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AIM: To evaluate the effect of remimazolam on early postoperative cognitive function in elderly patients with hip fracture based on a randomized controlled trial. METHODS: A total of 106 elderly patients, aged 65-90 years, ASA grade Ⅱ or III, who underwent hip fracture surgery under combined spinal-epidural anesthesia in the Sixth Affiliated Hospital of Wenzhou Medical University from December 2022 to June 2023 and met the inclusion criteria, were selected and randomized into remimazolam group (group R) and propofol group (group P) according to the random number table, with 53 cases in each group. Patients in group P received a slow intravenous injection of propofol at a dose of 0.3-0.5 mg / kg (injection time of 1min), followed by a pump infusion at 0.5-3 mg · kg
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Whole brain radiotherapy (WBRT) is the standard radiotherapy regimen of preventive radiation for patients diagnosed with brain metastases and non-small cell lung cancer, which can improve intracranial control and prolong overall survival. However, neurocognitive functions (NCF) decline due to impaired hippocampal might occur thereafter. Recent studies have shown that hippocampal sparing WBRT (HS-WBRT) is capable of protecting neurocognitive function and improving quality of life (QOL). In this review, the authors described the methods and significance of hippocampal sparing, summarized the research progress on clinical trials related to HS-WBRT in combination with the development of radiotherapy technology and experimental drugs, and discussed the existing controversies and problems, aiming to provide reference for clinical work.
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Objective To analyze the effect of physical activity intervention on the cognitive and neural functions of attention deficit hyperactivity disorder (ADHD) children. Methods Literatures related to physical activity intervention and functional rehabilitation of ADHD children in PubMed, EMBASE, Web of Science, CNKI and Wanfang data were searched from January, 1990 to July, 2021. The authors, countries, publication time, subjects and ages, research methods, intervention methods, measurement tools, results and conclusions of the included literatures were extracted. Based on the theory of the International Classification of Functioning, Disability and Health (Children and Adolescents Version) (ICF-CY), the terminology and research framework were established to systematically analyze physical activity intervention programs and intervention effects in the cognitive neural function of ADHD children. Results A total of 1995 literatures were returned, twelve of them were finally included. These studies came from six countries, mainly from clinical medicine, sports rehabilitation, psychotherapy and other related journals, published mainly after 2015. The study design included randomized controlled trial, pre- and post-test design, and quasi-experimental design. Subjects were ADHD children aged four to 16 years. The physical activities included sport games, sport activities, school physical education courses and rehabilitation training. The measurement methods mainly included cognitive task, scale, questionnaire and electroencephalogram, etc. Physical activity intervention can improve ADHD children's inhibitory control, working memory and cognitive flexibility, as well as improve their motor function, and activity and participation. Conclusion Physical activity intervention can improve the cognitive neural ability, motor ability and emotion-social ability of ADHD children. However, the dose-effect relationship, influencing factors and neural mechanism need further research.
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Objective To analyze the effect of physical activity intervention on the cognitive and neural functions of attention deficit hyperactivity disorder (ADHD) children. Methods Literatures related to physical activity intervention and functional rehabilitation of ADHD children in PubMed, EMBASE, Web of Science, CNKI and Wanfang data were searched from January, 1990 to July, 2021. The authors, countries, publication time, subjects and ages, research methods, intervention methods, measurement tools, results and conclusions of the included literatures were extracted. Based on the theory of the International Classification of Functioning, Disability and Health (Children and Adolescents Version) (ICF-CY), the terminology and research framework were established to systematically analyze physical activity intervention programs and intervention effects in the cognitive neural function of ADHD children. Results A total of 1995 literatures were returned, twelve of them were finally included. These studies came from six countries, mainly from clinical medicine, sports rehabilitation, psychotherapy and other related journals, published mainly after 2015. The study design included randomized controlled trial, pre- and post-test design, and quasi-experimental design. Subjects were ADHD children aged four to 16 years. The physical activities included sport games, sport activities, school physical education courses and rehabilitation training. The measurement methods mainly included cognitive task, scale, questionnaire and electroencephalogram, etc. Physical activity intervention can improve ADHD children's inhibitory control, working memory and cognitive flexibility, as well as improve their motor function, and activity and participation. Conclusion Physical activity intervention can improve the cognitive neural ability, motor ability and emotion-social ability of ADHD children. However, the dose-effect relationship, influencing factors and neural mechanism need further research.
