIND (n = 14 who also received the intervention. The multidisciplinary rehabilitation program lasted for 12 weeks and was composed by sessions of memory training, recreational activities, verbal expression and writing, physical therapy and physical training, delivered in two weekly 6-hour sessions. Results As compared to controls, mild AD patients who received the intervention had improvements in cognition (p = 0.021 and quality of life (p = 0.003, along with a reduction in depressive symptoms (p < 0.001. As compared to baseline, CIND patients displayed at the end of the intervention improvements in cognition (p = 0.005 and depressive symptoms (p = 0.011. No such benefits were found among patients with moderate AD.Discussion: This multidisciplinary rehabilitation program was beneficial for patients with mild AD and CIND. However, patients with moderate dementia did not benefit from the intervention.

  9. Profinteg: A Tool for Real-Life Assessment of Activities of Daily Living in Patients with Cognitive Impairment

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    Patrick Anselme

    2013-03-01

    Full Text Available Although there are many instruments for assessing activities of daily living (IADL in brain injured patients, few instruments specifically target cognitive impairment and its impact on IADL. The present study presents the development of the Profinteg instrument, a tool for real-life assessment as well as rehabilitation of IADL in patients with cognitive impairment. This two-stage instrument covers over 90 activities. Psychometric properties of the different Profinteg measures were explored in twenty-five patients with mild to severe cognitive difficulties and twenty-five caregivers. The feasibility of the Profinteg rehabilitation procedure was explored in three patients. Excellent interrater reliability ('r' > 0.90,' ''p' < 0.01 was observed for all measures. Good sensitivity to changes in IADL disability over time was also observed ('T' = 2.37, 'p' < 0.02. Significant improvement of IADL functioning was found after rehabilitation guided by Profinteg assessment. The Profinteg instrument detects with precision the difficulties patients encounter in their real-life setting via (1 assessment of a large number of activities and (2 detailed decomposition of activities into sub-activities. The Profinteg tool also provides promising results for guidance of IADL rehabilitation in the patient's real-life environment.

  10. Exercise-induced noradrenergic activation enhances memory consolidation in both normal aging and patients with amnestic mild cognitive impairment.

    Science.gov (United States)

    Segal, Sabrina K; Cotman, Carl W; Cahill, Lawrence F

    2012-01-01

    Post-trial pharmacological activation of the noradrenergic system can facilitate memory consolidation. Because exercise activates the locus coeruleus and increases brain norepinephrine release, we hypothesized that post-trial exercise could function as a natural stimulus to enhance memory consolidation. We investigated this in amnestic mild cognitive impairment (aMCI) and cognitively normal elderly individuals by examining the effects of an acute bout of post-learning, aerobic exercise (6 minutes at 70% VO2 max on a stationary bicycle) on memory for some emotional images. Exercise significantly elevated endogenous norepinephrine (measured via the biomarker, salivary alpha-amylase) in both aMCI patients and controls. Additionally, exercise retrogradely enhanced memory in both aMCI patients and controls. Acute exercise that activates the noradrenergic system may serve as a beneficial, natural, and practical therapeutic intervention for cognitive decline in the aging population.

  11. Cognitive and Learning Impairments

    Science.gov (United States)

    Lewis, Clayton

    People with cognitive disabilities are gaining in a long struggle for recognition of their right to control their lives. In the information society access to the Web is essential to this control. Cognitive barriers to this access are diverse, reflecting the complexity of human cognitive faculties. These barriers are not well managed in current accessibility practice and policy, in part because cognitive accessibility, like usability, cannot be reduced to a checklist of simple attributes. Advances in representing the meaning as well as the form of information, and in supporting configurable presentation and interaction methods, will yield progress. Increased inclusion of people with cognitive disabilities in the processes of technology development and policy making will also pay off.

  12. Cerebral perfusion (HMPAO-SPECT) in patients with depression with cognitive impairment versus those with mild cognitive impairment and dementia of Alzheimer's type: a semiquantitative and automated evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Staffen, W.; Bergmann, J.; Schoenauer, U.; Kronbichler, M.; Golaszewski, S.; Ladurner, G. [Paracelsus Medical University, Christian-Doppler-Clinic, Department of Neurology, and Center of Cognitive Research Salzburg, Salzburg (Austria); Zauner, H. [Rehabilitation Center of the Pensionsversicherungsanstalt, Grossgmain (Austria)

    2009-05-15

    Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimer's type (DAT) and depression with cognitive impairment (DCI). A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration. (orig.)

  13. Studies of Implicit Prototype Extraction in Patients with Mild Cognitive Impairment and Early Alzheimer's Disease

    Science.gov (United States)

    Nosofsky, Robert M.; Denton, Stephen E.; Zaki, Safa R.; Murphy-Knudsen, Anne F.; Unverzagt, Frederick W.

    2012-01-01

    Studies of incidental category learning support the hypothesis of an implicit prototype-extraction system that is distinct from explicit memory (Smith, 2008). In those studies, patients with explicit-memory impairments due to damage to the medial-temporal lobe performed normally in implicit categorization tasks (Bozoki, Grossman, & Smith, 2006;…

  14. Current therapy for cognitive impairments

    Directory of Open Access Journals (Sweden)

    Natalia Vasilyevna Vakhnina

    2011-01-01

    Full Text Available Cognitive impairments (CIs are a highly common type of neurological disorders particularly in elderly patients. Choice of a therapeutic strategy for CI is determined by the etiology of abnormalities and their degree. Measures to prevent CI progression and dementia: adequate treatment of existing cardiovascular diseases, prevention of stroke, balanced nutrition, moderate physical and intellectual exercises, and combatting overweight and low activity are of basic value in treating mild and moderate CIs. According to the data of a number of investigations, the above measures reduce the risk of dementia, including in the genetically predisposed. Pharmacotherapy for mild and moderate CIs generally comprises vasoactive, neurometabolic, and noradrenergic agents. The indication for the use of memantine and/or acetylcholinergic agents, i.e. basic therapy for the most common forms of dementia (Alzheimer's disease, Lewy body dementia, vascular, and mixed dementia, hepatic colics is severe CIs. The long-term use of memantine and/or acetylcholinergic agents alleviates the cognitive and behavioral symptoms of dementia, enhances self-dependence in patients, and prolongs their active lifetime.

  15. Multimodal Cognitive Enhancement Therapy for Patients with Mild Cognitive Impairment and Mild Dementia: A Multi- Center, Randomized, Controlled, Double-Blind, Crossover Trial.

    Science.gov (United States)

    Han, Ji Won; Lee, Hyeonggon; Hong, Jong Woo; Kim, Kayoung; Kim, Taehyun; Byun, Hye Jin; Ko, Ji Won; Youn, Jong Chul; Ryu, Seung-Ho; Lee, Nam-Jin; Pae, Chi-Un; Kim, Ki Woong

    2017-01-01

    We developed and evaluated the effect of Multimodal Cognitive Enhancement Therapy (MCET) consisting of cognitive training, cognitive stimulations, reality orientation, physical therapy, reminiscence therapy, and music therapy in combination in older people with mild cognitive impairment (MCI) or mild dementia. This study was a multi-center, double-blind, randomized, placebo-controlled, two-period cross-over study (two 8-week treatment phases separated by a 4-week wash-out period). Sixty-four participants with MCI or dementia whose Clinical Dementia Rating was 0.5 or 1 were randomized to the MCET group or the mock-therapy (placebo) group. Outcomes were measured at baseline, week 9, and week 21. Fifty-five patients completed the study. Mini-Mental State Examination (effect size = 0.47, p = 0.013) and Alzheimer's Disease Assessment Scale-Cognitive Subscale (effect size = 0.35, p = 0.045) scores were significantly improved in the MCET compared with mock-therapy group. Revised Memory and Behavior Problems Checklist frequency (effect size = 0.38, p = 0.046) and self-rated Quality of Life - Alzheimer's Disease (effect size = 0.39, p = 0.047) scores were significantly improved in the MCET compared with mock-therapy. MCET improved cognition, behavior, and quality of life in people with MCI or mild dementia more effectively than conventional cognitive enhancing activities did.

  16. Physicians' attitudes about artificial feeding in older patients with severe cognitive impairment in Japan: a qualitative study

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    Kai Ichiro

    2007-08-01

    Full Text Available Abstract Background The question of whether to withhold artificial nutrition and hydration (ANH from severely cognitively impaired older adults has remained nearly unexplored in Japan, where provision of ANH is considered standard care. The objective of this study was to identify and analyze factors related to the decision to provide ANH through percutaneous endoscopic gastrostomy (PEG in older Japanese adults with severe cognitive impairment. Methods Retrospective, in-depth interviews with thirty physicians experienced in the care of older, bed-ridden, non-communicative patients with severe cognitive impairment. Interview content included questions about factors influencing the decision to provide or withhold ANH, concerns and dilemmas concerning ANH and the choice of PEG feeding as an ANH method. The process of data collection and analysis followed the Grounded Theory approach. Results Data analysis identified five factors that influence Japanese physicians' decision to provide ANH through PEG tubes: (1 the national health insurance system that allows elderly patients to become long-term hospital in-patients; (2 legal barriers with regard to limiting treatment, including the risk of prosecution; (3 emotional barriers, especially abhorrence of death by 'starvation'; (4 cultural values that promote family-oriented end-of-life decision making; and (5 reimbursement-related factors involved in the choice of PEG. However, a small number of physicians did offer patients' families the option of withholding ANH. These physicians shared certain characteristics, such as a different perception of ANH and repeated communication with families concerning end-of-life care. These qualities were found to reduce some of the effects of the factors that favor provision of ANH. Conclusion The framework of Japan's medical-legal system unintentionally provides many physicians an incentive to routinely offer ANH for this patient group through PEG tubes. It seems

  17. Cognitive impairment in multiple sclerosis

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    Kutashov V.A.

    2016-06-01

    Full Text Available Aim: to identify the degree of cognitive impairment (CN and to optimize the treatment of patients with multiple sclerosis (MS. Material and methods. A total of 695 patients (278 men and 417 women were ranged from 18 to 63 years. The mean age was 30.2±0.7 years: women (417 28.5±0.5 years, while for men (278 31.8±0.7 years. Relaps-ing-remitting type (RT of MS was established in 520 patients (74.8%, secondary progressive type (VPT MS in 132 patients (18.9% and primary progressive type (PPT MS in 10 patients (1.5%. Clinically isolated syndrome (CIS was detected in 33 patients (4.8%. The diagnosis of MS 662 patients according to the criteria McDonald etal. (2005. Score of neurologic deficit was carried out on an extended scale of disability (Expanded Disability Status Scale — EDSS. CN were evaluated by conventional tests. To estimate the orientation in time, assessment of short-term and long-term memory, attention and concentration, as well as executive functions, memory, language, evaluation of optical-spatial activities, conceptual thinking, the account used by the Montreal Cognitive Assessment Scale (MoCA. For the screening of dementia with a primary lesion of the frontal lobes and subcortical cerebral structures used battery frontal test to assess frontal dysfunction. Results. The ratio of male (265 and female (397 was 1:1.5. The severity of the condition patients EDSS scale ranged from 1.5 to 8.0 points, and the average score was 3.5±1.2. In the group of patients with RT RS average score EDSS was more than a half (2.5±1.1, than in the group of patients with MS VAC (5.5±1.2 and POS PC (6.5±1.2. In the study of history, it was found that the development of the RS (662 patients was preceded by the following conditions: a viral infection in 277 patients (41.84%; fatigue in 147 patients (22.21%; transferred psycho-emotional load from 218 (32.93%; after pregnancy and childbirth in 20 patients (3.02%. Conclusion. Among the patients with MS

  18. Effects of propofol versus sevoflurane on cerebral oxygenation and cognitive outcome in patients with impaired cerebral oxygenation

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    Guo JY

    2016-01-01

    Full Text Available Jun-ying Guo,1,* Jie-yu Fang,1,* San-rong Xu,2 Ming Wei,1 Wen-qi Huang1 1Department of Anesthesia, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 2Department of Anesthesia, Zhangzhou Municipal Hospital of Fujian Province, Zhangzhou, Fujian, People’s Republic of China *These authors contributed equally to this work Background: Postoperative neurocognitive dysfunction induced by anesthetics, particularly in elderly patients with impaired oxygenation, is a common complication of surgery and is eliciting increased interest in clinical practice. To investigate the effects of anesthetics on neurocognition, we compared the effects of propofol versus sevoflurane on cerebral oxygenation and cognitive outcome in patients with impaired cerebral oxygenation undergoing general anesthesia. Methods: Sixty-three patients with impaired cerebral oxygenation (jugular venous bulb oxygen saturation [SjvO2] <50% or cerebral blood flow/cerebral metabolic rate of oxygen ([CBF/CMRO2] ≤15% undergoing elective abdominal surgery were randomly allocated into propofol group (group P or sevoflurane group (group S. The clinical parameters and jugular venous bulb blood gas analysis were monitored throughout the surgical procedure. Cognitive function was assessed with the mini-mental state examination and Montreal Cognitive Assessment at day 1 and day 7 following surgery. S100β protein in plasma was measured using enzyme-linked immunosorbent assay. Results: The SjvO2 increased during anesthesia induction and surgery when compared to baseline but had no significant difference between group P and group S. When compared to baseline, the CBF/CMRO2 was increased only at the end of surgery and extubation in group P; however, the CBF/CMRO2 in group S was increased during anesthesia induction at 1 hour, 2 hours, end of surgery, and extubation. Furthermore, the CBF/CMRO2 in group S was significantly higher than that in group P during anesthesia

  19. Computed tomography perfusion imaging may predict cognitive impairment in patients with first-time anterior circulation transient ischemic attack.

    Science.gov (United States)

    Wang, Jun; Li, Yunming; Zheng, Bo; Wang, Jian; Wang, Zhiqiang; Duan, Dan; Li, Yuxia; Wang, Qingsong

    2016-04-01

    To determine whether computed tomography perfusion imaging (CTPI)-derived parameters are associated with vascular cognitive impairment (VCI) in patients with transient ischemic attack (TIA). Patients with first-time anterior circulation TIA (diagnosed within 24 h of onset) and normal cognition, treated between August 2009 and August 2014 at the Department of Neurology of Chengdu Military General Hospital, China, were analyzed retrospectively. Patients underwent whole-brain CTPI within 1 week of TIA to detect cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) in the ischemic region. Based on cognitive function assessment 4 weeks after TIA, using the Montreal cognitive assessment (MoCA) and mini mental state examination, the patients were divided into control and VCI groups. CTPI parameters and other clinical data were compared between groups, and Spearman's correlation analysis used to identify associations between cognitive scores and CTPI parameters in the VCI group. 50 patients (25 per group; aged 55-72 years) were included. Patient age, gender, smoking status, alcohol consumption, educational level, time from TIA onset to admission, time from TIA onset to CTPI, and prevalence of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation and hyperhomocysteinemia did not differ between groups. Both groups showed TTP and MTT prolongation, CBF reduction, but no change in CBV in the ischemic region; these changes were significantly larger in the VCI group (P < 0.05). MTT correlated negatively with MoCA score (r = -0.51, P = 0.009). CTPI could facilitate early diagnosis of VCI in patients with anterior circulation TIA.

  20. Parkinson’s Disease and Cognitive Impairment

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    Yang Yang

    2016-01-01

    Full Text Available Parkinson’s disease (PD is a progressive neurodegenerative disease primarily characterized by the hallmarks of motor symptoms, such as tremor, bradykinesia, rigidity, and postural instability. However, through clinical investigations in patients and experimental findings in animal models of Parkinson’s disease for years, it is now well recognized that Parkinson’s disease is more than just a motor-deficit disorder. The majority of Parkinson’s disease patients suffer from nonmotor disabilities, for instance, cognitive impairment, autonomic dysfunction, sensory dysfunction, and sleep disorder. So far, anti-PD prescriptions and surgical treatments have been mainly focusing on motor dysfunctions, leaving cognitive impairment a marginal clinical field. Within the nonmotor symptoms, cognitive impairment is one of the most common and significant aspects of Parkinson’s disease, and cognitive deficits such as dysexecutive syndrome and visuospatial disturbances could seriously affect the quality of life, reduce life expectancy, prolong the duration of hospitalization, and therefore increase burdens of caregiver and medical costs. In this review, we have done a retrospective study of the recent related researches on epidemiology, clinical manifestation and diagnosis, genetics, and potential treatment of cognitive deficits in Parkinson’s disease, aiming to provide a summary of cognitive impairment in Parkinson’s disease and make it easy for clinicians to tackle this challenging issue in their future practice.

  1. Cued recall measure predicts the progression of gray matter atrophy in patients with amnesic mild cognitive impairment.

    Science.gov (United States)

    Koric, Lejla; Ranjeva, Jean-Philippe; Felician, Olivier; Guye, Maxime; de Anna, Francesca; Soulier, Elisabeth; Didic, Mira; Ceccaldi, Mathieu

    2013-01-01

    Amnesic mild cognitive impairment (aMCI) is a heterogeneous syndrome that could be subdivided into distinct neuropsychological variants. To investigate relationships between the neuropsychological profile of memory impairment at baseline and the neuroimaging pattern of grey matter (GM) loss over 18 months, we performed a prospective volumetric brain study on 31 aMCI patients and 29 matched controls. All subjects were tested at baseline using a standardized neuropsychological battery, which included the Free and Cued Selective Recall Reminding Test (FCSRT) for the assessment of verbal declarative memory. Over 18 months, patients with impaired free recall but normal total recall (high index of cueing) on the FCSRT developed subcortical and frontal GM loss, while patients with impaired free and total recall (low index of cueing) developed GM atrophy within the left anterior and lateral temporal lobe. In summary, cued recall deficits are associated with a progression of atrophy that closely parallels the spatiotemporal distribution of neurofibrillary degeneration in early Alzheimer's disease (AD), indicating possible AD pathological changes.

  2. Reversible brain atrophy and cognitive impairment in an adolescent Japanese patient with primary adrenal Cushing’s syndrome

    Directory of Open Access Journals (Sweden)

    Ohara N

    2014-09-01

    Full Text Available Nobumasa Ohara,1 Hiroshi Suzuki,1 Akiko Suzuki,1 Masanori Kaneko,1 Masahiro Ishizawa,1 Kazuo Furukawa,1 Takahiro Abe,1 Yasuhiro Matsubayashi,1 Takaho Yamada,1 Osamu Hanyu,1 Takayoshi Shimohata,2 Hirohito Sone1 1Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan; 2Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan Abstract: Endogenous Cushing’s syndrome is an endocrine disease resulting from chronic exposure to excessive glucocorticoids produced in the adrenal cortex. Although the ultimate outcome remains uncertain, functional and morphological brain changes are not uncommon in patients with this syndrome, and generally persist even after resolution of hypercortisolemia. We present an adolescent patient with Cushing’s syndrome who exhibited cognitive impairment with brain atrophy. A 19-year-old Japanese male visited a local hospital following 5 days of behavioral abnormalities, such as money wasting or nighttime wandering. He had hypertension and a 1-year history of a rounded face. Magnetic resonance imaging (MRI revealed apparently diffuse brain atrophy. Because of high random plasma cortisol levels (28.7 µg/dL at 10 AM, he was referred to our hospital in August 2011. Endocrinological testing showed adrenocorticotropic hormone-independent hypercortisolemia, and abdominal computed tomography demonstrated a 2.7 cm tumor in the left adrenal gland. The patient underwent left adrenalectomy in September 2011, and the diagnosis of cortisol-secreting adenoma was confirmed histologically. His hypertension and Cushingoid features regressed. Behavioral abnormalities were no longer observed, and he was classified as cured of his cognitive disturbance caused by Cushing’s syndrome in February 2012. MRI performed 8 months after surgery revealed reversal of brain atrophy, and his subsequent course has been uneventful. In summary, the young age at onset and the

  3. BrainAGE in Mild Cognitive Impaired Patients: Predicting the Conversion to Alzheimer's Disease.

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    Christian Gaser

    Full Text Available Alzheimer's disease (AD, the most common form of dementia, shares many aspects of abnormal brain aging. We present a novel magnetic resonance imaging (MRI-based biomarker that predicts the individual progression of mild cognitive impairment (MCI to AD on the basis of pathological brain aging patterns. By employing kernel regression methods, the expression of normal brain-aging patterns forms the basis to estimate the brain age of a given new subject. If the estimated age is higher than the chronological age, a positive brain age gap estimation (BrainAGE score indicates accelerated atrophy and is considered a risk factor for conversion to AD. Here, the BrainAGE framework was applied to predict the individual brain ages of 195 subjects with MCI at baseline, of which a total of 133 developed AD during 36 months of follow-up (corresponding to a pre-test probability of 68%. The ability of the BrainAGE framework to correctly identify MCI-converters was compared with the performance of commonly used cognitive scales, hippocampus volume, and state-of-the-art biomarkers derived from cerebrospinal fluid (CSF. With accuracy rates of up to 81%, BrainAGE outperformed all cognitive scales and CSF biomarkers in predicting conversion of MCI to AD within 3 years of follow-up. Each additional year in the BrainAGE score was associated with a 10% greater risk of developing AD (hazard rate: 1.10 [CI: 1.07-1.13]. Furthermore, the post-test probability was increased to 90% when using baseline BrainAGE scores to predict conversion to AD. The presented framework allows an accurate prediction even with multicenter data. Its fast and fully automated nature facilitates the integration into the clinical workflow. It can be exploited as a tool for screening as well as for monitoring treatment options.

  4. Voxel-based analysis of diffusion tensor imaging in patients with subcortical vascular cognitive impairment: correlates with cognitive and motor deficits.

    Science.gov (United States)

    Kim, Sook Hui; Park, Jun Sung; Ahn, Hyun-Jung; Seo, Sang Won; Lee, Jong-Min; Kim, Sung Tae; Han, Seol-Heui; Na, Duk L

    2011-10-01

    Patients with small vessel disease show high-signal intensity on T2-weighted magnetic resonance (MR) images that represent ischemic cell damage. However, despite a similar degree of ischemic change, the amount and the severity of clinical presentations may vary. We investigated the clinical correlations of ischemic changes using voxel-based morphometric analyses of diffusion tensor imaging (DTI). Twenty-seven MCI and 34 dementia patients were included who all had significant small vessel disease on magnetic resonance imaging (MRI). In all patients, neuropsychological tests, a rating on the Pyramidal and Extrapyramidal scale (PEPS) for motor deficits, and 3-Tesla MRI including DTI scans were performed. Voxel-based analysis of the fractional anisotropy and mean diffusivity maps were computed. Cognitive scores correlated with the DTI abnormalities in supratentorial areas with regional specificity according to each cognitive test. Unexpectedly, cognitive deficits in most neuropsychological tests, even in some frontal tasks, were associated with disruption of posterior white matter integrities. Motor deficits correlated with both supra- and infratentorial lesions. Our findings suggest that in patients with small vessel disease who show cognitive and motor impairments, a specific distribution of fiber tract damage is more related with clinical deficits than is the severity of the total ischemia. © 2010 by the American Society of Neuroimaging.

  5. Cognitive impairment in relapsing remitting Multiple Sclerosis

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    Saška Roškar

    2003-06-01

    Full Text Available The purpose of the study was to identify changes in cognitive abilities that affect patients with relapsing remitting form of multiple sclerosis (MS and to find out which instrument manifests them best. The performance of MS patients was compared to a matched group of healthy people using three neuropsychological tests: Wisconsin card sorting test (WCST, Stroop color and word test and Trail making test (TMT part B. Results on all three tests indicate general cognitive impairments in the group of patients. Compared to the group of healthy people patients with MS exhibited impaired ability of abstract reasoning (WCST, impaired cognitive flexibility and less resistance to irrelevant stimuli (Stroop color and word test, slowed information processing and impaired ability of shifting attention from one symbol to another (TMT. The largest differences between groups occured in Stroop color and word test as well as in TMT. The estimation of cognitive abilities of MS patients is of high importance and sistematicaly observing of changes in those abilities should be considered.

  6. Diabetes mellitus and cognitive impairments

    Institute of Scientific and Technical Information of China (English)

    Elham; Saedi[1; Mohammad; Reza; Gheini[2; Firoozeh; Faiz[3; Mohammad; Ali; Arami[4

    2016-01-01

    There is strong evidence that diabetes mellitus increases the risk of cognitive impairment and dementia. Insulin signaling dysregulation and small vessel disease in the base of diabetes may be important contributing factors in Alzheimer’s disease and vascular dementia pathogenesis, respectively. Optimal glycemic control in type 1 diabetes and identification of diabetic risk factors and prophylactic approach in type 2 diabetes are very important in the prevention of cognitive complications.In addition, hypoglycemic attacks in children and elderly should be avoided. Anti-diabetic medications especially Insulin may have a role in the management of cognitive dysfunction and dementia but further investigation is needed to validate these findings.

  7. Diabetes mellitus and cognitive impairments

    Science.gov (United States)

    Saedi, Elham; Gheini, Mohammad Reza; Faiz, Firoozeh; Arami, Mohammad Ali

    2016-01-01

    There is strong evidence that diabetes mellitus increases the risk of cognitive impairment and dementia. Insulin signaling dysregulation and small vessel disease in the base of diabetes may be important contributing factors in Alzheimer’s disease and vascular dementia pathogenesis, respectively. Optimal glycemic control in type 1 diabetes and identification of diabetic risk factors and prophylactic approach in type 2 diabetes are very important in the prevention of cognitive complications. In addition, hypoglycemic attacks in children and elderly should be avoided. Anti-diabetic medications especially Insulin may have a role in the management of cognitive dysfunction and dementia but further investigation is needed to validate these findings. PMID:27660698

  8. Cognitive impairment is correlated with reduced quality of life in patients with clinically isolated syndrome

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    Carolina Fiorin Anhoque

    Full Text Available OBJECTIVE: To evaluate the quality of life (QoL and potential QoL determinants in patients with clinically isolated syndrome (CIS. METHODS: Eighteen CIS patients and eighteen controls were submitted to QoL evaluation with Functional Assessment of Multiple Sclerosis QoL instrument (FAMS. Cognition was evaluated with specific battery tests; Anxiety and depression with Beck Anxiety (BAI and Depression (BDI Inventories and Neurological disability with Guy's Neurological Disability Scale (GNDS. RESULTS: There was a significant difference in QoL between CIS patients and controls. CIS patients had worse performance in Paced Auditory Serial Addition 2 seconds (p=0.009 and fluency tests (p=0.0038. There was a significant difference in BAI (p=0.003, but no significant difference in BDI between patients and controls. There were significant correlations between QoL measure and verbal fluency and Stroop's test. CONCLUSIONS: Cognition, but not anxiety, depression and disability, was associated with reduced quality of life.

  9. Sexual Behavior Among Persons With Cognitive Impairments.

    Science.gov (United States)

    Thom, Robyn P; Grudzinskas, Albert J; Saleh, Fabian M

    2017-05-01

    Although the cognitively impaired are frequently included in heterogeneous studies of problematic sexual behavior, the epidemiology, etiology, and approach to assessment and treatment of persons with dementia and intellectual disability are distinct from those of the general population. The incidence of inappropriate sexual behavior among the intellectually disabled is 15-33%; however, the nature tends to be more socially inappropriate than with violative intent. Limited sociosexual education is a large contributor, and better addressing this area offers a target for prevention and treatment. A thorough clinical assessment of problematic sexual behaviors in the cognitively impaired requires understanding the patient's internal experience, which can be challenging. Assessment tools validated for the general population have not been validated for this population. Very few studies have assessed treatment approaches specifically among the cognitively impaired; however, research does suggest utility in habilitative, psychotherapeutic, and pharmacologic approaches which have been validated among the general population.

  10. Common variants in MAGI2 gene are associated with increased risk for cognitive impairment in schizophrenic patients.

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    Takayoshi Koide

    Full Text Available Schizophrenia is a complex psychiatric disorder characterized by positive symptoms, negative symptoms, and cognitive impairment. MAGI2, a relatively large gene (∼1.5 Mbps that maps to chromosome 7q21, is involved in recruitment of neurotransmitter receptors such as AMPA- and NMDA-type glutamate receptors. A genetic association study designed to evaluate the association between MAGI2 and cognitive performance or schizophrenia has not been conducted. In this case-control study, we examined the relationship of single nucleotide polymorphism (SNP variations in MAGI2 and risk for schizophrenia in a large Japanese sample and explored the potential relationships between variations in MAGI2 and aspects of human cognitive function related to glutamate activity. Based on the result of first schizophrenia genome-wide association study in a Japanese population (JGWAS, we selected four independent SNPs and performed an association study using a large independent Japanese sample set (cases 1624, controls 1621. Wisconsin Card Sorting Test (WCST was used to evaluate executive function in 114 cases and 91 controls. We found suggestive evidence for genetic association of common SNPs within MAGI2 locus and schizophrenia in Japanese population. Furthermore in terms of association between MAGI2 and cognitive performance, we observed that genotype effect of rs2190665 on WCST score was significant (p = 0.034 and rs4729938 trended toward significance (p = 0.08. In conclusion, although we could not detect strong genetic evidence for association of common variants in MAGI2 and increased schizophrenia risk in a Japanese population, these SNPs may increase risk of cognitive impairment in schizophrenic patients.

  11. Adjunctive treatment for cognitive impairment in patients with chronic schizophrenia: a double-blind, placebo-controlled study

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    Zhu W

    2014-07-01

    Full Text Available Weiwei Zhu,1,2,* Zhanchou Zhang,1,* Jingfeng Qi,1 Fang Liu,3 Jindong Chen,1,4,5 Jingping Zhao,1,4,5 Xiaofeng Guo1,4,5 1Institute of Mental Health, Second Xiangya Hospital, Central South University, 2Brain Hospital of Hunan Province, Changsha, 3First Affiliated Hospital of Kunming Medical University, Kunming, 4National Technology Institute of Psychiatry, 5Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, People’s Republic of China *These authors contributed equally to this work Abstract: Cognitive impairment is closely related to real-life functioning in patients with schizophrenia. The aim of the present study was to evaluate the effects of adjunctive treatment with donepezil on cognition in patients with chronic schizophrenia. This was a 12-week, double-blind, randomized, placebo-controlled study of donepezil as an adjunct to antipsychotic drug therapy in patients with chronic stable schizophrenia. Sixty-one subjects were randomized to receive donepezil 5 mg/day (n=31 and/or placebo (n=30. A nine-test neuropsychological assessment battery was administered at baseline and at the end of the study. At the 12-week end point, the donepezil group showed significant improvements in the Wechsler Memory Scale Third Edition Spatial Span, Brief Visuospatial Memory Test total recall and delayed recall, Trail-Making Test Part A, and Category Fluency Test-animal naming (all P≤0.018. Compared with placebo, donepezil was associated with significant improvement in several cognitive domains, including working memory, speed of information processing, and visual learning and memory (P≤0.008. The results of the present study suggest that adjunctive use of donepezil is beneficial for improving cognitive function in patients with schizophrenia. Keywords: schizophrenia, cognitive function, donepezil

  12. Persistent cognitive impairment after transient ischemic attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.; Duijnhoven, D.A. van; Leeuw, F.E. de; Kessels, R.P.; Dijk, E.J. van

    2014-01-01

    BACKGROUND AND PURPOSE: By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whe

  13. Persistent Cognitive Impairment After Transient Ischemic Attack

    NARCIS (Netherlands)

    Rooij, F.G. van; Schaapsmeerders, P.; Maaijwee, N.A.M.M.; Duijnhoven, D.A. van; de Leeuw, F.E.; Kessels, R.P.C.; Dijk, E.J. van

    2014-01-01

    Background and Purpose—By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whet

  14. Explicit (semantic) memory for music in patients with mild cognitive impairment and early-stage Alzheimer's disease.

    Science.gov (United States)

    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

    2013-01-01

    BACKGROUND/STUDY CONTEXT: Explicit memory for music was investigated by using a new test with 24 existing and 3 newly composed pieces. Ten patients with mild cognitive impairment (MCI) and 10 patients with early stage of Alzheimer's disease (AD) were compared with 23 healthy subjects, in terms of verbal memory of music by the identification of familiar music excerpts and the discrimination of distortion and original timbre of musical excerpts. MCI and Alzheimer's patients showed significantly poorer performances in tasks requiring verbal memory of musical excerpts than the healthy participants. For discrimination of musical excerpts, MCI and AD patients surprisingly performed significantly better than the healthy comparison subjects. Our results support the notion of a specialized memory system for music.

  15. [Functional impairment associated with cognitive impairment in hospitalised elderly].

    Science.gov (United States)

    Ocampo-Chaparro, José Mauricio; Mosquera-Jiménez, José Ignacio; Davis, Annabelle S; Reyes-Ortiz, Carlos A

    2017-06-24

    The aim of this study was to analyse the effect of cognitive impairment on functional decline in hospitalised patients aged ≥60 years. Measurements at admission included demographic data, Charlson's comorbidity index, and cognitive impairment (according to education level). Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge. Patients with BI≤75 at admission (n=54) or with a missing BI value were excluded (n=1). Multivariate logistic regression analyses were conducted to explore predictive factors with functional decline (BI≤75) from admission to discharge, and 1-month later. Of the 133 patients included, 24.8% and 19.6% had a BI≤75 at discharge and at 1-month, respectively. Compared with men, women had more than double risk for functional decline at discharge and 1-month (P<.05). Compared with those without delirium and without cognitive impairment, those with delirium and cognitive impairment had an increased risk for functional decline (BI≤75) at discharge (OR 5.15, 95% CI; 1.94-13.67), and at 1-month (OR 6.26, 95% CI; 2.30-17.03). Similarly, those with comorbidity (≥2) had increased functional decline at discharge (OR 2.36, 95% CI; 1.14-4.87), and at 1-month after discharge (OR 2.71, 95% CI; 1.25-5.89). Delirium during hospitalisation, together with cognitive impairment on admission, was a strong predictor of functional decline. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Polypharmacy Cutoff for Gait and Cognitive Impairments

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    Antoine Langeard

    2016-08-01

    Full Text Available BACKGROUND: Polypharmacy is a well-established risk factor for falls, and these are one of the major health problems that affect the quality of life as people age. However, the risk of mobility and cognitive impairments consecutive to polypharmacy has been little addressed, despite the association between these adverse outcomes and falls. Moreover, the rare polypharmacy cut-offs were all but one arbitrarily determined. OBJECTIVE: Studying relationships between polypharmacy and both mobility and cognitive impairments, and statistically determining a cut-off point in the number of drugs beyond which polypharmacy has deleterious consequences with respect to mobility and cognitive impairment. METHODS: We enrolled 113 community-dwelling adults aged 55 years and older with a fall history, with or without injury, in the previous year. We carefully collected information about daily medications taken. We assessed basic mobility and global cognition with the Time-Up-and-Go and the Montreal Cognitive Assessment (MoCA test, respectively. (clinicaltrials.gov NCT02292316RESULTS: TUG and MoCA scores were both significantly correlated with the number of medications used. ROC curves indicate, with high prediction (p<0.002, that daily consumption of five or more medications is associated with risk for both impaired mobility and global cognition. These relationships were independent of the number of comorbidities and of the pharmacological class. CONCLUSION: Community-dwelling adults aged 55 years and older who take five or more daily drugs are at high risk for both mobility and cognitive impairments. Physicians and patients should be aware of these new findings, especially when there are multiple prescribers involved in the care of the patient.

