A randomized, double-blind, placebo controlled, parallel group, efficacy study of alpha BRAIN® administered orally.

OBJECTIVE: Alpha BRAIN® is a nootropic supplement that purports to enhance cognitive functioning in healthy adults. The goal of this study was to investigate the efficacy of this self-described cognitive enhancing nootropic on cognitive functioning in a group of healthy adults by utilizing a randomized, double blind, placebo-controlled design. METHODS: A total of 63-treatment naïve individuals between 18 and 35 years of age completed the randomized, double-blind, placebo controlled trial. All participants completed a 2-week placebo run in before receiving active product, Alpha BRAIN® or new placebo, for 6 weeks. Participants undertook a battery of neuropsychological tests at randomization and at study completion. Primary outcome measures included a battery of neuropsychological tests and measures of sleep. RESULTS: Compared with placebo, Alpha BRAIN® significantly improved on tasks of delayed verbal recall and executive functioning. Results also indicated significant time-by-group interaction in delayed verbal recall for the Alpha BRAIN® group. CONCLUSIONS: The use of Alpha BRAIN® for 6 weeks significantly improved recent verbal memory when compared with controls, in a group of healthy adults. While the outcome of the study is encouraging, this is the first randomized controlled trial of Alpha BRAIN®, and the results merit further study.

The imagination inflation effect in healthy older adults and patients with mild Alzheimer's disease.

OBJECTIVE: The imagination inflation effect is a type of memory distortion defined as an increased tendency to falsely remember that an item has been seen, or an action has been performed, when it has only been imagined. For patients with very mild Alzheimer's disease (AD), susceptibility to the imagination inflation effect could have significant functional consequences in daily life. METHOD: We assessed whether patients with very mild AD were more or less susceptible to the imagination inflation effect when compared with healthy older adults. In the first session, participants were read an action statement such as "fill the pillbox" and engaged in 1 of 3 activities: listened to the statement being read, performed the action, or imagined performing the action. During the second session, participants imagined action statements from the first session, as well as new action statements. During the recognition test, participants were asked to determine whether action statements were or were not performed during the first session. RESULTS: We found that imagining performing actions increased the tendency of patients with very mild AD to falsely recall the action as having been performed to an extent similar to that of healthy older adults. CONCLUSION: We concluded that, similar to healthy older adults, patients with very mild AD were susceptible to the imagination inflation effect, which we attributed to difficulties with source monitoring and reliance on familiarity.

A clinical trial to validate event-related potential markers of Alzheimer's disease in outpatient settings.

INTRODUCTION: We investigated whether event-related potentials (ERP) collected in outpatient settings and analyzed with standardized methods can provide a sensitive and reliable measure of the cognitive deficits associated with early Alzheimer's disease (AD). METHODS: A total of 103 subjects with probable mild AD and 101 healthy controls were recruited at seven clinical study sites. Subjects were tested using an auditory oddball ERP paradigm. RESULTS: Subjects with mild AD showed lower amplitude and increased latency for ERP features associated with attention, working memory, and executive function. These subjects also had decreased accuracy and longer reaction time in the target detection task associated with the ERP test. DISCUSSION: Analysis of ERP data showed significant changes in subjects with mild AD that are consistent with the cognitive deficits found in this population. The use of an integrated hardware/software system for data acquisition and automated data analysis methods make administration of ERP tests practical in outpatient settings.

Correlational analysis of 5 commonly used measures of cognitive functioning and mental status: an update.

There are numerous measures for detecting the presence of dementia and quantifying its severity and progression. We analyzed the relations between scores on 5 commonly used measures (Mini-Mental State Examination, Montreal Cognitive Assessment, Alzheimer's Disease Assessment Scale-Cognitive Subscale, Activities of Daily Living Scale, and Global Deterioration Scale) of 101 successive admissions to a memory clinic. Patients were included in the analysis only if they received a diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease (AD) pathophysiological process or probable AD and if they received all measures. Regression analysis yielded 20 linear equations that allow for conversion between test scores on any 2 measures. Further, participants were grouped by MMSE scores with regard to level of disease severity, allowing for the creation of a quick reference table for estimating an approximate score range between measures. Results from this study provide a useful tool for clinicians when comparing between multiple different instruments that measure the mental status and functional ability of individuals with AD and MCI due to AD pathology.

Memory for the 2008 presidential election in healthy ageing and mild cognitive impairment.

