Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 99.755
Filtrar
1.
Artigo em Russo | MEDLINE | ID: mdl-34481437

RESUMO

OBJECTIVE: To investigate whether visual processing abnormalities are the result of visual dysfunction involving cognitive impairment or independent abnormalities and to identify the relationship of visual impairments with cognitive functions and severity of psychopathological symptoms. MATERIAL AND METHODS: We compared results of visual size perception and actions on objects (motor assessment) in patients with schizophrenia (n=37), including patients with non-resistant schizophrenia (n=19) and healthy individuals (n=20). Cognitive impairments were assessed with BACS. Severity of schizophrenia symptoms was assessed with PANSS. RESULTS: The error in the visual size perception test was smaller in healthy controls compared with non-resistant patients (p<0.03). There are no significant differences between non-resistant patients and other groups. Also, there are no significant differences in motor assessment between healthy controls and patients with schizophrenia. In the visual size perception test, the amount of error correlates with cognitive impairments (r= -0.84, p<0.001), and the severity of psychotic symptoms on PANSS (r=0.55, p<0.05). CONCLUSION: Changes in visual threshold in patients with schizophrenia are correlated with cognitive dysfunction and reflect dysfunction in the parvocellular system.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Esquizofrenia , Cognição , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Humanos , Testes Neuropsicológicos , Esquizofrenia/complicações
2.
Alzheimers Res Ther ; 13(1): 147, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479635

RESUMO

BACKGROUND: Leukotriene receptor antagonists (LTRAs) alleviate Alzheimer's disease (AD) pathology and improve cognition in animal models; however, clinical evidence is limited. This study aimed to explore the associations between the use of LTRAs (montelukast or zafirlukast) and cognitive performance in people with normal cognition, mild cognitive impairment (MCI), or AD dementia. We hypothesized that LTRA use would be associated with better cognitive performance over time. METHODS: This longitudinal observational study used data from the National Alzheimer's Coordinating Center. Within groups of participants with normal cognition, MCI, or AD dementia, LTRA users were matched 1:3 to non-users using propensity score matching. Cognitive domains including immediate and delayed memory (Wechsler Memory Scale Revised-Logical Memory IA and IIA), psychomotor processing speed (Digit Symbol Substitution Test), and language (animal naming, vegetable naming, and Boston Naming Test) were compared between users and non-users in mixed-effects linear or Poisson regression models. RESULTS: In AD dementia, LTRA use was associated with a slower decline in psychomotor processing speed, as measured by the Digit Symbol Substitution Test (Β = 1.466 [0.253, 2.678] symbols/year, n = 442), and language, as measured by animal naming (Β = 0.541 [0.215, 0.866] animals/year, n = 566), vegetable naming (B = 0.309 [0.056, 0.561] vegetables/year, n = 565), and the Boston Naming Test (B = 0.529 [0.005, 1.053] items/year, n = 561). Effect sizes were small but persisted after controlling for a 10% false discovery rate. LTRA use was not associated with changes in memory performance in AD, nor was it associated with changes in cognitive performance in people with normal cognition or MCI. In a post hoc analysis, LTRA use was associated with a slower decline in clinical progression in MCI (B = -0.200 [-0.380, -0.019] points/year, n = 800) and AD dementia (B = -0.321 [-0.597, -0.046] points/year, n = 604) as measured by CDR Sum of Boxes. CONCLUSIONS: The use of LTRAs was associated with preserved function in non-amnestic cognitive domains in AD dementia. The role of leukotrienes and their receptors in cognitive decline warrants further investigation and the leukotriene pathway may represent a target for AD treatment.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/complicações , Doença de Alzheimer/tratamento farmacológico , Cognição , Disfunção Cognitiva/tratamento farmacológico , Progressão da Doença , Humanos , Antagonistas de Leucotrienos , Estudos Longitudinais , Testes Neuropsicológicos
3.
Alzheimers Res Ther ; 13(1): 148, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479648