  17. Neural Mechanism of Cognitive Control Impairment in Patients with Hepatic Cirrhosis: A Functional Magnetic Resonance Imaging Study

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    Long Jiang Zhang; Guifen Yang; Jianzhong Yin; Yawu Liu; Ji Qi [Dept. of Radiology, Tianjin First Central Hospital of Tianjin Medical Univ, Tianjin (China)

    2007-07-15

    Background: Many studies have claimed the existence of attention alterations in cirrhotic patients without overt hepatic encephalopathy (HE). No functional magnetic resonance imaging (fMRI) study in this respect has been published. Purpose: To investigate the neural basis of cognitive control deficiency in cirrhotic patients using fMRI. Material and Methods: 14 patients with hepatic cirrhosis and 14 healthy volunteers were included in the study. A modified Stroop task with Chinese characters was used as the target stimulus, and block-design fMRI was used to acquire resource data, including four stimulus blocks and five control blocks, each presented alternatively. Image analysis was performed using statistical parametric mapping 99. After fMRI examinations were complete, behavior tests of Stroop interference were performed for all subjects. Overall reaction time and error numbers were recorded. Results: Both healthy volunteers and patients with hepatic cirrhosis had Stroop interference effects. Patients with hepatic cirrhosis had more errors and longer reaction time in performing an incongruous color-naming task than healthy volunteers (P<0.001); there was no significant difference in performing an incongruous word-reading task (P 0.066). Compared with controls, patients with hepatic cirrhosis had greater activation of the bilateral prefrontal cortex and parietal cortex when performing the incongruous word-reading task. With increased conflict, activation of the anterior cingulate cortex (ACC), bilateral prefrontal cortex (PFC), parietal lobe, and temporal fusiform gyrus (TFG) was decreased when patients with hepatic cirrhosis performed the incongruous color-naming task. Conclusion: This study demonstrates that patients with hepatic cirrhostic have cognitive control deficiency. The abnormal brain network of the ACC-PFC-parietal lobe-TFG is the neural basis of cognitive control impairment in cirrhotic patients.

  18. Neural Mechanism of Cognitive Control Impairment in Patients with Hepatic Cirrhosis: A Functional Magnetic Resonance Imaging Study

    Energy Technology Data Exchange (ETDEWEB)

    Long Jiang Zhang; Guifen Yang; Jianzhong Yin; Yawu Liu; Ji Qi [Dept. of Radiology, Tianjin First Central Hospital of Tianjin Medical Univ, Tianjin (China)

    2007-07-15

    Background: Many studies have claimed the existence of attention alterations in cirrhotic patients without overt hepatic encephalopathy (HE). No functional magnetic resonance imaging (fMRI) study in this respect has been published. Purpose: To investigate the neural basis of cognitive control deficiency in cirrhotic patients using fMRI. Material and Methods: 14 patients with hepatic cirrhosis and 14 healthy volunteers were included in the study. A modified Stroop task with Chinese characters was used as the target stimulus, and block-design fMRI was used to acquire resource data, including four stimulus blocks and five control blocks, each presented alternatively. Image analysis was performed using statistical parametric mapping 99. After fMRI examinations were complete, behavior tests of Stroop interference were performed for all subjects. Overall reaction time and error numbers were recorded. Results: Both healthy volunteers and patients with hepatic cirrhosis had Stroop interference effects. Patients with hepatic cirrhosis had more errors and longer reaction time in performing an incongruous color-naming task than healthy volunteers (P<0.001); there was no significant difference in performing an incongruous word-reading task (P 0.066). Compared with controls, patients with hepatic cirrhosis had greater activation of the bilateral prefrontal cortex and parietal cortex when performing the incongruous word-reading task. With increased conflict, activation of the anterior cingulate cortex (ACC), bilateral prefrontal cortex (PFC), parietal lobe, and temporal fusiform gyrus (TFG) was decreased when patients with hepatic cirrhosis performed the incongruous color-naming task. Conclusion: This study demonstrates that patients with hepatic cirrhostic have cognitive control deficiency. The abnormal brain network of the ACC-PFC-parietal lobe-TFG is the neural basis of cognitive control impairment in cirrhotic patients.

  19. Depressive Symptoms are the Main Predictor for Subjective Sleep Quality in Patients with Mild Cognitive Impairment--A Controlled Study.

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    Stefan Seidel

    Full Text Available Controlled data on predictors of subjective sleep quality in patients with memory complaints are sparse. To improve the amount of comprehensive data on this topic, we assessed factors associated with subjective sleep quality in patients from our memory clinic and healthy individuals.Between February 2012 and August 2014 patients with mild cognitive impairment (MCI and subjective cognitive decline (SCD from our memory clinic and healthy controls were recruited. Apart from a detailed neuropsychological assessment, the subjective sleep quality, daytime sleepiness and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI, the Epworth Sleepiness Scale (ESS and the Beck Depression Inventory (BDI-II.One hundred fifty eight consecutive patients (132 (84% MCI patients and 26 (16% SCD patients and 75 healthy controls were included in the study. Pairwise comparison of PSQI scores showed that non-amnestic MCI (naMCI patients (5.4 ± 3.5 had significantly higher PSQI scores than controls (4.3 ± 2.8, p = .003 Pairwise comparison of PSQI subscores showed that naMCI patients (1.1 ± 0.4 had significantly more "sleep disturbances" than controls (0.9 ± 0.5, p = .003. Amnestic MCI (aMCI (0.8 ± 1.2, p = .006 and naMCI patients (0.7 ± 1.2, p = .002 used "sleep medication" significantly more often than controls (0.1 ± 0.6 Both, aMCI (11.5 ± 8.6, p < .001 and naMCI (11.5 ± 8.6, p < .001 patients showed significantly higher BDI-II scores than healthy controls (6.1 ± 5.3. Linear regression analysis showed that the subjective sleep quality was predicted by depressive symptoms in aMCI (p < .0001 and naMCI (p < .0001 patients as well as controls (p < .0001. This means, that more depressive symptoms worsened subjective sleep quality. In aMCI patients we also found a significant interaction between depressive symptoms and global cognitive function (p = .002.Depressive symptoms were the main predictor of subjective sleep quality in MCI

  20. Different patterns of white matter degeneration using multiple diffusion indices and volumetric data in mild cognitive impairment and Alzheimer patients.

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    Gilberto Sousa Alves

    Full Text Available Alzheimeŕs disease (AD represents the most prevalent neurodegenerative disorder that causes cognitive decline in old age. In its early stages, AD is associated with microstructural abnormalities in white matter (WM. In the current study, multiple indices of diffusion tensor imaging (DTI and brain volumetric measurements were employed to comprehensively investigate the landscape of AD pathology. The sample comprised 58 individuals including cognitively normal subjects (controls, amnestic mild cognitive impairment (MCI and AD patients. Relative to controls, both MCI and AD subjects showed widespread changes of anisotropic fraction (FA in the corpus callosum, cingulate and uncinate fasciculus. Mean diffusivity and radial changes were also observed in AD patients in comparison with controls. After controlling for the gray matter atrophy the number of regions of significantly lower FA in AD patients relative to controls was decreased; nonetheless, unique areas of microstructural damage remained, e.g., the corpus callosum and uncinate fasciculus. Despite sample size limitations, the current results suggest that a combination of secondary and primary degeneration occurrs in MCI and AD, although the secondary degeneration appears to have a more critical role during the stages of disease involving dementia.

  1. Altered Recruitment of the Attention Network Is Associated with Disability and Cognitive Impairment in Pediatric Patients with Acquired Brain Injury

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    Sandra Strazzer

    2015-01-01

    Full Text Available We assessed abnormalities of brain functional magnetic resonance imaging (fMRI activity during a sustained attention task (Conners’ Continuous Performance Test (CCPT in 20 right-handed pediatric acquired brain injury (ABI patients versus 7 right-handed age-matched healthy controls, and we estimated the correlation of such abnormalities with clinical and cognitive deficits. Patients underwent the Wechsler Intelligence Scale for Children (WISC, Wisconsin Card Sorting Test, and Functional Independence Measure (FIM evaluations. During fMRI, patients and controls activated regions of the attention network. Compared to controls, ABI patients experienced a decreased average fMRI recruitment of the left cerebellum and a decreased deactivation of the left anterior cingulate cortex. With increasing task demand, compared to controls, ABI patients had an impaired ability to increase the recruitment of several posterior regions of the attention network. They also experienced a greater activation of frontal regions, which was correlated with worse performance on FIM, WISC, and fMRI CCPT. Such abnormal brain recruitment was significantly influenced by the type of lesion (focal versus diffuse axonal injury and time elapsed from the event. Pediatric ABI patients experienced an inability to optimize attention network recruitment, especially when task difficulty was increased, which likely contributes to their clinical and cognitive deficits.

  2. Just lying there, remembering: improving recall of prose in amnesic patients with mild cognitive impairment by minimising interference.

    Science.gov (United States)

    Della Sala, Sergio; Cowan, Nelson; Beschin, Nicoletta; Perini, Michele

    2005-01-01

    The hallmark of amnesia is poor explicit long-term memory along with normal short-term memory. It is often stated that information encountered by amnesic patients is forgotten within 1 minute of presentation. However, previous work has not distinguished between forgetting as a function of time versus the interfering material occupying that time. We show that there is a marked benefit of reduced interference in amnesic patients with mild cognitive impairment (MCI), a condition that is characterised by anterograde amnesia in the absence of other neuropsychological deficits and carries an increased risk for Alzheimer's disease. The result suggests that long-term memory is encoded in these patients to a greater extent than had been realised but that their memory is highly vulnerable to interference.

  3. Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment?

    Science.gov (United States)

    Debruyne, Hans; Van Buggenhout, Michael; Le Bastard, Nathalie; Aries, Marcel; Audenaert, Kurt; De Deyn, Peter Paul; Engelborghs, Sebastiaan

    2009-06-01

    To determine the reliability of the 30-item Geriatric Depression Scale (GDS-30) for the screening of depressive symptoms in dementia and mild cognitive impairment (MCI) using the Cornell Scale for Depression in Dementia (CSDD) as the 'gold standard'. Diagnosed according to strictly applied clinical diagnostic criteria, patients with MCI (n = 156) and probable Alzheimer's disease (AD) (n = 247) were included. GDS-30, CSDD, Mini Mental State Examination (MMSE) and Global Deterioration Scale were assessed in all patients at inclusion. The AD group was divided in three subgroups: mild AD (MMSE>or=18) (n = 117), moderate AD (MMSEor=10) (n = 89) and severe AD (MMSEdepressive symptoms in MCI but not in AD patients. Copyright (c) 2009 John Wiley & Sons, Ltd.

  4. Cognitive impairment as a central cholinergic deficit in patients with Myasthenia Gravis.

    Science.gov (United States)

    Kaltsatou, Antonia; Fotiou, Dimitris; Tsiptsios, Dimitris; Orologas, Anastasios

    2015-06-01

    The purpose of this study was to investigate with neurophysiological and neuropsychological methods such as pupillometry, cognitive test and Hamilton Depression Rating Scale (HAM-D) the hypothesis of Central Nervous System (CNS) cholinergic involvement in patients with Myasthenia Gravis (MG). Thirty-two patients (32) with MG and a mean age of 51.1 ± 17.2 volunteered to participate in this investigation, while thirty-three (33) healthy subjects with a mean age of 50.2 ± 14.8 served as controls. All subjects underwent pupillometric measurements and performed the Wechsler Memory Scale (WMS) and HAM-D. The pupillometric indices studied were: 1) latency for the onset of constriction (T1), 2) maximum constriction velocity (VCmax) and 3) maximum constriction acceleration (ACmax). T1 was found significantly increased by 21.7% (p WMS by 41.6% (p System, through acetylcholine. The results of this study demonstrate that the CNS may be affected in MG and support the hypothesis that MG has central cholinergic effects manifested by cognitive dysfunction.

  5. Diagnosis advances in vascular cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    Hua Zhou; Zhong Zhao

    2009-01-01

    Vascular cognitive impairment(VCI) encompasses the entire range of cognitive deficits associated with cerebrovascular disease(CVD), from mild deficits with little or no functional impairment, such as vascular cognitive impairment-no dementia(VCIND), to full-blown vascular dementia(VaD). Accurate diagnosis of vascular cognitive impairment is important but may be difficult. In this review we report advances in VCI in the following areas: etiology, subtypes, neuropsychology, biomarkers, neuroimaging, and diagnostic criteria.

  6. Plasma clusterin and the CLU Gene rs11136000 variant are associated with mild cognitive impairment in type 2 diabetic patients

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    Rongrong Cai

    2016-07-01

    Full Text Available Objective: Type 2 diabetes mellitus (T2DM is related to an elevated risk of mild cognitive impairment (MCI. Plasma clusterin is reported associated with the early pathology of Alzheimer's disease (AD and longitudinal brain atrophy in subjects with MCI. The rs11136000 single nucleotide polymorphism within the clusterin (CLU gene is also associated with the risk of AD. We aimed to investigate the associations among plasma clusterin, rs11136000 genotype and T2DM-associated MCI. Methods: A total of 231 T2DM patients, including 126 MCI and 105 cognitively healthy controls were enrolled in this study. Demographic parameters were collected and neuropsychological tests were conducted. Plasma clusterin and CLU rs11136000 genotype were examined.Results: Plasma clusterin was significantly higher in MCI patients than in control group (p=0.007. In subjects with MCI, plasma clusterin level was negatively correlated with Montreal cognitive assessment and auditory verbal learning test_delayed recall scores (p=0.027 and p=0.020, respectively. After adjustment for age, educational attainment, and gender, carriers of rs11136000 TT genotype demonstrated reduced risk for MCI compared with the CC genotype carriers (OR=0.158, χ2=4.113, p=0.043. Multivariable regression model showed that educational attainment, duration of diabetes, HDL-c, and plasma clusterin levels are associated with MCI in T2DM patients.Conclusions: Plasma clusterin was associated with MCI and may reflect a protective response in T2DM patients. TT genotype exhibited a reduced risk of MCI compared to CC genotype. Further investigations should be conducted to determine the role of clusterin in cognitive decline.

  7. Impairments in Brain Perfusion, Metabolites, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients: An Integrated MRI Study

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    Tao Wang

    2017-01-01

    Full Text Available Carotid artery stenosis without transient ischemic attack (TIA or stroke is considered as “asymptomatic.” However, recent studies have demonstrated that these asymptomatic carotid artery stenosis (aCAS patients had cognitive impairment in tests of executive function, psychomotor speed, and memory, indicating that “asymptomatic” carotid stenosis may not be truly asymptomatic. In this study, when 19 aCAS patients compared with 24 healthy controls, aCAS patients showed significantly poorer performance on global cognition, memory, and executive function. By utilizing an integrated MRI including pulsed arterial spin labeling (pASL MRI, Proton MR Spectroscopy (MRS, and resting-state functional MRI (R-fMRI, we also found that aCAS patients suffered decreased cerebral blood flow (CBF mainly in the Left Frontal Gyrus and had decreased NAA/Cr ratio in the left hippocampus and decreased connectivity to the posterior cingulate cortex (PCC in the anterior part of default mode network (DMN.

  8. Cognitive impairment after sudden cardiac arrest

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    Jaszke-Psonka, Magdalena; Piegza, Magdalena; Ścisło, Piotr; Pudlo, Robert; Piegza, Jacek; Badura-Brzoza, Karina; Leksowska, Aleksandra; Hese, Robert T.; Gorczyca, Piotr W.

    2016-01-01

    Aim To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical parameters and the duration of cardiac arrest on the presence and severity of the described disorders. Material and methods The study group comprised 30 cardiac arrest survivors, the reference group comprised ...

  9. Sensitivity of P300 auditory event-related potentials for assessing cognitive impairment in elderly type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Hong Yang; Junhong She; Xianfu Lu; Rihong Peng

    2008-01-01

    significantly lower in the diabetes alone and diabetes and cerebral ischemia groups (P < 0.01) than in the normal control group. N2 and P3 latencies were significantly longer in the diabetes and cerebral ischemia group than in the diabetes alone group (P <0.01), but amplitude was not significantly different. N2 and P3 latencies were negatively correlated with MMSE score in elderly type 2 diabetic patients (r=-0.421, -0.604; both P < 0.01). P3 amplitude was positively related to the score of MMSE (r =0.517; P < 0.01). P3 latency was positively associated with age, course of disease, glycosylated hemoglobin and ischemic brain damage in elderly type 2 diabetic patients (t=2.186 to 3.490; all P < 0.05). P3 amplitude was negatively correlated with age, course of disease and glycosylated hemoglobin (t=-2.220, -2.491, and -2.024, respectively; all P < 0.05). N2latency was positively correlated with age, course of disease and ischemic brain damage (t=2.946, 2.511,and 2.331, respectively; P < 0.05).CONCLUSION: The course of disease, glycosylated hemoglobin and ischemic brain damage are key influential factors for cognitive impairment in elderly type 2 diabetic patients. The P300 event-related potential is a sensitive index for objective assessment of cognitive impairment in elderly diabetic patients.

  10. Does cerebral large-artery disease contribute to cognitive impairment?

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    Satoshi Kimura

    2017-09-01

    Conclusion: Impaired cognition was observed in some of the non-demented patients with CLAD. Older age, drinking habit, severe PVH and decreased cerebral perfusion contributed to their poor cognitive performance. Strict treatment of atherosclerosis and intervention for CLAD might be necessary to prevent cognitive decline in these patients.

  11. The effects of cognitive intervention on cognitive impairments after intensive care unit admission.

    Science.gov (United States)

    Zhao, Jingjing; Yao, Li; Wang, Changqing; Sun, Yun; Sun, Zhongwu

    2017-04-01

    Patients who survive critical illness commonly suffer cognitive impairments. We aimed to study the effects of cognitive intervention to treat the long-term impairments observed among different populations of intensive care unit (ICU) survivors. The results showed that the intervention significantly suppressed the deterioration of cognitive function in these patients. Medical and neurological ICU survivors were more susceptible than post-anaesthesia ICU patients to severe cognitive damage. In the former, the deterioration of impairments can be slowed by cognitive intervention. In comparison, intervention exerted significantly positive effects on the recovery of the cognitive functions of post-anaesthesia care unit patients. Furthermore, young populations were more likely than older populations to recover from acute cognitive impairments, and the impairment observed among the older population seemed to be multi-factorial and irreversible.

  12. Adenosine A2A Receptor and IL-10 in Peripheral Blood Mononuclear Cells of Patients with Mild Cognitive Impairment

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    Beatrice Arosio

    2011-01-01

    Full Text Available Adenosine suppresses immune responses through the A2A receptor (A2AR. This study investigated the interleukin 10 (IL-10 genetic profile and the expression of A2AR in peripheral blood mononuclear cells (PBMCs of patients with mild cognitive impairment (MCI, Alzheimer disease (AD, and age-matched controls to verify, if they may help distinguish different forms of cognitive decline. We analyzed the IL-10 genotype and the expression of A2AR in 41 subjects with AD, 10 with amnestic MCI (a-MCI, 49 with multiple cognitive domain MCI (mcd-MCI, and 46 controls. There was a significant linear increase in A2AR mRNA levels and A2AR density from mcd-MCI to a-MCI, with intermediate levels being found in AD. The IL-10 AA genotype frequency was 67% in a-MCI, 46% in AD, 35% in mcd-MCI, and 20% in controls. These data suggest that the assessment of the IL-10 genotype and the expression of A2AR in PBMCs may be a valuable means of differentiating between a-MCI and mcd-MCI.

  13. Visual assessment of [{sup 11}C]PIB PET in patients with cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Suotunen, Timo; Hirvonen, Jussi; Arponen, Eveliina; Teraes, Mika; Seppaenen, Marko [Turku PET Centre, P.O. Box 52, Turku (Finland); Immonen-Raeihae, Pirjo [Turku University Hospital, Turku (Finland); Aalto, Sargo [Turku PET Centre, P.O. Box 52, Turku (Finland); Aabo Academy University, Department of Psychology, Turku (Finland); Lisinen, Irina [University of Turku, Research Centre of Applied and Preventive Cardiovascular Medicine, Turku (Finland); Koski, Kari [Salo Regional Hospital, Neurologic Outpatient Department, Salo (Finland); Sulkava, Raimo [Kuopio University Hospital, Kuopio (Finland); University of Kuopio, Geriatric Unit, School of Public Health and Clinical Nutrition, Kuopio (Finland); Rinne, Juha O. [Turku PET Centre, P.O. Box 52, Turku (Finland); Turku University Hospital, Turku (Finland)

    2010-06-15

    The aim of this study was to evaluate the visual assessment of positron emission tomography images of N-[methyl-11C]2-(4{sup '}-methylaminophenyl)-6-hydroxybenzothiazole ([11C]PIB) in a patient population with mild to moderate memory impairment or dementia. We compared the visual ratings of two readers using kappa statistics and correlated the results of visual and quantitative region of interest (ROI) analyses. The one reader had good experience in evaluating PIB images and the other had little previous experience. The sensitivity and specificity of the visual assessment was determined using quantitative data from 18 healthy controls previously examined: [11C]PIB uptake was considered as abnormal if it was more than 2 SD above the mean of the healthy subjects. The evaluation of visual classification as ''normal'' or ''abnormal'' showed good interobserver agreement ({kappa} = 0.90). There was a clear correlation between visual and quantitative analysis (r = 0.47-0.79, p < 0.001). The most difficult visually assessed brain area was the putamen ({kappa} = 0.11; correlation with quantitative analysis: reader A r = 0.22; reader B r = 0.60). Our study shows that visual evaluation of [{sup 11}C]PIB images conforms with quantitative analyses also in a clinical patient population supporting the feasibility of visual evaluation in clinical settings. (orig.)

  14. Altered Functional Connectivity in Patients with Subcortical Vascular Cognitive Impairment--A Resting-State Functional Magnetic Resonance Imaging Study.

    Directory of Open Access Journals (Sweden)

    Weina Ding

    Full Text Available Recent neuroimaging studies have shown that people with subcortical vascular cognitive impairment (sVCI have structural and functional abnormalities in the frontal lobe and subcortical brain sites. In this study, we used seed-based resting-state functional connectivity (rsFC analysis and voxel-mirrored homotopic connectivity (VMHC techniques to investigate the alteration of rsFC in patients with sVCI. rsFC and structural magnetic resonance images were acquired for 51 patients with subcortical cerebrovascular disease. All patients were subdivided based on cognitive status into 29 with sVCI and 22 controls; patient characteristics were matched. rsFC of the posterior cingulate cortex (PCC and VMHC were calculated separately, and rsFC of the PCC and VMHC between the two groups were compared. The regions showing abnormal rsFC of the PCC or VMHC in sVCI patients were adopted as regions of interest for correlation analyses. Our results are as follows: The patients with sVCI exhibited increases in rsFC in the left middle temporal lobe, right inferior temporal lobe and left superior frontal gyrus, and significant decreases in rsFC of the left thalamus with the PCC. sVCI patients showed a significant deficit in VMHC between the bilateral lingual gyrus, putamen, and precentral gyrus. Additionally, the z-memory score was significantly positively associated with connectivity between the left thalamus and the PCC (r = 0.41, p = 0.03, uncorrected in the sVCI group. Our findings suggest that the frontal lobe and subcortical brain sites play an important role in the pathogenesis of sVCI. Furthermore, rsFC between the left thalamus and the PCC might indicate the severity of sVCI.

  15. An evaluation of screening measures for cognitive impairment after stroke

    OpenAIRE

    Blake, Holly; McKinney, Michelle; Treece, Karen; Lee, Elizabeth; Lincoln, Nadina B.

    2002-01-01

    Objectives: to assess the sensitivity and specificity of a screening battery for detecting cognitive impairment after stroke. Design: a randomized controlled trial. Methods: stroke patients were recruited from hospitals in three centres. Patients were screened for cognitive impairment on the Mini‐Mental State Examination, the Sheffield Screening Test for Acquired Language Disorders and Raven's Coloured Progressive Matrices and received a further battery of assessments of cognitive f...

  16. Awareness of deficits in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

    In this study we investigated impaired awareness of cognitive deficits in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Very few studies have addressed this topic, and methodological inconsistencies make the comparison of previous studies difficult. From a prospective...

  17. Awareness of deficits in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

    In this study we investigated impaired awareness of cognitive deficits in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Very few studies have addressed this topic, and methodological inconsistencies make the comparison of previous studies difficult. From a prospective...

  18. The MMSE and MoCA for Screening Cognitive Impairment in Less Educated Patients with Parkinson’s Disease

    Science.gov (United States)

    Kim, Ji In; Sunwoo, Mun Kyung; Sohn, Young H.; Lee, Phil Hyu; Hong, Jin Y.

    2016-01-01

    Objective To explore whether the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) can be used to screen for dementia or mild cognitive impairment (MCI) in less educated patients with Parkinson’s disease (PD). Methods We reviewed the medical records of PD patients who had taken the Korean MMSE (K-MMSE), Korean MoCA (K-MoCA), and comprehensive neuropsychological tests. Predictive values of the K-MMSE and K-MoCA for dementia or MCI were analyzed in groups divided by educational level. Results The discriminative powers of the K-MMSE and K-MoCA were excellent [area under the curve (AUC) 0.86–0.97] for detecting dementia but not for detecting MCI (AUC 0.64–0.85). The optimal screening cutoff values of both tests increased with educational level for dementia (K-MMSE < 15 for illiterate, < 20 for 0.5–3 years of education, < 23 for 4–6 years, < 25 for 7–9 years, and < 26 for 10 years or more; K-MoCA < 7 for illiterate, < 13 for 0.5–3 years, < 16 for 4–6 years, < 19 for 7–9 years, < 20 for 10 years or more) and MCI (K-MMSE < 19 for illiterate, < 26 for 0.5–3 years, < 27 for 4–6 years, < 28 for 7–9 years, and < 29 for 10 years or more; K-MoCA < 13 for illiterate, < 21 for 0.5–3 years, < 23 for 4–6 years, < 25 for 7–9 years, < 26 for 10 years or more). Conclusion Both MMSE and MoCA can be used to screen for dementia in patients with PD, regardless of educational level; however, neither test is sufficient to discriminate MCI from normal cognition without additional information. PMID:27667187

  19. Information and communication technology to support self-management of patients with mild acquired cognitive impairments: systematic review.

    Science.gov (United States)

    Eghdam, Aboozar; Scholl, Jeremiah; Bartfai, Aniko; Koch, Sabine

    2012-11-19

    Mild acquired cognitive impairment (MACI) is a new term used to describe a subgroup of patients with mild cognitive impairment (MCI) who are expected to reach a stable cognitive level over time. This patient group is generally young and have acquired MCI from a head injury or mild stroke. Although the past decade has seen a large amount of research on how to use information and communication technology (ICT) to support self-management of patients with chronic diseases, MACI has not received much attention. Therefore, there is a lack of information about what tools have been created and evaluated that are suitable for self-management of MACI patients, and a lack of clear direction on how best to proceed with ICT tools to support self-management of MACI patients. This paper aims to provide direction for further research and development of tools that can support health care professionals in assisting MACI patients with self-management. An overview of studies reporting on the design and/or evaluation of ICT tools for assisting MACI patients in self-management is presented. We also analyze the evidence of benefit provided by these tools, and how their functionality matches MACI patients' needs to determine areas of interest for further research and development. A review of the existing literature about available assistive ICT tools for MACI patients was conducted using 8 different medical, scientific, engineering, and physiotherapy library databases. The functionality of tools was analyzed using an analytical framework based on the International Classification of Functioning, Disability and Health (ICF) and a subset of common and important problems for patients with MACI created by MACI experts in Sweden. A total of 55 search phrases applied in the 8 databases returned 5969 articles. After review, 7 articles met the inclusion criteria. Most articles reported case reports and exploratory research. Out of the 7 articles, 4 (57%) studies had less than 10 participants, 5

  20. Mild cognitive impairment in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Shu-hua LI

    2016-06-01

    Full Text Available Cognitive dysfunction is common non-motor symptom (NMS in Parkinson's disease (PD, which affects the patients' quality of life and increases the burden of caregivers. Cognitive dysfunction in PD can be mild cognitive impairment (MCI or dementia. MCI presents in the early stage of PD and the incidence rate is increasing with the disease progression. In some cases it can advance to dementia. The diagnosis of MCI in PD includes inclusion criteria, exclusion criteria and damage level evaluation. Non-pharmacological therapy, such as exercise and cognitive behavior therapy (CBT can improve the symptoms of MCI in PD, while the pharmacological treatment remains to be further studied. DOI: 10.3969/j.issn.1672-6731.2016.06.002

  1. Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment

    Science.gov (United States)

    Chen, Hui-Mei; Lin, Hsiu-Fen; Huang, Mei-Feng; Chang, Chun-Wei; Yeh, Yi-Chun; Lo, Yi-Ching; Yen, Cheng-Fang; Chen, Cheng-Sheng

    2016-01-01

    Objective Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants’ reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), for vascular cognitive impairment (VCI) by examining its psychometric properties and diagnostic accuracy. Methods Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD), 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE), Lawton-IADL and Barthel Index (BI), were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined. Results Cronbach’s alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = –0.587, p IADL (r = –0.663) than with physical domain of Lawton IADL (r = –0.541). The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812–0.965) to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%. Conclusion The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD. PMID:27851810

  2. Deficits in narrative discourse elicited by visual stimuli are already present in patients with mild cognitive impairment

    Science.gov (United States)

    Drummond, Cláudia; Coutinho, Gabriel; Fonseca, Rochele Paz; Assunção, Naima; Teldeschi, Alina; de Oliveira-Souza, Ricardo; Moll, Jorge; Tovar-Moll, Fernanda; Mattos, Paulo

    2015-01-01

    Language batteries used to assess the skills of elderly individuals, such as naming and semantic verbal fluency, present some limitations in differentiating healthy controls from patients with amnestic mild cognitive impairment (a-MCI). Deficits in narrative discourse occur early in dementia caused by Alzheimer's disease (AD), and the narrative discourse abilities of a-MCI patients are poorly documented. The present study sought to propose and evaluate parameters for investigating narrative discourse in these populations. After a pilot study of 30 healthy subjects who served as a preliminary investigation of macro- and micro-linguistic aspects, 77 individuals (patients with AD and a-MCI and a control group) were evaluated. The experimental task required the participants to narrate a story based on a sequence of actions visually presented. The Control and AD groups differed in all parameters except narrative time and the total number of words recalled. The a-MCI group displayed mild discursive difficulties that were characterized as an intermediate stage between the Control and AD groups' performances. The a-MCI and Control groups differed from the AD group with respect to global coherence, discourse type and referential cohesion. The a-MCI and AD groups were similar to one another but differed from the Control group with respect to the type of words recalled, the repetition of words in the same sentence, the narrative structure and the inclusion of irrelevant propositions in the narrative. The narrative parameter that best distinguished the three groups was the speech effectiveness index. The proposed task was able to reveal differences between healthy controls and groups with cognitive decline. According to our findings, patients with a-MCI already present narrative deficits that are characterized by mild discursive difficulties that are less severe than those found in patients with AD. PMID:26074814

  3. Deficits in narrative discourse elicited by visual stimuli are already present in patients with Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Cláudia eDrummond

    2015-05-01

    Full Text Available Language batteries used to assess the skills of elderly individuals, such as naming and semantic verbal fluency, present some limitations in differentiating healthy controls from patients with amnestic mild cognitive impairment (a-MCI. Deficits in narrative discourse occur early in dementia caused by Alzheimer’s disease (AD, and the narrative discourse abilities of a-MCI patients are poorly documented. The present study sought to propose and evaluate parameters for investigating narrative discourse in these populations. After a pilot study of 30 healthy subjects who served as a preliminary investigation of macro- and microlinguistic aspects, 77 individuals (patients with AD and a-MCI and a control group were evaluated. The experimental task required the participants to narrate a story based on a sequence of actions visually presented. The Control and AD groups differed in all parameters except narrative time and the total number of words recalled. The a-MCI group displayed mild discursive difficulties that were characterized as an intermediate stage between the Control and AD groups’ performances. The a-MCI and Control groups differed from the AD group with respect to global coherence, discourse type and referential cohesion. The a-MCI and AD groups were similar to one another but differed from the Control group with respect to the type of words recalled, the repetition of words in the same sentence, the narrative structure and the inclusion of irrelevant propositions in the narrative. The narrative parameter that best distinguished the three groups was the speech effectiveness index. The proposed task was able to reveal differences between healthy controls and groups with cognitive decline. According to our findings, patients with a-MCI already present narrative deficits that are characterized by mild discursive difficulties that are less severe than those found in patients with AD.

  4. Cognitive impairment in affective psychoses: a meta-analysis.

    Science.gov (United States)

    Bora, Emre; Yücel, Murat; Pantelis, Christos

    2010-01-01

    It has recently been suggested that cognitive impairment should be included in the diagnostic criteria of schizophrenia. One of the main arguments in support of this suggestion has been the hope that cognitive impairment can help distinguish schizophrenia from bipolar disorder (BD). However, recent evidence shows that cognitive deficits occur in BD and persist beyond euthymia. Further, mood disorders with psychotic features might be expected to manifest greater cognitive impairment, which further complicates the potential to differentiate these disorders. The goal of the current meta-analysis was to examine the magnitude and characteristics of cognitive impairments in affective psychoses (AP). A systematic search of the existing literature sourced 27 studies that met the inclusion criteria. These studies compared cognitive performances of 763 patients with AP (550 BD and 213 major depressive disorder) and 1823 healthy controls. Meta-regression and subgroup analyses were used to examine the effects of moderator variables. Meta-analyses of these studies showed that patients with AP were impaired in all 15 cognitive tasks with large effect sizes for most measures. There were no significant differences between the magnitude of impairments between the BD and major depressive disorder groups. The largest effect size was found for symbol coding, stroop task, verbal learning, and category fluency, reflecting impairments in elementary and complex aspects of attentional processing, as well as learning and memory. In general, the pattern of cognitive impairments in AP was similar to reported findings in euthymic patients with BD, but relatively more pronounced.

  5. Living Alone With Cognitive Impairment.

    Science.gov (United States)

    Gibson, Allison K; Richardson, Virginia E

    2017-02-01

    Although most individuals experiencing cognitive impairment (CI) reside with a caregiver, an estimated 800,000 live alone. Such individuals may have an increased risk for injury to self or others through self-neglect as a result of the CI symptoms. While persons living alone with CI have been identified as an important area for needed research, few studies have been able to examine this population due to the challenges of identifying and recruiting study participants. By using the National Health & Aging Trends Study data set, the researchers explored the characteristics to describe this population. The results of this study indicated that the majority of persons living with CI were older, widowed females who were not diagnosed with Alzheimer's or dementia but tested positive on cognitive screening measures. Further, the majority of persons living alone with CI relied on adult children and paid professionals as the primary care providers.

  6. Atrial fibrillation and prestroke cognitive impairment in stroke.

    Science.gov (United States)

    Horstmann, Solveig; Rizos, Timolaos; Rauch, Geraldine; Fuchs, Maximilian; Arden, Cathrin; Veltkamp, Roland

    2014-03-01

    Dementia and atrial fibrillation (AF) are common comorbidities in stroke patients. The potential role of AF in cognitive impairment prior to a first stroke has yet not been characterized. The aim of our study was to evaluate the prevalence of prestroke cognitive impairment in stroke patients, and to identify whether AF is associated with prestroke cognitive impairment. In this prospective, single-center, explorative, observational study, consecutive patients with first ever transient ischemic attack (TIA), ischemic (IS) or hemorrhagic stroke (ICH) were included. For each patient cardiovascular risk factors and the National Institutes of Health Stroke Scale were recorded. Cognitive status prior to the stroke/TIA was assessed using the informant questionnaire on cognitive decline in the elderly (IQCODE). AF was diagnosed according to a standardised procedure that included the documented medical history, ECG upon admission, 24-h Holter-ECG, continuos ECG monitoring, and was categorized into paroxysmal and persistent. Logistic regression analysis was used to evaluate association of AF and prestroke cognitive impairment. A total of 788 patients were enrolled in our study. Of these, 548 (69.5 %) had an IS, TIA was present in 168 (21.3 %) and ICH in 72 (9.1 %) patients. Mean IQCODE was 3.1 (SD 0.4). Prestroke cognitive impairment (IQCODE ≥3.44) was detected in 96 (12.5 %) patients. Of these, 33 patients (4.3 %) were demented before the actual stroke event. AF was independently associated with prestroke cognitive impairment. Patients with an acute stroke frequently show a history of cognitive impairment before the event. AF is independently associated with prestroke cognitive impairment.

