Effects of Recent Alcohol Consumption Level on Neurocognitive Performance in HIV+ Individuals.

OBJECTIVES: Although HIV+ individuals may be at increased risk of alcohol-related cognitive impairment, the relations between drinking level and cognitive performance in these individuals are not well understood. We examined whether higher levels of recent drinking in HIV+ individuals were associated with poorer cognitive performance, particularly in executive functioning (EF) and memory. METHODS: We administered a comprehensive cognitive battery to 120 seropositive subjects (101 men) who reported alcohol consumption in the preceding 90 days. Participants were excluded if they were seeking alcohol treatment or showed evidence of dementia. Using the computerized CogState battery, we measured performance in EF, verbal learning/memory, visual learning/memory, attention, working memory, and psychomotor speed. The computerized Iowa Gambling Task was used to assess decision-making. RESULTS: The HIV+ subjects showed significantly slower psychomotor speed than a normative sample. Although across most domains, neurocognitive performance in our sample was not significantly associated with recent alcohol consumption, performance on the CogState measures of visual memory and attention was significantly poorer with a higher level of drinking in the past 3 months and a current alcohol use disorder, respectively. CONCLUSIONS: Although cognitive weaknesses were detectable among these non-treatment-seeking HIV+ drinkers, the level of alcohol consumption was not a primary determinant of neurocognitive performance in this group. A comprehensive profile analysis may be most valuable for detecting cognitive strengths and weaknesses given the heterogeneity of this population. Longitudinal studies are needed to examine the potential additive or synergistic effects of heavy drinking and HIV seropositivity on cognitive performance.

The head trauma amnesia cure: The making of a medical myth.

The myth that a second head trauma can restore memory to someone with a previous head injury is evident in popular fiction and believed by a significant number of people. The double trauma amnesia plot device appeared in 19th century fiction and was fully formed by the 1880s. This article explores the contributions of scientific and popular ideas related to brain symmetry and memory permanence that fueled inaccurate ideas about memory recovery following brain injury.

A practical guide to evaluating sleep disturbance in concussion patients.

PURPOSE OF REVIEW: To provide an introduction and review of sleep metrics appropriate for use with an outpatient concussed population. RECENT FINDINGS: Although sleep issues are frequently identified in concussion, sleep disturbance is rarely assessed in outpatient settings. Given that sleep disturbance may be indicative of, or contribute to, delayed neurocognitive recovery, measurement tools for sleep, rest, and activity behavior may be of both practical and research utility. SUMMARY: Because sleep disturbance symptoms may vary between or within an individual throughout the course of recovery, it is recommended that sleep be measured at regular intervals over the entirety of recovery. Included is a discussion on how to select appropriate measures based on patient symptomology in addition to common practical concerns. Additional clinical considerations, a review of traditional pencil and paper methods of continuous sleep behavior monitoring, as well as technologies for measuring sleep and activity behavior are also included.

Sex and cultural differences in spatial performance between Japanese and North Americans.

Previous studies have suggested that Asians perform better than North Americans on spatial tasks but show smaller sex differences. In this study, we evaluated the relationship between long-term experience with a pictorial written language and spatial performance. It was hypothesized that native Japanese Kanji (a complex pictorial written language) educated adults would show smaller sex differences on spatial tasks than Japanese Americans or North Americans without Kanji education. A total of 80 young healthy participants (20 native Japanese speakers, 20 Japanese Americans-non Japanese speaking, and 40 North Americans-non Japanese speaking) completed the Rey Complex Figure Test (RCFT), the Mental Rotations Test (MRT), and customized 2D and 3D spatial object location memory tests. As predicted, main effects revealed men performed better on the MRT and RCFT and women performed better on the spatial object location memory tests. Also, as predicted, native Japanese performed better on all tests than the other groups. In contrast to the other groups, native Japanese showed a decreased magnitude of sex differences on aspects of the RCFT (immediate and delayed recall) and no significant sex difference on the efficiency of the strategy used to copy and encode the RCFT figure. This study lends support to the idea that intensive experience over time with a pictorial written language (i.e., Japanese Kanji) may contribute to increased spatial performance on some spatial tasks as well as diminish sex differences in performance on tasks that most resemble Kanji.

Sex differences in spatial object-location memory in a virtual grocery store.

The grocery shopping Virtual Reality Spatial Object-Location Test (VRSOLT) was developed to examine sex differences in spatial object-location memory in a 3D virtual environment that simulates the real world. Forty college students (20 males, 20 females) were tested on the VRSOLT as well as mental rotation and 2D object-location memory tasks. Both convergent and divergent validity was demonstrated. Males showed an advantage on mental rotation, and results of the VRSOLT grocery store test replicated the female object-location advantage seen in 2D tests. A strategy of systematically navigating the environment may aid female encoding for object location.

The effect of familial sinistrality and academic experience on cognition in right-handed women.

Research in sex, brain lateralization, and cognition suggests that right-handed women vary in cognitive ability according to handedness inheritance patterns. Right-handed college women with positive familial sinistrality (FS+; i.e., the presence of at least one left-handed biological relative; n=30) were compared with right-handed women with negative familial sinistrality (FS-; n=30) by means of visuospatial (the Rey-Osterrieth Complex Figure Test and the Wechsler Adult Intelligence Scale--Revised Block Design subtest), verbal (the California Verbal Learning Test and Animal Naming), and motor performance tests (Finger Tapping and Grooved Pegboard). FS+ women outperformed FS- women on spatial tasks and used more efficient spatial strategies. The FS- group showed no corresponding verbal advantage. Spatial differences were not accounted for by motor skill, intellectual ability, or academic major.

Variation in medication understanding among the elderly.

PURPOSE: Types of medication misunderstanding among community-dwelling elderly people were studied. METHODS: Community-dwelling people who were at least 65 years of age and who volunteered to participate in a medication-review program were recruited for the study. A structured interview including a background interview, attitudinal questions, and questions related to dosage, frequency, timing, and what to do if a dose was missed was conducted. RESULTS: A total of 375 people were included in the study. Of these, 232 (62%) showed perfect understanding of their medication regimens. Twenty-eight (7.5%) of the subjects with less than perfect understanding misunderstood a limited aspect of their regimens across multiple medications, most frequently what to do if a dose was missed. These subjects had the least complex regimens, could name their medications and describe their purpose, and rated themselves as having few medical problems. Their lack of knowledge was not attributed to cognitive problems. Twenty-seven subjects (7%) did not know multiple aspects of at least one medication and appeared to be at high risk for nonadherence. These individuals had the most complex regimens, had difficulty naming and explaining the purpose of their medications, and rated themselves as less adherent. Eighty-eight subjects (23.5%) demonstrated mixed problems with understanding; they did not show a defined pattern attributable to cognitive or noncognitive factors. CONCLUSION: A majority of people over the age of 65 years had good understanding of the drugs they were taking.