RESUMO

BACKGROUND: Thoroughly understanding the temporal associations between cognitive and functional dimensions along the dementia process is fundamental to define preventive measures likely to delay the disease's onset. This work aimed to finely describe the trajectories of cognitive and functional declines, and assess their dynamic bidirectional relationships among subjects at different stages of the dementia process. METHODS: We leveraged extensive repeated data of cognition and functional dependency from the French prospective COGICARE study, designed to better characterize the natural history of cognitive and functional declines around dementia diagnosis. Cognition was measured by the Mini-Mental State Examination, the Isaacs Set Test for verbal fluency, the Benton Visual Retention Test for visuo-spatial memory, and Trail Making Test Part B for executive functioning. Functional dependency was measured by basic and instrumental activities of daily living. The study included 102 cognitively normal, 123 mildly cognitively impaired, and 72 dementia cases with a median of 5 repeated visits over up to 57 months. We used a dynamic causal model which addresses the two essential issues in temporal associations assessment: focusing on intra-individual change and accounting for time. RESULTS: Better cognitive abilities were associated with lower subsequent decline of the functional level among the three clinical stages with an intensification over time but no reciprocity of the association whatever the clinical status. CONCLUSION: This work confirms that the progressive functional dependency could be induced by cognitive impairment. Subjects identified as early as possible with clinically significant cognitive impairments could benefit from preventive measures before the deterioration of activities of daily living and the appearance of dementia clinical signs.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Atividades Cotidianas , Cognição , Humanos , Testes Neuropsicológicos , Estudos Prospectivos
4.
Alzheimers Res Ther ; 13(1): 151, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488882

RESUMO

BACKGROUND: In Alzheimer's disease, amyloid- ß (A ß) peptides aggregate in the lowering CSF amyloid levels - a key pathological hallmark of the disease. However, lowered CSF amyloid levels may also be present in cognitively unimpaired elderly individuals. Therefore, it is of great value to explain the variance in disease progression among patients with A ß pathology. METHODS: A cohort of n=2293 participants, of whom n=749 were A ß positive, was selected from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database to study heterogeneity in disease progression for individuals with A ß pathology. The analysis used baseline clinical variables including demographics, genetic markers, and neuropsychological data to predict how the cognitive ability and AD diagnosis of subjects progressed using statistical models and machine learning. Due to the relatively low prevalence of A ß pathology, models fit only to A ß-positive subjects were compared to models fit to an extended cohort including subjects without established A ß pathology, adjusting for covariate differences between the cohorts. RESULTS: A ß pathology status was determined based on the A ß42/A ß40 ratio. The best predictive model of change in cognitive test scores for A ß-positive subjects at the 2-year follow-up achieved an R2 score of 0.388 while the best model predicting adverse changes in diagnosis achieved a weighted F1 score of 0.791. A ß-positive subjects declined faster on average than those without A ß pathology, but the specific level of CSF A ß was not predictive of progression rate. When predicting cognitive score change 4 years after baseline, the best model achieved an R2 score of 0.325 and it was found that fitting models to the extended cohort improved performance. Moreover, using all clinical variables outperformed the best model based only on a suite of cognitive test scores which achieved an R2 score of 0.228. CONCLUSION: Our analysis shows that CSF levels of A ß are not strong predictors of the rate of cognitive decline in A ß-positive subjects when adjusting for other variables. Baseline assessments of cognitive function accounts for the majority of variance explained in the prediction of 2-year decline but is insufficient for achieving optimal results in longer-term predictions. Predicting changes both in cognitive test scores and in diagnosis provides multiple perspectives of the progression of potential AD subjects.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Idoso , Doença de Alzheimer/complicações , Peptídeos beta-Amiloides , Biomarcadores , Cognição , Disfunção Cognitiva/diagnóstico , Progressão da Doença , Humanos , Testes Neuropsicológicos , Proteínas tau
5.
Am J Alzheimers Dis Other Demen ; 36: 15333175211038237, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34490789