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With the advancement of imaging diagnosis and the development of modern radiotherapy, the survival of cancer patients has been prolonged and the incidence rate of brain metastases (BM) has been significantly increased. The quality of life of patients and potential radiotherapy-induced neurocognitive impairment have gradually captivated widespread attention. Whole brain radiotherapy (WBRT) is one of the common local therapies for BM patients. However, the application of WBRT is controversial because it may lead to neurocognitive impairment. The incidence of metastatic tumors in hippocampus and radiation-induced neurocognitive impairment can accelerate the implementation of hippocampal-avoidance WBRT (HA-WBRT). In this article, the feasibility of HA-WBRT was discussed and research progress in recent years was reviewed.
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Many patients with a traumatic brain injury (TBI) experience a range of sleep problems. Although some studies investigated the pathophysiology of sleep-wake cycle disturbances in TBI patients, it has not been clarified. This paper presents a middle aged female patient who showed sleep deprivation and sleep-wake cycle disturbances for approximately three months after TBI. The improvement in the subjective and objective sleep quality was shown by the sleep diary and actigraphy during this period. Moreover, the dim light melatonin onset (DLMO) had been delayed before returning to the normal range in 3 months. In addition, the patient showed an improvement in the neurocognitive function, including attention, memory and language function, along with a consolidation of the sleep-wake cycle. This case showed that the sleep disturbance following a TBI was probably caused by the disrupted melatonin rhythm based on the abnormality of the DLMO. In addition, the cognitive dysfunction after TBI could be associated with sleep-wake cycle disturbances because its gradual improvement occurred as the sleep disturbance diminished. Further studies on the change in circadian rhythm after a brain injury related to neurocognitive impairment are required.
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Female , Humans , Middle Aged , Actigraphy , Brain Injuries , Circadian Rhythm , Melatonin , Memory , Reference Values , Sleep DeprivationABSTRACT
Objective@#To explore the correlation between depression severity and neurocognitive function in patients with late-onset depression .@*Methods@#The patients with late-onset depression treated in Jinhua Second hospital from February 2015 to December 2017 were assigned into the mild,moderate and severe groups according to the severity of depression assessed by the Hamilton Depression Scale-17（HAMD-17）. At the same time,some healthy persons were selected as the control group. Wisconsin Card Sorting Test（WCST）,Verbal Fluency Test（VFT）and Stroop Test were carried out,and the scores of these tests were compared in the four groups. The correlations of WCST, VFT, Stroop Test and HAMD-17 scores were analyzed .@*Results@# There were 32,28,35 and 35 subjects involved in the mild,moderate,severe and control group,respectively. The subjects of the mild group,moderate group and severe group had more total errors,perseverative responses and perseverative errors than the control group,and less percent conceptual level responses than the control group （all P<0.05）. The total errors,perseverative responses,perseverative errors and percent perseverative errors increased and the percent conceptual level responses decreased gradually with the severity of depression（all P<0.05）. The correct numbers of Stroop-consistent group and VFT in the severe group were less than those in the control,mild and moderate group（all P<0.05）,which was significantly different between the mild,moderate and control group （P>0.05）. The HAMD-17 scores were negatively correlated with the correct numbers of Stroop congruent group（r=-0.448,P<0.001）and VFT（r=-0.401,P<0.001）,and were positively correlated with perseverative responses in the WCST（r=0.784,P<0.001） .@*Conclusion@#The neurocognitive impairment in patients with late-onset depression aggravated with the severity of depression.
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Whole brain radiotherapy (WBRT) was widely used clinically as the standard therapy for brain metastases (BM). With the development of radiotherapy technology and systemic therapies, the non-small cell lung cancer (NSCLC) patients have prolonged local control rate and median survival time, meanwhile post-radiotherapy intracranial toxicities often lead to serious impacts on the quality of life and neurocognitive function. Therefore, the role WBRT played should have been reevaluated. The purpose of this review is to analyze the clinical application value of WBRT in the context of new treatments for NSCLC with BM, and to predict the main developing directions of WBRT in the future.
