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1.
Heliyon ; 10(5): e26551, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38439866

RESUMO

Objective: To compare myocarditis/pericarditis risk after COVID-19 mRNA vaccination versus SARS-CoV-2 infection, and to assess if myocarditis/pericarditis risk varies by vaccine dosing interval. Methods: In this retrospective cohort study, we used linked databases in Quebec, Ontario, and British Columbia between January 26, 2020, and September 9, 2021. We included individuals aged 12 or above who received an mRNA vaccine as the second dose or were SARS-CoV-2-positive by RT-PCR. The outcome was hospitalization/emergency department visit for myocarditis/pericarditis within 21 days of exposure. We calculated age- and sex-stratified incidence ratios (IRs) of myocarditis/pericarditis following mRNA vaccination versus SARS-CoV-2 infection. We also calculated myocarditis/pericarditis incidence by vaccine type, homologous/heterologous schedule, and dosing interval. We pooled province-specific estimates using meta-analysis. Results: Following 18,860,817 mRNA vaccinations and 860,335 SARS-CoV-2 infections, we observed 686 and 160 myocarditis/pericarditis cases, respectively. Myocarditis/pericarditis incidence was lower after vaccination than infection (IR [BNT162b2/SARS-CoV-2], 0.14; 95%CI, 0.07-0.29; IR [mRNA-1273/SARS-CoV-2], 0.28; 95%CI, 0.20-0.39). Within the vaccinated cohort, myocarditis/pericarditis incidence was lower with longer dosing intervals; IR (56 or more days/15-30 days) was 0.28 (95%CI, 0.19-0.41) for BNT162b2 and 0.26 (95%CI, 0.18-0.38) for mRNA-1273. Conclusion: Myocarditis/pericarditis risk was lower after mRNA vaccination than SARS-CoV-2 infection, and with longer intervals between primary vaccine doses.

2.
Neuropsychology ; 38(4): 347-356, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38300580

RESUMO

OBJECTIVE: Prospective memory (PM) is the ability to remember to produce an action at a specific moment in the future signaled by the occurrence of a specific event (event-based [EB] condition), a time or a time interval (time-based [TB] condition). Detection of the appropriate moment corresponds to the prospective component, while production of the appropriate action corresponds to the retrospective component. Although PM difficulties have been reported in healthy aging and in association with multiple sclerosis (MS), PM has not been examined in older persons with MS (PwMS). The main objective of this study was to investigate whether the decline in PM performance with advancing age is influenced by the presence of MS. This study also aimed to clarify the type of PM impairment (prospective vs. retrospective component in TB and EB conditions) in MS as a function of age. METHOD: A total of 80 participants were recruited and separated into four groups: older PwMS (n = 20), younger PwMS (n = 20), older controls (n = 20), and younger controls (n = 20). PM and its components were measured using the Test Ecologique de Mémoire Prospective (TEMP), an experimental ecological tool using naturalistic stimuli developed by our laboratory that has been validated in previous studies. RESULTS: On the TEMP total score, a two-way analysis of covariance showed a main effect of age, a main effect of the presence of MS, as well as a significant Age × Disease interaction. Direct comparison between EB and TB conditions revealed that for the prospective component, only older PwMS had more difficulty in the TB than in the EB condition, whereas the retrospective component score was significantly lower in the TB than in the EB condition in all groups except in younger controls. CONCLUSIONS: The TEMP revealed a marked impairment in PM in older PwMS compared to older controls and young PwMS. This impairment was particularly evident on the prospective component in the TB condition. Retrospective difficulties noted in the TB condition in all, but younger controls reflect the arbitrary nature of the cue-action link that is particularly sensitive to episodic memory difficulties often observed in aging and MS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Envelhecimento , Memória Episódica , Esclerose Múltipla , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Esclerose Múltipla/fisiopatologia , Masculino , Feminino , Pessoa de Meia-Idade , Envelhecimento/fisiologia , Idoso , Adulto , Testes Neuropsicológicos , Transtornos da Memória/etiologia , Transtornos da Memória/diagnóstico , Adulto Jovem
3.
Neuropsychology ; 38(4): 309-321, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38358721