RESUMO

Subjective cognitive decline (SCD) has been considered a high-risk group preceding mild cognitive impairment (MCI). However, methods to quantify and track the complaints have not been well-established. The present study aimed to develop a questionnaire tailored for Mandarin-speaking individuals with SCD. A total of 175 adults aged above 55 years completed a comprehensive set of items evaluating cognitive problems and neuropsychological examinations. After item reduction, internal consistency, construct, and concurrent validity were examined. The 14-item Subjective Cognitive Decline Scale (SCDS) has acceptable internal consistency (Cronbach's α = .93) and construct validity with a three-factor structure. Individuals with SCD and MCI scored higher than the control group. The SCDS demonstrated significant but small correlations with multiple cognitive tests and emotional variables. The SCDS provides an alternative approach to measure cognitive complaints, while an influence of emotional status shall be taken into consideration when interpreting the results.


Assuntos
Disfunção Cognitiva , Adulto , Disfunção Cognitiva/diagnóstico , Humanos , Testes Neuropsicológicos , Inquéritos e Questionários
6.
Sensors (Basel) ; 21(17)2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34502647

RESUMO

Conventional clinical cognitive assessment has its limitations, as evidenced by the environmental shortcomings of various neuropsychological tests conducted away from an older person's everyday environment. Recent research activities have focused on transferring screening tests to computerized forms, as well as on developing short screening tests for screening large populations for cognitive impairment. The purpose of this study was to present an exergaming platform, which was widely trialed (116 participants) to collect in-game metrics (built-in game performance measures). The potential correlation between in-game metrics and cognition was investigated in-depth by scrutinizing different in-game metrics. The predictive value of high-resolution monitoring games was assessed by correlating it with classical neuropsychological tests; the area under the curve (AUC) in the receiver operating characteristic (ROC) analysis was calculated to determine the sensitivity and specificity of the method for detecting mild cognitive impairment (MCI). Classification accuracy was calculated to be 73.53% when distinguishing between MCI and normal subjects, and 70.69% when subjects with mild dementia were also involved. The results revealed evidence that careful design of serious games, with respect to in-game metrics, could potentially contribute to the early and unobtrusive detection of cognitive decline.


Assuntos
Benchmarking , Disfunção Cognitiva , Idoso , Cognição , Disfunção Cognitiva/diagnóstico , Exercício Físico , Humanos , Testes Neuropsicológicos , Curva ROC
7.
Neurol India ; 69(4): 931-936, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507415

RESUMO

Background: Reflected image processing is a unique brain function and its abnormalities result in problems of localizing, recognizing the images, and utilizing this information in everyday life. Objectives: The aim of this study was to characterize clinical and neuropsychological profiles and to identify the probable neural substrate for this phenomenon in major cognitive disorder. Materials and Methods: We conducted a prospective study from February 2015 to May 2017 in patients with Major Cognitive Disorder (MCD, DSM-5 criteria). All patients were tested for problems in reflected image processing using the detailed protocol after ethical approval of the institute and consent. They also underwent a detailed neuropsychological evaluation, biochemical tests and neuroimaging (structural, diffusion, and resting-state functional MRI) as per established protocol. Results: Of the 18 patients, 11 had mirror agnosia (MA), 5 had mirror image agnosia (MIA) and 2 had both. MRI of MA patients showed parietal atrophy and whereas diffuse pattern of atrophy was seen with MIA. In the MA group, the left superior longitudinal fasciculus showed significantly greater fractional anisotropy and the left angular gyrus showed increased functional connectivity with left anterior cingulate, left dorsolateral prefrontal and bilateral posterior cingulate regions. Conclusion: Mirror image processing defects were not related to the type of MCD, severity or pattern of neuropsychological dysfunction. There are structural and functional alterations in localized regions as well as both hemispheres. Therefore, it is more likely to be a network disorder, irrespective of the MCD type or severity.