  7. Comparison between mini mental state examination (MMSE) and Montreal cognitive assessment Indonesian version (MoCA-Ina) as an early detection of cognitive impairments in post-stroke patients

    Science.gov (United States)

    Lestari, S.; Mistivani, I.; Rumende, C. M.; Kusumaningsih, W.

    2017-08-01

    Mild cognitive impairment (MCI) is defined as cognitive impairment that may never develop into dementia. Cognitive impairment is one long-term complication of a stroke. The Mini Mental State Examination (MMSE), which is commonly used as a screening tool for cognitive impairment, has a low sensitivity to detect cognitive impairment, especially MCI. Alternatively, the Montreal Cognitive Assessment Indonesian version (MoCA-Ina) has been reported to have a higher sensitivity than the MMSE. The aim of this study was to compare the proportion of MCI identified between the MMSE and MoCA-Ina in stroke patients. This was a cross-sectional study of stroke outpatients who attended the Polyclinic Neuromuscular Division, Rehabilitation Department, and Polyclinic Stroke, Neurology Department Cipto Mangunkusumo General Hospital, Jakarta. The proportion of MCI identified using the MMSE was 31.03% compared to 72.41% when using the MoCA-Ina. This difference was statistically significant (Fisher’s exact test, p = 0.033). The proportion of MCI in stroke patients was higher when using the MoCA-Ina compared to the MMSE. The MoCA-Ina should be used as an alternative in the early detection of MCI in stroke patients, especially those undergoing rehabilitation.

  8. Cognitive reserve and cognitive impairments: drug and nondrug treatments

    Directory of Open Access Journals (Sweden)

    E.I. Dainikova

    2014-01-01

    Full Text Available The paper discusses concepts, such as cognitive reserve (CR and cognitive impairments (CI. It presents the controlled and uncorrectable factors that influence CR and considers the factors of increasing CR and reducing the risk of dementia. The mechanisms responsible for the development of vascular CIs and the role of vascular factor in the occurrence of neurodegenerative disease, primarily Alzheimer's disease and Parkinson's disease, are covered. The issues of correcting CIs in cerebrovascular and neurodegenerative diseases are discussed. The conception of CR is shown to be of value in the planning of management tactics for each patient to prevent dementia by drug and non-drug treatments.

  9. S-TOFHLA in mild Alzheimer's disease and Mild Cognitive Impairment patients as a measure of functional literacy: Preliminary study

    Directory of Open Access Journals (Sweden)

    Maira Okada de Oliveira

    Full Text Available Abstract The greatest difficulty in diagnosing cognitive loss in our population is the diversity of its education which has a broad spectrum ranging from illiteracy, functional illiteracy and different degrees of literacy, even in those with the same level of schooling. Objectives: To verify whether there is impairment on the S-TOFHLA among individuals with AD and MCI compared with healthy controls, and to compare performance on the S-TOFHLA performance with neuropsychological tests and the scores achieved on the Raven's Colored Matrices and Vocabulary and Block Design (WAIS-III as a measure of estimated intellectual level. Methods: 59 subjects: controls (n=23; age 70.96±8.31y; schooling 10.2±5.87y; 6 men, MCI patients (n=11; age 74.18±8.12y; schooling 7.55±4.32y; 5 men and AD patients (n=25; age 76.16±4.96y; schooling 7.32±4.78y; 10 men were submitted to neuropsychological assessment, S-TOFHLA and functional evaluation. Results: Differences on BD, Raven and Estimated IQ were found between controls and MCI patients as well as controls and AD patients. On the S-TOFHLA, differences were found between MCI and AD patients, controls and AD patients, but not between control and MCI groups. S-TOFHLA performance correlated strongly with schooling and all neuropsychological tests, except Clock Drawing. Conclusions: The S-TOFHLA seems to be a useful measure for determining the level of literacy in MCI patients, but not in AD patients. S-TOFHLA performance was more closely associated with neuropsychological test scores than were years of education and seems to be a good predictor of level of literacy. The Vocabulary subtest proved to be uninfluenced by the disease process in early stages and preserved in both MCI and AD patients, showing that semantic memory and crystallized intelligence are preserved.

  10. A Feasibility Study with Image-Based Rendered Virtual Reality in Patients with Mild Cognitive Impairment and Dementia.

    Science.gov (United States)

    Manera, Valeria; Chapoulie, Emmanuelle; Bourgeois, Jérémy; Guerchouche, Rachid; David, Renaud; Ondrej, Jan; Drettakis, George; Robert, Philippe

    2016-01-01

    Virtual Reality (VR) has emerged as a promising tool in many domains of therapy and rehabilitation, and has recently attracted the attention of researchers and clinicians working with elderly people with MCI, Alzheimer's disease and related disorders. Here we present a study testing the feasibility of using highly realistic image-based rendered VR with patients with MCI and dementia. We designed an attentional task to train selective and sustained attention, and we tested a VR and a paper version of this task in a single-session within-subjects design. Results showed that participants with MCI and dementia reported to be highly satisfied and interested in the task, and they reported high feelings of security, low discomfort, anxiety and fatigue. In addition, participants reported a preference for the VR condition compared to the paper condition, even if the task was more difficult. Interestingly, apathetic participants showed a preference for the VR condition stronger than that of non-apathetic participants. These findings suggest that VR-based training can be considered as an interesting tool to improve adherence to cognitive training in elderly people with cognitive impairment.

  11. A Feasibility Study with Image-Based Rendered Virtual Reality in Patients with Mild Cognitive Impairment and Dementia.

    Directory of Open Access Journals (Sweden)

    Valeria Manera

    Full Text Available Virtual Reality (VR has emerged as a promising tool in many domains of therapy and rehabilitation, and has recently attracted the attention of researchers and clinicians working with elderly people with MCI, Alzheimer's disease and related disorders. Here we present a study testing the feasibility of using highly realistic image-based rendered VR with patients with MCI and dementia. We designed an attentional task to train selective and sustained attention, and we tested a VR and a paper version of this task in a single-session within-subjects design. Results showed that participants with MCI and dementia reported to be highly satisfied and interested in the task, and they reported high feelings of security, low discomfort, anxiety and fatigue. In addition, participants reported a preference for the VR condition compared to the paper condition, even if the task was more difficult. Interestingly, apathetic participants showed a preference for the VR condition stronger than that of non-apathetic participants. These findings suggest that VR-based training can be considered as an interesting tool to improve adherence to cognitive training in elderly people with cognitive impairment.

  12. [Cognitive impairments accompanying the burnout syndrome - a review].

    Science.gov (United States)

    Riedrich, Karin; Weiss, Elisabeth M; Dalkner, Nina; Reininghaus, Eva; Papousek, Ilona; Schwerdtfeger, Andreas; Lackner, Helmut K; Reininghaus, Bernd

    2017-03-01

    The rising prevalence of the burnout syndrome has increasingly moved it into the focus of scientific interest. In addition to emotional exhaustion and depersonalization, particularly reduced personal accomplishment has strong societal and economic effects. In recent years reduced personal accomplishment has increasingly been linked to cognitive impairment. However, up to now only a few studies have objectively assessed cognitive deficits in burnout patients. This article gives an overview of 16 studies which examined cognitive abilities in burnout patients. The findings are partly contradictory, probably due to methodical differences. Consensus has emerged concerning impairments of executive functions, i.a. vigilance, and memory updating and monitoring. Multifactorial causation may underlie the cognitive impairments. Targeted longitudinal studies are necessary in order to identify the affected cognitive functions and be able to make causal inferences on links between the burnout syndrome and specific cognitive impairments.

  13. Biomarkers for Early Diagnostic of Mild Cognitive Impairment in Type-2 Diabetes Patients: A Multicentre, Retrospective, Nested Case–Control Study

    Directory of Open Access Journals (Sweden)

    Zhi-Peng Xu

    2016-03-01

    Interpretation: Aging, activation of peripheral circulating GSK-3β, expression of ApoE ε4 and increase of olfactory score are diagnostic for the mild cognitive impairment in T2DM patients, and combination of these biomarkers can improve the diagnostic accuracy.

  14. Relationship between episodic memory and resting-state brain functional connectivity network in patients with Alzheimer’s disease and mild cognition impairment

    Institute of Scientific and Technical Information of China (English)

    吴钦娟

    2013-01-01

    Objective To explore the relationship between the scores of episodic memory (EM) encoding and retrieving and the resting-state changes of brain functional connectivity (FC) network of Alzheimer’s disease (AD) and mild cognition impairment (MCI) patients.Methods All

  15. The use of metacognitive strategies to decrease false memories in source monitoring in patients with mild cognitive impairment.

    Science.gov (United States)

    Deason, Rebecca G; Nadkarni, Neil A; Tat, Michelle J; Flannery, Sean; Frustace, Bruno; Ally, Brandon A; Budson, Andrew E

    2017-02-03

    Patients with amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD) often demonstrate high rates of false memories, leading to stressful and frustrating situations for both patients and caregivers in everyday life. Sometimes these false memories are due to failures in monitoring the source of the information. In the current study, we examined interventions aimed to enhance the use of the metacognitive "recall-to-reject" memory strategy. Such interventions could improve source memory and decrease false memory in patients with MCI. Because the picture superiority effect (better memory for pictures compared to words) has been shown to be present in both patients with MCI and healthy older controls, we investigated whether pictures could help patients with MCI use a recall-to-reject strategy in a simulation of real-world source memory task. In this experiment, patients with MCI and healthy older adults were asked to simulate preparing for and then taking a trip to the market. Subjects first studied 30 pictures of items in their "cupboard," followed by a list of 30 words of items on their "shopping list." At test, participants saw 90 pictures (30 cupboard, 30 list, 30 new) organized as they would be if walking down the market aisles, and are provided with either standard or metacognitive instructions. With standard instructions, they were asked if they needed to buy the item. With the metacognitive instructions, they were asked a series of questions to help guide them through a recall-to-reject strategy to highlight the different sources of memories. Results showed that the metacognitive instructions did significantly reduce the false memory rates for patients with MCI. Further studies need to investigate how to best implement these practical strategies into the everyday lives of patients.

  16. Alpha spectral power and coherence in the patients with mild cognitive impairment during a three-level working memory task

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: The functional relationship between calculated alpha band spectral power and inter-/intra-hemispheric coherence during a three-level working memory task of patients with mild cognitive impairment (MCI) was investigated. Methods:Subjects included 35 MCI patients according to the DSM-Ⅳ criteria (mean age: 62.3, SD: 6.5) and 34 healthy controls (mean age:57.4, SD: 4.0) were selected from the community at large. All subjects performed a simple calculation and recall task with three levels of working memory load while electroencephalograph (EEG) signal was recorded. The spectral EEG power was computed over alphal (8.0~10.0 Hz) and alpha2 (10.5~13.0 Hz) frequency bands and was compared between rest stage and working memory processing stage by two-way ANOVA. Post hoc testing analyzed the differences between each two levels of working memory load during task processing. The inter-hemisphere EEG coherence of frontal (F3-F4), central (C3-C4), parietal (P3-P4), temporal (T5-T6) as well as occipital (O1-O2) was compared between MCI patients and normal controls. The EEG signals from F3-C3,F4-C4, C3-P3, C4-P4, P3-O1, P4-O2, T5-C3, T6-C4, T5-P3 and T6-P4 electrode pairs resulted from the intra-hemispheric action for alphal and alpha2 frequency bands. Result: There was significantly higher EEG power from MCI patients than from normal controls both at rest and during working memory processing. Significant differences existed between rest condition and three-level working memory tasks (P<0.001). The inter- and intra-hemispheric coherence during working memory tasks showed a "drop to rise" tendency compared to that at rest condition. There was significantly higher coherence in MCI patients than in the controls.When task difficulties increased, the cortical connectivity of intra-hemispheric diminished while the inter-hemispheric connectivity dominantly maintained the cognitive processing in MCI patients. Conclusion: The results of the present study indicate that the

  17. Impact of Resveratrol on Glucose Control, Hippocampal Structure and Connectivity, and Memory Performance in Patients with Mild Cognitive Impairment

    Science.gov (United States)

    Köbe, Theresa; Witte, A. Veronica; Schnelle, Ariane; Tesky, Valentina A.; Pantel, Johannes; Schuchardt, Jan-Philipp; Hahn, Andreas; Bohlken, Jens; Grittner, Ulrike; Flöel, Agnes

    2017-01-01

    In healthy older adults, resveratrol supplementation has been shown to improve long-term glucose control, resting-state functional connectivity (RSFC) of the hippocampus, and memory function. Here, we aimed to investigate if these beneficial effects extend to individuals at high-risk for dementia, i.e., patients with mild cognitive impairment (MCI). In a randomized, double-blind interventional study, 40 well-characterized patients with MCI (21 females; 50–80 years) completed 26 weeks of resveratrol (200 mg/d; n = 18) or placebo (1,015 mg/d olive oil; n = 22) intake. Serum levels of glucose, glycated hemoglobin A1c and insulin were determined before and after intervention. Moreover, cerebral magnetic resonance imaging (MRI) (3T) (n = 14 vs. 16) was conducted to analyze hippocampus volume, microstructure and RSFC, and neuropsychological testing was conducted to assess learning and memory (primary endpoint) at both time points. In comparison to the control group, resveratrol supplementation resulted in lower glycated hemoglobin A1c concentration with a moderate effect size (ANOVARM p = 0.059, Cohen's d = 0.66), higher RSFC between right anterior hippocampus and right angular cortex (p < 0.001), and led to a moderate preservation of left anterior hippocampus volume (ANOVARM p = 0.061, Cohen's d = 0.68). No significant differences in memory performance emerged between groups. This proof-of-concept study indicates for the first-time that resveratrol intake may reduce glycated hemoglobin A1c, preserves hippocampus volume, and improves hippocampus RSFC in at-risk patients for dementia. Larger trials with longer intervention time should now determine if these benefits can be validated and extended to cognitive function. PMID:28326010

  18. Mild cognitive impairment in Parkinson disease: heterogenous mechanisms.

    Science.gov (United States)

    Jellinger, Kurt A

    2013-01-01

    Cognitive impairment is common in Parkinson disease (PD), with long-term longitudinal studies reporting that most PD patients develop dementia. A high proportion of patients with PD and mild cognitive impairment (MCI) progress to dementia within a short time. Impairments occur in a range of cognitive domains, but single-domain impairment is more common than multiple one, non-amnestic more common than amnestic impairment. Although the term MCI applied to PD (PD-MCI) is not without controversy due to the lack of uniform diagnostic consensus criteria, the biological validity of PD-MCI is supported by many recent studies that show heterogenous mechanisms in the clinical presentation, neuropsychology, neuroimaging, biomarkers, and neuropathology, suggesting abnormal metabolic network activities involving several cortical and subcortical nervous systems. Prospective studies using specific biomarkers, including amyloid imaging, and cerebro-spinal fluid biomarkers are warranted for an exact diagnosis and prognostic assessment of early cognitive deficits in PD patients.

  19. Cognitive impairment as a central cholinergic deficit in patients with Myasthenia Gravis

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    Antonia Kaltsatou

    2015-06-01

    Conclusions: VCmax and ACmax are governed mainly by the action of the Parasympathetic Nervous System, through acetylcholine. The results of this study demonstrate that the CNS may be affected in MG and support the hypothesis that MG has central cholinergic effects manifested by cognitive dysfunction.

  20. A multi-contrast MRI study of microstructural brain damage in patients with mild cognitive impairment

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    C. Granziera

    2015-01-01

    Conclusion: Multi-contrast MRI appears to be a promising approach to infer pathophysiological mechanisms leading to brain tissue alterations in MCI. Likewise, parametric MRI data provide powerful correlates of cognitive deficits and improve automatic disease classification based on morphometric features.

  1. The Development of a Substance Abuse Treatment Program for Forensic Patients with Cognitive Impairment

    Science.gov (United States)

    Glassmire, David M.; Welsh, Robert K.; Clevenger, Jeanne K.

    2007-01-01

    The Substance Abuse and Mental Illness (SAMI) program combines cognitive rehabilitation and dual-diagnosis substance abuse treatment within a stages of change context. This article describes the development, implementation, and preliminary outcome analysis of the SAMI program in a forensic hospital.

  2. Cognitive impairment and mortality among nonagenarians

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Nybo, Hanne; Gaist, David;

    2002-01-01

    the impact of cognitive impairment on mortality over a 2-year period. No cognitive impairment was defined as a score of 24-30 points on the Mini Mental State Examination, mild cognitive impairment was defined as a score of 18-23 points, and severe impairment was defined as a score of 0-17 points. Cox...... regression analysis was applied to adjust for a number of known and suspected factors known or suspected of being associated with cognition and mortality (e.g. sociodemographic factors, sex, smoking, alcohol consumption, depressive symptoms, and physical abilities), and yielded hazard ratios (95% confidence...

  3. Inclusion criteria provide heterogeneity in baseline profiles of patients with mild cognitive impairment: comparison of two prospective cohort studies

    Science.gov (United States)

    Kawashima, Shoji; Kato, Takashi

    2012-01-01

    Background Mild cognitive impairment (MCI) is considered to represent a transitional stage between ageing and Alzheimer's disease (AD). To aim at identifying neuroimaging measures associated with cognitive changes in healthy elderly and MCI patients, longitudinal multicentre studies are ongoing in several countries. The patient profiles of each study are based on unique inclusion criteria. Objectives The purpose of the study is to clarify differences in baseline profiles of MCI patients between Studies on Diagnosis of Early Alzheimer's Disease—Japan (SEAD-J) and Alzheimer's Disease Neuroimaging Initiative (ADNI) and to examine the association between baseline profiles and risk of early conversion to AD. Design Prospective cohort study. Setting and participants SEAD-J recruited 114 patients from nine facilities in Japan. A total of 200 patients in ADNI with fluorodeoxyglucose–positron emission tomography (FDG-PET) were enrolled from the USA. Methods Baseline profiles were statistically analysed. For FDG-PET at a time of inclusion, associations between each profile and cerebral metabolic rate for glucose (CMRgl) were examined using SPM5 software. In each study, the ratio of conversion to AD within the 1-year and 2-year period after inclusion was investigated and differences in baseline profiles between AD converters and non-converters were analysed. Results SEAD-J included MCI patients with more severe verbal memory deficits and extracted patients with higher depressive tendencies. These differences were likely to be associated with criteria. SEAD-J exhibited a higher rate of conversion within 1 year compared with ADNI (24.5% vs 13.5%). In FDG-PET analyses of SEAD-J, AD converters within 1 year showed more severe decrease of FDG uptake in bilateral inferior parietal regions compared with non-converters. Conclusions Different inclusion criteria provided differences in baseline profiles. The severity of memory deficit might cause increase of the AD conversion

  4. Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices

    Science.gov (United States)

    Jones, Joshua; Sim, Tin Fei; Hughes, Jeff

    2017-01-01

    Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED. PMID:28970442

  5. Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management-A Narrative Review of Current Practices.

    Science.gov (United States)

    Jones, Joshua; Sim, Tin Fei; Hughes, Jeff

    2017-06-01

    Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED.

  6. Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices

    Directory of Open Access Journals (Sweden)

    Joshua Jones

    2017-06-01

    Full Text Available Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED. Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED.

  7. Age-Related Sensory Impairments and Risk of Cognitive Impairment.

    Science.gov (United States)

    Fischer, Mary E; Cruickshanks, Karen J; Schubert, Carla R; Pinto, Alex A; Carlsson, Cynthia M; Klein, Barbara E K; Klein, Ronald; Tweed, Ted S

    2016-10-01

    To evaluate the associations between sensory impairments and 10-year risk of cognitive impairment. The Epidemiology of Hearing Loss Study (EHLS), a longitudinal, population-based study of aging in the Beaver Dam, Wisconsin community. Baseline examinations were conducted in 1993 and follow-up examinations have been conducted every 5 years. General community. EHLS members without cognitive impairment at EHLS-2 (1998-2000). There were 1,884 participants (mean age 66.7) with complete EHLS-2 sensory data and follow-up information. Cognitive impairment was defined as a Mini-Mental State Examination score of impairment was a pure-tone average of hearing thresholds (0.5, 1, 2, 4 kHz) of >25 dB hearing level in either ear, visual impairment was a Pelli-Robson contrast sensitivity of impairment was a San Diego Odor Identification Test score of visual, and olfactory impairment were independently associated with cognitive impairment risk (hearing: hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.11-3.26; vision: HR = 2.05, 95% CI = 1.24-3.38; olfaction: HR = 3.92, 95% CI = 2.45-6.26)). Nevertheless, 85% of participants with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up. The relationship between sensory impairment and cognitive impairment was not unique to one sensory system, suggesting that sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  8. Cognitive Training in Older Adults with Mild Cognitive Impairment

    Institute of Scientific and Technical Information of China (English)

    LIU Xin Yan; LI Li; XIAO Jia Qing; HE Chang Zhi; LYU Xiu Lin; GAO Lei; YANG Xiao Wei; CUI Xin Gang; FAN Li Hua

    2016-01-01

    ObjectiveWe investigated the feasibility and efficacy of cognitive training for older adults in rural settings and with low education levels, who have mild cognitive impairment (MCI). MethodsForty-five older adults (ages >65 years) with MCI were assigned to treatment or control groups, at a 2:1 ratio. Cognitivetraining occurred in the treatment group for 2 months. The cognitive abilities of the participants were assessed at pre-training, metaphase, and post-training time points, using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and Hamilton Depression Scale (HAM-D). ResultsFollowing training, cognitive abilities improved in the treatment group, based on the total scores of all 4 measures, as well as specifically on the MoCA and LOTCA. There were differences in the main effects of group and time point on some subscales, but these differences had little, if any, effect on the overall analyses. ConclusionThe present study demonstrated that cognitive training has beneficial effects on attention, language, orientation, visual perception, organization of visual movement, and logical questioning in patients with MCI. Furthermore, the observed effects are long-term changes.

  9. Characteristics of Agraphia in Chinese Patients with Alzheimer's Disease and Amnestic Mild Cognitive Impairment

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    Jiong Zhou

    2016-01-01

    Conclusions: Our study confirmed that agraphia is an important feature in patients with AD. The writing error profile in patients whose native language is Chinese was unique compared to patients using the alphabetic language system.

  10. Depression increases in patients with Parkinson?s disease according to the increasing severity of the cognitive impairment

    Directory of Open Access Journals (Sweden)

    Marcos Hortes N. Chagas

    2014-06-01

    Full Text Available Objective : To test the hypothesis that severity of cognitive impairment modifies the association between depression and Parkinson’s disease (PD. Method : One-phase population-based door-to-door surveys. This is a secondary analysis of 1,451 people aged 65 years and older with cognitive impairment living in defined catchment areas. Depression was estimated according to ICD-10, self-reported PD, disability according to WHODAS-II and cognitive status according to the CSI-D. Results : The mean age of the sample was 79.3 years old and most (69% were women. Of the total sample, 16.1% had depression and it was significantly higher among participants with PD. There was an increase on the ORs of the association between depression and PD with decreased scores in the cognitive test (Adjusted OR from 0.98 to 8.04. Conclusion : The association between depression and PD increases with the severity of the cognitive impairment.

  11. Mild Cognitive Impairment as a single sign of brain hemiatrophy in patient with Localized Scleroderma and Parry-Romberg Syndrome.

    Science.gov (United States)

    Klimiec, Elzbieta; Klimkowicz-Mrowiec, Aleksandra

    2016-01-01

    Neurologic involvement is well recognized in Systemic Scleroderma and increasingly reported in Localized Scleroderma. MRI brain abnormalities are often associated with symptoms such as seizures or headaches. In some cases they may be clinically silent. We describe a 23 years old female with head, trunk and limbs scleroderma who developed Parry-Romberg Syndrome. Brain MRI showed ipsilateral temporal lobe atrophy without any prominent neurologic symptoms. Neuropsychological examination revealed Mild Cognitive Impairment. During the 7 years of follow up we have noticed progression of face atrophy but no progression of brain atrophy. Cognitive functions have been stable. This case highlight that major MRI brain abnormalities in LS may occur with only subtle clinical manifestation such as Mild Cognitive Impairment.

  12. Vascular cognitive impairment in Pemphigus vulgaris: a case report

    Directory of Open Access Journals (Sweden)

    José Ibiapina Siqueira- Neto

    Full Text Available ABSTRACT Pemphigus vulgaris is a systemic auto-immune medical condition that mainly manifests with changes in skin and vasculopathy. This is a case report of a 69-year-old male with confirmed histopathologic diagnosis of Pemphigus vulgaris presenting ulterior Cognitive Impairment, mostly in executive function. The patient was treated using steroids, immunomodulatory therapy, fluoxetine and galantamine. Neuropsychological testing and magnetic resonance (MRI were performed. This is the first report of correlational cognitive impairment with Pemphigus vulgaris in the literature. Physicians should be aware of vascular causes for cognitive impairment in patients presenting auto-immune conditions.

  13. Using functional Magnetic Resonance Imaging to differentiate between Healthy Aging subjects, Mild Cognitive Impairment, and Alzheimer’s Patients

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Oghabian

    2010-01-01

    Full Text Available

    Back ground: Alzheimer's disease is the most common form of dementia which is still difficult to be differentiated from other types of brain disorders. Moreover, Mild Cognitive Impairment refers to the presence of cognitive impairments that is not severe enough to meet the criteria of dementia, and its diagnosis in early stages is so critical. There is currently no distinct method available for diagnosing Alzheimer's or Mild Cognitive Impairment, and their diagnosis needs a combination of different methods and assessments.

    Methods: Our goal in this study was to evaluate the effectiveness of fMRI imaging in differentiating between Alzheimer's, Mild Cognitive Impairment (MCI and Healthy Aging. To prove fMRI's ability, we compared resting-state brain activation patterns between these three groups of subjects using Independent Component Algorithm (ICA. We examined 40 age- and sex-matched subjects, 15 elderly, 11 MCI and 14 Alzheimer's subjects.

    Results: The results show that during a certain resting-state session, healthy aging brain benefits from larger area and greater intensity of activation (compared with MCI and Alzheimer's group in Posterior Cingulate Cortex (PCC region of the brain, as part of Default Mode Network.

    Conclusion: This difference in activation pattern can be used as a diagnostic criterion in using fMRI for differentiating between Alzheimer's disease (AD, MCI and Healthy Aging.


    Keywords: fMRI, Default Mode Network, Alzheimer's, Mild Cognitive Impairment, Resting-State

  14. Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study

    Directory of Open Access Journals (Sweden)

    Erik Hessen

    2017-02-01

    Full Text Available Background/Aims: In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1 baseline cerebrospinal fluid biomarkers and (2 a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Methods: Eighty-one patients (mean age 61 years were recruited from university memory clinics and followed up for 6 years. Results: Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% (n = 4 developed dementia. Regression analysis revealed that low levels of Aβ42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Conclusions: Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

  15. Cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Ransmayr, Gerhard

    2015-12-01

    Parkinson's disease is the second most frequent neurodegenerative disorder. There is significantly elevated risk of cognitive decline and associated neuropsychiatric symptoms. Dementia may develop insidiously several years after manifestation of Parkinson motor symptoms (dementia associated with Parkinson's disease; Parkinson's disease dementia) or in close temporal relationship (within one year) after onset of motor symptoms (Dementia with Lewy bodies). There are clinical, pathophysiological and therapeutic similarities between these two conditions. Men are more frequently affected than women. Risk factor or indicators are advanced age at disease onset, disease duration, rigidity, akinesia and posture and gait impairment and falls as opposed to tremor dominance, and associated neuropsychiatric symptoms (depression, apathy, hallucinosis, delirium). Dementia is treatable with cholinesterase inhibitors (rivastigmine, donepezil), memantine, and adjustment of the pharmacological regimen of parkinsonian motor symptoms. Concomitant autonomic nervous system symptoms and neuropsychiatric complications warrant early clinical awareness and are accessible to pharmacological therapy.

  16. Retinal Vascular Fractals and Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Yi-Ting Ong

    2014-08-01

    Full Text Available Background: Retinal microvascular network changes have been found in patients with age-related brain diseases such as stroke and dementia including Alzheimer's disease. We examine whether retinal microvascular network changes are also present in preclinical stages of dementia. Methods: This is a cross-sectional study of 300 Chinese participants (age: ≥60 years from the ongoing Epidemiology of Dementia in Singapore study who underwent detailed clinical examinations including retinal photography, brain imaging and neuropsychological testing. Retinal vascular parameters were assessed from optic disc-centered photographs using a semiautomated program. A comprehensive neuropsychological battery was administered, and cognitive function was summarized as composite and domain-specific Z-scores. Cognitive impairment no dementia (CIND and dementia were diagnosed according to standard diagnostic criteria. Results: Among 268 eligible nondemented participants, 78 subjects were categorized as CIND-mild and 69 as CIND-moderate. In multivariable adjusted models, reduced retinal arteriolar and venular fractal dimensions were associated with an increased risk of CIND-mild and CIND-moderate. Reduced fractal dimensions were associated with poorer cognitive performance globally and in the specific domains of verbal memory, visuoconstruction and visuomotor speed. Conclusion: A sparser retinal microvascular network, represented by reduced arteriolar and venular fractal dimensions, was associated with cognitive impairment, suggesting that early microvascular damage may be present in preclinical stages of dementia.

  17. [Impaired cognitive function in hepatitis C - a review.

    DEFF Research Database (Denmark)

    Renvillard, Signe Groth; Leutscher, Peter; Hjerrild, Simon;

    2010-01-01

    Impaired cognitive function is commonly seen in patients with hepatitis C-virus (HCV). This might be due to a toxic effect of the virus itself or to neuroinflammatory processes with a direct damaging cerebral effect. The symptoms appear in the pre-cirrhotic stage and impair the patient's level...

  18. Advanced Asymptomatic Carotid Disease and Cognitive Impairment: An Understated Link?

    Directory of Open Access Journals (Sweden)

    Irena Martinić-Popović

    2012-01-01

    Full Text Available Advanced carotid disease is known to be associated with symptomatic cerebrovascular diseases, such as stroke or transient ischemic attack (TIA, as well as with poststroke cognitive impairment. However, cognitive decline often occurs in patients with advanced carotid stenosis without clinically evident stroke or TIA, so it is also suspected to be an independent risk factor for dementia. Neurosonological methods enable simple and noninvasive assessment of carotid stenosis in patients at risk of advanced atherosclerosis. Cognitive status in patients diagnosed with advanced carotid stenosis is routinely not taken into consideration, although if cognitive impairment is present, such patients should probably be called symptomatic. In this paper, we discuss results of some most important studies that investigated cognitive status of patients with asymptomatic advanced carotid disease and possible mechanisms involved in the causal relationship between asymptomatic advanced carotid disease and cognitive decline.

  19. Biomarkers for dementia and mild cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Delgado-Alvarado, Manuel; Gago, Belén; Navalpotro-Gomez, Irene; Jiménez-Urbieta, Haritz; Rodriguez-Oroz, María C

    2016-06-01

    Cognitive decline is one of the most frequent and disabling nonmotor features of Parkinson's disease. Around 30% of patients with Parkinson's disease experience mild cognitive impairment, a well-established risk factor for the development of dementia. However, mild cognitive impairment in patients with Parkinson's disease is a heterogeneous entity that involves different types and extents of cognitive deficits. Because it is not currently known which type of mild cognitive impairment confers a higher risk of progression to dementia, it would be useful to define biomarkers that could identify these patients to better study disease progression and possible interventions. In this sense, the identification among patients with Parkinson's disease and mild cognitive impairment of biomarkers associated with dementia would allow the early detection of this process. This review summarizes studies from the past 25 years that have assessed the potential biomarkers of dementia and mild cognitive impairment in Parkinson's disease patients. Despite the potential importance, no biomarker has as yet been validated. However, features such as low levels of epidermal and insulin-like growth factors or uric acid in plasma/serum and of Aß in CSF, reduction of cerebral cholinergic innervation and metabolism measured by PET mainly in posterior areas, and hippocampal atrophy in MRI might be indicative of distinct deficits with a distinct risk of dementia in subgroups of patients. Longitudinal studies combining the existing techniques and new approaches are needed to identify patients at higher risk of dementia. © 2016 International Parkinson and Movement Disorder Society.

  20. APOE and APOC1 gene polymorphisms are associated with cognitive impairment progression in Chinese patients with late-onset Alzheimer’s disease

    Institute of Scientific and Technical Information of China (English)

    Qin Zhou; Yige Yang; Haiqun Xie; Wandong Zhang; Caiyou Hu; Ze Yang; Dantao Peng; Xinrui Yuan; Zeping Lv; Shenghang Pang; Wenyu Jiang; Chuyu Yang; Xiaohong Shi; Guofang Pang

    2014-01-01

    Current evidence shows that apolipoprotein E (APOE), apolipoprotein CI (APOC1) and low density lipoprotein receptor-related protein (LRP) variations are related to late-onset Alzheimer’s disease. However, it remains unclear if genetic polymorphisms in these genes are associated with cognitive decline in late-onset Alzheimer’s disease patients. We performed a 30-month longitudi-nal cohort study to investigate the relationship between Alzheimer’s disease and APOE, APOC1, and LRP. In this study, 78 Chinese Han patients with late-onset Alzheimer’s disease were recruit-ed form Guangxi Zhuang Autonomous Region in China. APOE, APOC1, and LRP genotyping was performed using polymerase chain reaction-restriction fragment length polymorphisms. The Mini-Mental State Examination and Clinical Dementia Rating Scale were used to assess pa-tients’ cognitive function. After a 30-month follow-up period, we found a signiifcant reduction in Mini-Mental State Examination total score, a higher proportion of patients fuliflling cognitive impairment progression criteria, and a higher proportion of APOC1 H2 carriers in APOEε4 carriers compared with non-carriers. In addition, the APOEε4 allele frequency was signiifcantly higher in the cognitive impairment progression group compared with the non-cognitive im-pairment progression group. In conclusion, APOEε4 plays an important role in augmenting cognitive decline, and APOC1 H2 may act synergistically with APOEε4 in increasing the risk of cognitive decline in Chinese patients with late-onset Alzheimer’s disease.

  1. Caregivers of older adults with cognitive impairment.

    Science.gov (United States)

    DeFries, Erin L; McGuire, Lisa C; Andresen, Elena M; Brumback, Babette A; Anderson, Lynda A

    2009-04-01

    Because of the growing number of caregivers and the awareness of related health and quality-of-life issues, caregiving has emerged as an important public health issue. We examined the characteristics and caregiving experiences of caregivers of people with and without cognitive impairment. Participants (n = 668) were adults who responded to the 2005 North Carolina Behavioral Risk Factor Surveillance System. Caregivers were people who provided regular care to a family member or friend aged 60 years or older either with or without cognitive impairment (ie, memory loss, confusion, or Alzheimer's disease). Demographic characteristics of caregivers of people with cognitive impairment were similar to those of caregivers of people without cognitive impairment. However, compared with caregivers of people without cognitive impairment, caregivers of people with cognitive impairment reported higher levels of disability, were more likely to be paid, and provided care for a longer duration. Care recipients with cognitive impairment were more likely than care recipients without cognitive impairment to be older, have dementia or confusion, and need assistance with memory and learning. State-level caregiving surveillance is vital in assessing and responding to the needs of the growing number of caregivers.

