RÉSUMÉ
Objective:To investigate the impact of severe stenosis or occlusion of intracranial artery in anterior and posterior circulation on cognitive function in patients.Methods:Patients with Alberta stroke program early CT score(ASPECTS) and posterior circulation ASPECTS(pc-ASPECTS) of 10 were selected, and neuropsychological assessments were performed in 30 patients with intracranial artery severe stenosis or occlusion in anterior posterior circulation (anterior circulation group)and 23 patients with intracranial artery severe stenosis or occlusion in posterior circulation(posterior circulation group) and 53 control subjects using MMSE, MoCA and multidimensional psychological assessment system.Results:The scores of time orientation(control group: 5.00(5.00, 10.00), anterior circulation group: 5.00(5.00, 5.00), posterior circulation group: 5.00(5.00, 5.00)), attention (control group: 6.00(5.00, 6.00), anterior circulation group: 5.00(4.00, 6.00), posterior circulation group: 5.00(4.00, 6.00)) and word discrimination test (control group: 70.00(60.00, 82.00), anterior circulation group: 48.00(20.50, 67.50), posterior circulation group: 53.50(33.25, 75.25)) were significantly lower in patients of anterior circulation group and posterior circulation group than those of control group(all P<0.05); The scores of memory(control group: 3.00(2.00, 3.00), anterior circulation group: 2.00(1.00, 3.00), MMSE(control group: 29.00(28.00, 30.00), anterior circulation group: 28.00(26.75, 29.00)) and simple subtraction(control group: 72.00(53.50, 85.50), anterior circulation group: 53.50(37.00, 73.00)) were significantly lower in patients of anterior circulation group than those of control group(all P<0.05); The scores of visuospatial executive function(control group: 4.00(3.00, 5.00), posterior circulation group: 3.00(2.00, 4.00)) and digital sequence reasoning(control group: 74.50(51.50, 83.00), posterior circulation group: 42.00(28.00, 70.00)) were significantly lower in patients of posterior circulation group than those of control group(all P<0.05); The scores of spatial working memory test(control group: 77.50(51.75, 89.00), anterior circulation group: 56.50(34.00, 72.50), posterior circulation group: 31.00(18.50, 58.00))were significantly lower in patients of posterior circulation group than those of the other two groups(all P<0.05). Conclusion:Severe stenosis or occlusion of intracranial arteries in anterior and posterior circulation is associated with cognitive impairment in patients.Vascular lesions in different parts can lead to cognitive impairment in different aspects.
RÉSUMÉ
Objective To evaluate the therapeutic effect of computerized online cognitive training for children with attention deficit hyperactivity disorder (ADHD).Methods Fifteen children with ADHD recruited from Department of Neurology in the Children's Hospital Affiliated to Capital Institute of Pediatrics received computerized online cognitive training including attention training,visual spatial training and memory training.Cognitive neuropsychological test battery (choice reaction time,mental rotation,word semantic,simple subtraction,working memory and visual tracing) was used to assess the cognitive function in pre-training and post-training stages,such as basic response ability,reaction speed,visuo-spatial cognitive ability,semantic comprehension,calculation fluency,working memory and attention ability.Paired-samples t test was used to make comparison of the cognitive test results between pre-training condition and post-training condition.Results All the correction scores of cognitive tests were transformed to percentile scores.Paired-samples t test results showed that the ADHD children got higher scores in the post-training condition than in the pre-training condition in working memory test [(52.00 ± 20.77) ％ vs (39.73 ± 23.64) ％,t =2.72,P ＜ 0.05].There was no significant training effect in choice reaction time,mental rotation,sentence completion,simple subtraction and visual tracing(all P ＞ 0.05).Conclusions Computerized online cognitive training can significantly improve the working memory of children with ADHD,and has no side effects on other cognitive functions.It need to further expand the sample size and follow up the training effect for a long-term.
RÉSUMÉ
<p><b>OBJECTIVE</b>Benign epilepsy with centro-temporal spikes (BECTs) is a common idiopathic partial epileptic syndrome in childhood, which often affect the pre-school and school-age children and a considerable proportion have comorbidity including lower academic achievement and cognitive impairment. Few studies involved the psychocognitive assessment in such a drug-treatable epileptic syndrome especially in the newly diagnosed and medications-naive group. This study aimed to investigate the cognitive characteristics of children with newly onset BECTs before treatment.</p><p><b>METHOD</b>Forty-one outpatients with newly diagnosed BECTs who visited the Clinic during the periods from October 2012 to May 2014 before the medications against epilepsy and 41 healthy controls recruited from regular school in Beijing during the period from July 2013 to March 2014, who matched in age and gender underwent battery testing by computerized cognitive testing in epilepsy (CCTE). The BECTs group included 41 children, 20 boys and 21 girls, mean age (8.2 ± 1.7) years, the age of onset of epilepsy 4.5-11.5 years (the age of onset <8 years in 25 cases, ≥ 8 years in 16 cases). The cognitive characteristics and associated factors were analyzed. The primary data including correct answer numbers and reaction times were analyzed by independent sample t-test between the two groups of children with BECTs and healthy controls based on SPSS 18.0 statistical software.</p><p><b>RESULT</b>Raw data of 9 tasks' scores collected from BECTs and healthy control children were continuous variables in accordance with normal distribution. BECTs children performed significantly worse than controls in choice reaction time ((618+158) vs. (524+254) ms), three-dimensional mental rotation (11 ± 10 vs. 18 ± 12) and visual tracing (10 ± 6 vs.15 ± 6), t=2.01, 3.03 and 3.47, P<0.05, <0.01 and <0.001, respectively.While other 6 tasks showed no significant difference between the two groups (P>0.05 for all comparisons). BECTs boys performed significantly worse than girls on simple substraction tasks compared with standard nine score ((4.7 ± 1.5) vs. (5.6 ± 1.2), t=-2.24, P<0.05). Other 8 tasks showed no significant difference between boys and girls (P>0.05 for all comparisons). Other 9 tasks showed no significant differences between the two groups of BECTs children whose age of onset was before 8 years and those who started seizure ≥ 8 years (P all >0.05). The standard nine scores of simple substraction from the three BECTs groups of dominance sides of spikes and waves during NREM showed significant difference (P<0.05). BECTs children with bilateral discharges performed significantly worse than the other two groups dominantly right or left discharges (4.7 ± 1.2 vs. 6.0 ± 1.2 vs. 4.9 ± 1.4, P all <0.05). There was no significant difference between the two groups with right and left side dominance discharges (P>0.05). Other 8 tasks showed no significant differences among the three groups (P>0.05 for all comparisons).</p><p><b>CONCLUSION</b>Although EEG discharges index below 50% during NREM period, while newly diagnosed BECTs children before treatment with medications against epilepsy performed poorer on tasks of choice reaction time, three-dimensional mental rotation, and visual tracing. The two factors of male and bilateral discharges during NREM period correlate with dysfunction of simple subtraction, the mechanism needs further study and the cognitive function of epilepsy children should be evaluated and followed up, in order to provide psychologic baseline data for persistent cognitive disturbance.</p>