RESUMO

OBJECTIVE: Mild cognitive impairment (MCI) is a risk factor for developing Alzheimer's disease (AD), and about half of older people with MCI will progress to AD within the next 5 years. The aim of the present study was to compare the semantic performance of MCI progressors (MCI-p) and nonprogressors (MCI-np). The hypothesis was that MCI-p would present with poorer semantic performance relative to MCI-np at baseline, indicating that semantic deficits may increase the risk of future decline toward AD. METHOD: Fifty-six MCI participants (aged 65-89) from the Consortium for Early Identification of Alzheimer's Disease-Quebec study were analyzed, with 18 progressing and 38 remaining stable over 2 years. Analysis of covariance assessed their initial semantic and nonsemantic cognitive performance, and mixed analyses of variance gauged longitudinal patterns of cognitive decline at the 2-year follow-up. RESULTS: In the semantic domain, MCI-p performed significantly worse than MCI-np at baseline on two semantic tests (category fluency and object decision). In other cognitive domains, MCI-p performed worse than MCI-np on a test of executive functions (cognitive flexibility) but showed similar performance on a test of episodic memory. There were no significant differences between groups in the rates of progression on semantic tests over the 2-year period, but a steeper decline was observed in MCI-p at follow-up on tests of global cognition, episodic memory, and processing speed. CONCLUSION: This suggest that MCI patients who present with semantic memory impairment in addition to episodic memory impairment are at greater risk of future progression to AD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Disfunção Cognitiva , Progressão da Doença , Testes Neuropsicológicos , Semântica , Humanos , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Função Executiva/fisiologia , Memória Episódica , Estudos Longitudinais , Doença de Alzheimer/psicologia , Doença de Alzheimer/complicações , Doença de Alzheimer/fisiopatologia
4.
Neuropsychology ; 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38300582

RESUMO

OBJECTIVE: To determine whether the increased vulnerability to semantic interference previously observed in amnestic mild cognitive impairment (aMCI) is specifically associated with semantic material or if it also affects other types of material, suggesting generalized executive and inhibitory impairment. METHOD: Seventy-two participants divided into two groups (33 aMCI, 39 normal control [NC]) matched for age and education were included. They completed a comprehensive neuropsychological examination, the French version of the Loewenstein Acevedo Scale for Semantic Interference and Learning (LASSI-L; semantic interference test), and a homologous experimental phonological test, the phonological interference and learning test. Independent sample t tests, mixed analysis of variance (ANOVA), and analysis of covariance (ANCOVA) on memory and interference scores were conducted to compare memory and interference in both conditions for both groups. RESULTS: For memory scores, results revealed significant main effects of group (NC > aMCI) and condition (semantic > phonological) and significant interactions (poorer performance in the semantic condition for aMCI). aMCI committed more phonological false recognition errors, were disproportionately more vulnerable to retroactive semantic interference, and showed a higher percentage of intrusion errors associated with proactive semantic interference than NC. CONCLUSIONS: To our knowledge, this is the first study to compare vulnerability to interference in aMCI and normal aging with two similarly designed semantic and phonological word list learning tasks. Taken together, our results suggest that aMCI present with broad difficulties in source memory and inhibition, but that impaired deep semantic processing results in additional semantic intrusion errors during proactive interference and impacts their ability to show good recall after an interference list (greater semantic retroactive interference). Results are discussed according to the level-of-processing and activation/monitoring theories. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