The present study examined memory accuracy and confidence for personal and public event details of the 2008 presidential election in healthy older adults and those with mild cognitive impairment (MCI). Participants completed phone interviews within a week after the election and after a 10-month delay. MCI patients and healthy older adults had comparable emotional reactions to learning the outcome of the election, with most people finding it to be a positive experience. After the delay period, details about the election were better remembered by all participants than a less emotionally arousing comparison event. However, MCI patients had more difficulty than healthy older adults correctly recalling details of public information about the election, although often the MCI patients could recognise the correct details. This is the first study to show that MCI patients' memory can benefit from emotionally arousing positive events, complementing the literature demonstrating similar effects for negative events.

New criteria for Alzheimer disease and mild cognitive impairment: implications for the practicing clinician.

BACKGROUND: In most research studies and clinical trials, Alzheimer disease (AD) has been diagnosed using the criteria developed by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association work group in 1984. Developments over the last 27 years have lead to the need for new diagnostic criteria. REVIEW SUMMARY: Four articles in the journal Alzheimer's & Dementia in 2011 describe new criteria for AD dementia and mild cognitive impairment (MCI) due to the AD pathophysiological process (MCI due to AD) and the underlying rationale for them. These new criteria emphasize that the AD pathophysiological process starts years and perhaps decades before clinical symptoms, and that biomarkers can be used to detect amyloid ß deposition and the effects of neurodegeneration in the brain. CONCLUSIONS: These new criteria are immediately helpful to the practicing clinician, providing more accurate and specific guidelines for the diagnosis of AD dementia and MCI due to AD. As new diagnostic tools and new treatments for AD become available, diagnosis using these criteria will enable patients with this disorder to receive the best possible care.

New diagnostic criteria for Alzheimer's disease and mild cognitive impairment for the practical neurologist.

Four articles in the journal Alzheimer's and Dementia in 2011 describe new criteria for Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI) due to the AD pathophysiological process (MCI due to AD), as well as the underlying rationale for them. The new criteria also include preclinical AD criteria but these are intended purely for research purposes. The new criteria emphasise that the AD pathophysiological process starts years and perhaps decades before clinical symptoms, and that biomarkers can detect amyloid ß deposition and the effects of neurodegeneration in the brain. The criteria are recommendations based upon consensus meetings and will require future validation. Nonetheless, the authors believe that they are immediately helpful to the practising clinician, providing more accurate and specific guidelines for the diagnosis of AD dementia and MCI due to AD. As new diagnostic tools and treatments for AD become available, diagnoses using these criteria will enable patients with AD dementia, MCI due to AD and eventually preclinical AD to receive the best possible care.

Toward establishing guidelines for evaluating cognitive enhancement with complementary and alterative medicines.

The growing use of complementary and alternative medications (CAM) for cognitive enhancement in both healthy elderly and patients with Alzheimer's disease (AD) and other dementing disorders has led to rapidly growing literature with conflicting results. There are studies that suggest benefit from CAM in both the healthy elderly and dementing patients as well as studies that suggest no benefit for either group. Because of the lack of regulatory oversight (e.g., Food and Drug Administration [FDA], European Medicines Agency [EMeA]), there are currently no generally accepted guidelines to standardize the types of studies that are conducted. Due to the absence of guidelines that set standards for study design, outcomes, and analysis, it is difficult to compare studies with conflicting results. For example, Ginkgo biloba has been shown both to provide benefit and no benefit on cognition in both healthy elderly and patients with AD. Reconciling these divergent studies has been challenging because both sides often use divergent methodologies and designs and widely varying cognitive measures that may or may not be validated in the populations being studied. In this article, the authors suggest a roadmap for establishing guidelines for the evaluation of CAM in cognition. They then apply these guidelines to the conflicting literature on Ginkgo to determine whether they might help resolve the conflicting results.

Early diagnosis and treatment of Alzheimer's disease.

Recently, focus on early detection, diagnosis and treatment of Alzheimer's disease (AD) has been increasing. The rationale is that, as with any other serious illness, early intervention will lead to better outcomes for patients and families. Despite the intuitive appeal of this rationale, there is discussion and even debate regarding the issues surrounding early detection and treatment. This review begins with a futuristic case that is aimed at focusing this discussion/debate and then proceeds to consider each of the issues including: should AD screening be part of routine physical examinations? is the amyloid hypothesis correct?: implications for diagnosis and treatment? can neuroimaging studies be used to detect brain amyloid? can symptomatic medications be combined to facilitate cognition? can cognitive rehabilitation programs facilitate cognition? and can immunotherapy and other plaque-busting therapies modify the progression of AD?