  2. Chemotherapy-Induced Cognitive Impairment: A Novel Prospective Study of the Cognitive Effects of Platinum Taxane-Based Chemotherapy in Ovarian Cancer Patients

    Science.gov (United States)

    2016-09-01

    interested in participating in the MRI neuro -testing, but had to be excluded due to being left-handed (this study is only including right-handed...participants at this time). Enrollment is ongoing. 15. SUBJECT TERMS: OVARIAN CANCER,COGNITIVE IMPAIRMENT,CHEMOTHERAPY, CANCER 16. SECURITY CLASSIFICATION OF: 17

  3. Quantitative multivoxel proton MR spectroscopy study of brain metabolites in patients with amnestic mild cognitive impairment: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Zhong-Xian; Cheng, Xiao-Fang; Xu, Zhi-Feng; Cao, Zhen; Xiao, Ye-Yu; You, Ke-Zeng; Liu, Yan-Yan [Medical College of Shantou University, Department of Medical Imaging, The Second Affiliated Hospital, Shantou (China); Huo, Shan-Shan [Science College of Shantou University, Department of Physics, Shantou (China); Zeng, Jie-Xia; Chen, Wei [Medical College of Shantou University, Department of Neurology, The Second Affiliated Hospital, Shantou (China); Wu, Ren-Hua [Medical College of Shantou University, Department of Medical Imaging, The Second Affiliated Hospital, Shantou (China); Medical College of Shantou University, Provincial Key Laboratory of Medical Molecular Imaging, Guangdong, Shantou (China)

    2012-05-15

    The purpose of this study is to investigate brain metabolic changes in patients with amnestic mild cognitive impairment (aMCI) using multivoxel proton MR spectroscopy ({sup 1}H-MVS). Fourteen aMCI patients and fifteen healthy control subjects participated in this experiment. All MR measurements were acquired using a 1.5-T GE scanner. {sup 1}H-MVS point resolved spectroscopy (2D PROBE-CSI PRESS) pulse sequence (TE = 35 ms; TR = 1,500 ms; phase x frequency, 18 x 18) was used for acquiring MRS data. All data were post-processed using Spectroscopy Analysis by General Electric software and linear combination of model (LCModel). The absolute concentrations of N-acetylaspartate (NAA), choline (Cho), myoinositol (MI), creatine (Cr), and the metabolite ratios of NAA/Cr, Cho/Cr, MI/Cr, and NAA/MI were measured bilaterally in the posterior cingulate gyrus (PCG), inferior precuneus (Pr), paratrigonal white matter (PWM), dorsal thalamus (DT), and lentiform nucleus (LN). Patients with aMCI displayed significantly lower NAA levels in the bilateral PCG (p < 0.01), PWM (p < 0.05), and left inferior Pr (p < 0.05). The metabolite ratio of NAA/MI was decreased in the bilateral PCG (p < 0.01) and PWM (p < 0.05) and in the left DT (p < 0.01). NAA/Cr was decreased in the left PCG (p < 0.01), DT (p < 0.05), right PWM (p < 0.05), and LN (p < 0.05). However, MI/Cr was elevated in the right PCG (p < 0.01) and left PWM (p < 0.05). Significantly increased Cho level was also evident in the left PWM (p < 0.05). Our observations of decreased NAA, NAA/Cr, and NAA/MI, in parallel with increased Cho and MI/Cr might be characteristic of aMCI patients. (orig.)

  4. Female patients dosimetry in brain exams with PET/CT scan for diagnosis of Mild Cognitive Impairment (MCI)

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    Santana, P.C.; Mamede, M.; Carvalho, F.M.V., E-mail: pridili@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Mourao, A.P., E-mail: apratabhz@gmail.com [Centro Federal de Educacao Tecnologica, Belo Horionte, MG (Brazil). Dept. de Engenharia Eletrica; Oliveira, P.M.C.; Silva, T.A. da, E-mail: pmco@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    Dementia affects over 35 million people worldwide, with strong personal, social and financial impacts. Alzheimer's disease is the most common form of dementia, accounting for 60-70% of cases, affecting mostly females. Recent technological innovations, using methods of anatomical and functional neuroimaging, with particular emphasis on PET / CT (positron emission tomography with computed tomography associated), have shown excellent prospects for early diagnosis of Alzheimer's disease represented by Mild Cognitive Impairment (MCI). The use of PET / CT helps diagnosis, but the patients effective dose is higher and directly dependent on the radiopharmaceutical activity and the computed tomographic (CT) protocol used. The aim of this study was evaluated the organs absorbed doses and effective doses in 59 female patients undergoing the PET/CT diagnostic technique. For the measurements of radiation levels from the CT was used TLD100 (LiF:Mg, Ti) Rod detectors inserted in Alderson Randon ® anthropomorphic phantom, which simulates a female pattern, of 155 cm and weight 50 kg, subjected to the same clinical protocol of acquiring patients images. The effective dose resulting from the radiopharmaceutical injected activity was estimated by ICRP106 model using the weight of the patients undergoing to the procedure. The average effective dose due was (7.65 ± 2.22) mSv. The effective dose contribution to the brain and the thyroid due to CT were (2.21 ± 0.38) and (0.72 ± 0.14) mSv, respectively. The use of CT optimized protocols can assist in reducing the dose in this type of procedure. (author)

  5. Comparison of LCModel and SAGE in Analysis of Brain Metabolite Concentrations-A study of Patients with Mild Cognitive Impairment.

    Science.gov (United States)

    Shih, Chiu-Ming; Lai, Jui-Jen; Chang, Chin-Ching; Chen, Cheng-Sheng; Yeh, Yi-Chun; Jaw, Twei-Shiun; Hsu, Jui-Sheng; Li, Chun-Wei

    2017-03-15

    The purpose of this study was to compare brain metabolite concentration ratios determined by LCModel and Spectroscopy Analysis by General Electric (SAGE) quantitative methods to elucidate the advantages and disadvantages of each method. A total of 10 healthy volunteers and 10 patients with mild cognitive impairment (MCI) were recruited in this study. A point-resolved spectroscopy (PRESS) sequence was used to obtain the brain magnetic resonance spectroscopy (MRS) spectra of the volunteers and patients, as well as the General Electric (GE) MRS-HD-sphere phantom. The brain metabolite concentration ratios were estimated based on the peak area obtained from both LCModel and SAGE software. Three brain regions were sampled for each volunteer or patient, and 20 replicates were acquired at different times for the phantom analysis. The metabolite ratios of the GE phantom were estimated to be myo-inositol (mI)/creatine (Cr): 0.70 ± 0.01, choline (Cho)/Cr: 0.37 ± 0.00, N-acetylaspartate (NAA)/Cr: 1.26 ± 0.02, and NAA/mI: 1.81 ± 0.04 by LCModel, and mI/Cr: 0.88 ± 0.15, Cho/Cr: 0.35 ± 0.01, NAA/Cr: 1.33 ± 0.03, and NAA/mI: 1.55 ± 0.26 by SAGE. In the healthy volunteers and MCI patients, the ratios of mI/Cr and Cho/Cr estimated by LCModel were higher than those estimated by SAGE. In contrast, the ratio of NAA/Cr estimated by LCModel was lower than that estimated by SAGE. Both methods were acceptable in estimating brain metabolite concentration ratios. However, LCModel was marginally more accurate than SAGE because of its full automation, basis set, and user independency.

  6. Cognitive impairment in migraine:A systematic review

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    Caroline Martins de Araújo

    Full Text Available ABSTRACT Patients with migraine often report cognitive complaints, especially regarding attention and memory. Objective: To perform a systematic review of the studies available on cognitive evaluation in patients with migraine. Methods: We evaluated all articles containing the key words: "Migraine", "Cognition" and "Cognitive Impairment." Results: The search strategy resulted in 23 articles. Fifteen out of the 23 studies (65.3% retrieved reported abnormalities on neuropsychological tests in migraine patients, notably tests of memory, attention and information processing speed. Most of the studies showing cognitive changes in migraine were carried out in neurological care facilities. Conversely, among community-based studies, migraine patients were less likely to present cognitive changes. Conclusion: Patients with migraine, especially those followed at neurology clinics, show an elevated risk of mild changes in several cognitive domains. Further studies with greater methodological refinement are warranted in order to clearly establish whether this cognitive dysfunction is associated with an underlying migraine pathophysiological process.

  7. C-reactive protein, advanced glycation end products and their receptor in type 2 diabetic, elderly patients with mild cognitive impairment

    OpenAIRE

    2015-01-01

    Objective: The aim of the study was to evaluate serum levels of AGEs (advanced glycation end products), RAGE (receptor for advanced glycation end products) and CRP (C-reactive protein) in elderly patients with T2DM with and without mild cognitive impairment (MCI) and to determine the predictors (including AGEs, RAGE and CRP levels) of having MCI in elderly patients with type 2 diabetes.Methods: 276 diabetics elders were screened for MCI (using the Montreal Cognitive Assessment: MoCA score). D...

  8. [Cryptococcal meningoencephalitis presenting with treatable cognitive impairment and involuntary movement].

    Science.gov (United States)

    Ikumi, Kazuhiro; Yokoi, Katsunori; Ando, Tetsuo

    2016-01-01

    The patient is a 72-year-old Japanese woman. Seven years prior to admission, multiple nodules in her left lung were found. Bronchoscopic biopsy of the nodules did not provide a confirmative diagnosis, and probable diagnosis of cryptococcosis was made. Follow-up CT scan of the chest revealed reduction in size of the lung nodules. She was admitted to our hospital due to progressive cognitive impairment and difficulty in walking that lasted for 5 months. On admission, athetotic involuntary movement was observed in her lower extremities, predominantly in the right side. Blood and cerebrospinal fluid culture of the patient were positive for Cryptococcus neoformans. Antifungal drugs resolved the cognitive impairment, the difficulty in walking, and the involuntary movement. We assessed the cognitive impairment and observed the clinical improvement of the patient, with the use of neuropsychological examinations. To our knowledge, there has been only a few reported case of cryptococcal meningoencephalitis presenting with treatable cognitive impairment and involuntary movement.

  9. [Tractography of the uncinate fasciculus and the posterior cingulate fasciculus in patients with mild cognitive impairment and Alzheimer disease].

    Science.gov (United States)

    Larroza, A; Moratal, D; D'ocón Alcañiz, V; Arana, E

    2014-01-01

    Brain tractography is a non-invasive medical imaging technique which enables in vivo visualisation and various types of quantitative studies of white matter fibre tracts connecting different parts of the brain. We completed a quantitative study using brain tractography with diffusion tensor imaging in patients with mild cognitive impairment, patients with Alzheimer disease, and normal controls, in order to analyse the reproducibility and validity of the results. Fractional anisotropy (FA) and mean diffusivity (MD) were measured across the uncinate fasciculus and the posterior cingulate fasciculus in images, obtained from a database and a research centre, representing 52 subjects distributed among the 3 study groups. Two observers took the measurements twice in order to evaluate intra- and inter-observer reproducibility. Measurements of FA and MD of the uncinate fasciculus delivered an intraclass correlation coefficient above 0.9; ICC was above 0.68 for the posterior cingulate fasciculus. Patients with Alzheimer disease showed lower values of FA and higher MD values in the right uncinate fasciculus in images from the research centre. A comparison of the measurements from the 2 centres revealed significant differences. We established a reproducible methodology for performing tractography of the tracts in question. FA and MD indexes may serve as early indicators of Alzheimer disease. The type of equipment and the method used to acquire images must be considered because they may alter results as shown by comparing the 2 data sets in this study. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  10. A patient-centered analysis of enrollment and retention in a randomized behavioral trial of two cognitive rehabilitation interventions for Mild Cognitive Impairment.

    Science.gov (United States)

    Locke, Dona E C; Greenaway, Melanie Chandler; Duncan, Noah; Fields, Julie A; Cuc, Andrea V; Snyder, Charlene Hoffman; Hanna, Sherrie; Lunde, Angela; Smith, Glenn E

    2014-12-01

    A major potential barrier for studying behavioral interventions for patients with Mild Cognitive Impairment (MCI) is the willingness and ability of people to enroll in and adhere to behavioral interventions, especially when the intervention involves dyads of patients with MCI and support partners. Details regarding recruitment strategies and processes (such as number of dyads screened) are often missing from reports of behavioral trials. In addition, reports do not detail the reasons a potentially eligible candidate opts out of participation in a research study. To describe the challenges and successes of enrollment and retention in a behavioral trial for persons with MCI and their care partners, and to better understand barriers to participation from the patient's point of view. Multi-site, randomized trial. Major medical centers. Our accrual target for the study was 60 participants. Potential candidates were patients presenting to memory evaluation clinics whose resulting clinical diagnosis was MCI. A total of 200 consecutive potential candidates were approached about participating in the study across the three sites. Detailed recruitment and retention data of a randomized trial comparing two behavioral interventions (memory notebook training versus computer training) provided in two separate training time frames (10 days versus 6 weeks). Structured interview with those declining to participate in the trial. Overall recruitment 37% with a range of 13%-72% across sites. Overall retention 86% with a range of 74%-94% across sites. The primary barriers to enrollment from the patient's perspective were distance to the treatment center and competing comprehensive behavioral programming. However, retention data suggest that those dyads who enroll in behavioral programs are highly committed.

  11. Tobacco smoking in treatment-resistant schizophrenia patients is associated with impaired cognitive functioning, more severe negative symptoms, and poorer social adjustment

    Directory of Open Access Journals (Sweden)

    Iasevoli F

    2013-08-01

    Full Text Available Felice Iasevoli, Raffaele Balletta, Valentina Gilardi, Sara Giordano, Andrea de Bartolomeis Unit on Treatment Resistance in Psychiatry and Laboratory of Molecular and Translational Psychiatry, Section of Psychiatry, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University School of Medicine ‘Federico II’, Naples, Italy Abstract: Tobacco smoking is common in schizophrenia patients. It has been reported that schizophrenia patients who are tobacco smokers have better cognitive performances compared to those who are nonsmokers. However, little is known on the effects of tobacco smoking in treatment-resistant schizophrenia (TRS patients. The aim of this study was to compare cognitive performances, psychotic symptoms, and social adjustment in tobacco smoker TRS patients compared to nonsmoker TRS patients. Smoker and nonsmoker TRS patients did not differ in demographics and in mean daily antipsychotic dose. Smoker TRS patients had significantly higher scores than nonsmoker patients on the positive and negative syndrome scale (PANSS and on the negative symptoms subscale. These patients also performed worse than nonsmoker patients on problem-solving cognitive domain. Social adjustment was not significantly different between the two groups. In both groups of patients, worse cognitive performances were mostly predicted by higher severity of negative symptoms. Worse performances on the verbal memory and problem-solving cognitive domains were correlated with social-functioning impairment in tobacco smoker TRS patients but not in nonsmoker ones. The results showed that tobacco smoking was not significantly associated with better cognitive performances in TRS patients, while it was significantly associated with higher negative symptoms. Even if a direct causative mechanism cannot be inferred and despite the fact that these patients may use tobacco to self-medicate, it could be speculated that these associations may, at least

  12. Exploring the patterns of acupuncture on mild cognitive impairment patients using regional homogeneity.

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    Zhenyu Liu

    Full Text Available To investigate the different responses to acupuncture in MCI patients and age-matched healthy subjects reflected by the Regional Homogeneity (ReHo indices.The experiment was performed at the acupoint KI3 in 12 MCI patients and 12 healthy controls, respectively. A novel non-repeated event-related (NRER fMRI design paradigm was applied to separately detect neural activities related to different stages of acupuncture (pre-acupuncture resting state, needling manipulation and post-acupuncture resting state. ReHo values were calculated for MCI patients and healthy controls in pre- and post-acupuncture resting state. Then, a two-way ANCOVA with repeated measures with post-hoc two sample t-tests was performed to explore the different responses to acupuncture in the two groups.The ANCOVA revealed a significant main effect of group, but no significant main effect of acupuncture and interactions between group and acupuncture. During the pre-acupuncture resting state, ReHo values increased in the precentral gyrus (PCG, superior frontal gyrus (SFG, and insula (INS and decreased mainly in middle temporal gyrus (MTG, parahippocampal (PHIP and cingulate cortex in MCI patients compared with healthy controls. Furthermore, we found that the regions including precuneus (PCUN, and cingulate cortex showed increased ReHo values for MCI patients following acupuncture. For healthy controls, the medial frontal gyrus, PCG, anterior cingulate cortex (ACC and INS showed enhanced ReHo values following acupuncture. During the post-acupuncture resting state, MCI patients showed increased ReHo values mainly in the MTG, superior parietal lobule (SPL, middle frontal gyrus (MFG, supramarginal (SMG, and PCG, and decreased ReHo values mainly in the frontal regions, PHIP, and posterior cingulated cortex (PCC compared to healthy controls.Though we found some ReHo changes between MCI patients and healthy controls, the two-way ANCOVA results showed no significant effects after multiple

  13. Comparison between the story recall test and the word-list learning test in Korean patients with mild cognitive impairment and early stage of Alzheimer's disease.

    Science.gov (United States)

    Baek, Min Jae; Kim, Hyun Jung; Kim, Sangyun

    2012-01-01

    Among verbal memory tests, two that are commonly used to measure the ability of verbal memory function in cognitive impairment are story recall tests and word-list learning tests. However, research is limited regarding which test might be more sensitive in discriminating between normal cognitive aging and patients with Alzheimer's disease (AD) in the Korean population. The purpose of the current study was to compare the word-list learning test (Seoul Verbal Learning Test; SVLT) and the story recall test (Korean Story Recall Test; KSRT) to determine which test is more sensitive in discriminating between individuals with normal cognitive aging and patients with mild cognitive impairment (MCI) and early stage of AD in Korea. A total of 53 healthy adults, 127 patients with MCI, and 72 patients with early stage of AD participated in this study. The receiver-operating characteristic (ROC) curve and area under the curve (AUC) were evaluated to compare these two tests. The results showed that the AUC of the SVLT was significantly larger than the AUC of the KSRT in all three groups (healthy adults vs. MCI and early stage of AD; healthy adults vs. MCI; healthy adults vs. early stage of AD). However, in comparison of patients with MCI and early stage of AD, the AUC of SVLT and the AUC of KSRT were not significant. The word-list learning test is a more useful tool for examining verbal memory function for older adults in Korea than the story recall test.

  14. Plasticity, permanence and patient performance: study design and data analysis in the cognitive rehabilitation of acquired communication impairments

    Directory of Open Access Journals (Sweden)

    Patricia E Cowell

    2010-11-01

    Full Text Available Communication impairments such as aphasia and apraxia can follow brain injury and result in limitation of an individual's participation in social interactions, and capacity to convey needs and desires. Our research group developed a computerised treatment programme which is based on neuroscientific principles of speech production (Varley and Whiteside, 2001; Varley, 2010; Whiteside and Varley, 1998 and has been shown to improve communication in people with apraxia and aphasia (Dyson et al., 2009; Varley et al., 2009. Investigations of treatment efficacy have presented challenges in study design, effect measurement and statistical analysis which are likely to be shared by other researchers in the wider field of cognitive neurorehabilitation evaluation. Several key factors define neurocognitively based therapies, and differentiate them and their evaluation from other forms of medical intervention. These include: (1 inability to blind patients to the content of the treatment and control procedures; (2 neurocognitive changes that are more permanent than pharmacological treatments on which many medical study designs are based; and (3 the semi-permanence of therapeutic effects means that new baselines are set throughout the course of a given treatment study, against which comparative interventions or long term retention effects must be measured. This article examines key issues in study design, effect measurement and data analysis in relation to the rehabilitation of patients undergoing treatment for apraxia of speech. Results from our research support a case for the use of multiperiod, multiphase cross-over design with specific computational adjustments and statistical considerations. The paper provides researchers in the field with a methodologically feasible and statistically viable alternative to other designs used in rehabilitation sciences.

  15. Altered topological organization of high-level visual networks in Alzheimer's disease and mild cognitive impairment patients.

    Science.gov (United States)

    Deng, Yanjia; Shi, Lin; Lei, Yi; Wang, Defeng

    2016-09-06

    Altered regional activation of high-level visual (HLV) cortices in patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI) has been well documented in previous fMRI studies, which led us to investigate the underlying alteration of the HLV networks in the terms of intrinsic interaction and topological organization. First, the activation likelihood estimation, a coordinate-based meta-analysis approach, was used to define the cortical regions/nodes included in HLV networks of "what" and "where" visions. Secondly, the acquired HLV regions were used as seeds to calculate their interregional resting-state functional connectivities (RSFCs) based on the temporal correlation of rs-functional MRI (rs-fMRI) time series. Here, the rs-fMRI data of AD (n=30), late MCI (n=35), early MCI (n=52) and matched healthy controls (n=44) were obtained from the Alzheimer's Disease Neuroimaging Initiative dataset. Finally, based on the calculated pair-wise RSFCs, the "what" and "where" HLV networks were respectively constructed, and their topological properties were calculated and analyzed among groups using the graph theory method. The results demonstrated increased clustering coefficient combined with a prolonged characteristic path length of the "where" visual network in AD patients. No significant alternation of the "what" visual network was found among the groups. These results suggest that the abnormality of the HLV networks could be a late-stage outcome in AD and that the "where" visual network may be more susceptible to the AD-related neuropathological changes than the "what" visual network. In addition, the dysfunction of the "where" network is found to be characterized by a decreased integration combined with an increased local segregation.

  16. Estimation of Tau and Phosphorylated Tau181 in Serum of Alzheimer's Disease and Mild Cognitive Impairment Patients.

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    Shashank Shekhar

    Full Text Available The elevated level of cerebrospinal fluid (CSF Tau and phosphorylated Tau181 (p-Tau181 proteins are well established hallmarks of Alzheimer's disease (AD. Elevated level of p-Tau181 can differentiate AD from other neurodegenerative disease. However, the expression level of these proteins in serum of AD patient is not well set up. This study sought to evaluate the level of Tau and p-Tau181 in serum of AD, and mild cognitive impairment (MCI patients for an alternative approach to establish protein-based markers by convenient way. Blood samples were collected from 39 AD patients, 37 MCI patients and 37 elderly individuals as controls. The levels of Tau and p-Tau181 in the serum of the different groups were measured by label free real time Surface Plasmon Resonance technology by using specific antibodies, and were further confirmed by the conventional western blot method. An appropriate statistical analysis, including Receiver Operating Characteristic (ROC, was performed. The concentrations of serum Tau and p-Tau181 were significantly higher (p<0.00001 in AD (Tau; 47.49±9.00ng/μL, p-Tau181; 0.161±0.04 ng/μL compared to MCI (Tau; 39.26±7.78 ng/μL, p-Tau181; 0.135±0.02 ng/μL and were further higher compared to elderly controls (Tau; 34.92±6.58 ng/μL, p-Tau181; 0.122±0.01 ng/ μL. A significant (p<0.0001 downhill correlation was found between Tau as well as p-Tau181 levels with HMSE and MoCA score. This study for the first time reports the concentration of Tau and p-Tau181 in serum of AD and MCI patients. The cutoff values of Tau and p-Tau181 of AD and MCI patients with sensitivity and specificity reveal that serum level of these proteins can be used as a predictive marker for AD and MCI.

  17. Cognitive impairment in human chronic Chagas' disease

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    C.A. Mangone

    1994-06-01

    Full Text Available We proposed to investigate subclinical cognitive impairment secondary to chronic Chagas' disease (CCD. No similar study was previously done. The neuropsychological performance of 45 chronic Chagasic patients and 26 matched controls (age, education place and years of residency in endemic area was compared using the Mini Mental State Exam (MMSE, Weschler Memory Scale (WMS and the Weschler Adult Intelligent Scale (WAIS. Non-parametric tests and Chi2 were used to compare group means and multivariate statistics in two way frequency tables for measures of independence and association of categorical variables with the disease. Results: Chagasic patients showed lower MMSE scores (p<004, poor orientation (p<.004, and attention (p<.007. Lower WMS MQ were associated with CCD (Chi2 5.9; p<.01; Fisher test p<.02. Lower WAIS IQ were associated with CCD (Chi2 6.3, p<.01; Fisher test p<.01 being the digit symbol (p<.03, picture completion (p<.03, picture arrangement (p<.01 and object assembly (p<.03 subtests the most affected. The impairment in non-verbal reasoning, speed of information processing, problem solving, learning and sequencing observed in chronic Chagas disease patients resembles the cognitive dysfunction associated with white matter disease.

  18. Is the concept of quality of life relevant for multiple sclerosis patients with cognitive impairment? Preliminary results of a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Karine Baumstarck

    Full Text Available BACKGROUND: Cognitive impairment occurs in about 50% of multiple sclerosis (MS patients, and the use of self-reported outcomes for evaluating treatment and managing care among subjects with cognitive dysfunction has been questioned. The aim of this study was to provide new evidence about the suitability of self-reported outcomes for use in this specific population by exploring the internal structure, reliability and external validity of a specific quality of life (QoL instrument, the Multiple Sclerosis International Quality of Life questionnaire (MusiQoL. METHODS: DESIGN: cross-sectional study. INCLUSION CRITERIA: MS patients of any disease subtype. DATA COLLECTION: sociodemographic (age, gender, marital status, education level, and occupational activity and clinical data (MS subtype, Expanded Disability Status Scale, disease duration; QoL (MusiQoL and SF36; and neuropsychological performance (Stroop color-word test. STATISTICAL ANALYSIS: confirmatory factor analysis, item-dimension correlations, Cronbach's alpha coefficients, Rasch statistics, relationships between MusiQoL dimensions and other parameters. PRINCIPAL FINDINGS: One hundred and twenty-four consecutive patients were enrolled. QoL scores did not differ between the 69 cognitively non-impaired patients and the 55 cognitively impaired patients, except for the symptoms dimension. The confirmatory factor analysis performed among the impaired subjects showed that the structure of the questionnaire matched with the initial structure of the MusiQoL. The unidimensionality of the MusiQoL dimensions was preserved, and the internal validity indices were satisfactory and close to those of the reference population. CONCLUSIONS/SIGNIFICANCE: Our study suggests that executive dysfunction did not compromise the reliability and the validity of the self-reported QoL questionnaires.

  19. [Does pre-surgical cognitive impairment affect knee replacement results?].

    Science.gov (United States)

    Jiménez, M; Zorrilla, P; López-Alonso, A; León, A; Salido, J A

    2014-01-01

    To determine the influence of the pre-operative cognitive impairment on results of the total knee arthroplasty according to a doctor and patient perspective. A prospective study was conducted on patient from the surgical waiting list who had undergone a primary total knee arthroplasty. The sample initially included 265 patients, but 50 were subsequently excluded. Cognitive impairment was assessed pre-operatively by the Mini Cognitive Examination (MEC-35). The Visual Analog Scale (VAS), the Knee Society Score (KSS), the Western Ontario and McMaster Osteoarthritis Index (WOMAC), and the Hospital Anxiety and Depression Scale (HADS), were used pre-operatively and one year later post-operatively. A total of 215 patients were assessed (57 men and 158 women). Cognitive impairment had no influence on the results of total knee arthroplasty. In fact, there was no statistical significance in any of the scales analyzed. Preoperatively, and one year later, the patients with cognitive impairment showed higher levels of anxiety and depression, with these differences being statistically significant. All of the patients experienced an improvement in the specific outcomes and quality of life after the total knee arthroplasty procedure, regardless of the presence of preoperative cognitive impairment. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  20. Effect of Memo®, a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment

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    Yakoot M

    2013-07-01

    Full Text Available Mostafa Yakoot,1 Amel Salem,2 Sherine Helmy3 1Green Clinic and Research Center, 2Mabarrah Clinics, 3Pharco Pharmaceutical Industries, Alexandria, Egypt Background: Mild cognitive impairment encompasses the clinical continuum between physiologic age-related cognitive changes and dementia. A variety of medications, including herbal preparations (in particular Ginkgo biloba and Panax ginseng, have been advocated as treatments for cognitive impairment in the elderly. In this study, we investigated the effect of an already marketed dietary supplement (Memo® combining 750 mg of lyophilized royal jelly with standardized extracts of G. biloba 120 mg and P. ginseng 150 mg on Mini-Mental State Examination (MMSE scores in patients with mild cognitive impairment. Methods: Sixty-six subjects presenting with forgetfulness and satisfying the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR clinical criteria for mild cognitive impairment were randomly divided into an experimental group treated with one Memo capsule before breakfast daily for 4 weeks and a control group who took placebo. The mean change in MMSE score from baseline and reported adverse effects were compared between the two groups. Results: The mean change in MMSE score in the group treated with Memo for 4 weeks was significantly greater than in the control group (+2.07 versus +0.13, respectively by the Student’s t-test (t = 6.485, P < 0.0001. This was also true after adjusting for age as a covariate and educational level as a factor nested within the treatment groups in a general linear model (analysis of covariance, F = 9.675 [corrected model], P < 0.0001. Conclusion: This combined triple formula may be beneficial in treating the cognitive decline that occurs during the aging process as well as in the early phases of pathologic cognitive impairment typical of insidious-onset vascular dementia and in the early stages of Alzheimer’s disease. Larger

  1. Inter- and intra-hemispheric EEG coherence in patients with mild cognitive impairment at rest and during working memory task

    Institute of Scientific and Technical Information of China (English)

    JIANG Zheng-yan; ZHENG Lei-lei

    2006-01-01

    Objective: To assess functional relationship by calculating inter- and intra-hemispheric electroencephalography (EEG) coherence at rest and during a working memory task of patients with mild cognitive impairment (MCI). Methods: The sample consisted of 69 subjects: 35 patients (n=17 males, n=18 females; 52~71 years old) and 34 normal controls (n=17 males, n=17females; 51~63 years old). Mini-mental state examination (MMSE) of two groups revealed that the scores of MCI patients did not differ significantly from those of normal controls (P>0.05). In EEG recording, subjects were performed at rest and during working memory task. EEG signals from F3-F4, C3-C4, P3-P4, T5-T6 and O1-O2 electrode pairs are resulted from the inter-hemispheric action, and EEG signals from F3-C3, F4-C4, C3-P3, C4-P4, P3-O1, P4-O2, T5-C3, T6-C4, T5-P3 and T6-P4 electrode pairs are resulted from the intra-hemispheric action for delta (1.0~3.5 Hz), theta (4.0~7.5 Hz), alpha-1 (8.0~10.0 Hz), alpha-2 (10.5~13.0Hz), beta-1 (13.5~18.0 Hz) and beta-2 (18.5~30.0 Hz) frequency bands. The influence of inter- and intra-hemispheric coherence on EEG activity with eyes closed was examined using fast Fourier transformation from the 16 sampled channels. Results: During working memory tasks, the inter- and intra-hemispheric EEG coherences in all bands were significantly higher in the MCI group in comparison with those in the control group (P<0.05). However, there was no significant difference in inter- and intra-hemispheric EEG coherences between two groups at rest. Conclusion: Experimental results comprise evidence that MCI patients have higher degree of functional connectivity between hemispheres and in hemispheres during working condition. It suggests that MCI may be associated with compensatory processes during working memory tasks between hemispheres and in hemispheres. Moreover,failure of normal cortical connections may exist in MCI patients.

  2. Validity of conducting clinical dysphagia assessments for patients with normal to mild cognitive impairment via telerehabilitation.

    Science.gov (United States)

    Ward, Elizabeth C; Sharma, Shobha; Burns, Clare; Theodoros, Deborah; Russell, Trevor

    2012-12-01

    To assess the validity of conducting clinical dysphagia assessments via telerehabilitation, 40 individuals with dysphagia from various etiologies were assessed simultaneously by a face-to-face speech-language pathologist (FTF-SLP) and a telerehabilitation SLP (T-SLP) via an Internet-based videoconferencing telerehabilitation system. Dysphagia status was assessed using a Clinical Swallowing Examination (CSE) protocol, delivered via a specialized telerehabilitation videoconferencing system and involving the use of an assistant at the patient's end of the consultation to facilitate the assessment. Levels of agreement between the FTF-SLP and T-SLP revealed that the majority of parameters reached set levels of clinically acceptable levels of agreement. Specifically, agreement between the T-SLP and FTF-SLP ratings for the oral, oromotor, and laryngeal function tasks revealed levels of exact agreement ranging from 75 to 100% (kappa = 0.36-1.0), while the parameters relating to food and fluid trials ranged in exact agreement from 79 to 100% (kappa = 0.61-1.0). Across the parameters related to aspiration risk and clinical management, exact agreement ranged between 79 and 100% (kappa = 0.49-1.0). The data show that a CSE conducted via telerehabilitation can provide valid and reliable outcomes comparable to clinical decisions made in the FTF environment.

  3. Heterogenous mechanisms of mild cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Jellinger, Kurt

    2012-03-01

    Mild cognitive impairment in Parkinson disease (PD-MCI) shows heterogeneity in the clinical presentation, neuropsychology, neuroimaging, and neuropathology, suggesting abnormal metabolic network activities involving several cortical and subcortical systems. Prospective studies using specific biomarkers, including amyloid imaging and CSF biomarkers are important for the diagnosis and prognostic assessment of early cognitive deficits in PD patients.

  4. Relation between cognitive impairment and early death in the elderly.

    Science.gov (United States)

    Eagles, J M; Beattie, J A; Restall, D B; Rawlinson, F; Hagen, S; Ashcroft, G W

    1990-01-01

    STUDY OBJECTIVE--To study the association between cognitive impairment and early death in elderly patients living in the community. DESIGN--Case-control study of 410 patients assessed by the mental status questionnaire and followed up after three years. SETTING--A general practice in Inverurie, Aberdeenshire, with 14,000 patients. PATIENTS--205 Patients aged greater than or equal to 65 with cognitive impairment according to the mental status questionnaire (score less than or equal to 8) and 205 patients scoring greater than 8 on the questionnaire matched for age and sex. MAIN OUTCOME MEASURE--Death. RESULTS--The relative risk of death in the cognitively impaired patients overall was 3.5. Those patients who scored less than or equal to 7 on the mental status questionnaire were five times more likely to die than their controls. There was no difference in risk of death between those with severe or moderate cognitive impairment. CONCLUSIONS--Cognitive impairment is associated with early death. PMID:2106935

  5. Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in memory clinic patients

    Directory of Open Access Journals (Sweden)

    Joukje eOosterman

    2014-05-01

    Full Text Available In this retrospective study, we investigated the independent effects of white matter hyperintensities and hippocampal atrophy on cognitive functions in a broad sample of patients seen in a memory clinic. To ensure generalizability, these associations were examined irrespective of diagnosis and with minimal exclusion criteria. Next to these independent effects, interactions between white matter hyperintensities and hippocampal atrophy were examined. Between January 2006 and September 2011 a total of 500 patients visited the memory clinic, 397 of whom were included. Magnetic resonance images of 397 patients were visually analyzed for white matter hyperintensities (WMH, medial temporal atrophy (MTA and global atrophy. We evaluated the association of WMH and MTA with the following cognitive domains: global cognition, episodic memory, working memory, executive function and psychomotor speed. Main effects and interaction effects were examined by means of correlation and regression analyses. In the regression analyses, we controlled for potential confounding effects of global atrophy. The correlational results revealed that WMH were associated with global cognition, executive function and psychomotor speed, whereas a trend was found for episodic memory. MTA was associated with all these four cognitive domains; an additional trend was observed for working memory. Hierarchical regression analyses revealed main independent effects of MTA for episodic memory, executive function, psychomotor speed and global cognition; WMH were only associated with global cognition. The interaction between MTA and WMH was significant for episodic memory only. This study demonstrates that predominantly MTA is an independent predictor not only for memory function, with which is it classically associated, but also for global cognition and executive function. Taken together, MTA may be an important correlate of cognitive deficits found in people attending the memory clinic.

  6. Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in memory clinic patients.

    Science.gov (United States)

    Overdorp, Eduard J; Kessels, Roy P C; Claassen, Jurgen A; Oosterman, Joukje M

    2014-01-01

    In this retrospective study, we investigated the independent effects of white matter hyperintensities (WMH) and hippocampal atrophy on cognitive functions in a broad sample of patients seen in a memory clinic. To ensure generalizability, these associations were examined irrespective of diagnosis and with minimal exclusion criteria. Next to these independent effects, interactions between WMH and hippocampal atrophy were examined. Between January 2006 and September 2011 a total of 500 patients visited the memory clinic, 397 of whom were included. Magnetic resonance images of 397 patients were visually analyzed for WMH, medial temporal atrophy (MTA), and global atrophy. We evaluated the association of WMH and MTA with the following cognitive domains: global cognition, episodic memory, working memory, executive function and psychomotor speed. Main effects and interaction effects were examined by means of correlation and regression analyses. In the regression analyses, we controlled for potential confounding effects of global atrophy. The correlational results revealed that WMH were associated with global cognition, executive function and psychomotor speed, whereas a trend was found for episodic memory. MTA was associated with all these four cognitive domains; an additional trend was observed for working memory. Hierarchical regression analyses revealed main independent effects of MTA for episodic memory, executive function, psychomotor speed and global cognition; WMH were only associated with global cognition. The interaction between MTA and WMH was significant for episodic memory only. This study demonstrates that predominantly MTA is an independent predictor not only for memory function, with which is it classically associated, but also for global cognition and executive function. Taken together, MTA may be an important correlate of cognitive deficits found in people attending the memory clinic.