5.
Neurology ; 102(4): e208020, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38271662

RESUMO

BACKGROUND AND OBJECTIVES: Patients with isolated/idiopathic REM sleep behavior disorder (iRBD) are at high risk for developing mild cognitive impairment (MCI) and dementia with Lewy bodies (DLB). However, there is a lack of scientific knowledge regarding the accuracy of cognitive screening tools to identify these conditions in iRBD. This study aimed to determine in iRBD the psychometrics of 2 screening tests to discriminate patients with MCI and those at risk of DLB. METHODS: We retrospectively selected and followed 64 patients with polysomnography-confirmed iRBD seen in sleep clinic between 2006 and 2021, 32 with MCI (mean age 68.44 years, 72% men), 32 without MCI (67.78 years, 66% men), and 32 controls (69.84 years, 47% men). Participants underwent a neurologic evaluation and neuropsychological assessment for MCI diagnosis. They also completed the Montreal Cognitive Assessment (MoCA) and Clock Drawing Test (CDT). Fifty-three patients were followed (mean of 5.10 ± 2.64 years); 6 developed DLB, and 16 developed Parkinson disease. An independent cohort of 10 patients with iRBD who later developed DLB was also recruited and followed. Receiver operating characteristic curves with area under the curve (AUC) were performed assessing the discriminant value of the MoCA and CDT. RESULTS: The cut-off values that best differentiated patients who developed DLB from controls were on the MoCA total score (≤25/30 with 100% [95% CI 61%-100%] sensitivity and 78% [61%-89%] specificity, AUC = 0.888) and delayed recall (≤3/5 with 83% [44%-97%] sensitivity and 78% [61%-89%] specificity, AUC = 0.875). Both values yielded a sensitivity of 90% (60%-98%) to detect patients at risk of DLB in the independent cohort. Cutoffs that best discriminated patients with MCI from controls were: ≤25/30 (MoCA total score) with 72% [55%-84%] sensitivity, 78% [61%-89%] specificity, AUC = 0.803 and ≤2/5 (MoCA delayed recall) with 63% [45%-77%] sensitivity, 94% [80%-98%] specificity, AUC = 0.843. No acceptable optimal values were found for the CDT. DISCUSSION: In iRBD, the MoCA demonstrates adequate psychometric properties to identify patients most at risk of developing DLB and to screen for MCI, whereas the CDT does not. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that the MoCA, but not the CDT, is useful in screening patients with iRBD for the risk of developing DLB.


Assuntos
Disfunção Cognitiva , Demência , Transtorno do Comportamento do Sono REM , Masculino , Humanos , Idoso , Feminino , Transtorno do Comportamento do Sono REM/diagnóstico , Estudos Retrospectivos , Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Testes de Estado Mental e Demência , Demência/diagnóstico
6.
Clin Neuropsychol ; 37(2): 350-370, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35343382

RESUMO

Objective: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that frequently affects cognition. Persons with MS (PwMS) complain of difficulties with prospective memory (PM), the capacity to remember to perform an intended action at the appropriate moment in the future. The objective of this study was to assess the clinical utility of the Miami Prospective Memory Test (MPMT) in detecting PM deficits in MS. The test is brief, easy to administer and accessible, and allows direct comparison between scores on event- and time-based conditions. A secondary objective was to examine the relationship between PM performance and cognitive functioning. Method: Eighty-four PwMS between 27 and 78 years old were compared to 50 age-, sex- and education-matched healthy adults on the MPMT. Results: Time-based (TB) scores, but not event-based (EB) scores, were significantly lower in PwMS than in healthy adults. The MPMT showed good internal consistency, and correlations were found with disability assessed by the Expanded Disability Status Scale (EDSS). PM was also correlated with memory and executive/attention functioning. Conclusions: This study supports the clinical utility of the MPMT in assessing the presence of PM deficits in PwMS especially under TB constraints.


Assuntos
Memória Episódica , Esclerose Múltipla , Adulto , Humanos , Pessoa de Meia-Idade , Idoso , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Testes Neuropsicológicos , Cognição , Função Executiva/fisiologia , Transtornos da Memória/diagnóstico , Transtornos da Memória/etiologia
7.
Brain Lang ; 231: 105146, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35709592

RESUMO

We mapped the left hemisphere cortical regions and fiber bundles involved in picture naming in adults by integrating task-based fMRI with dMRI tractography. We showed that a ventral pathway that "maps image and sound to meaning" involves the middle occipital, inferior temporal, superior temporal, inferior frontal gyri, and the temporal pole where a signal exchange is made possible by the inferior fronto-occipital, inferior longitudinal, middle longitudinal, uncinate fasciculi, and the extreme capsule. A dorsal pathway that "maps sound to speech" implicates the inferior temporal, superior temporal, inferior frontal, precentral gyri, and the supplementary motor area where the arcuate fasciculus and the frontal aslant ensure intercommunication. This study provides a neurocognitive model of picture naming and supports the hypothesis that the ventral indirect route passes through the temporal pole. This further supports the idea that the inferior and superior temporal gyri may play pivotal roles within the dual-stream framework of language.