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Whole brain radiotherapy (WBRT) was widely used clinically as the standard therapy for brain metastases (BM).With the development of radiotherapy technology and systemic therapies,the nonsmall cell lung cancer (NSCLC) patients have prolonged local control rate and median survival time,meanwhile post-radiotherapy intracranial toxicities often lead to serious impacts on the quality of life and neurocognitive function.Therefore,the role WBRT played should have been reevaluated.The purpose of this review is to analyze the clinical application value of WBRT in the context of new treatments for NSCLC with BM,and to predict the main developing directions of WBRT in the future.
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Objective To investigate the rate of hippocampus injury during whole brain radiotherapy for intracranial metastasis and explore the effect of whole brain radiotherapy in reducing the radiotherapy induced neurocognitive dysfunction of hippocampu and provide reference for the treatment of intracranial metastatic tumors. Methods The intracranial metastases in 123 patients from January 2015 to December 2016 were enrolled in this study. The MRI image data before and after radiotherapy were analyzed retrospectively.The anatomical position of tumor and the hippocampus in patients with intracranial metastasis was outlined.According to outlined position, the relationship between location of intracranial metastatic tumor and the hippocampus was analyzed, and the probability of the hippocampal damage by tumor radiotherapy was calculated in the treatment of intracranial metastatic brain. Neurocognitive dysfunction improvement by protective irradiation of hippocampus was compared between different radiotherapy methods. Results Four hundred and seventeen intracranial metastatic tumors were observed in 123 patients, among which the sites of 15 tumors(3.60%) were within the 5mm of hippocampus, the sites of 146 tumors(35.01%)were 5-10 mm from the hippocampus, and the sites of 256 tumors(61.39%) were beyond 10 mm of hippocampus. The distribution of 417 metastatic tumors in the brain was as followings: 137 tumors (32.85%) were in frontal lobe, 98 tumors(23.50%) were in temporal lobe, 59 tumors(14.15%)were in parietal lobe, 46 tumors(11.03%)were in occipital lobe, 41 tumors (9.83%) were in cerebellum and 36 tumors (8.63%) were in basal ganglia. Using helical tomotherapy, intracranial metastasis radiotherapy and volumetric modulated arc radiotherapy, the rate of patients with cognitive dysfunction induced by hippocampal injury was 1.96%(1/51), 10.26%(4/39)and 18.18% (6/33), and there was significant difference (χ2= 6.595, P = 0.000). Conclusions The hippocampus injury possibility is very small, when whole brain radiotherapy is used in the treatment of intracranial metastatic tumors. Avoiding the hippocampus in radiation therapy of intracranial metastasis has high feasibility, among which the helical tomotherapy can effectively reduce hippocampus injury and improve patients'cognitive function.
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@#Objectives: The aim of this study is to evaluate the remedial effect of continuous positive airway pressure (CPAP) therapy on neurocognitive function in obstructive sleep apnoea (OSA) patients. Methods: The cognitive impairment in OSA patients was evaluated with Montreal Cognitive Assessments (MoCA) before and after CPAP therapy. The study assessed 54 patients who were diagnosed with OSAS seen at the neurology clinic of the Trakya University Medical Faculty. They were given MoCA the day of diagnosis, after one day of CPAP therapy, and after three months of CPAP therapy. Results: MoCA scores before treatment showed a statistically significant correlation between disease severity and abstract thinking (Correlation coefficient: 0.270±0.048). There was no significant difference between MoCA scores before treatment and after one day of CPAP therapy (p=0.244). However, there were significant improvements in MoCA scores after three months of treatment, when compared to scores from before treatment and after one day of therapy (p<0.001). Conclusions: CPAP treatment may improve cognitive function in OSA patients. MoCA is an effective and simple tool for evaluating cognitive function.