  7. Cognitive impairment and self-care in heart failure

    Directory of Open Access Journals (Sweden)

    Hajduk AM

    2013-10-01

    Full Text Available Alexandra M Hajduk,1,2 Stephenie C Lemon,3 David D McManus,1,2,4 Darleen M Lessard,1 Jerry H Gurwitz,1,2,4 Frederick A Spencer,5 Robert J Goldberg,1,2 Jane S Saczynski1,2,4 1Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA; 2Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA; 3Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA; 4Division of Geriatric Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA; 5Department of Medicine, McMaster University, Hamilton, ON, Canada Background: Heart failure (HF is a prevalent chronic disease in older adults that requires extensive self-care to prevent decompensation and hospitalization. Cognitive impairment may impact the ability to perform HF self-care activities. We examined the association between cognitive impairment and adherence to self-care in patients hospitalized for acute HF. Design: Prospective cohort study. Setting and participants: A total of 577 patients (mean age = 71 years, 44% female hospitalized for HF at five medical centers in the United States and Canada. Measurements and methods: Participants were interviewed for information on self-reported adherence to self-care using the European Heart Failure Self-care Behaviour Scale. We assessed cognitive impairment in three domains (memory, processing speed, and executive function using standardized measures. Patients' demographic and clinical characteristics were obtained through medical record review. Multivariable linear regression was used to examine the association between cognitive impairment and self-care practices adjusting for demographic and clinical factors. Results: A total of 453 patients (79% were impaired in at least one cognitive

  8. Gait Speed and Grip Strength Reflect Cognitive Impairment and Are Modestly Related to Incident Cognitive Decline in Memory Clinic Patients With Subjective Cognitive Decline and Mild Cognitive Impairment: Findings From the 4C Study

    NARCIS (Netherlands)

    Hooghiemstra, A.M.; Ramakers, I.; Sistermans, N.; Pijnenburg, Y.A.; Aalten, P.; Hamel, R.E.; Melis, R.J.F.; Verhey, F.R.J.; Olde Rikkert, M.G.M.; Scheltens, P.; Flier, W.M. van der

    2017-01-01

    Background: Prospective studies in the general population show that slow gait speed is associated with cognitive decline and clinical progression to dementia. However, longitudinal studies in memory clinic populations are mostly lacking. We aimed to study the association between gait speed and grip

  9. Cognitive impairments in Hashimoto's encephalopathy: a case-control study.

    Science.gov (United States)

    Wang, Jianhong; Zhang, Jun; Xu, Lan; Shi, Yunbo; Wu, Xunyi; Guo, Qihao

    2013-01-01

    Hashimoto's encephalopathy is considered as a treatable dementia, but it is often misdiagnosed. We investigated cognitive impairment and the MRI pathology of Hashimoto's encephalopathy patients. The study comprised eight patients with Hashimoto's encephalopathy, 16 patients with mild Alzheimer's disease and 24 healthy subjects. A neuropsychological battery included assessments of memory, language, attention, executive function and visuospatial ability. Cranial MRI was obtained from all Hashimoto's encephalopathy patients. Hashimoto's encephalopathy and mild Alzheimer's disease showed cognitive impairments in episodic memory, attention, executive function and visuospatial ability, but naming ability was unaffected in Hashimoto's encephalopathy. The MRI of Hashimoto's encephalopathy showed leukoencephalopathy-like type or limbic encephalitis-like type; the lesions did not affect the temporal cortex which plays a role in naming ability. Except that the naming ability was retained, the impairments in cognitive functions for the Hashimoto's encephalopathy patients were similar to those of Alzheimer's disease patients. These results were consistent with the MRI findings.

  10. [Non-pharmacological treatment of cognitive impairment].

    Science.gov (United States)

    Ramos Cordero, Primitivo; Yubero, Raquel

    2016-06-01

    This article reviews the effect of non-pharmacological therapies in persons with cognitive impairment, especially treatments aimed at brain stimulation and functional maintenance, since both pharmacological and non-pharmacological therapies affecting the cognitive and psychoaffective domains are reviewed in another article in this supplement. The article also discusses the close and reciprocal relationship between cognitive impairment, diet and nutritional status and describes the main nutritional risk factors and protective factors in cognitive decline. Copyright © 2016 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Cognitive impairment in a Brazilian sample of patients with bipolar disorder Prejuízo cognitivo em uma amostra brasileira de pacientes com transtorno do humor bipolar

    Directory of Open Access Journals (Sweden)

    Júlia J Schneider

    2008-09-01

    Full Text Available OBJECTIVE: Persistent neurocognitive deficits have been described in bipolar mood disorder. As far as we are aware, no study have examined whether the cognitive impairment is presented in the same way in a Brazilian sample. METHOD: Cognitive function of 66 patients with bipolar disorder (32 with depressive symptoms and 34 euthymic and 28 healthy subjects was examined using a complete cognitive battery. RESULTS: Patients with bipolar disorder presented a significantly poorer performance in eight of the 12 subtests when compared to healthy subjects. There was no significant difference between the subgroups of patients. These patients showed impairment in both verbal and non-verbal cognitive function. CONCLUSION: Cognitive impairment was found in both groups of patients with bipolar disorder. The findings described here suggest an overall impairment of cognitive function, independent of mood symptoms. This is in line with data showing that cognitive deficits may be a persistent characteristic of bipolar disorder.OBJETIVO: Déficits neurocognitivos persistentes têm sido descritos no transtorno do humor bipolar; entretanto, não há estudos em amostras brasileiras para avaliar se o prejuízo se apresenta da mesma forma. MÉTODO: Foi realizada uma avaliação cognitiva em 66 pacientes bipolares (32 com sintomas depressivos e 34 eutímicos e 28 controles, utilizando-se uma bateria cognitiva completa. RESULTADOS: Em oito dos 12 subtestes avaliados os pacientes apresentaram desempenho significativamente inferior em relação aos controles. Não houve diferença significativa entre os grupos de pacientes. Foram encontrados prejuízos cognitivos tanto na área verbal como na área não verbal da cognição. CONCLUSÃO: Foi observada uma performance inferior em ambos os grupos de pacientes com transtorno bipolar. As dificuldades cognitivas encontradas apontam para um prejuízo global no funcionamento cognitivo, independente da presença de sintomas

  12. Comparison of the quick mild cognitive impairment (Qmci) screen and the SMMSE in screening for mild cognitive impairment.

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2012-09-01

    differentiating mild cognitive impairment (MCI) from normal cognition (NC) is difficult. The AB Cognitive Screen (ABCS) 135, sensitive in differentiating MCI from dementia, was modified to improve sensitivity and specificity, producing the quick mild cognitive impairment (Qmci) screen.

  13. Hyperhomocysteinemia is associated with cognitive impairment in multiple sclerosis.

    Science.gov (United States)

    Russo, C; Morabito, F; Luise, F; Piromalli, A; Battaglia, L; Vinci, A; Trapani Lombardo, V; de Marco, V; Morabito, P; Condino, F; Quattrone, A; Aguglia, Umberto

    2008-01-01

    Hyperhomocysteinemia (HHcy) has been associated with cognitive impairment in various neurological diseases. Cognitive impairment occurs early in multiple sclerosis (MS). Conflicting data have been reported regarding plasma total homocysteine (tHcy) levels in MS patients, and the impact of HHcy on cognitive impairment in MS is not known. This study investigated whether plasma total homocysteine levels are increased in MS and if HHcy is associated with cognitive impairment in MS. We compared tHcy levels in 94 patients with MS and 53 healthy age-matched controls. We used a neuropsychological test battery that included the Raven's Coloured Progressive Matrices, the Visual Search Test, the Trail Making Test A and B, the Immediate and Delayed Recall of a Short Story, the 30 Paired Word Associates, the Rey-Osterrieth Complex Figure Test, and the Semantic and Verbal Fluency Tests. Clinical (sex, age, type of MS, relapse, disease duration, coexisting disease, smoking habit, and physical disability) and laboratory variables (HHcy, low serum levels of folate and vit.B12, MTHFR genotype) were evaluated for their ability to predict cognitive impairment. The mean tHcy was higher in patients (13.19 micromol/L, SD5.58) than in controls (9.81 micromol/L, SD2.53; p < 0.001). Univariate analysis determined the following factors to be associated with cognitive impairment: higher age at observation, chronic progressive course of disease, longer disease duration,moderate or severe physical disability, and frequency of HHcy. With multivariate regression analysis, there remained a significant association only between frequency of HHcy and cognitive impairment (beta 0.262, p = 0.01). We conclude that tHcy levels are increased in MS and that HHcy is associated with cognitive impairment in this disease.

  14. Verbal Fluency Deficits Co-Occur with Memory Deficits in Geriatric Patients at Risk for Dementia: Implications for the Concept of Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Maria E. Cottingham

    2010-01-01

    Full Text Available We tested the notion that patients at high risk for progression to Alzheimer's disease (AD display relatively isolated memory deficits by assessing the relationship between memory and fluency performances in a sample of 92 geriatric subjects with cognitive complaints and normal to mild clinical presentations. Patient groups were formed on the basis of memory test scores. Patients with normal memory scores also performed normally on fluency tests, and their fluency scores were significantly higher than those of patients with low memory performances. Patients falling between these two groups in memory abilities also displayed intermediate level fluency performances. Whereas the normal memory group performed at equivalent levels on semantic and phonemic fluency tasks, both the impaired memory group and the intermediate group displayed relatively greater weaknesses in semantic fluency. This pattern is similar to that seen in AD. Since the impaired memory patients meet criteria for Amnestic Mild Cognitive Impairment, these findings suggest that memory deficits in “pre-clinical” AD are likely to be accompanied by fluency weaknesses, with semantic fluency weaknesses predominating.

  15. Do subjective cognitive complaints correlate with cognitive impairment in systemic lupus erythematosus? A Danish outpatient study

    DEFF Research Database (Denmark)

    Vogel, A; Bhattacharya, S; Larsen, J L

    2011-01-01

    impaired patients only 18.2% had significantly higher PDQ scores than the normal range. PDQ scores were highly correlated to depressive symptoms (r = 0.67, p correlated with subjective cognitive complaints. When these variables and self...

  16. Cognitive and functional neuroimaging correlate for anosognosia in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Hasselbalch, Steen G; Gade, Anders

    2005-01-01

    To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD)....

  17. Screening for Cognitive Impairment in Older Adults

    Science.gov (United States)

    ... evidence to make a recommendation for or against screening all older adults for cognitive impairment. The Task Force recognizes that ... there was not enough evidence to determine whether screening all older adults would be beneficial. It therefore could not recommend ...

  18. Nutritional status and cognitive impairment in elderly.

    Science.gov (United States)

    Daradkeh, Ghazi; Essa, Musthafa M; Al-Adawi, S Samir; Koshy, Roopa P; Al-Asmi, Abdullah; Waly, Mostafa I

    2014-10-01

    The elderly population is increasing worldwide and it has been suggested that senior citizens will continue to constitute the bulk of the population in many countries. Nutritional status of senior citizens are adversely affected by their frailty, chronic condition and declining cognitive functioning. Conversely, malnourished elderly further deteriorate their frailty, chronic disease and cognitive functioning. The aim of this review article is to recognize the importance of nutritional assessment of elderly population particularly those with cognitive impairment. First part is to highlight characteristic cognitive impairment among senior citizens and the second one highlight t he background in which malnutrition is a factor that leads to increased risk of morbidity and mortality in the elderly. This review also highlight salgorithms for safeguarding nutritional status among senior citizen and focuses on importance of nutritional screening, assessment and early intervention for safeguarding further deterioration of elderly who are likely to prone to cognitive impairment.

  19. Cognitive impairment and vitamin B12: a review.

    Science.gov (United States)

    Moore, Eileen; Mander, Alastair; Ames, David; Carne, Ross; Sanders, Kerrie; Watters, David

    2012-04-01

    This review examines the associations between low vitamin B12 levels, neurodegenerative disease, and cognitive impairment. The potential impact of comorbidities and medications associated with vitamin B12 derangements were also investigated. In addition, we reviewed the evidence as to whether vitamin B12 therapy is efficacious for cognitive impairment and dementia. A systematic literature search identified 43 studies investigating the association of vitamin B12 and cognitive impairment or dementia. Seventeen studies reported on the efficacy of vitamin B12 therapy for these conditions. Vitamin B12 levels in the subclinical low-normal range (vitamin B12 levels and may independently increase the risk for cognitive impairment. Vitamin B12 deficiency (Vitamin B12 supplements administered orally or parenterally at high dose (1 mg daily) were effective in correcting biochemical deficiency, but improved cognition only in patients with pre-existing vitamin B12 deficiency (serum vitamin B12 levels 19.9 μmol/L). Low serum vitamin B12 levels are associated with neurodegenerative disease and cognitive impairment. There is a small subset of dementias that are reversible with vitamin B12 therapy and this treatment is inexpensive and safe. Vitamin B12 therapy does not improve cognition in patients without pre-existing deficiency. There is a need for large, well-resourced clinical trials to close the gaps in our current understanding of the nature of the associations of vitamin B12 insufficiency and neurodegenerative disease.

  20. Cognitive and functional neuroimaging correlate for anosognosia in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Hasselbalch, Steen G; Gade, Anders;

    2005-01-01

    To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD).......To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD)....

  1. Cognitive and functional neuroimaging correlate for anosognosia in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Hasselbalch, Steen G; Gade, Anders

    2005-01-01

    To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD).......To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD)....

  2. Relatedl factors of cognitive impairment after stroke

    Institute of Scientific and Technical Information of China (English)

    Xiaofang Chen; Yueji Sun; Haiyan Liu; Yunqiao Ding; Shujuan Liu; Jinghua Chen; Xueying Wang; Zhenpeng Han; Fang Qu

    2006-01-01

    BACKGROUND: Cognitive impairment after stroke associates with various factors, such as age, educational years, etc. Besides concerning about the recovery of limb function after stroke, we should also focus on the rehabilitation of cognition. Moreover, we'd better pay attention to the control of all the risk factors of stroke, and improve the quality of life in stroke patients.OBJECTIVE: To analyze the factors that affect cognitive impairment after stroke.DESIGN: A related factors analysis.SET-FINGS: Department of Neurology of Dalian Port Hospital and Dalian Second People's Hospital.PARTICIPANTS: Totally 148 stroke inpatients were selected from Department of Neurology, Dalian Port Hospital and Dalian Second People's Hospital from April 2004 to December 2005, including 100 males and 48females, aging 45-75 years with an average age of (67±8) years; Their educational years ranged 2-10 years with an average of (6.1 ±3.7) years; The disease course ranged 15-30 days; All were right-handed. Inclusive criteria: All were accorded with the diagnostic standard set by the Fourth National Academic Meeting for Cerebrovascular Disease; Confirmed by CT or MRI; Informed consents were obtained from all the subjects.METHODS: After the disease conditions were stable, the patients were assessed with Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). WMS included forward and backward recitation of numbers and short-term memory (verbal memory, visual recognition). The number of times for correct and wrong classifications in WCST and the time to complete the trail making tests A and B were recorded. The focal volume, area and layer were recorded at 24 hours after admission. The general data of the patients were recorded, including name, sex, age, educational years, history of hypertension, history of diabetes mellitus.Electroencepalograph (EEC) was examined to record the wave shape, blood lipids were detected, and the cognition related indexes were analyzed with the

  3. Clinical usefulness of the screen for cognitive impairment in psychiatry (SCIP-S scale in patients with type I bipolar disorder

    Directory of Open Access Journals (Sweden)

    Bernardo Miguel

    2009-04-01

    Full Text Available Abstract Background The relevance of persistent cognitive deficits to the pathogenesis and prognosis of bipolar disorders (BD is understudied, and its translation into clinical practice has been limited by the absence of brief methods assessing cognitive status in Psychiatry. This investigation assessed the psychometric properties of the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S for the detection of cognitive impairment in BD. Methods After short training, psychiatrists at 40 outpatient clinics administered the SCIP three times over two weeks to a total of 76 consecutive type I BD admissions. Experienced psychologists also administered a comprehensive battery of standard neuropsychological instruments to clinical sample and 45 healthy control subjects. Results Feasibility was supported by a brief administration time (approximately 15 minutes and minimal scoring errors. The reliability of the SCIP was confirmed by good equivalence of forms, acceptable stability (ICC range 0.59 to 0.87 and adequate internal consistency (Chronbach's alpha of 0.74. Construct validity was granted by extraction of a single factor (accounting 52% of the variance, acceptable correlations with conventional neuropsychological instruments, and a clear differentiation between bipolar I and normal samples. Efficiency was also provided by the adequate sensitivity and specificity. Limitations The sample size is not very large. The SCIP and the neurocognitive battery do not cover all potentially relevant cognitive domains. Also, sensitivity to change remains unexplored. Conclusion With minimal training, physicians obtained a reliable and valid estimate of cognitive impairment in approximately 15 minutes from an application of the SCIP to type I BD patients.

  4. Evoked Potentials and Memory/Cognition Tests Validate Brain Atrophy as Measured by 3T MRI (NeuroQuant in Cognitively Impaired Patients.

    Directory of Open Access Journals (Sweden)

    Eric R Braverman

    Full Text Available To our knowledge, this is the largest study evaluating relationships between 3T Magnetic Resonance Imaging (MRI and P300 and memory/cognitive tests in the literature. The 3T MRI using NeuroQuant has an increased resolution 15 times that of 1.5T MRI. Utilizing NeuroQuant 3T MRI as a diagnostic tool in primary care, subjects (N=169; 19-90 years displayed increased areas of anatomical atrophy: 34.62% hippocampal atrophy (N=54, 57.14% central atrophy (N=88, and 44.52% temporal atrophy (N=69. A majority of these patients exhibited overlap in measured areas of atrophy and were cognitively impaired. These results positively correlated with decreased P300 values and WMS-III (WMS-III scores differentially across various brain loci. Delayed latency (p=0.0740 was marginally associated with temporal atrophy; reduced fractional anisotropy (FA in frontal lobes correlated with aging, delayed P300 latency, and decreased visual and working memory (p=0.0115. Aging and delayed P300 latency correlated with lower FA. The correlation between working memory and reduced FA in frontal lobes is marginally significant (p=0.0787. In the centrum semiovale (CS, reduced FA correlated with visual memory (p=0.0622. Lower demyelination correlated with higher P300 amplitude (p=0.0002. Compared to males, females have higher demyelination (p=0.0064. Along these lines, the higher the P300 amplitude, the lower the bilateral atrophy (p=0.0165. Hippocampal atrophy correlated with increased auditory memory and gender, especially in males (p=0.0087. In considering temporal lobe atrophy correlations: delayed P300 latency and high temporal atrophy (p=0.0740; high auditory memory and low temporal atrophy (p=0.0417; and high working memory and low temporal atrophy (p=0.0166. Central atrophy correlated with aging and immediate memory (p=0.0294: the higher the immediate memory, the lower the central atrophy. Generally, the validation of brain atrophy by P300 and WMS-III could lead to cost

  5. Evoked Potentials and Memory/Cognition Tests Validate Brain Atrophy as Measured by 3T MRI (NeuroQuant) in Cognitively Impaired Patients

    Science.gov (United States)

    Braverman, Eric R.; Blum, Kenneth; Hussman, Karl L.; Han, David; Dushaj, Kristina; Li, Mona; Marin, Gabriela; Badgaiyan, Rajendra D.; Smayda, Richard; Gold, Mark S.

    2015-01-01

    To our knowledge, this is the largest study evaluating relationships between 3T Magnetic Resonance Imaging (MRI) and P300 and memory/cognitive tests in the literature. The 3T MRI using NeuroQuant has an increased resolution 15 times that of 1.5T MRI. Utilizing NeuroQuant 3T MRI as a diagnostic tool in primary care, subjects (N=169; 19–90 years) displayed increased areas of anatomical atrophy: 34.62% hippocampal atrophy (N=54), 57.14% central atrophy (N=88), and 44.52% temporal atrophy (N=69). A majority of these patients exhibited overlap in measured areas of atrophy and were cognitively impaired. These results positively correlated with decreased P300 values and WMS-III (WMS-III) scores differentially across various brain loci. Delayed latency (p=0.0740) was marginally associated with temporal atrophy; reduced fractional anisotropy (FA) in frontal lobes correlated with aging, delayed P300 latency, and decreased visual and working memory (p=0.0115). Aging and delayed P300 latency correlated with lower FA. The correlation between working memory and reduced FA in frontal lobes is marginally significant (p=0.0787). In the centrum semiovale (CS), reduced FA correlated with visual memory (p=0.0622). Lower demyelination correlated with higher P300 amplitude (p=0.0002). Compared to males, females have higher demyelination (p=0.0064). Along these lines, the higher the P300 amplitude, the lower the bilateral atrophy (p=0.0165). Hippocampal atrophy correlated with increased auditory memory and gender, especially in males (p=0.0087). In considering temporal lobe atrophy correlations: delayed P300 latency and high temporal atrophy (p=0.0740); high auditory memory and low temporal atrophy (p=0.0417); and high working memory and low temporal atrophy (p=0.0166). Central atrophy correlated with aging and immediate memory (p=0.0294): the higher the immediate memory, the lower the central atrophy. Generally, the validation of brain atrophy by P300 and WMS-III could lead to cost

  6. Evoked Potentials and Memory/Cognition Tests Validate Brain Atrophy as Measured by 3T MRI (NeuroQuant) in Cognitively Impaired Patients.

    Science.gov (United States)

    Braverman, Eric R; Blum, Kenneth; Hussman, Karl L; Han, David; Dushaj, Kristina; Li, Mona; Marin, Gabriela; Badgaiyan, Rajendra D; Smayda, Richard; Gold, Mark S

    2015-01-01

    To our knowledge, this is the largest study evaluating relationships between 3T Magnetic Resonance Imaging (MRI) and P300 and memory/cognitive tests in the literature. The 3T MRI using NeuroQuant has an increased resolution 15 times that of 1.5T MRI. Utilizing NeuroQuant 3T MRI as a diagnostic tool in primary care, subjects (N=169; 19-90 years) displayed increased areas of anatomical atrophy: 34.62% hippocampal atrophy (N=54), 57.14% central atrophy (N=88), and 44.52% temporal atrophy (N=69). A majority of these patients exhibited overlap in measured areas of atrophy and were cognitively impaired. These results positively correlated with decreased P300 values and WMS-III (WMS-III) scores differentially across various brain loci. Delayed latency (p=0.0740) was marginally associated with temporal atrophy; reduced fractional anisotropy (FA) in frontal lobes correlated with aging, delayed P300 latency, and decreased visual and working memory (p=0.0115). Aging and delayed P300 latency correlated with lower FA. The correlation between working memory and reduced FA in frontal lobes is marginally significant (p=0.0787). In the centrum semiovale (CS), reduced FA correlated with visual memory (p=0.0622). Lower demyelination correlated with higher P300 amplitude (p=0.0002). Compared to males, females have higher demyelination (p=0.0064). Along these lines, the higher the P300 amplitude, the lower the bilateral atrophy (p=0.0165). Hippocampal atrophy correlated with increased auditory memory and gender, especially in males (p=0.0087). In considering temporal lobe atrophy correlations: delayed P300 latency and high temporal atrophy (p=0.0740); high auditory memory and low temporal atrophy (p=0.0417); and high working memory and low temporal atrophy (p=0.0166). Central atrophy correlated with aging and immediate memory (p=0.0294): the higher the immediate memory, the lower the central atrophy. Generally, the validation of brain atrophy by P300 and WMS-III could lead to cost

  7. Association among depression, cognitive impairment and executive dysfunction after stroke

    Directory of Open Access Journals (Sweden)

    Luisa Terroni

    Full Text Available ABSTRACT The relationship between depression and cognitive impairment, frequent after stroke, is complex and has not been sufficiently elucidated. Objective: To review the relationship between post-stroke depression and cognitive impairment. Methods: We performed a PubMed database search spanning the last ten years, using the terms post-stroke depression, cognitive dysfunction, cognitive impairment and neuropsychological tests. Our target studies were original quantitative studies that investigated the relationship between post-stroke depression (PSD and cognitive impairment in stroke patients. Articles published in English, Spanish, Italian and Portuguese were considered. Selection criteria were the use of neuropsychological tests to assess cognitive function, and of either instruments to diagnose major depression, or scales to assess depressive symptoms, within the first three months after stroke. Results: Six original quantitative studies fulfilled the criteria. The prevalence of PSD within the first three months after stroke ranged from 22% to 31%. Incidence ranged from 25% to 27% and was evaluated in only two studies. PSD was associated with increased cognitive impairment. Cognitive impairment was reported in 35.2% to 87% of the patients. Post-stroke cognitive deficits were reported mostly in executive function, memory, language, and speed of processing. Conclusion: Executive dysfunction and depression occur in stroke survivors, are frequently coexistent, and also associated with worse stroke prognosis. Healthcare professionals need to address and provide adequate treatment for depression and executive dysfunctions in stroke patients early in the first three months after stroke. Future studies should evaluate the efficacy of programs evaluating the early detection and treatment of PSD and executive dysfunction in stroke survivors.

  8. Interrelationship of postoperative delirium and cognitive impairment and their impact on the functional status in older patients undergoing orthopaedic surgery: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Chih-Kuang Liang

    Full Text Available BACKGROUND: The impact of postoperative delirium on post-discharge functional status of older patients remains unclear, and little is known regarding the interrelationship between cognitive impairment and post-operative delirium. Therefore, the main purpose was to evaluate the post-discharge functional status of patients who experience delirium after undergoing orthopaedic surgery and the interrelationship of postoperative delirium with underlying cognitive impairment. METHOD: This prospective cohort study, conducted at a tertiary care medical center from April 2011 to March 2012, enrolled all subjects aged over 60 years who were admitted for orthopaedic surgery. The baseline characteristics (age, gender, BMI, and living arrangement, surgery-related factors (ASA class, admission type, type of surgery, and length of hospital stay, results of geriatric assessment (postoperative delirium, cognition, depressive mood, comorbidity, pain, malnutrition, polypharmacy, ADL, and instrumental [I]ADL and 1-12-month postoperative ADL and IADL functional status were collected for analysis. RESULTS: Overall, 9.1% of 232 patients (mean age: 74.7 ± 7.8 years experienced postoperative delirium, which was significantly associated with IADL decline at only 6 and 12 months postoperatively (RR: 6.22, 95% CI: 1.08-35.70 and RR: 12.54, 95% CI: 1.88-83.71, respectively. Delirium superimposed on cognitive impairment was a significant predictor for poor functional status at 6 and 12 months postoperatively (RR: 12.80, 95% CI: 1.65-99.40 for ADL at the 6th month, and RR: 7.96, 95% CI: 1.35-46.99 at the 12th month; RR: 13.68, 95% CI: 1.94-96.55 for IADL at the 6th month, and RR: 30.61, 95% CI: 2.94-318.54 at the 12th month, respectively. CONCLUSION: Postoperative delirium is predictive of IADL decline in older patients undergoing orthopaedic surgery, and delirium superimposed on cognitive impairment is an independent risk factor for deterioration of ADL and IADL functional

  9. Dementia and mild cognitive impairment in patients with Parkinson's disease Demência e transtorno cognitivo leve em pacientes com doença de Parkinson

    Directory of Open Access Journals (Sweden)

    Gloria Maria Almeida Souza Tedrus

    2009-06-01

    Full Text Available The objective of this research was to assess the occurrence of cognitive impairment in 32 individuals (average age: 67.2 years old with Parkinson' disease (PD. Procedures: clinical-neurological assessment; modified Hoehn and Yahr staging scale (HYS; standard neuropsychological battery of CERAD (Consortium to Establish a Registry for Alzheimer' Disease; Pfeffer questionnaire; and Clinical Dementia Rating. A comparison was made with a control group (CG, consisting of 26 individuals with similar age and educational level but without cognitive impairment. The PD patients showed an inferior performance in the CERAD battery when compared to the CG. Three PD sub-groups were characterised according to cognition: no cognitive impairment - 15 cases; mild cognitive impairment - 10; dementia - 7 cases. There was a significant association between motor disability (HYS and the occurrence of dementia. Dementia and mild cognitive impairment frequently occur in PD patients and should be investigated in a routine way.O objetivo desta pesquisa foi avaliar a ocorrência de déficits cognitivos em 32 indivíduos (idade média: 67,2 anos com doença de Parkinson (DP. Procedimentos: avaliação clínico-neurológica, escala de Hoehn and Yahr modificada (EHY, bateria neurospicológica do CERAD (Consortium to Establish a Registry for Alzheimer' Disease, questionário de Pfeffer e escore clínico da demência (Clinical Dementia Rating. Foi feita comparação com grupo controle (GC de 26 indivíduos sem declínio cognitivo, com idade e nível educacional similares. Os pacientes com DP tiveram desempenho inferior na bateria CERAD, quando comparados ao do GC. Foram caracterizados 3 subgrupos com PD segundo a cognição: sem déficits cognitivos - 15 casos; transtorno cognitivo leve - 10; demência - 7 casos. Houve associação entre comprometimento motor e ocorrência de demência. Demência e transtorno cognitivo leve são freqüentes em pacientes com DP e devem ser

  10. Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in memory clinic patients

    NARCIS (Netherlands)

    Overdorp, E.J.; Kessels, R.P.C.; Claassen, J.A.H.R.; Oosterman, J.M.

    2014-01-01

    In this retrospective study, we investigated the independent effects of white matter hyperintensities (VVMH) and hippocampal atrophy on cognitive functions in a broad sample of patients seen in a memory clinic. To ensure generalizability, these associations were examined irrespective of diagnosis an

  11. Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in memory clinic patients

    NARCIS (Netherlands)

    Overdorp, E.J.; Kessels, R.P.C.; Claassen, J.A.H.R.; Oosterman, J.M.

    2014-01-01

    In this retrospective study, we investigated the independent effects of white matter hyperintensities (WMH) and hippocampal atrophy on cognitive functions in a broad sample of patients seen in a memory clinic. To ensure generalizability, these associations were examined irrespective of diagnosis and

  12. Reversing cognitive-motor impairments in Parkinson's disease patients using a computational modelling approach to deep brain stimulation programming.

    Science.gov (United States)

    Frankemolle, Anneke M M; Wu, Jennifer; Noecker, Angela M; Voelcker-Rehage, Claudia; Ho, Jason C; Vitek, Jerrold L; McIntyre, Cameron C; Alberts, Jay L

    2010-03-01

    Deep brain stimulation in the subthalamic nucleus is an effective and safe surgical procedure that has been shown to reduce the motor dysfunction of patients with advanced Parkinson's disease. Bilateral subthalamic nucleus deep brain stimulation, however, has been associated with declines in cognitive and cognitive-motor functioning. It has been hypothesized that spread of current to nonmotor areas of the subthalamic nucleus may be responsible for declines in cognitive and cognitive-motor functioning. The aim of this study was to assess the cognitive-motor performance in advanced Parkinson's disease patients with subthalamic nucleus deep brain stimulation parameters determined clinically (Clinical) to settings derived from a patient-specific computational model (Model). Data were collected from 10 patients with advanced Parkinson's disease bilaterally implanted with subthalamic nucleus deep brain stimulation systems. These patients were assessed off medication and under three deep brain stimulation conditions: Off, Clinical or Model based stimulation. Clinical stimulation parameters had been determined based on clinical evaluations and were stable for at least 6 months prior to study participation. Model-based parameters were selected to minimize the spread of current to nonmotor portions of the subthalamic nucleus using Cicerone Deep Brain Stimulation software. For each stimulation condition, participants performed a working memory (n-back task) and motor task (force tracking) under single- and dual-task settings. During the dual-task, participants performed the n-back and force-tracking tasks simultaneously. Clinical and Model parameters were equally effective in improving the Unified Parkinson's disease Rating Scale III scores relative to Off deep brain stimulation scores. Single-task working memory declines, in the 2-back condition, were significantly less under Model compared with Clinical deep brain stimulation settings. Under dual-task conditions, force

  13. Gender, apolipoprotein E genotype, and mesial temporal atrophy: 2-year follow-up in patients with stable mild cognitive impairment and with progression from mild cognitive impairment to Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Spampinato, M.V.; Patrick, K.E.; Collins, H. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Langdon, B.R. [Medical University of South Carolina, Department of Internal Medicine, Charleston, SC (United States); Parker, R.O. [Vanderbilt University, Department of Anesthesiology, Nashville, TN (United States); Pravata' , E. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Ospedale Regionale di Lugano, Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano (Switzerland); Collaboration: For the Alzheimer' s Disease Neuroimaging Initiative

    2016-11-15

    This study aimed to examine the relationship between gender, apolipoprotein E (APOE) genotype, and mesial temporal atrophy in mild cognitive impairment (MCI) with and without progression to Alzheimer's disease (AD). We evaluated 236 MCI patients with (n = 121) and without (n = 115) AD progression. Longitudinal MRI-based hippocampal volumes (HV) and entorhinal cortex (ERC) thickness were obtained. The Clinical Dementia Rating Sum of Boxes (CDR-SB) score was used to assess disease severity. We found a significant effect of APOE, gender, and clinical course (stable MCI versus MCI-AD progression) on HV. There was a significant effect of clinical course and APOE, but not gender, on ERC. Baseline HV and APOE4 status predicted MCI-AD progression in women. Baseline ERC and APOE4 status predicted MCI-AD progression in men. There were significant differences in CDR-SB scores between patients with and without MCI-AD progression, but not between males and females, or APOE4 carriers and non-carriers. HV, but not ERC, is strongly influenced by gender in MCI. The effects of gender and APOE4 on neuroimaging biomarkers have potentially important implications in the prediction of MCI-AD progression and should be taken into account in clinical trials. (orig.)

  14. Normal Vitamin Levels and Nutritional Indices in Alzheimer’s Disease Patients with Mild Cognitive Impairment or Dementia with Normal Body Mass Indexes

    Science.gov (United States)

    Ulstein, Ingun; Bøhmer, Thomas

    2016-01-01

    Evidence supports an association between vitamin deficiencies and cognitive decline in Alzheimer’s disease (AD). If vitamin deficiencies are causative for AD development, they should be detectable during very early stages of AD. Here we investigated nutritional factors among home-living patients diagnosed with mild cognitive impairment (MCI) or mild dementia due to AD, compared to healthy controls. Our study included 73 patients with AD (25 with MCI, 48 with dementia) and 63 cognitively intact age-matched controls. All participants underwent cognitive testing, somatic examination, and measurements of vitamins A, B1, B6, folate, B12, C, D, and E, and F2-α-isoprostane. Results are given as mean (SD). MMSE scores were 29.1 (1.0) for healthy controls, 27.4 (1.8) for patients with MCI, and 24.3 (3.2) for patients with dementia. Vitamin concentrations for the these groups, respectively, were as follows: B1 (nmol/l), 157 (29), 161 (35), and 161 (32); B6 (nmol/l), 57 (63), 71 (104), and 58 (44); folate (mmol/l), 23 (9), 26 (10), and 23 (11); B12 (pmol/l), 407 (159), 427 (116), and 397 (204); C (μmol/l), 63 (18), 61 (16), and 63 (29); A (μmol/l), 2.3 (0.6), 2.2 (0.5), and 2.3 (0.5); E (μmol/l), 36 (6.3), 36 (6.9), and 36 (8.2); 25-OH vitamin D (nmol/l), 65 (18), 61 (19), and 65 (20); and 8-iso-PGFα (pg/ml), 64 (27); 60 (19), and 66 (51). These concentrations did not significantly differ (p≤0.05) between the three groups. Our results do not support the hypothesis that vitamin deficiencies play a causative role in the development of early cognitive impairment. PMID:27716664

  15. Cognitive Impairment in Rural Elderly Population in Ecuador

    Science.gov (United States)

    Wong-Achi, Xavier; Egas, Gabriela; Cabrera, Dayana

    2017-01-01

    Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48), and 63% (CI: 62.1–63.94) of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3) and 47.2% (95% CI: 45.2–49.2) in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.