Assuntos
Substância Branca , Adulto , Córtex Cerebral , Humanos , Idioma , Imageamento por Ressonância Magnética/métodos , Rede Nervosa/diagnóstico por imagem , Vias Neurais/diagnóstico por imagem
8.
Arch Phys Med Rehabil ; 103(11): 2131-2137, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35307342

RESUMO

OBJECTIVE: To determine how results on the EXAmen Cognitif abrégé en Traumatologie (EXACT), a new test specifically designed to briefly assess global cognitive functioning during the acute phase of traumatic brain injury (TBI), can predict long-term functional outcome compared with length of posttraumatic amnesia (PTA), a well-established predictor. DESIGN: Inception cohort. SETTINGS: Level 1 trauma center. PARTICIPANTS: A total of 90 patients (N=90) hospitalized for a moderate or severe TBI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Performance on the EXACT in the first 3 months after injury and results on the Disability Rating Scale (DRS) at follow-up 1-2 years later. RESULTS: EXACT scores were all correlated with length of PTA and DRS result. Compared with length of PTA, the EXACT added significantly to the regression and improved prediction of functional outcome. More specifically, a total score ≤80 on the EXACT was associated with a higher rate of long-term disability because of more severe TBI consequences. Behavioral regulation and executive functions were the cognitive domains that showed the most impairment, followed by attention and working memory as well as episodic memory. Except for length of PTA and hospital stay, the DRS score was not correlated with other demographic (age, education) or clinical variables (Glasgow Coma Scale and maximum score on the Therapy Intensity Level Scale). CONCLUSIONS: The EXACT can be administered to most patients early in the acute phase of TBI, and results could be used, along with other predictors such as PTA, to estimate their long-term functional sequelae. The EXACT may be a promising brief cognitive instrument for future studies investigating recovery after TBI.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas , Humanos , Lesões Encefálicas/psicologia , Lesões Encefálicas Traumáticas/psicologia , Escala de Coma de Glasgow , Testes Neuropsicológicos , Função Executiva , Recuperação de Função Fisiológica
9.
Mult Scler Relat Disord ; 58: 103478, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35033840

RESUMO

BACKGROUND: Studies suggest that emotion recognition and empathy are impaired in patients with MS (pwMS). Nonetheless, most studies are restricted to young samples, to facial emotion recognition and to self-report assessments of empathy. The aims of this study are to determine the impact of MS and age on multimodal emotion recognition (facial emotions and vocal emotional bursts) and on socioemotional sensitivity (as reported by the participants and their informants). We also aim to investigate the associations between emotion recognition, socioemotional sensitivity, and cognitive measures. METHODS: We recruited 13 young healthy controls (HC), 14 young pwMS, 14 elderly HC and 15 elderly pwMS. They underwent a short neuropsychological battery, an experimental emotion recognition task including facial emotions and vocal emotional bursts. Both participants and their study informants completed the Revised-Self Monitoring Scale (RSMS) to assess the participant's socioemotional sensitivity. RESULTS: There was a significant effect of age and group on recognition of both facial emotions and emotional vocal bursts, HC performing significantly better than pwMS, and young participants performing better than elderly participants (no interaction effect). The same effects were observed on self-reported socioemotional sensitivity. However, lower socioemotional sensitivity in pwMS was not reported by the informants. Finally, multimodal emotion recognition did not correlate with socioemotional sensitivity, but it correlated with global cognitive severity. CONCLUSION: PwMS present with multimodal emotion perception deficits. Our results extend previous findings of decreased emotion perception and empathy to a group of elderly pwMS, in which advancing age does not accentuate these deficits. However, the decreased socioemotional sensitivity reported by pwMS does not appear to be observed by their relatives, nor to correlate with their emotion perception impairments. Future studies should investigate the real-life impacts of emotion perception deficits in pwMS.


Assuntos
Reconhecimento Facial , Esclerose Múltipla , Idoso , Emoções , Empatia , Expressão Facial , Humanos , Esclerose Múltipla/psicologia , Testes Neuropsicológicos
10.
Neuropsychol Rehabil ; 32(7): 1576-1604, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33947319

RESUMO

Prospective memory (PM) problems in aging and, to a greater extent, in mild cognitive impairment (MCI), compromise functional independence. This study examined the effectiveness of a cognitive training program based on visual imagery to improve PM among older adults with and without MCI. Participants were older adults, 24 with MCI and 24 cognitively healthy (HOA). Half of them (12 MCI and 12 HOA) were randomly assigned to the PM training program, the other half to the no-training control group. All participants also completed a pre- and post-test evaluation, including neuropsychological tests, questionnaires, and the Ecological Test of Prospective Memory (TEMP). There was no significant effect of the intervention on the TEMP total, event-based or time-based scores for either the MCI or HOA groups. However, the trained MCI group committed fewer false alarms (i.e., more efficient identification of prospective cues) in the event-based condition of the TEMP at post-test. On the other hand, all trained participants performed better than control participants on retrospective memory tests, which suggests that visual imagery-based training is more effective to improve retrospective memory than PM. Possible explanations for these results are explored.