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Objective:To evaluate the changes of neurocognitive function in early stage in patients with first-episode schizophrenia.Methods:In this study,73 cases of patients with first-episode schizophrenia (research group) and 75 cases of health person (control group) were selected from January 2015 to January 2016 in our hospital.The neurocognitive function was evaluated by neuro-psychological testing tool and the data between two group were compared.Results:Scores of delayed recall,total recall,3 trial,2 trial and 1 trial of research group were lower than those of control group in BVMT-R test,and the difference was statistically significant (P＜0.05).In HVLT-R test,the scores of total delay,3 trial and 2 trial of research group were significantly lower than those of control group (P＜0.05).The consuming time of dominant hands and subdominant hands in pegboard tasks were significantly higher in research group than in control group (P＜0.05).Conpletion time of connection test A,color connection 1 and 2 in connection test of research group were significantly higher than those of control group (P＜0.05).Attempt number and correct number in research group in PASAT test were significantly lower than in control group (P＜0.05).Number of search errors in research group was higher than in control group,while number of search correct,search total score and digital sign score were significantly lower than in control group (P＜0.05).Total number of words,color and color / word count in research group were lower than in control group in Stroop color word test,and the difference was statistically significant (P＜0.05).WMS-Ⅲ test results between two group had no significant difference (P＞0.05).Conclusion:The neurocognitive function in early stage in patients with first-episode schizophrenia has been extensively damaged.
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Objective To observe the mental and motor development of children with biliary atresia before and after liver transplantation,and analyze the effect of liver transplantation on neurocognitive functions.Methods Fifty children with biliary atresia who experienced living related liver transplantation were selected from Jan.2016 to Dec.2016 in our hospital,with an average age of 5 to 12 months regardless of gender.All the children were assessed by Bayley Scale of Infant Development (BSID) one day before surgery,to obtain the mental and motor development conditions.The results were indicated with Mental Development Index (MDI) and Psychomotor Development Index (PDI).The levels of preoperative ammonia,bilirubin,albumin and white blood cells were recorded,and their relationship with preoperative neurocognitive development was analyzed.The development indexes were obtained at 2nd week,3rd week and 1st month after surgery by the same method,and the neurocognitive changes were analyzed in children before and after the surgery.The effects of postoperative biliary complications,secondary operations,pneumonia infection and other complications on the postoperative development indexes one month after surgery were assessed.Results The preoperative mental and motor development was both below the standard level in 50 infants with average MDI and PDI in middle and lower state.The correlation analysis among the levels of preoperative blood ammonia,bilirubin and albumin showed statistically significant on development index (P ＜ 0.05).The levels of blood ammonia and bilirubin were negatively correlated with development index,while albumin levels showed a positive correlation.As compared with one day before liver transplantation,MDI and PDI were decreased at 2nd week after operation;the MDI increased,and PDI had no significant change at 3rd week after operation.MDI and PDI were significantly higher at 1 st month after operation than preoperation.As compared with 2nd week after operation,PDI and MDI were significantly increased at 3rd week and 1st month after operation.Postoperative persistent pneumonia infection could affect children's MDI,and biliary complications could affect PDI (P＜0.05).Concision The mental and motor development conditions of children with biliary atresia were in medium/low level,and the levels of preoperative blood ammonia,bilirubin and albumin may have significant influence.Liver transplantation may obviously improve the patient's neurocognitive function.
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OBJECTIVES: Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. METHODS: Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. RESULTS: Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. CONCLUSIONS: Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.
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Humans , Ambulatory Care Facilities , Diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Executive Function , Memory , Obsessive-Compulsive Disorder , Prognosis , VocabularyABSTRACT
Radiotherapy has been an effective non surgical treatment for brain metastases.While the benefit of survival was achieved,the potential cognitive impairment caused by radiotherapy gradually arouse people's attention.To improve patient's prognosis,ensuring tumor control and caring patients' quality of life and neurocognitive functions should be weighed equally.This article reviews the related research on the neurocognitive protection of brain metastasis radiotherapy.