  16. Cognitive impairment in rural elderly population in ecuador

    Directory of Open Access Journals (Sweden)

    Xavier Wong-Achi

    2017-01-01

    Full Text Available Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48, and 63% (CI: 62.1–63.94 of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3 and 47.2% (95% CI: 45.2–49.2 in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.

  17. Cognitive function following stroke and vascular cognitive impairment

    NARCIS (Netherlands)

    de Haan, Edward H.; Nys, Gudrun M.; Van Zandvoort, Martine J.

    2006-01-01

    Purpose of review This review of the cognitive status following stroke and vascular cognitive impairment starts by questioning the concept of vascular dementia and related concepts. Our position is that in many cases these labels promote a superficial conceptualization of an inherently complex and h

  18. Cognitive Stimulation Modulates Platelet Total Phospholipases A2 Activity in Subjects with Mild Cognitive Impairment.

    Science.gov (United States)

    Balietti, Marta; Giuli, Cinzia; Fattoretti, Patrizia; Fabbietti, Paolo; Postacchini, Demetrio; Conti, Fiorenzo

    2016-01-01

    We evaluated the effect of cognitive stimulation (CS) on platelet total phospholipases A2 activity (tPLA2A) in patients with mild cognitive impairment (MCI_P). At baseline, tPLA2A negatively correlated with Mini-Mental State Examination score (MMSE_s): patients with MMSE_s cognitive conditions of MCI_P, and that CS acts selectively on subjects with a dysregulated tPLA2A.

  19. Cognitive performance in patients with COPD

    NARCIS (Netherlands)

    Liesker, JJW; Postma, DS; Beukema, RJ; ten Hacken, NHT; van der Molen, T; Riemersma, RA; van Zomeren, EH; Kerstjens, HAM

    2004-01-01

    Background: Hypoxemic patients with Chronic Obstructive Pulmonary Disease (COPD) have impaired cognitive performance. These neuropsychological impairments are related to the degree of hypoxemia. So far, cognitive performance has not been tested in non-hypoxemic patients with COPD. Methods: We recrui

  20. Benign multiple sclerosis: physical and cognitive impairment follow distinct evolutions.

    Science.gov (United States)

    Gajofatto, A; Turatti, M; Bianchi, M R; Forlivesi, S; Gobbin, F; Azzarà, A; Monaco, S; Benedetti, M D

    2016-03-01

    Benign multiple sclerosis (BMS) definitions rely on physical disability level but do not account sufficiently for cognitive impairment which, however, is not rare. To study the evolution of physical disability and cognitive performance of a group of patients with BMS followed at an University Hospital Multiple Sclerosis Center. A consecutive sample of 24 BMS cases (diagnosis according to 2005 McDonald's criteria, relapsing-remitting course, disease duration ≥ 10 years, and expanded disability status scale [EDSS] score ≤ 2.0) and 13 sex- and age-matched non-BMS patients differing from BMS cases for having EDSS score 2.5-5.5 were included. Main outcome measures were as follows: (i) baseline and 5-year follow-up cognitive impairment defined as failure of at least two tests of the administered neuropsychological battery; (ii) EDSS score worsening defined as confirmed increase ≥ 1 point (or 0.5 point if baseline EDSS score = 5.5). At inclusion, BMS subjects were 41 ± 8 years old and had median EDSS score 1.5 (range 0-2), while non-BMS patients were 46 ± 8 years old and had median EDSS score 3.0 (2.5-5.5). At baseline 16% of patients in both groups were cognitively impaired. After 5 years, EDSS score worsened in 8% of BMS and 46% of non-BMS patients (P = 0.008), while the proportion of cognitively impaired subjects increased to 25% in both groups. Patients with BMS had better physical disability outcome at 5 years compared to non-BMS cases. However, cognitive impairment frequency and decline over time appeared similar. Neuropsychological assessment is essential in patients with BMS given the distinct pathways followed by disease progression in cognitive and physical domains. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Impact of Cognitive Impairment on Functional Outcome in Stroke

    Directory of Open Access Journals (Sweden)

    Nurdan Paker

    2010-01-01

    Full Text Available The aim of this study was to investigate the effect of the cognitive impairment on functional status in patients with subacute stroke. Fifty-two patients with subacute stroke were included in the study. Mini mental state examination (MMSE test was used for the evaluation of cognitive status. Patients were separated into two groups according to their cognitive functions. Functional follow-up parameters were activities of daily living (ADL, global recovery and ambulation status. All patients were evaluated on admission to rehabilitation unit, at discharge and 6 months after discharge. Forty-four patients were completed the study. Mean age was 66 and 57 years; disease duration on admission was 4,8 and 3,5 months in the cognitively impaired and normal groups, respectively. Significant improvement was found in terms of functional follow-up parameters in both groups at discharge (<.05. Functional follow-up parameters did not show statistically significant difference between the groups. But community ambulation rate was higher in cognitively normal group at the sixth month visit. As a result of this study, inpatient rehabilitation was effective both cognitively normal and impaired subacute stroke patients.

  2. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

  3. Differential cognitive impairment for diverse forms of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Borges Monica

    2006-05-01

    Full Text Available Abstract Background Cognitive impairment is a common feature in multiple sclerosis (MS patients and occurs in 60% of all cases. Unfortunately, neurological examination does not always agree with the neuropsychological evaluation in determining the cognitive profile of the patient. On the other hand, psychophysiological techniques such as event-related potentials (ERPs can help in evaluating cognitive impairment in different pathologies. Behavioural responses and EEG signals were recorded during the experiment in three experimental groups: 1 a relapsing-remitting group (RRMS, 2 a benign multiple sclerosis group (BMS and 3 a Control group. The paradigm employed was a spatial attention task with central cues (Posner experiment. The main aim was to observe the differences in the performance (behavioural variables and in the latency and amplitude of the ERP components among these groups. Results Our data indicate that both MS groups showed poorer task performance (longer reaction times and lower percentage of correct responses, a latency delay for the N1 and P300 component, and a different amplitude for the frontal N1. Moreover, the deficit in the BMS group, indexed by behavioural and pyschophysiological variables, was more pronounced compared to the RRMS group. Conclusion The present results suggest a cognitive impairment in the information processing in all of these patients. Comparing both pathological groups, cognitive impairment was more accentuated in the BMS group compared to the RMSS group. This suggests a silent deterioration of cognitive skills for the BMS that is not usually treated with pharmacological or neuropsychological therapy.

  4. Assessing and treating cognitive impairment in schizophrenia: current and future.

    Science.gov (United States)

    Lin, Chun-Yuan; Tsai, Guochuan E; Lane, Hsien-Yuan

    2014-01-01

    Schizophrenia is a serious neuropsychiatric disease characterized by positive symptoms, negative symptoms and cognitive impairment. Evidence have shown that cognitive impairment sustains in every clinical stage, may relate with the liability, may predict functional outcome in schizophrenia and could be the core symptom of schizophrenia. The treatment of cognitive impairment in schizophrenia could alleviate the burden of the illness and has become the subject of intensive research. In this review, we synthesize current advances of assessing strategies, pharmacological and non-pharmacological treatments of cognitive impairment in schizophrenia. According to the registered records of ClinicalTrials.gov, the most widely studied strategies have aimed at modifying neurochemical mechanisms of dopamine metabolism, glutamate metabolism, γ-aminobutyric acid (GABA) metabolism, serotonin metabolism, acetylcholine metabolism, and oxytocin. Despite preclinical data for putative pro-cognitive drugs, their clinical benefits for schizophrenia patients have been limited. The small sample sizes and the short treatment duration could be related with the suboptimal results. Evidence supported the short-term benefits of cognitive remediation therapy on cognitive domains with small to moderate effects; however, the small sample sizes and the characteristics of subjects limited the generalization of the positive results and the long-term functional outcome is not clear. Combination therapy is promising, by integrating pro-cognitive agents and cognitive rehabilitation programs or combining two kinds of pro-cognitive agents via different mechanisms. Future studies should investigate the pro-cognitive drugs' long-term efficacy, rebound deterioration in psychosis/cognition following discontinuation, and related biomarkers of functional outcome.

  5. Some aspects of the validity of the Montreal Cognitive Assessment (MoCAfor evaluating cognitive impairment in Brazilian patients with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Vitor Tumas

    Full Text Available ABSTRACT Background: The Montreal Cognitive Assessment (MoCA is a short global cognitive scale, and some studies suggest it is useful for evaluating cognition in patients with Parkinson's disease (PD. However, its accuracy has been questioned in studies involving patients with low education. Objective: We sought to assess whether some of the MoCA subtests contribute to the low accuracy of the test. Methods: We performed a cross-sectional retrospective analysis of clinical data in a cohort of 71 patients with PD, most with less than 8 years of education. Patients were examined using the MDS-UPDRS, Hoehn and Yahr and the MoCA. The data were analyzed using mainly descriptive statistics. Results: We analyzed the data of 66 patients that were not demented according to the clinical evaluation and classified them using the proposed cut-off MoCA scores for diagnosis of MCI and dementia. Thirteen patients (19.7% were classified as having normal cognition, 24 (36.3% MCI and 29 (43.9% dementia. Patients with dementia had longer disease duration (p=0.016 and lower education (p=0.0001. Total MoCA scores had a an almost normal distribution with a wide range of scores and only one maximum score. Performance on the MoCA was highly correlated with education (correlation coefficient=0.66, p=0.0001. At least five of the 10 MoCA subtests showed significant floor effects. Conclusion: We believe that some of the MoCA subtests may be too difficult to be completed by PD patients with low educational level, thus contributing to the test's poor diagnostic accuracy.

  6. Gluten-induced cognitive impairment ("brain fog") in coeliac disease.

    Science.gov (United States)

    Yelland, Gregory W

    2017-03-01

    Much is known about the serious neurological effects of gluten ingestion in coeliac disease patients, such as sporadic ataxia and peripheral neuropathy, although the causal links to gluten are still under debate. However, such disorders are observed in only a small percentage of coeliac patients. Much less is known about the transient cognitive impairments to memory, attention, executive function, and the speed of cognitive processing reported by the majority of patients with coeliac disease. These mild degradations of cognitive functions, referred to as "brain fog," are yet to be formally recognized as a medical or psychological condition. However, subtle tests of cognitive function are measurable in untreated patients with coeliac disease and improve over the first 12 months' therapy with a gluten-free diet. Such deficits also occur in patients with Crohn's disease, particularly in association with systemic inflammatory activity. Thus, cognitive impairments associated with brain fog are psychologically and neurologically real and improve with adherence to a gluten-free diet. There is not yet sufficient evidence to provide a definitive account of the mechanism by which gluten ingestion causes the impairments to cognitive function associated with brain fog, but current evidence suggests that it is more likely that the causal factor is not directly related to exposure to gluten. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  7. High blood pressure in older subjects with cognitive impairment.

    Science.gov (United States)

    Mossello, Enrico; Simoni, David

    2016-06-22

    High blood pressure and cognitive impairment often coexist in old age, but their pathophysiological association is complex. Several longitudinal studies have shown that high blood pressure at midlife is a risk factor for cognitive impairment and dementia, although this association is much less clear in old age. The effect of blood pressure lowering in reducing the risk of dementia is only borderline significant in clinical trials of older subjects, partly due to the insufficient follow-up time. Conversely, dementia onset is associated with a decrease of blood pressure values, probably secondary to neurodegeneration. Prognostic effect of blood pressure values in cognitively impaired older subjects is still unclear, with aggressive blood pressure lowering being potentially harmful in this patients category. Brief cognitive screening, coupled with simple motor assessment, are warranted to identify frail older subjects who need a more cautious approach to antihypertensive treatment. Values obtained with ambulatory blood pressure monitoring seem more useful than clinical ones to predict the outcome of cognitively impaired older subjects. Future studies should identify the most appropriate blood pressure targets in older subjects with cognitive impairment.

  8. Retinal nerve fiber layer and ganglion cell complex thickness assessment in patients with Alzheimer disease and mild cognitive impairment. Preliminary results

    Directory of Open Access Journals (Sweden)

    A. S. Tiganov

    2014-07-01

    Full Text Available Purpose: to investigate the retinal nerve fiber layer (RNFL and the macular ganglion cell complex (GCC in patients with Alzheimer`s disease and mild cognitive impairment.Methods: this study included 10 patients (20 eyes with Alzheimer`s disease, 10 patients with mild cognitive impairment and 10 age- and sex-matched healthy controls that had no history of dementia. All the subjects underwent psychiatric examination, including the Mini-Mental State Examination (MMSE, and complete ophthalmological examination, comprising optical coherence tomography and scanning laser polarimetry.Results: there was a significant decrease in GCC thickness in patients with Alzheimer`s disease compared to the control group, global loss volume of ganglion cells was higher than in control group. there was no significant difference among the groups in terms of RNFL thickness. Weak positive correlation of GCC thickness and MMSE results was observed.Conclusion: Our data confirm the retinal involvement in Alzheimer`s disease, as reflected by loss of ganglion cells. Further studies will clear up the role and contribution of dementia in pathogenesis of optic neuropathy.

  9. Vascular cognitive impairment: Current concepts and Indian perspective

    Directory of Open Access Journals (Sweden)

    Alladi Suvarna

    2010-10-01

    Full Text Available Cognitive impairment due to cerebrovascular disease is termed "Vascular Cognitive Impairment" (VCI and forms a spectrum that includes Vascular Dementia (VaD and milder forms of cognitive impairment referred to as Vascular Mild Cognitive Impairment (VaMCI. VCI represents a complex neurological disorder that occurs as a result of interaction between vascular risk factors such as hypertension, diabetes, obesity, dyslipidemia, and brain parenchymal changes such as macro and micro infarcts, haemorrhages, white matter changes, and brain atrophy occurring in an ageing brain. Mixed degenerative and vascular pathologies are increasingly being recognised and an interaction between the AD pathology, vascular risk factors, and strokes is now proposed. The high cardiovascular disease burden in India, increasing stroke incidence, and ageing population have contributed to large numbers of patients with VCI in India. Inadequate resources coupled with low awareness make it a problem that needs urgent attention, it is important identify patients at early stages of cognitive impairment, to treat appropriately and prevent progression to frank dementia.

  10. Validation of the Falls Efficacy Scale and Falls Efficacy Scale International in geriatric patients with and without cognitive impairment: results of self-report and interview-based questionnaires

    DEFF Research Database (Denmark)

    Hauer, Kristiane; Yardley, L; Beyer, N;

    2010-01-01

    Frail, old patients with and without cognitive impairment are at high risk of falls and associated medical and psychosocial issues. The lack of adequate, validated instruments has partly hindered research in this field. So far no questionnaire documenting fall-related self-efficacy/fear of fallin...... has been validated for older persons with cognitive impairment or for different administration methods such as self-report or interview....

  11. Association between smoking and cognitive impairment in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Özcan ME

    2014-09-01

    Full Text Available Muhammed Emin Özcan,1 Bahri İnce,2 Ayhan Bingöl,3 Simge Ertürk,3 Meriç Adil Altınöz,4 Hasan Hüseyin Karadeli,1 Abdulkadir Koçer,5 Talip Asil1 1Deparment of Neurology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey; 2Department of Psychiatry, Bakirköy Research and Training Hospital for Psychiatry, Istanbul, Turkey; 3Mayis Psychology Center, Istanbul, Turkey; 4Department of Molecular Biology and Genetics, Haliç University, Istanbul, Turkey; 5Department of Neurology, Medical Faculty, İstanbul Medeniyet University, Göztepe, Istanbul, Turkey Purpose: Although smoking is known to cause various symptoms in multiple sclerosis (MS patients, there have been no reports regarding the relationship between smoking and cognitive impairment in MS. Studying the effects of cigarette smoking in MS patients is imperative as there is a high prevalence of cognitive impairment in MS patients. In this study we examined the potentially deleterious effects of heavy smoking on mentation of patients with MS. Patients and methods: MS patients receiving care at the Neurology Clinic at Bezmialem Vakif University, between the ages of 18–65 years who have at least graduated elementary school were included in the study. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N is a commonly used method to assess cognitive function in MS patients and was utilized in our study. Patients that smoked for at least 10 pack-years were considered heavy smokers.Results: All the patients were stratified into two groups: heavy smokers (n=20 and nonsmokers (n=24. For heavy smokers, their cognitive functioning was more impaired than that of nonsmokers (P=0.04, χ2=4.227. For patients with cognitive impairment, 78.9% of the Paced Auditory Serial Addition Test and 63.2% of the Symbol Digit Modalities Test scores were found to be lower.Conclusion: Previous reports have suggested that smoking increases the frequency of relapse among individuals with

  12. Citicoline in vascular cognitive impairment and vascular dementia after stroke.

    Science.gov (United States)

    Alvarez-Sabín, Jose; Román, Gustavo C

    2011-01-01

    Cognitive decline after stroke is more common than stroke recurrence. Stroke doubles the risk of dementia and is a major contributor to vascular cognitive impairment and vascular dementia. Neuropathological studies in most cases of dementia in the elderly reveal a large load of vascular ischemic brain lesions mixed with a lesser contribution of neurodegenerative lesions of Alzheimer disease. Nonetheless, few pharmacological studies have addressed vascular cognitive impairment and vascular dementia after stroke. Citicoline has demonstrated neuroprotective effects in acute stroke and has been shown to improve cognition in patients with chronic cerebrovascular disease and in some patients with Alzheimer disease. A recent trial lasting 6 months in patients with first-ever ischemic stroke showed that citicoline prevented cognitive decline after stroke with significant improvement of temporal orientation, attention, and executive function. Experimentally, citicoline exhibits neuroprotective effects and enhances neural repair. Citicoline appears to be a safe and promising alternative to improve stroke recovery and could be indicated in patients with vascular cognitive impairment, vascular dementia, and Alzheimer disease with significant cerebrovascular disease.

  13. Mild cognitive impairment: safe to drive?

    Science.gov (United States)

    Olsen, Kirsty; Taylor, John-Paul; Thomas, Alan

    2014-06-01

    Driving is an important aspect of daily living and for many older people provides autonomy and psycho-social benefits. Cognitive impairment has been found to impact driving skills at the level of dementia, however, uncertainty remains around the impact of a diagnosis of the pre-dementia condition mild cognitive impairment. Current official guidelines are unclear, and assessment of fitness to drive can be problematical. This editorial examines current official guidance available to the clinician and problems with existing assessment as well as the current position of research specifically into MCI and driving, and considers future direction for research in this field.

  14. Are CSF Biomarkers Useful as Prognostic Indicators in Diagnostically Unresolved Cognitively Impaired Patients in a Normal Clinical Setting

    DEFF Research Database (Denmark)

    Nielsen, Malene Schjønning; Simonsen, Anja Hviid; Siersma, Volkert

    2016-01-01

    in diagnostically unresolved patients. METHODS: Data on 348 patients were retrospectively evaluated. All participants had a standardized diagnostic workup and follow-up in a memory clinic. RESULTS: Aβ42 levels and Aβ42/p-tau ratios were reduced and levels of t-tau and p-tau as well as the t-tau × p-tau/Aβ42 ratio......BACKGROUND: Despite an extensive evaluation program, patients may remain diagnostically unresolved with regard to the etiology of their cognitive dysfunction. Cerebrospinal fluid neuroinflammation and Alzheimer disease (AD) biomarkers may act as indicators of neurodegenerative disorders...... were elevated in diagnostically unresolved patients who clinically progressed, compared to a stable group. No differences in neuroinflammatory parameters were found. CONCLUSION: AD biomarkers - in particular the Aβ42/p-tau ratio, but not neuroinflammatory parameters - predicted clinical progression...

  15. Different Patterns of Theory of Mind Impairment in Mild Cognitive Impairment.

    Science.gov (United States)

    Moreau, Noémie; Rauzy, Stéphane; Bonnefoi, Bernadette; Renié, Laurent; Martinez-Almoyna, Laurent; Viallet, François; Champagne-Lavau, Maud

    2015-01-01

    Theory of Mind refers to the ability to infer other’s mental states, their beliefs, intentions, or knowledge. To date, only two studies have reported the presence of Theory of Mind impairment in mild cognitive impairment (MCI). In the present study,we evaluated 20 MCI patients and compared them with 25 healthy control participants using two Theory of Mind tasks. The first task was a false belief paradigm as frequently used in the literature, and the second one was a referential communication task,assessing Theory of Mind in a real situation of interaction and which had never been used before in this population. The results showed that MCI patients presented difficulties inferring another person’s beliefs about reality and attributing knowledge to them in a situation of real-life interaction. Two different patterns of Theory of Mind emerged among the patients. In comparison with the control group, some MCI patients demonstrated impairment only in the interaction task and presented isolated episodicmemory impairment, while others were impaired in both Theory of Mind tasks and presented cognitive impairment impacting both episodic memory and executive functioning. Theory of Mind is thus altered in the very early stages of cognitive impairment even in real social interaction, which could impact precociously relationships in daily life.

  16. Changes of cerebrospinal fluid Aβ42, t-tau, and p-tau in Parkinson's disease patients with cognitive impairment relative to those with normal cognition: a meta-analysis.

    Science.gov (United States)

    Hu, Xiaohui; Yang, Yan; Gong, Daokai

    2017-08-14

    The cerebrospinal fluid (CSF) signature of reduced amyloid beta 1-42 (Aβ42), elevated total tau (t-tau), and phosphorylated tau181 (p-tau) is important for the early diagnosis of Alzheimer's disease (AD). Aβ42, t-tau, and p-tau have been reported in numerous studies to contribute to predicting cognitive impairment in Parkinson's disease (PDCI). However, no consistent conclusion can be drawn so far. Literatures regarding Aβ42, t-tau, and p-tau in CSF were systematically reviewed, and a meta-analysis was thus performed to evaluate the changes of these biomarkers in PDCI patients, including PD with mild cognitive impairment (PDMCI) and PD dementia (PDD) patients, relative to PD with normal cognition (PDNC) patients. Databases of "PubMed," "EBSCO," and "Springer" were retrieved for articles concerning Aβ42, t-tau, and p-tau in PDCI patients relative to those in PDNC patients published from January 1, 2000 to February 1, 2017. The following keywords were set, namely, "dementia" or "cognitive impairment" or "mild cognitive impairment" and "cerebrospinal fluid" and "Parkinson*." Sixteen articles comprising 590 PDCI patients and 1182 PDNC patients were included. The results showed that CSF Aβ42 level in PDCI cohort was lower than that in PDNC cohort (pooled Std.MD = -0.44, 95% CI [-0.61, -0.26], p < 0.00001). Reduced Aβ42 (pooled Std.MD = -0.60, 95% CI [-0.75, -0.45], p < 0.00001) as well as elevated t-tau (pooled Std.MD = 0.21, 95% CI [0.06, 0.35], p = 0.006) and p-tau (pooled Std.MD = 0.36, 95% CI [0.02, 0.69], p = 0.04) could be observed in PDD cohort compared with PDNC cohort. Therefore, amyloid pathology and tauopathy may participate in the development of PDD, which is similar to AD.

  17. Analysis of cognitive impairment of multiple sclerosis patients%多发性硬化患者认知障碍分析

    Institute of Scientific and Technical Information of China (English)

    李莉莉; 张星虎

    2011-01-01

    Aim: To evaluate the cognitive impairment of patients with multiple sclerosis( MS). Methods:Twenty-eight patients with remitting-relapsing MS were recruited. All of them underwent P300 test, MRI scan,and Wechsler Intelligence Tests,Clinical Memory Scale, HAMD, HAMA, EDSS, ADL and IADL were used to assess the patients. Results: 71.4% of MS patients had cognitive disorder,and 60.7% intelligence and 64. 3% memory ability were abnormal. Education time,MRI lesion grade score,and P300 latency were related to cognitive function of MS patients (P 0. 05 ) . Conclusion: A high incidence of cognitive impairment is in MS patients,P300 latency and MRI may be effective tools to evaluate cognitive function.%目的:对多发性硬化(MS)患者认知状况、神经电生理及影像学资料进行综合评价.方法:对28例复发缓解型MS患者进行神经心理评价(韦氏成人或儿童智力量表)、神经功能缺损状况评价(EDSS)和生活质量评价(ADL和IADL),以及事件相关电位检查、MRI检查.结果:71.4%(20/28)的MS患者存在认知障碍,其中智力缺损者占60.7%(17/28),临床记忆功能障碍者占64.3%(18/28).MRI病灶等级评分、P300潜伏期及受教育时间与认知状况有关(P0.05).结论:MS患者有较高认知功能损害发生率,MRI病灶等级评分与P300检查可能是评价认知功能的有效方法.

  18. [Cancer-related Cognitive Impairment: Current Knowledge and Future Challenges].

    Science.gov (United States)

    Tanimukai, Hitoshi

    2015-01-01

    Cancer patients often suffer from various distresses, including cognitive impairment. Cognitive impairment during and after cancer diagnosis and treatment are collectively called "Cancer-related cognitive impairment (CRCI)". The number of publications about cognitive impairment due to cancer therapy, especially chemotherapy, hormonal therapy, and radiotherapy, has been growing. Patients often worry not only about their disease condition and therapies, but also experience concerns regarding their memory, attention, and ability to concentrate. Even subtle CRCI can have a significant impact on social relationships, the ability to work, undergo treatment, accomplish meaningful goals, and the quality of life. Longitudinal studies of cancer patients indicated that up to 75% experience CRCI during treatment. Furthermore, CRCI may persist for many years following treatment. However, it is not well understood by most physicians and medical staff. CRCI can be mediated through increased inflammatory cytokines and hormonal changes. In addition, the biology of the cancer, stress, and attentional fatigue can also contribute to CRCI. Genetic factors and co-occurring symptoms may explain some of the inter-individual variability in CRCI. Researchers and patients are actively trying to identify effective interventional methods and useful coping strategies. Many patients are willing to discuss their disease condition and future treatment with medical staff and/or their families. Some patients also hope to discuss their end-of-life care. However, it is difficult to express their will after developing cognitive impairment. Advance care planning (ACP) can help in such situations. This process involves discussion between a patient, their family, and clinicians to clarify and reflect on values, treatment preferences, and goals to develop a shared understanding of how end-of-life care should proceed. The number of cancer patients with cognitive impairment has been increasing owing to the

  19. Subjective cognitive impairment: Towards early identification of Alzheimer disease.

    Science.gov (United States)

    Garcia-Ptacek, S; Eriksdotter, M; Jelic, V; Porta-Etessam, J; Kåreholt, I; Manzano Palomo, S

    2016-10-01

    Neurodegeneration in Alzheimer disease (AD) begins decades before dementia and patients with mild cognitive impairment (MCI) already demonstrate significant lesion loads. Lack of information about the early pathophysiology in AD complicates the search for therapeutic strategies.Subjective cognitive impairment is the description given to subjects who have memory-related complaints without pathological results on neuropsychological tests. There is no consensus regarding this heterogeneous syndrome, but at least some of these patients may represent the earliest stage in AD. We reviewed available literature in order to summarise current knowledge on subjective cognitive impairment. Although they may not present detectable signs of disease, SCI patients as a group score lower on neuropsychological tests than the general population does, and they also have a higher incidence of future cognitive decline. Depression and psychiatric co-morbidity play a role but cannot account for all cognitive complaints. Magnetic resonance imaging studies in these patients reveal a pattern of hippocampal atrophy similar to that of amnestic mild cognitive impairment and functional MRI shows increased activation during cognitive tasks which might indicate compensation for loss of function. Prevalence of an AD-like pattern of beta-amyloid (Aβ42) and tau proteins in cerebrospinal fluid is higher in SCI patients than in the general population. Memory complaints are relevant symptoms and may predict AD. Interpatient variability and methodological differences between clinical studies make it difficult to assign a definition to this syndrome. In the future, having a standard definition and longitudinal studies with sufficient follow-up times and an emphasis on quantifiable variables may clarify aspects of early AD. Copyright © 2012 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Predictors of functional disability in mild cognitive impairment and dementia

    NARCIS (Netherlands)

    van Rossum, M. E.; Koek, H. L.

    2016-01-01

    Objective Knowledge about factors predicting functional disability in mild cognitive impairment (MCI) and dementia would help health care providers to identify those patients who are at high risk of functional disability. Previous research is scarce and focused on only a small number of possible pre

  1. Structural deficits and cognitive impairment in tuberculous meningitis.

    Science.gov (United States)

    Chen, Hsiu-Ling; Lu, Cheng-Hsien; Chang, Ching-Di; Chen, Pei-Chin; Chen, Meng-Hsiang; Hsu, Nai-Wen; Chou, Kun-Hsien; Lin, Wei-Ming; Lin, Ching-Po; Lin, Wei-Che

    2015-07-22

    Chronic neuropsychological sequelae may occur in patients with tuberculous meningitis (TBM). The impact of structural abnormalities on the clinical performance of patients with TBM is unknown. This study applied the Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra (DARTEL) voxel-based morphometry (VBM) to determine if gray matter deficits in TBM are associated with acute presentations and chronic cognitive impairment. Seventeen patients with TBM who discontinued their anti-TB therapy for more than six months, and 17 age-, sex-, and education-matched healthy subjects were enrolled. Differences in gray matter volume (GMV) between patients and healthy controls were investigated using DARTEL-VBM to determine structural abnormalities. Disease severity during the acute stage was scored by clinical profiles and conventional imaging findings. Correlations among chronic structural deficits, cognitive impairment, and initial disease severity were assessed. The patients with TBM had worse neuropsychological subtest performances than the healthy controls. Compared to the controls, the patients showed smaller GMVs in the right thalamus, right caudate nucleus, right superior and middle temporal gyrus, right precuneus, and left putamen (p superior temporal gyrus, right precuneus, left putamen, and right caudate nucleus (p < 0.05) were further associated with worse cognitive function. More severe initial disease also correlated with smaller GMVs in the right caudate nucleus (p < 0.05). Multiple domain cognitive impairment may persist in patients with chronic TBM even after appropriate treatment. Worse initial disease severity may contribute to the vulnerability of brain tissue to damage, with subsequent neuropsychological consequences.

  2. Charles Bonnet syndrome and cognitive impairment: a systematic review.

    Science.gov (United States)

    Russell, Gregor; Burns, Alistair

    2014-05-22

    ABSTRACT Background: Charles Bonnet syndrome (CBS) is defined as complex persistent visual hallucinations in the absence of mental disorder. It is common in conditions causing significant visual impairment. Many authors advise reassurance, considering the condition benign. However, others have suggested that CBS may in some patients represent the early stages of dementia. This review seeks to systematically examine the evidence for any link between CBS and cognitive impairment. Methods: Literature search using OVID Medline, PsychINFO, and Embase. Results: Three studies where cognitive functioning was the primary focus of the research were found. All were small, did not properly apply diagnostic criteria, and reported conflicting results. Eight other studies commented on cognitive functioning, but none used tests sufficiently sensitive to detect changes seen in early dementia. One hundred and thirty four case reports were scrutinized, and reports found of 16 patients with CBS where dementia emerged. High rates of partial insight at diagnosis of CBS were seen in these patients. Conclusions: There have been no adequately powered studies, using accepted diagnostic criteria, where changes in cognitive functioning were the primary outcome. Existing studies are of limited methodological quality and allow no conclusion regarding a relationship between cognitive impairment and CBS to be reached. Numerous case reports of dementia developing in patients with CBS and partial insight raise the possibility of a link between these conditions. There is a clear need for properly constructed studies to investigate this.

  3. Phenotypic cognitive impairment in late-onset delusional disorder.

    Science.gov (United States)

    Harris, Ben S; Kotsopoulos, Eleftheria J; Yamin, Sami

    2014-06-01

    Previous use of heterogeneous diagnostic criteria and insensitive cognitive measures has impeded clarification of the extent and type of cognitive impairment specific to late-onset delusional disorder. We examined whether clinical presentations of late-onset delusional disorder are associated with prodromal or established dementia, and whether it might be a discrete clinical syndrome characterized by its own profile of cognitive impairment. Nineteen patients with late-onset delusional disorder from a hospital psychiatric service and 20 patients with dementia of the Alzheimer's type (AD) from an outpatient memory clinic were recruited in a consecutive case series. All patients underwent comprehensive neuropsychological assessment that included general intellectual function, executive function, new learning and delayed memory, language, processing speed, and visuo-perceptual skills. Late-onset delusional disorder patients showed moderate impairment to conceptual reasoning, visual object recognition, processing speed, and confrontation naming. Severe impairment appeared in visuo-perceptual planning and organization, and divided attention. Compared with the Alzheimer's disease (AD) group, the late-onset delusional disorder group demonstrated significantly poorer visuo-perceptual skills but a significantly better capacity to consolidate information into delayed memory. A high rate of marked cognitive impairment occurs in late-onset delusional disorder. There was evidence of a conceptual reasoning deficit, plus the presence of a visuo-perceptual impairment affecting object recognition. This impairment profile can explain the genesis and maintenance of the observed delusions. Understanding late-onset delusional disorder as other than a purely psychiatric phenomenon or a precursor to AD will lead to better assessment and management approaches.

  4. Decreased cerebral {alpha}4{beta}2* nicotinic acetylcholine receptor availability in patients with mild cognitive impairment and Alzheimer's disease assessed with positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kendziorra, Kai; Meyer, Philipp Mael; Barthel, Henryk; Hesse, Swen; Becker, Georg Alexander; Luthardt, Julia; Schildan, Andreas; Patt, Marianne; Sorger, Dietlind; Seese, Anita; Sabri, Osama [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Wolf, Henrike [University of Leipzig, Department of Psychiatry, Leipzig (Germany); University of Zurich, Department of Old Age Psychiatry and Psychiatry Research, Psychiatric University Hospital (PUK) Zurich, Zurich (Switzerland); Gertz, Herman-Josef [University of Leipzig, Department of Psychiatry, Leipzig (Germany)

    2011-03-15

    Postmortem studies indicate a loss of nicotinic acetylcholine receptor (nAChRs) in Alzheimer's disease (AD). In order to establish whether these changes in the cholinergic system occur at an early stage of AD, we carried out positron emission tomography (PET) with a specific radioligand for the {alpha}4{beta}2* nicotinic acetylcholine receptor ({alpha}4{beta}2* nAChR) in patients with mild to moderate AD and in patients with amnestic mild cognitive impairment (MCI), who have a high risk to progress to AD. Nine patients with moderate AD, eight patients with MCI and seven age-matched healthy controls underwent 2-[{sup 18}F]fluoro-3-(2(S)-azetidinylmethoxy)pyridine (2-[{sup 18}F]FA-85380) PET. After coregistration with individual magnetic resonance imaging the binding potential (BP{sub ND}) of 2-[{sup 18}F]FA-85380 was calculated using either the corpus callosum or the cerebellum as reference regions. PET data were analysed by region of interest analysis and by voxel-based analysis. Both patients with AD and MCI showed a significant reduction in 2-[{sup 18}F]FA-85380 BP{sub ND} in typical AD-affected brain regions. Thereby, the corpus callosum was identified as the most suitable reference region. The 2-[{sup 18}F]FA-85380 BP{sub ND} correlated with the severity of cognitive impairment. Only MCI patients that converted to AD in the later course (n = 5) had a reduction in 2-[{sup 18}F]FA-85380 BP{sub ND}. 2-[{sup 18}F]FA-85380 PET appears to be a sensitive and feasible tool for the detection of a reduction in {alpha}4{beta}2* nAChRs which seems to be an early event in AD. In addition, 2-[{sup 18}F]FA-85380 PET might give prognostic information about a conversion from MCI to AD. (orig.)