Assuntos
Agnosia , Substância Branca , Agnosia/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Testes Neuropsicológicos , Estudos Prospectivos
8.
An. psicol ; 37(2): 378-392, mayo-sept. 2021. graf, tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-202561

RESUMO

El Retén Episódico (RE) está tomando un creciente papel central en las explicaciones sobre el funcionamiento de la memoria operativa. De hecho, los últimos estudios de Baddeley y sus colaboradores sitúan al RE en el corazón del sistema de memoria. Recientemente la discusión también atañe a si este componente de la memoria operativa presenta una naturaleza independiente respecto a los recursos del ejecutivo central. Algunos estudios muestran como en tareas automatizadas, la construcción y mantenimiento de elementos almacenados en el RE no requieren de recursos desde el ejecutivo central. El presente trabajo pretende analizar esta cuestión para lo que se toman diferentes variables y se ha diseñado un nuevo test para medir el EB. En este test de doble tarea, la tarea secundaria consiste en la lectura de textos sencillos que contienen palabras ocultas. Los resultados muestran como a pesar del aumento del procesamiento debido al incremento de la longitud de los textos, no se produce un aumento en la carga demandada por el ejecutivo central, ni en la creación de los agrupamientos de información ni en su mantenimiento. Es por ello, que pensamos que el RE bajo ciertas circunstancias es independiente del ejecutivo central


The Episodic Buffer (EB) is taking a growing central role in explanations regarding the functioning of working memory. In fact, in the most recent studies by Baddeley and his collaborators, the EB has situated itself at the core of this memory system. Recently, the discussion also concerns whether this component of working memory seems to demonstrate an independent nature with respect to central executive resourcing. Some studies show that in automatic tasks the creation and maintenance of elements stored in the episodic buffer do not require resources from the central executive. The current work attempts to evaluate this assumption for what different variables are taken and a new test has been developed to measure the EB. In this double task test, the processing task consists of reading short simple texts that contain missing words. The results show that further processing due to increasing the length of the texts does not correspond to higher load demands made on the central executive, nor in the creation of chunks or their maintenance. Thus, we think that the EB is under certain circumstances independent of the central executive


Assuntos
Humanos , Adulto Jovem , Memória de Curto Prazo/fisiologia , Função Executiva/fisiologia , Testes Neuropsicológicos , Leitura , Fatores de Tempo , Rememoração Mental/fisiologia , Retenção Psicológica/fisiologia , Análise e Desempenho de Tarefas
9.
AIDS Behav ; 25(10): 3347-3354, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34382119

RESUMO

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) affects around 20-50% of people living with HIV (PLWH). Although batteries of tests are used to identify neurocognitive impairment (NCI), they are long and difficult to perform during a routine clinic visit, thus impairing the ability to diagnose HAND. Therefore, a brief yet sensitive screening tool to identify NCI is necessary. This study prospectively evaluated an abbreviated screening battery with reported 86.5%/87.1% sensitivity/specificity, identified from a planned post-hoc analysis in a prior neurocognitive study among military PLWH. Adult HIV-positive military beneficiaries in the U.S. Military HIV Natural History Study, who agreed to undergo a comprehensive seven-domain neuropsychological battery (16 tests), and who completed an additional 20-min abbreviated battery (AB), comprised of four tests, prior to the full battery (FB) were included in this analysis. A group of 169 individuals completed both tests, of which 25.4% had a positive AB and 17.8% had NCI on FB (global deficit score ≥ 0.5). With the FB as the reference standard, the specificity for the AB was 79.9% (73.2-86.5), however the sensitivity was 50.0% (32.1-67.9). In those with NCI by FB but not AB, the most common impaired domains were executive function (73.3%) and memory (73.3%), both being domains not fully tested by the AB. An abbreviated HAND screening battery of four tests requiring approximately 20 min provided a relatively high level of specificity but lacked sensitivity for detection of NCI. Inclusion of additional domains or alternative scoring approaches may improve sensitivity but require further study. Continued efforts are needed to develop an effective brief screening test for HAND.