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OBJECTIVES: Obsessive-compulsive disorder (OCD) and schizophrenia have many common clinical and neurocognitive features. However, not all of them share the same underlying mechanism. The aim of this study was to discover evidences that indicate a pathophysiological mechanism specific to OCD by comparing correlations of quantitative electroencephalography (QEEG) patterns and neurocognitive function in patients with OCD and schizophrenia. METHODS: Resting-state QEEG data of total 265 patients were acquired retrospectively and parameters such as absolute power, relative power and peak frequency were analyzed from the data. Stroop test and Trail Making Test results as well as demographic features were reviewed for this study. The correlation of neurocognitive functions and brain electrical activities in each group were assessed and compared by correlation analysis. RESULTS: Compared with the OCD group, the schizophrenia group performed poorly in neurocognitive tests. Mean values of QEEG parameters in patients with OCD and schizophrenia did not show significant differences. Both absolute and relative power of alpha rhythm in central and frontal regions showed significant positive correlation with Stroop test results in OCD patients. CONCLUSIONS: Findings in this study shows distinctive correlations between frontal executive dysfunction and frontal alpha rhythm in the OCD patients, both of which might be a candidate for endophenotype underlying obsessive rumination.
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Humans , Alpha Rhythm , Brain , Electroencephalography , Endophenotypes , Obsessive-Compulsive Disorder , Retrospective Studies , Schizophrenia , Stroop Test , Trail Making TestABSTRACT
A growing body of evidence supports that Internet gaming disorder (IGD) is considered as ‘behavioral addiction’ with neurobiological alterations. We have reviewed previous research into the clinical and neurobiological features of IGD, and suggest a flowchart for the comprehensive evaluation of IGD. Several self-rating screening tests based on Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-5) IGD criteria were developed. IGD is often comorbid with depressive disorder, social anxiety disorder, attention deficit/hyperactivity disorder (ADHD), and smartphone addiction. Individuals with IGD are prone to act impulsively and make risky decisions, especially in response to game-related cues. Functional neuroimaging results have shown altered functional activities in prefrontal cortex, cingulate cortex, superior temporal gyrus and nucleus accumbens (NAc). Structural neuroimaging demonstrated gray matter volume changes in prefrontal cortex and NAc, while showing white matter integrity disruption in thalamus and posterior cingulate cortex. There are few evidences on the attribution of specific genes to IGD. To evaluate IGD comprehensively, self-rating scales based on DSM-5 are useful, but a diagnostic interview by a clinician is more helpful to assess functional impairments of IGD. Presence of psychiatric comorbidities such as depressive disorder, social anxiety disorder, ADHD, and smartphone addiction should be evaluated. Neurocognitive tests that assess impulsivity, decision-making under risk, and cue-reactivity are helpful when planning individualized IGD treatment.
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Anxiety Disorders , Comorbidity , Cues , Depressive Disorder , Functional Neuroimaging , Gray Matter , Gyrus Cinguli , Immunoglobulin D , Impulsive Behavior , Internet , Mass Screening , Mental Disorders , Neuroimaging , Nucleus Accumbens , Prefrontal Cortex , Smartphone , Software Design , Temporal Lobe , Thalamus , Weights and Measures , White MatterABSTRACT
OBJECTIVES: The aim of this study was to examine the association between current suicidal or violent behavior and deficits of specific neurocognitive variables in child and adolescent inpatient samples diagnosed with mood disorder. METHODS: A retrospective review of the charts of mood disorder patients hospitalized at Samsung Medical Center between April 2004 and April 2015 was conducted. Child and adolescent patients aged between 10 and 18 years old and those who finished neurocognitive function testing during their hospitalization were included. Among them patients whose full scale IQ was between 85 and 115 were selected (N=111). Participants were first divided into two age-groups-group Y (10≤age≤15, N=54) and group O (16≤age≤18, N=57)-because neurocognitive function test tools were different according to age [Wechsler Intelligence Scale for Children (WISC) for 10 to 15-year-old patients, Wechsler Adult Intelligence Scale (WAIS) for 16 to 18-year-old patients]. They were then divided according to their suicidal or violent behavior-non suicidal/violent group (NG), suicidal group (SG), violent group (VG), and both suicidal/violent group (BG). The Child Behavior Checklist (CBCL) was checked for measurement of participants' behavior and the Gordon Diagnostic System was checked for measurement of their attention efficiency. Kruskal-Wallis Test and Tukey test was used to determine the differences in neurocognitive function between groups. RESULTS: O-SG patients showed lower scores on the comprehension subscale of WAIS-III than O-NG patients (χ2=8.454, p=.015). O-VG patients showed lower scores on the block design subscales of WAIS than O-SG patients (χ2=7.496, p=.024). Y-VG patients showed higher scores in aggressive behavior, externalizing problems, and total problems scores of CBCL. CONCLUSION: This study showed relationship between specific neurocognitive deficits and suicidal or violent behavior. These relationships were significant in relatively older adolescents.