Assuntos
Disfunção Cognitiva , Memória Episódica , Idoso , Humanos , Transtornos da Memória , Testes Neuropsicológicos , Estudos Retrospectivos
11.
Eur J Psychotraumatol ; 12(1): 1959117, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34721819

RESUMO

Background: Neuropsychological alterations co-occur with Posttraumatic Stress Disorder (PTSD); yet, the nature and magnitude of such alterations in police officers remains unknown despite their high level of trauma exposure. Objective: The current research sought to examine (1) cognitive functioning among police officers with and without PTSD; (2) the clinical significance of their cognitive performance; and (3) the relationship between PTSD symptoms and cognition. Method: Thirty-one police officers with PTSD were compared to thirty age- and sex-matched trauma-exposed officers without PTSD. Clinical assessment and self-report questionnaires established PTSD status. All participants underwent a neuropsychological evaluation. Results: Police officers with PTSD displayed lower cognitive performance across several domains, notably executive functioning, verbal learning and memory, and lexical access, compared to controls. The neuropsychological decrements in the PTSD group were mild compared to normative data, with average performances falling within normal limits. Among officers with PTSD, higher levels of intrusion symptoms were associated with reduced efficacy in executive functioning, as well as attention and working memory. Moreover, increased intrusion and avoidance symptoms were associated with slower information processing speed. Conclusion: Considering that even mild subclinical cognitive difficulties may affect their social and occupational functioning, it appears important to integrate neuropsychological assessments in the clinical management of police officers diagnosed with PTSD.


Antecedentes: Pueden co-ocurrir alteraciones neuropsicológicas con el trastorno de estrés postraumático (TEPT); sin embargo, la naturaleza y magnitud de tales alteraciones en oficiales de policía aún no se conoce a pesar de su alto nivel de exposición al trauma.Objetivo: La presente investigación buscó examinar (1) el funcionamiento cognitivo entre oficiales de policía con y sin TEPT; (2) la importancia clínica de su rendimiento cognitivo; y (3) la relación entre los síntomas de TEPT y la cognición.Método: Treinta y un oficiales de policía con TEPT fueron comparados a treinta oficiales expuestos a trauma sin TEPT, emparejados por edad y sexo. El estado de TEPT fue establecido mediante evaluación clínica y cuestionarios de auto-reporte. Todos los participantes se sometieron a una evaluación neuropsicológica.Resultados: Los oficiales de policía con TEPT desplegaron un menor rendimiento cognitivo a través de varios dominios, notablemente el funcionamiento ejecutivo, aprendizaje verbal y memoria, y acceso léxico, comparado con los controles. Las mermas neuropsicológicas en el grupo de TEPT fueron leves comparado con los datos normativos, con rendimientos promedio dentro de los límites normales. Entre los oficiales con TEPT, los mayores niveles de síntomas intrusivos se asociaron a una eficacia reducida en el funcionamiento cognitivo, así como también en la atención y en la memoria de trabajo. Más aún, los síntomas de intrusión y evitación aumentados se asociaron con una velocidad de procesamiento de la información más lenta.Conclusión: Considerando que incluso leves dificultades cognitivas subclínicas pueden afectar a su funcionamiento social y ocupacional, parece ser importante integrar evaluaciones neurocognitivas en el manejo clínico de los oficiales de policía diagnosticados con TEPT.