Assuntos
Infecções por HIV , Soropositividade para HIV , Militares , Adulto , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Transtornos Neurocognitivos , Testes Neuropsicológicos
11.
Artigo em Inglês | MEDLINE | ID: mdl-34444269

RESUMO

The clinical manifestations of dementia are often rapidly matched to a specific clinical syndrome, but the underlying neuropathology is not always obvious. A genetic factor often plays an important role in early onset dementia, but there are cases in which the phenotype has a different genetic basis than is assumed. Two patients, at different times, presented to the Memory Clinic because of memory problems and difficulty in performing daily activities and work. Neither caregiver complained of marked behavioural or personality changes, except for apathy. Patients underwent standard dementia evaluation procedures including clinical symptoms, family history, neuroimaging, neuropsychological evaluation, and genetic analysis of selected genes. Based on specific clinical phenotypes and genetic analysis of selected genes, both patients were diagnosed with frontal variant of Alzheimer's disease. The presence of a rare polymorphism in PSEN2 in both patients allowed the discovery that they belong to the same family. This fact reinforced the belief that there is a strong genetic factor responsible for causing dementia in the family. Next-generation sequencing based on a panel of 118 genes was performed to identify other potential genetic factors that may determine the background of the disease. A mutation in the GRN gene was identified, and the previous diagnosis was changed to frontotemporal dementia. The described cases show how important it is to combine all diagnostic tests available in the diagnostic centre, including new generation genetic tests, in order to establish/confirm the pathological background of clinical symptoms of dementia. If there is any doubt about the final diagnosis, persistent efforts should be made to verify the cause.


Assuntos
Doença de Alzheimer , Demência Frontotemporal , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Mutação , Testes Neuropsicológicos
12.
Artigo em Inglês | MEDLINE | ID: mdl-34444331

RESUMO

Brief cognitive screening instruments are used to identify patients presenting with cognitive symptoms that warrant further assessment. This study aimed to evaluate the reliability and validity of the Persian version of the Quick Mild Cognitive Impairment (Qmci-Pr) among middle-aged and older Iranian adults. Consecutive patients aged ≥55 years and caregivers attending with them as normal controls (NCs) were recruited from geriatric outpatient clinics and a hospital in Tehran, Iran. All patients completed the Qmci-Pr before completing an independent detailed neuropsychological assessment and staging using the Clinical Dementia Rating (CDR) Scale. NCs underwent the same assessment. In all, 92 participants with a median age of 70 years (±13) were available. Of these, 20 participants were NCs, 24 had subjective memory complaints (SMC), 24 had mild cognitive impairment (MCI), and 24 had Alzheimer's disease (AD). The Qmci-Pr had good accuracy in differentiating SMC and NC from MCI (area under the curve (AUC): 0.80 (0.69-0.91)) and in identifying cognitive impairment (MCI and mild AD) (AUC: 0.87 (0.80-0.95)) with a sensitivity of 88% and specificity of 80%, at an optimal cut-off of <53/100. The Qmci-Pr is an accurate short cognitive screening impairment for separating NC and patients with SMC from MCI and identifying cognitive impairment. Further research with larger samples and comparison with other widely used instruments such as the Montreal Cognitive Assessment is needed. Given its established brevity, the Qmci-Pr is a useful screen for Iranian adults across the spectrum of cognitive decline.


Assuntos
Disfunção Cognitiva , Demência , Adulto , Idoso , Disfunção Cognitiva/diagnóstico , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Testes Neuropsicológicos , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
13.
Pol Merkur Lekarski ; 49(292): 283-285, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34464369

RESUMO

Using central nervous system (CNS) neuroimaging techniques, it was possible to identify structural changes in the brain associated with eating disorders. Due to the occurrence of organic changes, the search for the impact of these changes on the cognitive sphere was undertaken. Research to date suggests that people with eating disorders exhibit cognitive dysfunction. However, these results remain inconsistent. AIM: The aim of the study was to check whether people with eating disorders (anorexia nervosa and bulimia) have cognitive deficits. MATERIALS AND METHODS: 40 female participants took part in the study. The research group consisted of people with eating disorders, while the control group consisted of healthy people. The study included a diagnostic interview and original diagnostic tools: Wisconsin Card Sorting Test (WCST), Color Trials Test (CTT), d2, California Verbal Learning Test (CVLT), Rey- Osterrieth complex figure (ROCF), and WAIS-R- Digit Span. RESULTS: On the basis of the conducted study, the occurrence of deficits in some aspects of executive functions (planning, cognitive flexibility) and memory (verbal, visual-spatial) in people with eating disorders was demonstrated. It has not been shown that people with eating disorders would experience difficulties in searching the material, however, more errors in the d2 test were observed, which may indicate difficulties with shifting and maintaining attention. The study showed that the duration of the disease affects some aspects of cognitive functioning in people with eating disorders.