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Adolescent , Adult , Child , Humans , Checklist , Child Behavior , Comprehension , Hospitalization , Inpatients , Intelligence , Mood Disorders , Retrospective StudiesABSTRACT
Objective To preliminarily observe the clinical efficacy of hippocampal-sparing prophylactic cranial irradiation (HS-PCI) using helical tomotherapy (HT) in patients with limited-stage small-cell lung cancer (LS-SCLC) after chemoradiotherapy,and compare HT with intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in dose distribution.Methods From April to June,2014,six patients with LS-SCLC who had achieved a complete remission after chemoradiotherapy were assigned to HS-PCI using HT within a month after brain metastasis was ruled out using brain magnetic resonance imaging (MRI).After fusing CT images and MRI images,the hippocampus was contoured in the fusion images and hippocampal avoidance regions were created using a volumetric expansion of 3 mm around the hippocampus.A dose of 25 Gy in 10 fractions to 95％ of planning target volume (PTV) was prescribed in HT,IMRT,and VMAT.The clinical efficacy,adverse reactions,neurocognitive function,and brain metastasis were evaluated for HT.The dose distribution in PTV and hippocampus were compared between HT,IMRT,and VMAT.Results There were one patient with abdominal wall and abdominal lymph node metastases,one patient with local recurrence,and no patient with brain metastasis during the observation period.The numbers of patients with grade 1 and grade 2 headache,dizziness,and hair loss reactions were 3 and 1,3 and 1,and 4 and 2,respectively.There were no significant differences in the average score of the Mini-Mental State Examination before treatment and at 3 and 6 months after treatment (29.7,29.2,and 29.3 ; P =0.083,0.317,and 0.157).The mean dose to the hippocampus was 16.85 Gy for IMRT and 17.59 Gy for VMAT.For HT,the mean doses to the hippocampus and avoidance regions were reduced to 5.26 Gy and 6.21 Gy,respectively.The prescribed dose for HT was reduced by 79％ and 71％ compared with IMRT and VMAT,respectively.The average coverage rate of the prescribed dose was 94.48％ for HT.Conclusions HT achieves promising dose distribution and target coverage in sparing of the hippocampus.Moreover,HT dose not increase the incidence of adverse reactions.The change in neurocognitive function needs to be further studied with longterm observation and large-scale sampling.
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OBJECTIVES: Obstructive sleep apnea (OSA) is classified as positional sleep apnea (POSA) and non-positional sleep apnea (NPOSA) according to apnea-hypopnea index (AHI) changed by sleep position. The aim of this study was to compare neurocognitive functions between two groups in the elderly Korean population. METHODS: Forty-four subjects in OSA patients with total AHI> or =5 participated as criteria for POSA (n=25) with 1) supine position AHI/non-supine position AHI> or =2 and 2) total AHI> or =5 or not (NPOSA, n=19). All participants completed clinical interview by physician and neurocognitive function assessments. Mann-Whitney U and chi-square test were performed for comparison of neurocognitive functions and sleep characteristics with polysomnography between two groups. RESULTS: No significant difference in demographic and clinical characteristics was observed between the two groups. However the NPOSA group showed more decline than the POSA group on the Boston naming test (p=0.034), digit span test (p=0.001), go-no-go test (p=0.042), and fist-edge-palm test (p=0.007). CONCLUSION: In this study NPOSA patients were found to have lower cognitive functions compared to POSA patients. A larger sample and long term follow-up study might be needed.