Should we screen for Alzheimer's disease? A review of the evidence for and against screening Alzheimer's disease in primary care practice.

Fewer than one-half of all Alzheimer's disease (AD) patients are currently diagnosed; approximately 25% are treated with antidementia compounds. Screening has been proposed to help combat underdiagnosis of AD. An emerging consensus suggest that the three keys to the successful treatment of Alzheimer's disease are early detection, use of currently approved medications to provide symptomatic treatment, and development of medications to slow and eventually halt disease progression. If early detection of Alzheimer's disease is the first step, screening would seem to be an important strategy. We review the arguments for and against screening and suggest several strategies and instruments that may be helpful in the context of screening for Alzheimer's disease in primary care practice.

Memory and emotions for the september 11, 2001, terrorist attacks in patients with Alzheimer's disease, patients with mild cognitive impairment, and healthy older adults.

National traumatic events can produce extremely vivid memories. Using a questionnaire administered during telephone interviews, the authors investigated emotional responses to, and memory for. the September 11, 2001, terrorist attacks in patients with Alzheimer's disease (AD), patients with mild cognitive impairment (MCI), and healthy older adults in the initial weeks following the event and again 3-4 months later. There were several notable findings. First, patients with AD showed less memory than patients with MCI and older adults. Second, patients with AD, but not patients with MCI or older adults, appeared to retain more memory for personal versus factual information. Third, patients with AD and older adults did not differ in the intensity of their reported emotional responses to the attacks, whereas patients with MCI reported relatively less intense emotional responses. Last, distortions of memory for personal information were frequent for all participants but were more common in patients with AD.

Ginkgo for memory enhancement: a randomized controlled trial.

CONTEXT: Several over-the-counter treatments are marketed as having the ability to improve memory, attention, and related cognitive functions in as little as 4 weeks. These claims, however, are generally not supported by well-controlled clinical studies. OBJECTIVE: To evaluate whether ginkgo, an over-the-counter agent marketed as enhancing memory, improves memory in elderly adults as measured by objective neuropsychological tests and subjective ratings. DESIGN: Six-week randomized, double-blind, placebo-controlled, parallel-group trial. SETTING AND PARTICIPANTS: Community-dwelling volunteer men (n = 98) and women (n = 132) older than 60 years with Mini-Mental State Examination scores greater than 26 and in generally good health were recruited by a US academic center via newspaper advertisements and enrolled over a 26-month period from July 1996 to September 1998. INTERVENTION: Participants were randomly assigned to receive ginkgo, 40 mg 3 times per day (n = 115), or matching placebo (n = 115). MAIN OUTCOME MEASURES: Standardized neuropsychological tests of verbal and nonverbal learning and memory, attention and concentration, naming and expressive language, participant self-report on a memory questionnaire, and caregiver clinical global impression of change as completed by a companion. RESULTS: Two hundred three participants (88%) completed the protocol. Analysis of the modified intent-to-treat population (all 219 participants returning for evaluation) indicated that there were no significant differences between treatment groups on any outcome measure. Analysis of the fully evaluable population (the 203 who complied with treatment and returned for evaluation) also indicated no significant differences for any outcome measure. CONCLUSIONS: The results of this 6-week study indicate that ginkgo did not facilitate performance on standard neuropsychological tests of learning, memory, attention, and concentration or naming and verbal fluency in elderly adults without cognitive impairment. The ginkgo group also did not differ from the control group in terms of self-reported memory function or global rating by spouses, friends, and relatives. These data suggest that when taken following the manufacturer's instructions, ginkgo provides no measurable benefit in memory or related cognitive function to adults with healthy cognitive function.

Guía para redactar informes de investigación / Research report writing in psychology

Este libro ofrece tanto al escritor científico principiante como al experimentado, las directrices, normas y convencionalismos básicos de la escritura científica, con el afán de que el investigador logre emitir los resultados de sus trabajos o redactar artículos especializados sin padecer complicaciones metodológicas. Los temas incluidos en el libro son expuestos de una forma didáctica y sencilla, lo cual facilita la aclaración de muchas de las dudas que se presentan al elaborar ese tipo de documentos y, por lo tanto, hace más fluida la comunicación entre el científico y sus lectores