Assuntos
Anorexia Nervosa , Disfunção Cognitiva , Transtornos da Alimentação e da Ingestão de Alimentos , Função Executiva , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Feminino , Humanos , Testes Neuropsicológicos
14.
Rev Bras Enferm ; 74(5): e20190306, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34346953

RESUMO

OBJECTIVE: to analyze the cognitive capacity and functional development of the elderly with and without diabetes. METHODS: case-control study, comparing elderly people with and without diabetes. 218 patients interviewed in outpatient clinics: geriatrics and endocrinology. Validated instruments were used for cognitive and functional assessment. RESULTS: people with diabetes had low scores on cognitive tests. HbA1c and education were related to memory loss, compromising the basic and instrumental activities of daily life. CONCLUSION: this study evaluated that high glycemic values affect the autonomy of the elderly, compromising cognition and functional performance in activities of daily living.


Assuntos
Diabetes Mellitus Tipo 2 , Atividades Cotidianas , Idoso , Estudos de Casos e Controles , Cognição , Diabetes Mellitus Tipo 2/complicações , Humanos , Testes Neuropsicológicos
15.
Behav Neurol ; 2021: 5548623, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34373762

RESUMO

This cross-sectional study is aimed at assessing the effects of opium use disorder (OUD) on attention, working memory, and information-processing speed. Thirty outpatients with OUD and 20 healthy controls (HCs) were assessed using a neuropsychological battery consisted of Auditory Verbal Learning Test-Revised (AVLT-R), Brief Visuospatial Memory Test-Revised (BVMT-R), Digit Forward and Backward Tests (DFT and DBT), and WAIS-R Digit Symbol Substitution Test (DSST). The most affected cognitive functions in patients with OUD were detected by DBT and DSST. However, we found no significant difference between patients according to the route of administration. Within patients with OUD, DBT score was associated with opium use quantity (OUQ) (r = -0.385), and DBT (r = 0.483) and DSST (r = 0.542) scores were correlated with duration of use. Our findings indicated that working memory and information-processing speed are the most affected domains of cognitive functioning. DBT and DSST could be used as brief assessments in clinical settings to screen for cognitive deficits in patients with OUD.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Dependência de Ópio , Disfunção Cognitiva/etiologia , Estudos Transversais , Humanos , Testes Neuropsicológicos
16.
J Athl Train ; 56(8): 851-859, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34375406