Assuntos
Cognição/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos , Adulto , Atenção , Função Executiva , Feminino , Humanos , Masculino , Polícia/psicologia , Polícia/estatística & dados numéricos , Quebeque , Autorrelato , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários/estatística & dados numéricos
12.
Brain Sci ; 11(10)2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34679381

RESUMO

The insula is involved in a wide variety of functions, including social and emotional processing. Despite the numerous connections it shares with brain structures known to play a role in autobiographical memory (AM), little is known on the contribution of the insula to AM processing. The aim of the study was to examine emotional AM retrieval in patients with insular resection for drug-resistant epilepsy. Ten patients who underwent partial or complete insular resection (IR) were matched on age, sex, and education, to fifteen patients who underwent temporal lobectomy (TL), and to fifteen healthy controls. Participants were asked to recall four positive, four negative, and four neutral memories from their past using the autobiographical interview procedure. The results suggest that AM for emotional and neutral events after IR was comparable to that of healthy controls, whereas deficits were observed after TL. However, an independent examiner judged IR patients' memories as poorer than those of healthy controls on the episodic richness scale, suggesting a lack of some aspects of rich and vivid remembering. Furthermore, analysis on subjective self-rated scales revealed that, contrary to healthy controls, patients with IR judged their neutral memories as more emotional. This study suggests that AM is generally preserved after IR. However, given the small sample size and varied lesion location, one cannot totally exclude a potential role of specific insular sub-regions on some aspects of autobiographical memory. In addition, IR patients showed poor emotional judgment for neutral memories, which is congruent with previous findings of altered emotional processing in this population.

13.
Neuropsychol Rev ; 31(2): 221-232, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32815030

RESUMO

Accumulating evidence over the past decade suggests that semantic deficits represent a consistent feature of Mild Cognitive Impairment (MCI). A meta-analysis was performed to examine if semantic deficits are consistently found in patients with MCI. Studies meeting all inclusion criteria were selected for the current meta-analysis. An effect size and a weight were calculated for each study. A random effect model was performed to assess the overall difference in semantic performances between MCI patients and healthy subjects. 22 studies (476 healthy participants, 476 MCI patients, mean Mini Mental Status Examination of the MCI patients: 27.05 ± 0.58) were included in the meta-analysis. Results indicate that MCI patients systematically performed significantly worse than healthy matched controls in terms of overall semantic performance (mean effect size of 1.02; 95% CI [0.80; 1.24]). Semantic deficits are a key feature of MCI. Semantic tests should be incorporated in routine clinical assessments.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Humanos , Memória , Transtornos da Memória , Testes Neuropsicológicos , Semântica
14.
Artigo em Inglês | MEDLINE | ID: mdl-32487003

RESUMO

The objective of this study was to explore the exact nature, extent, and cognitive correlates of prospective memory deficits in mild cognitive impairment (MCI) by using the Ecological Test of Prospective Memory (TEMP). Twenty-five MCI participants and 25 healthy older adults (HOA) performed the TEMP, the Envelope Task, the Comprehensive Assessment of Prospective Memory (CAPM), and a neuropsychological test battery. Results showed that, during the TEMP, MCI participants had difficulty detecting the moment to perform the intentions in the time-based condition (prospective component) and retrieving the associated actions in the event- and time-based conditions (retrospective component). The prospective component of the event-based condition was correlated with retrospective memory, whereas the prospective component of the time-based condition was correlated with executive functions. Finally, the TEMP yielded good sensitivity and specificity for discriminating between MCI and HOA, contrary to the Envelope Task and the CAPM.


Assuntos
Envelhecimento/fisiologia , Associação , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/fisiopatologia , Intenção , Memória Episódica , Rememoração Mental/fisiologia , Testes Neuropsicológicos/normas , Idoso , Feminino , Humanos , Masculino , Sensibilidade e Especificidade
15.
Brain Cogn ; 146: 105650, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33212390

RESUMO

OBJECTIVES: Multiple sclerosis (MS) is a disease of the central nervous system that can interfere with cognitive functions. The purpose of this study is to document the impact of MS, aging and disease duration on cognitive functioning as both life expectancy and incidence of the disease among persons with MS (PwMS) aged 50 years and over (late-onset MS) are increasing in the last two decades. METHODS: Exhaustive neuropsychological evaluation was performed in 84 PwMS (30 young, 30 elderly adult-onset, 25 elderly late-onset) and 50 control participants (25 young, 24 elderly). ANCOVAs and hierarchical linear regressions were used to meet the objectives. RESULTS: Interaction effects were found between age and presence of MS on higher executive function and information processing speed/working memory. After controlling for confounding variables (fatigue, quality of life, depression, MS course, comorbidity), results demonstrated an important role of age on all cognitive functions but only a trend of disease duration on information processing speed/working memory. CONCLUSION: Decline in higher executive functions and information processing speed/working memory in aging is accentuated by the presence of MS, but the impact of age and MS on memory are independent. Age appears to be the variable having the most important role on cognition.