  5. C-reactive protein, advanced glycation end products and their receptor in type 2 diabetic, elderly patients with mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Malgorzata eGorska-Ciebiada

    2015-10-01

    Full Text Available Objective: The aim of the study was to evaluate serum levels of AGEs (advanced glycation end products, RAGE (receptor for advanced glycation end products and CRP (C-reactive protein in elderly patients with T2DM with and without mild cognitive impairment (MCI and to determine the predictors (including AGEs, RAGE and CRP levels of having MCI in elderly patients with type 2 diabetes.Methods: 276 diabetics elders were screened for MCI (using the Montreal Cognitive Assessment: MoCA score. Data of biochemical parameters and biomarkers were collected. Results: Serum AGEs, RAGE and CRP levels were significantly increased in MCI patients compared to controls. In group of patients with MCI serum RAGE level was positively correlated with AGEs level and with CRP level. RAGE, AGEs and CRP concentrations were positively correlated with HbA1c levels and negatively correlated with MoCA score. The univariate logistic regression models revealed that variables which increased the likelihood of diagnosis of MCI in elderly patients with type 2 diabetes were: higher levels of HbA1c, RAGE, AGEs, CRP, TG, lower level of HDL cholesterol, previous CVD, HA or use of HA drugs, hiperlipidaemia, retinopathy, nephropathy, increased number of co-morbidities, older age and less years of formal education. HA or use of HA drugs, previous CVD, higher level of RAGE and CRP, older age and less years of formal education are the factors increasing the likelihood of having MCI in elderly patients with type 2 diabetes in multivariable model. Conclusions: In summary, serum AGEs, RAGE and CRP are increased in the circulation of MCI elderly diabetic patients compared to controls. A larger population-based prospective study needs to be performed to further confirm the relationship between AGEs, RAGE and the cognitive decline or progress to dementia.

  6. Posterior Atrophy and Medial Temporal Atrophy Scores Are Associated with Different Symptoms in Patients with Alzheimer's Disease and Mild Cognitive Impairment.

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    Jung-Lung Hsu

    Full Text Available Whether the occurrence of posterior atrophy (PA and medial temporal lobe atrophy (MTA was correlated with cognitive and non-cognitive symptoms in Alzheimer's disease (AD and mild cognitive impairment (MCI patients are unclear.Patients with probable AD and MCI from a medical center outpatient clinic received attention, memory, language, executive function evaluation and Mini-Mental Status Examination (MMSE. The severity of dementia was rated by the Clinical Dementia Rating (CDR Sum of Box (CDR-SB. The neuropsychiatric inventory (NPI subscale of agitation/aggression and mood symptoms was also applied. Magnetic resonance imaging (MRI was scored visually for the MTA, PA and white matter hyperintensity (WMH scores.We recruited 129 AD and 31 MCI (mean age 78.8 years, 48% female patients. MMSE scores, memory, language and executive function were all significantly decreased in individuals with AD than those with MCI (p < 0.01. MTA and PA scores reflected significant atrophy in AD compared to MCI; however, the WMH scores did not differ. The MTA scores were significantly correlated with the frontal, parieto-occipital and global WMH scores (p < 0.01 while the PA scores showed a correlation with the parieto-occipital and temporal WMH scores (p < 0.01. After adjusting for age, education, APOE4 gene and diagnostic group covariates, the MTA scores showed a significant association with MMSE and CDR-SB, while the right side PA scores were significantly associated with NPI-agitation/aggression subscales (p < 0.01.Regional atrophy is related to different symptoms in patients with AD or MCI. PA score is useful as a complementary measure for non-cognitive symptom.

  7. Impaired cognitive performance and hippocampal atrophy in Parkinson disease.

    Science.gov (United States)

    Yildiz, Demet; Erer, Sevda; Zarifoğlu, Mehmet; Hakyemez, Bahattin; Bakar, Mustafa; Karli, Necdet; Varlibaş, Zeynep Nigar; Tufan, Fatih

    2015-01-01

    Dementia is common in Parkinson disease (PD). Since magnetic resonance imaging has been used, hippocampal atrophy has been shown in PD patients with or without dementia. In this study we sought the correlation of cognitive decline with bilateral hippocampal volume in PD patients. Thirty-three patients with diagnosis of idiopathic PD and 16 healthy subjects were included in this study. PD patients were divided into two groups as normal cognitive function and mild cognitive impairment (MCI). The Mini-Mental State Examination and detailed cognitive assessment tests were performed for all patients for cognitive analyses. Depression was excluded by the Geriatric Depression Scale. The mean onset age of disease was 55 years for PD patients without dementia and 59 for PD patients with MCI. According to the Hoehn-Yahr scales, 24% of patients had grade 1, 58% had grade 2, and 18% had grade 3 disease. Right and left hippocampal volumes decreased along with cognitive test scores in PD patients. Increased right hippocampal volume was correlated with forward number test in the MCI-PD group. These findings suggest that memory deficit is associated with hippocampal atrophy in PD patients.

  8. Cardiovascular disease and cognitive function in maintenance hemodialysis patients

    Science.gov (United States)

    Cardiovascular disease (CVD) and cognitive impairment are common in dialysis patients. Given the proposed role of microvascular disease on cognitive function, particularly cognitive domains that incorporate executive functions, we hypothesized that prevalent systemic CVD would be associated with wor...

  9. Interrelationship of postoperative delirium and cognitive impairment and their impact on the functional status in older patients undergoing orthopaedic surgery: a prospective cohort study

    National Research Council Canada - National Science Library

    Liang, Chih-Kuang; Chu, Chin-Liang; Chou, Ming-Yueh; Lin, Yu-Te; Lu, Ti; Hsu, Chien-Jen; Chen, Liang-Kung

    2014-01-01

    ... delirium with underlying cognitive impairment. This prospective cohort study, conducted at a tertiary care medical center from April 2011 to March 2012, enrolled all subjects aged over 60 years who were admitted for orthopaedic surgery...

  10. A neuropsychological study of patients with mild cognitive impairment%轻度认知功能障碍患者的神经心理学研究

    Institute of Scientific and Technical Information of China (English)

    王延平; 李海员; 杨少青; 黄绍宽; 邓永萍; 陈智超; 陈盛强; 徐桂兰

    2010-01-01

    Objective To explore the neuropsychological features of patients with mild cognitive impairment (MCI). Methods Forty-two patients with MCI and 50 normal controls were examined with a series of neuropsychoiogieai tests. These test included mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), clinical dementia rating scale (CDR), rapid verbal retrieve (RVR), activity of daily living scale (ADL), Wechsler intelligence scale (WAIS-RC) and its sub-tests (digit span[DS], blocks design test [BD], similarity test), Wechsler memory scale (WMS-R) and its sub-tests (logical memory, associative learning, visual recognition, picture recall). The difference of these data were compared and analyzed. Results The patients with MCI had significantly lower MMSE total score, MoCA total score, RVR score, WAIS-RC score and its sub-tests scores, WMS-R score and its sub-test scores than healthy controls (P0.05). For the MoCA sub-items, the patients with MCI had significantly lower scores than healthy controls in all the cognitive function measures except fixed orientation (P<0.05). Conclusions In addition to memory impairment, naming, visuospatial ability and executive function may also be impaired in patients with MCI; delayed recall, calculation and attention are obviously impaired in patients with MCI. MoCA, covering the important cognitive domains, can comprehensively assess the cognitive functions of patients with MCI and has its value in the clinical application.%目的 探讨轻度认知功能障碍(MCI)患者神经心理学的特点. 方法 对42例MCI患者和55例健康对照者进行多项神经心理学检查,包括简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、临床痴呆评定量表(CDR)、语言流畅性测验(RVR)、韦氏智力测验(WAIS-RC)[包括数字广度测验(DS)、积木测验(BD)、相似性测验]、韦氏记忆测验(WMS-R)(包括逻辑记忆、联想学习、视觉再认、图片回忆)、日

  11. Modeling of cognitive impairment by disease duration in multiple sclerosis: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Anat Achiron

    Full Text Available BACKGROUND/AIMS: Large-scale population studies measuring rates and dynamics of cognitive decline in multiple sclerosis (MS are lacking. In the current cross-sectional study we evaluated the patterns of cognitive impairment in MS patients with disease duration of up to 30 years. METHODS: 1,500 patients with MS were assessed by a computerized cognitive battery measuring verbal and non-verbal memory, executive function, visual spatial perception, verbal function, attention, information processing speed and motor skills. Cognitive impairment was defined as below one standard deviation (SD and severe cognitive impairment as below 2SD for age and education matched healthy population norms. RESULTS: Cognitive performance in our cohort was poorer than healthy population norms. The most frequently impaired domains were information processing speed and executive function. MS patients with secondary-progressive disease course performed poorly compared with clinically isolated syndrome, relapsing-remitting and primary progressive MS patients. By the fifth year from disease onset, 20.9% of patients performed below the 1SD cutoff for impairment, p=0.005, and 6.0% performed below the 2SD cutoff for severe cognitive impairment, p=0.002. By 10 years from onset 29.3% and 9.0% of patients performed below the 1SD and 2SD cutoffs, respectively, p=0.0001. Regression modeling suggested that cognitive impairment may precede MS onset by 1.2 years. CONCLUSIONS: The rates of cognitive impairment in this large sample of MS patients were lower than previously reported and severe cognitive impairment was evident only in a relatively small group of patients. Cognitive impairment differed significantly from expected normal distribution only at five years from onset, suggesting the existence of a therapeutic window during which patients may benefit from interventions to maintain cognitive health.

  12. The relationship between cognitive impairment and in vivo metabolite ratios in patients with clinical Alzheimer's disease and vascular dementia: a proton magnetic resonance spectroscopy study

    Energy Technology Data Exchange (ETDEWEB)

    Waldman, A.D. [Department of Imaging, Charing Cross Hospital and Dementia Research Group, University College London, Fulham Palace Road, W6 8RF, London (United Kingdom); Rai, G.S. [Department of Care of Older People, Whittington Hospital, Highgate Hill, London (United Kingdom)

    2003-08-01

    Previous magnetic resonance spectroscopy (MRS) studies have shown increased myo-inositol (MI) and decreased N-acetyl aspartate (NAA) levels in the parieto-occipital lobes of patients with Alzheimer's disease (AD) compared to those with other dementias and normal subjects. This study aimed to establish the quantitative relationship between metabolite ratios and degree of cognitive impairment in patients with mild to moderate AD and sub-cortical ischaemic vascular dementia (SIVD). Forty-four older people with clinical dementia were recruited from a memory clinic and followed up for 2.0-3.5 years; 20 cases were finally classified as probable AD, 18 as SIVD and 6 as mixed type. Mini Mental State Examination (MMSE) and short echo time single voxel automated MRS from the mesial parieto-occipital lobes were performed at the time of initial referral. Spearman rank correlation coefficients were calculated for MMSE scores and measured metabolite ratios MI/Cr, NAA/Cr, Cho/Cr and NAA/MI. The AD group showed a significant correlation between MMSE and NAA/MI (r=0.54, P=0.014) and NAA/Cr (r=0.48, P=0.033), and a negative, non-significant association with MI/Cr (r=-0.41, P=0.072). MI/Cr was negatively correlated with NAA/Cr (r=-0.51, P=0.021). Neither Cho/Cr ratios nor age correlated with cognitive function. The SIVD group showed no correlation between any of the measured metabolite ratios and MMSE score. This study reinforces the specific association between reduced NAA and increased MI levels in the parieto-occipital region and cognitive impairment in AD. MRS may have a role in evaluating disease progression and therapeutic monitoring in AD, as new treatments become available. (orig.)

  13. Assessing the synergy between cholinomimetics and memantine as augmentation therapy in cognitive impairment in schizophrenia. A virtual human patient trial using quantitative systems pharmacology.

    Science.gov (United States)

    Geerts, Hugo; Roberts, Patrick; Spiros, Athan

    2015-01-01

    While many drug discovery research programs aim to develop highly selective clinical candidates, their clinical success is limited because of the complex non-linear interactions of human brain neuronal circuits. Therefore, a rational approach for identifying appropriate synergistic multipharmacology and validating optimal target combinations is desperately needed. A mechanism-based Quantitative Systems Pharmacology (QSP) computer-based modeling platform that combines biophysically realistic preclinical neurophysiology and neuropharmacology with clinical information is a possible solution. This paper reports the application of such a model for Cognitive Impairment In Schizophrenia (CIAS), where the cholinomimetics galantamine and donepezil are combined with memantine and with different antipsychotics and smoking in a virtual human patient experiment. The results suggest that cholinomimetics added to antipsychotics have a modest effect on cognition in CIAS in non-smoking patients with haloperidol and risperidone and to a lesser extent with olanzapine and aripiprazole. Smoking reduces the effect of cholinomimetics with aripiprazole and olanzapine, but enhances the effect in haloperidol and risperidone. Adding memantine to antipsychotics improves cognition except with quetiapine, an effect enhanced with smoking. Combining cholinomimetics, antipsychotics and memantine in general shows an additive effect, except for a negative interaction with aripiprazole and quetiapine and a synergistic effect with olanzapine and haloperidol in non-smokers and haloperidol in smokers. The complex interaction of cholinomimetics with memantine, antipsychotics and smoking can be quantitatively studied using mechanism-based advanced computer modeling. QSP modeling of virtual human patients can possibly generate useful insights on the non-linear interactions of multipharmacology drugs and support complex CNS R&D projects in cognition in search of synergistic polypharmacy.

  14. Heart failure and cognitive impairment: Challenges and opportunities

    Directory of Open Access Journals (Sweden)

    George A Heckman

    2007-07-01

    Full Text Available George A Heckman, Christopher J Patterson, Catherine Demers, Joye St.Onge, Irene D Turpie, Robert S McKelvieDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaAbstract: As populations age, heart failure (HF is becoming increasingly common, and in addition to a high burden of morbidity and mortality, HF has an enormous financial impact. Though disproportionately affected by HF, the elderly are less likely to receive recommended therapies, in part because clinical trials of HF therapy have ignored outcomes of importance to this population, including impaired cognitive function (ICF. HF is associated with ICF, manifested primarily as delirium in hospitalized patients, or as mild cognitive impairment or dementia in otherwise stable outpatients. This association is likely the result of shared risk factors, as well as perfusion and rheological abnormalities that occur in patients with HF. Evidence suggests that these abnormalities may be partially reversible with standard HF therapy. The clinical consequences of ICF in HF patients are significant. Clinicians should consider becoming familiar with screening instruments for ICF, including delirium and dementia, in order to identify patients at risk of nonadherence to HF therapy and related adverse consequences. Preliminary evidence suggests that optimal HF therapy in elderly patients may preserve or even improve cognitive function, though the impact on related outcomes remains to be determined.Keywords: heart failure, mild cognitive impairment, delirium, dementia, elderly

  15. Visual personal familiarity in amnestic mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Luisa Jurjanz

    Full Text Available BACKGROUND: Patients with amnestic mild cognitive impairment are at high risk for developing Alzheimer's disease. Besides episodic memory dysfunction they show deficits in accessing contextual knowledge that further specifies a general concept or helps to identify an object or a person. METHODOLOGY/PRINCIPAL FINDINGS: Using functional magnetic resonance imaging, we investigated the neural networks associated with the perception of personal familiar faces and places in patients with amnestic mild cognitive impairment and healthy control subjects. Irrespective of stimulus type, patients compared to control subjects showed lower activity in right prefrontal brain regions when perceiving personally familiar versus unfamiliar faces and places. Both groups did not show different neural activity when perceiving faces or places irrespective of familiarity. CONCLUSIONS/SIGNIFICANCE: Our data highlight changes in a frontal cortical network associated with knowledge-based personal familiarity among patients with amnestic mild cognitive impairment. These changes could contribute to deficits in social cognition and may reduce the patients' ability to transition from basic to complex situations and tasks.

  16. Brain imaging of mild cognitive impairment and Alzheimer's disease

    Institute of Scientific and Technical Information of China (English)

    Changhao Yin; Siou Li; Weina Zhao; Jiachun Feng

    2013-01-01

    The rapidly increasing prevalence of cognitive impairment and Alzheimer's disease has the potential to create a major worldwide healthcare crisis. Structural MRI studies in patients with Alzheimer's disease and mild cognitive impairment are currently attracting considerable interest. It is extremely important to study early structural and metabolic changes, such as those in the hippocampus, entorhinal cortex, and gray matter structures in the medial temporal lobe, to allow the early detection of mild cognitive impairment and Alzheimer's disease. The microstructural integrity of white matter can be studied with diffusion tensor imaging. Increased mean diffusivity and decreased fractional anisotropy are found in subjects with white matter damage. Functional imaging studies with positron emission tomography tracer compounds enable detection of amyloid plaques in the living brain in patients with Alzheimer's disease. In this review, we will focus on key findings from brain imaging studies in mild cognitive impairment and Alzheimer's disease, including structural brain changes studied with MRI and white matter changes seen with diffusion tensor imaging, and other specific imaging methodologies will also be discussed.

  17. Effectiveness of Compensatory Strategies applied to Cognitive impairment in Schizophrenia

    DEFF Research Database (Denmark)

    Hansen, Jens Peter; Østergaard, Birte; Nordentoft, Merete

      Background Between 75% and 85% of patients with schizophrenia have cognitive impairments. The impairments have a negative influence on the patient's ability to maintain work, maintain contact with friends, independent living and living in a social relationship. Compared to treatment as usual......, studies using Cognitive Adaptation Training (CAT), including training of compensatory strategies to sequence patient's adaptive behaviours, have shown improvement in social functioning, decreased relapse, better compliance to medical treatment and increased quality of life. However, no studies, up to now......, have investigated the effect of CAT in younger patients with schizophrenia   Purpose The purpose of this study is to evaluate the effect of CAT in comparison with treatment as usual, focusing on social functions, symptoms, relapse, re-hospitalisation, and quality of life in younger outpatients...

  18. Effectiveness of Compensatory Strategies applied to Cognitive impairment in Schizophrenia

    DEFF Research Database (Denmark)

    Hansen, Jens Peter; Østergaard, Birte; Nordentoft, Merete

    Background Bewteen 75% and 85% of patients with schizophrenia have cognitive impairments. The impairments have a negative influence on the patient's ability to maintain work, maintain contact with friends, independent living and living in a social relationship. Compared to treatment as usual......, studies using Cognitive Adaptation Training (CAT), including training of compensatory strategies to sequence patient's adaptive behaviours, have shown improvement in social functioning, decreased relapse, better compliance to medical treatment and increased quality of life. However, no studies, up to now......, have investigated the effect of CAT in younger patients with schizophrenia     Purpose The purpose of this study is to evaluate the effect of CAT in comparison with treatment as usual, focusing on social functions, symptoms, relapse, re-hospitalisation, and quality of life in younger outpatients...

  19. Vascular cognitive impairments in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    I. V. Rogova

    2015-01-01

    Full Text Available Objective: to study the specific features of development of cognitive impairments (CIs, the role of traditional cardiovascular risk factors and renal failure-induced factors in patients with Stages I–IV chronic kidney disease (CKD and to assess an association of CIs with the signs of vascular wall remodeling in them. Patients and methods. Fifty-one patients aged 53±10 years with CKD were examined. Among them, there were 20 patients with Stages I–II CKD: a glomerular filtration rate (GFR of і60 ml/min/1.73 m2, signs of renal lesion; 20 with Stages III CKD: a GFR of <60–30 ml/min/1.73 m2, and 11 with Stages VI CKD: a GFR of <30–15 ml/min/1.73 m2. Results and discussion. CIs were more common in the patients with Stages III–IV than in those with Stages I–II, as shown by the scores of the mini-mental state examination (p<0.001, the frontal assessment battery (p=0.001, and the regulatory function test (p<0.001. These tests showed that the magnitude of CIs increased with the higher stage of CKD. Stages III–IV CKD is an independent predictor of CIs in persons with predialysis-stage kidney lesion. CIs were found to be related to hyperhomocysteinemia, anemia, abdominal obesity, left ventricular hypertrophy, and patient age. The signs of atherosclerotic lesion of the common carotid arteries and the indicators of arterial stiffness were also associated with the incidence and magnitude of CIs in CKD. The detection of CIs in patients with early CKD allows one to timely initiate adequate therapy aimed particularly at improving cerebral circulation, eliminating the impact of risk factors, and slowing down the vascular remodeling. The management tactics for patients with CKD must involve the identification and correction of cardiovascular risk factors, and duplex scanning of the wall of the common carotid arteries may be used as a noninvasive method to assess the risk of the development and progression of CIs in predialysis CKD. 

  20. Frequency-dependent brain regional homogeneity alterations in patients with mild cognitive impairment during working memory state relative to resting state

    Directory of Open Access Journals (Sweden)

    Pengyun eWang

    2016-03-01

    Full Text Available Several studies have reported working memory deficits in patients with mild cognitive impairment (MCI. However, previous studies investigating the neural mechanisms of MCI have primarily focused on brain activity alterations during working memory tasks. No study to date has compared brain network alterations in the working memory state between MCI patients and normal control subjects. Therefore, using the index of regional homogeneity (ReHo, we explored brain network impairments in MCI patients during a working memory task relative to the resting state, and identified frequency-dependent effects in separate frequency bands.Our results indicate that, in MCI patients, ReHo is altered in the posterior cingulate cortex in the slow-3 band (0.073–0.198 Hz, and in the bottom of the right occipital lobe and part of the right cerebellum, the right thalamus, a diffusing region in the bilateral prefrontal cortex, the left and right parietal-occipital regions, and the right angular gyrus in the slow-5 band (0.01–0.027 Hz. Furthermore, in normal controls, the value of ReHo in clusters belonging to the default mode network decreased, while the value of ReHo in clusters belonging to the attentional network increased during the task state. However, this pattern was reversed in MCI patients, and was associated with decreased working memory performance. In addition, we identified altered functional connectivity of the abovementioned regions with other parts of the brain in MCI patients.This is the first study to compare frequency-dependent alterations of ReHo in MCI patients between resting and working memory states. The results provide a new perspective regarding the neural mechanisms of working memory deficits in MCI patients, and extend our knowledge of altered brain patterns in resting and task-evoked states.

  1. Cognitive Impairment: An Increasingly Important Complication of Type 2 Diabetes

    National Research Council Canada - National Science Library

    Saczynski, Jane S; Jónsdóttir, María K; Garcia, Melissa E; Jonsson, Palmi V; Peila, Rita; Eiriksdottir, Gudny; Olafsdottir, Elin; Harris, Tamara B; Gudnason, Vilmundur; Launer, Lenore J

    2008-01-01

    Persons with type 2 diabetes are at increased risk of cognitive dysfunction. Less is known about which cognitive abilities are affected and how undiagnosed diabetes and impaired fasting glucose relate to cognitive performance...

  2. Electronic reminding technology for cognitive impairment.

    Science.gov (United States)

    Mason, Sarah; Craig, David; O'Neill, Sonia; Donnelly, Mark; Nugent, Chris

    Demographic changes highlight the need to address disabilities associated with the costly morbidities of old age, such as dementia. Memory impairment associated with dementia represents a significant challenge for many older people. Difficulties occur in carrying out activities in their entirety or in commencing them at all. Technology has the potential to help individuals overcome the barriers created by cognitive disability in terms of performing activities of daily living and therefore help to maintain independence and enhance quality of life (Czaja, 2005). This literature review examines the current reported research, which employs electronic reminding technology to support individuals with cognitive impairment. These devices range from everyday technologies, such as phones, to sophisticated interactive devices with specifically designed software. A summary of the current evidence base is presented and recommendations for future practice are made.

  3. Effect of sensory integration training on the cognition in patients with mild cognitive impairment%感觉统合训练对轻度认知功能障碍患者认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    王培玲; 魏秀红

    2012-01-01

    目的 观察感觉统合训练对老年(60~80岁)轻度认知功能障碍(MCI)患者认知功能的影响.方法 将41例老年MCI患者随机分为观察组21例和对照组20例,观察组进行感觉统合训练3个月,对照组不予任何干预.观察简明精神状态量表( MMSE)总体疗效,训练前后MMSE积分、日常生活能力量表(ADL)积分.结果 观察组MMSE积分明显高于、ADL积分明显低于训练前及对照组,P均<0.05;观察组显效3例,有效17例,无效8例,总有效率为71.42%;对照组分别为0、2、25例和7.41%,观察组总有效率明显高于对照组(P<0.01).结论 感觉统合训练可改善MCI患者的认知功能,提高日常生活能力.%Objective To investigate the effects of sensory integration training on aged patients ( from 60 to 80-year-old) with mild cognitive impairment. Methods Forty-one patients with mild cognitive impairment were randomly divided into observed group(n=21) and control group (n=20) , the observed group were treated with sensory integration training for 3 months, and the control group was not intervened. Before and after the training, Mini-Mental state examination ( MMSE) and activity of daily living scale ( ADL) were used to evaluate each patient's cognitive function and daily living a-bility. Results The MMSE or ADL total scores after training in observed group were significantly higher or lower than those before training and which in control group( all P <0.05). Conclusions The cognitive function and daily Living a-bility can be enhanced through sensory integration training in patients with mild cognitive impairment.

  4. Retrieval deficiency in brain activity of working memory in amnesic mild cognitive impairment patients: A brain event-related potentials study

    Directory of Open Access Journals (Sweden)

    Binyin eLi

    2016-03-01

    Full Text Available In the early stage of Alzheimer disease (AD or mild cognitive impairment (MCI, working memory (WM deficiency is prominent and could be attributed to failure in encoding, maintenance or retrieval of information. However, evidence for a retention or retrieval deficit remains equivocal. It is also unclear what cognitive mechanism in working memory is impaired in MCI or early AD. We enrolled forty-six subjects from our Memory Clinics and community, with 24 amnesic MCI patients and 22 normal subjects. After neurological and cognitive assessments, they performed a classic delayed match to sample task with simultaneous event-related potential (ERP recorded. The ERPs in encoding and retrieval epoch during WM were analyzed separately. The latency and amplitude of every ERP component were compared between two groups, and then analyzed to explore their relationship with neuropsychological performance. Finally, the locations of maximal difference in cortex were calculated by standard low-resolution tomographic analysis. A total of five components were found: P1, N1, P2, N2 and P300. The amplitude of P2 and P300 was larger in normal subjects than in MCI patients only during retrieval, not encoding epoch, while the latency did not show statistical difference. The latency and amplitude of P1 and N1 were similar in two groups. P2 amplitude in the retrieval epoch positively correlated with memory test (auditory verbal learning test and visual spatial score of Chinese Addenbrooke’s Cognitive Examination-Revised (ACE-R, while P300 amplitude correlated with ACE-R. The activation difference in P2 time range was maximal at medial frontal gyrus. However, the difference in cortex activation during P300 time range did not show significance. The amplitude of P2 indicated deficiency in memory retrieval process, potentially due to dysfunction of central executive in WM model. Regarding the location of P2 during WM task, medial frontal plays important role in memory

  5. Retrieval Deficiency in Brain Activity of Working Memory in Amnesic Mild Cognitive Impairment Patients: A Brain Event-Related Potentials Study.

    Science.gov (United States)

    Li, Bin-Yin; Tang, Hui-Dong; Chen, Sheng-Di

    2016-01-01

    In the early stage of Alzheimer disease (AD) or mild cognitive impairment (MCI), working memory (WM) deficiency is prominent and could be attributed to failure in encoding, maintenance or retrieval of information. However, evidence for a retention or retrieval deficit remains equivocal. It is also unclear what cognitive mechanism in WM is impaired in MCI or early AD. We enrolled 46 subjects from our Memory Clinics and community, with 24 amnesic MCI patients and 22 normal subjects. After neurological and cognitive assessments, they performed a classic delayed match to sample (DMS) task with simultaneous event-related potential (ERP) recorded. The ERPs in encoding and retrieval epoch during WM were analyzed separately. The latency and amplitude of every ERP component were compared between two groups, and then analyzed to explore their relationship with neuropsychological performance. Finally, the locations of maximal difference in cortex were calculated by standard low-resolution tomographic analysis. A total of five components were found: P1, N1, P2, N2, and P300. The amplitude of P2 and P300 was larger in normal subjects than in MCI patients only during retrieval, not encoding epoch, while the latency did not show statistical difference. The latency and amplitude of P1 and N1 were similar in two groups. P2 amplitude in the retrieval epoch positively correlated with memory test (auditory verbal learning test) and visual spatial score of Chinese Addenbrooke's Cognitive Examination-Revised (ACE-R), while P300 amplitude correlated with ACE-R. The activation difference in P2 time range was maximal at medial frontal gyrus. However, the difference in cortex activation during P300 time range did not show significance. The amplitude of P2 indicated deficiency in memory retrieval process, potentially due to dysfunction of central executive in WM model. Regarding the location of P2 during WM task, medial frontal plays important role in memory retrieval. The findings in the

  6. Combined omega-3 fatty acids, aerobic exercise and cognitive stimulation prevents decline in gray matter volume of the frontal, parietal and cingulate cortex in patients with mild cognitive impairment.

    Science.gov (United States)

    Köbe, Theresa; Witte, A Veronica; Schnelle, Ariane; Lesemann, Anne; Fabian, Sonja; Tesky, Valentina A; Pantel, Johannes; Flöel, Agnes

    2016-05-01

    Previous studies in older adults suggested beneficial effects of omega-3 fatty acid (FA) supplementation, aerobic exercise, or cognitive stimulation on brain structure and function. However, combined effects of these interventions in patients suffering from mild cognitive impairment (MCI) are unknown. Using a randomized interventional design, we evaluated the effect of combined omega-3 FA supplementation, aerobic exercise and cognitive stimulation (target intervention) versus omega-3 FA supplementation and non-aerobic exercise (control intervention) on cognitive function and gray matter volume in patients with MCI. Moreover, we analyzed potential vascular, metabolic or inflammatory mechanisms underlying these effects. Twenty-two MCI patients (8 females; 60-80years) successfully completed six months of omega-3 FA intake, aerobic cycling training and cognitive stimulation (n=13) or omega-3 FA intake and non-aerobic stretching and toning (n=9). Before and after the interventions, cognitive performance, magnetic resonance imaging of the brain at 3T (n=20), intima-media thickness of the internal carotid artery and serum markers of glucose control, lipid and B-vitamin metabolism, and inflammation were assessed. Intervention-related changes in gray matter volume of Alzheimer's disease (AD)-related brain regions, i.e., frontal, parietal, temporal and cingulate cortex were examined using voxel-based morphometry of high resolution T1-weighted images. After the intervention period, significant differences emerged in brain structure between groups: Gray matter volume decreased in the frontal, parietal and cingulate cortex of patients in the control intervention, while gray matter volume in these areas was preserved or even increased after the target intervention. Decreases in homocysteine levels in the target intervention group were associated with increases in gray matter volume in the middle frontal cortex (p=0.010). No significant differences in cognitive performance or

  7. Cognitive impairments in Hashimoto's encephalopathy: a case-control study.

    Directory of Open Access Journals (Sweden)

    Jianhong Wang

    Full Text Available BACKGROUND/AIMS: Hashimoto's encephalopathy is considered as a treatable dementia, but it is often misdiagnosed. We investigated cognitive impairment and the MRI pathology of Hashimoto's encephalopathy patients. METHODS: The study comprised eight patients with Hashimoto's encephalopathy, 16 patients with mild Alzheimer's disease and 24 healthy subjects. A neuropsychological battery included assessments of memory, language, attention, executive function and visuospatial ability. Cranial MRI was obtained from all Hashimoto's encephalopathy patients. RESULTS: Hashimoto's encephalopathy and mild Alzheimer's disease showed cognitive impairments in episodic memory, attention, executive function and visuospatial ability, but naming ability was unaffected in Hashimoto's encephalopathy. The MRI of Hashimoto's encephalopathy showed leukoencephalopathy-like type or limbic encephalitis-like type; the lesions did not affect the temporal cortex which plays a role in naming ability. CONCLUSION: Except that the naming ability was retained, the impairments in cognitive functions for the Hashimoto's encephalopathy patients were similar to those of Alzheimer's disease patients. These results were consistent with the MRI findings.

  8. White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio

    Directory of Open Access Journals (Sweden)

    Yoshiaki Tamura

    2017-07-01

    Full Text Available Aims: Although evidence has accumulated that white matter hyperintensity (WMH is associated with the deterioration of cognitive function and impairment of activities of daily living (ADL, the clinical relevance of WMH in elderly patients with diabetes mellitus (DM is not still clear. The aim of this study was to examine whether WMH volume is associated with ADL and cognitive function and whether glucose control and glucose variability can affect WMH volume in these patients.Methods: This cross-sectional study investigated the associations of WMH with cognitive function and instrumental ADL (IADL, as well as metabolic and vascular risk factors in a total of 178 elderly patients with diabetes. The study assessed WMH volumes and the functional status of cognition and IADL. WMH volumes were evaluated by obtaining axial T2-weighted and fluid-attenuated inversion recovery sequence images on brain magnetic resonance imaging and assessing the images using Software for Neuro-Image Processing in Experimental Research.Results: We found a significant association between WMH volumes and Mini-Mental State Examination (MMSE scores (p = 0.039 and between WMH and IADL status (p = 0.006. Furthermore, we found significant relations of large WMH volumes with a high glycoalbumin/glycohemoglobin ratio (GA/HbA1c (p < 0.001. Large WMH volumes were also found to be associated with a low body mass index (p = 0.014 and a low diastolic blood pressure (p = 0.024, but not with HbA1c. Multiple regression analysis showed that high GA/HbA1c, which reflects high glucose variability, was a significant determining factor for large WMH volumes. We also found that GA/HbA1c was negatively associated with both MMSE (p = 0.036 and IADL (p < 0.001.Conclusion: GA/HbA1c, which is a marker of glucose variability, was independently associated with WMH volumes, which could lead to the decline of cognition and IADL in elderly patients with DM.

  9. The concept of vascular cognitive impairment.

    Science.gov (United States)

    Bowler, J V

    2002-11-15

    Vascular dementia (VaD) is increasingly recognised to reflect an outmoded concept in that it identifies cases too late for preventive therapy to have an opportunity to prevent the development of dementia and uses a cognitive paradigm inappropriately based on Alzheimer's disease. A replacement is urgently required and a new concept, that of vascular cognitive impairment (VCI), has been proposed to meet this need. It is imperative that criteria for VCI are developed on the basis of knowledge and data rather than supposition and assumption, as was the case for VaD. This review details the state of knowledge that we have now reached concerning the fundamental points of severity and cognitive paradigm and also covers a number of other imaging-related essential points embracing atrophy, leukoaraiosis, infarct volume and infarct location. Finally, the increasingly important concept of mixed dementia (co-existent Alzheimer's disease and VCI) is discussed.

  10. Physical Activity Prevents Progression for Cognitive Impairment and Vascular Dementia

    DEFF Research Database (Denmark)

    Verdelho, Ana; Madureira, Sofia; Ferro, José M

    2012-01-01

    BACKGROUND AND PURPOSE: We aimed to study if physical activity could interfere with progression for cognitive impairment and dementia in older people with white matter changes living independently. METHODS: The LADIS (Leukoaraiosis and Disability) prospective multinational European study evaluates...... the impact of white matter changes on the transition of independent elderly subjects into disability. Subjects were evaluated yearly during 3 years with a comprehensive clinical protocol and cognitive assessment with classification of cognitive impairment and dementia according to usual clinical criteria....... Physical activity was recorded during the clinical interview. MRI was performed at entry and at the end of the study. RESULTS: Six hundred thirty-nine subjects were included (74.1±5 years old, 55% women, 9.6±3.8 years of schooling, 64% physically active). At the end of follow-up, 90 patients had dementia...

  11. Cognitive Impairments Preceding and Outlasting Autoimmune Limbic Encephalitis

    Directory of Open Access Journals (Sweden)

    Robert Gross

    2016-01-01

    Full Text Available Mild cognitive impairment (MCI can be the initial manifestation of autoimmune limbic encephalitis (ALE, a disorder that at times presents a diagnostic challenge. In addition to memory impairment, clinical features that might suggest this disorder include personality changes, agitation, insomnia, alterations of consciousness, and seizures. Once recognized, ALE typically responds to treatment with immune therapies, but long-term cognitive deficits may remain. We report two cases of patients with MCI who were ultimately diagnosed with ALE with antibodies against the voltage gated potassium channel complex. Months after apparent resolution of their encephalitides, both underwent neuropsychological testing, which demonstrated persistent cognitive deficits, primarily in the domains of memory and executive function, for cases 1 and 2, respectively. A brief review of the literature is included.