RESUMO

CONTEXT: Preseason testing can be time intensive and cost prohibitive. Therefore, using normative data for postconcussion interpretation in lieu of preseason testing is desirable. OBJECTIVE: To establish the recovery trajectory for clinical reaction time (RTclin) and assess the usefulness of changes from baseline (comparison of postconcussion scores with individual baseline scores) and norm-based cutoff scores (comparison of postconcussion scores with a normative mean) for identifying impairments postconcussion. DESIGN: Case-control study. SETTING: Multisite clinical setting. PATIENTS OR OTHER PARTICIPANTS: An overlapping sample of 99 participants (age = 19.0 ± 1.1 years) evaluated within 6 hours postconcussion, 176 participants (age = 18.9 ± 1.1 years) evaluated at 24 to 48 hours postconcussion, and 214 participants (age = 18.9 ± 1.1 years) evaluated once they were cleared to begin a return-to-play progression were included. Participants with concussion were compared with 942 control participants (age = 19.0 ± 1.0 years) who did not sustain a concussion during the study period but completed preseason baseline testing at 2 points separated by 1 year (years 1 and 2). MAIN OUTCOME MEASURE(S): At each time point, follow-up RTclin (ie, postconcussion or year 2) was compared with the individual year 1 preseason baseline RTclin and normative baseline data (ie, sex and sport specific). Receiver operating characteristic curves were calculated to compare the sensitivity and specificity of RTclin change from baseline and norm-based cutoff scores. RESULTS: Clinical reaction time performance declined within 6 hours (18 milliseconds, 9.2% slower than baseline). The decline persisted at 24 to 48 hours (15 milliseconds, 7.6% slower than baseline), but performance recovered by the time of return-to-play initiation. Within 6 hours, a change from baseline of 16 milliseconds maximized combined sensitivity (52%) and specificity (79%, area under the curve [AUC] = 0.702), whereas a norm-based cutoff score of 19 milliseconds maximized combined sensitivity (46%) and specificity (86%, AUC = 0.700). At 24 to 48 hours, a change from baseline of 2 milliseconds maximized combined sensitivity (64%) and specificity (61%, AUC = 0.666), whereas a norm-based cutoff score of 0 milliseconds maximized combined sensitivity (63%) and specificity (62%, AUC = 0.647). CONCLUSIONS: Norm-based cutoff scores can be used for interpreting RTclin scores postconcussion in collegiate athletes when individual baseline data are not available, although low sensitivity and specificity limit the use of RTclin as a stand-alone test.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Tempo de Reação , Adolescente , Atletas , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Volta ao Esporte , Adulto Jovem
17.
Zh Nevrol Psikhiatr Im S S Korsakova ; 121(7. Vyp. 2): 94-98, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34387454

RESUMO

One of the leading symptoms in patients with multiple sclerosis (MS) is cognitive impairment. It often affects aspects of cognition such as learning ability, memory, processing speed, and attention. It has been proven that patients often complain of difficulties in multitasking and choosing the right words. These problems are often underestimated. Various studies show that regular physical activity, mainly aerobic exercise, can potentially improve cognitive function. Positive effects on concentration, memory, and multitasking were described. In March 2019, the Tyumen regional center of MS, together with the clinical Institute of the brain (Yekaterinburg), launched a clinical study of methods for rehabilitation of cognitive disorders in patients with MS. There was a statistically significant improvement in MOCA-test scores, according to SDMT and PASSAT data in the main group of MS patients. Despite a significant improvement in cognitive function, the self-assessment of mental function according to the MSQOL54-MN test in this group of patients did not change. Our preliminary results suggest that a comprehensive and well-controlled training program can improve cognitive abilities in MS patients even after a short course of treatment.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Esclerose Múltipla , Cognição , Disfunção Cognitiva/etiologia , Humanos , Aprendizagem , Esclerose Múltipla/complicações , Testes Neuropsicológicos
18.
Handb Clin Neurol ; 183: 261-281, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34389121

RESUMO

Degenerative dementias such as Alzheimer's disease and frontotemporal dementia result in distinct alterations in emotional processing, emotional experiences, and mood. The neuropathology of these dementias extends to structures involved in emotional processing, including the basolateral limbic network (orbitofrontal cortex, anterior temporal lobe, amygdala, and thalamus), the insula, and ventromedial frontal lobe. Depression is the most common emotion and mood disorder affecting patients with Alzheimer's disease. The onset of depression can be a prodromal sign of this dementia. Anxiety can also be present early in the course of Alzheimer's disease and especially among patients with early-onset forms of the disease. In contrast, patients with behavioral variant frontotemporal dementia demonstrate hypoemotionality, deficits in the recognition of emotion, and decreased psychophysiological reactivity to emotional stimuli. They typically have a disproportionate impairment in emotional and cognitive empathy. One other unique feature of behavioral variant frontotemporal dementia is the frequent occurrence of bipolar disorder. The management strategies for these alterations of emotion and mood in degenerative dementias primarily involve the judicious use of the psychiatric armamentarium of medications.