Assuntos
Envelhecimento , Cognição , Esclerose Múltipla , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Testes Neuropsicológicos , Qualidade de Vida
16.
Can J Neurol Sci ; 47(5): 620-626, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32450922

RESUMO

BACKGROUND: Although cognitive deficits are frequent in multiple sclerosis (MS), screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess self-reported subjective complaints in MS. Nonetheless, it does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation. The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits among patients with MS without subjective complaints using the Minimal Assessment of Cognitive Function in MS (MACFIMS) as the gold standard. METHODS: The sample included 98 patients who were recruited from a university hospital MS clinic. The MSNQ was used to select patients without subjective cognitive complaints who also completed the MACFIMS, MoCA test and MSQOL-54. RESULTS: 23.5% of patients without subjective cognitive complaints had evidence of objective cognitive impairment on the MACFIMS (z score < -1.5 on two or more tests). The MoCA had a sensitivity of 87% and a specificity of 68% for detecting objective cognitive impairment in this patient population using a cut-off score of 27. CONCLUSION: A significant proportion of patients without self-reported cognitive impairment do have evidence of cognitive deficits on more exhaustive cognitive assessment. The MoCA is a rapid screening test that could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.


Assuntos
Disfunção Cognitiva , Esclerose Múltipla , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Humanos , Testes de Estado Mental e Demência , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Testes Neuropsicológicos , Sensibilidade e Especificidade , Inquéritos e Questionários
17.
Clin Neuropsychol ; 33(7): 1175-1194, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31007154

RESUMO

Objective: Prospective memory (PM) is the ability to remember to perform an intention at the appropriate time in the future. It is of primary importance for daily living, and its disruption may impact functional autonomy. To date, few studies have examined PM during the acute phase of mild traumatic brain injury (mTBI), despite the high prevalence of this neurological condition and its potential impact on cognition. Method: Twenty mTBI patients (time since injury ranged from 45 to 73 days) and 15 healthy control participants performed the Ecological Test of Prospective Memory (TEMP), a simulated errand task in which participants were required to execute 10 event-based (EB) and five time-based (TB) tasks. The TEMP separately evaluates PM phases as well as prospective and retrospective components in event- and time-based conditions. Participants also completed a neuropsychological test battery. Correlations were performed between cognitive composite scores and the TEMP. Results: mTBI patients experienced difficulty in learning the content of intentions, retrieving these intentions in the time-based condition (prospective component) and recalling the associated actions in the event- and time-based conditions (retrospective component). Retrospective memory composite score was correlated with the learning and retention phases of the TEMP, whereas attention/working memory and executive composite scores were correlated with the time-based condition and performance on the ongoing task. Conclusion: These results suggest the presence of global PM impairment during the acute phase of mTBI, as well as impairment of retrospective memory, attention/working memory, and executive functions, which are key components for PM performance.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico , Memória Episódica , Testes Neuropsicológicos/normas , Doença Aguda , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Adulto Jovem
18.
Cortex ; 117: 284-298, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31034993