  12. Subclinical naming errors in mild cognitive impairment: A semantic deficit?

    Directory of Open Access Journals (Sweden)

    Indra F. Willers

    Full Text Available Abstract Mild cognitive impairment (MCI is the transitional stage between normal aging and Alzheimer's disease (AD. Impairments in semantic memory have been demonstrated to be a critical factor in early AD. The Boston Naming Test (BNT is a straightforward method of examining semantic or visuo-perceptual processing and therefore represents a potential diagnostic tool. The objective of this study was to examine naming ability and identify error types in patients with amnestic mild cognitive impairment (aMCI. Methods: Twenty aMCI patients, twenty AD patients and twenty-one normal controls, matched by age, sex and education level were evaluated. As part of a further neuropsychological evaluation, all subjects performed the BNT. A comprehensive classification of error types was devised in order to compare performance and ascertain semantic or perceptual origin of errors. Results: AD patients obtained significantly lower total scores on the BNT than aMCI patients and controls. aMCI patients did not obtain significant differences in total scores, but showed significantly higher semantic errors compared to controls. Conclusion: This study reveals that semantic processing is impaired during confrontation naming in aMCI.

  13. Where did I put that? Patients with amnestic mild cognitive impairment demonstrate widespread reductions in activity during the encoding of ecologically relevant object-location associations

    Science.gov (United States)

    Hampstead, Benjamin M.; Stringer, Anthony Y.; Stilla, Randall F.; Amaraneni, Akshay; Sathian, K.

    2011-01-01

    Remembering the location of objects in the environment is both important in everyday life and difficult for patients with amnestic mild cognitive impairment (aMCI), a clinical precursor to Alzheimer’s disease. To test the hypothesis that memory impairment for object location in aMCI reflects hippocampal dysfunction, we used an event-related functional magnetic resonance imaging paradigm to compare patients with aMCI and healthy elderly controls (HEC) as they encoded 90 ecologically-relevant object-location associations (OLAs). Two additional OLAs, repeated a total of 45 times, served as control stimuli. Memory for these OLAs was assessed following a 1-hour delay. The groups were well matched on demographics and brain volumetrics. Behaviorally, HEC remembered significantly more OLAs than did aMCI patients. Activity differences were assessed by contrasting activation for successfully encoded novel stimuli vs. repeated stimuli. The HEC demonstrated activity within object-related (ventral visual stream), spatial location-related (dorsal visual stream), and feature binding-related cortical regions (hippocampus and other memory-related regions) as well as in frontal cortex and associated subcortical structures. Activity in most of these regions correlated with memory test performance. Although the aMCI patients demonstrated a similar activation pattern, the HEC showed significantly greater activity within each of these regions. Memory test performance in aMCI patients, in contrast to the HEC, was correlated with activity in regions involved in sensorimotor processing. We conclude that aMCI patients demonstrate widespread cerebral dysfunction, not limited to the hippocampus, and rely on encoding-related mechanisms that differ substantially from healthy individuals. PMID:21530556

  14. Quality of life and mild cognitive impairment in early Parkinson's disease: does subtype matter?

    Science.gov (United States)

    Lawson, Rachael A; Yarnall, Alison J; Duncan, Gordon W; Khoo, Tien K; Breen, David P; Barker, Roger A; Collerton, Daniel; Taylor, John-Paul; Burn, David J

    2014-01-01

    We evaluated the association between mild cognitive impairment (MCI) subtypes and quality of life (QoL) in 219 newly diagnosed Parkinson's disease (PD) patients without dementia. Participants completed neuropsychological tests of attention, executive function, visuospatial function, memory, and language, and reported QoL using the Parkinson's Disease Questionnaire. Impairments were most common in executive function, memory and attention. MCI subtypes were classified according to Movement Disorder Society Task Force criteria. More severe cognitive impairment was associated with poorer quality of life (p = 0.01), but subtype of impairment was not (p > 0.10), suggesting that the nature of cognitive impairment is less significant than its severity.

  15. Specialized Pro-Resolving Mediators from Omega-3 Fatty Acids Improve Amyloid-β Phagocytosis and Regulate Inflammation in Patients with Minor Cognitive Impairment.

    Science.gov (United States)

    Fiala, Milan; Terrando, Niccolo; Dalli, Jesmond

    2015-01-01

    In this review we discuss the immunopathology of Alzheimer's disease (AD) and recent advances in the prevention of minor cognitive impairment (MCI) by nutritional supplementation with omega-3 fatty acids. Defective phagocytosis of amyloid-β (Aβ) and abnormal inflammatory activation of peripheral blood mononuclear cells (PBMCs) are the two key immune pathologies of MCI and AD patients. The phagocytosis of Aβ by PBMCs of MCI and AD patients is universally defective and the inflammatory gene transcription is heterogeneously deregulated in comparison to normal subjects. Recent studies have discovered a cornucopia of beneficial anti-inflammatory and pro-resolving effects of the specialized proresolving mediators (SPMs) resolvins, protectins, maresins, and their metabolic precursors. Resolvin D1 and other mediators switch macrophages from an inflammatory to a tissue protective/pro-resolving phenotype and increase phagocytosis of Aβ. In a recent study of AD and MCI patients, nutritional supplementation by omega-3 fatty acids individually increased resolvin D1, improved Aβ phagocytosis, and regulated inflammatory genes toward a physiological state, but only in MCI patients. Our studies are beginning to dissect positive factors (adherence to Mediterranean diet with omega-3 and exercise) and negative factors (high fat diet, infections, cancer, and surgeries) in each patient. The in vitro and in vivo effects of omega-3 fatty acids and SPMs suggest that defective phagocytosis and chronic inflammation are related to defective production and/or defective signaling by SPMs in immune cells.

  16. Deficits in episodic memory retrieval reveal impaired default mode network connectivity in amnestic mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Cameron J. Dunn

    2014-01-01

    Full Text Available Amnestic mild cognitive impairment (aMCI is believed to represent a transitional stage between normal healthy ageing and the development of dementia. In particular, aMCI patients have been shown to have higher annual transition rates to Alzheimer's Disease (AD than individuals without cognitive impairment. Despite intensifying interest investigating the neuroanatomical basis of this transition, there remain a number of questions regarding the pathophysiological process underlying aMCI itself. A number of recent studies in aMCI have shown specific impairments in connectivity within the default mode network (DMN, which is a group of regions strongly related to episodic memory capacities. However to date, no study has investigated the integrity of the DMN between patients with aMCI and those with a non-amnestic pattern of MCI (naMCI, who have cognitive impairment, but intact memory storage systems. In this study, we contrasted the DMN connectivity in 24 aMCI and 33 naMCI patients using seed-based resting state fMRI. The two groups showed no statistical difference in their DMN intra-connectivity. However when connectivity was analysed according to performance on measures of episodic memory retrieval, the two groups were separable, with aMCI patients demonstrating impaired functional connectivity between the hippocampal formation and the posterior cingulate cortex. We provide evidence that this lack of connectivity is driven by impaired communication from the posterior cingulate hub and does not simply represent hippocampal atrophy, suggesting that posterior cingulate degeneration is the driving force behind impaired DMN connectivity in aMCI.

  17. Deficits in episodic memory retrieval reveal impaired default mode network connectivity in amnestic mild cognitive impairment

    Science.gov (United States)

    Dunn, Cameron J.; Duffy, Shantel L; Hickie, Ian B; Lagopoulos, Jim; Lewis, Simon J.G.; Naismith, Sharon L.; Shine, James M.

    2014-01-01

    Amnestic mild cognitive impairment (aMCI) is believed to represent a transitional stage between normal healthy ageing and the development of dementia. In particular, aMCI patients have been shown to have higher annual transition rates to Alzheimer's Disease (AD) than individuals without cognitive impairment. Despite intensifying interest investigating the neuroanatomical basis of this transition, there remain a number of questions regarding the pathophysiological process underlying aMCI itself. A number of recent studies in aMCI have shown specific impairments in connectivity within the default mode network (DMN), which is a group of regions strongly related to episodic memory capacities. However to date, no study has investigated the integrity of the DMN between patients with aMCI and those with a non-amnestic pattern of MCI (naMCI), who have cognitive impairment, but intact memory storage systems. In this study, we contrasted the DMN connectivity in 24 aMCI and 33 naMCI patients using seed-based resting state fMRI. The two groups showed no statistical difference in their DMN intra-connectivity. However when connectivity was analysed according to performance on measures of episodic memory retrieval, the two groups were separable, with aMCI patients demonstrating impaired functional connectivity between the hippocampal formation and the posterior cingulate cortex. We provide evidence that this lack of connectivity is driven by impaired communication from the posterior cingulate hub and does not simply represent hippocampal atrophy, suggesting that posterior cingulate degeneration is the driving force behind impaired DMN connectivity in aMCI. PMID:24634833

  18. Visual hallucinations and cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Park, Hee Kyung; Kim, Jae Seung; Im, Ki Chun; Kim, Mi Jung; Lee, Jae-Hong; Lee, Myoung C; Kim, Juhan; Chung, Sun Ju

    2013-09-01

    Visual hallucination (VH) is a common psychotic symptom in patients with Parkinson's disease (PD) and may be a significant predictor of cognitive impairment (CI) in such patients. This study aimed to investigate the pattern of glucose metabolism of VH and the relationship between VH and CI in PD. We studied 28 PD patients, including 15 with VH (PD-VH) and 13 without VH (PD-NVH). Of the 15 PD-VH patients, 8 patients had cognitive impairment (PD-VHCI) whereas 7 did not (PD-VHNCI). All patients underwent [18F] fluorodeoxyglucose positron emission tomography ([18F] FDG PET) followed by statistical parametric mapping (SPM) analyses. Compared to the patients with PDNVH, PD-VHNCI patients showed glucose hypometabolism in the inferior and middle temporal cortices, fusiform gyri, and frontal areas, suggesting the involvement of the ventral visual pathway. Compared to the patients with PDNVH, PD-VHCI patients showed glucose hypometabolism in the temporoparietal association cortices with scattered frontal areas. Dysfunction of ventral visual pathway involving the temporal lobe may play a key role in VH development in PD patients. The evolving distribution from the ventral visual pathway to more extensive posterior cortices in PD-VHCI patients suggests that VH may be a prodromal symptom occurring prior to CI in PD patients.

  19. Differences in cognitive impairment between schizophrenia and bipolar disorder: Considering the role of heterogeneity.

    Science.gov (United States)

    Bora, Emre

    2016-10-01

    Schizophrenia is associated with significant cognitive impairment. Bipolar disorder (BD) also presents with cognitive deficits that are similar to, albeit less severe, than those reported in schizophrenia. There has been controversy over whether selective deficits in social cognition or developmental trajectory of cognitive deficits can distinguish schizophrenia from BD. Also, available studies have not generally considered the potential effect of cognitive heterogeneity within the two disorders on between-group differences. The current review examines the evidence on the specificity of social cognitive deficits and early neurocognitive impairment to schizophrenia and explores the overall outcome of studies investigating within and cross-diagnosis cognitive heterogeneity in schizophrenia and BD. Current evidence does not support the specificity of social cognitive impairment to schizophrenia. Available studies also suggest that cognitive impairment in premorbid and early stages is evident not only in schizophrenia but also in many BD patients. Both schizophrenia and BD have a number of cognitive subgroups, including severe impairment, good functioning, and one or more selective or modest impairment clusters. While both disorders are represented in each cognitive subgroup, there are significant cross-diagnostic differences regarding prevalences of individuals belonging to the severe impairment and good functioning subgroups. Individuals with schizophrenia are much more likely to exhibit severe cognitive impairment than individuals with BD and good cognitive functioning is more often observed in BD patients than schizophrenia patients. Further identification of the neurobiological and genetic characteristics of the cognitive subgroups in major psychoses can improve the validity of diagnostic systems and can advance the development of personalized management approaches, including cognitive remediation.

  20. Motor and cognitive impairment after stroke : A common bond or a simultaneous deficit?

    NARCIS (Netherlands)

    Verstraeten, S.M.M.; Mark, R.E.; Sitskoorn, M.M.

    2016-01-01

    Abstract Background: The prevalence of both motor deficit and cognitive impairment after stroke is high and persistent. Motor impairment, especially paresis, is often more obvious to both patients and their carers while cognitive problems can also have devastating effects on quality of life. The

  1. Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines

    NARCIS (Netherlands)

    Litvan, I.; Goldman, J.G.; Tröster, A.I.; Schmand, B.A.; Weintraub, D.; Petersen, R.C.; Mollenhauer, B.; Adler, C.H.; Marder, K.; Williams-Gray, C.H.; Aarsland, D.; Kulisevsky, J.; Rodriguez-Oroz, M.C.; Burn, D.J.; Barker, R.A.; Emre, M.

    2012-01-01

    Mild cognitive impairment is common in nondemented Parkinson's disease (PD) patients and may be a harbinger of dementia. In view of its importance, the Movement Disorder Society commissioned a task force to delineate diagnostic criteria for mild cognitive impairment in PD. The proposed diagnostic cr

  2. White Matter Damage in the Cholinergic System Contributes to Cognitive Impairment in Subcortical Vascular Cognitive Impairment, No Dementia

    Science.gov (United States)

    Liu, Qing; Zhu, Zude; Teipel, Stefan J.; Yang, Jianwei; Xing, Yi; Tang, Yi; Jia, Jianping

    2017-01-01

    Cholinergic deficiency has been implicated in the pathogenesis of vascular cognitive impairment (VCI), but the extent of involvement and underlying mechanism remain unclear. In this study, targeting the early stage of VCI, we determined regional atrophy within the basal forebrain and deficiency in cholinergic pathways in 25 patients with vascular cognitive impairment no dementia (VCIND) compared to 24 healthy elderly subjects. By applying stereotaxic cytoarchitectonic maps of the nucleus basalis of Meynert (NbM), no significant atrophy was identified in VCIND. Using probabilistic tractography analysis, our study tracked the two major white matter tracks which map to cholinergic pathways. We identified significantly lower fractional anisotropy (FA) in VCIND. Mediation analysis demonstrated that FA in the tracked pathways could fully account for the executive dysfunction, and partly mediate the memory and global cognition impairment. Our study suggests that the fibers mapped to the cholinergic pathways, but not the NbM, are significantly impaired in VCIND. MRI-based in vivo tracking of cholinergic pathways together with NbM measurement may become a valuable in vivo marker for evaluating the cholinergic system in cognitive disorders. PMID:28289381

  3. Probabilistic Sequence Learning in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Dezso eNemeth

    2013-07-01

    Full Text Available Mild Cognitive Impairment (MCI causes slight but noticeable disruption in cognitive systems, primarily executive and memory functions. However, it is not clear if the development of sequence learning is affected by an impaired cognitive system and, if so, how. The goal of our study was to investigate the development of probabilistic sequence learning, from the initial acquisition to consolidation, in MCI and healthy elderly control groups. We used the Alternating Serial Reaction Time task (ASRT to measure probabilistic sequence learning. Individuals with MCI showed weaker learning performance than the healthy elderly group. However, using the reaction times only from the second half of each learning block – after the reactivation phase - we found intact learning in MCI. Based on the assumption that the first part of each learning block is related to reactivation/recall processes, we suggest that these processes are affected in MCI. The 24-hour offline period showed no effect on sequence-specific learning in either group but did on general skill learning: the healthy elderly group showed offline improvement in general reaction times while individuals with MCI did not. Our findings deepen our understanding regarding the underlying mechanisms and time course of sequence acquisition and consolidation.

  4. New strategies for Alzheimer's disease and cognitive impairment.

    Science.gov (United States)

    Maiese, Kenneth; Chong, Zhao Zhong; Hou, Jinling; Shang, Yan Chen

    2009-01-01

    Approximately five million people suffer with Alzheimer's disease (AD) and more than twenty-four million people are diagnosed with AD, pre-senile dementia, and other disorders of cognitive loss worldwide. Furthermore, the annual cost per patient with AD can approach $200,000 with an annual population aggregate cost of $100 billion. Yet, complete therapeutic prevention or reversal of neurovascular injury during AD and cognitive loss is not achievable despite the current understanding of the cellular pathways that modulate nervous system injury during these disorders. As a result, identification of novel therapeutic targets for the treatment of neurovascular injury would be extremely beneficial to reduce or eliminate disability from diseases that lead to cognitive loss or impairment. Here we describe the capacity of intrinsic cellular mechanisms for the novel pathways of erythropoietin and forkhead transcription factors that may offer not only new strategies for disorders such as AD and cognitive loss, but also function as biomarkers for disease onset and progression.

  5. Identification and classification of traditional Chinese medicine syndrome types among senior patients with vascular mild cognitive impairment using latent tree analysis.

    Science.gov (United States)

    Fu, Chen; Zhang, Nevin Lianwen; Chen, Bao-Xin; Chen, Zhou Rong; Jin, Xiang Lan; Guo, Rong-Juan; Chen, Zhi-Gang; Zhang, Yun-Ling

    2017-05-01

    To treat patients with vascular mild cognitive impairment (VMCI) using traditional Chinese medicine (TCM), it is necessary to classify the patients into TCM syndrome types and to apply different treatments to different types. In this paper, we investigate how to properly carry out the classification for patients with VMCI aged 50 or above using a novel data-driven method known as latent tree analysis (LTA). A cross-sectional survey on VMCI was carried out in several regions in Northern China between February 2008 and February 2012 which resulted in a data set that involves 803 patients and 93 symptoms. LTA was performed on the data to reveal symptom co-occurrence patterns, and the patients were partitioned into clusters in multiple ways based on the patterns. The patient clusters were matched up with syndrome types, and population statistics of the clusters are used to quantify the syndrome types and to establish classification rules. Eight syndrome types are identified: Qi deficiency, Qi stagnation, Blood deficiency, Blood stasis, Phlegm-dampness, Fire-heat, Yang deficiency, and Yin deficiency. The prevalence and symptom occurrence characteristics of each syndrome type are determined. Quantitative classification rules are established for determining whether a patient belongs to each of the syndrome types. A solution for the TCM syndrome classification problem for patients with VMCI and aged 50 or above is established based on the LTA of unlabeled symptom survey data. The results can be used as a reference in clinic practice to improve the quality of syndrome differentiation and to reduce diagnosis variances across physicians. They can also be used for patient selection in research projects aimed at finding biomarkers for the syndrome types and in randomized control trials aimed at determining the efficacy of TCM treatments of VMCI.

  6. Multi-modal MRI analysis with disease-specific spatial filtering: initial testing to predict mild cognitive impairment patients who convert to Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Kenichi eOishi

    2011-08-01

    Full Text Available Background: Alterations of the gray and white matter have been identified in Alzheimer’s disease (AD by structural MRI and diffusion tensor imaging (DTI. However, whether the combination of these modalities could increase the diagnostic performance is unknown.Methods: Participants included 19 AD patients, 22 amnestic mild cognitive impairment (aMCI patients, and 22 cognitively normal elderly (NC. The aMCI group was further divided into an aMCI-converter group (converted to AD dementia within three years, and an aMCI-stable group who did not convert in this time period. A T1-weighted image, a T2 map, and a DTI of each participant were normalized, and voxel-based comparisons between AD and NC groups were performed. Regions-of-interest, which defined the areas with significant differences between AD and NC, were created for each modality and named disease-specific spatial filters (DSF. Linear discriminant analysis was used to optimize the combination of multiple MRI measurements extracted by DSF to effectively differentiate AD from NC. The resultant DSF and the discriminant function were applied to the aMCI group to investigate the power to differentiate the aMCI-converters from the aMCI-stable patients. Results: The multi-modal approach with AD-specific filters led to a predictive model with an area under the receiver operating characteristic curve (AUC of 0.93, in differentiating aMCI-converters from aMCI-stable patients. This AUC was better than that of a single-contrast-based approach, such as T1-based morphometry or diffusion anisotropy analysis. Conclusion: The multi-modal approach has the potential to increase the value of MRI in predicting conversion from aMCI to AD.

  7. 老年人甲状腺功能低下的认知损害特点研究%Features of cognitive impairment in elderly hypothyroidism patients

    Institute of Scientific and Technical Information of China (English)

    张媛媛; 王鲁宁; 解恒革

    2012-01-01

    Objective To study the features of cognitive impairment in elderly hypothyroidism patients. Methods Sixty primary hypothyroidism patients were divided into old-age group(n=15) and young-age group(n = 45). The patients underwent neuropsychological eamination. Results The scores of figure delayed recall test, trail A test, word list learning test 3, backward reciting digitals test,and digital symbol test were significantly lower in old-age group than in young-age group(P0. 05). Conclusion Cognitive im-pairement in certain easy aging areas is severer in elderly hypothyroidism patients than in young hypothyroidism patients.%目的 探讨老年甲状腺功能低下患者的认知损害特点.方法 选择原发性甲状腺功能减退患者60例,根据年龄分为老年组15例和年轻组45例,并2组患者进行神经心理学检测.结果 老年组在图形延迟回忆、连线A、词表学习3、数字倒背、符号数字试验中较非老年组成绩差,差异有统计学意义(P<0.05).而简易智能状态检查量表评分、立体图形、画钟表试验、图像记忆、摆积木、复杂图形描摹、复杂图形回忆、连线B、词表学习1、词表学习2、词表延迟回忆、词语再认、数字顺背、词语流畅性等方面差异无统计学意义(P>0.05).结论 老年原发性甲状腺功能低下患者的认知损害在一些认知易老化区域表现较年轻患者有更严重的损害.

  8. Which part of the Quick mild cognitive impairment screen (Qmci) discriminates between normal cognition, mild cognitive impairment and dementia?

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2013-05-01

    the Qmci is a sensitive and specific test to differentiate between normal cognition (NC), mild cognitive impairment (MCI) and dementia. We compared the sensitivity and specificity of the subtests of the Qmci to determine which best discriminated NC, MCI and dementia.

  9. Validation of the Falls Efficacy Scale and Falls Efficacy Scale International in geriatric patients with and without cognitive impairment: results of self-report and interview-based questionnaires

    DEFF Research Database (Denmark)

    Hauer, Kristiane; Yardley, L; Beyer, N

    2010-01-01

    Frail, old patients with and without cognitive impairment are at high risk of falls and associated medical and psychosocial issues. The lack of adequate, validated instruments has partly hindered research in this field. So far no questionnaire documenting fall-related self-efficacy/fear of falling...

  10. The patterns of cognitive and functional impairment in amnestic and non-amnestic mild cognitive impairment in geriatric depression.

    Science.gov (United States)

    Reinlieb, Michelle; Ercoli, Linda M; Siddarth, Prabha; St Cyr, Natalie; Lavretsky, Helen

    2014-12-01

    Depressed older adults are at risk for the development of mild cognitive impairment (MCI), but few studies have characterized MCI subtypes in geriatric depression. The objective of this study was to identify the clinical patterns of MCI in late-life depression. Baseline demographic, clinical, and neuropsychological test data collected as part of a randomized antidepressant trial for geriatric depression. UCLA-based outpatient clinic. One hundred thirty-eight older adults with major depression. A neuropsychological test battery and comprehensive evaluations of depression, apathy, quality of life, medical burden, and vascular risk factors. Seventy-one participants (51%) had MCI and 67 (49%) were cognitively normal. Of subjects with MCI, 14 (20%) had amnestic MCI and 57 (80%) had non-amnestic MCI. Overall, patients with MCI had greater depression severity, poorer quality of life, and worse performance on the Mini-Mental State Exam than patients without MCI. Patients with non-amnestic MCI had significantly greater depression severity than patients without MCI. Across all subjects, depression severity correlated with impaired performance in language and visuospatial functioning. Our findings suggest that MCI is associated with greater severity of depression, poorer quality of life, and worse global cognitive function. Overall, subtypes of MCI in geriatric depression differ in the patterns of functional impairment, which may require different therapeutic approaches. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  11. Sleep disorders and their significance in the development of cognitive impairments

    Directory of Open Access Journals (Sweden)

    Irina Sergeyevna Preobrazhenskaya

    2013-01-01

    Full Text Available The review of literature considers the possible mechanisms responsible for the development of sleep disorders in patients with varying degrees of cognitive impairments. It assesses the association of the severity of cognitive impairments (CI with the degree of sleep disorders. The treatment of sleep disorders in patients with cognitive disorders, the benefits and risks of current hypnotic drugs are discussed in detail. Recommendations are given to manage patients with sleep disorders concurrent with cognitive dysfunctions. Melatonin preparations are noted to be effective in treating insomnia in patients with CI.

  12. Hypersexuality among cognitively impaired older adults.

    Science.gov (United States)

    Wallace, Meredith; Safer, Meredith

    2009-01-01

    Hypersexuality, also referred to in the literature as sexually inappropriate behavior and sexual disinhibition, involves persistent, uninhibited sexual behaviors directed at oneself or at others. For older adults, the literature generally attributes the behavior to biochemical or physiological changes that accompany cognitive impairment-specifically, dementia. Although less common than other behavioral issues, such as aggression and agitation, hypersexuality presents complex logistical and ethical problems for caregivers. This article reviews the current literature on hypersexual behavior. Assessment essentials as well as nonpharmacological and pharmacological treatment approaches are discussed, identifying the need for standardization as well as caregiver education and training.

  13. Beta-amyloid deposition and cognitive function in patients with major depressive disorder with different subtypes of mild cognitive impairment: {sup 18}F-florbetapir (AV-45/Amyvid) PET study

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Kuan-Yi; Liu, Chia-Yih; Chen, Chia-Hsiang; Lee, Chin-Pang [Chang Gung Memorial Hospital and Chang Gung University, Department of Psychiatry, Tao-Yuan (China); Chen, Cheng-Sheng [Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Department of Psychiatry, Kaohsiung (China); Hsiao, Ing-Tsung; Hsieh, Chia-Ju; Yen, Tzu-Chen; Lin, Kun-Ju [Chang Gung Memorial Hospital, Department of Nuclear Medicine and Molecular Imaging Center, Kuei Shan Hsiang, Taoyuan (China); Chang Gung University, Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Tao-Yuan (China)

    2016-06-15

    The objective of this study was to evaluate the amyloid burden, as assessed by {sup 18}F-florbetapir (AV-45/Amyvid) positron emission tomography PET, in patients with major depressive disorder (MDD) with different subtypes of mild cognitive impairment (MCI) and the relationship between amyloid burden and cognition in MDD patients. The study included 55 MDD patients without dementia and 21 healthy control subjects (HCs) who were assessed using a comprehensive cognitive test battery and {sup 18}F-florbetapir PET imaging. The standardized uptake value ratios (SUVR) in eight cortical regions using the whole cerebellum as reference region were determined and voxel-wise comparisons between the HC and MDD groups were performed. Vascular risk factors, serum homocysteine level and the apolipoprotein E (ApoE) genotype were also determined. Among the 55 MDD patients, 22 (40.0 %) had MCI, 12 (21.8 %) non-amnestic MCI (naMCI) and 10 (18.2 %) amnestic MCI (aMCI). The MDD patients with aMCI had the highest relative {sup 18}F-florbetapir uptake in all cortical regions, and a significant difference in relative {sup 18}F-florbetapir uptake was found in the parietal region as compared with that in naMCI subjects (P < 0.05) and HCs (P < 0.01). Voxel-wise analyses revealed significantly increased relative {sup 18}F-florbetapir uptake in the MDD patients with aMCI and naMCI in the frontal, parietal, temporal and occipital areas (P < 0.005). The global cortical SUVR was significantly negatively correlated with MMSE score (r = -0.342, P = 0.010) and memory function (r = -0.328, P = 0.015). The negative correlation between the global SUVR and memory in the MDD patients remained significant in multiple regression analyses that included age, educational level, ApoE genotype, and depression severity (β = -3.607, t = -2.874, P = 0.006). We found preliminary evidence of brain beta-amyloid deposition in MDD patients with different subtypes of MCI. Our findings in MDD patients support the

  14. Response to Algarabel et al., 2012 "Recognition memory deficits in mild cognitive impairment". Reconsidering claims of familiarity disruptions in mild cognitive impairment.

    Science.gov (United States)

    Migo, E M; Westerberg, C E

    2014-01-01

    There is some debate over the relative impairment of recollection and familiarity in mild cognitive impairment (MCI). A recent publication by Algarabel et al. (2012, Recognition memory deficits in mild cognitive impairment, Aging, Neuropsychology, and Cognition, 19, 608-619) claims to undermine previous studies reporting preserved familiarity in patients with MCI. Here, we respond to their main criticisms, concluding that they are not sufficiently supported by the data presented. The role of recollection and familiarity in MCI remains unresolved and further work will be required to disentangle the mixed literature.

  15. Repeatability and Reproducibility of Retinal Neuronal and Axonal Measures on Spectral-Domain Optical Coherence Tomography in Patients with Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Edwin Hong-Teck Loh

    2017-08-01

    Full Text Available BackgroundWith increasing interest in determining if measurement of retinal neuronal structure with spectral-domain optical coherence tomography (SD-OCT is useful in accessing neurodegenerative process in cognitive decline and development of dementia, it is important to evaluate whether the SD-OCT measurements are repeatable and reproducible in these patients.MethodsThis is a retrospective cohort study. Patients with Alzheimer’s disease (AD or mild cognitive impairment (MCI with no change in global clinical dementia rating (CDR score at 1-year follow-up were eligible to be included. Ganglion cell-inner plexiform layer (GC-IPL and retinal nerve fiber layer (RNFL parameters were measured with SD-OCT at baseline, 6-month, and 1-year follow-up visits. At baseline, SD-OCT scans were repeated to access intra-visit repeatability of the SD-OCT measurement. SD-OCT measurement over three visits was used to access inter-visit reproducibility. We calculated intraclass correlation coefficients (ICC and coefficients of variation (CoVs.ResultsWe included 32 patients with stable AD and 29 patients with stable MCI in the final analysis. For GC-IPL measures, the average intra-visit ICC was 0.969 (range: 0.948–0.985, and CoV was 1.81% (range: 1.14–2.40; while the average inter-visit ICC was 0.968 (0.941–0.985, and CoV was 1.91% (range: 1.24–2.32. The average ICC and CoV of intra-visit RNFL measured were 0.965 (range: 0.937–0.986 and 2.32% (range: 1.34–2.90%, respectively. The average ICC and CoV of inter-visit RNFL measures were 0.927 (range: 0.845–0.961 and 3.83% (range: 2.71–5.25%, respectively.ConclusionBoth GC-IPL and RNFL measurements had good intra-visit repeatability and inter-visit reproducibility over 1 year in elderly patients with no decline in cognitive function, suggesting that SD-OCT is a reliable tool to assess neurodegenerative process over time.

  16. Glutamine and Glutamate Complex, as Measured by Functional Magnetic Resonance Spectroscopy, Alters During Face-Name Association Task in Patients with Mild Cognitive Impairment and Alzheimer's Disease.

    Science.gov (United States)

    Jahng, Geon-Ho; Oh, Janghoon; Lee, Do-Wan; Kim, Hyug-Gi; Rhee, Hak Young; Shin, Wonchul; Paik, Jong-Woo; Lee, Kyung Mi; Park, Soonchan; Choe, Bo-Young; Ryu, Chang-Woo

    2016-03-05

    The metabolite response during a memory task in Alzheimer's disease (AD) patients is unknown. To investigate the metabolite changes in subjects with AD, amnestic mild cognitive impairment (aMCI), and cognitively normal (CN) elderly during a memory task using functional magnetic resonance spectroscopy (fMRS). This study involved 23 young normal controls (YC), 24 CN elderly, 24 aMCI, and 24 mild and probable AD individuals. fMRS data were acquired at the precuneus and posterior cingulate brain regions during a face-name association task. Statistical analyses of quantified metabolites were performed to evaluate differences of the metabolite values between the stimulation conditions and among the four subject groups. Receiver operating curve analysis was performed to evaluate whether the metabolic changes after functional activations can differentiate the subject groups. Glutamine and glutamate complex (Glx) was statistically significantly different between the fixation and repeat conditions in aMCI (p = 0.0492) as well as between the fixation and the novel conditions in the AD (p = 0.0412) group. The total N-acetylaspartate (tNAA) was statistically significantly different among the four subject groups in the fixation condition (DF = 3, F = 7.673, p <  0.001), the novel condition (DF = 3, F = 6.945, p <  0.001), and the repeat condition (DF = 3, F = 7.127, p <  0.001). tNAA, tCr, and mIns could be used to differentiate CN from aMCI. Furthermore, tNAA, tCr, Glx, and Glu could also differentiate CN from AD, and aMCI from AD. Glx was altered during a stimulation that may be used to evaluate neuronal dysfunction in a demented patient. tNAA and tCr were reduced in patients with AD.

  17. 老年DM2患者认知功能障碍与C型利钠肽的关系%The Relationship Between C-type Natriuretic Peptide and Cognitive Impairment in Older Patients with Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    李新玲; 朱向阳; 黄怀宇; 金艳

    2011-01-01

    目的:研究老年2型糖尿病(DM2)患者认知障碍与C型利钠肽(C-type natriuretic peptide,CNP)的关系,进一步探讨糖尿病认知障碍的发病机制.方法 80例60岁以上的DM2患者,根据蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)分为认知障碍组(31例)和非认知障碍组(49例).另取80例正常对照组.采用放射免疫分析血浆CNP水平,分析各组间血浆CNP水平的变化及相关因素.结果 与正常对照组比较,DM2非认知障碍组血浆CNP水平明显增高,差异存在统计学意义(P<0.01).而DM2认知障碍组与正常对照组及非认知障碍组比较,血浆CNP水平明显降低,差异均存在统计学意义(P<0.01).老年DM2认知障碍患者的MoCA评分与血浆CNP水平呈正相关(r=0.513,P<0.01),具有统计学意义.结论 CNP在DM2早期可代偿性分泌增多,在糖尿病合并认知障碍时则失代偿性分泌减少.CNP与糖尿病认知障碍密切相关,糖尿病血管病变是糖尿病认知障碍的重要发病机制.%Objective To investigate the relationship between C-type natriuretic peptide and cognitive impairment in older patients with type 2 diabetes, and to explore the pathogenesis of diabetic cognitive impairment. Methods According to the Montreal Cognitive Assessment (MoCA) scores,80 type 2 diabetic patients over the age of 60 years were divided into two groups,one group including 31 cases with cognitive impairment,the other 49 patients with non-cognitive impairment. And 80 normal participants were selected as the control group. Plasma level of C-type natriuretic peptide was measured by radio-immunity assay in all subjects. The changes and associations of the plasma C-type natriuretie peptide level among three groups was analyzed. R6SUlt In the non-cognitive impairment group, plasma level of C-type natriuretic peptide was higher than that in the control group(P <0. 01) . But the plasma level of C-type natriuretic peptide in the cognitive impairment group was

  18. Increased dosage of RAB39B affects neuronal development and could explain the cognitive impairment in male patients with distal Xq28 copy number gains.

    Science.gov (United States)

    Vanmarsenille, Lieselot; Giannandrea, Maila; Fieremans, Nathalie; Verbeeck, Jelle; Belet, Stefanie; Raynaud, Martine; Vogels, Annick; Männik, Katrin; Õunap, Katrin; Jacqueline, Vigneron; Briault, Sylvain; Van Esch, Hilde; D'Adamo, Patrizia; Froyen, Guy

    2014-03-01

    Copy number gains at Xq28 are a frequent cause of X-linked intellectual disability (XLID). Here, we report on a recurrent 0.5 Mb tandem copy number gain at distal Xq28 not including MECP2, in four male patients with nonsyndromic mild ID and behavioral problems. The genomic region is duplicated in two families and triplicated in a third reflected by more distinctive clinical features. The X-inactivation patterns in carrier females correspond well with their clinical symptoms. Our mapping data confirm that this recurrent gain is likely mediated by nonallelic homologous recombination between two directly oriented Int22h repeats. The affected region harbors eight genes of which RA