Assuntos
Doença de Alzheimer , Demência Frontotemporal , Emoções , Empatia , Humanos , Imageamento por Ressonância Magnética , Transtornos do Humor/etiologia , Testes Neuropsicológicos
19.
Handb Clin Neurol ; 183: 99-108, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34389127

RESUMO

One of the most important means of communicating emotions is by facial expressions. About 30-40 years ago, several studies examined patients with right and left hemisphere strokes for deficits in expressing and comprehending emotional facial expressions. The participants with right- or left-hemispheric strokes attempted to determine if two different actors were displaying the same or different emotions, to name the different emotions being displayed, and to select the face displaying an emotion named by the examiner. Investigators found that the right hemisphere-damaged group was impaired on all these emotional facial tests and that this deficit was not solely related to visuoperceptual processing defects. Further studies revealed that the patients who were impaired at recognizing emotional facial expressions and who had lost these visual representations of emotional faces often had damage to their right parietal lobe and their right somatosensory cortex. Injury to the cerebellum has been reported to impair emotional facial recognition, as have dementing diseases such as Alzheimer's disease and frontotemporal dementia, movement disorders such as Parkinson's disease and Huntington's disease, traumatic brain injuries, and temporal lobe epilepsy. Patients with right hemisphere injury are also more impaired than left-hemisphere-damaged patients when attempting to voluntarily produce facial emotional expressions and in their spontaneous expression of emotions in response to stimuli. This impairment does not appear to be induced by emotional conceptual deficits or an inability to experience emotions. Many of the disorders that cause impairments of comprehension of affective facial expressions also impair facial emotional expression. Treating the underlying disease may help patients with impairments of facial emotion recognition and expression, but unfortunately, there have not been many studies of rehabilitation.


Assuntos
Demência Frontotemporal , Doença de Huntington , Compreensão , Emoções , Expressão Facial , Lateralidade Funcional , Humanos , Testes Neuropsicológicos
20.
Neurol Neurochir Pol ; 55(4): 394-402, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34379319

RESUMO

AIMS OF THE STUDY: We aimed to define the cognitive burden of the largest pseudotumor cerebri syndrome (PTCS) population to date, compare objective to subjective cognitive dysfunction, and determine clinical predictors of cognitive dysfunction amongst an array of previously unstudied factors. CLINICAL RATIONALE: Patients with PTCS commonly report cognitive dysfunction, a factor associated with poor quality of life. It is not definitively known whether cognitive impairment is present in these patients, and what features of the syndrome predict impairment. MATERIALS AND METHODS: We administered a cognitive battery consisting of the National Adult Reading Test, Mini-Mental Status Exam, Digit Span, Boston Naming Test, Rey Auditory Verbal Learning Test, Clock Drawing, Trail Making Test, Controlled Oral Word Association, and Category Fluency. Cognitive impairment was defined as mild-single domain with one test score, and mild-multiple domain with two scores, more than two standard deviations below the mean for age-, gender-, and education-adjusted norms. RESULTS: One-hundred and one prospectively recruited PTCS patients were enrolled. The objective testing showed 30 patients had mild-single domain impairment, and 25 had mild-multi domain impairment. More patients without objective cognitive impairment had transverse venous sinus stenosis, but otherwise the groups did not differ. Two measures of headache severity, the Headache Impact Test and pain on the Numeric Rating Scale, were negatively associated with the composite cognitive score, as was ocular pain, vision-related disability, and mental health. Opening pressure and visual function were not associated with objective cognitive impairment. We found no association between subjective and objective cognitive impairment. CONCLUSIONS AND CLINICAL IMPLICATIONS: Patients with PTCS may be cognitively impaired, and this correlates with measures of headache burden. Studies evaluating cognitive impairment before and after remission of the headache disorder would have to be performed to investigate this relationship further. Patients with self-perception of cognitive burden are no more likely to be cognitively impaired.


Assuntos
Disfunção Cognitiva , Pseudotumor Cerebral , Adulto , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Humanos , Testes de Estado Mental e Demência , Testes Neuropsicológicos , Pseudotumor Cerebral/complicações , Qualidade de Vida
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...