RESUMO

Patients with Alzheimer's disease (AD) and semantic variant primary progressive aphasia (svPPA) can present with similar language impairments, mainly in naming. It has been hypothesized that these deficits are associated with different brain mechanisms in each disease, but no previous study has used a network approach to explore this hypothesis. The aim of this study was to compare resting-state functional magnetic resonance imaging (rs-fMRI) language network in AD, svPPA patients, and cognitively unimpaired elderly adults (CTRL). Therefore, 10 AD patients, 12 svPPA patients and 11 CTRL underwent rs-fMRI. Seed-based functional connectivity analyses were conducted using regions of interest in the left anterior temporal lobe (ATL), left posterior middle temporal gyrus (pMTG) and left inferior frontal gyrus (IFG), applying a voxelwise correction for gray matter volume. In AD patients, the left pMTG was the only key language region showing functional connectivity changes, mainly a reduced interhemispheric functional connectivity with its right-hemisphere counterpart, in comparison to CTRL. In svPPA patients, we observed a functional isolation of the left ATL, both decreases and increases in functional connectivity from the left pMTG and increased functional connectivity form the left IFG. Post-hoc analyses showed that naming impairments were overall associated with the functional disconnections observed across the language network. In conclusion, AD and svPPA patients present distinct language network functional connectivity profiles. In AD patients, functional connectivity changes were restricted to the left pMTG and were overall less severe in comparison to svPPA patients. Results in svPPA patients suggest decreased functional connectivity along the ventral language pathway and increased functional connectivity along the dorsal language pathway. Finally, the observed connectivity patterns are overall consistent with previously reported structural connectivity and language profiles in these patients.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Afasia Primária Progressiva/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Idioma , Rede Nervosa/diagnóstico por imagem , Idoso , Doença de Alzheimer/psicologia , Afasia Primária Progressiva/psicologia , Feminino , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos
19.
Clin Neuropsychol ; 33(1): 137-165, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29431015

RESUMO

OBJECTIVE: The aim of this study was to verify the effect of age, education and sex on Miami Prospective Memory Test (MPMT) performance obtained at baseline of the Canadian Longitudinal Study on Aging (CLSA) by neurologically healthy French- and English-speaking subsamples of participants (N = 18,511). METHOD: The CLSA is a nation-wide large epidemiological study with participants aged 45-85 years old at baseline. The MPMT is an event- and time-based measure of prospective memory, with scores of intention, accuracy and need for reminders, administered as part of the Comprehensive data collection. Participants who did not self-report any conditions that could impact cognition were selected, which resulted in 15,103 English- and 3408 French-speaking participants. The samples are stratified according to four levels of education and four age groups (45-54; 55-64; 65-74; 75+). RESULTS: There is a significant age effect for English- and French-speaking participants on the Event-based, Time-based, and Event- + Time-based scores of the MPMT. The effect of the education level was also demonstrated on the three MPMT scores in the English-speaking group. The score 'Intention to perform' was the most sensitive to the effect of age in both the English and French samples. Sex had no impact on performance on the MPMT. CONCLUSIONS: This study confirms the impact of age and level of education on this new prospective memory task. It informs future research with this measure including the development of normative data in French- and English-speaking Canadians on the Event-based and Time-based MPMT.


Assuntos
Memória Episódica , Testes Neuropsicológicos/normas , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Canadá , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
20.
Clin Neuropsychol ; 33(3): 571-593, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29411691

RESUMO

OBJECTIVE: The ability to execute delayed intentions, known as prospective memory (PM), is crucial to everyday living. PM failures are reported in mild cognitive impairment (MCI) and Parkinson's disease, however, no study to date has investigated PM functioning in individuals at high risk of developing these conditions, precisely those diagnosed with idiopathic REM sleep behavior disorder (iRBD). We aimed to assess PM in iRBD according to patients' cognitive status and to determine the underlying nature of their difficulties. METHOD: Fifty-eight participants, including 20 healthy controls (HC) and 38 polysomnographic-confirmed iRBD patients with (iRBD-MCI = 13) or without (iRBD-nMCI = 25) MCI participated in this study. Following a neuropsychological assessment, PM was evaluated using a self-administered questionnaire (PRMQ), a simple clinical measure (envelope test), and a laboratory cue salience task. RESULTS: No significant group differences were noted on the PRMQ and envelope test. On the PM laboratory task, non-parametric analyses revealed better detection accuracy in HC than both iRBD groups for all high and low salient cues. While iRBD-nMCI and iRBD-MCI patients performed similarly on the high salient condition, the latter showed significant difficulty in detecting low salient cues. Multiple regression analyses revealed executive dysfunction as the best predictor to significantly account for differences in the low salient condition in iRBD. CONCLUSION: PM difficulties in iRBD are most important in patients with MCI (vs without MCI) and may be attributed to a gradual alteration in executive mechanisms. PM impairment could act as a promising indicator of early cognitive dysfunction in iRBD.


Assuntos
Disfunção Cognitiva/diagnóstico , Memória Episódica , Testes Neuropsicológicos/normas , Transtorno do Comportamento do Sono REM/complicações , Idoso , Feminino , Humanos , Masculino
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